The case of a Texas woman who sought a court-approved abortion but wound up leaving the state for the procedure is reigniting political arguments that have roiled elections for more than two years, placing Democrats on the offensive and illustrating Republicans’ continued lack of a unified policy response or clear strategy on how to talk about the issue.
The Texas woman, Kate Cox, a Dallas-area mother of two, has emerged as the living embodiment of what Democrats say remains one of their strongest arguments heading into the 2024 election: that Republicans will ban all abortion. Ms. Cox was more than 20 weeks pregnant with a fetus that had a fatal genetic abnormality known as trisomy 18, and lawyers and doctors argued that carrying the pregnancy to term put her health and her future fertility at risk.
Her lawsuit was one of the first attempts by an individual woman to challenge the enforcement of abortion bans put in place by Republican states after Roe v. Wade was overturned a year and a half ago. Hours before the Texas Supreme Court ruled against granting Ms. Cox a medical exemption to the state’s abortion bans, she had decided to travel to receive the procedure in a state where it remained legal.
From top officials on President Biden’s campaign to candidates in battleground states, Democrats jumped on Ms. Cox’s plight as a cautionary tale for voters next year, highlighting her situation as they have done with the wrenching, deeply personal stories of other women and girls since Roe was overturned.
Representative Colin Allred, the Texas Democrat running to unseat Senator Ted Cruz, cast the ruling as emblematic of the kind of abortion bans Republicans would enact across the country.
“This is not an unintended consequence of these extreme policies — this is exactly what folks like Ted Cruz wanted and a pretty predictable outcome of their policies,” Mr. Allred said. “Unfortunately, Kate’s story is not going to be the last one we hear like this.”
The Biden campaign offered an even simpler message about the case: Blame Trump. Campaign aides connected the case directly to Mr. Trump’s legacy as president, pointing out that he appointed three of the Supreme Court justices who cast decisive votes in Dobbs v. Jackson Women’s Health Organization, the ruling that overturned Roe in 2022.
“This is happening right here in the United States of America, and it’s happening because of Donald Trump,” Julie Chávez Rodríguez, Mr. Biden’s campaign manager, said on a call with reporters. “As the chaos and cruelty created by Trump’s work overturning Roe v. Wade continues to worsen all across the country, stories like Kate Cox’s in Texas have become all too common.”
The party’s quick embrace of Ms. Cox underscores how Democrats plan to place abortion rights at the center of their political campaigns next year, part of an effort to replicate their playbook from the 2022 midterms and transform the 2024 elections into another referendum on abortion rights.
Their attacks were largely met with silence from Republicans.
At a town-hall meeting CNN hosted in Des Moines on Tuesday night, Ron DeSantis, the Florida governor running for the Republican presidential nomination, avoided giving a direct answer to a question about whether women in Ms. Cox’s position should be forced to carry their babies to term. Mr. DeSantis noted that a six-week abortion ban he signed in Florida this year contained exceptions for a fatal fetal abnormality or to save the life of the woman.
“These things get a lot of press attention, I understand. But that’s a very small percentage that those exceptions cover,” he added. “There’s a lot of other situations where we have an opportunity to realize really good human potential, and we’ve worked to protect as many lives as we could in Florida.”
Republican strategists working for the party’s Senate campaign committee and for other candidates have urged their politicians to state their support for “reasonable limits” on late-term abortions with exceptions for rape, incest and the life of the mother, part of an effort to craft a more popular response on the issue. While majorities of Americans support abortion rights, they also back restrictions later in pregnancy, particularly as women move into the second trimester.
Yet, as Ms. Cox’s situation shows, the messy medical realities of pregnancy can challenge those poll-tested stances. Ms. Cox was denied exactly the kind of medical exception that many Republicans now support. In Congress, Republicans have been trying to enact a federal ban on abortions after 20 weeks — a marker Ms. Cox had passed in her pregnancy — for about decade.
