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Texas women increasingly sought out-of-state abortion care after HB 2, analysis finds

The number of Texas women traveling out of state to obtain abortion care has increased significantly since the passage of the state's omnibus antiabortion-rights law (HB 2), according to a recent analysis, Rewire reports (Wilson, Rewire, 6/22). One provision of HB 2 required abortion clinics in the state to meet the same building standards as ambulatory surgical centers, and the other required abortion providers to have admitting privileges at local hospitals.

The Supreme Court today issued a ruling in a case,Whole Woman's Health v. Hellerstedt, challenging these two provisions (Women's Health Policy Report, 6/24). In the ruling, the high court struck down the provisions as unconstitutional (Women's Health Policy Report, 6/27).

Analysis details

The Rewire analysis was based on data from neighboring states. Texas health officials have not released data on the number of abortions provided in the state since HB 2 was implemented (Rewire, 6/22).

Earlier this month, the American Civil Liberties Union (ACLU) of Texas sent a letter to Texas Department of State Health Services (DSHS), calling on the agency to "stop concealing" 2014 data on abortion provision in the state.

While state officials in March released preliminary data showing a 14.2 percent decline in the number of abortions provided in the state in 2014, a DSHS insider said the full 2014 abortion data have been "in limbo" since they were submitted to DSHS' legal office for final approval (Women's Health Policy Report, 6/24).

Findings

While the preliminary DSHS data show that the number of abortions in Texas has fallen, data from neighboring states show a "dramatic increase" in the number of Texas women seeking abortion care. Neighboring states include Arkansas, Kansas, Louisiana, New Mexico and Oklahoma.

Specifically, the DSHS data show that abortions in the state declined by nearly 22 percent between 2008 and 2013. The DSHS data also show that the number of women who sought abortion care out of state fell by almost 57 percent between 2008 and 2012, before HB 2 was signed into law. However, according to Rewire, that number increased in 2013, after Gov. Rick Perry (R) signed HB 2 into law.

Overall, the number of Texas women who sought out-of-state abortion care increased from 97 in 2012 to 681 in 2013, and increased again in 2014 by at least 400 women, Rewire reports. According to Rewire, data from Arkansas, Kansas, Louisiana and Oklahoma health departments show that at least 1,086 Texas women traveled to those states to access abortion care after HB 2's implementation. Of those states, Rewire reported that Louisiana saw the highest number of Texas women seeking abortion care.

Texas women also increasingly are seeking abortion care in New Mexico, where out-of-state women accounted for about 20 percent of abortion care patients in 2014. Brittany Defeo, program manager at the New Mexico Religious Coalition for Reproductive Choice, estimated that about one-third of those out-of-state women were from Texas.

Comments

Natalie St. Clair -- who works with Fund Texas Choice, a not-for-profit that helps women seeking abortion care -- said in an interview with the Texas Observer that every month, she helps about 10 women travel to New Mexico for the procedure.

Noting that many women seeking care are surprised by the obstacles they face, St. Clair said, "I hear a lot of 'I had no idea that the laws were this way. I have to go out of state?' There's a lot of shame and guilt because people think it's their fault, or they weren't prepared enough." She added, "I explain that (Texas laws) are set up this way on purpose … (They're) making abortion inaccessible on purpose."

Trisha Trigilio, staff attorney at the ACLU of Texas, said that "it's clear that this law doesn't make women safer, it forces them to travel across the Texas border to get the care they need -- and for women who can't afford to leave the state, Texas law may prevent them from seeing a doctor at all." She added, "When a woman makes the deeply personal decision to have an abortion, she needs access to safe medical care and respect for the decision she has made. HB 2 impedes that" (Rewire, 6/22).

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"A woman's ability to end her pregnancy too often depends on where she lives, her age and how much money is in her pocket."

— Marcela Howell of In Our Own Voice: National Black Women's Reproductive Justice Agenda, discussing ongoing disparities in women's access to abortion care on the 43rd anniversary of Roe v. Wade.

At a Glance

"If women are not free to make decisions about their own lives and health, they are not free. And if women are not free, none of us are."

— Abortion provider Warren Hern, in a STAT News opinion piece on why he continues to offer abortion care despite receiving harassment and death threats throughout his 42-year career.

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"Not since before Roe v. Wade has a law or court decision had the potential to devastate access to reproductive health care on such a sweeping scale."

— Nancy Northup, president and CEO of the Center for Reproductive Rights, on a ruling from the 5th U.S. Circuit Court of Appeals that upheld major portions of a Texas antiabortion-rights law.