Tennessee demands abortion data from hospitals in ban exceptions case
The four subpoenas were issued this spring to Vanderbilt University medical center and a Tennessee hospital run by the national Catholic chain Ascension, as well as two smaller medical practices in Tennessee, Heritage Medical Associates and the Women's Group of Franklin.
Although each subpoena is different, they broadly ask these organizations to turn over extensive information about instances in which they may have provided abortions, including the number of abortions performed since 2022 and, in some of the subpoenas, all 'documents and communications' related to those abortions.
When and if the medical providers turn in the records, they are legally allowed to preserve 'all patient confidentiality as necessary', according to the subpoenas. A protective order has also been issued to block the records from being used to investigate the hospitals and medical providers outside of the scope of the lawsuit, as well as to potentially mark even the anonymized patient records as 'confidential'.
The sweeping requests raise questions about red-state attempts to track abortion providers in a post-Roe v Wade US. In the three years since the US supreme court overturned Roe, reproductive rights activists have grown increasingly concerned about government efforts to collect information on abortions, especially as states such as Louisiana and Texas have recently launched efforts to penalize abortion providers.
Mary Ziegler, a professor at the University of California, Davis who studies the legal history of reproduction, shared her concerns that the Tennessee subpoenas could have 'a tremendous chilling effect'.
'Republican legislators have recognized that doctors are already not performing procedures that they – Republican legislators – say are justified under exceptions,' Ziegler said.
'The message being sent here is that every single decision, even ones that would have been legal, then would be second-guessed.'
The subpoenas were issued as part of a 2023 lawsuit brought by several Tennessee women and doctors who are seeking to broaden the exceptions in the state's abortion ban. Although Tennessee – like every other state with an abortion ban – technically permits abortions in medical emergencies, these women say they were denied medically necessary abortions. Doctors across the country have said that the exceptions embedded in abortion bans are worded so vaguely that they are incompatible with medical standards, forcing doctors to delay or deny care until a patient becomes sick enough to legally qualify for treatment.
At least five pregnant women have reportedly died under abortion bans in Georgia and Texas. In the years since Roe fell, more pregnant Texas women have also begun to be diagnosed with sepsis – a life-threatening condition – or almost bled to death after they miscarried, according to reporting by ProPublica.
Lawyers for Tennessee, however, have said in court that the state's abortion exceptions are workable as written. Some doctors' failure to accurately interpret the law does not justify amending the state's ban, Tennessee has argued, especially since the state legislature passed a bill in 2025 that sought to clarify the circumstances under which people can get abortions.
The subpoenas issued to the medical providers ask them to turn over 'all protocols, policies, guidelines, practice guides or handbooks' that they have used to determine whether patients can get abortions. The subpoena for Vanderbilt also demands records from the Nashville hospital's abortion committee, which deliberates on whether and how to provide legal abortions to patients, including all 'documents and communications' that may reveal the resolution of each case considered by the committee.
The other subpoenas were issued to at least one medical practice that employs a Tennessee doctor who is a part of the lawsuit. They ask those practices to count the number of abortions they have performed since 2020, two years before Roe fell. They also ask for records from instances in which doctors did not provide abortions because they felt that the Tennessee ban blocked them from doing so.
The subpoenaed groups and Tennessee attorney general's office did not respond to the Guardian's requests for comment.
Despite the court protections in place to keep the subpoenaed records from leaking, assurances from state officials may not be enough to quell doctors' fears of prosecution, Ziegler said. She pointed to the case of Adriana Smith, a brain-dead pregnant woman in Georgia who was kept on life support until she delivered a baby via caesarean section in June. While Georgia's attorney general said that the state's near-total abortion ban did not force doctors to keep pregnant women on life support, Smith's doctors reportedly felt that the language of the ban was so strict that they still had no choice but to keep her alive.
'Prior to any of these data requests, a lot of physicians and providers were really anxious about civil or criminal liability,' Ziegler said. 'I don't see how this is going to help matters.'
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