“It used to be a good idea politically to talk about later abortion,” said Mary Ziegler, a law professor and historian of abortion at the University of California, Davis. “The claims just don’t land the same way when abortion bans are actually being enforced and when it is the patients themselves who are speaking.”
Nikki Haley, the former governor of South Carolina and a Republican presidential candidate, deflected when asked whether she would support rulings similar to the one from the Texas Supreme Court that block an individual woman’s decisions on the matter. Ms. Haley has positioned herself as seeking “consensus” on the issue, arguing that she is both “unapologetically pro-life” and that decisions about whether to undergo the procedure are deeply personal.
“You have to show compassion and humanize the situation,” Ms. Haley said, speaking after at a packed town-hall meeting in a ski area in Manchester, N.H. “We don’t want any women to sit there and deal with a rare situation and have to deliver a baby in that sort of circumstance any more than we want women getting an abortion at 37, 38, 39 weeks.”
That kind of response is unlikely to satisfy the socially conservative flank of the party’s base. Tensions between anti-abortion activists and establishment Republicans, who are more willing to compromise on the issue for political gain, flared as the party debated Ms. Cox’s case.
“The prolife movement has gone from compassion for the child to cruelty to the mother (and child),” Ann Coulter, the conservative commentator, posted on social media. “Trisomy 18 is not a condition that is compatible with life.”
Rick Santorum, the socially conservative Republican former senator from Pennsylvania, shot back with a photo of his daughter Bella. “Meet my incompatible w life daughter,” he wrote. “Every kid deserves a shot at life, not be brutally dismembered for not being perfect.”
Ardent anti-abortion advocates such as Mr. Santorum argue that just as the law would not permit the killing of a terminally ill adult, it should forbid the abortion of a fetus with a fatal diagnosis — like the one carried by Ms. Cox.
“There are two patients involved, and targeting one of them for brutal abortion will never be the compassionate answer,” said Katie Daniel, the state policy director for SBA Pro-Life America, an anti-abortion political organization. “Texas law protects mothers who need lifesaving care in a medical emergency, which a doctor can provide without deliberately taking a patient’s life and without involving the court.”
The argument that abortion is akin to murder, a foundational belief of the anti-abortion movement, is more difficult to make when it is no longer hypothetical. As conservative states have begun enforcing bans that all but completely forbid abortion, pregnant women have emerged as some of Democrats’ strongest messengers.
In Ohio, the account of a girl who was raped at age 9 and had to travel to Indiana to end her pregnancy at age 10 became a national controversy after Republicans publicly questioned the veracity of the story. And in Kentucky, Gov. Andy Beshear, a Democrat, spent nearly $2 million on startling ads for his re-election campaign that featured Hadley Duvall, a young woman who said she was raped by her stepfather as a girl.
Eric Hyers, Mr. Beshear’s campaign manager, said those ads had the biggest impact among older men living in more rural and conservative parts of the state.
“A lot of folks there had just never had to think about this in the terms that Hadley was describing,” Mr. Hyers said. “This is the road map for how Democrats should talk about this in tough states like Kentucky and specifically on how extreme these laws and bans are.”
Across the country, activists have been pushing to introduce ballot measures that would enshrine abortion rights in state constitutions. Many Democrats believe those referendums could help energize their voters, increasing turnout in Arizona, Florida and other crucial states. In Florida, abortion-rights supporters said they were close to capturing the necessary number of signatures to put an amendment to the state constitution on the ballot.
Some Democrats say such measures aren’t enough, particularly for women in conservative states such as Texas, where legislation had already banned abortion nearly completely even before the Supreme Court overturned Roe.
“It is absolutely unacceptable that women have to ask permission to get lifesaving health care,” said Ashley All, who helped run a campaign for an abortion-rights ballot measure in Kansas and urges Democrats to push legislation codifying abortion rights in federal law. “The fact that we aren’t making some sort of effort nationally to fix that problem is frustrating.”
Nicholas Nehamas and Jazmine Ulloa contributed reporting.