In the months since Texas banned all but the earliest abortion in September, the number of legal abortions in the state has roughly halved. But two new studies show that the total number of Texan women has fallen much less — by about 10 percent — due to a significant increase in the number of Texans who traveled to a clinic in a neighboring state or ordered abortion pills online.
Two groups of researchers from the University of Texas at Austin calculated the number of women using these alternatives. They found that while a Texas law that bans abortion after fetal heart activity can be detected, or after about six weeks, reduced abortion rates, it did so much more modestly than previous measurements suggested.
Taken together, the data indicate what could happen to access to abortion if the Supreme Court decides to strike down Roe v. Wade when it rules on another abortion law this summer. The data shows the limitations of laws restricting abortion. However, it also shows how restrictions put up serious barriers that cause some women to carry unwanted pregnancies to term.
“The law did nothing to change people’s needs for abortion care; the place where people get abortions has changed,” said Kari White, principal investigator at the University of Texas Policy Assessment Project and lead investigator on the new out-of-state abortion study. She expressed surprise at how few abortions were prevented by such a massive set of restrictions: “The numbers are much higher than we expected. It’s pretty amazing.”
But for the framers of the Texas law, even a modest reduction in the number of abortions is a success.
“We have no hesitation in declaring this a victory for the de facto protection of premature babies from elective abortion,” said John Seago, legislative director of the Texas-based Right to Life organization who helped draft the law. “We are realists here, so the best thing we can do is encourage women to have children.”
Gov. Greg Abbott, the Republican who said the bill “ensures that the life of every unborn child who has a heartbeat will be saved from the ravages of abortion” when he signed it, declined to comment on the new numbers.
As state legislatures await the Supreme Court’s decision and take stock of Texas’ experience this year, some have introduced new restrictions on abortion, even if they go against Rowe’s position. On Thursday evening, the Florida Legislature voted to ban most abortions after 15 weeks of pregnancy. Between 21 and 26 states are expected to ban or significantly restrict abortion if the Supreme Court allows it. On Monday, an attempt by Senate Democrats to codify abortion rights into federal law failed to win enough votes.
Abortion problem around the world
Women’s access to abortion continues to be debated around the world. Here is a look at the state of affairs in some countries:
Every month between September 2021, when the Texas law went into effect, and through the end of the year, an average of 1,400 women traveled to one of the seven surrounding states, according to one new study released Sunday. That was 12 times more than the usual out-of-state abortion requirement before the law was passed.
Seven nearby states were included in the study: New Mexico, Oklahoma, Louisiana, Arkansas, Kansas, Mississippi, and Colorado. Nearly half of the Texans who traveled went to Oklahoma, and a quarter went to New Mexico. Texans who attended 34 of the 44 clinics were counted, so the total was likely higher.
Average 1100 women ordered abortion pills online every month through Aid Access, an overseas service that mails pills, bypassing US abortion restrictions by connecting women to European doctors and Indian pharmacies. According to a second study published last week in JAMA Network Open, this is more than three times the number of those who ordered pills on average in the month before the law was passed.
Previously, there were an average of 11 requests per day. Immediately thereafter, the number of requests rose to 138 requests per day and stabilized at around 30. The study was unable to determine whether all drug requests resulted in abortions.
“The law works halfway; it won’t stop all abortions,” said Abigail R. A. Aiken, author of the study, who teaches public affairs and leads a research group studying self-managed abortion at the University of Texas at Austin.
Many studies have shown that those who fail to have an abortion are more likely to be poor. It is expensive to travel to another state and pay for transportation, child care and accommodation in addition to the procedure.
The new data covers the most common alternative methods at state clinics, but does not include all Texans who have had an abortion. numbers; crossing the border into Mexico to buy over-the-counter pills; trips to additional states for abortions; or using herbs or other self-abortion methods.
If Rowe is ousted, the same patterns may not spread across the country because access to abortion will be even more difficult than for Texans.
Recent studies have shown that abortion pills outside of formal medical settings are available, reliable, and effective, and that information about access to care is increasingly being shared online. But some women don’t know it’s an option. “For the past 10 years, I have been tormented by the question: how to contact those who cannot find you?” said Rebecca Gomperts, the physician in charge of access to care.
In addition, it is technically illegal to sell prescription drugs to American patients in another country without a prescription from a physician licensed in the United States. However, enforcement is difficult even if Texas and several other states have expressly restricted medical abortion.
Without Rowe, clinics would close in the South and Midwest. The closure will increase the average distance to the nearest clinic to about 280 miles, compared to 35 miles for women in states where none exists, a study by Middlebury College economist Caitlin Knowles Myers and colleagues found.
Studies of past abortion laws have shown that long distances tend to reduce abortion rates as travel-related issues increase. Groups offering financial and logistical support to Texas women said donations declined after the law went into effect.
The groups added that they would not have enough resources to help women in many states. The rest of the clinics are likely to be overwhelmed with patients. Trust Women, which has an abortion clinic in Oklahoma, is taking in 10 times as many Texans as it used to. This causes a ripple effect. According to Rebecca Tong, executive director of the clinics, many Oklahoma residents cannot get local help and are forced to look elsewhere.
Clinics have been trying to expand to meet demand, but especially in Oklahoma, where abortion would be outlawed if Roe were toppled, it’s hard to hire doctors, she said: “?”
At Hope Medical in Shreveport, Louisiana, two-thirds of patients are now from Texas, up from one-fifth before the Texas law went into effect. The clinic used to do most abortions before nine weeks, but now most patients are in the late first or early second trimester due to longer waiting times.
“Ultimately, because we are very busy and cannot work faster, we see women who have prolonged pregnancies,” said Kathleen Pittman, clinic administrator. “This happens not only to women from Texas, but also to women from Louisiana, because they also have to wait.”
However, clinics are bracing for an even bigger surge if Rowe is ousted, planning to expand facilities if abortion remains legal in their state, or if not, reopen outside of states where it’s legal. offer more advice through telemedicine; or offer pre-abortion help.
Cristina Tocce, medical director of Planned Parenthood of the Rocky Mountains, said the influx of patients from Texas offered a glimpse of a possible future in which Colorado, which is expected to leave abortion fully legal, could become a post-Row abortion center. .
“What will happen when this happens to more and more states?” she said. “I don’t know, but we can’t gobble up 26 states that go out.”
Note. Our calculation of the reduction in the total number of abortions compares recent figures with the pre-legislation pre-legislative abortion rate. For legal abortions in the state and requests for abortion pills, we compared March to July 2021 with September to December 2021.
For out-of-state abortions, we compared March to July 2021 with the 2019 monthly average. (Data as of early 2021 not available.)
As the abortion rate in Texas increased in August 2021, pending new restrictions, we did not include this figure when establishing historical figures.