The battle for reproductive rights in Texas entered a new phase last week, with a second challenge to House Bill 2, the state’s high-profile abortion restriction bill. At issue are two specific sections of the bill: that abortion providers must have admitting privileges (in particular, as that requirement applies to Reproductive Services in El Paso and Whole Woman’s Health in McAllen), and that all reproductive health clinics that provide abortions must meet the same building requirements as ambulatory surgical centers. It is estimated that if that requirement goes into effect as scheduled next month, fewer than 10 clinics in Texas — a state with more than 26 million residents, that covers an area of 270,00 square miles — would be able to remain open.
These restrictions are part of a continuing effort by the anti-choice movement to make abortion so difficult to access that, for millions of women, it is legal in name only. Neither requiring admitting privileges or mandating medically unnecessary building requirements will make abortion care any safer. The clinics that can’t afford to undertake costly structural renovations or retrofitting close down; those that are able to meet the requirements often afford to do so by raising the fees that patients must pay.
Likewise, insisting that abortion providers have admitting privileges at local hospitals willfully ignores a number of realities. Licensed abortion providers have excellent safety records. Hospitals can also refuse to grant admitting privileges for reasons that have nothing to do with a physician’s record — not that a woman experiencing complications would be turned away from a hospital in the first place. The American College of Obstetricians and Gynecologists (ACOG) observed, “Emergency room physicians, hospital-based physicians, and on-call specialists already provide prompt and effective treatment to all patients with urgent medical needs, including women with abortion-related complications.” For that reason and others, ACOG, along with the American Medical Association and other medical organizations, opposes the admitting privileges requirements and other parts of the Texas bill.
Not that the supporters of HB2 or similar measures have been swayed by the expert opinions of medical authorities. Nor have they appeared to take into account the real-world consequences of such requirements — for example, that forcing clinics to close for reasons that have nothing to do with patient safety will not make abortion safer for women. Rather, it will force women that can’t afford the higher fees or are unable to travel to another area of the state for health care to turn to risky methods to terminate their pregnancies.
Because that’s something else HB2 proponents want to ignore: that making abortion more difficult to access doesn’t automatically remove all the reasons a woman may want or need to end her pregnancy. Contraception will still fail, and women will still become pregnant as a result of rape. Women will still know best when to increase the size of their family; they, very often along with their partner or spouse, will still be the best equipped to decide if they have the economic security or social support or simple desire to be parents.
While the final verdict on HB2 has yet to be reached, other states that have attempted to restrict abortion access through similar measures have suffered significant setbacks lately. In early August, a federal judge rejected an Alabama law that would have mandated admitting privileges for abortion clinics. The law, which could have closed three of the state’s five remaining clinics, would have severely restricted access, according to U.S. District Judge Myron Thompson. In his decision, Judge Thompson stated that “If this requirement would not, in the face of all the evidence in the record, constitute an impermissible undue burden then almost no regulation, short of those imposing an outright prohibition on abortion, would.” Judge Thompson’s decision comes on the heels of a 2-1 ruling by the Fifth Circuit Court of Appeals that Mississippi’s attempt to enact its own admitting privileges law is unconstitutional.
And in Virginia, Governor Terry McAuliffe has promised to “undo” structural building regulations that were passed by his predecessor, Robert McDonnell. The regulations are currently under review after McAuliffe asked for an expedited review process.
While the news out of these three states is encouraging, the real-world effects of HB2 remain troubling. Just days before this most recent trial began, Whole Woman’s Health was forced to close its flagship clinic in Austin, leaving women with one less place to receive safe and comprehensive health care.
Sarah Erdreich is the author of Generation Roe: Inside the Future of the Pro-Choice Movement. She lives in Washington, D.C. with her family.