The lack of hard data available to help predict the effects of Texas' anti-abortion House Bill 2 came up again and again earlier this month when the Supreme Court heard arguments about whether to strike down portions of the law. The most contentious regulation, the one that requires any abortion performed in Texas to take place in a quasi hospital — what's known as an ambulatory surgical center — has never been in effect for more than a couple of weeks, so what happens if the law is enforced is uncertain.
What is clear is that about half of the state's 19 clinics would close immediately if the stepped-up requirements for clinics become settled law. Pro-choice advocates say the closures would mean restricted access to abortion thanks to increased drive times for those located far from clinics, and increased wait times for appointments for any woman seeking an abortion. Anti-choicers point out that every metropolitan area that currently has at least one clinic besides El Paso will continue to have at least one. Women in El Paso can just go to New Mexico for an abortion, Joe Pojman, the executive director of the Texas Alliance for Life, said earlier this month. Supreme Court Justice Ruth Bader Ginsburg pointed out that New Mexico does not have restrictions like Texas'. Anti-choicers, who claim that HB 2 is about protecting women from unsafe abortion practices, seem willing to send women to a state that engages in those very practices, as long as they get their way in Texas, Ginsburg said.
Thursday afternoon, data published in the American Journal of Public Health by researchers at the University of Texas' Policy Evaluation Project shows just what women are going through thanks to the already effective first wave of HB 2 restrictions. After a provision requiring all doctors performing abortions to have admitting privileges at a hospital within 30 miles of the clinic at which they practice, more than half of Texas abortion clinics that were open at the beginning of 2013 closed.
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For their report, the project interviewed 398 women seeking abortion between May and August 2014. Of those women, 38 percent reported that the clinic nearest to them had closed following HB 2's passage. Those women, the ones whose nearest clinic closed, drove an average of 70 miles to get to the next closest clinic, compared with a previous one-way trip distance of 17 miles. About 10 percent of women surveyed drove more than 139 miles to the nearest clinic and 4 percent traveled more than 256 miles.
Those women seeking an abortion whose nearest clinic closed also faced increased out-of-pocket costs above the normal cost of abortion, and many had to stay overnight near the clinic, thanks to the distance they'd traveled and the 2011 Texas law requiring a 24-hour waiting period between consultation with a doctor and an abortion. Thirty-seven percent of the surveyed women whose nearest clinic had closed sought a medication based abortion but were unable to obtain one — Texas law requires that both doses of the abortion-causing pill be taken in front of the same doctor — almost doubling the number of women forced to choose surgical abortion whose clinic did not close.
“This study is unusual in its ability to assess multiple burdens imposed on women as a result of clinic closures, but it is important to note that the burdens documented here are not the only hardships that women experienced as a result of HB2,” the study's author, Liza Fuentes, says.
Previous research by Fuentes' group has shown that women in Dallas seeking an abortion have faced vastly increased wait times following the closure of the Routh Street Women's Clinic in June 2015. Abortions that occur later in pregnancy are still safe, but they are riskier than early-term abortions. They can also be far more expensive than abortions occurring earlier in pregnancy.