ProPublica slams Texas Medical Board's attempts to clarify pro-life law

ProPublica's latest article in its "Life of the Mother" series criticizes the Texas Medical Board for issuing new guidance on medical exceptions to the state's pro-life laws... and along the way, the outlet repeats a number of falsehoods already debunked.

Key Takeaways:

• The Texas Medical Board has begun to issue guidance to doctors regarding scenarios in which abortion may be considered 'medically necessary' and therefore allowable under state law; currently, state law disallows the intentional killing of nearly all preborn children in the state.

• In its "Life of the Mother" series, ProPublica has blamed pro-life laws in Texas and other states for the deaths of numerous women, despite evidence indicating otherwise.

• ProPublica's latest entry continues to present multiple falsehoods about pro-life laws and the supposed "medical necessity" of abortion.

The Details:

As ProPublica reported, Texas passed its "Life of the Mother Act" into law last year. The legislation was introduced specifically due to deceptively presented narratives from pro-abortion media, including from outlets like ProPublica.

The Change

The previous wording in the Texas Health and Safety Code § 34.001 defined a “life-threatening condition” as one “from which the likelihood of death is probable unless the course of the condition is interrupted.”

The amended wording now permits induced abortion for any condition considered to be “capable of causing death or potentially fatal” and “is not necessarily one actively injuring the patient.”

The Consequence

The pro-life movement criticized the legislation — not because pro-life advocates do not want to save women's lives, but because the vague wording is extremely problematic.

Abortionists have been known to claim that pregnancy itself is a life-threatening condition or medical problem, even when the mother is healthy and has no complications. Planned Parenthood abortionists likewise have claimed that all abortions may be considered “medically necessary.”

The Training

The Texas Medical Board was required to create guidance for doctors by January 1, 2026, which it has done. ProPublica obtained the educational training information, which offers nine example scenarios.

The training also lists scenarios which are not considered abortions under Texas law, such as:

• ectopic pregnancy

• removal of the body of a preborn child who has already died

• early delivery needed to save the mother's life

• birth control

• procedures — both surgical and otherwise, like chemotherapy — that may unintentionally lead to the preborn child's death

This is similar to what the pro-life movement has been pointing out for years: induced abortion is the intentional and targeted killing of a preborn child, and it is not the medical standard of care for pregnancy-related emergencies.

The guidelines likewise reiterates that women cannot be prosecuted for having abortions — not even chemical abortions at home.

The nine example scenarios in the training regarding when an induced abortion would be allowed included the scenario of preterm premature rupture of membranes (PPROM). And yet, while PPROM may necessitate preterm delivery, there would be no need to directly, intentionally kill the child.

Zoom In:

ProPublica, however, was not satisfied with the educational training, complaining that it does not give examples for every possible pregnancy complication.

"[M]edical and legal experts who reviewed the training for ProPublica said the case studies represent only the most straightforward situations doctors encounter," the outlet wrote. "The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training 'the bare minimum.'"

And yet, as has been made clear, doctors may use their "reasonable medical judgment" in situations outside the most common or straightforward.

ProPublica continued by pointing out that some patients have chronic conditions, which it admitted is a "gray area" (which would likely be why OBGYNs should and do refer patients to specialists such as high-risk OBs/perinatologists), and then made it clear that its actual goal is the eradication of of Texas' pro-life laws (emphasis added):

And no amount of training can solve what many doctors see as the main problem: the law’s steep criminal penalties. If found guilty of performing an illegal abortion, doctors face up to 99 years in prison, $100,000 in fines and the loss of their medical license.

Even the possibility of a lengthy and public court battle can be a powerful deterrent, many physicians told ProPublica. 

This objection rings fairly hollow; after all, OBGYNs are no strangers to malpractice claims, which can also lead to lengthy and public court battles, and may lead to loss of a medical license. A MedScape Ob/Gyn Malpractice Report for 2021 pointed out just how common malpractice claims against OBGYNs are, even if on the decline (emphases added):

Nearly 80% of obstetrician-gynecologists report having been named in at least one malpractice claim, but the total number who report such suits has fallen steadily since 2017...

