Texas Women Suing Over Abortion Law Give Heartbreaking, Historic Testimony

Yon March, unable to obtain abortion services legally in Texas, Samantha Casiano was forced to carry a non-viable pregnancy to term, giving birth to a three-pound baby who died hours later.

Ms. Casiano is among 13 women denied emergency abortion care under state law who are suing the state in a landmark case now before a Texas judge.

In harrowing and historic testimony in Austin court on July 19, Ms. Casiano and two other plaintiffs described their agony, isolation and anguish as they detailed their traumatic and life-threatening pregnancies and lack of care from the state.

As she tearfully described her experience in court, Ms. Casiano vomited from the witness stand.

“I watched my baby suffer for four hours,” she said in her testimony. “I’m so sorry that I couldn’t send you to heaven sooner. There was no mercy for her.”

Abortion rights legal advocacy group Center for Reproductive Rights Texas filed the lawsuit on behalf of the women in March to force Texas authorities to clarify emergency medical exceptions to the state’s overlapping anti-abortion laws, marking the first case brought by pregnant patients against such laws.

Her testimony has underscored the depth of the impacts of the Texas laws and similar anti-abortion laws across the country, with abortion access eliminated for millions of Americans who are now exposed to dangerous legal and medical minefields during their pregnancies.

Conflicting exemptions for medical emergencies in Texas have resulted in widespread confusion among providers and hospitals for fear of legal setbacks or harsh criminal penalties, according to abortion rights advocates. Health care providers in the state who violate those laws could lose their medical license, face tens of thousands of dollars in fines, or receive a life sentence.

The plaintiffs “suffered an unimaginable tragedy” directly because of the state’s anti-abortion laws, Molly Duane, an attorney with the Center for Reproductive Rights, said in her opening arguments.

Texas officials and the state medical board “have done nothing” to clarify the law, he said.

“I feel like my hands are tied,” said Dr. Damla Karsa, an OB/GYN in Houston. “I have the skill, training and experience to provide care, but I can’t do it. It’s heartbreaking. I’m looking for clarity, a promise that I won’t be prosecuted for providing care.”

Attorneys for the state have sought to dismiss the case altogether, arguing in court documents that the women lack standing to challenge the law because it is ultimately uncertain that they will face similar complications again, that their “alleged potential injuries are purely hypothetical,” and that some of the plaintiffs admitted that they have since “struggled to get pregnant” again after their traumatic experiences.

Amanda Zurawski, the lead plaintiff in the case, is still hoping to get pregnant after her life-threatening pregnancy. She called the argument from the state “infuriating, sickening and ironic.”

“Don’t they realize that the reason I can’t get pregnant again is because of what happened to me as a result of the laws they support?” she told the court. “Anyone who has been through infertility will tell you that it is the most isolating, exhausting, lonely, and difficult thing a person can go through.”

‘I wish I was dreaming. He knew it wasn’t’

Casiano, mother of four children, was expecting a girl. When she visited her doctor for a checkup last September, “suddenly the room got cold” and she went silent, she testified.

Her daughter was diagnosed with anencephaly, a fatal birth defect in which a baby is born without parts of the brain or skull.

“My first thought was… ‘maybe it’s surgery, maybe it can be fixed,’ and then he said, ‘I’m sorry, but your daughter is incompatible with life and will die before or after birth,’” Casiano said.

“I felt cold,” he said. “I was hurt. I wish I was dreaming. I knew I wasn’t. I just felt lost.”

A caseworker at her obstetrician’s office gave her a brochure with funeral homes. They prescribed antidepressants. She could not be referred for abortion care anywhere in the state.

Texas was the first to implement a near-total ban on abortion, months before the US Supreme Court and threatened providers with criminal penalties.

Amanda Zurawski endured several rounds of fertility treatments, tests, surgeries, and misdiagnoses before finding out she was pregnant in May of last year.

“At first we were in shock…we were excited,” Ms. Zurawski said.

But her obstetrician discovered that she was dilating prematurely and soon after her membranes ruptured, draining amniotic fluid and endangering the life of her expected child. Doctors told her there was nothing they could do under newly enacted state law, despite knowing “with absolute certainty that we were going to lose our daughter,” she said.

The condition led to life-threatening sepsis. The doctors finally induced labor. His daughter, whom he named Willow, was not alive when she gave birth.

Ms. Zurawski and her husband are still trying to get pregnant, but the trauma closed one of her fallopian tubes and a doctor had to surgically reconstruct her uterus. They are also considering IVF, surrogacy, and adoption.

He previously testified before members of Congress about his experience, a story he will continue to tell, even if it is “excruciating,” he said in a Texas courtroom.

“I know that what happened to me is happening to people all over the country. … Many people are harmed by similarly restrictive bans,” she said.

She has spoken “because I can, and I know a lot of people who are experiencing or will experience something similar who can’t speak, and I will do it for those people,” she said.

Health care providers caring for pregnant patients in the months after the Supreme Court’s decision to overturn Roe vs. Wade have faced severe obstacles to providing standard medical care in states where abortion is effectively prohibited, leading to delays and worsening health for patients and dangerous outcomes, according to a first-of-its-kind report published earlier this year.

Individual patient and provider reports like those named in the Texas lawsuit have shed some light on the wide range of harms pregnant women face in states where access to abortion care is restricted or outright prohibited.

But the report from the University of California, San Francisco captures examples from around the country, painting a “stark picture of how the Roe crash is affecting health care in states that restrict abortion,” according to the report’s author, Dr. Daniel Grossman.

More than a dozen states, mostly in the South, have banned or severely restricted access to abortion care after the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization last June.

The decision also opened new legal challenges, which could once again reshape the future of abortion access in the United States, as anti-abortion lawmakers and Republican candidates face a public that is overwhelmingly against such bans.

‘I no longer feel safe having children in Texas’

Ashley Brandt sent her husband a picture of an ultrasound when he found out she was pregnant with twins. But after her 12-week ultrasound last May, doctors discovered that one of the twins had acrania, in which the fetus’s skull fails to form and brain tissue is exposed to amniotic fluid. The condition is fatal.

Despite the fact that there was no chance of the twin surviving, Ms. Brandt was not eligible under Texas law for a procedure called selective fetal reduction; Twin A still had some signs of life, such as muscle spasms and heart activity.

They traveled to neighboring Colorado for care, and she returned home the day after the procedure.

She gave birth to their daughter in November.

“If I hadn’t gone out of state and done what was legal in Texas, my daughter … probably would have been in the [neonatal intensive care unit],” she said. “All my pre-labor ultrasounds would have had to watch twin A…deteriorate more and more, every ultrasound. …I would have to give birth to an identical version of my daughter with no skull, no brain, and I would have to hold her until she died, and I would have to sign a death certificate and have a funeral.”

She said the state has not considered medical emergencies like hers.

“I no longer feel safe having children in Texas,” she said. “It was very clear that my health didn’t really matter, that my daughter’s health didn’t really matter.”