SB31

Clarifying emergency exceptions, not repealing the abortion ban

SB31, the Life of the Mother Act, aligns several Texas abortion-law exceptions around a physician’s reasonable medical judgment and adds training for doctors and lawyers. It was signed and took effect June 20, 2025. It leaves the general abortion prohibition in place; it does not create a general right to an abortion for any pregnancy complication. official history; final law.

The core exception requires a licensed physician to determine, using reasonable medical judgment, that the pregnant patient has a life-threatening physical condition aggravated by, caused by or arising from pregnancy that creates a risk of death or a serious risk of substantial impairment of a major bodily function unless an abortion is performed. The act expressly says the risk need not be imminent, the patient need not first suffer physical impairment or damage, and “life-threatening” means capable of causing death or potentially fatal—not necessarily actively injuring the patient. final law, Section 170A.002.

“Reasonable medical judgment” remains an objective standard: the judgment of a reasonably prudent physician knowledgeable about the case and treatment possibilities. It is not merely a doctor’s subjective good-faith belief, but neither does it require every doctor to agree. The law still focuses on the patient’s qualifying physical condition; it does not add a general mental-health or fetal-diagnosis-alone exception. The retained restriction on acting solely on a claim or diagnosis that the patient will engage in self-harming conduct also remains. prior Section 170A.001; prior Section 170A.002; final law; State v. Zurawski, May 31, 2024, pages 20–28.

Treatment method, ectopic pregnancy and unintended harm

A physician treating the qualifying condition must use the method offering the best opportunity for fetal survival unless, in reasonable medical judgment, that method would create a greater risk of the patient’s death or substantial impairment of a major bodily function. The act does not require delaying, changing or withholding treatment if that would create the greater maternal risk. It expressly says this provision does not authorize an otherwise prohibited abortion. final law, Section 170A.0021.

Reasonable medical judgment expressly includes removal of an ectopic pregnancy or a dead fetus whose death resulted from spontaneous abortion. The ectopic-pregnancy definition now also includes implantation in an abnormal or scarred location inside the uterus causing the pregnancy to be nonviable, as well as implantation outside the uterus. The existing definition of abortion excludes acts intended to remove an ectopic pregnancy or a fetus already dead from spontaneous abortion. These are not newly prohibited procedures. final law, Sections 170A.0022 and 245.002(4-a); prior Section 245.002.

The act creates an express exception for accidental or unintentional fetal injury or death resulting from treatment based on a physician’s reasonable medical judgment, applicable across laws with the specified emergency exception. It repeals the older accidental-injury provision in Section 170A.002(d) while replacing it with this cross-law provision, rather than simply deleting protection for unintended outcomes. final law, Sections 170A.0023 and 17.

Aligning the surrounding laws

The act uses the same qualifying-condition definition for “medical emergency” in Chapter 171 and aligns the exception to the 20-week post-fertilization restrictions and specified method/timing requirements. It changes the drug-provision record to document pregnancy location to determine whether an ectopic pregnancy exists, while retaining the listed in-person examination, pregnancy verification, Rh-related duties and 49-day gestational limit. These changes are not a general permission for medication abortion outside an applicable exception. final law, Sections 5–7.

The private-enforcement subchapter applies only to abortions otherwise prohibited by law and not covered by a legal exception. Specified communications, services and products connected with determining or carrying out an applicable exception are not aiding or abetting: these include clinician-to-clinician and clinician-to-patient work, legal advice, and assistance/products relating to an abortion for which the treating physician has made the required medical judgment. The protection is tied to an exception, not every form of assistance for every abortion. final law, Section 171.2011.

The act aligns physician discipline and criminal-practice provisions with the same emergency exception and bars the Medical Board from the specified disciplinary action when the physician exercises the protected reasonable medical judgment. It also states an exception to the unlicensed-abortion-facility offense for the qualifying emergency, but excludes from that facility provision an individual/entity barred from receiving appropriated funds under the General Appropriations Act. This is not a general licensing exemption for all abortion facilities. final law, Sections 10–13.

Civil claims against physicians or providers alleging violations of Chapters 170, 170A or 171 and subject to a statutory exception are treated as health-care liability claims under the ordinary requirements for those claims. Other grounds for medical-liability claims are unaffected. The act repeals the earlier special affirmative defenses in Civil Practice and Remedies Code Section 74.552 and Penal Code Section 9.35, which addressed ectopic pregnancy and previable premature rupture of membranes, while adopting the exception framework described above. It should not be read as making all treatment for a named diagnosis automatically lawful or as abolishing ordinary malpractice liability. final law, Sections 2 and 17; prior Section 74.552; prior Section 9.35.

What the court references and older-law clause mean

The legislature directs construction consistent with In re State on non-imminent/non-irreversible threats and with Zurawski on the state’s enforcement burden. Those opinions say a qualifying patient does not need advance court permission and that, in an enforcement action under the Human Life Protection Act, the state must prove that no reasonable physician would have concluded the qualifying condition and risk existed. SB31 does not give judges authority to substitute a broader exception or turn any doctor’s unsupported belief into reasonable medical judgment. final law, Section 15; In re State, December 11, 2023, pages 4–6; State v. Zurawski, May 31, 2024, pages 20–28.

The act updates the emergency exception in the older pre-Roe civil statutes but expressly does not decide whether those statutes are valid, revived or currently enforceable, or moot litigation over them. It also instructs that amended civil-statute chapters be read consistently with the cited Texas decisions that a pregnant patient obtaining or attempting her own abortion is not guilty as a party, principal, perpetrator or accomplice to an offense prohibiting that conduct. The act includes severability, so invalidation of one provision/application does not automatically invalidate the rest. final law, Sections 14–16 and 20–21.

Required professional education

The State Bar had to offer a comprehensive program by January 1, 2026, developed with its Health Law Section, clinician organizations and other qualified stakeholders. It must be free to Texas-licensed attorneys, available online and promoted to attorneys, clinicians and health institutions. The act does not make this course mandatory for every lawyer. final law, Section 18.

The Medical Board had to make approved pregnancy-emergency-law courses available by January 1, 2026, with at least one free to Texas-licensed physicians and an online list. Physicians providing obstetric care face a one-time course of at least one hour before initial Texas licensure or before license renewal after January 1, 2026; a covered license cannot be issued or renewed without compliance. It counts toward continuing medical education. The instruction itself is not aiding or abetting, and the training provisions do not create a new lawsuit or standard of care. These are statutory requirements, not a claim that every provider has completed them. final law, Section 19.