A divided Supreme Court on Wednesday declined to stop a restrictive Texas abortion law from taking effect, allowing the state to prohibit medical providers from ending a pregnancy after detecting an embryo’s cardiac activity.
In effect, the law bans Texans from getting abortions after about six weeks of pregnancy.
Few in the Lone Star state will now be able to get an abortion — though there are some options for those wanting to end an unwanted pregnancy. In recent years, a network of nationwide volunteers and nonprofit groups have sprung as restrictions in several states make abortions more difficult to access.
Yes, within the parameters of Senate Bill 8 (S.B. 8).
Care providers are emphasizing that though the time frame when clinics can offer abortions has been restricted, their doors are still open and they are providing services to people who meet the law’s criteria.
Andrea Ferrigno, corporate vice president of Whole Women’s Health clinics in Texas, encouraged anyone who is pregnant and doesn’t know how many weeks along they are to call a clinic or schedule an appointment.
“People need to know that providers are still here,” she said.
Women who are eligible to receive a legal abortion but cannot afford transportation still have the option to tap into resources like the Houston-based Clinic Access Support Network, which coordinates travel within the state.
Kylie McNaught, a board member with the organization, said phone lines have been relatively quiet since S.B. 8 was allowed to stand, likely because so many people are no longer eligible for services within Texas.
“It’s week one, so we’re just going to see what’s to come,” she said.
Yes. People who are no longer legally allowed to receive abortions in Texas can leave the state to find care.
Advocacy organizations such as the National Abortion Federation have begun offering targeted assistance with transportation, food and hotel stays for those who decide they want to end a pregnancy but don’t have the means to travel.
Texas organizations that provide logistical support for people traveling to abortion appointments are largely shifting their focus to supporting people who need to leave the state, said Stephanie Gomez, a board member at Fund Texas Choice.
Gomez said in June, the group organized about 10 to 12 trips each week, but the number has reached an average of 20 and is climbing.
“The need for people just needing to get out of Texas is going to be so high,” she said. “It’s often people who under other circumstances, or pre-S.B. 8 circumstances, wouldn’t have needed travel support at all. But those people are just being put into a position where what could have been a drive across Texas and a gas reimbursement now has to be a trip to another state.”
Numerous other organizations offer funding for the procedure, which costs an average of $550, according to Guttmacher Institute, a research organization that supports access to reproductive health.
Even with the help of various funds, advocates say the logistical barriers of traveling to another state for abortion care are towering. Some people cannot take time off work to leave the state. Others don’t have the necessary documents to travel.
Advocates and experts also said there’s concern that Texans are going to overload other states’ abortion clinics. This combined with the possibility of more states enacting bans mirroring S.B. 8 could create a shortage of appointments, they predict.
“We could be looking at a whole swath of the country where abortion could potentially be inaccessible,” said Elisabeth Smith, director of state policy and advocacy for the Center for Reproductive Rights.
Abortion pills, which are FDA-approved and estimated to be used in more than a third of abortions before eight weeks of gestation, are also restricted under Texas’s new law.
Though the law doesn’t specifically address pills, they legally count as an abortion in the same way surgical procedures do — meaning they face the same constraints.
Texas Gov. Greg Abbott is expected to sign a bill within days that would further limit access to abortion pills, banning them from being mailed in Texas and preventing physicians from administering them to people more than seven weeks pregnant.
A medicated abortion is already restricted to around the six-week mark under the new Texas law, so advocates contend the bill on Abbott’s desk could be a backup measure to address abortion pills if S.B. 8 is overturned.
Pills have long been at the forefront of efforts by abortion rights groups to ensure access.
Groups like Amsterdam-based Aid Access believe everyone is entitled to abortion care and prescribe pills to people in the U.S. after a consultation. The prescription is then filled at a pharmacy in India and shipped to the states.
The website received a warning letter from the FDA in 2019 for importing the drugs that make up an abortion regimen, one of which is closely controlled in the U.S. Rebecca Gomperts, who runs Aid Access, stopped providing the pills for about two months before resuming.
“There are other ways people are accessing care outside of mainstream medical channels,” said Elisa Wells, co-founder and co-director of Plan C, a U.S.-based organization. “And those ways of accessing care are still working.”
University of Houston law professor Seth Chandler said while ordering abortion pills from outside of Texas doesn’t appear to be specifically prohibited by S.B. 8, the decision could run afoul of several other laws, including those regarding the international shipment of drugs and practicing medicine in Texas without a license.
While there are exceptions, the FDA says: “In most circumstances, it is illegal for individuals to import drugs into the United States for personal use.” The FDA warns people not to purchase Mifeprex, one of the drugs used for medication abortions, on the internet, saying buyers will “bypass important safeguards designed to protect your health.”
There have been isolated instances of people being charged after using the pill to have an abortion.
“It’s not just a question of is it legal, but it’s also the question of where does the person live and if someone found out about this, would the police and prosecutors or DA attempt a prosecution even if there wasn’t a specific law prohibiting the conduct,” said Smith, of the Center for Reproductive Rights.
Experts and advocates say that while abortion pills are considered safe, they do carry risks and that anyone considering this option should seek legal and medical advice through a trusted and reputable organization.
Abortion access for minors has always been complicated, advocates say, and has grown even more complex under S.B. 8.
In the past, organizations have helped minors who do not have parental support in seeking an abortion or fear for their safety. These groups help minors obtain a judicial bypass, an order from a judge allowing them to get an abortion without the clinic notifying their parents or requiring their consent.
Those services are expected to continue, while operating within the law’s new limits.
Minors who have to leave the state without parental permission to access abortion care could face steep legal challenges, experts say. Hotlines from groups such as the National Abortion Federation can help steer young people toward resources to address those challenges.
Ferrigno, at Whole Women’s Health, said people who are too far along and are not able to leave the state will essentially be forced to continue their pregnancies.
She said organizations like WWH can help connect these people with resources to address their physical and emotional needs. The group is fortifying its relationships with other organizations that can help with post-birth questions about adoption and other considerations, she said.