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More women denied abortions in Texas join lawsuit against the state 

Nearly two dozen women say they were unable to get the healthcare they needed for their medically complex pregnancies. The lawsuit heads to the state Supreme Court this week.
Image: Abortion-rights demonstrators hold up letters spelling out "My Choice."
Abortion-rights demonstrators hold up letters spelling out "My Choice," on May 14, 2022, outside the Supreme Court in Washington.Jacquelyn Martin / AP

Just over a year ago, Kimberly and David Manzano were eagerly trying for their first child. After they suffered a miscarriage in November of 2022, Kimberly Manzano found out she was pregnant just two months later. The couple was elated.

But 10 weeks into the pregnancy, they heard news from a fetal specialist that rocked their world — the baby had several abnormalities.

The couple, who live in the Dallas/Fort Worth area and are devout Christians, didn’t lose hope, however. They sought out second and third opinions with pediatric surgeons and maternal fetal medicine physicians in Texas. After a fetal MRI revealed several more severe complications to their baby, including a leakage of spinal fluid due to the spinal cord not having fused, a missing kidney, a defect to the baby’s abdominal wall, and a lack of genitalia, the Manzanos knew they were looking at a fatal pregnancy. Both Kimberly and her husband were heartbroken and devastated.

Image: Kimberly and David Manzano
Kimberly and David ManzanoCourtesy Kimberly and David Manzano

“We literally walked into our worst nightmare,” said Kimberly Manzano, 34.

But despite doctors telling the Manzanos that the baby “would never see the outside of the hospital,” they were unable to advise her medically on termination options, Kimberly Manzano recounted. That’s because Texas, like several other states with abortion bans, does not have exceptions for lethal abnormalities.  Currently in the state of Texas, abortion is illegal. The state has a pre-Roe abortion ban, a six-week abortion ban, and a trigger ban (a ban on abortion known as The Human Life Protection Act that took effect after the Supreme Court overturned Roe v. Wade), with exceptions for the life and health of the mother.

“My hands are tied,” Kimberly Manzano recalled her doctor saying. “If it was my son, I would want him to be with God now sooner than later.” The nurse at her doctor’s office then sent Kimberly Manzano the name of an abortion clinic in New Mexico over email, leaving it to her to send her medical records to the New Mexico clinic in order to avoid ties or communication with the abortion clinic.

After long deliberation with their pastor, family and friends, the Manzanos decided to travel to New Mexico for an abortion — the very thing she admitted she had always been strongly against.

Kimberly Manzano is the latest plaintiff to join the ongoing case, Zurawski v. State of Texas. The lawsuit was filed by the Center for Reproductive Rights on behalf of Texas women, like Kimberly Manzano, who were allegedly denied abortions despite serious pregnancy complications. The lawsuit was originally filed in March and started with seven plaintiffs and has since grown to 22, including 20 women who were denied abortion care and two Texas obstetrician-gynecologists. This is the first apparent lawsuit led by women affected by the abortion bans since Roe v. Wade was overturned in the summer of 2022.

In August, a decision in the case by a Texas District Judge brought a temporary block to the state’s abortion law, letting doctors use their own medical judgment to determine when to provide abortion care. But on the same day, an appeal filed by the office of Attorney General Ken Paxton — who has been a fierce defender of the current abortion law — blocked the judge’s order from taking effect. On Tuesday, the Texas Supreme Court will hear oral arguments on whether to uphold the ruling

“What we are essentially asking the courts to do is to translate this non-medical terminology in this abortion ban into language physicians can understand, so that they know they can provide a standard of care treatments to their patients, and that they can exercise their medical judgment," Marc Hearron, a senior attorney for the Center of Reproductive Rights said. Hearron said that while this is still a narrow case, that won’t restore abortion access across Texas, it’s a step in the “right direction” in securing women’s essential healthcare in the state.

Lauren Miller, from Dallas, Texas, is one of the original plaintiffs in the lawsuit. Like the Manzanos, Lauren and her husband were eagerly awaiting to get pregnant with a sibling for their first son.

