A group of doctors, women who experienced high risk pregnancies and the American Medical Association are challenging the vagueness of medical exceptions to Tennessee’s strict abortion ban. (John Partipilo/Tennessee Lookout)
In a defeat for Gov. Bill Lee’s administration, a three-judge panel ruled against the state’s effort to end a longstanding lawsuit challenging the vagueness and inadequacy of exceptions to Tennessee’s near-total abortion ban.
Attorneys for the state asked for a ruling in their favor, without a trial, in a lawsuit brought in 2023 by a group of Tennessee OB-GYNs and women who had suffered serious medical problems during their pregnancies. The American Medical Association subsequently joined the lawsuit.
State attorneys had argued that a 2025 amendment adding “medical necessity exceptions” to Tennessee’s 2022 abortion ban made the lawsuit moot.
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But the Chancery Court panel disagreed, signaling skepticism that exceptions to the state’s abortion ban were adequate to protect the lives and health of pregnant women in Tennessee.
The plaintiffs, the judges wrote, “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk in violation of their constitutional right to life.”
“The changes made by the 2025 Amendment do not significantly alter the status of this case,” the panel wrote, concluding the lawsuit contained sufficiently serious and credible allegations to move forward.
Tennessee abortion ban
Tennessee’s strict abortion ban, which went into effect after the Supreme Court overturned Roe v Wade in 2022, was amended twice to provide limited exceptions for medical conditions. The law, in its original form and as amended, does not contain exceptions for victims of rape or incest, or for pregnancies with fetal abnormalities.
In 2023, Gov. Bill Lee signed into law an amendment that said a doctor may perform one “using reasonable medical judgement, based upon the facts known to the physician at the time” if the abortion is necessary to prevent a pregnant woman’s death or to “prevent serious risk of substantial and irreversible impairment of a major bodily function.” The legislation also added molar and ectopic pregnancies as exceptions to the state’s abortion ban.
It was this 2023 legislation the lawsuit initially challenged as overly vague.
In 2024, the three-judge panel temporarily blocked the state’s medical board from disciplining doctors for providing emergency abortions but declined to block criminal prosecution of physicians, saying it lacked the authority to do so.
Their ruling also outlined four specific pregnancy-related conditions that qualify as “medical necessity” exceptions to the state’s abortion ban, noting the then “confusion and lack of consensus within the Tennessee medical community on the circumstances requiring necessary health- and life-saving abortion care.”
The four conditions include: “previable preterm premature rupture of the membranes; inevitable abortion, defined as dilation of the cervix prior to viability of the pregnancy, either by preterm labor or cervical insufficiency;” :fatal fetal diagnoses that lead to maternal health conditions, such as severe preeclampsia and mirror syndrome associated with fetal hydrops;” and “fatal fetal diagnoses leading to an infection that will result in uterine rupture or potential loss of fertility.”
This year, lawmakers further amended the state’s abortion ban to include the four conditions outlined by the chancery court ruling. The amendment says doctors “may” provide an abortion for these conditions.
The 2025 legislation also explicitly excludes mental health diagnoses as a medical exception to the state’s abortion ban. The panel’s decision, issued last week, allows the plaintiffs to challenge the lack of a mental health- related exception to the abortion ban.
State must turn over documents
The panel in a separate decision last week allowed the plaintiffs to obtain internal documents from the Tennessee General Assembly, the governor and legislative committees that reveal the” state’s interest in enforcing the amended abortion ban and medical exceptions.”
The panel likewise allowed for subpoenas to Tennessee Department of Health for data on abortions, maternal mortality and any unofficial guidance the department has issued to health providers since 2022.
On Monday, attorneys for the state filed an emergency motion seeking permission to appeal the ruling requiring state officials to comply with the subpoenas.
State attorneys said the decision to force state officials to turn over internal documents “presents a momentous separation-of-powers question – pitting the state judiciary against the other two branches – that should be decided by the appellate courts.”
The group filing suit is represented by the Center for Reproductive Rights, a New York-based law firm.
Tennessee requires three-judge panels to consider challenges to state law. Chancellor Patricia Head Moskal, Judge Sandra Donaghy and Chancellor Kasey Culbreath issued the opinion in this case.
MEMORANDUM AND ORDER ON DEFENDANTS’ MOTION FOR JUDGMENT ON THE PLEADINGS
Tennessee Lookout is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Tennessee Lookout maintains editorial independence. Contact Editor Holly McCall for questions: info@tennesseelookout.com.
