4 People Fighting to Save Abortion Access in Texas Explain What’s at Stake

This piece was originally published in Self. 

Though abortion technically remains legal in all 50 states, access to it can be severely restricted depending on where a person is seeking to terminate an unwanted pregnancy. During the new coronavirus crisis, lawmakers in certain states have attempted to enact even more restrictions on abortions, making them all but impossible to get for far too many people. Texas is one such place.

According to the most recent data available from the Guttmacher Institute, 96% of Texas counties already had zero clinics that provided abortions before the pandemic. Nearly half of Texas women live in these counties. Even if you happen to live next door to an abortion clinic in Texas, the procedure still wouldn’t automatically be easy to obtain. Someone living in Texas who is pursuing a legal abortion must first overcome a series of burdensome measures mandated by the state, including more than one visit to the clinic, an ultrasound viewing, parental consent for minors, and biased antichoice counseling. Public and private insurance companies in Texas are banned from funding abortions except in the cases of life endangerment, rape, or incest, making the procedure very costly. The difficulty of getting an abortion—emotionally, financially, and bureaucratically—is by design. And all of these mandates were already in effect before the COVID-19 pandemic hit, making abortion access even more fraught.

On March 22, during the rampant spread of COVID-19, Texas governor Greg Abbott issued an executive order banning medical procedures “that are not immediately medically necessary.” This included any abortions not related to life endangerment.

Abortion advocates and providers kicked into action to reinstate services as quickly as possible. Thanks in large part to these efforts, abortions have resumed in Texas, but not without their usual restrictive barriers. And the fight is far from over. Lawmakers in a host of other states are still trying to restrict abortion access in new ways during the COVID-19 pandemic. Here, advocates on the front lines of safeguarding abortion access in Texas offer insights and advice for those in other states.

“We will continue to raise and distribute money for abortion access because funding abortion is mutual aid.”

Kamyon Conner, executive director of the Texas Equal Access Fund

Many Texans already struggle to access abortion care due to coverage bans, lack of providers, and long travel distances. When these barriers are combined with a pandemic, we fear that even more people who need abortions will not be able to access care at all or will be unable to have support people, including abortion doulas, with them at appointments. All pregnancy care is necessary and essential—including abortion. We will continue to raise and distribute money for abortion access because funding abortion is mutual aid.

During this pandemic, abortion funds have witnessed access severely restricted to the point that some people are just not able to get their procedure. We have had callers to our helpline, reporting having to travel over 600 miles. The same people losing their jobs are calling clinics and local abortion funds to figure out how to get the abortion they want and need. Our clients have very limited incomes and are the same people losing their jobs. Many are essential workers, who are predominantly people of color.

Our strong relationships with abortion providers in Texas, Oklahoma, New Mexico, Colorado, and Louisiana provided us with a comprehensive understanding of the abortion landscape in our region, which helped us navigate these restrictions and support people who need abortions in Texas’s ever-changing landscape.

While the Texas barriers were in place, we held weekly virtual workshops to provide information to our supporters about the abortion landscape in Texas. We held a town hall with partner organizations to inform folks about the restrictions, followed by an Abortion 101 the next week. We also felt it was important to educate folks so they know how they can expand abortion access through advocacy, so we held a Public Policy 101 workshop. Lastly, we had a virtual happy hour with our Repro Power Dallas coalition to engage supporters to take action at the county-level by contacting their county judge to publicly support abortion access.

Be diligent, unwavering, and radical. Fight for abortions to happen in your state as essential and time-sensitive health care. Fight to waive mandatory waiting periods, allow for telemedicine for medication abortion to decrease the chance of community spread of COVID-19, and waive restrictions that limit access to abortion. We cannot put all of our trust in the court, even with our most recent favorable ruling from the Supreme Court. As grassroots abortion funds, we know the power is in the people.

“The potential impact of this ban was even worse for teens than it was for adults.”

Rosann Mariappuram, executive director of Jane's Due Process

Texas law requires people under the age of 18 to get their parent or guardian's permission before accessing abortion care. Jane's Due Process was founded to help teens navigate these laws and confidentially get reproductive health care. For example, we help teens obtain a judicial bypass, which is special permission from a judge to receive abortion care without parental consent. The judicial bypass process is confidential and the court refers to teens as “Jane” to protect their anonymity. So we help “Jane” find a free attorney to represent her during the judicial bypass hearing and provide one-on-one case management to help with transportation, funding, and emotional support.

While the abortion ban was a huge barrier for teens, throughout it, we were still able to help young people with the judicial bypass process. The potential impact of this ban was even worse for teens than it was for adults. Many of the teens we work with would have been kicked out of their homes if their pregnancies were discovered or would have been forced to stay pregnant against their will by parents or guardians. Since the abortion ban was lifted, Jane's Due Process has helped many teens whose abortion care had been delayed.

