More than a year after the Texas Legislature passed a law aimed at clarifying when doctors can legally perform abortions in emergencies, professionals who advocated for the legislation are now working to ensure women and physicians know their rights.
Abortion is banned in Texas, with a narrow exception for when a woman's life or a major bodily function is at risk. But, leading up to the 2025 legislative session, many doctors and reproductive rights advocates said the law was unclear about what defined a medical emergency. Doctors could face up to $100,000 fines, the loss of their medical license and extensive prison time for violating the ban.
That's why many physicians urged legislators to pass Senate Bill 31, also known as the Life of the Mother Act.
"I know this bill will help save women's lives," Dr. Deborah Fuller, a Dallas-based OB-GYN, said during a hearing for SB 31's House companion bill last year.
After extensive debate and some key amendments, the law passed with bipartisan support. It clarified that a pregnant person's death or impairment does not have to be "imminent" before a doctor can step in, and that doctors can discuss abortion with colleagues and patients while considering the best treatment option. While SB 31 did not remove the potential penalties for doctors who break the law, it confirmed that the burden of proof is on the state, which must demonstrate that "no reasonable doctor" would have provided an abortion in the same situation.
Now that the Life of the Mother Act is law, Fuller said she believes it is working and has eased many doctors' anxieties when making critical medical decisions. But she said work still needs to be done to educate both physicians and pregnant women throughout the state about their rights under the law.
"Most of [my patients] have not heard of it," Fuller said.
Spreading the word
Fuller is now on the advisory committee for "Asking for a Mom," a campaign to ensure that pregnant women and their loved ones are informed about Texas' abortion laws, including the Life of the Mother Act. It's a project of the Texas Campaign for Mothers, a nonprofit that lobbied for SB 31. The group defines itself as nonpartisan and encourages Texans across party lines to join but has several influential Republicans on its advisory board.
In addition to a website, "Asking for a Mom" puts information on brightly colored fliers for physicians to post or hand out inside their clinics. They include facts about when women can and can't receive an abortion — and what to do if they face barriers, like pushing to hear a doctor's reasoning or asking to transfer to another facility.
"You deserve timely, appropriate medical care," the flyers read.
Fuller said she hopes these resources will arm women with knowledge to navigate conversations with both their own OB-GYNs and emergency room doctors.
"Very few of us in the state of Texas access legislation and know exactly what was written in laws," Fuller said. "In an obstetrical emergency, it would be very unusual for someone to access a law to find out, 'Oh, what is and what isn't happening? What is and isn't covered? Where am I in this legislation?"
Getting doctors up to speed
Patients are only one half of the equation; the other is doctors.
Senate Bill 31 requires Texas OB-GYNs, ER doctors and family medicine physicians to receive online education on the law in order to renew their medical licenses. The Texas Medical Board's course includes a little over 40 slides of material and discusses what to do in a few specific scenarios. For instance, it describes a pregnant woman with cancer who needs chemotherapy treatment and confirms that a termination would be allowed.
But because doctors only renew their licenses every two years, some have not yet taken the TMB's training course. "Asking for a Mom" is attempting to bridge that gap by hosting in-person trainings at medical schools and in other clinical settings.
Assisting in the effort is Central Texas OB-GYN Dr. Charles Brown, who said he sees value in providing an in-person forum, even for physicians who have already completed the training online.
"I really felt like we needed to clear the air to try and get back on track to let the physicians do what they know how to do," Brown said.
Brown estimates he has visited at least a dozen medical residency programs to provide in-person training. The questions he gets from participants, he said, tend to be legal rather than medical.
"All the OB-GYN doctors know what to do," he said. "They need to have the confidence they can legally do it."
Lingering uncertainty
Brown acknowledges, however, that he sometimes receives specific legal questions he can't answer.
"I'm not a legal scholar," he said. "If it's a detailed question about the legal interpretation or some sort of legal obligation of the hospital corporation or someone else, I just defer that to their legal advice."
TMB's training emphasizes that doctors are able to lean on their judgment in emergencies. Reasonable medical judgment, according to the slides, is defined as "judgment made by a reasonably prudent physician who is knowledgeable about a case and the treatment possibilities for the medical condition involved." It does not mean all physicians would agree with the decision, and it does not require "medical certainty."
"Bottom line: if you are practicing evidence-based medicine, following standard emergency protocols, and documenting appropriately, the legal risk of prosecution is extremely low," one slide reads.
Some OB-GYNs in Texas still say the emergency exception to the state's abortion ban is too vague, even after Senate Bill 31's passage. Dr. Damla Karsan, a Houston-based physician who has challenged Texas' abortion law in multiple high-profile lawsuits, said SB 31 "didn't go near far enough," noting that it explicitly excluded lethal fetal anomalies. She also said she feels confusion persists for many doctors.
"I think there's still so much fear," she said. "If providers aren't 100% certain, they're going to delay."
Are delays in care still happening?
Delaying care can cost lives. A recent investigation from ProPublica found that deaths from ectopic pregnancies doubled between 2020 and 2025, with the worst rates in states with strict abortion bans — such as Texas. Ectopic pregnancies occur when an embryo implants outside the uterus; they are not viable, and can result in lethal complications if not terminated promptly. In Texas, it is legal to terminate an ectopic pregnancy, as is specifically carved out in SB 31.
In one documented instance, a federal investigation found a hospital in Williamson County failed to promptly treat a woman's ectopic pregnancy in 2023, instead waiting until it ruptured and her fallopian tube had to be removed. More recently, The Texas Tribune reported that an Austin-area woman lodged federal complaints against multiple local hospitals for risking her health by delaying treatment for a miscarriage. She said the incident occurred in October 2025, after the Life of the Mother Act had become law; TMB specifies that removing the products of a miscarriage is legal in its training.
It may be some time before data is available that can shed light on whether Senate Bill 31 and the training tied to it are ultimately having the effect of saving lives at scale.
Texas' Maternal Mortality and Morbidity Review Committee releases reports on deaths associated with pregnancy and childbirth on a delayed schedule; it is now set to release data from 2024 in December after a highly-criticized decision to skip data from 2022 and 2023, the years immediately after Texas instituted its ban. Initial data published by Texas Health and Human Services shows 68 abortions were performed under the exception during the first six months of 2026, compared to 62 during the same period in 2025.
Dr. Charles Brown said "time will tell" if the law is effective.
"But I'm trying to make it as effective as it can be," he added.
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