Down and Out in Texas
Did you know that since January 1, women in Texas have not been able to obtain abortions from the sixteenth week of pregnancy on? This blackout on women's rights and health is happening not because abortions after the fourth month were declared illegal--far from it: In theory, all that has changed is a bureaucratic regulation included in a bundle of antiabortion legislation, HB15. Most of the provisions in HB15, which sailed through the Republican-dominated state legislature, are familiar: There's a twenty-four-hour waiting period and a requirement that clinics offer a flower-decorated pamphlet called A Woman's Right to Know, which suggests a link between abortion and breast cancer, stresses the possibility of psychological damage and gives the death rate for abortions performed at various stages of pregnancy. The bill also requires providers to photocopy patients' IDs and keep them on file.
The killer provision, though, is the one that has received the least press coverage: Beginning with the sixteenth week of pregnancy, abortions can no longer take place in clinics--they must now be performed in a hospital or an ambulatory surgical center. The catch is, Texas hospitals, many of which are Catholic, do almost no abortions, and of the state's 273 surgicenters not one performs the procedure or plans to take it on. For a clinic to qualify as a surgical center it would have to meet hundreds of architectural specifications at a cost of well over a million dollars. "There's nothing about these abortions that requires these regulations," says Sarah Wheat, director of public affairs at TARAL, the state's NARAL affiliate. "They were presented as necessary for women's health, but women's health organizations opposed them."
What happens when the only facilities that can legally provide abortions after sixteen weeks won't, and the only facilities that want to provide them are legally barred from doing so? Thousands of Texas girls and women suffer. The law is written so tightly--no exceptions even to save the woman's life--that clinics have no wiggle room, says Amy Hagstrom Miller, who owns the Whole Woman's Health Clinic in Austin and another in McAllen, near the Mexican border. In fact, many clinics have stopped doing abortions after fourteen weeks just to be on the safe side. Miller has been referring three or four women a week to clinics in Louisiana, Arkansas and Kansas. (Paradoxically, HB15 has meant plenty of work for Wichita's Dr. George Tiller, whom anti-choicers consider the Antichrist.) "Anyone I refer is at least eight hours away from an out-of-state clinic. It's a real burden on them. The majority don't make the trip--it's too expensive." Even if the two clinics now considering an upgrade manage to pull it off, the state is so huge that most women will be left in the cold.
The vast majority of women who terminate their pregnancies do so quickly: 88 percent of abortions are performed before the twelfth week; 96 percent before the sixteenth week. Most who wait that long are young, poor or both: teens in denial about what's happening to their bodies, women trapped in abusive situations, rural women without transportation, women who spend the first trimester chasing the money to pay for the procedure even as delay drives up the price. These women have little political power and get little sympathy from those who do. Along with the stealthy nature of the regulation, that helps explain the lack of furor over what is a ban in all but name. Another Chicana tenth grader has a baby; who gets all worked up about that? Even the most privileged woman, though, can have a wanted pregnancy that goes terribly wrong. Amniocentesis, still the main method for detecting genetic defects, yields its results well after the Texas cutoff date. Think about it: You get the worst news about your baby a doctor can give--it has Tay-Sachs disease, say, which means it will die, horribly, by age 3--and the State of Texas shrugs its shoulders. Or you find that your health or even your life is suddenly at risk--and the State of Texas washes its hands of you. Recently, Miller says, she got a call from a woman who had aborted a much-wanted pregnancy because the fetus had defects incompatible with life. What would happen to her today, the caller wondered? Would she have to go through a whole pregnancy in order to deliver a dying baby? How is "life" served by that?
HB15 is a flagrant violation of Roe v. Wade, which allows states to regulate second-trimester abortions only to protect women's health; if ever there was an "undue burden" on women's ability to access abortion, this is it. Eventually, it may be thrown out in court--but how many girls and women will have been forced to bear children by then? How many will have injured their health and risked, perhaps even lost, their lives? There's a bigger agenda here, too: Around the nation, antichoicers are proposing bills that contradict Roe in hopes of providing the Supreme Court with an occasion to overturn it down the road, when George W. Bush has had his chance to alter the balance of the Court.
Texas is a conservative state, where the religious right is strong. In Austin, Planned Parenthood has had to become its own contractor on building a new clinic when local contractors boycotted the project. In Denton, an Eckerd pharmacist refused to fill a rape victim's prescription for emergency contraception, and a CVS pharmacist refused to refill a prescription for ordinary birth control pills. Waco recently made the news when locals organized a boycott of Girl Scout cookies to protest the scouts' endorsement of Planned Parenthood sex-ed programs. But Texas is also a big, rich, modern state: Houston and Dallas are the fourth- and eighth-largest cities in the country. If abortion access can be denied across the board in Texas, where will it happen next? Utah, for one, is moving in that direction: A law just enacted by the legislature cuts off state funding to any agency (including hospitals) that performs an abortion except in cases of rape, incest or "permanent, irreparable and grave damage" to the woman. As a result, Salt Lake City's University Hospital has announced that it will no longer terminate pregnancies involving fatal fetal deformities.