On Nov. 3, Texas voters will weigh questions about the future of reproductive healthcare as they decide whether to send Attorney General Ken Paxton (R) or State Rep. James Talarico (D) to the US Senate.
The candidates are stark opposites when it comes to abortion, with Paxton notably celebrating the end of Roe v. Wade in 2022 and threatening to impose legal ramifications on medical providers who perform abortions on women facing life-threatening conditions. Talarico has emphasized his stance against what he calls “extreme” abortion bans and outlined steps he would take to reduce Texas’ maternal mortality rates.
Here’s where each candidate stands on reproductive healthcare issues in Texas.
Where do Talarico and Paxton stand on Texas’ abortion ban?
Paxton has been outspoken about his anti-abortion stance.
In the aftermath of the Dobbs decision that repealed Roe v. Wade, Paxton called previous federally protected abortion rights “unconstitutional and unconscionable.” He expressed support for Texas’ highly restrictive abortion ban and said he looked forward to “defending the pro-life laws of Texas and the lives of all unborn children moving forward.”
In 2022, Paxton again defended Texas’ ban, which outlaws the procedure from conception, making exceptions only in exceedingly rare circumstances. When the Biden administration asserted that the EMTALA law, which requires hospitals nationwide to provide emergency care to every patient, also included performing health-saving abortions, Paxton pushed back, claiming that its directive would “transform every emergency room in the country into a walk-in abortion clinic.”
The 5th Circuit Court of Appeals ruled that Texas’ abortion restrictions take precedence over EMTALA, even when an abortion is necessary to stabilize a patient experiencing a medical emergency.
Talarico, in contrast, said the state’s existing abortion restrictions have removed autonomy from women and their healthcare providers.
“I don’t believe that’s a place for the government. I don’t believe that’s a place for the state,” he said of abortion restrictions. “And that’s a belief I hold not despite my (Christian) faith, but because of my faith.”
Voters who consider themselves “pro-life” should be bothered by the risks associated with Texas’ ban, Talarico argued, particularly when it comes to the state’s very narrow scope of exceptions for extreme medical emergencies.
“They should be deeply disturbed by this abortion ban in Texas because we have women who are literally dying in emergency room parking lots because doctors are too afraid to provide the healthcare they need,” he said during an interview with The Jamie Kern Lima Show.
Dallas mom Lauren Miller had already been hospitalized twice due to a rare pregnancy side effect when she had to flee Texas to get a complex procedure to save one of the twins she was carrying. Early in her pregnancy she and her husband had learned that one of their twins suffered from Trisomy 18, a genetic condition that would lead to death in Miller’s uterus or very shortly after birth. The fetus only had half a brain, major heart issues, and other serious abnormalities.
“The risk of miscarriage with a Trisomy 18 baby is so severe that I could have lost both babies,” Miller told Courier Texas in a 2025 interview.
Miller needed a single fetal abortion to save the healthy twin. While she was already deeply ill from hyperemesis gravidarum, Miller had to board a plane and fly to Colorado for a safe procedure.
“I needed an abortion of an obviously unviable twin in order to protect the life of a viable twin. I was heading towards organ failure but apparently I wasn’t dead enough,” Miller recently told Courier Texas. “The decision between Ken Paxton and James Talarico comes down to a simple question: If you believe that a politician should make life or death medical decisions for you and your kids, by all means vote for Ken Paxton. If you believe you and your doctor know your medical needs better than a politician, vote for James Talarico.”
Talarico’s legislative record supports his stance of supporting women’s healthcare rights.
In 2022, Talarico filed HB 819, which would repeal several pre-Roe v. Wade restrictions on abortion, including the current “trigger ban” and a 1925 abortion ban that could open the door to women facing criminal prosecution for having an abortion. The proposal was advanced to the House State Affairs Committee in 2023, but failed to proceed.
How would each candidate handle medical exceptions to the ban?
When Amanda Zurawski, who almost died of sepsis when her water broke at 18 weeks of pregnancy, led a case up to the Texas Supreme Court, Ken Paxton fought the women every step of the way. The women involved in the suit sought to clarify the legal medical exceptions to Texas’s abortion ban, including asking that pregnant women carrying fetuses with fatal fetal anomalies be allowed to have legal abortions in the state.
“To me, the choice is incredibly obvious. It’s night and day,” Zurawski told Courier Texas. “I’ve met James (Talarico) as a state legislator and he’s been supportive of my work and of the other women who were plaintiffs. He apologized for the pain and suffering that I and the other women went through as a result of the abortion ban.”
When the Texas Supreme Court refused to clarify medical exceptions to the state’s abortion bans, as the women requested, Paxton celebrated the ruling.
“Ken Paxton has made life worse for us, and his legal team insisted in our court case that we weren’t even harmed by the abortion ban,” Zurawski said. “I also don’t trust that Ken Paxton will support access for Texas women to IVF—something that I need to have a family now.
