Women suing Texas over abortion bans give emotional testimony

Four plaintiffs began the first day of testimony Wednesday as part of a lawsuit filed against the state of Texas, saying the state's abortion bans put their lives in jeopardy.

The women are some of the 15 individuals party to the lawsuit who have alleged they were denied lifesaving emergency care due to Texas' abortion laws.

Lawyers representing the women are seeking a preliminary injunction on Texas' abortion laws that would allow for lifesaving abortions. They are asking the court to provide a "remedy applied to patients whose life, health or fertility is at risk from an emergent medical condition," Molly Duane, a senior staff attorney at the Center for Reproductive Rights and lead attorney on the case, said during opening statements Wednesday.

"Tens of thousands of Texans have already been denied abortions. By any measure, Texas is in a health care crisis. The only issue in this case, however, is who should be getting abortions, under the medical exception to the abortion ban and two years later, still, no one knows," Duane said. "In the words of the state's own expert, it is 'the blind leading the blind on the ground.'"

Prosecutors appearing on behalf of the state of Texas claimed the suit was due to dissatisfaction with medical care that the plaintiffs received and that they did not approve of Texas laws.

"Plaintiffs simply do not like Texas' restrictions on abortion," Cindy Fletcher, a representative for the state in the lawsuit, said.

Plaintiffs testifying at the hearings include Amanda Zurawski, who developed sepsis and nearly died after being refused an abortion when her water broke at 18 weeks; Ashley Brandt, who was forced to leave the state for abortion care after one of the twins she was carrying was diagnosed with a fatal condition; Samantha Casiano, who was forced to carry a nonviable pregnancy to term and give birth to a baby who died four hours later and Dr. Damla Karsan, a Houston-based OB-GYN representing her patients. A fifth plaintiff -- Dr. Austin Dennard, an OB-GYN who had to travel out of state to receive abortion care for a nonviable pregnancy -- will testify Thursday.

During a press conference after the hearing, Duane said this is the first time women denied abortions have testified against a state since Roe v. Wade in the 1970s.

Samantha Casiano

Casiano said she was forced to carry a nonviable pregnancy to term only to watch her baby die four hours after giving birth. Casiano's fetus was diagnosed with anencephaly, a birth defect where a baby is born without parts of the brain and skull.

She described the shock of receiving the news at an ultrasound appointment she had gone to alone.

"I felt cold. I was hurt. I wished that I was dreaming. I know I wasn't. I just felt lost," Casiano said, in tearful testimony.

After finding out her baby's diagnosis, Casiano met with her obstetrician who did not offer her abortion care.

"She told me that my daughter had been diagnosed with anencephaly -- I believe that means that her skull and her brain is not full developed -- and that she was sorry, I didn't have any options," Casiano said.

"She then called in a caseworker. The caseworker came in and they handed me a paper that said funeral homes on top of it," Casiano said through tears.

Casiano said her doctor prescribed her with antidepressants, but nothing else.

"I felt like I was abandoned. I felt like I didn't know how to deal with this situation," Casiano said. "This was just supposed to be a scan day. I was supposed to know what I'm going to have and it just escalated to me finding out that my daughter was gonna die inside or outside of my womb."

After leaving her appointment, Casiano said she looked into traveling to get abortion care elsewhere but the family was having car trouble and needed to care for her other children. She said she then "became scared" of getting into trouble for traveling for care or getting someone else into trouble if they helped her do so.

"I couldn't do it alone. I was scared and I have children and I thought, 'I can't go to jail. I can't get this fine. How would I pay for that? I could lose my job.' It felt like I had no options," Casiano said.

Casiano, crying throughout her testimony, got sick when she was asked what concerns she had for herself while continuing her pregnancy after receiving the diagnosis and the judge called a recess.

When the hearing resumed, Casiano testified that the drive to the hospital when she went into labor was difficult and she was worried she would give birth in the car.

"I felt like it was torture," Casiano said. "I was so scared because I didn't know what was going to happen."

At the hospital, she discovered her baby was in breach, coming out with her legs first. But, Casiano said she was not offered a cesearan section.

"My daughter came out of me and she was gasping for air. It's all I can remember," Casiano said.

"I had to watch my daughter go from being pink, to red to purple, from warm to cold. Her eyeballs being regular to things just popping in there, bleeding. I had to watch my baby suffer," Casiano said.

"I just kept telling myself and my baby that I'm so sorry that this had to happen to you. I was so sorry that I couldn't help her and release her, going to heaven sooner rather than later," Casiano said.

"I felt so bad. She had no mercy. There was no mercy there for her," Casiano said.

Because of Texas' ban and this pregnancy, Casiano said she decided to get her tubes removed.

"I was so worried [about getting pregnant] I decided the only way I can save my eggs from that harm and myself from that pain and going through that torture would be to get my tubes removed," Casiano said.

Casiano testified that she has struggled since that pregnancy and vomits when she remembers certain parts of her pregnancy, but she still decided to testify because this is now her reality.

"My health is everywhere. I now have a psychiatrist and I now vomit a lot more. I've never vomited before like that ever before my pregnancy," Casiano said.

At the press conference, Casiano said she heard about the original lawsuit filed in March and reach out to the Center, asking if she could join.

"I have a daughter and it makes me sick to my stomach to think that one day she might have to go through what I went through," she said.

Amanda Zurawski

In her testimony Wednesday, Zurawski said she went into sepsis after doctors said they could not induce labor because her fetus still had a heartbeat. Zurawski said she was told she had an incompetent cervix, premature dilation of her cervix, and would miscarry.

