New regulations requiring Texas abortion providers to have hospital admitting privileges forced more than half of the clinics in that state to stop offering abortion services. This was expected, by both pro- and anti-choicers, to cause a significant drop in the abortion rate in the state. But as Amelia Thomson-DeVeaux reports at The Week, the drop was much less significant than expected. Research by the Texas Policy Evaluation Project at the University of Texas at Austin found a 13 percent drop in legal abortions over the previous year, which is significant, but not nearly as big a drop as you’d expect when half the clinics in the state shut down. “In some ways, we were expecting a bigger decline,” study author Daniel Grossman told the Texas Tribune. Abortion rates have been falling on their own nationwide for decades, likely due to improved contraception use. That suggests that while most of this drop is due to the law, some of it might just be part of the larger national trend.
The findings demonstrate a fairly serious flaw behind the push for more and more restrictions on abortion laws. “If more clinics close, one might reasonably assume, the demand for abortion will also decline, either because wait times at the existing facilities are too long or because women will decide that an abortion isn’t worth the hassle or expense,” Thomson-DeVeaux writes. However, this thinking relies on the false belief that women enter into the abortion decision lightly, and that a few obstacles will deter them. Avoiding the expense and hassle of having a child when you don’t want one remains extremely motivating, more than many health care experts realized.
It’s important to note that researchers only measured the legal abortion rate by asking for numbers from clinics. Those numbers won’t count the women who instead resort to buying the ulcer drug misoprostol, which can induce a miscarriage, on the black market or in Mexico, where it’s sold over the counter. Andrea Ferrigno, who ran an abortion clinic that had to close in the Rio Grande Valley, told Jill Filipovic of Cosmopolitan that she contacted the hospital in the area to talk about the widespread use of Cytotec, a brand-name version of misoprostol. “The director of one ER said to us, ‘Oh, I was wondering what was going on, since I’ve been seeing a lot of miscarriages lately,’ ” Ferrigno recalled. “We tilted our heads and said, ‘It’s not miscarriages. It’s underground use of Cytotec.’ ” It’s impossible to say how many women are doing this, but it’s likely that some of the legal drop in the abortion rate is due to women aborting anyway, but doing so on the sly.
Meanwhile, legal medication abortions in the state have dropped by a stunning 70 percent. Part of the drop is likely because the restrictions mean that women are putting off abortions until it’s too late in the pregnancy to get a medication abortion. (According to the National Abortion Federation, medication abortions are typically only conducted within nine weeks of a pregnant woman’s last menstrual period.) Part of it is that the law now requires patients to go to the clinic a whopping four times to take what amounts to two pills—a hassle that women can avoid by just getting the surgical abortion instead.
Women are doing a remarkable job overcoming these restrictions to get the abortions that they need, but that doesn’t mean that the restrictions are no big deal. Come September, a new restriction requiring abortions to be performed only in ambulatory surgical centers will reduce the working-clinic number in Texas to six. At that point, the clinics will not be capable of handling the current number of women seeking abortion, which will mean that women will have to take increasingly drastic measures to secure the procedure. Putting up obstacles to abortion doesn’t magically persuade women to joyously embrace their pregnancies. It only serves to raise the expense, put women through unnecessary stress, delay an abortion until later in the pregnancy, and push women to seek abortion drugs on the black market. Proponents of the law say it’s about protecting women’s health, but the effects look much more like punishing women for seeking a safe and legal health care procedure.