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Study: Nearly Half of Texas’ Legal Abortion Providers Have Closed Post-HB 2

Andrea Grimes

The study is the first academic evaluation of the impact of HB 2 to be released since the law passed last year.

Forty-six percent of Texas’ legal abortion providers have closed since May 2013, according to a new study led by university researchers in Texas, California, and Alabama, that evaluates the impact of HB 2, the omnibus anti-abortion law passed by Texas lawmakers in July 2013.

Researchers estimate that while the number of unintended pregnancies has likely increased in Texas, the number of legal abortions in the state decreased by 13 percent—and the number of medication abortions decreased by 70 percent—between the six-month period before the passage of HB 2 and the six-month period after the passage of HB 2 and the implementation of three of its four provisions: those that restrict the prescription of medication abortions, require abortion-providing doctors to have hospital admitting privileges, and ban abortion after 20 weeks.

Researchers also estimate that the number of Texans living hundreds of miles from legal abortion facilities has increased by tens of thousands, from 10,000 living more than 200 miles from a clinic in May 2013 to 290,000 by April 2014.

According to the study (abstract available here), the provision of HB 2 that requires abortion-providing doctors to have hospital admitting privileges “was almost certainly the main driver of the large number of clinic closures observed in the months preceding and following its implementation.” At that point, “vast swaths of the state were left without a provider, and the number of women required to travel great distances to reach a provider increased dramatically.”

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The corresponding decrease in the overall abortion rate “may have been muted by a potential increased demand for abortion following the severe reduction in public funding for family planning in Texas in 2011.”

The study, to be published in the medical journal Contraception, is the first academic evaluation of the impact of HB 2 to be released since the law passed last year. Researchers at the Texas Policy Evaluation Project, Ibis Reproductive Health, the Bixby Center for Global Reproductive Health, the University of Alabama at Birmingham School of Public Health, and the Population Research Center and Department of Sociology at the University of Texas focused on three six-month periods: November 2012 through April 2013, before legislators filed HB 2; May 2013 through October 2013, during public debate and passage of HB 2 but before it went into effect; and November 2013 through April 2014, when three of HB 2’s four provisions went into effect.

Researchers drew their conclusions from data provided by 36 of the 41 abortion providers that were open in Texas in November 2012, including all six of Texas’ abortion-providing ambulatory surgical centers, along with demographic data from the U.S. Census Bureau.

“Our findings suggest that most women desiring an abortion—but not all—overcame the barriers of distance and additional cost to obtain the service they needed,” wrote the researchers. “In addition, the public opposition to HB2 galvanized a coordinated response among activists who provided financial and logistical support to women seeking abortions.”

Throughout all three research periods, researchers found that less than a quarter of legal abortions in Texas were performed at the state’s ambulatory surgical centers, which will be the only remaining facilities licensed to practice legal abortion care after September 1, when the fourth provision of HB 2 goes into effect. At that time, according to the study, “it seems highly unlikely that existing facilities could expand their capacity four-fold to meet the demand for services.”

Correction: A version of this article noted that University of Alabama researchers were a part of this study; in fact, the researchers are from the University of Alabama at Birmingham. We regret the error.

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