Analysis Politics

What’s Behind Texas’ Proposed New Abortion Reporting Requirements? No One Knows

Andrea Grimes

The Texas Department of Health is putting in place vague new abortion requirements, despite repeated failure of a law to mandate them. And even DSHS itself can't articulate what the reporting requirements mean or why they are necessary.

See all of our exclusive coverage of Rep. Bill Zedler here.

We know Republican Rep. Bill Zedler thinks the new abortion reporting requirements he’s “requested” from the Texas Department of State Health Officials are necessary, but does anyone besides Bill Zedler think so? The abortion providers to which Rewire spoke this week question the necessity of and intentions behind the new requirements, and the DSHS itself can’t seem to articulate why the new rules are needed.

The proposed requirements are twofold: first, they would require clinics to submit more, and more personal, information about women getting abortions, and second, they would require individual doctors to report any “complications” from abortions within twenty days of the procedure. The requirements don’t define “complications” or give doctors providing safe abortion care guidance on what might constitute a “complication.” 

“The additional requirements – such as the handful of new questions and the complications reporting requirement — could help from a regulatory perspective and in demographic and trend analysis,” Carrie Williams, the DSHS press officer told Rewire via e-mail.

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The information gathered would ostensibly be confidential, but the State of Texas has, in the past, leaked personal information for nearly a year online before the mistake was realized.

It’s important to remember that Bill Zedler requested that DSHS put in place these new reporting requirements despite the repeated failure to pass a law mandating them. Rewire therefore wanted to know whether the DSHS had reason to believe there were problems with existing reporting requirements, or reason to suspect that individual doctors were not reporting complications or hiding wrongdoing from DSHS. So far, the DSHS has not given Rewire any indication that it believes that the existing requirements were inadequate, faulty or otherwise insufficient.

Instead, said Williams via e-mail, “If there is a critical issue or flaw, we can consider opening rules at any time based on stakeholder and legislative input,” though DSHS has so far been unable or unwilling to identify any specific “critical issue or flaw” with the existing requirements. Even Zedler’s staunchly conservative peers in the legislature haven’t felt there was enough wrong with the existing reporting requirements to give this kind of bill any serious consideration in years past. Instead, Zedler has asked the DSHS to do whatever they could to accommodate his desires from their end, and they’ve complied with his wishes.

Writes Williams: “During the special session, Rep. Zedler offered an amendment to [State Bill 7] that would have added additional reporting requirements. The amendment wasn’t added but at the time HHSC and DSHS agreed to look at the additional requirements and determine what elements could possibly be adopted by rule.”

The Texas DSHS’s openness about their willingness to instate new rules at the behest of one lone anti-choice lawmaker — rules that have been repeatedly shot down by fellow legislators — worries abortion providers, who say they’re doing all they can to take advantage of the public comment period before June 14th, when DSHS will officially write in the new rules.

Amy Hagstrom Miller, the founder of Whole Woman’s Health in Austin, which provides privately-funded abortion care in addition to other reproductive health services like cancer screenings and contraception, says she’s “amazed” that the DSHS is now making “the very changes that our elected officials weren’t prepared to make.”

And as for Zedler, says Hagstrom Miller, “I’m sort of amazed that he’s got the chutzpah to do that, and that the health department feels like they have to take it seriously.” She worries, she says, “about the kind of pressure they must be under.”

Hagstrom Miller says she’d like a more thorough explanation from the health department as to why they’re writing these new rules — apart from, as DSHS has repeatedly told Rewire, that they have the authority to do so.

“It doesn’t explain why it’s a good idea,” said Hagstrom Miller. She called the updated reporting requirements “invasive,” and said, “there’s a lot of data that we’re already reporting. What’s the purpose for gathering all this?”

According to Carrie Williams at DSHS, that purpose still remains vague, writing only that the new requirements “could help from a regulatory perspective and in demographic and trend analysis.” Williams emphasized that the abortion complication reporting requirements are done “at the discretion of the doctor,” but those aren’t comforting words to Hagstrom Miller.

 “To me, that vague definition is really problematic, and potentially dangerous for the licensee and the physician’s career,” she said. The new reporting rule doesn’t outline what kind of penalties physicians might face for reporting (or not reporting) these vaguely-defined “complications,” or set out guidelines as to whether doctors will be penalized if a woman experiences complications, but isn’t treated by the doctor who performed the procedure.

“If the patient, post-op, goes to the hospital with something, the doctor may not ever know about that,” said Hagstrom Miller. “Would the doctor be held accountable for a complication they aren’t aware of?”

Her concerns echo that of other providers, who’ve wondered if the complication reporting requirements are meant to intimidate doctors, particularly those who are not part of a larger clinical practice that specializes in abortions.

“That vagueness concerns me on behalf of the physician,” said Hagstrom Miller.

In the meantime, DSHS seems happy to act on behalf of one individual legislator. And that also “amazes” Hagstrom-Miller.

“It’s just amazing that when the Republicans have a super majority in the legislature and something like this amendment doesn’t pass even with a Republican super majority,” says Hagstrom Miller, “that [Rep. Zedler] still has the guts to actually put pressure on the health department and bypass that political forum, to make the very changes that our elected offiicals weren’t prepared to make.”

The DSHS continues to accept comments from the public about the requirements, and those wishing to provide input can contact Amy Harper ( or Ellen Cooper ( at DSHS’s Regulatory Services division. 

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