The Texas Medical Board is providing new training to doctors on when they can legally perform abortions, almost five years after the state's abortion ban. While the training clarifies certain scenarios, doctors still face significant legal risks and complexities in navigating the law.
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The Texas Medical Board, in a landmark move, has initiated training for physicians on the legal parameters surrounding abortion provision. This training, a first since Texas criminalized abortion, aims to guide doctors on when they can legally terminate a pregnancy to safeguard the patient's life, an area where clear guidance has been sorely needed as women have suffered and doctors have faced potential imprisonment for providing care. The new training material comes almost five years after Texas enacted its strict abortion ban in 2021, a law that imposed severe penalties on doctors who perform abortions. ProPublica's investigations have revealed the increased dangers of pregnancy in the state following the ban's implementation, with a concerning number of maternal deaths linked to the lack of timely reproductive care. The abortion ban has led to more than a hundred OB-GYNs stating that the state's abortion ban was the root of the problem.\The training, obtained by ProPublica via a public records request, offers assurance to doctors that they can legally provide abortions in certain circumstances, even when a patient's life is not in immediate danger. The training outlines nine specific scenarios, including cases of premature rupture of membranes and complications arising from incomplete abortions. Some of these scenarios directly address situations akin to those ProPublica has previously investigated. One example highlighted a case in 2021 where a woman experienced a ruptured amniotic sac, placing her at high risk of a dangerous infection, which unfortunately led to her death after doctors were unwilling to intervene while a fetal heartbeat was present. The new training includes a similar case, indicating when an abortion might be considered legal. However, medical and legal experts who reviewed the training for ProPublica cautioned that these case studies present only the most straightforward scenarios doctors encounter. They emphasized that the complexities and variations in pregnancy complications cannot be fully captured in a brief presentation, with one attorney referring to the training as the “bare minimum.” Concerns have been raised by practicing physicians, and one OB-GYN pointed out that the training, despite its limitations, still represents a significant effort to distill years of medical training into a concise format. The absence of guidance on caring for patients with chronic conditions, a recurring issue in ProPublica's reporting, has also been noted.\Furthermore, the training has been criticized for not addressing the central problem of steep criminal penalties. Doctors face severe consequences, including up to 99 years in prison, $100,000 in fines, and the potential loss of their medical license, if found guilty of performing illegal abortions. Many physicians have expressed that the threat of lengthy and public legal battles is a significant deterrent to providing abortion care, which is affecting women’s access to the medical care they need. The Texas Medical Board asserts that the “legal risk of prosecution is extremely low” if doctors adhere to evidence-based medicine, follow standard emergency protocols, and document cases appropriately. The training stresses that the state now bears the burden of proving that “no reasonable doctor” would have performed the abortion. Some doctors remain skeptical, citing the actions of Texas Attorney General Ken Paxton. One OB-GYN based in Houston, appreciates the training's emphasis on allowing physicians to use their expertise in emergency situations. In 2023, Paxton overruled Karsan's medical judgement when her patient Kate Cox sought an abortion at 20 weeks after learning the fetus had a fatal genetic anomaly
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