Only one thing can keep the doors from closing at more Texas abortion clinics next month: a federal judge.
As more clinics prepare to close Sept. 1, when the final piece of the state’s abortion law requires procedures to be performed at ambulatory surgical centers, its opponents hope that U.S. District Judge Lee Yeakel, who is considering a legal appeal of the case, will prevent the law from taking effect fully.
If that fails, the number of abortion clinics in Texas, a state of more than 26 million people, is expected to shrink to six.
“Make no mistake, this is the result of politicians in Austin acting against the women in our state,” said Amy Hagstrom Miller, CEO and president of Whole Woman’s Health. “They couldn’t make abortion illegal, so instead they made it unavailable and unaffordable.”
Supporters of the measure say it’s time for the law to be fully implemented, and since the legal arguments in the appeal wrapped up last week in Austin, they hope Yeakel does so.
“It really is a win for women and it certainly is a win for babies,” said Kyleen Wright of Mansfield,president of the anti-abortion Texans for Life Coalition. “It’s one more step.
“But we will still have to be monitoring the process to make sure doctors are following the law and that we have the higher [quality] medical care for women that we were seeking.”
Abortion became a hot-button issue last year in Texas when the GOP-led Legislature tried to pass a comprehensive abortion law and state Sen. Wendy Davis, D-Fort Worth, filibustered the bill.
Davis, propelled into the national spotlight because of the filibuster and now the Democrat in the race to become Texas’ next governor against Republican Texas Attorney General Greg Abbott, temporarily killed the bill, but it passed weeks later during another special session.
As each wave of requirements has gone into effect, more clinics have closed.
A trial over an appeal of the last phase of the law stretched through this month in Austin, and both sides hope a ruling comes before Sept. 1.
Statistics show a 13 percent decline in the abortion rate in Texas — totaling about 9,200 fewer abortions a year — since the law took effect.
The number of Texas abortion clinics dropped from 41 in April 2013 to 22 in April this year, according to a report form The Texas Policy Evaluation Project.
The report points out that vast areas of the state lack clinics.
Last puzzle piece
The last piece of is the provision requiring abortion clinics to meet the standards of ambulatory surgical centers, which are also known as day surgery centers.
These standards include determining “the width of the janitor’s closet, the frequency of the air flow in the ventilation system, the number of parking spaces, the type of faucets in the sink and other structural mandates,” said Kelly Hart, senior director of government relations with Planned Parenthood of Greater Texas.
She and others fear that the cost of meeting these requirements, which they say are unnecessary and overbearing, will lead to another round of clinic closures.
“Texas already requires that abortions performed after 16 weeks be performed at ambulatory surgical centers, which is medically unnecessary,” Hart said. “These restrictions go even further by requiring that all health centers that provide abortions comply with regulations that are equivalent to those governing ambulatory surgical centers.”
An estimated six Texas clinics — one in Fort Worth, one in Austin, two in Dallas and two in Houston — now meet those requirements.
The 1-year-old Planned Parenthood Southwest Fort Worth Health Center, a $46.5 million licensed ambulatory surgical center that was privately funded by North Texas contributors, is still open and will remain open after Sept. 1.
Shortly after the first phase of the law took effect last year, the Whole Woman’s Health clinic in far west Fort Worth closed because it couldn’t meet some of the requirements. That changedand the clinic reopened.
But the clinic doesn’t meet the standards of ambulatory surgical centers and will likely be one of the casualties of the last phase of this law — if it takes effect — unless they can find another facility that meets the criteria, said Fatimah Gifford, a spokeswoman for Whole Woman’s Health.
Whole Woman’s Health has closed clinics in Austin, Beaumont and McAllen because of the law. Its San Antonio clinic, which is an ambulatory surgical center, may be the only one left open after Sept. 1, officials say.
Houston Mayor Anniese Parker and others have called for the repeal of the law known as House Bill 2, sending letters to the Legislature and Congress.
