The war on abortion access in Texas has already fundamentally shifted the landscape of women’s lives in the state. Now, the fallout continues: The closure of Planned Parenthood (PP) clinics in the state—which once served as primary sources of reproductive health care for women there—has left the few clinics remaining in west Texas underfunded, understaffed, and overwhelmed by demand.
According to new research, 60 percent of women receiving a low salary who were of reproductive age accessed health care through PP before the cuts and defunding which took place in 2013. The majority of those patients have since been directed to Texas Tech University and Midland County Health Services (MCHS) after PP’s clinics in west Texas closed—increasing demand at an overwhelming rate for their capacity to provide services.
“There are women [who] need these services but can’t afford them and we see as many as we can,” Michael Austin, director of MCHS, told Women’s Health Policy Report. “But the state program to help these folks along has basically evaporated. So I’m afraid there are probably a lot of folks flying under the radar who need care and aren’t getting it.” Austin pointed to the challenges of seeking funding in a state that has “eliminated or severely messed up” many of their programs which provide reproductive health care to women.
In 2011, the Texas State Assembly passed legislation which blocked funding to women’s health clinics, including Planned Parenthood, and cut the state’s family planning budget by two-thirds. Two years later, the draconian anti-abortion bill known as HB2 was signed into law by Governor Rick Perry, putting in place numerous obstacles meant to shutter clinics and restrict women’s access to safe and legal abortion. HB2 requires that abortion providers have admitting privileges at a local hospital and clinics are licensed ambulatory centers. It also bans surgical abortion after 20 weeks and medication abortion after seven. (Medication abortion is the most cost- and time-effective abortion procedure.)
HB2’s impact was immediate and drastic. 82 percent of family planning clinics closed. The number of abortion practitioners decreased by over 75 percent. Over half of the clinics performing abortion closed, which in turn drastically increased the time it would take for women to make an appointment to 28 days— essentially rendering the option of medication abortion moot. When it comes to clinics, Texas is in crisis.
In a 2014 study, analysts determined that HB2 was dramatically reducing access—and predicted that as a result, remaining clinics would be unable to serve to demand:
The study, released last week, details the striking impact that HB2 has had on abortion access in Texas. The researchers collected data on abortion services for the first six months after one of HB2’s four provisions, which requires abortion providers to have admitting privileges at a hospital within 30 miles of their clinic, went into effect in November 2013. They found that the abortion rate decreased at an unusually rapid rate of 13 percent, likely because of the large number of clinic’s that closed or stopped providing abortion care. In May 2013, there were 41 facilities providing abortion throughout the state, but 20 of those clinics have now either closed to stopped providing abortion services.
When another provision requiring facilities to meet the standards of ambulatory surgical centers goes into effect this September, the researchers predict that the six or seven facilities that already meet the standards are the only ones that will be able to remain open. But less than one-fourth of abortion procedures took place at an ambulatory surgical center during the research period, so they do not expect those clinics to be able to handle a four-fold increase in abortion procedures.
They were right.
These obstacles have cut access for women across the state, but pose the greatest threat to low income women—who often struggle to find the time, money and means of transportation to access any abortion clinic, let alone a clinic left standing under HB2’s rigorous and extraneous requirements.
Amanda Robb reported in the Ms. Spring 2016 edition about the Texas law’s impact, and in doing so told the story of one working mother who had scheduled an abortion for the day after HB2 became law. Because of the legislation, the clinic couldn’t perform the abortion; after she explained that she did’t have the financial resources or time to feasibly travel 500 miles to another clinic, she asked how she could perform her own abortion at home. One study found that at least 100,000 women in the state of Texas attempted to self-abort in 2014 and 2015.
The fallout from HB2 serves as crucial testimony to how important access to legal abortion remains for women across the country. Advocates are waiting for a decision from the Supreme Court in the case Whole Women’s Health v. Hellerstedt, due before the Court adjourns later this month, which will shape reproductive health access not only in Texas but around the nation in states that have passed similar abortion restrictions.
“I saw the moment that the law was passed also as the moment stigma melted off people,” Amy Hagstrom Miller, Founder and CEO of Whole Woman’s Health, said to Ms. Magazine. “For too long we’ve acted like abortion doesn’t happen to people we know and love.”