Texas Medical Board sets abortion guidelines for doctors after 3 years of legal ambiguity

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TYLER, Texas (KETK) – After the Texas Supreme Court asked the Texas Medical Board to further define abortion restrictions following high profile abortion cases, the board issued proposed guidelines for medical doctors.

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The board said a physician must prove through the patient’s medical records that the abortion was performed in response to a medical emergency. Those guidelines include if the fetus puts the woman’s life in danger and to prevent a serious risk of substantial impairment to a major bodily function.

The board defined a medical emergency as “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed.”

These guidelines will be in effect after the board accepts comments from the public for a minimum of 30 days. Once the board reviews the comments, they will hold a public hearing where they can adopt the new guidelines or make changes and republish the rule.

However, the board did not comment on pregnancies that are a result of rape or incest as it was “out of the board’s jurisdiction.”


This decision comes nearly three years after the implementation of the Texas Heartbeat Act, which prohibits abortions upon detection of a fetal heartbeat, effectively limiting access to abortion after six weeks.

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The following year, the Supreme Court’s ruling on Dobbs v. Jackson overturned Roe v. Wade, granting states the authority to regulate abortion without federal restriction. This decision triggered House Bill 1280, making abortion illegal in Texas and imposing severe penalties on doctors who performed the operation. The law states penalties include life in prison or a fine with a price tag of $100,000.

The bill did not specify when a woman can undergo an abortion in cases of rape, incest or fetal abnormalities. Though situations where the pregnancy posed a risk of death or “a serious risk of substantial impairment of a major bodily function” were excluded from the measure, it failed to provide proper guidelines to what constitutes as a risk to a woman’s life.


According to a report from KXAN, 40 Texas companies and business leaders entered a fight against Texas’ abortion ban in November 2023, stating the law’s ambiguity was costing the state an estimated $14.5 billion in lost revenue every year.

Additionally, research by the Center on the Economics of Reproductive Health found that the state-level abortion restrictions cost state economies $105 billion annually due to the reduced labor force and earnings level particularly among women aged 15 to 44.

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The center also found the abortion ban would increase turnover and time off from work among women in the same age range.

“Texas’ abortion ban is a giant step backwards and will impede women’s economic and social progress. Restrictions like these will also have a devastating impact on state economies and the financial security of women and their families,” Dr. C. Nicole Mason, President and CEO of the Institute for Women’s Policy Research, said.

Researchers from the John Hopkins Bloomberg School of Public Health also estimated that from April to December 2022, there were nearly an additional 10,000 live births in Texas that would not have occurred if the 2021 ban had not been in effect.

In December 2023, the Texas Supreme Court rejected Kate Cox, a 31-year-old mother of two, from getting an abortion. This decision was made despite the court knowing that the fetus had a fatal condition and had caused Cox medical issues including four emergency room visits, elevated vital signs and a risk of a uterine rupture.

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When the Texas Supreme Court issued their ruling, they called for the state’s medical board to provide better guidelines on the medical emergency exceptions.

Since then, medical experts have been wary of what truly defines a medical emergency worthy of an abortion, putting the lives of women at risk.


A University of Texas at Tyler February poll found that 49% of Texans believe there should be a national law protecting abortions in all states. While 30% of Texans believe each state should establish its own abortion laws.

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When asked about exceptions to the ban, UT Tyler found:

  • If the pregnancy was unwanted for any reason: 31% of Texans polled said a woman should never be allowed to get an abortion if it is unwanted for any reason, while 38% said only in the first trimester.

  • If a serious birth defect is detected: 81% of Texans believe women have the right to an abortion if the fetus has a defect. Among them, 30% of those said the operation should be granted only during the first trimester, with 21% supporting access during the first and second trimesters. Among respondents, 30% said women should have the option to get an abortion at any stage.

  • If the pregnancy was the result of rape or incest: A total of 84% of those polled believed women should have the ability to get an abortion at some point of the pregnancy. 32% of respondents said women should have the right to an abortion till the third trimester.

  • If the pregnancy puts the woman’s life at risk: Nearly 88% of respondents believe a woman should have the right to an abortion if it poses a risk to the woman’s life. 51% of those polled believe a woman should have the right to an abortion at any time during all three trimesters.

Though the Texas Medical Board did not comment on instances of rape, incest or fetal abnormalities, the new exception guidelines correlate to the consensus UT Tyler identified in February.

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