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ACOG Responds to SB8

On September 1, 2021, Texas Senate Bill 8 (SB8) went into effect, banning virtually all abortions and medical counseling and support related to abortion after six weeks. In a joint statement, Maureen G. Phipps, MD, MPH, FACOG, ACOG chief executive officer and Eugene Toy, MD, FACOG, chair of ACOG District XI (Texas), stated, "By allowing third-party lawsuits against clinicians, by virtually banning all abortions, and by curtailing the sharing of information and support related to access to vital women’s health care, Texas’s new law creates a coercive environment for patients and clinicians across the spectrum of care and from all corners of the state."

ACOG is committed to advocating at all levels for our members' ability to provide quality patient care and medical counsel, free from interference or threat of punishment or retribution. This page provides information about ACOG’s response to the Texas ban, advocacy and clinical resources, and reproduces some, but not all, relevant provisions of SB8. We will continue to update this page as ACOG generates additional information and member resources.

Please note: This site is for informational purposes only and should not be construed as legal advice on any subject matter. You should not act or refrain from acting on the basis of any content included in this site without seeking legal or other professional advice.

Official SB8 Statements

  • ACOG and ACOG District XI joint statement on Texas SB8
  • ACOG joint statement on SB8 with the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Osteopathic Association, and the American Psychiatric Association

Evidence-Based Resources

ACOG routinely creates and updates evidence-based resources for members related to access to, provision of, and advocacy for reproductive health care. Several starting points include:

  • ACOG Spontaneous and Induced Abortion Resource Center: A member portal for questions about spontaneous or induced abortion, such as reimbursement issues, patient materials, and clinical questions. ACOG members can receive an expert response free of charge by submitting your questions online.
  • Information for Patients Seeking Abortion Care Resource Digest: A guide compiled by the ACOG Implementing Progress in Abortion Care and Training (IMPACT) Program to help clinicians identify resources available for patients subject to the limitations of applicable law.
  • Policy Priorities page: A clearinghouse for ACOG advocacy resources, policies, and clinical guidance related to abortion access.
  • ACOG State Government Affairs Department: To find ways to plug into advocacy efforts in your state, contact ACOG’s State Government Affairs team at stateleg@acog.org.

Make Your Voice Heard

  • Share your story: To help us highlight the voices of obstetrician-gynecologists across the country, we encourage you to share a personal perspective demonstrating the urgent need to protect access to care and cease political interference in the patient-physician relationship.  
  • Call on Congress to pass the Women's Health Protection Act, which would establish federal protections safeguarding clinicians and patients from state restrictions on medically appropriate care. Read more about WHPA.
  • Spread the word: Follow @ACOGAction on Twitter and @acog_org on Instagram for additional updates on ACOG’s advocacy and join the conversation on social media. Share this graphic on social media.
  • Keep up-to-speed on developments by reading ACOG Rounds: in your inbox every Friday. Not getting Rounds? Check your email preferences in the MyACOG section of the ACOG website.

Information for Texas Members

ACOG encourages Texas members to read the full text of the law. Some relevant provisions are reproduced below. ACOG provides this information for your reference. Please note that by reproducing this information, ACOG is not endorsing any of the terminology used by SB8, such as "unborn child."

Prohibitions

  • SB8 bans abortion—or the intent to provide an abortion—when a "fetal heartbeat" is detected, defined as "cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac."
  • In addition, the law bans "aiding or abetting"—or intent to do so—a prohibited abortion "regardless of whether the person knew or should have known that the [prohibited] abortion would be performed or induced."
  • Conduct qualifying as "aiding and abetting" is not defined in the law, but it does explicitly prohibit "paying for or reimbursing the costs of an abortion through insurance or otherwise."

Enforcement

  • SB8 empowers any private citizen to file a civil suit against someone they claim has violated the law, whether or not they have connections to the patient or even are in the state of Texas.
  • The award for a successful suit is a minimum of $10,000 (there is no maximum specified) plus attorneys’ fees and costs.
  • The civil action does not need to be brought in the jurisdiction of the state where the alleged violation took place.

Requirements for Determining Cardiac Activity

  • The ban requires that a "fetal heartbeat" must be determined via "standard medical practice," defined in the law as "the degree of skill, care, and diligence that an obstetrician of ordinary judgment, learning, and skill would employ in like circumstances."
  • It further elaborates that "standard medical practice" includes "employing the appropriate means of detecting the heartbeat based on the estimated gestational age of the unborn child and the condition of the woman and her pregnancy."
  • It directs the use of a test that is: "(1) consistent with the physician's good faith and reasonable understanding of standard medical practice; and (2) appropriate for the estimated gestational age of the unborn child and the condition of the pregnant woman and her pregnancy."

Exceptions

  • Medical emergency: An exception to the law exists only for a medical emergency. SB8 amends Chapter 171, Health and Safety Code, which defines medical emergency as "a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy that, as certified by a physician, places the woman in danger of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed."
  • If an abortion is "performed or induced" because of a medical emergency, the law states that physicians must "execute a written document that certifies the abortion is necessary due to a medical emergency and specifies the woman ’s medical condition requiring the abortion." And must maintain a copy "in the physician ’s practice records” and place it “in the pregnant woman’s medical record."
  • Ectopic pregnancy: SB8 uses the definition of abortion in Chapter 245, Health and Safety Code, which excludes the intent to "remove an ectopic pregnancy," defined as "the implantation of a fertilized egg or embryo outside of the uterus."
  • Spontaneous abortion: SB8 uses the definition of abortion in Chapter 245, Health and Safety Code, which excludes the intent to "remove a dead, unborn child whose death was caused by spontaneous abortion." ACOG’s Practice Bulletin 200, Early Pregnancy Loss, states that “[i]n the first trimester, the terms miscarriage, spontaneous abortion, and early pregnancy loss are used interchangeably, and there is no consensus on terminology in the literature;” however, SB8 and its underlying statutes do not define spontaneous abortion.
  • Fetal health: SB8 uses the definition of abortion in Chapter 245, Health and Safety Code, which excludes the intent to “save the life or preserve the health of an unborn child.”