Texas abortion clinics soon might have to shut their doors
Even with the strictest abortion laws in the country, some two dozen clinics in Texas managed to survive. Now, their time might soon be up.
A leaked draft of a Supreme Court decision indicates that the court will likely overturn Roe v. Wade, meaning that for the first time since 1973, abortion will no longer be a constitutional right. It would vary from state whethwomen er abortion is legal. About 22 states — including Texas — are poised to ban abortion if Roe is overturned, through trigger laws or legal mechanisms.
That means that abortion clinics across Texas may soon have to shut their doors, leaving scores of workers without jobs and women without access.
Doctors and other experts say it’s going to create a huge supply and demand problem. States where abortion remains legal are likely to be overwhelmed by from states where it would be outlawed, resulting in long waitlists that will delay the procedure to later in the term and increase costs.
Women also will have to incur costs for traveling.
For Texas women, those costs are likely to grow as neighboring states such as Louisiana and Oklahoma are also likely to ban abortion if Roe is overturned. Louisiana and Oklahoma clinics became havens for Texas women after the state last year enacted Senate Bill 8, which essentially made abortions after six weeks illegal — before most women even know they are pregnant.
“What we’re seeing emerging is kind of like two different Americas,” said Amy Hagstrom Miller, CEO of Whole Woman’s Health, headquartered in Virginia with four Texas locations. “Some people will have access to health care and reproductive health services because of where they live and other people’s access will be restricted because of where they live.”
Between September and December, about 1,400 Texans traveled each month for an abortion, according to The Texas Policy Evaluation Project, a University of Texas at Austin group that evaluates the effect legislation has on women’s reproductive health. That 1,400 far surpasses the 142 Texans who traveled out of state following widespread clinic closures after a 2013 law
placed restrictions on abortion facilities, such as requiring doctors to have admitting privileges at hospitals within 30 miles.
Dr. Stephanie Mischell, a family medicine physician in Texas and fellow with Physicians for Reproductive Health, an advocacy group, fears the court’s looming decision could have lasting effects in Texas, similar to the 2013 laws. She works at an abortion clinic in the Dallas area, and remembers very clearly when other clinics began shutting down years ago.
“Most of the clinics that closed during that time never opened back up,” Mischell said. “Overturning Roe v. Wade is going to have a devastating impact on not just my practice, but on everyone’s practice; and it’s really going to change the landscape of health care in the state.”
After SB8 went into effect in September, Texas abortions dropped by about half to 2,250 from about 4,500 in September 2020. Meanwhile, Texas women who didn’t realize they were pregnant until after six weeks have been driving to Hope Medical Group for Women in Shreveport, La., said Kathaleen Pittman, an administrator at the clinic. The clinic’s waiting list, which was nonexistent before Texas enacted SB8, has grown to about 300. It takes about two weeks to get an appointment, up from about a day.
“The influx of patients has been relentless,” Pittman said.
If Roe is overturned, Pittman said, the clinic’s operations will come to a “screeching halt.” The Louisiana Legislature passed a trigger law in 2006 that would make abortion illegal in the event Roe v. Wade is overturned, leaving Texas women with fewer options within driving distance.
Many of the Texas woman who arrive at Hope Medical Group have low incomes, and buying a plane ticket isn’t an option.
Oklahoma is also off the table. The Oklahoma Legislature recently approved a law similar to SB8, and has a trigger law that would ban abortions if Roe were overturned.
As closer options dwindle, waitlists in states where abortion would remain legal would only become longer, said Veronica Jones, the chief operating officer of the National Abortion Federation, a professional association of abortion providers based in Washington. The group maintains a hotline to help people access abortions, particularly in states with restrictive laws.
“Destination, haven states where individuals are going to be traveling are going to see a significant surge,” Jones said. “We’re looking at the map and seeing where patients can travel and how providers can be prepared for that surge because it is coming.”
Beyond New Mexico, the closest state where abortions would likely remain legal is Colorado. As a result, Texas women are going to have to travel farther, incurring costs of airfare, lodging and child care. They also might
end up paying more for procedures.
“It may delay when they get care,” Jones said. “They may need later abortion care, which will have higher procedural costs.”
On average, a first-trimester in-clinic abortion costs roughly $508, according to the National Abortion Federation. Secondtrimester abortions can cost more than $2,000.
Long-distance travel isn’t always conducive to complicated pregnancies, said Dr. Lauren Thaxton, an OB-GYN and assistant professor with Dell Medical School, University of Texas at Austin. But outlawing abortion will leave doctors with impossible choices: have women travel and hope their conditions don’t worsen, or wait until their lives are imminently in danger. Texas law would allow abortions to save the life of the mother.
“Anybody who provides obstetric care knows that conditions can change on a dime,” Thaxton said. “We want to do the right thing for the patients, but now we’re in this position of having a conversation about how imminent the threat is to someone’s health.”