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Texas clinics say later abortions rose after state's temporary ban

“It’s infuriating because you can't just turn on and off health care,” a Dallas clinic's co-medical director said.
Image: Director of Clinical Services Marva Sadler prepares the operating room at the Whole Woman's Health clinic in Forth Worth, Texas, on Sept. 4, 2019.
Marva Sadler, director of clinical services, prepares the operating room at the Whole Woman's Health clinic in Forth Worth, Texas, on Sept. 4, 2019.Tony Gutierrez / AP file

Several Texas clinics say they saw an uptick in women seeking abortions later in their pregnancies this spring, after the state temporarily halted most abortions amid the coronavirus pandemic.

Hundreds of abortions were canceled after Texas Gov. Greg Abbott, a Republican, signed an executive order on March 22 banning all nonessential medical procedures, and the state’s attorney general, Ken Paxton, said in a statement that the ban included abortions, unless a woman’s health was at risk.

The executive order was intended to help preserve hospital space and personal protective equipment for the care of COVID-19 patients.

“For years, abortion has been touted as a ‘choice’ by the same groups now attempting to claim that it is an essential procedure,” Paxton said in a statement at the time.

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After a monthlong legal fight, and what doctors describe as confusion and uncertainty among their patients as the rules about who could receive an abortion kept changing, Texas clinics were allowed to resume offering abortions on April 22 — and they soon saw an influx of women who had planned to terminate their pregnancy weeks earlier.

Southwestern Women’s Surgery Center in Dallas reported a 57 percent jump in second trimester abortions in the month after the ban was lifted compared to the month leading up to it, said Dr. Robin Wallace, the center’s co-medical director. The clinic declined to release the raw numbers.

“It’s infuriating because you can't just turn on and off health care,” Wallace said. “The hardship incurred when patients upon arrival were told that the courts just made a new decision and their appointment was now canceled — it was heartbreaking for patients and our staff.”

By the time the executive order expired, many patients were no longer able to receive a medication abortion, which is only offered in the first 10 weeks of pregnancy in Texas, and instead could only receive a surgical abortion, according to several clinics.

Planned Parenthood Center for Choice in Houston recorded a 28 percent increase in abortions after 10 weeks of pregnancy once the ban was lifted — an average of 51 weekly patients seeking these later abortions in the three weeks after April 22, compared to about 40 patients per week prior to the ban.

“At the first visit, folks had expressed wanting to do a medication abortion, but then so many people weren't able to come back for several weeks, which put them out of the window when they would have been able to access that care,” said Dr. Bhavik Kumar, medical director for primary and trans care at Planned Parenthood Gulf Coast.

“We were ready, capable and able to do what we needed to do to take care of our patients, but we legally weren't able to do that,” he said.

At Whole Woman’s Health in Austin, the number of surgical abortions nearly doubled in the three weeks after April 22 — there were 60 total during those three weeks — compared to the three weeks before the ban.

Soraya Dadras, the clinic director, said many patients were upset when they learned they were no longer eligible for a medication abortion.

“The idea of having an in-clinic procedure was more daunting for them than having a medication abortion in the safety of their home with their partner,” she said.

When Paige, 21, found out she was pregnant in late March, she knew she wasn’t ready to have a child. At first she worried about the cost of an abortion, but then realized she might not be able to receive an abortion in Texas at all.

“I felt like I was being punished in some way for getting pregnant,” said Paige, a Houston resident who spoke on the condition of anonymity to protect her privacy. “I felt like I was on an emotional and physical roller coaster.”

After traveling from Houston to Dallas for an appointment that was later canceled, Paige said she couldn’t keep waiting. She flew to Albuquerque, New Mexico, and had an abortion there.

When she returned to Texas, a sense of relief washed over her.

“I was back in the comfort of my own space, where I knew COVID couldn’t get me, and I was finally able to lay down and breathe, because I didn't feel like I was breathing through any of it,” she said.

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While abortion access has returned to normal in Texas, doctors are watching the state’s COVID-19 surge warily, concerned that they could be forced to close their doors again.

“There has been so much back and forth with the state, and as a provider in Texas, I know I need to be prepared for another instance when I am forced to stop providing essential care to my patients due to the harmful orders from our state leaders,” Kumar said. “My patients deserve better, and I demand better for them.”