“It’s so frustrating that we are no closer to giving doctors the clarity they need to help patients like me or Kate,” said Amanda Zurawski when the Texas Supreme Court denied Kate Cox an abortion. “People are left living in fear of prison or losing their livelihood.”
This story was originally published on American Journal News.
“I can’t carry a pregnancy again,” Amanda Zurawski said sadly, but matter of factly. The Austin, Texas, resident will never be able to carry a pregnancy again because she was refused a necessary abortion in her state after her water broke at 18 weeks, long before her baby would have been viable.
Tragically, the delay in receiving what used to be normal healthcare allowed a massive bacterial infection to develop and turn into life-threatening sepsis—which ravaged her body and reproductive organs.
But that’s what life is now like in the post-Roe world for pregnant women who run into serious pregnancy complications in Texas and 13 other Republican-led states. These states have all banned abortions with virtually no exceptions unless the mother is on the verge of death.
Zurawski can thank Texas’ three draconian abortion bans for her own brush with death—and a future in which she can never risk pregnancy again. Zurawski’s baby girl still had a heartbeat after her mom-to-be’s amniotic sac ruptured prematurely at 18 weeks—a condition called PPROM (premature rupture of the membranes)—so her doctor was not legally able to give her an abortion in Texas and was forced to send her home to wait.
What she awaited was the development and spread of an inevitable bacterial infection throughout her uterus and then her body. Amanda and her husband Josh had no choice but to sit nervously at home for three days while toxic bacteria grew, and then swiftly turned into a dangerous and damaging case of septic shock that ruined her reproductive organs. The sepsis also killed her fetus—and only then could an abortion be provided as a ‘medical emergency’ exception in Texas.
Before the procedure could be performed, Zurawski twice went into septic shock, a condition that has a frightening 60 percent mortality rate. She only survived thanks to the heroic efforts of her doctors.
Now, the 36 year-old, an account manager in the tech industry, is the lead plaintiff in Zurawski v. State of Texas. Along with 21 other co-plaintiffs, she anxiously awaits a decision from the Texas Supreme Court to decide whether it will ‘clarify’ the scope of the ‘medical emergency’ exceptions allowed under the state’s abortion bans.
Zurawski’s journey—from grieving mom of a baby she had desperately wanted, to a lawsuit against the state of Texas—began as she lay in her hospital bed recovering from the physically and emotionally traumatic experience. After doctors had spent a grueling three days battling to save her life in the ICU, she and Josh began talking about what they could do to change Texas’ abortion laws so that other women wouldn’t suffer the horror she had been through.
“We were like, we need to do something immediately,“ she told the American Journal News. But the couple had no idea at the time that she would end up taking legal action against the state, let alone elevating it all the way up to the Texas Supreme Court.
She and Josh did realize, as she fought to regain her strength after undergoing an abortion, a blood transfusion and massive doses of antibiotics, that “as insane as it sounds, my scenario is the best version of this story because I had all the resources to survive sepsis,” she said.
She was lucky to have a devoted husband at home, she said, ready to rush her to the emergency room as soon as her fever spiked and she became incoherent—which happened suddenly, three days after her water broke.
“But what about people who are at jobs, or who have other children and can’t find childcare, or don’t have a spouse that can get them to a hospital? They’re going to die,” she said. “That’s going to be the outcome for a lot of people if things don’t change.”
She decided that she had a responsibility to tell her story. “If we don’t speak out, it’s not going to get better … so I really do feel like this is not where I want to be in life, but this is what life has dealt me. I feel very passionately that this is my duty. This is why I’m on earth—to fight this fight for so many.”
First, Zurawski went public with her harrowing story, speaking to a media outlet, and as word spread about her nightmarish experience, she was approached by lawyers from the Center for Reproductive Rights (CRR) who wanted her to consider taking legal action. At first, she thought the idea of suing the state of Texas was “madness.” But about five minutes into the meeting, “my mind was changed,” she said. “It was like, yeah, we’re doing this.” She said CRR’s legal team “helped me see the importance of doing this.”
