However a government might seek to restrict abortion, people with pregnancies they don't wish to carry to term are going to seek the procedure out. It's a fact one will hear again and again from pro-choice researchers and activists, and a new study from TxPEP, the Texas Policy Evaluation Project, bears it out.
TxPEP interviewed and surveyed more than 700 patients seeking abortions at Texas clinics between 2012 and 2015. Researchers found that 7% of those surveyed had sought an abortion through other means before coming to the clinic, more than three times the national average of 2.2%.
Some of the women sought, and completed, an abortion by taking misoprostol, a drug commonly used for medication abortions. It can be purchased in Mexico and through other black or gray market sources. Others sought less effective means, frequently at the recommendation of relatives, like herbs, teas or vitamins.
When women looked for these alternatives, according to the study, they did so because they couldn't afford to get to the clinic or pay for an abortion, their local abortion provider closed or no longer provides abortions or a friend or family member recommended an alternative.
“No single reason was enough for anyone to consider self-managing their abortion,” Liza Fuentes, senior research scientist at Guttmacher Institute and researcher with TxPEP at the time of the study, said in announcing the study's results. “For all of the women we interviewed, poverty intersected with other obstacles to leave them feeling they had no other option.”
The dates during which the patients were interviewed are key. In 2011, Texas passed abortion restrictions requiring that anyone seeking the procedure be shown a sonogram of their fetus and forced to wait at least 24 hours between their initial appointment and their abortion, as long as they live within 100 miles of clinic. State law shortens the waiting period to two hours for those living more than 100 miles from the nearest abortion provider.
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In 2013, Texas passed additional laws requiring that doctors performing abortions have admitting privileges at hospitals within 30 miles of the clinic at which they perform abortions and that abortion clinics be outfitted like hospital surgical suites. The U.S. Supreme Court overturned the Texas law in 2016, but more than half the clinics in the state had already closed because of the effects of both laws.
Fewer clinics means higher wait times and more difficulty for patients who want an abortion in a traditional setting.
“Even though the women we interviewed said they would prefer going to a clinic, many chose self-managed abortion when that was the only feasible option,” said Daniel Grossman, investigator at TxPEP and director of Advancing New Standards in Reproductive Health at the University of California at San Francisco. “These findings highlight how barriers to care force some people to self-manage their abortion when faced with limited options.”
Correction 1/13/2020: An earlier version of this article said that anyone seeking an abortion in Texas had to wait 24 hours between their mandatory ultrasound and the procedure. That's true for those who live withing 100 miles of an abortion clinic. For those who live more than 100 miles from a clinic, the required wait is two hours. The story has been updated to reflect this fact.