Texas abortion clinics struggle to survive under restrictive law

By Julia Harte

(Reuters) – Since Texas enacted the strictest anti-abortion law in the country a month ago, the four Whole Woman’s Health abortion clinics across the state have seen patient visits plummet, some staff quit and recruitment efforts falter.

The new law, which bans abortions after about six weeks and empowers private citizens to enforce it, has the clinics “teeter-tottering between financial risk, legal risk and staffing risk,” said Marva Sadler, the facilities’ director of clinical services.

As the law is debated in courts – with a key hearing slated for Friday – abortion rights advocates say its impact has been swift and wide-ranging since it took effect on Sept. 1.

Abortion clinics are struggling to survive: The number of patients getting abortions at Whole Woman’s Health clinics dropped 70%, Sadler said. Women are seeking other options, including traveling to out-of-state clinics or obtaining abortion-inducing pills via mail.

Abortion rights advocates warn Texas will be a blueprint for other Republican-led states if its law is upheld. They consider it a major blow to Roe v. Wade, the U.S. Supreme Court’s landmark 1973 decision that established the right to abortion access, which will itself be tested by a Mississippi case the court will hear in December.

“Lawmakers from across the country were watching the Texas bill very closely… and when the Supreme Court allowed this unconstitutional ban to go into effect, they said, ‘now’s our chance,'” said Elizabeth Nash, a state policy analyst at the Guttmacher Institute, a reproductive rights research and policy organization.

Texas’ so-called “heartbeat” law bans abortion after cardiac activity is detected in the embryo, usually around six weeks. That’s before most women know they are pregnant and before 85% to 90% of all abortions are carried out, experts say.

The law makes no exception for cases of rape and incest. It lets citizens enforce the ban, rewarding them at least $10,000 if they successfully sue anyone who helped provide an abortion after cardiac activity is detected.

Some of Texas’ so-called “crisis pregnancy centers,” Christian-based facilities that encourage women to not have abortions, have seen a rise in visits since the law took effect, with more women seeking ultrasounds earlier in their pregnancies.

The Raffa pregnancy clinic in Greenville had a 166% increase in ultrasounds in the first three weeks of September compared to the same period last year, said the facility’s executive director Threesa Sadler, who supports the law.

Two clients whose scans revealed a fetal heartbeat were women she thinks might have terminated their pregnancies had that still been an option, she said.

“Beyond helping decrease abortion in Texas, I don’t know if it was an intended consequence that the law would also push more women to (crisis) pregnancy centers, but I love that that’s what’s happening,” she said.

On Friday, the U.S. Justice Department will ask a federal judge in Austin to temporarily block the law while its constitutionality is challenged. Under Roe v. Wade, states cannot ban abortion before the fetus is viable outside the womb, which doctors generally view as between 24 and 28 weeks.

Abortion rights advocates worry the law will have lasting damage even if eventually overturned.

“We know that when these laws are passed, part of the strategy is to close clinics while these bills sit in the courts awaiting decisions,” said Nikki Madsen, executive director of Abortion Care Network, a national association that includes seven independent abortion clinics in Texas.

Madsen said 23 of Texas’ 42 surgical abortion clinics closed after the state passed a law in 2013 requiring clinic physicians to have admitting privileges at a hospital within 30 miles. The U.S. Supreme Court overturned that law in 2016, but today there are still only 19 clinics offering surgical abortions in Texas.


Hundreds of women now are seeking abortions outside Texas, lengthening wait times in nearby states such as Oklahoma and Louisiana, according to evidence the Justice Department cited in its lawsuit.

In court documents, an Oklahoma-based Planned Parenthood doctor said Texas patients had traveled long distances to get treatment at his clinic since Sept. 1. One woman drove six hours alone, one way, because she feared any companion could get in trouble under the law.

Others are procuring abortion-inducing medication by mail.

KT Volkova, a graduate student in central Texas who uses the pronoun “they,” discovered they were pregnant a few days before the law’s effective date.

No appointments for surgical abortions near Volkova were available before Sept. 1, and Volkova was already nearly six weeks pregnant. Volkova, who volunteers with a group that provides financial assistance to abortion seekers, opted against seeking funds to travel out of state for the procedure and instead took an abortion-inducing medication that came by mail.

“I would have preferred to have it in-clinic, with staff holding my hand, but I had to go through the entire process in my apartment alone,” Volkova said.

Access to abortion-inducing medication will soon be further restricted in Texas.

A state law taking effect on Dec. 2 will narrow the window for medical abortions from 10 weeks to seven weeks after conception. Providing women with abortion-inducing drugs by mail will be a criminal offense under the law.

(Reporting by Julia Harte; Editing by Colleen Jenkins and Aurora Ellis)

Supreme Court blocks restrictive Louisiana abortion law

FILE PHOTO - An abortion rights activist holds up a sign as marchers take part in the 46th annual March for Life in Washington, U.S., January 18, 2019. REUTERS/Joshua Roberts

By Lawrence Hurley

WASHINGTON (Reuters) – A divided U.S. Supreme Court on Thursday stopped a Louisiana law imposing strict regulations on abortion clinics from going into effect in its first major test on abortion since the retirement of Justice Anthony Kennedy last summer.

The court on a 5-4 vote granted an emergency application by Shreveport-based abortion provider Hope Medical Group for Women to block the Republican-backed law from going into effect while litigation continues.

The four liberal justices were joined by conservative Chief Justice John Roberts in the majority, suggesting that Roberts, as Kennedy used to be, is now the key vote on the issue.

