In 2013, when several provisions of Texas' onerous anti-abortion law took effect, women with unwanted pregnancies were left startled and helpless as dozens of clinics closed literally overnight.
In a phone conference, Whole Women's Health CEO Amy Hagstrom Miller recalled a woman who had visited a provider she oversaw, Whole Women's Health McAllen, which sits on the Texas–Mexico border. The woman had scheduled an appointment, which unfortunately fell one day after the provider had been forced to close. "She was devastated by the absurdity of the law, noting immediately that if she'd just come yesterday, the same doctor and staff would have been able to help her," said Hagstrom Miller. "When we had to cancel her appointment and send her away, she told us that she could not travel to San Antonio to get an in-clinic abortion and that she had no other option than to see what was available off the grid in her local community, or over the border."
Read More: How to Run a Back-Alley Abortion Service
For at least 100,000 women in Texas, this is now the reality. According to a new study from the Texas Policy Evaluation Project, 1.7 percent of Texas women aged 18-49 have reported that they tried to self-induce an abortion; 4.1 either know or suspect that their best friend had tried to self-induce (this second figure being higher likely reflects the fact that women tend to underreport abortion in surveys). "Our findings indicate that abortion self-induction is most definitely happening in Texas," said Dr. Daniel Grossman, one of the study's authors, in the press call. "While it appears to be a small proportion of women who have ever tried to do this, the absolute number is quite large because of the size of the population in Texas."
There are currently nearly six million women of reproductive age in the state of Texas. This indicates that between 100,000 and 240,000 women have tried to self-induce abortion with no medical assistance.
The study cites two major reasons for self-induction: The first is that Texas has imposed several draconian restrictions on abortion access in the past three years, most notably the omnibus bill HB2, which Whole Women's Health is currently challenging in the Supreme Court. The second is that women are becoming more aware that misoprostol, one of the two pills that comprise medical, non-surgical abortion, is widely accessible; in Mexico and many other South and Central American countries, it's available in pharmacies, where it's marketed as ulcer medication, without a prescription. According to the study, this is the most common method among women who reported knowing someone who had self-induced an abortion. Other methods included herbs or homeopathic remedies, getting punched in the stomach, using alcohol or illicit drugs, and taking hormone pills.
The study notes that certain groups are more likely to be familiar with self-induction, including Latinas who are living near the US–Mexico border and women who have experienced barriers to accessing reproductive healthcare. In addition, a second study from the Texas Policy Evaluation Project found that there are four major reasons that a woman would self-induce an abortion: If she does not have enough money to either travel to a clinic or pay for the procedure; if her local clinic had been forced to close; if a close friend or family member had recommended self-induction; or if she wanted to avoid the stigma or shame associated with going to an abortion clinic.
A common thread through all these interviews was that poverty left them feeling like they had no other options.
"No single one of these reasons was sufficient for a woman to consider self-induction," Dr. Grossman said. "A common thread through all these interviews was that poverty, layered upon one or more of these other obstacles, left them feeling like they had no other options."
With the implementation of HB2 in 2013, the number of abortion providers in Texas has fallen from 40 to just 19. Unless the Supreme Court intervenes, that number could plummet even further—to ten. "I didn't have any money to go to San Antonio or Corpus [Christi]," said a 24-year-old woman interviewed in the second study. "I didn't even have any money to get across town. I was just dirt broke. I was poor."
Texas Latina Advocacy Network director Ana DeFrates recalled a story that a woman named Vanessa, a Latina immigrant in her mid-30s, had shared at a town hall in the Rio Grande Valley (an area hit especially hard by HB2). Vanessa had three children during a time at which all the clinics in the region had been forced to close, DeFrates said. When she realized she was pregnant with a fourth child she could not afford to support, she decided to end her pregnancy. She tried twice, once with an herbal tea and once with injections, but neither method was effective. "Going to the Corpus Christi clinic for multiple appointments would mean long travel, high cost, and expensive childcare," said DeFrates. "She simply didn't have the means to overcome the obstacles to get an abortion in Texas."
Eventually, Vanessa ran out of options. "Left with no other choice, and feeling hopeless, she returned to her Texas community, where she was forced to carry the pregnancy to term. Now Vanessa struggles to make ends meet for her four children," said DeFrates.
"It's stunning to hear stories like these. It's shocking to hear the data that Dr. Grossman presents to us today," said Hagstrom Miller. "But we're only going to hear more stories [like these], as Texas' clinics continue to close their doors, if the Supreme Court doesn't intervene."