On September 1 the most stringent portion of House Bill 2, the anti-abortion legislation passed by the Texas Legislature last year, is scheduled to go into effect. Any healthcare clinic in the state that provides abortions will be required to be an ambulatory surgical center.
If the rule takes effect, the number of clinics that provide abortions in Texas will drop from 20 to seven, all located in urban areas. Whether or not it will comes down to a lawsuit awaiting a decision in federal court. The suit, brought by the Center for Reproductive Rights, asserts that the final requirement of HB2 places an "undue burden" on women seeking an abortion.
One of the seven clinics would be Planned Parenthood's new Dallas clinic, pictured above, a retrofitted ambulatory surgical center. The clinic, which began serving patients two weeks ago, meets every HB2 requirement regardless of what happens with the lawsuit, says Sarah Wheat, spokeswoman for Planned Parenthood of Greater Texas.
"When a state restriction on abortion creates a substantial obstacle to women's ability to access safe and legal abortion, that's unconstitutional. As we described during the trial that happened just a few weeks ago in Texas, the ambulatory surgical center requirement is going to severely restrict access in the state," Julie Rikelman, the Center for Reproductive Rights' litigation director says.
Before any HB2 requirements were effective, 10,000 Texas women of reproductive age lived more than 200 miles from an abortion provider. Now, that number is 290,000 and will increase further should the lawsuit be unsuccessful. When access decreases, danger to pregnant women increases, says Dr. Hal Lawrence, the executive vice president and CEO of the American Congress of Obstetricians and Gynecologists.
"Women will resort to other means to try to terminate a pregnancy, which will put their lives at risk," Lawrence says. "Second, some women will deny that they are pregnant and not seek pre-natal care and end up having increased risk in pregnancy, increased risk of maternal mortality and increased risk of babies with developmental abnormalities."
A similar suit in Mississippi, decided in late July, led to the state's only abortion clinic being allowed to stay open. A portion of the ruling in that case says that forcing women to seek an abortion across state lines does create an undue burden on those women.
"In the Texas case, the state's attorneys were saying that the elimination of access to abortion in certain large parts of the state was OK, and was constitutional, because women could go to New Mexico. That argument by the state is of course flatly contradictory to what the panel of judges in Mississippi found," Rikelman says.
A ruling is expected in the Texas case before September 1.
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