The Texas Supreme Court on Monday overturned a lower court ruling that allowed an American woman to terminate her high-risk pregnancy, hours after her lawyers said she was “forced” to leave the state to get an abortion elsewhere.

About 21 weeks pregnant, 31-year-old Kate Cox recently received confirmation that the fetus she is carrying suffers from trisomy 18, a chromosomal abnormality linked to severe malformations. The fetus is at risk of dying in the womb, and even if it does succeed, there is an increased chance of stillbirth or death a few days later.

According to her doctor, this pregnancy also threatens Cox’s health and reproductive capacity. However due to Texas’s particularly strict abortion laws, she was not allowed to proceed with a voluntary termination of her pregnancy.

The young woman, a mother of two, went to court asking to be able to undergo an abortion in Texas. A judge granted her request last week, but state Attorney General Ken Paxton appealed the decision to the Texas Supreme Court.

Ultimately the Supreme Court, after suspending, then overturned the first instance decision, again asking doctors to make their own decision about whether an abortion should be performed.

“Our decision today does not prevent an emergency abortion in the particular case where a doctor determines that such an operation is necessary, according to the law,” the Supreme Court decision said.

“If Cox’s condition is or becomes such that it corresponds to the statutory exception, no court order is necessary,” the Supreme Court added.

The case is a prime example of the obstacles facing doctors and women after the US Supreme Court overturned in the summer of 2022 its 1973 ruling that guaranteed American women’s federal right to abortion. Since then, about 20 states have banned abortions or imposed highly restrictive laws, including Texas.

Shortly before the Texas Supreme Court’s decision was announced, Cox’s attorneys announced that their client had left the state to have an abortion.

“Due to the continued deterioration of Cox’s health (…), she was forced to seek medical care outside of Texas,” they pointed out in a court document.

“This week of legal uncertainty has been hell for Kate,” Nancy Northup of the Center for Reproductive Rights, the organization suing on her behalf, said in a statement.

“It’s crazy,” Ohio Democratic Rep. Greg Landsman commented on X. “People are going to die because of these extreme abortion bans,” he complained.

The Center for Reproductive Rights declined to say where Cox went to get the abortion. But, according to the organization, it had received offers of help “from Kansas to Colorado and even Canada.”

First time in 50 years

Texas prohibits voluntary termination of pregnancy, even in cases of rape or incest. The only exception is when there is a risk of death or serious disability for the mother. But advocates for women’s abortion rights complain that the exceptions have not been clearly spelled out, leading doctors to fear prosecution.

When the judge sided with Cox, Attorney General Ken Paxton, an ultraconservative Republican, sent a letter to three hospitals warning them that the decision does not protect the institutions, “nor any other person from being held civilly and criminally liable for violating Texas abortion law.”

In Texas, doctors risk up to 99 years in prison, a $100,000 fine and the revocation of their medical license if they agree to perform an abortion on a woman outside of the framework defined by the law.

After the summer of 2022 and the Supreme Court’s decision, many American women were forced to make difficult and expensive trips to get an abortion.

According to the Center for Reproductive Rights, it is the first time since 1973 that a pregnant woman has asked a court for permission to undergo an emergency abortion.

On Friday, an eight-week pregnant woman who wants to terminate her pregnancy filed a lawsuit against the abortion ban in the state where she lives, Kentucky.