“Each year, legislatures across the country pass restrictions to limit a woman’s right to make the best health care decisions for herself and her family,” the Aug. 11 letter says. “Texas is no exception to this trend.”
Supporters of the bill said they are surprised that half of the state’s abortion clinics have already closed.
“We really had no clue that this many abortion clinics would close,” Wright said. “We thought more clinics would have stayed.”
She and others say that ultimately there may be about 10 clinics in Texas, as more facilities are converted or built to meet the demand.
Wright said increasing safety standards at abortion clinics, which include requiring that doctors have hospital admitting privileges within 30 miles of the clinic where they provide abortions, is needed to protect the lives of women who choose the procedure.
Planned Parenthood officials have said they are creating a patient assistance fund to make sure that women seeking abortions who have to travel out of their community to find the service are not denied medical care.
“Planned Parenthood of Greater Texas is today publicly announcing the launch of our current initiative to ensure that Texas women can continue to access the healthcare they need— regardless of their income level or ZIP code,” said Ken Lambrecht, president and CEO of Planned Parenthood of Greater Texas.
People on both sides are waiting for Yeakel to settle the latest challenge to the law, and they hope that he rules before the law takes effect.
Owners of clinics have asked the judge to prevent the ambulatory surgical center requirements from taking effect. They say it could cost millions to upgrade current facilities or build new ones, which will prompt a number of clinics to close.
And that could leave nearly 1 million Texas women farther than 150 miles from a clinic, creating an unconstitutional burden and possibly prompt some women to try to end their own pregnancies, abortion-rights advocates say.
The number of Texas women of reproductive age living more than 100 miles from an abortion clinic rose from 417,000 in May 2013 to more than 1 million in April 2014. That number is expected to rise to 1.3 million after the requirement for ambulatory surgical centers takes effect, according to policy evaluation project statistics.
Supporters of the law say 85 percent of Texas women will still live within a three-hour drive of a clinic even with the new restrictions. And some women may find it easier to head into another state such as New Mexico and quickly find a clinic there, they say.
Attorneys for the state said some clinics are simply choosing not to comply with the standards “because they disagree with the law,” state Deputy Attorney General James D. Blacklock has said.
And they believe that Texas will have more than six clinics when all is said and done.
Both supporters and opponents say they expect another round of appeals no matter which way Yeakel rules.
This issue propelled Davis to national attention and prompted many to encourage her to run for governor.
She eventually jumped into the race, as did Abbott.
Neither has made abortion the most talked-about part of their gubernatorial platform, but both have addressed the issue.
“Wendy Davis has been a champion for women and families, fighting against laws that have now shuttered over 60 health centers across Texas that once provided thousands of Texas women with care that they can't get elsewhere,” her campaign spokesman Zac Petkanas said.
“Greg Abbott supports policies that cut off preventive care like cancer screenings and birth control for hundreds of thousands of Texas women, even advocating to make abortion illegal for victims of rape or incest,” Petkanas said.
Last weekend, Abbott criticized Davis for her stance on the issue during a speech to the RedState conservative group gathered in Fort Worth.
He said she stood “for 13 hours to advocate for abortion even after five months of pregnancy.”
“Then, of all things, she went out and said she was pro-life,” Abbott said. “She forgot for a child to have a chance in life, a child must first have a chance at life.”
For now, those on both sides of the issue are looking at Sept. 1 and waiting to hear what Yeakel’s ruling in Austin will be.
Some fear that as the number of abortion clinics in Texas continues to shrink, more and more women may try to terminate their pregnancies themselves — which could become deadly.
“We don’t want to see that,” Wright said. “We want to discourage that.
“Our response is to have over 200 pregnancy centers throughout the state reaching out to women to help.”
Meanwhile, Planned Parenthood officials say they aren’t giving up on helping as many women in Texas.
“Planned Parenthood has been in Texas for more than 75 years, and we aren't going anywhere,” a note on their website says.