‘No Mercy’: Women Denied Abortions Testify, Cry, and Vomit in Texas Court

AUSTIN, Texas — As she sat on the witness stand, Samanthia Casiano told the packed courtroom about her joy at learning she was pregnant. Her family bought a bassinet to prepare; they all dreamed of having a girl.

But that joy instantly dissolved when Casiano  learned that her fetus had a lethal condition. Her baby would likely survive for a few hours at most.

When her lawyer asked her to talk about how it felt to have a “high-risk pregnancy,” Casiano, who had so far spoken calmly, flailed for words.

Then, on the witness stand, she threw up. It was all too much.

Casiano is one of 13 Texan women who were denied abortions and who have sued the state, arguing that they should have been allowed to have abortions under Texas’ overlapping bans, which permit people to get the procedure in medical emergencies. Some of these women, who live in communities across Texas, are mothers already, while others are desperate to have children. All have been devastated by their pregnancy losses.

Their case is believed to be the first lawsuit of its kind to be filed in the wake of the overturning of Roe v. Wade last year. Wednesday also marked the first time since Roe’s overturning that women denied abortions have testified in court against an abortion ban, according to the Center for Reproductive Rights, which is representing the women. 

The women are hoping for a ruling that would explain, exactly, when people in medical emergencies should be able to get abortions in Texas, but the case could also have implications that stretch far beyond the state’s borders. Texas is one of at least 14 states that have banned almost all abortions, but these states’ bans technically allow people to get abortions in medical emergencies. However, doctors across the country have repeatedly said that these exceptions are vague and contradictory, leading them to ignore their medical judgment and watch as patients get sick enough to qualify for abortions.

If the women in Texas succeed, others could follow their example.

“I’m looking for clarity,” Dr. Damla Karsan, a Texas OB-GYN, testified Wednesday. She told the courtroom that she felt deeply afraid of Texas’ bans, since doctors who break the law could lose their license, be fined $100,000, or spend up to 99 years behind bars. “I feel like my hands are tied.”

Amanda Zurawski, whose name is on the lawsuit, was the first to testify on Wednesday. Having met on the playground at four years old, Zurawski and her husband started trying to get pregnant in 2020. After several rounds of infertility treatments, Zurawski said she finally got pregnant. However, nearly 18 weeks into her pregnancy—and weeks before a fetus has reached viability and can survive outside the womb—Zurawski learned that her cervix had dilated prematurely. There was no way she would give birth to a healthy baby.

However, because doctors could still detect a fetal heartbeat, they couldn’t perform an abortion, Zurawski testified. During one visit to the hospital, staffers hooked her up to a fetal heart rate monitor.

“I had to listen to her heartbeat while simultaneously wanting to hear it and not wanting to hear it,” she said, as she broke into tears.

Zurawski could do nothing but wait, she said. Then, on the drive home from a visit to her doctor, her body started to feel unbearably icy. “It was freezing cold, even though it was 110 degrees out,” she recalled. When her husband asked her to rate her pain on a scale of 1 to 10, Zurawski couldn’t remember if 1 or 10 was the higher number.

Zurawski had developed sepsis. She ended up speaking a week in the hospital, including three days in the ICU. Her family, afraid that she would die, flew to her side.

Afterward, Zurawski and her husband wanted to start trying for a baby as soon as they could. But the experience, she learned, had left her reproductive organs scarred, she testified. One of her fallopian tubes is closed forever. Her uterus had to be surgically reconstructed using a balloon.

In court papers and in its cross-examinations, Texas has suggested that it is doctors, not the state, to blame for what happened to these women. On Wednesday, Assistant Attorney General Amy Pletscher asked each woman who testified whether Attorney General Ken Paxton or any other Texas official had directly told them that they could not get abortions. Each woman said no.

“Any future harm is purely hypothetical and therefore does not warrant injunctive relief,” Pletscher said. “Given the nature of plaintiffs’ past experiences, it is understandable that they are seeking to place blame, but the blame directed at defendants is misplaced. Rather, plaintiffs sustained their alleged injuries as a direct result of their own medical providers failing them.”

Pletscher also issued a running objection to all patients’ discussion of past medical issues and pregnancies—which was largely the entirety of their testimony.

Molly Duane, senior counsel for the Center for Reproductive Rights, dismissed that line of thinking.

“Does the state think that the only person who would have standing to challenge an abortion law is a woman who comes to court with amniotic fluid or blood dripping down her leg?” she asked District Judge Jessica Mangrum, who oversaw the hearing.

Ashley Brandt, the second woman to testify on Wednesday, is a stay-at-home mom. She and her husband had always wanted three children, so when she recently learned she was pregnant with twins, she was thrilled. She smiled in court as she recounted handing her husband a photo of her ultrasound and telling him, “Count ‘em.”

But 12 weeks into her ultrasound, Brandt learned that one of her fetuses was developing precursors to a condition similar to anencephaly, a condition where a fetus does not have parts of its skull and brain. Babies born with the condition typically survive only a matter of hours. 

Brandt fled to Colorado to undergo a procedure known as a “single twin reduction,” where doctors abort just one fetus in a pregnancy, Brandt testified. Without the procedure, Brandt said, she would have been forced to watch one of her fetuses deteriorate while imperiling the health of the other.

“I would have given birth to an identical version of my daughter without a skull and without a brain,” Brandt sobbed.

As the women on the stand each broke down and cried, multiple people in the packed courtroom teared up along with them. At various points during the testimony, onlookers gasped and whimpered, or even fled the room when the stories grew to be too much. When Mangrum announced breaks, people gathered their things and left the courtroom as if they were moving underwater—silently and slowly.

Many of the women in the audience were also plaintiffs in the lawsuit who have said that they, too, have suffered pregnancy losses. 

Brandt said that she no longer feels safe getting pregnant in Texas. After their ordeal, she said, her husband got a vasectomy. They gave up their dream of raising three children.

Casiano, who returned to the stand after she threw up, was the third and final patient to share her story on the stand on Wednesday. A 29-year-old mother of four, Casiano learned that her fetus also had anencephaly. She wanted to get an abortion and release her baby to heaven, as she put it in court. But she didn’t have the money or resources to travel out of state, so she and her family started to prepare, instead, to bury her baby—a girl who they named Halo, “because she’s always going to be above us,” Casiano said. 

They tried to raise money by selling soup, among other things.

After she gave birth, Casiano recalled, she had to watch her daughter struggle and gasp for air. As she testified, Casiano rocked back and forth as well as looked up and away, as if reliving the memory. She recalled watching her baby turn from pink to blue, from warm to cold, as she died over the course of four hours.

“I kept telling my baby, ‘I’m so sorry this had to happen to you,’” Casiano said. “There was no mercy for her and I couldn’t do anything.”

Afterwards, Casiano had a simple funeral service for Halo. When the funeral tried to charge her an extra $1,100 because the funeral was set for Good Friday, she cried. “I felt like there was always something,” Casiano testified. 

She still hasn’t picked up Halo’s death certificate. She’s also had her tubes removed and has started to throw up whenever something happens that triggers her body to “remember” what it’s gone through.

After the hearing, the women and their lawyers gathered outside in Austin’s 100-plus degree heat for a brief press conference. Lauren Miller, a plaintiff in the lawsuit who did not testify Wednesday but flew in anyway, told reporters that she came because she wanted to support her fellow plaintiffs. But she also wanted “to see the people who put my life at risk, who put my son’s life at risk.” 

The state, she said, totally dismissed their trauma.

“What the state of Texas said is that we are disposable and so I wanted to see the people who were saying that,” Miller said. “We should not be torturing babies and calling it pro-life.”