Last year, when the Texas legislature was passing a radical anti-abortion law that included stringent new standards for abortion clinics, I observed:
[T]he purpose of these restrictions is not to make abortions safer but to make it as difficult as possible for women to obtain legal abortions– especially low-income women outside of a few urban areas.
And as State Sen. Wendy Davis– who filibustered against the law and is now running for governor– pointed out, the law may reduce the number of safe and legal abortions in Texas, but it is unlikely to reduce the total number of abortions.
I hope nobody will be surprised to learn that these apprehensions were justified, as Amelia Thomson-DeVeaux reports in The American Prospect:
Since November, the last abortion clinics in East Texas and the Rio Grande Valley, some of the poorest and most remote parts of the state, have been hanging on by their fingernails. The two clinics, both outposts of a network of abortion providers called Whole Woman’s Health, stayed open with slimmed-down staffs while their owner, Amy Hagstrom Miller, struggled to comply with the first chunk of HB2—the voluminous anti-choice law passed by the Texas legislature last summer—which requires abortion doctors to obtain admitting privileges at a local hospital. Today, after weeks of failed negotiations with nearby hospitals, Hagstrom Miller announced that both clinics are closing their doors.
The clinics in Beaumont, about an hour east of Houston, and McAllen, just north of the Mexico border, were the last rural abortion providers left in Texas. Between July, when HB2 passed, and November, when the admitting privileges requirement went into effect, nearly half of the state’s 44 abortion clinics folded, unable to comply with the new rules. The health center in McAllen stopped offering abortions and pared down its staff, providing ultrasounds and counseling to the women who continued to walk in the door and helping them coordinate travel to the nearest clinic, two hours north in Corpus Christi. The Beaumont clinic survived this initial purge because one of its physicians had admitting privileges, but he’s in his seventies and wants to retire. His colleagues couldn’t get privileges in his stead, leaving the clinic in a precarious position.
“I had to come to terms with the fact that those clinics had no future,” Hagstrom Miller says. She might have kept looking for a way to keep them open, if she wasn’t facing a much bigger threat. In September, the rest of HB2 will go into effect, requiring all abortion providers to conform to the same standards as ambulatory surgical centers (ASCs), outpatient care units that offer more complicated procedures, usually involving high levels of anesthesia. Only one of Hagstrom Miller’s remaining three clinics, the Whole Woman’s Health in Fort Worth, qualifies as an ASC. Updating the other two clinics to comply with ASC regulations—which include wider hallways and specialized heating and cooling systems—could cost $6 million.
The Corpus Christi clinic (which isn’t one of Hagstrom Miller’s) also has until September to renovate. If that clinic closes, Rio Grande residents will have to embark on a five-hour trek to San Antonio…
Rather than waiting for months to scrape together the money for the procedure and the trip—a Sisyphean task in itself, since the price for abortion skyrockets from as little as $300 in the first trimester to several thousand dollars by the end of the second—more women may take matters into their own hands. The Rio Grande Valley already has one of the highest rates of self-induced abortion in the country. A 2012 survey found that 12 percent of women in clinics near the Mexico border said they had attempted to end their pregnancy on their own before seeking professional help. “They’re getting drugs from Mexico, drinking teas, eating herbs, falling down the stairs on purpose or convincing their boyfriends to beat them up,” Hagstrom Miller says. “Any of those methods could be fatal.”
Long wait times for appointments will undoubtedly become the norm. By next fall, when the ASC requirement kicks in, six clinics in major urban centers—Houston, Austin, San Antonio, Dallas, and Fort Worth—could be responsible for performing more than 70,000 abortions each year. Hagstrom Miller and others are fundraising to help poor women pay for transportation to these cities, but for many, a trip to Mexico to buy illegal abortion drugs might seem like a better bet.