The Texas Supreme Court unanimously rejected on Friday a challenge to the state's strict abortion laws brought by women who had serious pregnancy complications but were denied abortions.

The case was filed last year on behalf of two dozen women who were denied abortions even though they had in some cases life-threatening medical issues with their pregnancies.

The suit was the first in the nation brought on behalf of women denied abortions since the US Supreme Court overturned the constitutional right to the procedure in June 2022.

The Center for Reproductive Rights argued in the Texas case that the way medical exceptions are defined under the conservative state's abortion restrictions are confusing, stoking fear among doctors and causing a "health crisis."

In August a lower court found in favor of the plaintiffs, confirming the women who brought the case should have received abortion care.

The Texas attorney general's office immediately filed an appeal staying Judge Jessica Mangrum's temporary order, which said doctors can use their own "good faith" medical judgment to determine when to terminate unsafe pregnancies.

The nine-member Texas Supreme Court, made up entirely of Republicans, struck down Mangrum's order saying it was too expansive and "departed from the law as written without constitutional justification."

Texas law already "permits a life-saving abortion," the justices said.

"A physician may perform an abortion if, exercising reasonable medical judgment, the physician determines that a woman has a life-threatening physical condition that places her at risk of death or serious physical impairment unless an abortion is performed."

A state "trigger" ban went into effect in Texas when Roe v. Wade was overturned, prohibiting abortions even in cases of rape or incest.

Texas also has a law that allows private citizens to sue anyone who performs or aids an abortion.

Texas physicians found guilty of providing abortions face up to 99 years in prison, fines of up to $100,000 and the revocation of their medical license. 

Beth Klusmann, representing the attorney general's office, had argued that the lower court "overstepped its constitutional bounds when it rewrote and expanded the medical emergency exceptions and then concluded that the expansion was constitutionally required."

The ruling would "permit abortions for pregnant females with medical conditions ranging from a headache to feelings of depression," the state said in a filing.

Women involved in the case gave harrowing court testimony.

Amanda Zurawski, after whom the initial case is named, said she was denied an abortion even though her water broke very early in her pregnancy, meaning a miscarriage was inevitable.

Zurawski said her doctor told her that she "couldn't intervene, because the baby's heart was still beating and inducing labor would have been considered an illegal abortion."

Zurawski went into life-threatening septic shock and the fetus was stillborn.