AUSTIN — Five women who were denied abortions under Texas law while facing medical crises are suing the state, asking a judge to clarify exceptions to the laws.

"[The women] have been denied necessary and potentially life-saving obstetrical care because medical professionals throughout the state fear liability under Texas's abortion bans," says the lawsuit, filed in state court by the Center for Reproductive Rights on behalf of the five women and two doctors.

"Just because Roe v. Wade is no longer the law of the land does not mean that women and pregnant people are without constitutional and basic human rights," says Molly Duane, senior staff attorney with the center. "We're talking about people who are in medical emergencies, who need urgent medical care and whose physicians are too scared to provide that care because of the state's laws and because of the state's failure to provide any clarification around what its law means."

The suit names Texas Attorney General Ken Paxton as a defendant. His office responded Tuesday by saying Paxton "will continue to defend and enforce the laws duly enacted by the Texas Legislature" and by forwarding a "guidance letter" on the state ban triggered by the U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization.

Narrow exceptions

Texas was the first state to implement a near-total abortion ban with a law known as SB 8, which took effect in September 2021. The law enabled individuals to file civil lawsuits worth tens of thousands of dollars against anyone found to have provided an abortion, or helped a patient get one. The law includes limited exceptions for medical emergencies.

Last June, the Dobbs decision allowed roughly a dozen more states' abortion bans to take effect. That included the "trigger ban" in Texas, which made nearly all abortions a felony, and allowed only narrow exceptions to save a pregnant woman's life.

'Somebody is going to die eventually'

Two of the plaintiffs in the new lawsuit, Anna Zargarian and Lauren Miller, have previously told their stories to NPR.

For a story published in early 2022, just months after SB 8 took effect, Zargarian spoke to NPR using only her first name out of fear of repercussions for herself or her doctor; she agreed to go public with her full name as part of the lawsuit. Zargarian's doctors denied her an abortion after her water broke at 19 weeks — too early for the fetus to survive. Fearing the prospect of severe infection, she flew to Colorado for a termination.

Zargarian told NPR that she came forward because "it's important to share this story. Because somebody is going to die eventually."

In the months that followed, more Texas patients with medically complex pregnancies were turned away, and several of those faced life-threatening conditions. Miller and a second patient, Ashley Brandt, each faced complicated twin pregnancies in which doctors told them that terminating one twin would offer the best chance to preserve the life and health of the other twin, as well as the pregnant women.

Four of the five women ultimately left Texas to seek abortions in other states, among them Colorado and Washington.

Doctors fear fines, prison

Two Texas doctors, Damla Karsan and Judy Levison, also are suing the state on behalf of themselves and their patients. The lawsuit notes that doctors who violate Texas' abortion bans could face severe penalties.

"With the threat of losing their medical licenses, fines of hundreds of thousands of dollars, and up to 99 years in prison lingering over their heads, it is no wonder that doctors and hospitals are turning patients away—even patients in medical emergencies," the suit reads.

Faced with complaints from doctors who say they're unable to provide abortions in emergency situations for fear of running afoul of state law, some abortion rights opponents have accused medical groups of failing to help doctors make sense of what the laws require.

Speaking to NPR last year, John Seago of Texas Right to Life — a major force in pushing SB 8 through the state Legislature — said it was "politically advantageous for some of these groups that oppose the bill ... to just say this is unreasonable."

Seeking clarity

At the time, groups such as the Texas Association of Obstetricians and Gynecologists pushed back, saying the laws were too vague to provide physicians with assurances they would not face legal consequences.

Duane, with the Center for Reproductive Rights, says the goal of the new suit is to obligate the state to provide clear guidelines for Texas doctors whose pregnant patients face serious medical complications.

"What is a doctor to do in Texas right now? They had no choice but to come forward and seek clarification," Duane says. "They had immense bravery in doing so."

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