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The Guardian - US
The Guardian - US
World
Ava Sasani

Kate Cox case: what led to the Texan fleeing the state for an abortion?

blonde pregnant woman wearing black
Kate Cox’s story has grown increasingly common in conservative states such as Texas. Photograph: AP

A Texas woman fled her home state to obtain an abortion after Texas’s top court ruled last week that she cannot terminate her non-viable pregnancy despite risks to her life and future fertility.

What was the Kate Cox case about?

Earlier this month, Kate Cox, a 31-year-old mother of two young children, sued to obtain an abortion after learning that her fetus has trisomy 18, a fatal chromosomal condition, as well as other health issues, including a spinal abnormality.

Doctors informed Cox and her husband “there was virtually no chance that their baby would survive to birth or long afterwards”, according to court filings. Continuing the pregnancy would pose grave risks to Cox’s life and would probably jeopardize her future fertility.

Still, Cox was unable to obtain an abortion in Texas because of the state’s strict laws prohibiting the procedure. Earlier this month, Cox filed an emergency lawsuit asking a judge to allow her OB-GYN to provide an abortion without threat of prosecution.

What are ‘medical exceptions’ to Texas’s abortion bans?

Texas began enforcing a law banning virtually all abortion last year, shortly after the US supreme court ruled that there is no constitutional right to abortion in the United States.

The state law technically includes exceptions for cases of medical emergencies, but Texas doctors have said that the exceptions are too vague, and force them to wait until their patients get sick enough to intervene.

Cox’s story has grown increasingly common in conservative states like Texas.

In March, five women denied abortions in Texas, along with two doctors, sued the state after they were refused care despite suffering severe complications with their pregnancies. Fifteen Texas women have since joined the lawsuit, which seeks to clarify the murkiness surrounding medical exceptions to the state’s ban on abortion.

Why didn’t Kate Cox’s pregnancy qualify as a medical exception?

According to court filings, Cox’s doctors said that if the baby’s heartbeat stopped, they could induce labor – but they cannot perform an abortion procedure known as dilation and evacuation (D&E). Due to her prior C-sections, inducing labor means she faces a higher risk of rupturing her uterus. A D&E would be the best medical option for her health, but doctors in the state who might provide it fear prosecution under Texas’s criminal abortion ban.

Texas doctors accused of violating the state’s abortion law face up to $100,000 in fines or even life in prison.

Do similar provisions exist in other states’ abortion bans?

Texas is among the 21 states that ban or heavily restrict abortion access in the United States today. Most of these anti-abortion laws include narrow exceptions to protect the life or health of the pregnant person.

But doctors and hospitals face serious punishment if they misinterpret these medical exceptions. In Texas and other conservative states, abortion providers are threatened with hefty fines, loss of medical license or even prison time.

Many abortion providers said bans, like those effective in Texas, create a chilling effect among doctors who are scared to misinterpret what constitutes a medical emergency.

What happened to Kate Cox’s lawsuit?

After a lower court judge ruled in favor of Kate Cox, the Texas attorney general, Ken Paxton, a conservative serving his third term as the state’s top prosecutor, threatened to punish any doctor who provided an abortion to Cox.

Texas has a law on the books that permits private individuals to sue over suspected illegal abortions. Regardless of the lower court order, doctors could be held liable under that law, Paxton warned.

The Texas attorney general’s threats underscored the limits of medical exceptions in a state that is hostile to abortion rights, sowing fear and confusion among doctors involved in Cox’s treatment.

Hours later, Paxton and his office filed an appeal with the state’s top court.

The Republican-stacked Texas state supreme court sided with Paxton, blocking Cox from obtaining an abortion in her home state. Her attorneys have since announced that, after the protracted legal battle, Cox fled Texas to obtain the procedure out of state.

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