The number of abortions in Texas decreased by about 13 percent statewide and 21 percent in the Lower Rio Grande Valley following the passage of strict abortion regulations that went into effect last November, according to a report that academic researchers released Wednesday.
The study, by the Texas Policy Evaluation Project at the University of Texas, which is analyzing the effects of reproductive health-related laws passed during the last two legislative sessions, found that as the number of clinics that provide abortions declined, so did the number of abortions performed statewide. Researchers said the decline was not as large as expected but that the numbers could continue to drop as more restrictions take effect under the law this year. While supporters of the regulations in HB 2 said the new law is making the procedure safer for women, opponents said they worry that continued restrictions to access could lead to more unwanted pregnancies and self-induced abortions.
Legislators approved HB 2 in 2013, and it took effect last November. Among other restrictions, the law requires abortion providers to have admitting privileges at hospitals within 30 miles of their clinics. That measure reduced the number of legal abortion providers in Texas from 42 before the law to 20 as of July 1, mainly because physicians had difficulty obtaining admitting privileges, according to the researchers. All facilities in the Rio Grande Valley and all but one in West Texas have shut down. Those closures, the report estimates, caused the number of women of reproductive age living more than 100 miles from an abortion provider to grow from about 400,000 to about 1.3 million.
HB 2 also put new restrictions on medical abortion, which is induced by swallowing a pill. Under the new law, women can only obtain medical abortions within seven weeks of becoming pregnant, down from nine weeks. It also requires most women to make four separate doctor's visits. The study found that those changes caused the percentage of medical abortions to decrease by 70 percent.
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Joe Pojman, the executive director of Texas Alliance for Life, an anti-abortion group, had not yet read the report, but he argued that any decline in abortions resulted from several factors. Some clinics, he said, chose to close even though they were able to comply with HB 2 regulations. And laws approved in previous legislative sessions that require women to receive ultrasounds and counseling before an abortion procedure also contributed to the decline, he said.
Pojman said that the law is making abortions safer for women, which lawmakers who supported the measures said was the goal of HB 2.
Opponents of the law, though, said the intent was to reduce access to abortions.
“There’s no evidence that the safety of abortion has been increased by these restrictions,” said Daniel Grossman, a California-based physician and one of the authors of the report, adding that the American College of Obstetricians and Gynecologists and the American Medical Society opposed the law. “The provisions in this law were not based on any medical evidence.”
Fatimah Gifford, a spokeswoman for Whole Woman’s Health, a reproductive health provider, said she saw an increase in the number of women traveling long distances to get abortions at her organization’s San Antonio clinic. And typical wait times at the clinic have increased from one week to four or five weeks, she said.
But given the dramatic reduction in the number of abortion providers, researchers said they were surprised that legal abortions had only decreased 13 percent overall.
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“In some ways, we were expecting a bigger decline,” said Grossman. One possible explanation, he said, is that most of the facilities that remain open are in population centers like Austin, Dallas and San Antonio. Reproductive rights groups have also been contributing money and resources to help women obtain abortions since the law went into effect, which the report suggests may have mitigated its impact.
Andrea Ferrigno, who oversees Whole Woman’s Health’s clinics in Texas, said she worried about how long those groups could continue providing help.
“A lot of those organizations are out of funds already, and the full extent of the law hasn’t even taken effect,” she said. Beginning Sept. 1, abortion providers must meet the standards of ambulatory surgical centers, or ASCs. Currently, only six of the remaining 20 providers in the state qualify. Ferrigno said that Whole Woman’s Health, which has one ASC in San Antonio, has been trying to figure out how to meet the standards to avoid closing its other two remaining Texas clinics. So far, she said, leasing an existing facility or converting the clinics has proven too expensive.
Grossman said that the percentage of abortions performed at existing ASCs did not increase after HB 2, suggesting that they may already be operating near their maximum capacity.
Gifford, of Whole Woman's Health, said, “We may be performing procedures seven days a week in order to keep up with the amount of people who need abortion care in the area.”
Grossman said his organization plans to conduct additional studies to determine the impact of the additional restrictions and to examine the effects of HB 2 on unintended pregnancies and on women performing self-induced abortions.
“This is certainly not the end of this story,” he said.