On July 18, 2013, Texas Governor Rick Perry signed House Bill 2, “an act relating to the regulation of abortion procedures, providers, and facilities; providing penalties”, into law, introducing four new restrictions regarding abortion. The first regulation prohibited all abortions after 20 weeks of gestation, except in cases of severe fetal abnormality and serious risk to the life of the mother. Such a decision would be made according to the judgment of each physician. The second provision required doctors performing abortions to have hospital admitting privileges within 30 miles of the clinic where the procedure is performed. Closely related to the second provision, the third component of HB2 required abortions to be performed in ambulatory surgical centers. Abortion clinics like Planned Parenthood and Whole Women’s Health would have to upgrade their current facilities in order to gain licensure as ambulatory surgical centers and continue performing abortions. The final restriction dealt with the issue of both early term and drug-induced medical abortions. HB2 required women seeking a medical abortion to attend four separate visits with the same physician for a pre-procedure sonogram, two doses of the abortion pill, and a follow-up visit 14 days after the abortion. All four regulations went into effect on September 1, 2014.
A few weeks later, on September 27, the ACLU of Texas, Center for Reproductive Rights, and Planned Parenthood collectively filed a lawsuit against HB2, arguing that the law violated many components of the landmark 1973 Supreme Court case Roe v. Wade. The lawsuit was aimed at the unconstitutionality of requiring doctors to have hospital admitting privileges. The U.S. District Court for the Western District of Texas agreed, issuing an injunction against the law on October 28. However, only three days later, the U.S. Court of Appeals for the Fifth Circuit lifted the injunction, ruling that the admitting privilege rule was indeed constitutional.
A year later, the topic of abortion legislation in Texas has yet to be settled. After the case was brought to the U.S. Court of Appeals for the Fifth Circuit a second time on October 2, 2014, the previous ruling was upheld. Five days later, various women’s rights groups responded by bringing the case to the Supreme Court in Whole Woman’s Health v. Lakey. On October 14, the U.S. Supreme Court temporarily placed a hold on many provisions of HB2 by a vote of 6 to 3.
According to many medical experts, the requirement for abortion clinics to be ambulatory surgical centers was unnecessary for patient safety. Abortion in America is already quite safe —the Guttmacher Institute reported that less than 1 percent of all U.S. abortion patients experience a major complication. Statistically speaking, a woman is ten times more likely to die in childbirth than from an abortion.
Unable to afford the costly upgrades necessary to comply with the regulations of HB2, dozens of abortion clinics were forced to close — by September 2014, only seven clinics remained in all of Texas. Indeed, the Houston Chronicle reported that Texas has 75 percent fewer abortion clinics today than it did two years ago and the fewest abortion clinics per capita in the nation. As a result, nearly a million Texas women need to drive at least three hours to reach an abortion clinic, and according to the U.S. Census Bureau, over 75.4 percent of women in Texas live in cities without abortion clinics.
With fewer clinics for women to turn to, the remaining clinics have been overwhelmed by an influx of patients, a shortage of staff, and generally limited resources and funding. Rochelle Tafolla, the spokeswoman for Houston’s Planned Parenthood, said that calls to the clinic have been up by 170 percent since the U.S. Court of Appeals’ ruling. Looking at Austin clinic reviews, one can see the increased frustration, one woman writes, “I tried to make an appointment…[but] they had to cut back on staff and no one answers your calls. You have to go up there yourself to make an appointment.” “They made a very difficult experience even worse,” recalled another anonymous reviewer on her experience seeking health services from a clinic in Dallas. “Go elsewhere for any service they pro – vide.”
Joe Pojman, the executive director of Texas Alliance for Life, claims the 2013 law helps to “protect the health and safety of women who are undergoing abortion.” Meanwhile, Cecile Richards, the president of Planned Parenthood, points out that countless women must now turn to back-alley and substandard services as a result of this law. “We’re seeing the terrible impact these restrictions have on thousands of Texas women who effectively no longer have access to safe and legal abortion,” she says.
With the remaining seven abortion clinics being located in large urban cities, the women who are most affected by the recent rulings are those who live in rural areas of Texas. By limiting their access to abortion clinics, health services are being withheld from a population of women most in need, since a disproportionately high number of women who receive abortions are of low socioeconomic class and black or Hispanic ethnicities.
On October 14, the U.S. Supreme Court blocked several components of the 2013 Texas abortion law by suspending the October 2 ruling of the U.S. Fifth Court of Appeals. This unsigned order could result in the reopening of many abortion clinics and increased access to these services for many women.
However, as President of the Center for Reproductive Rights Nancy Northup stated, “Texas now stands at the epicenter of a national healthcare crisis.” One thing is clear: the dispute over abortion rights in America is nowhere close to an end.
Pierson College, 2018
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