Is D and C still permissible in Texas after the 2026 abortion law changes? Yes— the procedure can be performed when it meets the narrow medical‑exception criteria embedded in the 2026 statutes, but any use that a physician or patient could interpret as an elective termination will be prosecuted as a felony under the new “abortion‑ban‑plus” framework.
The 2026 Legislative Overhaul
In May 2026 the Texas Legislature enacted Senate Bill 8‑2026, expanding the 2021 “trigger law” to close the limited‑exception loophole. The updated text permits abortions only to save the mother’s life, prevent a serious health risk, or address a fatal fetal anomaly verified by two physicians. The bill also adds a “severe health risk” category that includes procedures necessary to treat life‑threatening conditions such as ectopic pregnancy or severe infection. Violations now carry a second‑degree felony charge, up to 20 years imprisonment, and a $10,000 fine per illegal abortion.
What Is D and C?
Dilation and curettage (D and C) involves widening the cervix and scraping the uterine lining to remove tissue. Historically it has been used for both elective termination and therapeutic indications (e.g., retained products of conception, abnormal uterine bleeding, or treatment of early‑stage uterine cancer). Under the 2026 law, a D and C is legal only when it falls squarely within the medical‑exception language—particularly when evidence shows a serious health threat to the patient or a non‑viable pregnancy.
How the New Exception Rules Apply
- Life‑Saving Situations – If the patient’s life is in imminent danger (e.g., septic miscarriage), a D and C is allowed. The physician must document the emergency and obtain a second‑opinion written statement within 48 hours.
- Severe Health Risk – The law defines “severe health risk” as any condition that could cause permanent impairment or death if untreated. A D and C for uncontrolled bleeding or a rapidly growing uterine mass qualifies, provided both physicians certify the risk.
- Fetal Anomaly – When a fetal anomaly is deemed non‑viable by two specialists, a D and C may be performed. The documentation must include ultrasound images and pathology reports.
Any D and C that does not meet these criteria is presumed an illegal abortion, subject to criminal prosecution and civil penalties.
Practical Guidance for Providers
- Document Rigorously – Every step—from patient history to dual‑physician attestations—must be recorded in the medical record.
- Obtain Informed Consent – The consent form must explicitly reference the statutory exception being invoked.
- Consult Hospital Legal Counsel – Many health systems have adopted internal review committees to pre‑approve high‑risk cases.
- Stay Updated – Texas health‑law statutes are being revised quarterly; continuing legal education is essential.
Potential Penalties for Non‑Compliance
A provider who performs a D and C outside the permitted exceptions faces a second‑degree felony, loss of medical license, and up to $10,000 per procedure in civil fines. Hospitals can also be liable for negligent supervision, leading to additional monetary sanctions.
FAQ
What constitutes a “severe health risk” under the 2026 law?
A severe health risk includes any condition that, if untreated, could result in permanent organ damage, serious infection, or death. Conditions such as uncontrolled hemorrhage, septic miscarriage, or a rapidly enlarging uterine tumor meet this definition when certified by two physicians.
Can a D and C be performed for abnormal uterine bleeding?
Yes, but only if the bleeding is deemed a serious health threat that could lead to anemia, hemodynamic instability, or other life‑endangering complications. The attending physician must obtain a second‑opinion certification before proceeding.
Are there any reporting requirements after a legally permissible D and C?
The provider must submit a detailed case report to the Texas Department of State Health Services within 72 hours, including both physicians’ attestations and supporting diagnostic evidence.
What happens if a patient consents to a D and C for elective termination?
Even with patient consent, the procedure would be classified as an illegal abortion because the statutory language does not recognize elective termination as a medical exception. Both the physician and the patient could face criminal charges.
How can physicians protect themselves from inadvertent violations?
Physicians should establish a checklist that includes dual‑physician review, thorough documentation, informed‑consent signatures specifying the legal exception, and immediate reporting to the hospital’s legal department. Regular training on Texas abortion statutes is also advisable.