Texas Supreme Court rules against woman seeking emergency abortion after she leaves state for procedure

Austin, Texas — A Texas woman who had sought a legal medical exemption for an abortion has left the state after the Texas Supreme Court paused a lower court decision that would allow her to have the procedure, lawyers for the Center for Reproductive Rights said Monday. 

State District Judge Maya Guerra Gamble last week had ruled that Kate Cox, a 31-year-old mother of two from Dallas, could terminate her pregnancy. According to court documents, Cox's doctors told her her baby suffered from the chromosomal disorder trisomy 18, which usually results in either stillbirth or an early death of an infant. 

As of the court filing last week, Cox was 20 weeks pregnant. According to the Center for Reproductive Rights, which brought the lawsuit, Cox left the state because she "couldn't wait any longer" to get the procedure.

"Her health is on the line," said Center for Reproductive Rights CEO Nancy Northup. "She's been in and out of the emergency room and she couldn't wait any longer."

In response to Gamble's decision, Texas Attorney General Ken Paxton warned a Texas medical center that it would face legal consequences if an abortion were performed. 

In an unsigned order late Friday, the Texas Supreme Court then temporarily paused Gamble's ruling. 

On Monday, after Cox left the state, the state Supreme Court lifted the pause, dismissing it as moot, and overturned the lower court ruling that had granted Cox's request. 

The state high court said in its opinion that Cox's doctor had the discretion to determine whether her case met the standard for an exception to the state's abortion ban, that is, whether her life or a major bodily function was threatened by her pregnancy.

It found that Cox's doctor did not assert a "good faith belief" about whether Cox's condition met the law's standard, and yet the lower court granted her the exception to obtain an abortion anyway.

"Judges do not have the authority to expand the statutory exception to reach abortions that do not fall within its text under the guise of interpreting it," the high court said in its opinion.

According to court documents, Cox's doctors had told her that early screening and ultrasound tests suggested her pregnancy is "unlikely to end with a healthy baby," and due to her two prior cesarean sections, continuing the pregnancy puts her at risk of "severe complications" that threaten "her life and future fertility." 

The lawsuit alleged that due to Texas' strict abortion bans, doctors had told her their "hands are tied" and she would have to wait until the fetus dies inside her or carry the pregnancy to term, when she would have to undergo a third C-section "only to watch her baby suffer until death."

The lawsuit was filed as the state Supreme Court is weighing whether the state's strict abortion ban is too restrictive for women who suffer from severe pregnancy complications. An Austin judge ruled earlier this year that women who experience extreme complications could be exempt from the ban, but the ruling is on hold while the all-Republican Supreme Court considers the state's appeal. 

In the arguments before the state Supreme Court, the state's lawyers suggested that a woman who is pregnant and receives a fatal fetal diagnosis could bring a "lawsuit in that specific circumstance." 

According to the Center for Reproductive Rights, Cox v. Texas is the first case since the overturning of Roe v. Wade to be filed on behalf of a pregnant person seeking emergency abortion care. Last week, a woman in Kentucky who is 8 weeks pregnant filed a lawsuit challenging the state's two abortion bans. 

Joe Ruiz contributed to this report. 

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• Texas
• Abortion