Texas women seek abortions for the same reasons 1 in 3 American women will have one by age 45
AUSTIN, Texas (Thomson Reuters Foundation)—The parking lot at the Whole Woman’s Health clinic, a low-slung building on a leafy lot beside Interstate Highway 35, was jammed early on a sultry morning in mid-June.
One of the cars belonged to Laken, 26, a slim casino worker from Lake Charles, Louisiana.
Laken, who, like other women interviewed at the clinic declined to give her full name, finished work at her casino at 2 a.m. and at 3 a.m. started the five-hour drive to Austin to make it to the clinic by 9 a.m.
Already an unmarried mother of three children under the age of 8, Laken was tired, nervous and about 13 weeks pregnant.
Unable to find an abortion clinic with an appointment closer to home, she had planned to go to the Whole Woman’s Health clinic an hour away in Beaumont, Texas only to find that it had closed in March. Instead, she came to Austin, leaving her children with her mother and taking unpaid time off from her job.
“I was on the birth control pills for four months, but I worked the overnight shift,” she said. “I never missed one (pill) but I took it at different times,” she said, sitting in the quiet, softly lit waiting room before her abortion.
“I’m not really sure how I’m feeling,” she said about the abortion. “It’s not about ‘Do I want to?’ It’s ‘Can I?’” There was no way she could afford another child, she added.
The leading reasons women choose abortion are concerns about affordability and responsibility for others, according to the Guttmacher Institute, a nonprofit organization that works to advance sexual and reproductive health through research, policy analysis and public education.
Because Laken lives more than 100 miles from the clinic, the state waived the mandatory 24-hour waiting time between the initial consultation and sonogram and the abortion procedure.
Asked what she would do if the Austin clinic no longer existed, she looked perplexed. “I wouldn’t know any place closer. It’s just so long of a drive and $60 to fill up the car to drive here, $150 here and back,” she said.
Because of a network of organizations around the country, like the Lilith Fund, the National Abortion Federation and the Texas Equal Access Fund (TEA Fund), that help low-income women meet the cost of abortion services, Laken was able to get a grant of $200 toward the $510 cost of her abortion.
What Laken couldn’t know was that a month later, on July 31, the Whole Woman’s Health Clinic in Austin would close its doors.
It was the latest casualty in a war of attrition sparked by the July 2013 passage of Texas House Bill 2 (HB2). As of November 2013, the law required doctors performing abortions to have admitting privileges at hospitals within 30 miles of the clinic; banned abortions after 20 weeks and restricted the administration of medical or medication abortions. As of Sept. 1, it will require facilities providing abortions to have the hospital-grade physical attributes of an ambulatory surgical center or ASC.
The bill’s requirements, which supporters argue are for the health and safety of women and critics call medically unnecessary and aimed at restricting access to abortion, already have closed nearly half of the abortion clinics in Texas.
“This law was a solution without a problem,” said Amy Hagstrom Miller, founder, president and CEO of Whole Woman’s Health. A for-profit abortion provider, Hagstrom Miller has closed three of the five clinics she operated in Texas since HB2 was passed.
A lead plaintiff in the current federal court challenge to the ASC provision, she’ll be down to one facility, an ASC in San Antonio, if that part of the law goes into effect.
The number of Texas women of reproductive age living more than 100 miles from an abortion clinic grew from 417,000 in May 2013 to 1,020,000 by April 2014. When the ASC requirement goes into effect, that number will increase to 1,335,000, according to researchers at the Texas Policy Evaluation Project (TxPEP), a study based at the University of Texas at Austin.
Saira, a 22-year-old paralegal from Lubbock, is already one of them. “This was the closest clinic that could see me the soonest,” she said, noting that she, her medical student boyfriend and her young daughter had flown the nearly 400 miles to Austin rather than drive for nearly 6 hours.
“I was on Depo-Provera,” she said, referring to the contraceptive injected every three months. “I didn’t think this would happen,” she said,
She never thought she would consider an abortion, but having another child would be extremely difficult, she said. Before she could finish her thoughts she was called in for her mandatory sonogram.
In an email a few days later, she wrote that it turned out she had an ectopic pregnancy, a potentially life-threatening condition in which the embryo implants outside the uterus, usually in the fallopian tubes. The clinic told her she didn’t need an abortion but should have the ectopic tissue removed as soon as possible. She chose to do it back home in Lubbock.
“It’s like nature took this decision out of my hands,” she wrote, noting that a staff member mentioned the clinic might have to close. “This is very overwhelming. Not so much for me now, but there might be another girl going through a similar situation. Where shall she go?”
For women who can’t afford the time or expense of travel to a distant abortion provider, the answer may be that they go nowhere and resort to a potentially dangerous do-it-yourself abortion at home.
“It’s just a matter of time before we’ll have a clandestine abortion market,” said Hagstrom Miller, noting that already there were reports of women self-inducing by buying the abortifacient drug Misiprostol, also used for arthritis, in Mexico or elsewhere. “We’re going to see a black market because the need hasn’t changed,” she said.
(Editing by Tim Pearce; timothy.pearce@homsonreuters.com)
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