News Abortion

Two Texas Reproductive Health Clinics Close, a Harbinger of a Coming Access Crisis

Andrea Grimes

Two clinics in underserved areas of Texas—one an abortion provider—closed their doors this week, as the effects of the omnibus anti-abortion access bill passed last summer with the support of conservative lawmakers continue to unfold across the state.

Read more of Andrea Grimes’ reporting from the Rio Grande Valley here.

Two more reproductive health clinics—one an abortion provider—in underserved areas of Texas closed their doors this week, as the effects of the omnibus anti-abortion access bill passed last summer with the support of conservative lawmakers continue to unfold across the state.

Both now-shuttered clinics, in McAllen and Beaumont, are part of the Whole Woman’s Health group, which once had five facilities in Texas: in Fort Worth, Austin, San Antonio, McAllen, and Beaumont. As of this week, the organization will be down to three locations. And come September, when abortion providers are required to meet the standards of ambulatory surgical centers, there will be just one Whole Woman’s left, in San Antonio. At that time, it will be one of six abortion providers left in a state that, according to data from Texas Department of State Health Services, sees about 70,000 legal abortion procedures performed each year.

“It’s hard for me to feel like I’m giving up, letting people down,” Whole Woman’s Health CEO Amy Hagstrom Miller told Rewire. But when her doctors can’t get admitting privileges in socially conservative communities, and she can’t afford the million-dollar retrofitting required to turn her small clinics into hospital-like surgical centers, she said, “there’s no miracle way to pay the bills.”

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The two shuttered clinics were both located in communities where poverty rates are high and many residents are un- or under-insured. The Beaumont facility, in southeast Texas, was the only provider between Houston and Louisiana, while the McAllen facility, in the Rio Grande Valley, served clients in the poorest city in the United States.

“Both of those communities have had safe, legal abortion since Roe v. Wade,” said Hagstrom Miller, until the passage of HB 2 last summer started a wave of clinic closures across the state. The four-fold law puts heavy restrictions on the prescription of medication abortion, bans abortion after 20 weeks, requires abortion-providing doctors to have admitting privileges at hospitals within 30 miles and mandates that abortion facilities meet the standards of ambulatory surgical centers.

While the McAllen clinic stopped providing abortion care last November when the admitting privileges provision of HB 2 went into place, abortion care at the Beaumont Whole Woman’s clinic continued until the end of February, when Hagstrom Miller ultimately decided she couldn’t sustain the facility in the wake of HB 2. The Beaumont clinic’s OB-GYN, who has provided legal abortion care since Roe and who Hagstrom Miller jokes has “delivered half the town,” had admitting privileges, but Hagstrom Miller says there’s no way she could turn the clinic into an ambulatory surgical center come September. It became time, she said, to “rip the Band-Aid off” and close both the McAllen and Beaumont clinics.

The conservative lawmakers who pitched HB 2 with the help of Gov. Rick Perry, who called two special sessions to pass the bill, claimed that it would improve the standard of care for Texans seeking abortions. Instead, a Whole Woman’s employee who worked in Beaumont for two-and-a-half years told Rewire that women in the area will now have a harder time than ever accessing not only abortion, but the affordable contraception and cancer screenings that Whole Woman’s helped them find.

“We’ve been well aware that Texas has been against us and on us for many, many years,” said Marva Sadler, a regional director at Whole Woman’s. “But I did not think I would see a day where they would have put up such barriers that now that we’re actually closing clinics, and they’re essentially taking away the right to fair and safe comprehensive health care that all women, not only in the state of Texas, deserve to have.”

Sadler describes experiencing the clinic closures as a “grieving process,” fraught with anger and frustration at onerous laws that do little to prevent the need for abortion in the first place, or increase access to quality reproductive health care.

“It’s not just a plan on a piece of paper anymore,” said Sadler. “It just seems like breathing gets a little harder every day.”

Patients seeking legal abortion in Beaumont now face a 90-minute drive to Houston or a three-hour drive to Baton Rouge, Louisiana, for their procedures, while Valley residents face a three-and-a-half hour drive to San Antonio or a two-and-a-half hour drive to Corpus Christi, where the city’s sole abortion provider will close in September after the surgical center regulations go into place.

The lengthy drive is just one barrier to accessing legal abortion care; an estimated 61 percent of patients seeking abortions are already parents, which means they must find child care in addition to taking time off work, and in many cases, finding a place to stay overnight.

