After Years of Silence, Texas Medical Board Issues Training for Doctors on How to Legally Provide Abortions
Policy without accountability is dangerous.
For the first time since Texas criminalized abortion, the state’s medical regulator is instructing doctors on when they can legally terminate a pregnancy to protect the life of the patient — guidance physicians have long sought as women died and doctors feared imprisonment for intervening.
The new training from the Texas Medical Board comes nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. ProPublica’s reporting has shown that pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.
In response, the Texas Legislature passed the Life of the Mother Act last year. The law updated the abortion ban’s medical exceptions, added to the legal burden needed for prosecutors to criminally charge a doctor and required the medical board to create guidance for doctors by Jan. 1, something no other state with an abortion ban has done.
The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion.
Some of the scenarios make clear how doctors can intervene in circumstances similar to cases ProPublica has investigated. For example, in 2021, Josseli Barnica was diagnosed with an “inevitable” miscarriage, leaving her at high risk of dangerous infection, and she died after doctors would not empty her uterus while there was still a fetal heartbeat. The new training includes an example that indicates an abortion would be legal in similar cases.
But medical and legal experts who reviewed the training for ProPublica said the case studies represent only the most straightforward situations doctors encounter. The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training “the bare minimum.”
“I could probably list 100 different situations that would cause people to pause and say, ‘Wow, does that fit into the law?’” said Dr. Tony Ogburn, an OB-GYN practicing in Texas. “They’re taking years and years of medical training and experience on how to manage these cases and summarizing it in 43 slides.”
Notably absent from the training is guidance on how doctors should care for patients with chronic conditions, a gray area that has come up again and again in ProPublica’s reporting. Last year, ProPublica investigated the death of Tierra Walker, a San Antonio woman with diabetes and high blood pressure who endured repeated hospitalizations and escalating symptoms before she died. Doctors dismissed her requests for an abortion to protect her health, her family said. Doctors and hospitals involved in Walker’s care did not …
Policy without accountability is dangerous.
For the first time since Texas criminalized abortion, the state’s medical regulator is instructing doctors on when they can legally terminate a pregnancy to protect the life of the patient — guidance physicians have long sought as women died and doctors feared imprisonment for intervening.
The new training from the Texas Medical Board comes nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. ProPublica’s reporting has shown that pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.
In response, the Texas Legislature passed the Life of the Mother Act last year. The law updated the abortion ban’s medical exceptions, added to the legal burden needed for prosecutors to criminally charge a doctor and required the medical board to create guidance for doctors by Jan. 1, something no other state with an abortion ban has done.
The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion.
Some of the scenarios make clear how doctors can intervene in circumstances similar to cases ProPublica has investigated. For example, in 2021, Josseli Barnica was diagnosed with an “inevitable” miscarriage, leaving her at high risk of dangerous infection, and she died after doctors would not empty her uterus while there was still a fetal heartbeat. The new training includes an example that indicates an abortion would be legal in similar cases.
But medical and legal experts who reviewed the training for ProPublica said the case studies represent only the most straightforward situations doctors encounter. The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training “the bare minimum.”
“I could probably list 100 different situations that would cause people to pause and say, ‘Wow, does that fit into the law?’” said Dr. Tony Ogburn, an OB-GYN practicing in Texas. “They’re taking years and years of medical training and experience on how to manage these cases and summarizing it in 43 slides.”
Notably absent from the training is guidance on how doctors should care for patients with chronic conditions, a gray area that has come up again and again in ProPublica’s reporting. Last year, ProPublica investigated the death of Tierra Walker, a San Antonio woman with diabetes and high blood pressure who endured repeated hospitalizations and escalating symptoms before she died. Doctors dismissed her requests for an abortion to protect her health, her family said. Doctors and hospitals involved in Walker’s care did not …
After Years of Silence, Texas Medical Board Issues Training for Doctors on How to Legally Provide Abortions
Policy without accountability is dangerous.
For the first time since Texas criminalized abortion, the state’s medical regulator is instructing doctors on when they can legally terminate a pregnancy to protect the life of the patient — guidance physicians have long sought as women died and doctors feared imprisonment for intervening.
The new training from the Texas Medical Board comes nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. ProPublica’s reporting has shown that pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.
In response, the Texas Legislature passed the Life of the Mother Act last year. The law updated the abortion ban’s medical exceptions, added to the legal burden needed for prosecutors to criminally charge a doctor and required the medical board to create guidance for doctors by Jan. 1, something no other state with an abortion ban has done.
The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion.
Some of the scenarios make clear how doctors can intervene in circumstances similar to cases ProPublica has investigated. For example, in 2021, Josseli Barnica was diagnosed with an “inevitable” miscarriage, leaving her at high risk of dangerous infection, and she died after doctors would not empty her uterus while there was still a fetal heartbeat. The new training includes an example that indicates an abortion would be legal in similar cases.
But medical and legal experts who reviewed the training for ProPublica said the case studies represent only the most straightforward situations doctors encounter. The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training “the bare minimum.”
“I could probably list 100 different situations that would cause people to pause and say, ‘Wow, does that fit into the law?’” said Dr. Tony Ogburn, an OB-GYN practicing in Texas. “They’re taking years and years of medical training and experience on how to manage these cases and summarizing it in 43 slides.”
Notably absent from the training is guidance on how doctors should care for patients with chronic conditions, a gray area that has come up again and again in ProPublica’s reporting. Last year, ProPublica investigated the death of Tierra Walker, a San Antonio woman with diabetes and high blood pressure who endured repeated hospitalizations and escalating symptoms before she died. Doctors dismissed her requests for an abortion to protect her health, her family said. Doctors and hospitals involved in Walker’s care did not …