Her water broke later that evening but she did not miscarry until three days later, she said.

"I went from feeling physically OK to shaking uncontrollably. I was freezing cold even though it was 110 degrees out. My teeth were chattering violently. I couldn't get a sentence out. My husband Josh asked me how I was feeling on a scale from 1 to 10. I didn't know the difference between 1 and 10 -- which one was higher," Zurawski said.

"[I was] completely devastated. I'd just been given the worst news of my life, and I was terrified because I didn't know what was going to happen. Again, this was my first pregnancy. I didn't know what labor would be like, I didn't know if I would go into labor. I didn't know if I'd get sick. It was terrifying," Zurawski said.

She said she suffered two bouts of sepsis and one of her fallopian tubes has since been permanently closed. Zurawski also needed several procedures to remove scar tissue and reconstruct her uterus after it collapsed.

"I felt like I'd been hit by a truck. It felt like the worst flu I had ever had in my life. I was so sore. Every muscle in my body was so sore that I couldn't sit up without assistance. I couldn't roll over. I actually lost control of my bowels and soiled the bed multiple times, which was absolutely humiliating," Zurawski said.

Zurawski said she did not feel comfortable traveling to receive care elsewhere.

"We looked into it briefly but we quickly learned that I would either have to drive at least eight hours to get to a state where they could provide an abortion or we would have to fly and we didn't feel like that would be safe, especially since the physician had advised that we not be more than 15 to 20 minutes from a hospital," Zurawski said during her testimony.

Zurawski -- who has done three egg retrievals since going into sepsis -- said she still wants to have children and is having difficulty getting pregnant due to complications from developing sepsis.

"Doctors weren't allowed to give me an abortion until my life was on the line, despite he fact that there was absolutely no way my daughter would survive," Zurawski said at the press conference. "I joined this case to make change so that no other pregnant people and their families will have to go through what we went through."

Ashley Brandt

Ashley Brandt testified she was forced to leave the state for abortion care after one of the twins she was carrying was diagnosed with a fatal condition.

Brandt said that she traveled to Denver to receive a selective fetal reduction after one of her twins was diagnosed with a fatal condition called acrania -- its skull had not fused and it left the baby's brain and tissue exposed to the amniotic fluid.

The procedure aborts one of the two pregnancies to give the other fetus the best chance at survival.

Brandt said she was advised to stay in Colorado for two weeks after the procedure but that wasn't doable so the couple traveled home just one day later. After returning to Texas, she had some bleeding but was initially hesitant to head to a hospital because she received a procedure that was illegal in Texas.

"I didn't want anyone to get in trouble and I didn't want to get in trouble. So it seems silly now but that's what was holding me back from going. But we eventually did," Brandt said.

Brandt detailed what she would have had to go through if she had not received care in Colorado.

"If I had not gone out of state and had just done what was legal in Texas, my daughter Marley would most likely be in the NICU because she would have been born before 37 weeks. All my ultrasounds up to labor I would have had to watch twin A deteriorate more and more every week," Brandt said.

"I would have had to give birth to an identical version of my daughter without a skull and without a brain and hold her until she died. Then I would have had to submit a death certificate and plan a funeral and decide if I wanted to bury her or cremate her. It just would have been heartbreaking. But instead I got to just give birth to my healthy daughter," Brandt said in tears.

"Instead of crying from heartbreak that day, I was crying tears of joy and relief," Brandt said.

Brandt said her husband had a vasectomy after her daughter was born and that the couple does not plan to have more children out of fear. In her testimony, Brandt said that the couple had always wanted to have three children and were elated when they found out she was pregnant with twins, before receiving the fatal diagnosis for one of the twins.

"I don't feel safe to have children in Texas anymore. I know that it was very clear that my health didn't really matter, that my daughter's health didn't really matter, which was really heartbreaking," Brandt said.

Dr. Damla Karsan

Karsan, the OB-GYN, testified that she had seen several women who should have qualified for abortion care under the state's ban but were not able to receive care.

She described one case at Woman's Hospital of Texas, during which a patient came into the ER about 15 weeks pregnant and bleeding. According to Karsan, during tests, the fetus was diagnosed with anencephaly.

"Not only was she carrying a fetus with no chance of survival, she was at high risk for hemorrhaging," Karsan said.

She said before SB 8, one of the abortion bills, she would have offered an abortion but she was not able to do so because of the new ban.

Karsan said she took the patient from the ER to speak with a maternal-fetal medicine specialist about potentially performing an abortion.

"She advised me that because the patient was not actively hemorrhaging that she did not feel like we met the exception, that we could justify the abortion." he said.

Texas' abortion bans

The suit alleged that Texas' abortion bans have denied the plaintiffs and countless other pregnant people necessary and potentially lifesaving medical care because physicians in the state fear liability, according to the suit.

Texas has several abortion laws in place, prohibiting all abortions after six weeks of pregnancy, except in medical emergencies, which the laws do not define. One of the bans -- called SB 8 -- prohibits abortions after cardiac activity is detected, which kept several plaintiffs from accessing care despite their pregnancies being nonviable, according to the suit.

Under Texas' bans, it is a second-degree felony to perform or attempt an abortion, punishable by up to life in prison and a fine of up to $10,000. The law also allows private citizens to sue anyone who "aids or abets" an abortion.

The suit is the first to be filed by women impacted by the abortion bans since the U.S. Supreme Court overturned Roe v. Wade last year, ending federal protections for abortion rights.

The lawsuit is filed against the state of Texas, Attorney General Ken Paxton -- who was recently impeached -- and the Texas Medical Board.