A three-judge panel ruled on Thursday that Tennessee doctors who perform emergency abortions to save the mother’s life cannot have their medical licenses revoked or face any disciplinary actions while a case challenging the state’s broad abortion prohibition is ongoing.
The court also defined particular pregnancy-related illnesses that would now be considered “medical necessity exceptions” under the ban, which now excludes fetal deformities and victims of rape or incest.
“This lack of clarity is evidenced by the confusion and lack of consensus within the Tennessee medical community on the circumstances requiring necessary health- and life-saving abortion care,” the court’s decision said. “The evidence presented underscores how serious, difficult, and complex these issues are and raises significant questions about whether the medical necessity exception is sufficiently narrow to serve a compelling state interest.”
The judges ruled that the following medical conditions now qualify for the state’s abortion exemptions: premature rupture of the amniotic sac that surrounds the fetus; unavoidable abortions; fatal fetal diagnoses that result in severe preeclampsia or mirror syndrome associated with fetal hydrops; and fatal fetal diagnoses that lead to an infection that causes uterine rupture or potential loss of fertility.
Initially, the abortion law only explicitly stated that ectopic or molar pregnancies qualify as exemptions, as well as doctors who use their “reasonable medical judgment” to “prevent the death of the pregnant woman or to prevent the serious risk of substantial and irreversible impairment of a major bodily function.”
The decision is a victory for reproductive rights supporters who have contended that the Volunteer State’s abortion ban, which has been in effect since 2022, is overly broad and unfairly exposes doctors to a high legal risk of breaking the statute.
However, the justices stated that because they are a chancery court, they lack the authority to block the criminal legislation within the ban, which punishes violators with felony charges and jail sentences of up to 15 years.
This means that, while doctors will not face disciplinary action from the Attorney General’s Office or the Tennessee Board of Medical Examiners, they may still face criminal prosecution under Thursday’s decision.
Last year, a group of women and doctors filed a lawsuit requesting judges to define the circumstances under which patients can legally get abortions. Specifically, they asked the court to include a fatal diagnosis.
The Center for Reproductive Rights, which represents the women and doctors, argued that the GOP-dominated General Assembly wrote Tennessee’s abortion ban in such a broad and vague manner that doctors have no choice but to operate in fear that their decisions on whether to perform an abortion will be second-guessed, undermined, and potentially used to bring career-ending charges.
Rebecca Milner, one of the plaintiffs, discovered she was pregnant with her first child in February 2023 after years of fruitless reproductive treatments.
According to court records, Milner was informed at her 20-week appointment that the amniotic fluid surrounding her baby was low. A specialist then stated that her water had probably ruptured several weeks prior and that nothing could be done to preserve the baby.
However, her doctor informed her that Tennessee’s abortion restriction barred abortion services in her situation, so Milner was obliged to fly to Virginia for an abortion and returned to Tennessee with a high fever. Doctors informed her that she had an infection and that the delay in obtaining an abortion had allowed the condition to progress.
The state’s attorney replied that doctors did not want the government to question their medical decisions and moved to dismiss the case, claiming the plaintiffs lacked standing to suit. The judges mainly dismissed the motion but did agree to dismiss one of the women who filed the claim because she had surgery that prevented her from becoming pregnant again.
“The State’s position from the outset has been that Tennessee’s Human Life Protection Act allows pregnant women to receive all necessary care to address serious health risks,” stated Attorney General Jonathan Skrmetti. “The court’s limited restraining decision reflects this understanding. We all believe that doctors should save lives and safeguard their patients.
The legal challenge in Tennessee is one of a handful of lawsuits filed around the United States in Republican-majority states since the Supreme Court eliminated the constitutional right to abortion in 2022.
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