FORT WORTH -- Women seeking abortions at Whole Woman's Health in south Fort Worth often arrive upset or angry about Texas' new sonogram law, which began being fully enforced three weeks ago, a health center official says.
Some are unhappy about the requirement that a physician must describe the fetus during a sonogram. But it's the hardship of having to schedule two appointments -- one for the sonogram and another for the surgery at least 24 hours later -- that draws the most consistent ire.
For many women, that means unnecessarily missing two days of work, paying for two days of child care or arranging extra transportation, said Amy Hagstrom Miller, CEO of Whole Woman's Health. Those challenges are common at the Fort Worth center because it serves some rural clients who must travel farther.
"What we have noticed primarily is absolute outrage that they have to come twice," Hagstrom Miller said. "Many of our clients are already mothers; they know what is on a sonogram. They don't see it and say 'Oh my gosh, I'm pregnant' and change their minds."
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Proponents of the law, however, say the delay merely guarantees that women have complete and informed consent before making a potentially life-altering decision.
"This might add some time to the process," said Becky Visosky, director of communications for the Catholic Pro-Life Committee in Dallas. "But it is important information before they undertake a very serious procedure that takes a human life and that could very well change their lives."
The law, approved during the 2011 legislative session, technically took effect in October. But legal challenges delayed full enforcement until Feb. 7.
Besides the two appointments, the law requires doctors to play the heartbeat audibly, describe the fetus and show women a sonogram image, unless they decline to view it.
A similar bill in Virginia recently set off a firestorm of national debate, primarily over the use of invasive transvaginal sonograms. While the Texas law does not require a specific type of sonogram, providers say the transvaginal version will often be necessary early in pregnancies to meet the level of detail required by the law.
Nevertheless, the Texas Department of State Health Services says feedback from providers and women has been mild since it released guidelines for the law last month.
Texas abortion providers have reported a range of client reactions to the law. Some women have looked away or plugged their ears with their fingers when the doctor described the fetus, but many didn't show strong emotions.
Most find the requirements condescending, said Jenni Beaver, assistant director at Southwestern Women's Surgery Center in Dallas.
"It treats women as if they are stupid and don't know what is in their uterus," she said. "The law just creates hoops and barriers and drives up the cost for the women. And we have not had anyone decide not to have an abortion because of a sonogram."
Supporters of the law also say they know of no instance when it has changed a woman's mind. But it has been enforced for only three weeks and the true impact won't be known until new state abortion statistics are collected, said Joe Pojman, executive director of Texas Alliance of Life.
Providers report abortions to the Texas Department of State Health Services Bureau of Vital Statistics.
However, the state likely won't make data available for a while -- the most recent statistics on the department's website are from 2009, Pojman said.
In that year, there were almost 75,000 abortions in Texas, 5,678 in Tarrant County.
Pojman said he views abortion providers reports of clients' reactions with a skeptical eye.
"It is impossible to know what is really going on, and I'm not sure I trust those accounts from providers," he said.
Visosky said that before the law, the pro-life committee "saw the power of the sonogram images" when they were shown to women considering abortions at pregnancy resource centers.
"We fully expect [the new law] to play into the decision-making process," she said.
At the Fort Worth center, scheduling complications have been the biggest problem caused by the law, Hagstrom Miller said. Finding two days in which the doctor and patient are available for the sonogram and abortion is challenging.
Pojman said scheduling sonograms and abortions should be no more difficult for doctors and patients than scheduling consultations and procedures for any elective surgery.
Hagstrom Miller said a significant number of clients travel to the Fort Worth center from west of Tarrant County, she said. The only centers offering abortion in West Texas are in Lubbock and Midland.
The new law includes a provision that women who live more than 100 miles from an abortion center can have the sonogram two hours before the abortion. But that still leaves clients who live 90 miles away, for example, making a three-hour round trip twice, she said.
That exemption for rural areas has created additional confusion because the law did not clarify whether that distance should be measured by how the crow flies or by driving distance, said Sara Cleveland, executive director of NARAL Pro-Choice Texas.
Delays in abortions caused by scheduling problems can affect the women's health, Beaver said. The later in pregnancy that an abortion occurs, the greater the medical risk.
Cleveland called that consequence "a stark reminder that this isn't about the health or the well-being of the women."
Alex Branch, 817-390-7689