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Texans who want access to abortion at any stage of pregnancy will soon have to cross state lines, look beyond the US-Mexico border or operate outside the law, while d others will carry unwanted pregnancies to term.
The United States Supreme Court on Friday overturned Roe v. Wade and will allow states to establish their own laws regulating access to abortion. Texas, along with 12 other states, has a trigger law that will automatically ban all abortions, with only small exceptions to save the mother’s life, 30 days after the ruling.
More than half of all states, mostly in the South and Midwest, are expected to ban or severely restrict abortion access in the coming weeks and months, leaving most Texans in the hundreds, if not thousands kilometers from the nearest clinic.
Texas already has a window on what’s to come; the state has been operating under one of the nation’s most restrictive abortion bans since Sept. 1.
Data collected during the first few months under existing abortion restrictions in Texas, as well as in countries that have banned abortion, show that many, but not all, pregnant patients who wish to have an abortion will find ways to terminate their pregnancy.
“It’s always been the case that people find ways to end pregnancies when they need to, and we’re so lucky now that the methods are safer than they’ve ever been in the history of humanity,” said Farah Diaz-Tello, senior attorney with an If/When/How reproductive rights group. “Abortion is, in many ways, too big to fail.”
But Diaz-Tello and other advocates warn that unequal access to abortion will only be exacerbated by these blanket bans. Notably, some Texas lawmakers have signaled their desire to pass legislation that would make it illegal to travel people out of state to get the procedure.
The new patchwork of laws
All of Texas’ neighboring states except New Mexico are expected to ban abortion to varying degrees.
Oklahoma already enforces the toughest abortion law in the nation, which prohibits all abortions using the same civil lawsuit enforcement mechanism Texas launched in September, allowing civilians to sue clinics and people. who “aid and abet” prohibited abortions. This state also has a trigger ban which means abortion will be banned, with exceptions to save the life of the mother, in the future.
Louisiana and Arkansas also have trigger laws that will ban abortion, with life-saving exceptions for the mother, almost immediately now that Roe v. Wade is canceled.
New Mexico is expected to become a “paradise state,” where abortion remains legal and widely available. This state currently has six abortion clinics and is preparing for an influx of patients. The Jackson Women’s Health Organization, the Mississippi abortion clinic at the center of the Supreme Court case, said it was considering moving to New Mexico.
But even the closest clinic in New Mexico is a 10-hour drive from Dallas and 12 hours from Houston, the two largest population centers in Texas.
Abortion will also remain legal in Colorado and Kansas, though Kansans vote in August on a constitutional amendment to roll back abortion protections. If the amendment passes, the Kansas Legislature should quickly pass strict restrictions on abortion, possibly including a complete ban on the procedure.
The other states that are supposed to fully preserve abortion access are much farther from Texas – along the west coast or clustered in the northeast. Most population centers in Texas will be hundreds of miles, if not more, from the nearest abortion clinic.
Abortion advocates are building networks and strengthening existing ones to help people get to states that allow abortion. But that’s not an option for everyone. Neesha Davé, deputy director of the Lilith Fund, an Austin-based abortion fund, said the impact of these abortion laws will not be felt equally by everyone.
“People who have resources, people who are wealthy, will always be able to access the care they need, even if they have to overcome countless obstacles to be able to do so,” Davé told the Texas Tribune in May. “But it’s low-income people, people of color, the people we serve on our helpline who are disproportionately affected by abortion bans.”
It’s not just about the cost of a plane ticket or a hotel, Davé said. Many of their clients can’t or can’t afford it, don’t get paid time off, or aren’t able to safely share their plans with their families. And some people can’t leave the state, including undocumented immigrants and teenagers, especially those in foster care.
People who cannot travel out of state can find ways to access abortion-inducing drugs outside the law, either by ordering them online or obtaining them through advocacy networks.
Even before the Supreme Court’s decision, it was illegal for anyone other than a doctor to distribute these drugs or provide them by mail. Existing Texas law and the trigger ban specifically exempts the person who undergoes the abortion from prosecution.
A medical abortion, approved by the Federal Drug Administration for use during the first 10 weeks of pregnancy, is a two-drug regimen of mifepristone and misoprostol. Taken as prescribed, medical abortion is extremely effective and extremely safe, and accounts for the majority of abortions in Texas.
But in recent years, as abortion access has shrunk in Texas and across the country, more people are looking to access these drugs through other means. Some people order from online pharmacies that operate overseas, beyond the reach of US law, or have someone send them the drugs from another state, in violation of US law. ‘State.
AidAccess, an international nonprofit organization, provides Texans with the drugs through the mail, despite state laws that prohibit them from doing so. Although the federal government has made efforts to clamp down on AidAccess, it continues to operate openly.
Demand for abortion-inducing drugs is rising following increased restrictions, according to University of Texas researcher Abigail Aiken. After Texas passed its law banning abortions after around six weeks of pregnancy, Aiken found that requests to AidAccess increased by more than 1,000%.
“And of course this time it won’t just be Texas,” Aiken said. “When we have these geographic blocks of the country that are basically abortion-free zones, that’s going to increase the need for self-management.”
The drug should be used in early pregnancy and the patient should have a place where she can safely undergo the abortion, which many experience as being similar to a very heavy menstrual period, depending on her stage of pregnancy. pregnancy. It also inherently requires operating outside of the legal and healthcare system, which can make some patients uncomfortable, Aiken said.
“We know that really serious complications are very rare, but at the same time someone can be very worried about what happens if they have to go to the hospital or want follow-up,” said said Aiken. “They may feel unable to do so, for fear of surveillance.”
Crackdowns on the shipment of abortion-inducing drugs should be a future area of focus for Texas Republican lawmakers. Even with exemptions for the pregnant patient, Diaz-Tello warns that some pregnant people will inevitably be caught in the net of investigations and lawsuits.
“We know prosecutors are going to try to criminalize people regardless of what the law says,” she said. “So for us to be able to stand up to this, it’s important to note that this is unlawful criminalization.”
Texas saw it with its own eyes in April when a Starr County prosecutor charged a woman with murder after she self-administered an abortion. The Texas murder law specifically exempts abortion; the charges were later dropped after an international outcry.
Traveling South of the Border
As access to abortion shrinks in the United States, some pregnant patients may turn south of the border for treatment. In Texas, this is already the case.
Residents of the Rio Grande Valley have long turned to pharmacies across the border to access a variety of medications, including abortifacients. There is little data available on the number of pregnant patients who seek to self-manage their abortions in this way, but advocates working near the border expect it to become more common in the future.
Clinic-based care in Mexico is also becoming a more feasible option following a 2021 Mexican Supreme Court ruling decriminalizing abortion nationwide. Legalization still varies from state to state, even after the ruling, but it was seen as a major victory for abortion advocates in the world’s second-largest Catholic country.
State Rep. Erin Zwiener, D-Driftwood, recently traveled to Mexico as part of a delegation of state lawmakers to learn about the impact of the ruling. While abortion advocates in Mexico have long seen the United States as a “beacon” of hope, she said, “now Mexico is in the lead.”
“To see the care and compassion with which the people I serve are treated across our borders was incredibly touching,” Zwiener said. “I’m so grateful to those who are giving Texans this lifeline right now.”
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