Ob/gyns were the fifth most likely among practitioners in 29 specialties to be sued, and they are much more likely than the typical physician to be party to a malpractice case (51%), according to the new report... In most cases, multiple parties were named in the lawsuit (64%), although 27% of ob/gyns reported having been sued individually.

The most common reasons for lawsuits were complications from treatment/surgery (39%), poor outcome/disease progression (30%), failure to diagnose/delayed diagnosis (25%), patients suffering an abnormal injury (17%), and failure to treat/delayed treatment (16%)....

Ob/gyns carry higher malpractice insurance costs than nearly every other medical specialty....

Yet ProPublica claims that Texas' pro-life law causes women's deaths, because doctors will refuse to act, even when it is legal and necessary to do so, out of fear of prosecution. (But wouldn't this risk a malpractice claim?)

ProPublica then stated:

The Texas Medical Board writes in its training that “the legal risk of prosecution is extremely low” if doctors practice “evidence-based medicine,” follow “standard emergency protocols” and document cases appropriately.

The training also emphasizes multiple times that the burden now falls on the state to prove that “no reasonable doctor” would have performed the abortion.

Before the Life of the Mother Act, prosecutors could accuse a physician of performing an illegal abortion with little evidence.

However, it should be noted that in the TMB's training, the phrase "no reasonable doctor" cites as its source Texas' Health and Safety Code Chapter 170A.002(b), which does not actually use this phrase.

Instead, the code states that "the person performing, inducing, or attempting the abortion [must be] a licensed physician" who is exercising "reasonable medical judgment."

It is unclear how the TMB training arrived at the conclusion regarding "burden of proof" based on its cited footnote, which links to the same H&S code linked above.

The H&S code also states:

"Reasonable medical judgment" means a medical judgment made by a reasonably prudent physician, knowledgeable about a case and the treatment possibilities for the medical conditions involved.

Regardless of the medical board's attempt to add legal clarifications, the insinuation from ProPublica is that if Texas truly cared about women's lives, it would simply legalize the indiscriminate killing of babies prior to birth.

The Big Picture:

Induced abortion (the intentional and direct killing of preborn children) does not need to be legal to keep women safe, and that can be seen simply by examining the claims made repeatedly by ProPublica — many of which have been debunked already.

Sepsis

In its latest article, as well as in others written previously, ProPublica argued that pro-life laws have led to skyrocketing cases of sepsis in pregnant women (emphasis added):

Sepsis rates spiked for women suffering a pregnancy loss...

The standard of care for miscarrying patients in the second trimester, for example, is to offer to empty the uterus, which can lower the risk of infection and sepsis, according to leading medical organizations.

While some Texas doctors told ProPublica last year they regularly offer to empty the uterus in these cases, others said their hospitals didn’t allow them to do so until the fetal heartbeat stopped or they could document a life-threatening complication, leading to delays in care like the one that [Josseli] Barnica experienced.

Across the state, cases of sepsis in second-trimester pregnancy losses shot up more than 50% after the ban took effect, according to a data analysis by ProPublica.

This is a claim ProPublica has made before, and it continues to be misleading. For example, what ProPublica did not point out is that sepsis has been steadily increasing among pregnant women for decades; according to the Sepsis Alliance:

The number of cases of maternal sepsis is increasing. One study of the National Inpatient Sample, a national database, reported a 10% annual increase in cases of maternal severe sepsis and sepsis-related deaths in the U.S. between 1998 and 2008.

ProPublica also failed to be transparent with its data, meaning it could not be further analyzed by other journalists. Furthermore, according to Charlotte Lozier scholar Dr. Michael New, sepsis during pregnancy is exceedingly rare, including in Texas.