Amy Hagstrom Miller told Rewire that she’s now turned most of her attention toward trying to find ambulatory surgical centers (ASCs) in Austin and Fort Worth where her doctors might be able to provide legal abortion care, perhaps through leasing the facilities on nights and weekends. But her luck, so far, has not been good.

“I’ve cold-called every ASC in the book,” she said. But even when she finds sympathetic landlords who don’t fear anti-choice protesters turning their sidewalks into soap boxes or harassing their patients, she also finds that there are barriers that keep her from operating, such as land “covenants” in formerly Catholic hospital-owned ASCs that prevent doctors in those locations from performing vasectomies or tubal ligations or providing abortion care.

“It’d be a miracle if I could pull it off in those two communities,” said Hagstrom Miller, of finding ASCs in Austin or Fort Worth. But, she said, “if anyone’s going to figure it out, I’m going to figure it out.”

Marva Sadler said she thinks often of the patients who have come to the Beaumont clinic over the past decade, and those who will soon find the clinic’s doors shut.

“I’m grieving for the women,” said Sadler. “I know the day after we close our clinic, they’ll call and that line is not going to have anyone on the other end to answer their questions. Where are they going to go? What are they going to do?”

To mark the closure of the McAllen clinic, the Whole Woman’s Health staff has invited the community to come to a candlelight vigil outside the downtown facility on the evening of Thursday, March 6, while a private event will be held for staff in Beaumont.

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.

News Law and Policy

Texas District Attorney Drops Felony Charges Against David Daleiden and Sandra Merritt

Jessica Mason Pieklo

The grand jury returned indictments against Daleiden and Merritt on felony charges of tampering with an official government document for purportedly using a fraudulent driver's license to gain access to a Planned Parenthood center in Houston.

UPDATE, July 26, 2:47 p.m.: This piece has been updated to include a statement from Planned Parenthood.

On Tuesday, the Harris County District Attorney’s office in Texas dismissed the remaining criminal charges against anti-choice activists David Daleiden and Sandra Merritt related to their production of widely discredited, heavily edited videos alleging Planned Parenthood was illegally profiting from fetal tissue donations.

The criminal charges against the pair originally stemmed from Republican Texas lawmakers’ responses to the videos’ release. Attorney General Ken Paxton, Gov. Greg Abbott, and Lt. Gov. Dan Patrick all called for the Harris County District attorney’s Office to begin a criminal investigation into Planned Parenthood Gulf Coast last August, after the release of one video that featured clinic staff in Houston talking about the methods and costs of preserving fetal tissue for life-saving scientific research.

A Texas grand jury found no evidence of wrongdoing by Planned Parenthood staff and declined to bring any criminal charges against the health-care provider. More than a dozen state and federal investigations have similarly turned up no evidence of lawbreaking by the reproductive health-care provider.

Instead, in January, the grand jury returned indictments against Daleiden and Merritt on felony charges of tampering with an official government document for purportedly using a fraudulent driver’s license to gain access to a Planned Parenthood center in Houston. Daleiden was also indicted on a misdemeanor charge related to trying to entice a third party to unlawfully purchase human organs.

A Texas judge in June dismissed the misdemeanor charge against Daleiden on procedural grounds.

“This meritless and retaliatory prosecution should never have been brought,” said Daleiden’s attorney, Peter Breen of the Thomas More Society, in a statement following the announcement that the district attorneys office was dismissing the indictment. “Planned Parenthood did wrong here, not David Daleiden.”

“Planned Parenthood provides high-quality, compassionate health care and has been cleared of any wrongdoing time and again. [Daleiden] and other anti-abortion extremists, on the other hand, spent three years creating a fake company, creating fake identities, and lying. When they couldn’t find any improper or illegal activity, they made it up. They spread malicious lies about Planned Parenthood in order to advance their anti-abortion agenda. The decision to drop the prosecution on a technicality does not negate the fact that the only people who engaged in wrongdoing are the extremists behind this fraud,” Melaney A. Linton, President and CEO of Planned Parenthood Gulf Coast, said in a statement emailed to Rewire after publication.

The district attorney’s dismissal of the felony charges against Daleiden and Merritt happened just before a scheduled court hearing requested by their attorneys to argue the felony indictment should be dismissed.

Daleiden still faces three civil lawsuits elsewhere in the country related to the creation and release of the Planned Parenthood videos.