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Texans were leaving the state for abortions long before six-week ban

While abortion rights advocates say Senate Bill 8 has been particularly damaging to patients, Texas lawmakers have spent years finding ways to limit those rights.

(CN) — Anna was always in favor of choice when it came to abortion, but she figured she would “never make that choice.” That calculus changed in 2014, when she discovered she was pregnant by her abusive ex-boyfriend.

The man at first seemed like Prince Charming, but his behavior grew increasingly erratic and violent. He punched holes in her walls, stalked her and injured three of her dogs, killing one. A fourth dog died from what a veterinarian suspected was rat poison.

“If he could kill a four-pound dog to upset me, what would he do to a child?” Anna remembered thinking. Besides, she worried that sharing a child would make it harder to disentangle from him.

“That would be the way he could manipulate and control me,” she said in an interview. “I’d have to deal with this man for the rest of my life.” Anna’s identity and location are not being revealed for her safety.

Today in Texas, Anna may not have been able to receive an abortion at all. Senate Bill 8, which the Texas Legislature passed last year, bans abortions past fetal cardiac activity, which typically occurs around six weeks. The law also allows ordinary citizens to pursue damages against anyone who allegedly “aids or abets” an abortion.

SB 8 is the most successful attempt by Texas lawmakers to undermine abortion rights — but it's hardly the first. When Anna decided she needed an abortion, another Texas law had recently shuttered clinics across the state, and there were none nearby. In the end, she had the procedure in New Mexico — a state that remains a lifeline for Texans needing abortions.

The latest law didn't exactly criminalize abortion. Instead, SB 8 allows people to sue providers and others if they believe an unlawful abortion has occurred.

Planned Parenthood called the rules a “bounty-hunting scheme.” Supreme Court Justice Sonia Sotomayor accused Texas of outsourcing “the enforcement of unconstitutional laws to its citizenry.” This unusual strategy has so far paid off for anti-abortion activists: Because state officials don’t enforce the law, both the U.S. Supreme Court and the Texas Supreme Court have ruled abortion providers can’t seek temporary injunctions against them.

While legal battles over the law play out, Texans have had to look outside the state for abortion care. Many people don’t even realize they’re pregnant during the first six weeks of pregnancy — and most who receive abortions do so after this window.

Sarah Wheat, a spokesperson for Planned Parenthood, says that clinics in nearby states like New Mexico have seen around an 800% increase in Texas patients. The Texas Policy Evaluation Project, a group that tracks and studies abortion restrictions, estimates that the number of Texans seeking out-of-state abortions increased more than tenfold in the months after SB 8 took effect, from around 500 in the final months of 2019 to more than 5,500 in the same time period in 2021.

As abortion rights erode across the country, advocates fear the worst is yet to come. In Oklahoma, where many Texas women have traveled for care, lawmakers recently passed a bill that adopted Texas’ citizen-enforced system to limit abortions past six weeks. The local branch of Planned Parenthood announced they were no longer “providing surgical or medical abortion procedures in Oklahoma,” though they said they could help direct patients to other states.

Oklahoma Governor Kevin Stitt, a Republican who calls himself “the most pro-life governor in the country,” also signed an even harsher bill that makes almost all abortions a felony punishable by up to 10 years in prison. At least 13 states have passed such “trigger laws” that would automatically criminalize abortion if Roe v. Wade is overturned — and that possibility seems increasingly likely. In a draft majority opinion leaked this week, Justice Samuel Alito called the Roe decision “egregiously wrong” and compared ending abortion to overturning segregation.

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The result: Clinics in states that still allow abortions are becoming “inundated,” said Dr. Bhavik Kumar, a medical director at Planned Parenthood Gulf Coast. If abortion bans continue to spread, he predicts those problems will get worse.

When SB 8 first passed, Planned Parenthood predicted it would cut Texas abortion numbers by as much as 85% to 90%. That figure now appears closer to 50%. Ironically, that’s because SB 8 has caused Texans to seek abortions earlier in their pregnancies.

"People have to make a decision very, very quickly,” Kumar said. In some cases, patients have contacted Planned Parenthood before they're even sure they're pregnant.

