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What just happened when Texas' abortion bans briefly lifted — and what comes next

MARY LOUISE KELLY, HOST:

Late Friday, for a few hours, Texas' abortion laws changed. Abortions became legal for patients with serious pregnancy complications. On Saturday, the bans came back in full force. NPR's Selena Simmons-Duffin has more on what happened with the state's abortion laws and what happens next.

SELENA SIMMONS-DUFFIN, BYLINE: This back-and-forth came as part of a lawsuit filed earlier this year by the Center for Reproductive Rights. Thirteen patients sued Texas, saying the medical exceptions were unclear. They all needed abortion care for pregnancy complications, but that care was denied or delayed. In July, four of them took the stand in Travis County in two days of intense, dramatic testimony, arguing that the bans should be put on hold while the case moves through the courts. On Friday evening, Jessica Mangrum, the judge who heard that testimony, filed a six-page decision in favor of the patients and put a hold on the abortion bans when it comes to emergent medical conditions and serious fetal anomalies.

LAUREN MILLER: Just so excited.

SIMMONS-DUFFIN: Lauren Miller of Dallas is one of the patients who sued. On Friday night, when she saw the decision come out, she was elated.

MILLER: I feel like for the last year, we have just been crying, screaming for somebody in the legislature, somebody in the judiciary to help us, and we really hadn't gotten that until now. And so it just - it felt like we were finally being heard.

SIMMONS-DUFFIN: Dr. Damla Karsan is also one of the plaintiffs. She is an OB-GYN.

DAMLA KARSAN: I was on call Friday night. I thought, OK, send me all the patients that need care quick (laughter).

SIMMONS-DUFFIN: She says that night with the injunction, she felt like she could be freer to treat patients facing complications without worrying about the possibility of life in prison or losing her medical license, the penalties for violating the state's abortion bans. In her decision, Judge Mangrum wrote that the medical exceptions in the current laws are unclear and that doctors need to be able to follow their good-faith judgment in treating patients with complications without waiting for them to get near death before intervening.

KARSAN: It was definitely validation, but I also knew that it was going to be very short-lived. I mean, we fully expected an appeal.

SIMMONS-DUFFIN: And that's what happened. On Saturday, the state of Texas used a special avenue to appeal the decision on the injunction directly to the Texas Supreme Court, putting the bans back in place. The Texas attorney general's office did not respond to NPR's request for comment for this story. Doctors are the target of the laws in Texas, and during the hearing last month, attorneys for the state asked every patient who testified if they were planning to file malpractice claims against their providers for the harrowing experiences they described.

KARSAN: They tried to say that anybody who didn't provide the "appropriate care," quote-unquote, that was malpractice. And then they took it a level further, I think, and implied, at least, that it was the hospital attorney's fault.

SIMMONS-DUFFIN: In reality, Dr. Karsan says, everybody in the medical field is scrambling and afraid. The penalties are so steep. She recalls a recent exchange with a pharmacist who refused to fill a prescription for one of her patients. It was for misoprostol, a medication that can be used for abortion but is also used for many other things, in this case, for a woman who was getting an IUD for birth control.

KARSAN: He had the nerve to get on the phone and say, if I administer this medicine to someone who's trying to get an abortion, it's a $10,000 fine. And I said, I am absolving you of your responsibility. I am telling you it's not for an abortion.

SIMMONS-DUFFIN: She says she realizes this kind of circumstance isn't going to go away overnight. The lawsuit is a long game, and she's glad she can be part of it and not feel helpless. So now the question of the injunction goes to the Texas Supreme Court. Elizabeth Sepper is a law professor at UT Austin. She explains all nine justices are Republican. She says they can be nimble, so they could make a decision quickly. But it's not clear what they'll do in this case.

ELIZABETH SEPPER: So you could imagine a very narrow ruling that says something like - right? - there's not a need for an injunction right now because the status quo is the abortion ban is in place. Let's have a trial.

SIMMONS-DUFFIN: If it is a narrow ruling like this, the trial is set for March 2024 in Austin.

SEPPER: But a lot of times - right? - when you're dealing with injunctions, courts are also analyzing the merits, right? So if the court says a lot about the merits of the case, you would certainly see, for example, a motion to dismiss or a motion for summary judgment.

SIMMONS-DUFFIN: That argument would go, this case shouldn't go to trial because you don't need a trial to know that Texas will ultimately prevail and keep the abortion laws as is. Sepper thinks going to trial is important to draw attention to what's happening to patients in Texas.

SEPPER: I think it matters to have their voices heard and reported on.

SIMMONS-DUFFIN: For now, the Texas abortion bans with their narrow medical exceptions and steep penalties remain in place. Selena Simmons-Duffin, NPR News.

(SOUNDBITE OF AUDIO TWO SONG, "TOP BILLIN") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Selena Simmons-Duffin reports on health policy for NPR.