AUSTIN, Texas — More than a year after Texas lawmakers passed the Life of the Mother Act, physicians and reproductive health advocates are working to ensure doctors and pregnant women understand when state law allows emergency abortions.
Texas bans abortion except in limited circumstances, including when a pregnant woman faces a risk to her life or a major bodily function. Before lawmakers passed Senate Bill 31 in 2025, physicians and reproductive health advocates argued that the law did not clearly define when a medical emergency qualified for the exception.
Doctors who violate the abortion ban can face fines of up to $100,000, loss of their medical licenses and prison time.
Physicians pushed lawmakers to clarify the law. Dr. Deborah Fuller, a Dallas-based OB-GYN, told lawmakers during a hearing on the House version of SB 31 that she believed the measure could help save women’s lives.
After lawmakers debated and amended the bill, the Legislature passed it with bipartisan support.
The law clarified that a patient’s death or impairment does not have to be “imminent” before a doctor can intervene. It also allows physicians to discuss abortion with patients and other doctors while determining appropriate treatment.
SB 31 did not eliminate penalties for physicians who violate the abortion ban. However, it established that prosecutors must prove that “no reasonable doctor” would have provided an abortion under the circumstances.
Fuller said the law has eased some physicians’ concerns when they make emergency medical decisions. She said many patients, however, remain unaware of the protections and exceptions under state law.
“Most of [my patients] have not heard of it,” Fuller said.
Campaign aims to educate patients
Fuller now serves on the advisory committee for “Asking for a Mom,” a campaign designed to educate pregnant women and their families about Texas abortion laws, including the Life of the Mother Act.
The Texas Campaign for Mothers, a nonprofit that lobbied for SB 31, operates the campaign. The organization describes itself as nonpartisan.
The campaign provides information through its website and distributes flyers for doctors to display or provide to patients. The materials explain circumstances in which Texas law allows or prohibits abortion and outline steps patients can take if they encounter barriers to care.
Fuller said the resources could help patients understand their options when speaking with OB-GYNs and emergency room physicians.
“In an obstetrical emergency, it would be very unusual for someone to access a law to find out, ‘Oh, what is and what isn’t happening? What is and isn’t covered? Where am I in this legislation?’” Fuller said.
Doctors receive new training
SB 31 also requires OB-GYNs, emergency room physicians and family medicine doctors in Texas to complete online education about the state’s abortion laws when they renew their medical licenses.
The Texas Medical Board’s training covers several emergency scenarios, including treatment involving a pregnant patient with cancer who needs chemotherapy.
Because physicians renew their licenses every two years, some doctors have not yet completed the required course. “Asking for a Mom” has responded with in-person training sessions at medical schools and clinical settings.
Central Texas OB-GYN Dr. Charles Brown has participated in the effort and said in-person sessions give doctors an opportunity to discuss questions that may not receive enough attention in an online course.
Brown said he has visited at least a dozen medical residency programs. He said physicians generally ask legal questions rather than medical ones.
“All the OB-GYN doctors know what to do,” Brown said. “They need to have the confidence they can legally do it.”
The Texas Medical Board’s training says physicians can rely on reasonable medical judgment during emergencies. The guidance defines that judgment as a decision from a reasonably prudent physician who understands the patient’s condition and available treatments.
The training also says physicians do not need medical certainty or agreement from every doctor before making an emergency treatment decision.
Some doctors still question the law
Despite the new law and training, some Texas physicians continue to argue that the emergency exception remains unclear.
Dr. Damla Karsan, a Houston OB-GYN who has challenged Texas’ abortion restrictions in court, said SB 31 did not address all of the concerns raised by physicians. She also pointed to the law’s exclusion of lethal fetal anomalies.
Karsan said uncertainty could continue to cause doctors to delay treatment.
“I think there’s still so much fear,” she said. “If providers aren’t 100% certain, they’re going to delay.”
Brown also said he encounters legal questions that fall outside his expertise. He said he directs physicians to hospital or legal counsel when they seek interpretations of specific legal obligations.
Questions remain about delays in care
The debate over emergency abortion care has continued as physicians and advocates examine cases involving delayed treatment.
A recent ProPublica investigation reported that deaths associated with ectopic pregnancies doubled between 2020 and 2025, with higher rates in states with strict abortion restrictions, including Texas. Ectopic pregnancies occur when an embryo implants outside the uterus and can cause life-threatening complications.
Texas law allows doctors to terminate ectopic pregnancies, and SB 31 specifically addresses the treatment.
A federal investigation previously found that a Williamson County hospital failed to promptly treat a woman’s ectopic pregnancy in 2023. The pregnancy later ruptured, and doctors removed her fallopian tube.
The Texas Tribune also reported in June that an Austin-area woman filed federal complaints against several hospitals over treatment she received for a miscarriage in October 2025. The woman alleged that delays placed her health at risk.
The Texas Medical Board’s training states that removing the products of a miscarriage remains legal.
It could take years before researchers have enough data to determine whether SB 31 and the required physician training have changed emergency care outcomes across the state.
The Texas Maternal Mortality and Morbidity Review Committee releases pregnancy-related mortality data on a delayed schedule. The committee plans to release data from 2024 in December after skipping reports covering 2022 and 2023.
Texas Health and Human Services data show that doctors performed 68 abortions under the state’s exception during the first six months of 2026, compared with 62 during the same period in 2025.
Brown said more time and data will show how effectively the law works.
“Time will tell,” Brown said. “But I’m trying to make it as effective as it can be.”
