State begins its defense of Texas’ new abortion law

Most common process in 2nd trimester illegal

AUSTIN — Attorneys defending a state law restricting the most common second-trimester abortion procedure accused a Dallas abortion provider of altering medical consent forms days before filing a lawsuit to block the law.

In the second day of the trial before U.S. District Judge Lee Yeakel, Andrew Stephens, an attorney for the state, pressed the medical director of Southwestern Women’s Surgery Center, a clinic in Dallas, to explain why the clinic had altered a form explaining the risks and benefits of an injection used to cause fetal demise.

Earlier this year the Republican-led Legislature passed Senate Bill 8, a set of comprehensive abortion regulations that banned dilation and evacuation — a medical procedure used to remove a fetus using surgical tools — unless the fetus is deceased. It is the most common method used to perform an abortion in the second trimester.

During a dilation and evacuation procedure, doctors use surgical instruments to remove fetal issue. Proponents of the law have called this method inhumane and refer to it as “dismemberment abortion.”

Whole Woman’s Health, Planned Parenthood and other abortion providers sued the state because they believe it will further limit access to abortions.

But the state argues there are several safe and straightforward methods that doctors can use to de-

mise the fetus prior to the abortion.

Administering an injection of digoxin, a drug used to treat heart disease in adults, is one method. Dr. Robin Wallace, the medical director at Southwestern Women’s, routinely uses the injection for patients seeking an abortion who are at least 20 weeks pregnant.

Form notes ‘toxicity’

In 2014, the form read that the abortion process after 20 weeks was made “easier and safer” by injecting the digoxin. In July, the same month the lawsuit was filed, that language was removed. The updated form also listed “toxicity” as a potential complication. The original form did not use that word.

Wallace denied the change was related to the lawsuit, and said the clinic was in the process of changing all the consent forms so that they were concise and easier to read.

“That’s just one of them that was changed at the time, and it was not at all prompted by this lawsuit,” she said.

The state contends this is a significant point because the injection’s safety and efficacy are a key issue in the lawsuit.

Not always effective

But Wallace only administers the injection to patients who are at least 20 weeks pregnant. SB8 requires a fetal demise for all abortions using dilation and evacuation.

Several doctors, including Wallace, testified that using digoxin in earlier stages of a pregnancy is uncommon, has not been thoroughly studied and is not always effective.

The abortion providers say causing fetal demise is not medically necessary, and adding the requirement will only further limit abortion access in the state.

Under SB8, doctors would face criminal charges for violating the ban, except in a case of a medical emergency. The law was set to go into effect Sept. 1, but Yeakel blocked its implementation with a temporary restraining order which remains in effect.

A ruling in the trial is expected by the end of the month.