The Texas Policy Evaluation Project has studied the impacts of these rules on patient well-being. In interviews, many said they felt “anger and frustration” with SB 8. One anonymous patient said that Texas wanted to force people into “pregnancy slavery.”

Patients reported spending up to thousands of dollars traveling out of state. In some cases, they lost their jobs or failed classes after missing an important exam in school.

“I’ve never felt more like the government doesn’t give a shit about me …. than I do right now,” one patient told the group. “I’ve never felt it so deep inside of me that I am so disposable, that I don’t matter, that I don’t get any bodily autonomy.”

Protesters walk along Jackson St. during the North Texas March for Life, celebrating the passage and court rulings upholding the Texas law known as Senate Bill 8, on Saturday, Jan. 15, 2022, in Dallas. (Shafkat Anowar/The Dallas Morning News via AP)

Back in 2014, when Anna sought her abortion, Texas was involved in another legal fight over abortion rights.

The state had recently passed House Bill 2, which banned abortions past 20 weeks and imposed a variety of restrictions on clinics, including requiring that they meet the same standards as surgical centers and that doctors have admitting privileges at a nearby hospital.

Especially for smaller clinics in rural areas, the law was too expensive and onerous to comply with. In Fort Worth alone, Planned Parenthood spent $6.5 million building a center that met the new codes.

The U.S. Supreme Court ultimately overturned parts of HB 2 in 2016, ruling that it posed an “undue burden” on abortion rights. By then, the number of abortion clinics in Texas had plummeted from 41 to 17. Out of the 254 counties in Texas, just six still had clinics after the law.

HB 2 was just one of many anti-abortion laws that led up to SB 8. In 2012, Texas lawmakers required sonograms and a waiting period for women seeking abortions. In 2016, they required clinics to bury or cremate fetal remains.

In 2020, during the coronavirus pandemic, Texas Governor Greg Abbott issued an executive order halting abortions on the grounds that they were not "medically necessary." The courts have ultimately stopped many of these rules, but litigation can take months or years — and in the meantime, the rules served their intended purpose of making abortion harder to obtain.

Few Texas laws have impacted abortion patients quite like SB 8, said Wheat, the Planned Parenthood spokesperson.

"What’s different now is the scale of restriction,” she said. “It’s so significant, and it’s affecting so many Texans.”

While past laws mostly targeted abortion clinics, SB 8 “targets the patients” by creating possible civil liabilities for people who try to help them, Wheat said. Still, she views SB 8 as part of a “very coordinated and equally relentless” attack on abortion rights and family planning that has gone on for years.

Kari White, a researcher at the Texas Policy Evaluation Project, agrees on SB 8's impact. While HB 2 reduced abortions by around 13%, she said, SB 8 has cut abortion numbers in half.

White stressed these restrictions could be dangerous for women — and not just because they might seek out unsafe abortion options. She pointed to premature rupture of the amniotic membrane, a life-threatening condition that can cause pregnant women to hemorrhage. In cases like these, she said, “doctors feel they cannot treat [patients] immediately” out of fear of getting sued.

While SB 8 has curtailed abortion access like no other law, "it’s been years that women have had to evacuate the state," said Anna, the abortion patient. As she considered her options in 2014, a nearby clinic had recently closed. The nearest Texas clinic was hours away, in Dallas.

Anna decided against going to Dallas because she worried the law requiring a waiting period for abortions would make it too long of a trip. Technically, since Anna lived more than 100 miles from the nearest clinic, she would have only had to wait two hours. Still, her misunderstanding is noteworthy: As clinics closed across the state after HB 2, many Texans "experienced confusion about where to go for abortion services” and "reported increased cost and travel time to obtain care," one study found. The end result: Texans “delayed abortion care" or were prevented from "having the abortion they wanted.”

In the end, Anna was able to get her abortion. Her mother drove her to Albuquerque. She also got away from her abusive ex-boyfriend, who remains in a high-security prison for animal abuse and other charges, state records show.

Even years later, though, Anna still feels frustration and anger about her experiences.

“Why do I have to take two days off of work for a procedure that takes 10 minutes?” she asked.

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