Doctors say the Texas abortion ban is complicating other types of medical decisions

The law bans nearly all abortions, and doctors providing pregnancy care are hoping for more clarity soon, as legal challenges continue.

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Today, a federal judge will consider an effort by the Biden administration to block a Texas law that bans abortions after a fetal heartbeat is detected. It's called SB8. Some doctors in Texas say the law is also complicating other medical decisions. Quick warning for you, there's some sensitive material in this story. Here's NPR's Sarah McCammon.

SARAH MCCAMMON, BYLINE: Each month, Dr. Andrea Palmer (ph) delivers about 20 babies. It's the best part of her job. But some days, she has to deliver difficult news.

ANDREA PALMER: I mean, first of all, the conversations are just - they're gut-wrenching every time.

MCCAMMON: Palmer is an OB-GYN in Fort Worth, Texas. She recently had to tell a woman that her fetus had a fatal condition called anencephaly.

PALMER: That is where, essentially, the baby doesn't have a brain.

MCCAMMON: It's always fatal, often during the pregnancy or else soon after birth. Palmer says patients can choose whether to terminate. But staying pregnant comes with additional health risks.

PALMER: I've had some moms who choose to continue the pregnancy because this is the only time they're going to have with their baby, which is just heartbreaking to me. And then I have other patients who just, like, the - imagining the sorrow that each prenatal visit would bring knowing that's never going to result in a baby they could take home. That is just too much to bear.

MCCAMMON: Before SB8, Palmer would have offered to end the pregnancy by inducing labor. But SB8 prohibits abortions after cardiac activity is detectable, except for medical emergencies. At more than 16 weeks, Palmer's patient decided to go out of state for an abortion, an option Palmer says many of her patients could never afford. Some doctors say the law also is complicating medical decisions when women come in for help while experiencing a miscarriage.

THERESA PATTON: For example, a patient comes in 17 weeks with her water broken. That's a non-viable pregnancy. And the biggest risk to the patient is that she could become infected.

MCCAMMON: That's Dr. Theresa Patton (ph), an OB-GYN in Dallas. She says in those cases, she'd normally offer medication that could expedite the miscarriage and reduce the risk of infection, which can trigger a severe condition called sepsis. But she says, it's not clear under the law what constitutes a medical emergency.

PATTON: We don't want a patient to get sick for a pregnancy that is not going to progress. It's not going to continue. So we offer that termination. Now, am I going to be in legal trouble for offering that termination now? Do I need to wait until she's septic and imminently endanger herself?

MCCAMMON: John Seago of Texas Right to Life defends the law but acknowledges that it removes some options for health care providers.

JOHN SEAGO: We understand that our ethics and our commitment to human life does limit medicine from being as efficient as it wants to be. However, this is protecting innocent human life and seeking to protect these values.

MCCAMMON: Some doctors tell NPR they worry about advising patients about going outside Texas for procedures because the law allows lawsuits targeting anyone who aids or abets an illegal abortion. John Seago says he believes the fear of frivolous lawsuits is overblown and notes that the law only applies to abortions in Texas. But Dr. Andrea Palmer in Fort Worth says that's not very reassuring. She says the law gives broad authority to anyone who believes an illegal abortion has taken place to sue anyone they believe was involved.

PALMER: We're scared for our patients. I am going to continue to provide the counseling that I think is appropriate for my patient regardless of what the law says I can or can't say in my exam room, frankly. But it's definitely a weird and scary time to be an obstetrician in the state of Texas.

MCCAMMON: Doctors like Palmer are hoping to get more clarity soon as court challenges continue. But for now, they say they're cautiously moving forward, trying to keep their pregnant patients healthy while keeping themselves out of court.

Sarah McCammon, NPR News.

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