Texas Supreme Court Upholds Texas Law Protecting Unborn Babies from Elective Abortion

Emphasizes the Availability of the Medical Necessity Exception to Save Women’s Lives or Physical Health

AUSTIN, TX – On Friday, the Supreme Court of Texas issued a ruling in Zurawski v. Texas (23-0629) a challenge brought by the New York-based Center for Reproductive Rights (CRR) against Texas’ laws protecting unborn babies from elective abortion.

The Court unanimously upheld the constitutionality of the Human Life Protection Act, the 2021 law that protects unborn babies from abortion beginning at conception, while affirming the availability and clarity of the medical necessity exception to allow doctors to perform abortion “to save the woman’s life or major bodily function, in the exercise of reasonable medical judgment and with the woman’s informed consent” according to their “reasonable medical judgment.” The Court clarified that a woman’s death does not have to be imminent for the exception to apply.

“We are ecstatic that the Texas Supreme Court has allowed legal protections from elective abortions for unborn babies to continue while acknowledging that doctors can perform abortions to save women’s lives,” said Amy O’Donnell, Texas Alliance for Life’s Communications Director. “The law can continue to save babies’ lives and, in rare a tragic cases, save women’s lives, just as the Legislature intended.”

Focusing on the Human Life Protection Act, the Court ruled that protections for unborn children from abortion in the Human Life Protection Act are constitutional, and the medical necessity exception that allows abortions when a pregnancy endangers a woman’s life or physical health is available for cases when “a woman has a life-threatening physical condition that places her at risk of death or serious physical impairment unless an abortion is performed.” They further elaborated that “[t]he law permits a physician to intervene to address a woman’s life-threatening physical condition before death or serious physical impairment are imminent.”

After the United States Supreme Court overturned Roe v. Wade in June 2022, reported elective abortions have plummeted from thousands per month to zero, according to reports from the Texas Health and Human Services Commission, as summarized here. However, from August 2022 through December 2023, doctors have performed 81 abortions under the medical necessity exception of the Human Life Protection Act. Notably, no woman has died for lack of an exception. No doctor has faced prosecution by a DA, a lawsuit from the Attorney General, or sanctions by the Texas Medical Board related to these cases.




Representing several women who experienced rare, life-threatening pregnancies or were pregnant with unborn babies diagnosed with terminal illnesses, the CRR sought to expand the exceptions far beyond the carefully written language passed by the Texas Legislature in 2021 in the Human Life Protection Act, essentially paving the way for abortion-on-demand, which Texas laws currently prohibit.

Texas Alliance for Life submitted two amicus curiae (friend-of-the-court) briefs in the case. The first brief on behalf of 92 members of the Texas Legislature, made the point that nowhere in the state constitution is there a right to abortion. The second brief on behalf of the Texas Catholic Conference of Bishops, Texans for Life, and Texas Alliance for Life showed how the medical necessity exception in the Human Life Protection Act is clear and that Texas abortion laws have always been found by courts to be clear.

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