Abortion rights group files legal action over narrow medical exceptions to abortion bans in 3 states

Washington — A pro-abortion rights legal organization is taking legal action in three states on behalf of physicians and women who were denied or delayed access to abortion care despite facing pregnancy complications as part of efforts to clarify "medical emergency" exceptions to state abortion bans.

The lawsuits filed by the Center for Reproductive Rights in state courts challenge the narrow scope of laws in Idaho and Tennessee that allow for abortions to be performed in limited circumstances to protect the life or health of the mother. The third action, brought against the Oklahoma Children's Hospital and filed with the Department of Health and Human Services, alleges the facility violated federal law when it denied abortion care to a woman suffering a life-threatening complication during pregnancy.

The efforts are not aimed at overturning the abortion bans, but rather seek to amplify the experiences of pregnant women who faced severe risks to their health after they faced complications during pregnancy and were denied abortions, as well as those of physicians who said they are unable to provide care for fear of liability.

Eight patients, four physicians and an Idaho medical association are named across the three complaints. The actions are the latest from the Center for Reproductive Rights that involve women denied care in states that outlawed abortion after the Supreme Court overturned Roe v. Wade, which legalized abortion nationwide, in June 2022.

"The Supreme Court's unwarranted reversal of Roe v. Wade has led repeatedly, in multiple states, to women being denied abortion care when they face serious complications in their pregnancies," Nancy Northup, the center's president and CEO, said in a statement. "No one should have to be at death's door to receive essential health care, but that is exactly what happens when doctors are forced to practice medicine under threat of imprisonment."

In March, the center sued the state of Texas over its abortion law, which allows the procedure to be performed on a patient with an "emergent medical condition." The suit was the first brought on behalf of patients denied abortions despite facing dangerous pregnancy complications and sought to clarify the medical exemptions in Texas' abortion law.

In August, a state court judge ruled that women who experience complications are exempt from the state's ban. Texas officials appealed the ruling, which is now on hold.

Legal action in Idaho, Tennessee and Oklahoma

The latest legal actions filed in Idaho, Tennessee and Oklahoma seek to expand on the work in Texas by clarifying the situations in those states when doctors can perform and pregnant patients can receive abortions under exceptions to state bans.

Without clarification on what circumstances qualify under the exceptions, pregnant women facing serious health risks must wait to receive abortion care or leave the state, the complaints allege. The threat of steep penalties for physicians — including prison time, fines and a loss of licensure — has left them hesitant to provide care, the group says.

The lawsuit in Tennessee was filed on behalf of three pregnant women and two physicians, who argue the state's medical exception to its abortion ban violates the state constitution and want clarification as to whether the exception allows abortions in cases of fatal fetal diagnoses. The measure allows abortions to be performed if a physician determines that it is necessary to "prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman," but the suit argues the law is vague and can hinder the delivery of necessary medical care. 

Two of the women involved in the case learned during their pregnancies that their babies had fatal fetal diagnoses, but had to continue their pregnancies. One, Nicole Blackmon, began to show warning signs of preeclampsia, and delivered a stillborn baby in the seven month of pregnancy. The other, Allie Phillips, raised money to travel to New York to receive an abortion after she was denied care in Tennessee. The third plaintiff, Katy Dulong, was diagnosed with cervical insufficiency and told she would lose the pregnancy, but had to wait 10 days following her diagnosis to receive medication to expel the pregnancy without more of a risk to her health. The lawsuit argues the woman would have died from the delay in receiving care.

In the Idaho lawsuit, the challengers — four women denied abortions, two physicians and the Idaho Academy of Family Physicians — argue that since the Supreme Court overturned Roe, the state's reproductive health care infrastructure has "spiraled into crisis," leading to an exodus of obstetrician-gynecologists and maternal fetal medicine specialists who fear liability under the state's abortion restrictions.

All four patients who are suing over Idaho's law, which includes an exception to prevent a pregnant woman's death, traveled out of state to obtain abortions after their babies were diagnosed with conditions that made them unlikely to survive after birth.

"All of the above-described women in this case wanted children, and all suffered unimaginable tragedy and health risks due to Idaho's abortion bans," the suit states. "Their experiences show that contrary to their stated purpose of furthering life, the bans endanger pregnant Idahoans, risking loss of fertility, injury, and even death."

The Idaho plaintiffs argue that clarifying the state's exception would allow health care providers to provide life-saving care without waiting for the mother's health to deteriorate. Like in Tennessee, the challengers are also seeking to expand the exceptions under Idaho's laws to allow physicians to provide abortions when the baby has a fatal diagnosis. 

The Oklahoma action was filed with the U.S. Department of Health and Human Services on behalf of Jaci Statton, who was diagnosed with a partial molar pregnancy that was not viable. Despite experiencing severe pain and bleeding after learning of her condition, she was not provided with an abortion by the University of Oklahoma Medical Center, which the complaint states was necessary stabilizing treatment. Statton was instead moved to Oklahoma Children's Hospital, where providers told her she would die absent treatment. 

Though she asked the staff to provide an abortion, Statton alleges that providers said they could not perform the procedure until she was "actively crashing in front of them" or near a heart attack, according to the filing. They allegedly offered to let Statton wait in the parking lot so she would be close to the hospital when her health deteriorated, the complaint states.

With her condition worsening, Statton drove three hours from Oklahoma to Kansas to receive an abortion, according to the filing.

"Pregnant people should not have to fear that they will be denied life-saving treatment from Oklahoma hospitals, nor should they be forced to wait until they are at death's door before health care providers intervene," the complaint states.

The complaint filed with the department argues Oklahoma Children's Hospital violated the Emergency Medical Treatment and Labor Act, or EMTALA, when it denied medically necessary care to Statton. The law requires health care providers that receive Medicare funds to provide necessary stabilizing treatment to a mother whose health is at risk, including an emergency abortion.

Statton is requesting the Department of Health and Human Services investigate the hospital for violations of EMTALA and "take all necessary steps to remedy all unlawful conduct identified in its investigation, including by imposing all appropriate penalties and by clarifying that EMTALA preempts Oklahoma law."