Texas Is Already Creating Abortion Refugees

If they can get an appointment — and have the means to get there. Photo: grandriver/Getty Images/iStockphoto

Just pause and breathe. We’re going to help, but I need you to take a breath and calm down for a moment.

Kathaleen Pittman, director of the Hope Medical Clinic for Women in Shreveport, Louisiana, repeated this mantra over and over to the teary women on the other end of the phone. The calls were coming from all over Texas, where abortion is currently banned at about six weeks, before many women know they are pregnant. They wanted to know if they could get an abortion in Louisiana instead.

“The phone has been ringing off the wall, patients attempting to get in,” Pittman said. But appointments were scarce. When I spoke with her on Thursday, Hope Medical Clinic was the only functioning abortion clinic in the state of Louisiana; the other two remaining clinics were closed due to power outages caused by Hurricane Ida. “Right now we are booked out three, possibly four weeks just to get in for that first visit,” Pittman said, noting that a state-mandated waiting period requires patients to come to the clinic twice. “We’re going to see women who are terminating later in the pregnancy than desired because they simply can’t get in quickly enough,” she said. Others, she feared, wouldn’t be able to get an abortion at all. “Of course it’s going to be the women who have no money,” she added. “It’s always the women without the means that suffer the most.”

In the wake of SB 8, which went into effect on Wednesday, many clinics in Texas are still providing abortions for patients up to six-weeks pregnant, or before embryonic cardiac activity can be detected. Everyone else — estimated to be about 85 percent of all abortion patients — is now being referred out of state. As a result, clinics in Oklahoma, Louisiana, New Mexico, Colorado, and Kansas are being inundated with a surge of pregnant people who are racing against the clock for care. Yet, in many of these states, years of constant anti-abortion attacks have eroded the existing reproductive health infrastructure, leaving a fragile system that is ill-equipped to absorb the additional demand.

“The second largest state in the country goes dark on a service and everyone else surrounding is trying to support and provide care,” said Emily Wales, interim president and CEO of Planned Parenthood Great Plains, which covers Arkansas, Kansas, and Oklahoma. Clinics in all three states are seeing an increase in Texas patients, she said, especially in Oklahoma. At the same time, abortion access is under attack there; five new abortion restrictions are set to go into effect on November 1. “It feels a little bit like it’s whack-a-mole right now in trying to beat back what are medically unnecessary requirements to ensure ongoing access,” Wales said.

While other states have passed similar six-week abortion bans, the Texas law is the only one that has been allowed to go into effect. That’s because of the unique way it was drafted. The state does not enforce the law. Instead, SB 8 deputizes regular people to file civil lawsuits against doctors or anyone else who knowingly “aids or abets” an abortion. The law appears to have been intentionally designed this way to thwart judicial action.

At Trust Women’s clinic in Oklahoma City, which is one of the closest abortion clinics for people in north Texas, abortion appointments are already being booked three weeks into September, just like at Hope Medical Clinic in Louisiana. “All of our doctors fly in from other states,” explained Zack Gingrich-Gaylord, communications director for Trust Women. “We’re currently asking them to consider working additional days, but of course, our doctors also practice medicine in their home states as well.” Trust Women has another clinic in Wichita, Kansas, with slightly more availability, but to get there, Texas patients must travel even further. “We’ve already started seeing some of those Texas patients today, and we’ve got some scheduled tomorrow,” said Ashley Brink, the Wichita clinic director. “It’s been a really emotional time. A lot of these folks, they’re scared, they’re confused, they’re sad.”

Kristina Tocce, medical director at Planned Parenthood of the Rocky Mountains, said she was seeing the same uptick in Colorado and New Mexico. “I’m very nervous for patients who need services immediately because this was an immediate hard stop to abortion services in Texas without a clear path for those patients as to where they can go,” she said. “Texas is essentially a pre-Roe world now.”

The distance to the nearest clinic is only one of the problems that Texas patients now face, said Alan Braid, the owner and medical director of Alamo Women’s Reproductive Services in San Antonio. Many patients are already mothers, and cannot leave their jobs or their children for the length of time needed to access care in another state. Some are undocumented and cannot travel with ease.

“It sounds very easy — oh well, you can’t get it in Texas, just go to Oklahoma, New Mexico. But the people that we see — that hourly wage patient, the single mom, the people that don’t have the means to travel — it’s impossible for them,” he said. “That’s like saying well, just hop on a plane and, you know, go to France. It’s beautiful there, you can get an abortion and then take a walk down the Champs-Élysées.”

Braid, who has been providing abortion care in Texas since he began his OB/GYN internship in 1972, said this was the worst climate he had ever seen for reproductive rights in Texas since before Roe v. Wade. The new law, with its vigilante-enforcement scheme, is spreading fear and distrust. “You can feel it in the room,” he said. “It hangs heavy.” As a provider, he said, he is usually optimistic that he can support his patients and meet their needs. “Now, when I walk in the room, I have huge doubts about whether I’m going to be able to help,” he said. “I’m not used to that.”

He expressed deep concern about what patients will do to obtain abortions if they can’t get one inside Texas when they need it. He still has a powerful memory of three teenagers dying from septic shock and organ failure after obtaining back-alley abortions back when he was an intern in 1972.

“That’s where we’re headed,” he said. “I promise you that people are going to cross the border to Mexico. They’re going to self-induce.”

Texas Is Already Creating Abortion Refugees