“Taking their data at face value, since the TX Heartbeat Act took effect, the average annual increase in sepsis cases [involving pregnancy loss] was 28. Sepsis is a serious issue. But there has not been an enormous surge in sepsis cases involving pregnancy loss," he said, adding, “[T]here are nearly 400,000 babies born in Texas every year. As such, about 1 in every 14,000 pregnancies involve sepsis.”

ProPublica has consistently failed to compare states with pro-life laws to those with pro-abortion laws. Sepsis during pregnancy has been increasing nationwide, even in pro-abortion states. California, for example, has seen similar preventable deaths from sepsis during pregnancy, despite having some of the most liberal abortion laws in the country.

According to the California Maternal Quality Care Collaborative, “Obstetric sepsis is now the second-leading cause of maternal mortality” in the state and “the primary cause of severe maternal morbidity during both the antepartum and postpartum periods, and the third-leading cause at delivery.” The California Pregnancy Associated Mortality Review Committee likewise found that 63% of maternal deaths from sepsis in California could have been prevented.

Finally, ProPublica fails to acknowledge the increase at-home abortions using the abortion pill, which has a black box warning for sepsis.

Hundreds of doctors blame Texas' pro-life laws?

ProPublica pointed to a letter signed in late 2024 by 111 Texas OB/GYNs in which they blamed the state's pro-life laws for the deaths of some pregnant women. This letter, however, deserved serious scrutiny.

First, there is the question of who these doctors actually are. Many of the signers were clearly biased; multiple abortionists signed the letter, as did OB/GYNs who have sued Texas seeking to have pro-life laws overturned.

Dr. Ingrid Skop, a Texas OB/GYN who is also the VP of Medical Affairs for the Charlotte Lozier Institute, pointed out at that time that OB/GYNs have navigated laws restricting abortion for decades, due to the Hyde Amendment.

"[T]he federal Hyde Amendment, for example, prohibits payment of elective abortion, and yet it has always allowed payment and doctors to perform an abortion if it is needed to save the life of the mother. So doctors know what it means," she said in 2024, adding that “there is no imminency requirement in [Texas] law,” which means “a doctor does not need to wait until a woman is dying until he can intervene.” This was prior to the passage of the Life of the Mother Act.

While Skop acknowledged that there may have been some confusion surrounding the new law when it was first passed, there had been over 100 abortions committed due to supposed medical necessity since 2022, without prosecution.

“Most doctors do understand," she said. "So I think we need to look at the doctors who wrote this letter and recognize that there is some other agenda there. The law is not confusing.”

Tierra Walker, Josseli Barnica, and Kate Cox

ProPublica includes three different cases in an attempt to blame pro-life laws for putting women's lives at risk. The first woman, Josseli Barnica, died after doctors refused to take action when she was experiencing a second-trimester miscarriage; Tierra Walker had pre-existing conditions during her pregnancy and died after they got worse, and Kate Cox claimed to need a "medically necessary" abortion because her preborn child had a disability.

But let's review what actually happened.

Josseli Barnica

Barnica began bleeding at 17 weeks and four days, and doctors failed to follow the standard of care. She was originally sent home, but when she returned to the hospital, still bleeding, her cervix was almost fully dilated and an ultrasound found “bulging membranes in the vagina with the fetal head in the open cervix.”

Yet her doctors claimed they could not do anything until the baby's heart was no longer beating, and ProPublica has used this as an excuse to blame pro-life laws in this case.

In reality, the standard of care for Barnica likely wouldn't have been to induce an abortion but to assist Barnica in completing the imminent delivery of her child.

Houston OB/GYN Dr. Shirley Lima eventually did this, administering drugs to further induce labor for delivery. But she did so far too late — an astonishing 40 hours after Barnica was admitted. A different OB/GYN, Dr. Joel Ross, then discharged Barnica a mere eight hours after delivery, and Barnica died days later.

Her cause of death was sepsis due to retained fetal material.

