The Supreme Court is expected to hand down a potentially landmark decision about abortion policy on Monday, as the justices prepare to rule on a Texas law that’s shuttered dozens of abortion clinics and contributed to an increasing health care crisis in the Lone Star State.
The 2013 law, known as HB 2, places onerous restrictions on abortion clinics under the guise of protecting patients’ health and safety. The question before the justices is whether this law goes too far to prevent women from exercising their constitutionally protected right to have an abortion.
The debate over HB 2 has been framed as a tug-of-war between safeguarding women’s health and protecting their right to choose. But there’s actually plenty of evidence that this is a false dichotomy. HB 2 has had disastrous consequences for Texas that, since it was passed several years ago, have already made women less safe.
Clinics across Texas are being forced out of business.
Immediately after HB 2 was signed into law, abortion providers started closing their doors because they couldn’t afford to comply with the legislation’s stringent standards, which require clinics to make costly and unnecessary upgrades like widening their hallways and installing new water fountains. About half of the state’s 40 clinics have shut down. The remaining clinics are concentrated in major cities, leaving large swaths of the massive state — which extends 801 miles north to south and 773 miles east to west — without any legal providers whatsoever.
Women are struggling to access basic reproductive health care.
With so many fewer clinics in the state, women are being forced to travel farther, wait longer, and ultimately pay more to get the health care they need. According to data from the Texas Policy Evaluation Project — a research group based at the University of Texas at Austin that tracks the state’s reproductive health policy — women’s health clinics are simply turning patients away because they can’t keep up with demand. Some women are being forced to travel to different states to end a pregnancy. Others aren’t so lucky, particularly if they don’t have the financial resources to make a long trip, and simply can’t get the abortion procedure they need.
This is having a huge impact on Texans’ abortion access, of course, but it’s also affecting other aspects of reproductive health care. Many of the clinics that have been forced to close in the aftermath of HB 2 also provided family planning and cancer prevention services. Coupled with deep cuts to Texas’ family planning safety net, these clinic closures have left some women — particularly low-income immigrant women who can’t move freely past the state’s internal border checkpoints — unable to get birth control or have regular Pap smears.
Pregnant women are resorting to illegal abortion procedures.
As women’s options are limiting, some of them are turning to dangerous alternatives. There’s been a demonstrative increase in the number of women trying to induce their own abortion, according to the Texas Policy Evaluation Project, which estimates that between 100,000 and 240,000 women have resorted to this option. Some of those women are crossing the Mexico border to buy abortion-inducing medication on the black market. Others are trying out more harmful methods of ending a pregnancy, like asking someone to punch them in the stomach.
The situation is reminiscent of the days before Roe v. Wade, when desperate women resorted to back alley abortions. “It was like we were back in the days of the Wild West, like we have to figure this out by ourselves and just grit our teeth and get through it,” one Texas woman who had an illegal abortion two years ago, at the age of 23, told Reuters.
Doctors who want to provide safe abortions have nowhere to get trained.
The harsh restrictions in Texas have also had ripple effects on the medical community as a whole. With a dwindling number of abortion clinics in the state, the doctors who want to get trained on how to prove this particular procedure have very limited options. Considering the fact that there’s already a shortage of abortion providers in the United States — and that OB-GYNs who have access to abortion training during their medical residencies are more likely to choose to provide this procedure later in their careers — failing to expose Texas doctors to abortion threatens to have serious consequences.