Analysis Abortion

Roe at Forty: Today in Texas, it is Yesterday

Andrea Grimes

What does a future without Roe v. Wade look like? In a lot of ways, it looks like Texas, where those who are in the least ideal financial and socio-economic position to provide for an unplanned-for child are the ones for whom abortion--and contraception--is hardest to access.

Tuesday was the much-celebrated 40th anniversary of the seminal Roe v. Wade decision that legalized abortion in America. But today, Texans are waiting 24 hours for mandatory, forced trans-vaginal sonograms. Today, Texans are being turned away from clinics they’ve relied on for years for contraceptive care. Today, Texans are crossing the border into Mexico in hopes of ending unintended pregnancies. Today, Texans are choosing between the possibility of losing their jobs and the possibility of raising a family they can’t support.

Today in Texas, it is yesterday. 

Texas is the future of the past; it is a place where regressive politics and backwards thinking have resulted not in strong families and healthy kids but in 6.3 million uninsured people—the highest percentage of any state—and a consistently rising poverty rate.

Our governor, Rick Perry, makes no bones about the fact that he’d like to make abortion a thing of the past, not by increasing access to contraceptives and thereby reducing the number of unintended pregnancies, but by increasing funding to religious, ideologically- driven crisis pregnancy centers, forcing women to get mandatory trans-vaginal ultrasounds and listen to or read about medically-unfounded claims linking abortion to breast cancer and infertility. 

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“In Texas, we’ve worked hard to strengthen our abortion laws to the greatest extent possible under Roe v. Wade,” the governor said in a statement released on Tuesday. This is precisely the tactic, and an effective one, that conservative lawmakers and their religious-right backers have taken in Texas: if abortion can’t be made illegal, it can at least be made so difficult to get that only a very few people have access to it.
Perry claims that this reduction in access to abortion will “empower families and protect our children’s future.”

What it does, instead, is ensure that people have less control over the size of their families because the state government works to diminish access to both the means of preventing unintended pregnancies, and to the one safe, legal and common medical procedure available to women facing them. The result? A state where more and more people rely on public assistance every year. Texas has America’s highest number of citizens on food stamps, sees somewhere between a fifth and a quarter of its population living in poverty, and taxpayers here help fund 223,128 Medicaid-funded births per year (the second highest in the nation).

The state has dismantled its highly successful, money-saving Medicaid Women’s Health Program this year, preferring to shell out $40 million per year on a new, state-run program, all for the privilege of thumbing its nose at Planned Parenthood, with the ultimate result of vastly reducing access for low-income Texans to the free contraception and cancer screenings the WHP provided at a fractional cost to the state. In 2011, the state legislature cut family planning funds by two-thirds; as a result, numbers from the Texas Department of State Health Services show that the state is spending $37 more per family planning client to serve fewer than half the number of clients it saw two years ago. Paying more to do less.

In light of these facts, it is hard to see why reducing access to family planning and safe abortion care is anything but a step backwards. Abortion is, of course, technically legal in Texas. But if we want a preview of what a world without Roe v. Wade might look like, Texas is, sadly, a pretty good test case.

Because having the right to an abortion isn’t nearly the same thing as having access to one, Rewire reached out to activists, non-profit leaders and abortion providers in Texas, asking the question: Who really has access to safe abortion care in Texas?

“Women living in the major urban areas who have insurance that covers abortion or access to the funds have the greatest access to abortion in Texas,” said Heather Busby, the executive director of NARAL Pro-Choice Texas. But “if you are a young woman, a low-income woman or a rural woman, your access is severely limited.”

Texas requires women seeking abortion to undergo trans-vaginal ultrasounds 24 hours before their procedures unless they can prove they live farther than 100 miles from an abortion provider. During the ultrasound, doctors must show and describe the image to their patient, who can look away or choose not to listen. (The state makes an exception to the law for those who are aborting non-viable fetuses.)

This means Texans must make two appointments, at least 24 hours apart. They must come up with the funds for their abortion in a matter of days, and the cost of an abortion goes up as a pregnancy advances. A $250 procedure at eight weeks becomes a $500 procedure just a couple of weeks later, and there are fewer doctors who provide later procedures. Cities with multiple providers will have overall lower abortion costs; in areas like Corpus Christi on the Gulf Coast, where there are fewer or perhaps only one provider, costs will be higher and appointments harder to make.

Shailey Gupta-Brietzke, who volunteers with the Lilith Fund, a non-profit organization that helps Texans fund their abortions, says that travel issues are a major barrier to Texans seeking abortions.

“There’s a lot of travel that’s required,” she says. Especially for Texans who live, say, 40 to 99 miles from their providers. They must take off work—if they have jobs that allow them to do so without fear of being fired—to drive or ride public transportation, an all-day affair when clinics aren’t just down the street.

