Demonstrating the frontier spirit of self-reliance so praised by Texas' conservative lawmakers, at least 100,000 women have escaped an abortion industry reeling from a law that closed about half the state's abortion clinics. House Bill 2, the tough anti-abortion bill the Legislature passed in 2013, has left large swaths of the state nowhere near a clinic and has meant longer waits for appointments at the 20 or so still open. Getting an abortion in a clinic, in other words, has become much harder, particularly for poor women in remote places.
Undaunted, women are taking matters into their own hands.
According to a report from UT's Texas Policy Evaluation Project, at least 1.7 percent of reproductive-aged women in Texas have attempted to end their pregnancies without the help of a medical professional. The project's research team, led by Daniel Grossman, says the state meets two conditions that lead women to seek to end pregnancies on their own: laws that limit access to clinics and proximity to Mexico, where abortion drugs are sometimes obtainable without a prescription.
"We found that 1.7 percent to 4.1 percent of woman aged 18-49 have attempted to self-induce an abortion," Grossman said. "We also explored which populations in Texas are more familiar with abortion self-induction. Overall, 22 percent of women either knew someone who had attempted to self-induce an abortion or had done this themselves. We found that Latinas living near the U.S./Mexico border and women who had experienced barriers to accessing reproductive healthcare were significantly more likely to know someone who'd self-induced or to have done this themselves."
Only two of H.B. 2's three significant restrictions have taken effect so far. Women cannot get abortions more than 20 weeks after conception. (Later-term abortions are riskier for women's health, the bill's supporters say.) Also, any doctor performing abortions at a clinic must have admitting privileges at a hospital nearby. (Access to a hospital also keeps women safer, H.B. 2's proponents claim.) The bill would also require abortion clinics to become ambulatory surgical centers, which are basically mini-hospitals. That last rule is on hold until the U.S. Supreme Court decides whether it's constitutional.
So, to sum up, an anti-abortion measure whose supporters argue — maybe a bit disingenuously — is better for women's health is the sort of law that prompts Texas women to cross the Rio Grande to pick up some DIY pills from a Mexican pharmacy. The silver lining, we suppose, is that the drugs are safer than old-school coat-hangers, though less safe than other methods. From the report:
Women have heard of a range of methods that are used to induce an abortion on one’s own, but misoprostol is the only effective abortion-inducing drug that was mentioned. Other methods, such as herbs or hormonal pills, are not effective, and some methods, such as getting punched in the abdomen, are potentially dangerous.
Before the Supreme Court stepped in, the Rio Grande Valley had no abortion clinics. When it blocked the surgical center rule, the court also temporarily allowed Whole Women's Health in McAllen to stay open without admitting privileges at a nearby hospital. Ana DeFrates, director of the Texas Latina Advocacy Network, recounted the story of Vanessa, a woman in the Rio Grande Valley who attempted a self-induced abortion after H.B. 2 became law.
"Vanessa has three children which she planned with her husband. When she found out she was pregnant for the fourth time, she knew she could not afford a fourth child and decided to end her pregnancy" DeFrates said Monday. "At the time, both of the clinics in Harlingen and McAllen were closed. Frustrated but determined, she unsuccessfully tried to end her pregnancy with herbs and then with injections obtained for her by her mother."
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To get an abortion at a clinic, Vanessa would've had to travel to San Antonio, more the 250 miles away, for multiple appointments, something she could not afford, DeFrates said. Instead, Vanessa went to a doctor in Reynosa, who was also unable to perform the abortion, before she returned home to carry the pregnancy to term.
"No one should have to leave their state or go to another country to end their pregnancy or be forced to carry an unwanted pregnancy to term," DeFrates said.
The Supreme Court will decide whether stories like Vanessa's represent an undue burden for Texas women seeking abortion. If the court decides that H.B. 2 does make getting an abortion unreasonably tough instead of just really difficult, the 20 clinics now open will stay open. If it doesn't, that means 8-10 abortion clinics are plenty enough to serve Texas' 5.4 million reproductive-age women, and women in the Rio Grande Valley are adequately served with the closest clinic in San Antonio.