Jo Anne Embleton
Jacksonville Daily Progress
An epic battle over abortion catapulted Texas to the national stage, but women in the Lone Star State’s smaller urban centers such as Abilene, Corpus Christi, San Angelo and Wichita Falls stand to lose if the legislation passes, said opponents of measures restricting abortion.
Under proposals on the table, Texas women could join those in other states whose access to abortion dwindled, along with availability of birth control and preventive care, after sweeping new laws would tighten requirements on abortion clinics and doctors.
The Texas legislation targets abortion providers, but Texas women – especially the poor and those in smaller cities – could see cumulative effects.
“I think it will be really devastating,” said Dr. Dan Grossman, a physician and researcher for the Texas Policy Evaluation Project.
Lawmakers are moving to restrict abortion while the safety net to provide birth control and preventive care still is frayed, Grossman said.
Right-to-life groups have swung their weight to support the issue and aren’t moved by arguments like Grossman’s.
“They say the same arguments no matter what pro-life bill is being pursued,” Elizabeth Graham, director of Texas Right to Life, said.
The omnibus abortion bill is expected to come before the Texas House for a vote next week during the second special session. State Sen. Wendy Davis, D-Fort Worth, grabbed national attention by filibustering to block passage of the omnibus abortion bill in the first special session.
But supporters say the legislation improves health care by banning abortions at 20 weeks, requiring abortion clinics to meet the higher standards of ambulatory surgical centers and specifying doctors must have admitting privileges at a hospital within 30 miles.
In Pennsylvania, the Abortion Control Act requiring free-standing clinics to meet ASC requirements resulted in the closing of several family planning clinics and has burdened others, said Dr. Sherry Blumenthal, chairwoman of the Pennsylvania Section of the American Congress of Obstetricians and Gynecologists.
“The consequences of this legislation is to limit preventative health services such as cancer screening, STD (sexually transmitted diseases) screening, and contraception care for uninsured and underinsured women,” Blumenthal said.
ACOG “vehemently” opposes the ASC requirement, especially since the regulations have no scientific or medical basis, she said.
“These laws are dangerous, medically unsound and discriminatory,” she said.
Will birth control and preventive care get caught up in the latest push in Texas to legislate abortion out of the state?
It depends how clinics react to the new rules and what their business models are, said Kari White, a TPEP co-investigator.
Of the 42 abortion providers in Texas, five clinics in Austin, Dallas, Houston and San Antonio are ASCs and could remain open under the new rules, according to a Texas Tribune interactive map.
“Some of these abortion clinics do provide a range of reproductive health services. It may or may not mean that those services discontinue,” White, a co-investigator for TPEP, said.
For Texas women in smaller cities – 80 percent of the population – the legislation puts more miles between them and an abortion.
However, Tom Mittler, president of Right to Life of East Texas, said because the nearest facilities that offer abortion facilities are hours and miles away from the region, “that argument is hyperbole.
“It's not going to make a big difference (for East Texan women), from a convenience stand-point,” he said.
The Coastal Birth Control Center in Corpus Christi is the only abortion provider between San Antonio and the Lower Rio Grande Valley, according to a TPEP brief.
The clinic wouldn’t meet standards if lawmakers approve the ASC legislation as widely expected. So women from the Corpus Christi area would have to drive about 140 miles to San Antonio.
But don’t assume the Corpus Christi clinic’s Dr. Eduardo Aquino will bow out.
“He’s committed to making sure that the Coastal Bend is not without a provider, regardless of what hoops we have to jump through,” head nurse Sarah Guerrero said.
A San Angelo abortion provider isn’t ASC-licensed, either, and Wichita Falls and Abilene don’t have abortion facilities.
Women in those areas may have to spend more money, more time away from home to meet the rules for a sonogram and 24-hour wait period while scrambling to meet the usual needs of others, White said.
“For some women, that is just going to be an insurmountable burden, and they may try less safe options to terminate their pregnancy,” White said.
Yet it's the goal of Right to Life groups and The Gabriel Project ministry to help women in crisis pregnancies understand that there are other options available to them.
Pro-abortion supporters' claim that they 'care about the woman' “is a hollow argument – all of us in the pro-life community care very deeply about the woman,” Mittler said.
“Those services and offers for help have been there for many, many years – to say we don't care about the pregnant mothers … the facts speak for themselves when groups (ministering to the needs of women in crisis pregnancies) have become more prevalent since before the 1970s,” when Roe V. Wade was argued, he said. “Our group in the Longview area gets pretty good press promoting the services available, but I sometimes think that (pro-life groups) just may not be tooting their horn loudly enough to get the word out.”
One way of doing this, he said, is by getting involved in sidewalk counseling at abortion clinics, where “we pray for the women, we help by offering to provide them a place to live, or education and maternal health care, whatever her needs might be.”
Many communities also have maternity homes for women in such situations, or operation crisis counseling centers, and churches also have been wonderful about stepping up to meet those needs, he added, citing the Catholic ministries like The Gabriel Project – which focuses on helping women in crisis pregnancies – and Rachel's Vineyard, which ministers to women – and men – struggling with the emotional and spiritual pain of an abortion.
“Many studies have proved that post-abortion trauma doesn't appear until many years later, things like anxiety and depression are common in post-abortion patients,” he said.
Graham said Texas clinics will have months if not a year to comply with ASC standards.
But jumping through those hoops might be costly.
Virginia enacted a law in 2012 that requires abortion providers meet hospital-like standards at a cost of $15 million statewide to get providers up to standards, according to the spring 2013 Guttmacher Policy Review.
The average cost is estimated to be $700,000 to $969,000 per site. One abortion clinic has shuttered its doors as a result.
These standards include mandates for procedure rooms, hallways, the ventilation system, parking lots and covered entrances.
TPEP is studying the impact of 2011 Texas laws slashing family planning funding by two-thirds and requiring a mandatory sonogram and 24-hour waiting period before an abortion. After the legislation was enacted, 53 family planning clinics shut down in Texas.
Yet, Mittler pointed out, over the years, “many abortion clinics in Texas have closed for financial reasons – there's either not enough business or doctors available to do the abortions. Some of these clinics have doctors who drive from out of town one or two days a week to provide these abortions.”
State officials estimated almost 24,000 unplanned pregnancies and a $273 million tab for taxpayers would result from the cuts.
Amid concerns over the impact, lawmakers reversed the cuts in late 2012 and added millions, partly to make up for lost federal funding.
Graham said there’s no data behind the claims of those who oppose the bill, contending it will shrink women’s access to birth control and preventive care. She added that Perry expanded funding.
The funding’s good news, but it’s just the first piece in rebuilding the safety net, said Dr. Janet Realini, steering committee chairwoman for the Texas Women’s Health Coalition, a group focused on preventive care.
While a raucous throng of abortion rights activists disrupted Senate action on the proposed proposed bill restricting late-term abortion helped contribute to “a big showing at (Democratic Sen. Wendy Davis') filibuster, my thought is that pro-lifers spoke during the last election by electing a pro-life Legislature (that will) submit and pass this type of legislation,” Mittler said.
“Over the past 40 years, the medical science community has made great strides proving viability as early as 20-24 weeks of pregnancy – it seems reasonable to protect unborn life at this stage,” he said. “And if you look at it, there are a lot of states that have similar restrictions. It's not like Texas is the first to propose at this level these restrictions – some of these (states) have (legislation with) the same features.”