Kennedy backed abortion rights in two key cases. Justice Brett Kavanaugh, who President Donald Trump appointed to replace Kennedy, joined the court’s four other conservatives in dissent.

Hope Medical Group challenged the law’s requirement that doctors who perform abortions must have an arrangement called “admitting privileges” at a hospital within 30 miles (48 km) of the clinic.

Kavanaugh, writing for himself, said it was not clear whether doctors would be unable to obtain the admitting privileges were the law to go into effect. He said that he would have favored allowing them to bring a later legal challenge if their efforts were unsuccessful.

The Center for Reproductive Rights, an abortion-rights group that represents the challengers, said the law could lead to the closure of two of the three abortion clinics operating in Louisiana, a state of more than 4.6 million people.

The law was passed in 2014 but courts had prevented it from going into effect. The Supreme Court itself blocked the law in 2016, two days after hearing another major case involving a similar Texas law that the justices struck down months later.

Kennedy, a conservative who retired in July 2018, had voted to preserve abortion rights in 1992 and again in the 2016 Texas case.

Roberts was a dissenter in the 2016 case, but his vote on Thursday, for now, suggests the court is not retreating from that precedent.

Kavanaugh is one of two Trump appointees who are part of the court’s 5-4 conservative majority, along with Neil Gorsuch.

The Supreme Court recognized a woman’s constitutional right to an abortion and legalized the procedure nationwide in the landmark 1973 Roe v. Wade ruling.

The court on Feb. 1 temporarily blocked the Lousiana law, which was due to go into effect on Feb. 4, while the justices decided how to proceed.

(Reporting by Lawrence Hurley; Editing by Sandra Maler)

U.S. top court rejects challenge to strict Arkansas abortion law

Visitors to the Supreme Court are pictured in the rain in Washington, October 7, 2013. The U.S. Supreme Court will this week step into the politically charged debate over campaign finance for the first time since its controversial ruling three years ago paved the way for corporations and unions to spend more on political candidates and causes. REUTERS/Jason Reed (UNITED STATES - Tags: POLITICS CRIME LAW) - GM1E9A71U4B01

By Lawrence Hurley

WASHINGTON (Reuters) – In a setback to abortion rights advocates, the U.S. Supreme Court on Tuesday paved the way for Republican-backed restrictions on medication-induced abortions to take effect in Arkansas that could lead to the shuttering of two of the state’s three abortion clinics.

The nine justices, with no noted dissents, declined to hear an appeal by abortion provider Planned Parenthood of a lower court ruling that had revived the state law, which sets regulations regarding the RU-486 “abortion pill,” after it was earlier struck down by a federal judge. The law had remained blocked pending the outcome of the appeal to the Supreme Court.

The high court’s action may not be the final word on the matter. Planned Parenthood can still ask a judge to reimpose the injunction blocking the law.

The Supreme Court in 1973 legalized abortion nationwide, but many Republican-governed states have passed laws seeking to impose a variety of restrictions, some so demanding that they may shut down abortion clinics and make the procedure far more difficult to obtain.

The justices, in a 2016 ruling, struck down a restrictive Republican-backed Texas law that had targeted abortion clinics and doctors in a decision that was seen as reaffirming and fortifying legal protections for abortion rights. Planned Parenthood had claimed the appeals court ruling in the Arkansas case had disregarded the precedent set in the Texas case.

The St. Louis-based 8th U.S. Circuit Court of Appeals restored the law last year, reversing a 2016 ruling by a district court judge that had prevented it from going into effect.

Planned Parenthood Great Plains, which runs two of the three clinics that provide abortions in Arkansas, sued the state in 2015, saying the law would deprive many Arkansas women of their legal right to an abortion.

The law involves the RU-486 “abortion pill,” also called mifepristone (brand name Mifeprex) and misoprostol (brand name Cytotec). It requires any doctor dispensing the drug to sign a contract with another doctor who would agree to handle any medical complications from it, an unusual and difficult-to-achieve arrangement. The contracted doctor also must have admitting privileges at a hospital designated to handle emergencies.

Arkansas said the law was aimed at protecting women against the “dangerous and potentially dangerous” off-label use of the abortion pills.

RU-486 was approved by the U.S. Food and Drug Administration in 2000 subject to the instructions stated on the label. The “off-label” use prohibited by Arkansas allowed for less physician oversight when RU-486 is used. Planned Parenthood, which offers only medication-induced abortions at its two facilities in Arkansas, said the effect of the law would be to ban such abortions in the state.

The only other abortion clinic in the state, Little Rock Family Planning Services in the state capital, offers both surgical and medication abortions. The district court judge had found that women in Fayetteville, for example, would then have to make two 380-mile (610-km) round trips to get an abortion at what would be the state’s last remaining abortion clinic.

The state’s lawyers said the Arkansas law differs from the Texas law as it does not require the doctors who provide abortions to have hospital admitting privileges. They also said the abortion providers failed to provide evidence that a significant number of women would be adversely affected.

In 2013, the Supreme Court left intact an Oklahoma court ruling that struck down a state law that would have effectively banned RU-486.

In the Supreme Court’s current term, which runs through the end of June, the justices are weighing another abortion-related case in which operators of Christian-affiliated “crisis pregnancy centers” that steer women with unplanned pregnancies away from abortion are challenging a California law that requires them to post notices telling women about the availability of state-subsidized abortions.

(Reporting by Lawrence Hurley; Editing by Will Dunham)