Bloomberg Law
Dec. 14, 2022, 2:50 PMUpdated: Dec. 19, 2022, 7:08 PM

Texas Veterans Affairs Nurse Sues to Stop Abortion Rule (1)

Mary Anne Pazanowski
Mary Anne Pazanowski
Legal Reporter
Courtney Rozen
Courtney Rozen

The US Veterans Affairs Department’s new rule requiring its medical centers to offer abortions and related counseling infringes health professionals’ religious liberties, a new federal lawsuit says.

Stephanie Carter, an Army vet and a nurse at a Temple, Texas, VA facility, sued the agency Tuesday in the US District Court for the Western District of Texas. She’s seeking an injunction barring the VA from compelling her and her colleagues at the facility to participate in providing any abortion-related services.

This is believed to be the first case challenging the VA’s allowance of abortions at its health facilities in very limited circumstances. Under the rule, pregnant veterans and some of their direct family members can get abortions at a VA health facility if carrying the pregnancy to term threatens the patient’s life or health.

Service members and direct family members also would be eligible if the pregnancy is the result of rape or incest. The VA would provide the treatment even in a state where criteria to receive the procedure is more restrictive, such as in Texas or Alabama, the agency has said.

The rule’s application to Carter has deprived and will continue to deprive her of her “paramount rights and guarantees” under the US Constitution and the Religious Freedom Restoration Act, the complaint says.

Carter said that her Christian beliefs prevent her from performing, prescribing, or counseling for abortions and from working in a facility that offers nonemergency abortion services. The VA rule doesn’t account for religious objections, and there’s currently no process for considering accommodation requests, she says.

The nurse also is facing possible criminal prosecution in Texas if forced to provide abortion-related services because abortion is illegal there except in limited circumstances, the complaint says.

Carter also argues that the VA needs clear approval from Congress to facilitate abortions, an authorization that President Joe Biden didn’t have when he moved to allow VA hospitals to provide abortions.

Causes of Action: Religious Freedom Restoration Act, First Amendment’s free exercise clause.

Relief: Declare rule invalid as applied to Carter, enjoin agency from enforcing rule against Carter and Temple facility, costs and attorneys fees.

Response: “From the moment VA announced this new rule, Secretary McDonough has made clear to all employees that their religious beliefs are protected here at VA,” Press Secretary Terrence Hayes said in a statement commenting on the case emailed to Bloomberg Law Dec. 19. The agency doesn’t comment on pending litigation, but Hayes noted that it provides an accommodation for VA employees who wish to opt out of providing abortion counseling or services. The agency has provided all VA health-care employees with opt-out information, “including information for how to exercise those protections through VA’s Office of Resolution Management Diversity and Inclusion—and we have encouraged employees to inform their supervisors of any requests for exemptions,” he said.

Attorneys: First Liberty Institute represents Carter.

The case is Carter v. McDonough, W.D. Tex., No. 22-cv-1275, complaint filed 12/13/22.

(Updated Dec. 14 story to add comments by VA Press Secretary Terrance Hayes in second-to-last paragraph.)

With assistance from Courtney Rozen

To contact the reporter on this story: Mary Anne Pazanowski in Washington at

To contact the editors responsible for this story: Rob Tricchinelli at; Brian Flood at