Judge Blocks Texas Admitting Privileges Requirement, Upholds Some Medication Abortion Restrictions

October 29, 2013 — A federal judge on Monday blocked a provision in a Texas law (HB 2) that would have required abortion providers to have admitting privileges at nearby hospitals and partially upheld state restrictions on medication abortion, the New York Times reports. The surviving provisions of the law take effect Oct. 29 (Eckholm, New York Times, 10/28).

In September, Planned Parenthood of Greater Texas Surgical Health Services and 11 other advocacy groups filed a lawsuit challenging the provisions, which require that physicians who perform abortions have admitting privileges at a hospital within 30 miles and that physicians administer medication abortion drugs in person. Another provision in the law bans abortion after 20 weeks of pregnancy, but Jim George, a lawyer representing the plaintiffs, said they did not challenge that aspect in order to focus on the provisions that will have a more immediate effect (Women's Health Policy Report, 10/23).

U.S. District Judge Lee Yeakel issued a permanent injunction against the admitting privileges requirement and said the medication abortion requirements impose an undue burden on women in certain instances. The state immediately filed an appeal, according to the Washington Post (Eilperin, Washington Post, 10/28).

According to the AP/U-T San Diego, the appeal could be the first to directly addresses the question of whether admitting privileges requirements violate the Supreme Court's Roe v. Wade decision because similar cases in other states only involve temporary injunctions (Blaney/Tomlinson, AP/U-T San Diego, 10/28).

Ruling Details

In his opinion, Yeakel wrote that the admitting privileges requirement "does not bear a rational relationship to the legitimate right of the State in preserving and promoting fetal life or a woman's health and, in any event, places a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus and is thus an undue burden to her."

Under the medication abortion provision, women would have to take two doses of the drugs on two separate days in the presence of a physician (Washington Post, 10/28). According to physicians, the medical consensus is that the drugs are safe and effective through nine weeks of pregnancy when used in lower dosages than those stipulated in FDA's 2000 approval, but the Texas law requires doctors to uses higher dosages and to use the method no later than seven weeks of pregnancy, as outlined by FDA (New York Times, 10/28).

Yeakel ruled that while the Texas medication abortion requirements "do not generally place an undue burden on a woman seeking an abortion, they do if they ban a medication abortion where a physician determines, in appropriate medical judgment, such a procedure is necessary for the preservation of the life or health of the mother."

According to the Washington Post, Yeakel enjoined the provision in those instances, which means that Texas doctors are permitted to determine whether a patient should take the medication at home or in the doctor's office (Washington Post, 10/28).

Yeakel in his ruling acknowledged that "at the end of the day, these issues are going to be decided definitely not by this court, but by either the Circuit or the Supreme Court of the United States."


Texas Gov. Rick Perry (R) said, "We will continue fighting to implement the laws passed by the duly elected officials of our state, laws that reflect the will and values of Texans" (New York Times, 10/28).

Brigitte Amiri, a senior staff attorney at the American Civil Liberties Union, said the ruling gave "women in Texas ... a huge victory today." She added that the plaintiffs are still "assessing our decision about next steps after assessing what the court has said" regarding medication abortion (Washington Post, 10/28).

Texas abortion-rights supporters had argued that up to one-third of the state's abortion providers could close if the law took effect because they would not be able to meet the admitting privileges requirement. Whole Woman's Health CEO Amy Hagstrom Miller said the judge's "decision will keep thousands of women safe and allows our Whole Woman's Health clinics to continue to provide compassionate, professional care to women in our communities."

However, she expressed disappointment that Yeakel did not completely strike down the medication abortion rules, which she said "are not based on sound medical practice" (Aaronson, Texas Tribune, 10/28). Hagstrom Miller added, "Nearly 40 percent of the women we serve at Whole Woman's Health choose medication abortion and now Texas is preventing those women from the advances in medical practice that other women across the United States will be able to access" (AP/U-T San Diego, 10/28).

Center for Reproductive Rights President and CEO Nancy Northup in a statement said the ruling "averted a catastrophic health crisis for women across the state of Texas." She added, "Politicians, not doctors, pushed for both of these unconstitutional restrictions -- despite the best medical standards for women's health care" (Texas Tribune, 10/28).

Meanwhile, Texas Sen. Wendy Davis (D) -- whose filibuster against the legislation brought national attention to the issue -- said, "Texas families are stronger and healthier when women across the state have access to quality healthcare." Davis added that while she was "not surprised by the judge's ruling," she would "rather see our tax dollars spent on improving our kids' schools rather than defending this law" (Washington Post, 10/28).