For the first time since Texas criminalized abortion, the state’s medical regulator is instructing doctors on when they can legally terminate a pregnancy to protect the life of the patient — guidance physicians have long sought as women died and doctors feared imprisonment for intervening.

The new training from the Texas Medical Board comes nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. ProPublica’s reporting has shown that pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.

In response, the Texas Legislature passed the Life of the Mother Act last year. The law updated the abortion ban’s medical exceptions, added to the legal burden needed for prosecutors to criminally charge a doctor and required the medical board to create guidance for doctors by Jan. 1, something no other state with an abortion ban has done.

The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion.