Study: Texas women wait longer, self-induce abortions after HB-2 closes clinics

Study author: "There is no evidence that any of the provisions in this law has improved the safety of abortion in the state. They have just made it harder for women to access the services they want and need."
By JC Sevcik  |  Updated July 24, 2014 at 3:31 PM
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AUSTIN, Texas, July 23 (UPI) -- A new study released Wednesday reports in the six months since Texas' new anti-abortion law took effect, the number of legal medical abortions has dramatically declined while the number of second-trimester abortions has risen, suggesting to researchers that women are being forced to wait for the procedure.

HB-2 limits medical abortions, a non-surgical method, by restricting the time window during which the drug can be prescribed from 9 weeks to 7 weeks, and by forcing patients to return to a medical provider to ingest the medicine in front of a doctor four separate times rather than taking the regimen at home, something not all women can afford financially or logistically. The law also requires abortion providers to have admitting privileges at local hospitals, which many hospitals can't accommodate, and bans abortions after 20 weeks of pregnancy.

HB-2 went into effect last November and has already had a dramatic impact on women's access to reproductive healthcare in the months since.

Of the 41 clinics open in May 2013, only 20 remain open, causing the number of women of reproductive age living more than 200 miles from a facility to jump from 10,000 to 290,000, according to the report.

Medical abortions, which allowed women seeking abortion early in their pregnancy to avoid an invasive and potentially traumatic surgical procedure, have dropped by 70 percent under HB-2.

Legal abortions have decreased 13 percent, 9,200 fewer than last year, and researchers, noting surprise this number wasn't higher, credited the state's network of non-profits and abortion funds helping to finance women's reproductive healthcare with mitigating the decline.

Despite the overall decline in abortions, the number of second-trimester abortions actually increased, suggesting the decrease in access to clinics and medication abortions is forcing women to wait until later in their pregnancies to have the procedure.

Fatimah Gifford, a spokeswoman for Whole Woman's Health, a reproductive health provider, told the Texas Tribune her organization's San Antonio clinic has seen an increase in the number of women traveling long distances, and wait times have increased from one week to four or five weeks.

Making patients wait and travel to obtain abortion procedures places increased financial hardship on women who may not have a vehicle or be able to afford time off, childcare, travel and lodging expenses.

And in Septemeber when a fourth provision of HB-2 requiring all abortions to take place in ambulatory surgical centers takes effect, the number of clinics in the state will drop to 6, further limiting access.

Data Source: The Texas Policy Evaluation Project Graphic: DataBlick

"It does not appear that the existing ambulatory surgical centers could meet the demand for abortion services for the entire state when the final provision of HB2 goes into effect," said said Daniel Grossman, author of the study and vice president for research at Ibis Reproductive Health.

And with many of the organizations helping women obtain reproductive healthcare already running out of funds, it is unlikely non-profits could continue to mitigate the decline in legal abortions by further subsidizing access to the procedures.

Between HB-2's sweeping restrictions which limit access and Texas' 2011 cuts to family planning funding, Grossman says he expects the unintended birthrate to rise and worries the rate of self-induced and illegal abortions will rise as well.

"[Researchers] suspect that self-induced abortion will rise in Texas as access to clinic-based care becomes more difficult," Grossman told the Huffington Post. "Depending on the method used and when in pregnancy women attempt to do this, there may be health risks for women associated with self-induction."

Proponents of HB-2 touted the law as making abortion safer.

"There is no evidence that any of the provisions in this law has improved the safety of abortion in the state," said Grossman. "They have just made it harder for women to access the services they want and need."

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