With full support from Josh, Amanda signed on to the lawsuit along with four other women who had been forced to give birth to infants that couldn’t survive outside the womb or who had to flee the state for abortions, as well as two plaintiffs who are obstetrician-gynecologists. The OB-GYNs joined in the legal action because the abortion ban “prevented them from meeting their ethical obligations as physicians and providing the medical care their patients needed,” according to the Zurawski v. Texas lawsuit overview, published by the Center For Reproductive Rights.
The suit was filed on March 6, 2023, and on May 22, eight more Texas women joined the groundbreaking case. As of November 2023, there are a total of 22 plaintiffs named in the lawsuit, including 20 women denied abortion care.
Zurawski admitted she was nervous despite a lot of preparation before finally testifying in court when a hearing was held in a Texas state courtroom on July 19 and 20.
“I knew the state’s defense team was probably not going to be very nice. What I wasn’t prepared for was how excruciatingly detailed the questioning was going to be,” she said. “They wanted me to recount very horrific pieces of my story. They wanted to know exactly when the baby’s heart stopped beating. It was just gruesome.”
My anatomy essentially has been permanently compromised. How is that pro-life for my future children and my future family?Amanda Zurawski
The inhumanity of the trial got even worse when, she said, the Texas state defense team relentlessly tried to make the point that Amanda had “no standing” to challenge the abortion law because she probably couldn’t be pregnant again.
In other words, she and some of the other plaintiffs were in a cruel catch-22: They couldn’t be pregnant in the future because the Texas abortion law had taken away their fertility—and now the state was saying that because they couldn’t give birth to a baby again, the law could no longer affect them, so they didn’t have the right to sue.
This was particularly brutal for Zurawski, who was distraught that sepsis had left such massive scarring on her reproductive organs that both of her fallopian tubes were completely blocked and her uterus had collapsed. She and Josh had wanted a family so much.
Her reproductive endocrinologist was able to surgically unblock one of her tubes and he rebuilt her uterus in surgery after surgery. But it’s still not safe for her to carry again because “my anatomy essentially has been permanently compromised,” she said.
“How is that pro-life for my future children and my future family? How is what happened to some of the plaintiffs who joined my case? And their children?
“How is it pro-life that they had to be carried to term, and then they suffered for hours after being born and then slowly suffocated to death?” she continued, referring to Samantha Casiano, a fellow plaintiff whose baby suffered from anencephaly, a condition in which a baby doesn’t develop part of its brain and skull, and died shortly after birth. Casiano was denied an abortion and was forced to give birth to a daughter, Halo, who was born gasping for air and died within hours.
Despite the difficulty of testifying, Zurawski said the experience was nevertheless “empowering,” because “there were so many of my fellow plaintiffs in that courtroom at the same time. We hadn’t been together before and just feeling our collective strength and determination to fight was amazing.”
Unfortunately, the joy of hearing the Texas district judge issue an injunction last August 4, blocking the Texas abortion bans as they apply to dangerous pregnancy complications, was extremely brief. The state immediately appealed the ruling under the direction of Republican Attorney General Ken Paxton, a persistent opponent of reproductive choice for women.
Amanda’s next hearing was before the state Supreme Court on November 28. By then seven more Texas women had joined the lawsuit, so the plaintiffs now numbered 22. Although Amanda didn’t need to testify again, the courtroom experience wasn’t any less infuriating. One of the state’s lawyers didn’t even appear familiar with the terrible medical issues each of 20 of the plaintiffs had experienced, when they were denied abortions.
“It was very indicative of how the state [of Texas] feels about us. They don’t give us any sort of credibility. It really shows how they feel about the lives of pregnant people in Texas,” she points out.
“They just don’t care.”
There were so many of my fellow plaintiffs in that courtroom at the same time. We hadn’t been together before and just feeling our collective strength and determination to fight was amazing.Amanda Zurawski
Zurawski said she was hopeful at first that Kate Cox, the Texas mom of two, pregnant with a baby suffering from a fatal condition which threatened her future fertility, would be considered a ‘medical emergency exception’ under the state’s restrictive laws. A federal district judge did rule that the 31 year-old was eligible for an abortion, but once again the state’s far-right attorney general intervened.
Paxton immediately obtained an emergency injunction against the ruling, threatened to charge hospitals and any doctor who gave her the abortion with a felony, and then appealed the case to the Texas Supreme Court.