The pandemic shone a light on how inaccessible politicians have made abortion care in the U.S. Medically unnecessary laws like waiting periods, mandatory ultrasounds, and banning health insurance from covering abortion care were major barriers before the pandemic. But during COVID-19, they have pushed abortion care completely out of reach for so many people.

The June Medical Services decision from the U.S. Supreme Court this summer reaffirmed that abortion must be accessible across our entire country, not just in some states. But it's hard doing this work in the South and Midwest. We don't have the same resources as the coasts. It’s more important than ever before to donate to state-based organizations, especially Black-, Indigenous-, and people of color-led groups. Those leaders and organizations know how to win true reproductive freedom for their communities and need your support.

“Don’t allow pressure from antiabortion protesters or politicians to dissuade you.”

Amy Hagstrom Miller, president and CEO of Whole Woman’s Health and Whole Women's Health Alliance

Every clinic managed by Whole Woman's Health provides some type of abortion services up to the legal limit in whatever state we happen to be in. Since the beginning of the pandemic, our work has changed a lot. As frontline health care providers, we needed to comply instantly with a lot of the Centers for Disease Control and Prevention recommendations to protect our staff and our patients. We changed as many protocols as we could so that we would use as little personal protective equipment (PPE) as possible. We skipped steps in the visit that might not be absolutely necessary. If somebody has no history of low iron, we don't have to check their iron, for example. The other thing we did was to limit any extra people in the building to protect the staff and patients as much as possible.

From there, we had to navigate all the various executive orders from the different governors in the five states we work in. Then you've got the political interference that happened in Texas. The requirement that they issued in Texas said we had to certify that we would reserve 25% of “hospital capacity” for coronavirus patients. We had to send a letter on behalf of every one of our clinics in Texas and also every doctor who works in those clinics reminding them that we're not a hospital. Then we had to wait until we got a response from them saying they did receive that information from us in order for us to proceed.

After that, we were able to resume all abortion services. There were many people who were denied an abortion for at least a month, so there are a lot of people who are further into their pregnancy. Of those, we’re trying to prioritize folks that are hitting the legal limits.

We also flew some patients to be seen in Whole Woman's Health clinics in Virginia and Maryland because we were able to coordinate the care really efficiently. It's pretty powerful and our staff really served as case managers for those patients. A couple of them had never even flown before and never stayed in a hotel before. I’m super proud of the staff for figuring out how to navigate this. But I feel it's sad heroism. It shouldn't take extreme measures just to be seen.

I've been thinking a lot about how, unfortunately, abortion providers in the South and the Midwest have really well-developed muscles when it comes to emergency changes of protocol. We have been uniquely positioned to maintain services compared to a lot of other health care providers because it is something that we have grown used to—that has become, in some senses, normal for abortion providers.

Don’t allow pressure from antiabortion protesters or politicians to dissuade you. They may try to use the city or county officials or the health department to file complaints about your clinic in the pandemic, but don’t let that intimidate you. Just because they may claim you are not following the guidelines does not mean their complaints are well-founded. You are providing essential care, and you are frontline health workers that deserve the community’s thanks and respect.

“Some states will stop at nothing to ban abortion, even in the middle of a global pandemic.”

Nancy Northup, J.D., president and CEO of the Center for Reproductive Rights

The Center is a nonprofit organization that uses the power of law to advance reproductive rights as fundamental human rights in courts around the world. We have been working around the clock during this pandemic to make sure women still have access to abortion care.

Some states have exploited the current health crisis to ban abortion. Since March we have filed cases in multiple states to fight these actions. We immediately took them to court because abortion is time-sensitive, essential health care that cannot be delayed. Court hearings have been taking place remotely via phone, so our cases have not been delayed.

Leading medical groups, including the American Medical Association, weighed in on the case in Texas, asking the court to rule in our favor. They stated: “The governor’s order is likely to increase, rather than decrease, burdens on hospitals and use of PPE. At the same time, it will severely impair essential health care for women, and it will place doctors, nurses, and other medical professionals in an untenable position by criminalizing necessary medical care.” The courts agreed.

Leading up to our case, abortion was largely unavailable for weeks in Texas, and hundreds of appointments had to be canceled during that time. Many patients were forced to drive out of state to find abortion care, and it’s very likely that some women were pushed past the legal gestational limit and will no longer be able to have an abortion.

If people are looking to help women seeking abortions in Texas and other states, we suggest donating to an abortion fund. You can find a list of abortion funds by state here. Those looking to help fund our legal fight to protect abortion rights can donate to the Center for Reproductive Rights here.

Fighting for abortion access during the pandemic confirmed what we already knew: Some states will stop at nothing to ban abortion, even if it means cutting people off from time-sensitive, essential care in the middle of a global pandemic. Our legal fight during the pandemic also reaffirmed just how strong the abortion rights movement is.