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The Summary

  • On the second anniversary of the Supreme Court’s Dobbs decision, women who sued the state of Texas over exceptions to its abortion ban say reproductive rights are a defining election issue for them.
  • The Texas Supreme Court last month ruled against the plaintiffs in the case, Zurawski vs. State of Texas.
  • Amanda Zurawski, the lead plaintiff, told NBC News that she plans to dedicate all of her time and energy to re-electing President Joe Biden.

On the second anniversary of the Supreme Court’s Dobbs decision, women who sued the state of Texas in a high-profile lawsuit over exceptions to its abortion ban say their experiences have made abortion a defining issue for them heading into the November election.   

The Texas Supreme Court last month, in Zurawski v. State of Texas, ruled against a group of women who had sued after they were denied abortions despite serious health complications during pregnancy. The group, represented by the Center for Reproductive Rights, grew to include a total of 20 women and two obstetrician-gynecologists who sought more specific guidelines about what situations qualify for medical emergency exceptions to Texas’ strict ban. 

The state Supreme Court rejected their challenge, however, saying that Texas law does not permit abortion even when a fetus has a severe abnormality, and that it is up to doctors to determine when terminating a pregnancy is warranted under the law.

Samantha Casiano, one of the plaintiffs, said the experience of being denied an abortion brought home the reality of how severe Texas’ restrictions are. 

“Now, everyone in my family has to vote,” she said. “If you’ve never voted before, you’re going to vote this year. I will drive you there. It’s just so important to me.”

Casiano was pregnant and living in East Texas with her husband and four children when she learned in December 2022 that her fetus had anencephaly, a fatal condition in which the brain and skull do not fully develop. She did not have the finances or child care to travel out of state for an abortion, so she carried the pregnancy to term and gave birth, only to watch her baby die within hours.

“Waking up every morning, knowing that your child is going to die and planning your child’s funeral before your child’s even here is insane, and it’s unfair. There’s just a lot of suffering there,” she said. 

Casiano said supporting abortion access is especially important to her because she has a 3-year-old daughter.  

“Later on, she’s going to be a mother. I have nieces that are going to be mothers, and I want them to have the health care that they need,” she said. “If, God forbid, they need it, it should be there for them.” 

From left, Damla Karsan, Austin Dennard, Samantha Casiano, Taylor Edwards, Molly Duane, and Amanda Zurawski stand in a line and listen
From left, plaintiffs Damla Karsan, Austin Dennard, Samantha Casiano, Taylor Edwards, Center for Reproductive Rights attorney Molly Duane and plaintiff Amanda Zurawski at the Travis County Courthouse in Austin, Texas, in July 2023.Suzanne Cordeiro / AFP – Getty Images file

One in 10 women say the right to abortion is the most important issue determining their vote, according to a survey published last week by KFF, a health care research and policy organization. 

Five states — Colorado, Florida, Maryland, New York and South Dakota — have abortion rights on the November ballot, and similar measures are pending in six more. Organizers in Montana on Friday submitted the required number of signatures to get a constitutional amendment on the ballot there that would enshrine abortion access.

Texas — where abortions are prohibited unless a patient has a life-threatening emergency and where doctors risk fines of at least $100,000, up to 99 years in prison and the loss of their medical licenses for performing abortions — does not have an abortion measure on the ballot. 

The state’s medical board on Friday issued updated guidance for doctors about its abortion ban but refused to provide a list of specific medical conditions that would qualify as an exception.

“Exceptions do not exist. They are a lie. They don’t exist in practice,” said Lauren Miller, another plaintiff in the Zurawski case.

“We just shouldn’t be in a situation where there is a defined point at which your bodily autonomy is forfeited to the state,” Miller added. “People’s lives are on the line.” 

Miller, who is from Dallas, was excited when she learned she was pregnant with twins in September 2022. But at 12 weeks’ gestation, she found out that one twin had trisomy 18, a life-threatening condition that also threatened the health of Miller and the other fetus. 

She ended up in the emergency room with severe vomiting and dehydration, which put her at risk of organ damage, but doctors would not perform an abortion to remove the affected twin. She traveled nearly 800 miles and spent thousands of dollars to get care in Colorado. In March 2023, she gave birth to her son, Henry. 

“We’ve seen so many elections now that are decided on very thin margins, and every vote matters,” Miller said.

Amanda Zurawski, the lead plaintiff in the lawsuit, vowed that “from now until November, I am dedicating all of my time, all of my energy into re-electing President Biden and Vice President Harris.”

Zurawski quit her job to become a campaign surrogate for Biden.

“Frankly, I’m terrified at what would happen if Trump makes his way back to the White House,” she said.

Zurawski was denied an abortion after her water broke at 18 weeks — far too early for a baby to survive. Zurawski wanted to leave the state to end the pregnancy, but doctors warned her that she was likely to get an infection and should not be more than 15 minutes from a hospital. 

After her condition deteriorated, doctors performed an emergency abortion. Zurawski then developed sepsis and spent three days in intensive care. 

The Texas Supreme Court noted in its Zurawski ruling that abortions can be allowed in cases where a patient’s water breaks before the point of fetal viability, since that often leads to infection. That’s cold comfort to Zurawski now.

“I have to use a surrogate now because of what happened to me. The damage to my reproductive organs is permanent,” Zurawski said.

Now, she added, protecting reproductive rights “is the most important thing in the world to me.”

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