Zurawski said she is disgusted with Paxton. “He’s essentially saying that he, who is not a medical doctor, knows more about medicine than actual medical doctors and he should be the one making these decisions.”
She laughed ironically when she’s asked if she feels like she’s living in a real life Handmaid’s Tale in Texas. “It feels like I’m trapped in some sort of dystopian novel.”
Physicians and hospitals don’t dare violate Texas’ strict abortion laws for some very clear reasons. Doctors face fines of up to $100,000, prison sentences of up to 99 years, and can also have their state medical licenses revoked. All of which explains why there have only been about 34 abortions performed in Texas—a state of almost 30 million people—since the bans were imposed. Before the three new abortion bans, there were more than 50,000 abortions a year in the state.
When the Texas Supreme Court denied Kate Cox an abortion, a disappointed Zurawski told the American Journal News, “It’s so frustrating that we are no closer to giving doctors the clarity they need to help patients like me or Kate. Without clarity, people are left living in fear of prison or losing their livelihood.”
Kate Cox quietly fled Texas to get her medically necessary abortion.
Since the Zurawski v. Texas lawsuit began, Amanda and Josh have lived through the sad anniversary of the loss of their beloved baby girl and her own emergency hospitalization.
Zurawski said the year has been difficult for her husband Josh in a way that was different from her. “On the anniversary, I was obviously mourning the loss of our baby. But something he shared with me was that it was really difficult for him since he was not only mourning the loss of our baby but he was reliving that day and what it did to me. He lost a child and he almost lost his wife.”
She continued, “Josh has already told some of our friends who are family planning, that as well as making a plan for when to try to have children, and a plan for where you are going to deliver and what’s going to be on your delivery playlist—now you also have to have a plan for what you’re going to do if things go south. How are you going to get out of the state if you need to? That’s the sad reality. It’s not something anybody wants to think about, but that’s the reality that our [Republican] lawmakers have put us in.”
Pregnant people deserve equal rights to other Texans.Marc Hearron, Center for Reproductive Rights
Texas currently has a Republican governor, two Republican U.S. senators, and Republicans control both the Senate and the House of Representatives in the state legislature.
With that in mind, Zurawski said she hopes that by acting as the leading plaintiff in this lawsuit against Texas, she can encourage people to come out and vote in upcoming elections for the “right people” who support the right to choose.
In the meantime, she awaits a decision from the Texas Supreme Court, which could clarify when the state’s doctors can legally provide abortions without repercussions.
Marc Hearron, the senior counsel for the Center for Reproductive Rights, who has represented both Amanda Zurawski and Kate Cox, said he is feeling “cautiously optimistic that the court will provide more clarity.”
While he acknowledges that the judges appear to view “medical exceptions’ very narrowly,” he said they didn’t comment in Cox’s case on the constitutional arguments that the Center has put forward.
Hearron said that the Texas Constitution provides pregnant people with ‘a right to life’: “A Texan cannot be deprived of life and liberty.” There is also an equal protection clause in the state constitution and therefore “pregnant people deserve equal rights to other Texans,” he insists.
If the Texas Supreme Court rules against Zurawski and her co-plaintiffs, there is no more legal action that can be taken on their behalf, Hearron said. In that case, he said, “The people of Texas have to put pressure on politicians and change who they elect. It’s in their hands.”
While waiting for the court’s decision, aside from using her voice, Zurawski has honored her daughter along with her husband Josh, by naming her and memorializing her in a very special way.
“When Josh and I were in the hospital, we talked about whether to name her and I said it would be really nice to name her after a plant or flower or tree that we could plant in the yard of the new house we had just bought,” she said.
The couple decided on the name “Willow” since the desert willow is native to Texas, weeping willows are native to Indiana, the couple’s home state, and the meaning of the name is “strength.”
“We also felt that it was very fitting for us because you can take the roots of one willow and use those to plant new willows. So we like to think we’re going to take her roots to plant our future babies.”
Zurawski revealed that because she can no longer support a pregnancy in her own uterus, she and Josh have done a number of rounds of IVF and were thankfully able to create some embryos.
“We are hopeful that we will still have children, but will have to have somebody help us out with that,” she confided. “We’re hopeful we will have something exciting in 2024.”
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