“I fear that if Ken Paxton becomes our state senator, that the amount of damage that he will do to 49 other states will know no bounds.”
When mom Kate Cox received a judge’s permission to abort her fetus after the diagnosis of a fatal fetal anomaly, Paxton immediately threatened to criminally prosecute and civilly sue her OBGYN, Dr. Damla Karsan, as well as any hospital which provided the abortion.
“Ken Paxton threatened to come after me if I had performed the abortion. He threatened me with 99 years in jail, a $100,000 fine and the loss of my medical license,” Karsan told Courier Texas.
Cox was already gravely ill from the effects of carrying a fetus with Trisomy 18, and she feared losing her fertility from the doomed pregnancy.
“If she was forced to continue the pregnancy in Texas, she would have had to undergo a C-section, which is major surgery in order to have a baby that wouldn’t survive,” Karsan said. “She already had two babies by C-section and she really wants to have a third child, but every C-section is more dangerous.”
After Paxton’s threat, Cox fled to a state where abortion was legal and underwent the procedure.
“Ken Paxton doesn’t care if Texas women die as a result of the abortion ban,” Karsan said. “His message to women is that you are only valued for your ability to bear children—but women in Texas are now afraid to start a family. I hear that from patients all the time. The ban has had a chilling effect on having children.”
Talarico has repeatedly pushed back on Texas’ ultra-strict abortion ban, calling out GOP leaders for their opposition to exceptions even in the most complex cases.
A spokesperson for Talarico emphasized Talarico’s opposition to Paxton on the issue of abortion exceptions, telling Courier Texas, “Ken Paxton has consistently pushed to criminalize women’s healthcare and put politicians in the middle of decisions that should be left to Texas women, their doctors, and their faith. Paxton defended and enforced the most extreme abortion ban in the entire country, with no exceptions for rape or incest.”
Talarico was a co-sponsor for SB 31, “The Life of The Mother Act,” which permits exceptions to the state’s near-absolute abortion ban by allowing doctors to intervene before a pregnant patient dies or suffers very serious physical impairment when medical criteria for the law are met.
What would they do about Texas’ maternal mortality rate?
Texas’ maternal mortality rate has consistently measured higher than the national average—and women of color face the starkest consequences. From 2016-2020, 83 Black women died per 100,000 live births in Harris County, Texas—the highest rate in the US.
In September 2026, the family of Tierra Walker, a Black woman who died after developing preeclampsia during pregnancy, sued Paxton and other defendants. They alleged that Texas’ abortion restrictions and the type of care she received contributed to her death, ProPublica reported.
Paxton has made no public comment on Walker’s death. His campaign website does not mention maternal health, but states he “will work alongside President Trump to Make America Healthy Again.”
Talarico has spoken publicly about maternal mortality, proposing specific reduction measures like insurance coverage for doulas and midwives and supporting the Healthy Start program, whose stated mission is “to improve the health and well-being of women, infants, and families in Dallas County by providing comprehensive prenatal, maternal, postpartum, and infant care.”
A statement on Talarico’s campaign website says he hopes to “end maternal care deserts, improve data collection, provider training, and investment in maternal health research, extend eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)” and “guarantee all new mothers can take time off work to tend to their health.
Dr. Austin Dennard is a Dallas OB-GYN and mother who learned early in her third pregnancy that the fetus had anancephaly—a condition not compatible with survival. Despite wanting the pregnancy, she and her husband traveled out of state for an abortion.
“I have spent my entire adult life training to care for women in the moments when minutes matter,” Dennard told Courier Texas. “OB-GYNs wake up in the middle of the night to operate on ruptured ectopic pregnancies. We run toward hemorrhages. We deliver babies in emergencies, perform life-saving surgery with little warning and make extraordinarily complicated decisions under enormous pressure. We train for years to know what to do when a woman’s life is suddenly in our hands.
“So I have very little patience for politicians who have never taken care of a patient, never stood in an operating room at 2 a.m., never managed an obstetric hemorrhage, and never had to make a split-second decision to save a woman’s life, telling us how to practice medicine.”
Dennard said Paxton has championed a version of government in which politicians and prosecutors can second-guess doctors and women during extraordinarily complex medical circumstances.
“We have seen the consequences of that approach in Texas: fear, confusion, delayed care and physicians forced to consider the legal consequences of treatment while standing at a patient’s bedside.”
She said Talarico brings a different approach to governance in Texas.
“James Talarico offers something fundamentally different: trust. Trust women to know their own lives. Trust physicians who have devoted theirs to caring for them. And understand that bodily autonomy isn’t some abstract political argument. It is a fundamental freedom.
“OBYNs don’t need politicians practicing medicine from the Capitol. We need them to get out of the exam room and let us do the jobs we sacrificed so much of our lives to learn how to do.”
READ MORE: What to know about the Talarico vs Paxton US Senate race
