Texas reproductive justice groups were alarmed, but not surprised to see a highly restrictive abortion bill become the focus of the special session of the Texas legislature. In fact, the majority of this special session will be concerned with limiting abortion access in Texas even further than 2011.
Gov. Rick Perry and his allies have made no secret of their wish to outlaw abortion access in Texas. However, none of these bills advanced during the regular session.
Those bills require a 2/3 majority to pass, and even some Republicans were uneasy about the proposed restrictions, and chose to join Democrats to block the bills. In a special session called by the governor, however, only a simple 51% majority is required for a bill to pass. The state's far-right is using this as their opportunity to ram through legislation that the majority of Texans oppose.
There are four major problems with Senate Bill 5 that concern advocates.
This bill would close all but five clinics in Texas. Abortion will only be available in Houston, Dallas, Austin and San Antonio, and nowhere else in the nation's third largest state by geography.
Anti-abortion activists and politicians are claiming that the requirement to be ambulatory surgical centers (ASCs) simply keeps women safer. In reality, these regulations put safe, good doctors out of business and push abortion back to the back alley.
There is no eliminating abortion. People who can afford it have always, and will always have access to travel and to doctors where they can have abortions. There is only eliminating safe, legal abortion, which means that more desperate people will be forced to seek out dangerous alternatives to the caring doctors who have made the safety and autonomy of Texans their priority.
As we all know, there are miles and miles of Texas. Closing access centers means that rural Texans and Texans without access to easy transportation and/or paid time off, medical care and benefits (a high number in San Antonio) will face additional undue burdens in trying to obtain abortion care.
It's already incredibly difficult for those groups to deal with multiple days off because of a mandatory sonogram and waiting period; this will add to that burden and make it even more difficult to travel to obtain care. Add in the fact that many will need to spend more on childcare (most patients are already parents) and travel, and abortion has now been priced out of reach for many Texans who need it most due to economic circumstances.
San Antonio already has an influx of patients coming from the Rio Grande Valley for access to abortion services. These patients will now be forced to cross the border south for abortion access rather than obtaining it in here in Texas. In addition, closing many clinics in Texas will overwhelm the services and resources of the those left open. Texas is a massive state, with too many patients for so few clinics to be able to function.
Restricted Access to Medical Abortion
The abortion pill, which is safe and uncomplicated, will be highly regulated. This is often the method of abortion favored by people who have choices. It is usually less expensive, can be taken at home to fit a work schedule or days off, and many people feel it is less intrusive and more private than a surgical abortion.
Patients will need to travel to two appointments - before and after. Remember there are only four cities they can go to, so they may have to travel many miles. They will need to go for an appointment before and then a follow up appointment after, in person, and with a doctor.
A doctor will have to administer the medication - where a nurse practitioner could do it, and does in many areas - or it could be done via telemedicine, which is allowed in many states that recognize that the pills are safe and easy to take, and that distance and barriers to access can complicate the procedure for many.
New doctor regulations
For both surgical abortions and the abortion pill, doctors will be highly regulated. While this sounds like a positive thing in theory, abortion is a very safe procedure, and this is highly unusual for a medical procedure. It's definitely not the case in a vasectomy or most other simple out-patient procedures. This is an unfair stigma placed on abortion access, which has it's fair share of stigma-related, non-scientific barriers due already to the Hyde Amendment, which prohibits federal funds (Medicaid) from being used for abortion access.
Physicians will need admitting privileges at a hospital within 30 miles of their clinic.
They will have to be available 24 hours a day in case complications arise.
Most of these hospital admitting privileges are incredibly difficult, if not impossible, for a doctor who doesn't regularly work in a hospital (because they don't need to) to obtain, which means there will not only be fewer clinics, but also fewer actual providers.
Later term bans
This bill calls abortions after 20 weeks, about four months, illegal.
The bill states, "women have adequate time to decide whether to have an abortion in the first 20 weeks," which we know is not always the case. Moreover, it's not always time that they need; often, they simply can't get the money together.
Nationwide, only 1.5% of abortions are late term; for the patients we work with the rate is much higher. Low-income patients often CAN'T access to abortion services earlier on. Many wish they could have had a lower cost, earlier procedure, but procuring enough money is a race against the clock, and each week brings an exponentially higher cost. For someone who is making the decision between groceries, rent, electricity, and an abortion, these barriers are unfair and discriminatory.
San Antonio has a higher rate of low-income Texans who will be hurt by these barriers. In addition, language barriers, not having an ID, or sometimes immigration issues can force Texans to undergo longer periods of waiting, or denial altogether of, access. None of these barriers are accidental, and none are for the health or protection of patients, although the government likes to wrap its anti-abortion ideas in condescending, paternal protective tones.
These barriers in other states have made abortion much more difficult to obtain. The idea is not to protect patients, but to place so many barriers in front of them that they are priced and waited out of an abortion before they can hit the continually moving target of regulations. This should be a private decision between a patient and their medical provider, and the government is interfering heavily in the personal lives of Texans. We have a long history in Texas of independence and self-autonomy, of being able to run our own lives, and of the government running on that idea.
With these regulations, they propose to take us back to the days of back alley abortions. They want to codify the already steep chasm in out healthcare between haves and have-nots, and punish people for geographic and income-related barriers. These politicians are the same ones cutting out social safety net in Texas, making it difficult for many children and families to grow up protected with fair wages, healthcare, and access to equal education, but they do it under the banner of "respecting life."
It's time to let legislators know that you're watching, and they will pay the electoral price if they decide to go around the wishes of Texans to make their own healthcare decisions.
These decisions are not without consideration, and they are not decided on capriciously or without information. People make the decision to have an abortion for the health, safety, and welfare of their families, and our Texas government shouldn't stand between them.
There is a hearing at the Texas State Capitol in Austin today, Thursday, at 3:45 p.m. If you can go, make sure you show your support for Texans' autonomy and liberty. If you can't go, call your reps and let them know you're watching, and you trust Texan families to make their own health decisions. Let them know there will be electoral costs if they skirt the wishes of their constituents. Be a voice for change.
Lindsay Rodriguez is on the board of directors for the Lilith Fund for Reproductive Equity, an abortion fund that assists Texans in exercising their legal right to abortion by removing barriers to access. They can be found on twitter @LilithFund and on Facebook.