And more than half of Americans who get abortions are already mothers, which means finding child care for the children already at home while they travel to and from their doctors.

Lilith Fund president Amelia Long hears frequently from these women: “A poor woman who works an hourly job, doesn’t have a car and can’t pay someone to take care of her children—she can’t take that time off and she doesn’t have the money to pay for it all.”

Because Texans of color tend to have fewer economic resources than whites, she says, “obtaining an abortion is a far greater financial strain on a black or Latino family than it is on a white family.”

And because of the swiftly rising cost of abortion with every week of pregnancy, a woman won’t “have months to set aside a few dollars here and there,” explains NARAL’s Heather Busbee. “We’re talking about mere days or weeks of coming up with what is likely the majority of her monthly income.”

The cost of the procedure is just one aspect of what it takes to fund an abortion; many women may need to stay overnight in a hotel and come up with bus fare or gas money to get to their clinic. What would be a $250 procedure for a woman in an urban area who already has, or can quickly access, the money in time for an abortion at eight weeks can turn into thousands of dollars for a woman who has to save or borrow before she can travel to her provider.

For undocumented women in Texas, the stakes are even higher. They fear that, in trying to access abortion, their information will be shared with government agencies.

“There are a lot of huge barriers in place for undocumented people,” says Gupta-Brietzke. “You have to show residency, a photo ID to show who you are, and where your address is to see if you’re within the hundred miles” of a provider. Women wonder, she says, “Is this something that’s going to be sent to other agencies? Is my confidentiality at risk?”

Those fears aren’t unfounded; new abortion reporting requirements enacted in 2013 mean the state is gathering more information than ever about Texans who seek abortion.

Minors in Texas also face challenges when they seek out contraception and abortions. The state requires parental consent for those under 18, or the alternative of a judicial bypass, something Jane’s Due Process, a non-profit legal hotline for pregnant minors, helps them obtain when their parents aren’t available to grant consent, or when abusive home situations make getting that consent dangerous.

“The majority of minors who call the hotline aren’t using any kind of birth control,” says Tina Hester, executive director at Jane’s Due Process. “Most of them tell us they thought they needed parental consent to get a prescription.”

But that isn’t true: clinics in Texas that receive federal Title X funding, says Hester, “are required to provide confidential family planning services for minors.” But a survey conducted by her organization last summer found “a number of clinics” that “gave misinformation, telling us parental consent is required.”

In Texas, misinformation, or a lack of information, for minors when it comes to sexual health is the norm; abstinence-only sex education is the government-endorsed default, and the result is the country’s fourth-highest teen birth rate.

The Texans who are in the least ideal financial and socio-economic position to provide for an unplanned-for child are the ones for whom abortion–and contraception–is hardest to access. This is by design; it isn’t an unfortunate accident or cruel happenstance of fate. And Texas lawmakers are doing all they can not to remedy the problem, but to make it worse.

This wouldn’t be a problem if Texas had a strong safety net for low-income people who want to grow their families, and who have every right in the world to do so. But Rick Perry has openly rejected the Affordable Care Act, which would make 1.7 million more Texans eligible for Medicaid. And conservative policymakers in Texas—from the governor to the attorney general to the executive commissioner of Texas Health And Human Services, Republicans hold most every high office and top bureaucratic position in the state—do not want to use the resources the state has to help break the cycle of poverty for its citizens.

At the opening of the 83rd Texas Legislature earlier this month, Gov. Perry touted what he sees as the state’s upcoming budget surplus—to the tune of about $8.8 billion—as an opportunity not to restore slashed education funds or family planning dollars, but an opportunity for more tax cuts. Lt. Governor David Dewhurst is excited about using some of the money to train teachers to carry handguns.

And of course, making abortion even harder to access is a top priority for the governor and the bureaucrats and lawmakers who share his views. State Senator Dan Patrick has proposed a bill that will increase restrictions on medical abortions. In a back-door deal made with the Texas Department of State Health Services, Rep. Bill Zedler has succeeded in his quest to gather more information, Big Brother-style, about abortion providers and people who seek abortions.

The big abortion-related legislative action on the horizon for the 2013 lawmaking session is a Perry-endorsed 20-week abortion ban; the details of the ban haven’t yet been worked out, and a bill hasn’t yet been filed. But when it is, Perry’s office told Rewire, he’s going to let the legislators work out the appropriate punishment for abortion-seeking women.

If that happens, says the Lilith Fund’s Amelia Long, “a rich woman who wants or needs to terminate her pregnancy can still go out of state and get her abortion.” But low-income Texans, or Texans without the time and resources to travel out of state, will not have that luxury. And they will not necessarily be provided the resources they need to give birth to and raise an unplanned-for child even though, practically speaking, the state deliberately does all it can to give them no other choice.

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.