Essentially, Barnica's doctors did not complete the delivery, and placental and pregnancy tissue remained in her uterus, which became infected. Barnica appeared to be a victim of medical neglect and malpractice; she did not need doctors to directly and intentionally kill her baby by induced abortion.

Tierra Walker

ProPublica claimed Walker died because she was not given an abortion, suggesting she needed one due to pre-existing and chronic medical conditions prior to pregnancy. Walker already had diabetes and hypertension, and had experienced pre-eclampsia in a previous pregnancy, which resulted in the loss of twins.

This time, Walker began experiencing seizures and blood clots while pregnant, and thought abortion was needed. Over 90 doctors were involved in treating Walker throughout her pregnancy, and none of them agreed that she needed an abortion — but that doesn't mean Walker's concerns were taken seriously.

By the time Walker was into her second trimester, she had been diagnosed with pre-eclampsia again. The standard of care, according to the Cleveland Clinic, is not induced abortion; it is for the mother to remain in the hospital until she can safely deliver her baby. If her health becomes too compromised, the baby should be delivered early, even if the baby cannot survive... which, again, is not an abortion.

As Live Action News previously noted:

Walker continued to suffer health concerns, and at 12 weeks pregnant, a blood clot in her leg became so severe that she needed a thrombectomy to remove it. 

At 20 weeks pregnant, she reportedly went to University Hospital's emergency room with rising blood pressure and was officially diagnosed with pre-eclampsia. She was admitted to the hospital, where she was to be monitored.

However, Walker's doctors did not induce delivery or even keep her in the hospital for monitoring. She was given medication and sent home, where she died.

Like Barnica, Walker did not die because she was denied an abortion. She died because she did not receive proper medical care.

Kate Cox

The only example on ProPublica's list who did not die, Kate Cox garnered national headlines for claiming she had to flee Texas to undergo a medically necessary abortion. Yet it was not Cox whose health was at issue.

Cox's preborn baby had been diagnosed with Trisomy 18, and because Cox had undergone two previous c-sections, she claimed she needed an abortion so she could have other children in the future... children without disabilities. As Live Action News previously explained:

Notably, Trisomy 18 is labeled “incompatible with life,” but it actually is that label itself which may lead to the short life spans of children diagnosed with it. Because of that diagnosis, doctors are often unwilling to provide the medical care that children with Trisomy 18 need, therefore leading to an early death, and perpetuating the “incompatible with life” cycle.

Numerous people with Trisomy 18 are proving that they can survive… if they are given the chance to do so.

Doctors at Children’s Hospital and Medical Center in Omaha, Nebraska, are proving that. ... According to Dr. [James] Hammel, 70 to 80% of babies with Trisomy 18 survive heart surgery, and 50% will still be alive 16 years later. Other research has found even higher success rates.

Notably, the American Academy of Pediatrics now states that Trisomy 18 is no longer considered "incompatible with life."

Cox's daughter, Chloe, wasn't necessarily doomed to die. And Cox's own life was not at risk.

According to the Mayo Clinic, there is no definitive research as to how many c-sections are dangerous. “There are some people who have had six or seven C-sections without any issues, and others with only one C-section whose next pregnancy is associated with a very difficult problem such as placenta accreta spectrum disorder, or a horrible adhesions (things stuck together),” Dr. Robert O. Atlas, chairperson of the department of obstetrics and gynecology at Mercy Medical Center told Healthline.

Essentially, there was nothing to guarantee that Cox could not have had more children in the future. The fact remains that Cox was only willing to carry to term a child without a disability, and she got her chance. Months after obtaining a D&E (dismemberment) for Chloe (which also comes with a risk of uterine rupture), and joyfully announced that she was expecting a new baby (who did not have a disability).

The Bottom Line:

ProPublica has again made it clear that there is nothing, short of legalizing abortion, that will satisfy the biased outlet. It continues to use misinformation, emotional manipulation, and deceives the public in the process.