In the two-year period that the Texas House Bill 2 (known as HB2) was operational, it blighted the lives of women living across the state. Now, new research reveals its stark human cost for the first time.
Under the onerous and ultimately illegal provisions of HB2, abortion providers were required to reach the same medical standards as hospital-like ambulatory surgical centers. Additionally, doctors performing abortions needed to have admitting privileges at local hospitals. Consequently, 24 out of 41 Texan abortion clinics closed.
As a result thousands of women—predominantly from poorer Hispanic and black communities—were denied their reproductive rights. Some were forced to self-induce abortions to end unwanted pregnancies. And with few clinics remaining open, women often had to travel thousands of miles, at considerable expense, to access basic reproductive care.
In a rare victory for reproductive rights advocates, the Supreme Court ruled that HB2 was unconstitutional, striking down the Texas law in a 5-3 ruling. But the legacy of HB2 continues to be felt today by the Texan women denied access to abortions in this period.
Now a research team led by Dr Daniel Grossman of the University of California-San Francisco has quantified for the first time how geographical factors affected the Texas abortion rate. The team wanted to know how a woman's physical proximity to an operational clinic between 2012 (before the law was introduced) and 2014 (when it was operational) affected her ability to access an abortion.
Researchers measured how far a Texan woman would have needed to travel to obtain an abortion in 2012 and 2014. They then calculated the difference between these two distances, hypothesizing that the greater the change in difference, the more the abortion rate would have declined.
They found that the abortion rate in predominantly rural areas in West and South Texas dramatically decreased as clinics closed. In 2014, women living in these areas would have to travel an average of 51 extra miles for an abortion than in 2012. Under these circumstances, only the most fortunate—those able to fork out money for gas, childcare, with sympathetic bosses who allowed them time off—would be able to terminate their pregnancies.
There was a 50.3 percent decrease in the abortion rate in areas where the distance to an abortion clinic increased by over 100 miles. In areas where the change in distance was between 50 and 99 miles, abortions declined by 35.7 percent. Areas with a lesser—but still substantial—25 to 49 mile change saw abortions reduced by a quarter. Overall, the Texas abortion rate dropped 17.2 percent in the 2012-2014 period.
"The change was higher than I expected," Grossman confirms in an email to Broadly. "We did know that abortions to women in the Rio Grande Valley dropped by about 50 percent, but I was surprised that the drop was so large in this category of distance change across the state." Certain communities also shouldered the burden disproportionately: "The Rio Grande Valley is disproportionately Latina and lower income, and this was an area hard hit by the clinic closures."
Even in areas where clinics remained open, the abortion rate decreased by 1.3 percent. "We suspect this may be more related to clinic capacity than to distance to the nearest facility," Grossman explains. "We tracked wait times to get an appointment at clinics in Texas and found that these increased intermittently as clinics closed. When one large facility in Dallas closed in 2015, wait times in Dallas and Ft. Worth increased to 21 days or longer."
These figures show the damaging consequences of statewide laws limiting abortion access. And while HB2 is thankfully no longer in place, Trump's presidency will bolster the efforts of Republican lawmakers across the nation to come up with new, imaginative ways to deny women their constitutional rights.