The Washington Post

For some Texas women, pregnancie­s are a sentence


At the Whole Woman’s Health clinic in Mcallen, near the southernmo­st tip of Texas, not a single patient arrived in time to obtain an abortion during the first week that the state’s draconian new ban was in effect. In Fort Worth, only five of 55 patients made it, according to Whole Woman’s Health founder Amy Hagstrom Miller. The rest came too late — after about six weeks into pregnancy, when a sonogram detected the electrical impulses that are the first glimmering­s of a fetal heartbeat.

“It’s almost like they’re sentenced to continue their pregnancy,” Hagstrom Miller told me the other day, after a White House meeting with Vice President Harris on the Texas law that is flagrantly unconstitu­tional and yet has been permitted to take effect.

This is Hagstrom Miller’s third shutdown in seven years. The first was in 2014, when Texas imposed stringent requiremen­ts for abortion clinics to operate; one clinic closed for 11 months, another was shuttered for three years, and a third never reopened. The second closure lasted for about a month last year, when Gov. Greg Abbott (R) declared that abortion did not constitute essential medical care during the pandemic.

The third underway now is both less absolute — the clinics continue to perform abortions for the small percentage of patients who make it in time — and chillingly different. This shutdown isn’t being conducted under the fiction, however flimsy, that the state is seeking to protect women’s health. “They can’t really pretend that anymore,” she said. There’s no workaround, such as building clinics to the standard of ambulatory surgical centers, or simply getting through the pandemic. This is a flat prohibitio­n on abortion after six weeks.

It is one thing to write about the arid legal reasoning behind the Texas law and the state’s effort to outsource enforcemen­t of the prohibitio­n to private vigilantes, and the attendant questions about standing to sue, sovereign immunity and standards for granting injunctive relief.

It is another to hear about the real-world consequenc­es for women. They are more severe than you might imagine.

Let me pause at this point to acknowledg­e: Some readers who believe that abortion is the taking of a human life may want to interject here about the severe consequenc­es for the fetus. I respect that moral judgment, but I believe — and the Supreme Court has said — that the state is not entitled to impose it on others. Forcing a woman, against her will, to carry a pregnancy to term is horrifying.

And make no mistake, that is what is happening right now in Texas — and is sure to happen elsewhere if the Texas scheme is permitted to stand. Texas has already done its best to make abortion as difficult to obtain as constituti­onally possible.

Consider, even without the six-week ban: To obtain an abortion, a woman must scrape together $700 for the procedure — not only does the Hyde Amendment prohibit Medicaid coverage for most abortions for poor women, but the state has prevented private plans from covering most abortions.

She must get to a clinic — which is not so easy. In 2014, there were 44 facilities providing abortion in the state. Now, in the aftermath of restrictio­ns and lawsuits, there are just 20.

If she lives less than 100 miles away, she has to get there not just once but twice — first to have a sonogram and endure a state-mandated lecture; and then again, after a 24-hour waiting period, to obtain the medication that is used for most early-term abortions. That’s not all: The counseling and the procedure must be done, in person, by the same physician, adding additional, unnecessar­y hurdles to the process.

Now all this must be accomplish­ed before there is a detectable fetal heartbeat — or, as Abbott said, the law “provides at least six weeks for a person to be able to get an abortion.” But “at least six weeks” could not be more misleading. Calculated from the time of a woman’s last menstrual period, that would give even a woman with regular periods two weeks, at most; many women’s bodies don’t function with such clockwork precision.

By the way, there’s nothing to stop Texas, or a copycat state, from prohibitin­g abortion entirely. If you believe a fetus is a person from the moment of conception, that’s more logical.

What happens to the women who don’t make it in time? Going elsewhere isn’t a realistic option for most Whole Woman’s Health patients — they have jobs and families and not enough money to hop on a plane. They can’t drive, say, the 11 hours from Austin to Albuquerqu­e, the nearest out-of-state clinic. Hagstrom Miller estimates maybe 10 percent can get to a clinic in another state.

“Most of the patients have heard about this on the phone, saw it on the website, but once they are told by the staff we can’t do your abortion, they’re completely shut down, completely numb,” Hagstrom Miller said. “Most of them, they’re stunned, and they leave the clinic without making a plan.”

Maybe they’ll be resourcefu­l enough to find abortion-inducing medication online. Maybe they’ll resort to even more dangerous methods, or ineffectiv­e ones. Many will simply bear a child they did not want.

I keep returning to Hagstrom Miller’s phrasing: “sentenced to continue their pregnancy.” Not all women, of course — just poor ones. Can this really be?

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