A month of court battles has left behind chaos and confusion for patients seeking abortions.
Though abortion is — at least for the moment — legal in Texas again during the pandemic, the back-and-forth court battles will have lingering effects, including leaving people unclear as to whether they can still obtain one in the state, when they can, and where.
Providers throughout the state were able to begin offering abortions again on April 22, following nearly a month of litigation during which the availability of abortion changed nearly from day to day.
In late March, Republican Gov. Greg Abbott issued an order postponing all surgeries that weren't "immediately medically necessary," and GOP Attorney General Ken Paxton said that included all methods of abortion.
Providers sued over whether or not abortions could be considered elective or delayed without consequence, pointing out that delays of 30 days or even fewer can make abortion "completely inaccessible."
After several rounds in Court, Texas providers began performing abortions again in late April, after Abbott's original executive order expired.
But the return of services is being tempered by the confusion created by the ever-shifting status of abortion in the state. And that confusion may lead to a situation where Texas abortion clinics become overwhelmed, further delaying — or denying — access.
First, there may be people who fell into a "donut hole" during the litigation over the ban. These are people who, Bridget Schilling of the Clinic Access Support Network in Houston explains, "were kind of caught in the middle there who had to wait about a month between maybe knowing that they wanted to get an abortion and actually being able to."
Those people may now be forced to scramble to find a provider before it's too late.
Kamyon Connor, executive director of an abortion fund in North Texas, told the Dallas Morning News that, "Calls to our helpline have increased since the COVID restrictions have been lifted on abortion."
Patients may also need abortions at a later time in their pregnancy.
Schilling points out "you're going to have a delay" — even though clinics are now open — because there may be an influx of people seeking care.
Elizabeth Nash of the Guttmacher Institute, a research organization that looks at laws and policies affecting reproductive health care, told the Morning News that it was difficult to calculate exactly how much access had been impacted during the chaotic legal proceedings.
"As soon as people start talking about abortion bans, or clinics closing, people who aren't in the weeds of it, they think abortion is banned," she said. "People might not think that they can still access abortion services when some services or all services are available."
However, Amy Hagstrom Miller, the CEO of Whole Women's Health, which operates three clinics in Texas, said they had to cancel "hundreds of appointments...and numerous times" during the litigation over the ban.
With abortion becoming available in Texas after a month of delays and uncertainty, the system may simply not be able to absorb a rush of hundreds of additional appointments in a timely manner.
Abortion access in Texas is already fragile. Only 35 facilities perform abortions in Texas, 21 of those standalone clinics, according to the most recent data. The number of clinics has been steadily decreasing. In 2013, for example, there were more than 40 standalone clinics.
Texas bars abortions later in pregnancy in most instances, forcing people who are more than 20 weeks pregnant to travel out of state.
If people can't easily get in to see a local provider in time, they may be forced to travel across the state. And if people passed Texas' 20-week ban mark while the litigation continued, they now have to seek care out of state. Guttmacher estimated that requiring people to drive out of state for care increases the median driving distance from 12 miles to 243 miles.
Abortions later in pregnancy can be much more expensive, not simply because of the cost of the procedure, but because traveling far away may require lodging, childcare, and multiple days off of work.
All in all, the uncertainty created by Texas' efforts to ban abortion during the pandemic could have lasting effects on both patients and providers.
Published with permission of The American Independent Foundation.