Texas Supreme Court denies judge-approved abortion for woman with nonviable pregnancy

The Texas Supreme Court ruled Monday night that a Dallas woman who had sought and obtained a court order allowing her to terminate her nonviable pregnancy did not meet the state's narrow threshold to obtain an abortion. The woman, Kate Cox, left Texas to obtain the procedure in another state, her lawyers said earlier Monday.

Cox's "health is on the line. She's been in and out of emergency rooms, and she couldn't wait any longer," said Nancy Northup, CEO of the Center for Reproductive Rights, which represented Cox in the case. For women who can't leave Texas, "a situation like this could be a death sentence."

Cox's case "marked a new chapter in the legal history of abortion in the United States, with pregnant women now going to court seeking permission for their doctors to do what they determine to be medically necessary without fear of severe criminal or civil penalties," The New York Times reported.

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Cox learned last week, 20 weeks into the pregnancy, that her fetus has a fatal condition called trisomy 18, which almost always ends in miscarriage, stillbirth, or infant death. She asked a judge to clear her for an abortion under the law's medical exemption, and Travis County District Judge Maya Guerra Gamble did so on Thursday. Texas Attorney General Ken Paxton (R) threatened to prosecute the doctor and any hospital involved in the abortion and asked the Texas Supreme Court to block the order. The high court issued a stay on Friday.

Cox's doctor said continuing the pregnancy could result in serious medical complications, including the loss of her uterus and any chance at having more children. The all-Republican state Supreme Court said the doctor "could not, or at least did not, attest to the court that Ms. Cox's condition poses the risks the exception requires," and Gamble, a Democrat, incorrectly used the doctor's "good faith" determination an abortion was necessary, not the "reasonable medical judgment" required by state law.

"A woman who meets the medical-necessity exception need not seek a court order to obtain an abortion," the court said in its ruling. "The law leaves to physicians — not judges — both the discretion and the responsibility to exercise their reasonable medical judgment." The justices asked the Texas Medical Board to "provide guidance in response to any confusion that currently prevails" about when a doctor can perform an abortion without risking life in prison.