Then when their son turned 1 in 2022, they found out they were pregnant — not with one but with two babies. “Here we go again!!!!," she wrote, in the first entry of her pregnancy journal.

Image: Lauren Miller
Lauren MillerCourtesy Lauren Miller

“We were really excited. We had wanted to have kids fairly close together,” Miller recalled. Then at 12 weeks, Miller learned that one of her twins had trisomy 18—a condition that causes multiple structural abnormalities.

 When she had conversations with her doctors about what that meant, she was frustrated at the lack of clarity she received. She blames the Texas abortion ban laws for the fear she believes prevented her medical team from being direct about what her condition meant and the medical care she needed. “It just eliminates trust in a healthcare environment," she said.

In a conversation with a genetic specialist Miller recalled, “The genetic counselors would be going down a train of thought, and then just stop in the middle of a sentence, and you could just feel the fear. They were scared to say anything else, and then they would start apologizing to us. And then we were apologizing to them because their job has become impossible. They’re trying to help us through the worst news that we’ve ever received, and she can’t say anything. She’s trying to counsel us and she can’t do that.”

Without having a clear understanding of what her diagnosis meant for the other twin, Miller was terrified to lose both babies. “All anybody can say to me is that the longer this pregnancy continues, the more risk it is for the healthy twin and myself.”

While there is no law that prevents doctors in Texas from counseling a patient to go get an abortion somewhere outside of the state, Hearron says he hears cases like Millers, where doctors are hesitant to have conversations around pregnancy termination, too often.

“Physicians are so terrified to come close to violating the law because of the extraordinary extreme penalties — life imprisonment, fines of over $100,000, loss of their license, ending their livelihoods…They are being so risk averse that they don’t even want to say the word 'abortion.' And we’ve heard that time and again.” The Texas trigger law criminalizes performing an abortion from the moment of fertilization, except in life-threatening cases to the pregnant mother.

Having abortion bans in place is making physicians' job to treat patients even harder Hearron said, “Physicians are trained to not wait until their patients are on the verge of death before they provide treatment. Yet because they are not trained on how to read these vague and ambiguous statutes, they don’t know, is this the point that I can intervene? Does a patient have to be showing signs of infection? Do they have to be literally on death’s door? We don’t know. And so, we’re trying to get the courts to clarify.”

Miller landed again in the hospital the same week one of her twins was diagnosed with trisomy 18. She had severe dehydration and was diagnosed with hyperemesis gravidarum — a symptom characterized by severe nausea and vomiting — for the second time.

“It was such a frustrating situation, and you could feel that from the hospital staff, because they could see they couldn’t do anything for me. They could see that the pregnancy was what was causing me to be so sick. They could see that I had this unviable twin. They could see the risk to me. They could see the risk to my healthy twin, and they couldn’t do anything,” Miller recalled. It’s not clear if her condition was caused the baby’s trisomy 18 diagnosis, but doctors told her it could be caused by the higher hormones that come from a twin pregnancy, and she felt frustrated that they didn’t give her a clearer explanation outside of that.

It was then she decided to travel out of state to Colorado to obtain a fetal reduction abortion to give the healthy twin a chance of survival. She gave birth to baby Henry, the surviving twin, in March of this year — three weeks after she joined the lawsuit.

Both Miller and Manzano hope the November 28 hearing will reaffirm the Texas district judge’s short lived injunction on the case back in August. The Center for Reproductive Rights has filed similar cases in Tennessee, Idaho and Oklahoma, seeking clarification and expansion around the exceptions to the abortion bans in those States.

Of the Texas lawsuit, Nancy Northup, president of Center Reproductive Rights said, “Everyone should be paying attention to this case…because right now, in the state of Texas, it is unsafe to be pregnant because you do not know if you will be one of the people who ends up with an obstetric emergency that threatens your life, your health, your future fertility…So this is important for everyone, including people who think they would never decide to end a pregnancy.”