Thanks to a harsh state law, the wait time for women to get an abortion in Texas is becoming dangerously long — and a pending court decision could make it even worse.
A new report released by the Texas Policy Evaluation Project — a research group based at the University of Texas at Austin that’s been tracking the state’s reproductive health policy over the past four years — finds that recent clinic shutdowns have greatly limited access to timely abortions statewide. In some cases, women had to wait nearly a month to be seen. In others, clinics had to turn women away, since they had no available appointment slots open.
As wait time to get an abortion increases, the estimated proportion of abortions performed in the second trimester increases. These later surgical abortions, although safe, are associated with a higher risk of complications and are significantly more costly to women than an earlier medical abortion. And even staunch abortion opponents are more opposed to late-term abortions compared to earlier procedures, citing the scientifically disputed theory that fetuses can feel pain after 20 weeks gestation.
The researchers behind the new study have been collecting data since the initial passage of the 2013 law, known as HB2, considered among the harshest anti-abortion measures in the country. HB2 imposes harsh restrictions on abortion clinics and providers under the guise of improving patient safety. Since it was approved, the number of abortion clinics in Texas have dropped from 48 to 18. Now, there are only nine surgical centers left in Texas that are able to perform later abortions.
“It was so frustrating to hear legislators behind these bills saying things completely not based on fact,” said Daniel Grossman, a lead researcher and a professor of obstetrics and gynecology at University of California, San Francisco. “We saw, on the ground, how women were affected by these laws, and knew it was important to document.”
Grossman said that state-level data on abortion clinics is often released years after a bill is debated, giving lawmakers little to lean on during the initial fight. The Texas Policy Evaluation Project hopes to help fill this gap.
“We saw such a delay in needed data collection. Meanwhile, all these laws are being passed in quick succession without real data to challenge them,” he said.
After the initial closures, abortion providers in the state quickly filed suit against multiple provisions of the omnibus HB2. Grossman said he and his fellow researchers knew right away the state wouldn’t have enough time to get data to the courts in defense of HB2.
“So instead, we stepped in,” he said. “We visited each abortion provider and collected the data needed to stand up for them.”
One of the law’s contested provisions, currently on hold as the Supreme Court decides whether to weigh in, includes the requirement that all abortion facilities make costly renovations to bring their building codes in line with ambulatory surgical centers (ASCs).
Grossman’s research team found that in early 2014, only 22 percent of all abortions in Texas were being provided by ASCs. However, if HB2’s regulations are allowed to fully take effect and all non-ASC clinics are forced to close, those clinics will be responsible for conducting abortions for the entire state.
“We suggested that it would be difficult for those facilities to increase their capacity sufficiently to meet the demand for all abortions in the state, while proponents of HB2 said that there was no reason to believe that they could not meet this demand,” the report states.
The conservative U.S. Court of Appeals for the Fifth Circuit has allowed most of HB2 to take effect. Now, the fate of the non-surgical clinics lies in the hands of the Supreme Court. This summer, the Supreme Court temporarily put the ACS provision on hold while the justices decide whether to weigh in on Texas’ law. The justices may decline to take up the case, which would leave in place a previous decision from the Fifth Circuit that upheld the ASC rules.
Right after HB2 was passed, Grossman talked with women who had abortion procedures scheduled at the newly shuttered clinics. They were suddenly rushing to find money to travel at least 150 miles to the nearest center before they were no longer eligible for the procedure. Not all got the abortion they had hoped for.
“It was difficult seeing these women late into pregnancy who really didn’t want to be. They were so angry at the state for making the decision for them,” he said. “I can only hope we won’t be seeing more bills taking away these rights.”