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For one Texas doctor, abortion bans are personal and professional

Dr. Austin Dennard at her home in Dallas in May. She is one of 13 patients and two other doctors suing Texas over its abortion bans.
LM Otero
Dr. Austin Dennard at her home in Dallas in May. She is one of 13 patients and two other doctors suing Texas over its abortion bans.

On a recent Friday night, as her husband made dinner at the family's home in Dallas and her toddlers ran around underfoot, Dr. Austin Dennard saw an email come in on her phone.

The judge who heard her testify last month in an Austin courtroom about Texas's abortion laws had reached a decision. Dennard is among 13 women who sued the state arguing that the current abortion bans are unclear when it comes to pregnancy complications. She is also an OB-GYN, and she's nearing the end of a healthy pregnancy – she was visibly pregnant while on the stand.

The email that came in that night during dinner prep had big news. Judge Jessica Mangrum had ruled decisively in favor of Dennard and the other plaintiffs represented by the Center for Reproductive Rights. Mangrum's decision temporarily blocked the Texas abortion bans in cases of serious pregnancy complications.

"I didn't anticipate the amount of emotion that was just going to pour out of me when I read it," she says. "I just scrolled through it and just cried."

The first thing she thought about was her previous pregnancy – the one that ended in an abortion.

Reading a victory through tears, with Google

Last summer, she learned that she was carrying a fetus with anencephaly — a fatal condition in which the skull and brain do not develop fully. She traveled to the east coast for an abortion.

When she read the opinion, she thought, "I would not have had to go out of state if I had [the anencephaly] diagnosis right now."

Mangrum's ruling specifies that doctors cannot be charged for providing abortions when the fetus is unlikely to survive after birth. Texas abortion bans do not have an explicit exception for fatal fetal conditions.

"My husband came over and gave me a big hug and he was crying. And it just – it felt really good. It felt like a victory that you so wanted but never really thought you were going to have to fight for," Dennard says. "I was reading it through tears, and there's all this lawyer jargon in it. And so we have Google up, and I'm Googling different terms and we're trying to really understand the whole thing."

Dennard also thought about her OB-GYN patients, and the possibility of speaking to them openly when they face complications. She says it felt validating for a person in power to listen to all of their stories and conclude the law needed to change.

'Emotional whiplash'

Even as she celebrated, she knew it likely wouldn't last long because attorneys for the state of Texas would appeal.

Less than 12 hours later, that's what happened. The appeal blocked the Mangrum's injunction, and all the abortion restrictions were suddenly back. "Texas pro-life laws are in full effect," the Texas attorney general's office said in a press release. "This judge's ruling is not."

That means the ban on abortions when a fetus has a condition "incompatible with life," as doctors often deliver the news to patients, is back in force in Texas.

"I went back to clinic and put on my white coat and just started seeing patients again with the same laws that are in place," Dennard says. "It's emotional whiplash."

A response to Texas AG Ken Paxton

The Texas attorney general's office has fiercely defended the state's abortion laws and fought the legal challenge. In a June court filing, attorneys for the state wrote that Dennard "fails to allege that her baby's diagnosis posed a threat to her life such that she could get an abortion under one of the exceptions in Texas's abortion statutes."

They also wrote that she cannot blame Texas for "her personal feelings and inability to abort her baby in Texas."

During the July hearing, Assistant Attorney General Amy Pletscher asked each witness if Attorney General Ken Paxton had personally denied them an abortion. Dennard, who was the last patient to testify, retorted, "You know, I never thought to ask him."

The Texas Attorney General's office did not respond to multiple requests by NPR for comment for this story.

Anti-abortion rights activists in the state oppose adding exceptions for fetal anomalies. Samantha Casiano is a plaintiff in the same case as Dennard and received the same fetal diagnosis of anencephaly. But Casiano couldn't leave Texas for an abortion, and her daughter, Halo, lived for only four hours.

In commenting on Casiano's story, Texas Alliance for Life spokesperson Amy O'Donnell told NPR, "I do believe the Texas laws are working as designed."

O'Donnell was also present at the hearing in Austin, telling NPR she was there "just to keep an eye on it and watch how it unfolds." She said she believes that the laws are clear as is. "Doctors can exercise reasonable medical judgment; they can provide the standard of care," she said.

Waiting for her 3rd child and the next ruling

Next in the case, attorneys for the state of Texas have to submit a filing to the Texas Supreme Court related to their appeal. Then attorneys for the plaintiffs will file a response, and the court will decide whether or not to hear the case. There's no set timeline for this to unfold.

In the meantime, the state legislature has actually moved to change what's banned in Texas. Lawmakers just passed a new law clarifying two conditions that do qualify for abortions: preterm premature rupture of membranes (when someone's water breaks too early for the fetus to survive), and ectopic pregnancy (when a fertilized egg implants outside of the uterine lining). The law goes into effect on September 1.

Dennard thinks the new law is helpful, but inadequate. "If this leads to physicians feeling more comfortable practicing standard medical care, then I'm all about it," she says. "It's just such a small, little portion of reasons why patients need [abortion] care in pregnancy. It doesn't in any way grapple with the scope of all medical complications that can arise."

Dr. Austin Dennard, center, stands between fellow plaintiffs, Dr. Damla Karsan, left, and Samantha Casiano, outside a courthouse in Austin where their case was heard on July 20.
AFP via Getty Images
Dr. Austin Dennard, center, stands between fellow plaintiffs, Dr. Damla Karsan, left, and Samantha Casiano, outside a courthouse in Austin where their case was heard on July 20.

The Texas ban on abortions for pregnancies with anencephaly diagnoses is back in effect, after all. Texas women who get that diagnosis today have to leave the state as Dennard did, or carry the doomed pregnancy to term as Casiano did. That means they face all the considerable risks of childbirth to a person's health and future fertility.

As Dennard awaits the birth of her third child, she's thinking a lot about what it means to participate in the lawsuit challenging the abortion bans.

"Standing alongside some incredibly brave women talking about abortion – which is such a taboo subject – and really putting it all out there in such a raw way, is difficult to say the least," she says.

It has also been energizing to be a part of the lawsuit, she says. She hopes it's helping to change how people think about abortion restrictions and how they affect people's lives.

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Selena Simmons-Duffin reports on health policy for NPR.