Amy Hagstrom Miller runs two organizations that offer holistic abortion care services and are committed to fostering open and honest conversations to lift the stigma that surrounds abortion in this country—she is the founder, president, and CEO of Whole Woman’s Health LLC, and founder and president of Whole Woman’s Health Alliance. Whole Woman’s Health was first established in Austin, Texas, in 2003, and it now has nine clinics in five states—Texas, Minnesota, Maryland, Virginia, and Indiana—offering reproductive health care to more than 30,000 people a year. Miller has also litigated a case that went all the way to the Supreme Court in 2016, reaffirming a woman’s right to choose to terminate a pregnancy in Texas. Her clinics in Texas were providing abortion care until the minute Texas’ six-week ban went into effect at midnight on Sept. 1, but once SB 8 took effect, they had to stop providing services for anyone beyond six weeks of pregnancy. I wanted to check in with her to learn what was happening in Texas in the three intervening weeks. Our conversation has been edited and condensed for clarity.
Dahlia Lithwick: We’re hearing stories of pregnant people being turned away, traveling to Mexico and Oklahoma for abortion care. I wonder if you can say a little more about what is happening at your Texas clinics in the weeks since the law went into effect?
Amy Hagstrom Miller: It is heartbreaking what we are dealing with right now in our four Texas clinics. The clinics are open and complying with SB 8 because not to do so is far too terrifying for our staff and doctors to even consider. Staff are so scared of being sued—nurses and medical assistants and counselors—these folks don’t have attorneys or funds to hire them. Staff are being surveilled constantly—from the protesters on our sidewalks to some of the callers and even some of the fake patients our opposition sends into our clinics. Staff are constantly on alert, afraid, anxious, worried.
We have been losing staff for a couple of months now—even as early as when the bill was first signed into law, we started losing folks. Two of our four managers moved on this summer, and about one clinic staffer per week gives notice. Even many of our physicians have opted out of providing care while SB 8 is in effect. It is just too risky for them. These are the folks who kept our clinics open during this pandemic—essential health care workers providing time sensitive health care at great risk to themselves and their loved ones during COVID-19—and workers who also navigated their own kids home/virtual schooling, loss of child care, and the same family stressors we all have been juggling. Coming through all that and then to be met with this law? A law that requires them to serve as agents of the state, as enforcers, and all the anger from the patients about this law is directed at them, for a law they don’t support? This law goes against all they believe in and stops them from providing the care that is their life’s work to provide. It is more than anyone should have to bear.
Our new reality these past three weeks is that all day, every day, we have to say no to the majority of folks who come to us for care. We do provide care for all those we can under this new scheme—the folks who get to us early enough, who are lucky enough to make it in under the limit. As for those denied? They are stunned, numb, frozen—often leaving our clinics unable to make a plan for other options because of their shock. It is not OK for any of us.
Since the Supreme Court refused to enjoin SB 8, everyone’s been in a kind of contest waiting for something to happen. Finally, this week Dr. Alan Braid said he had performed an unlawful abortion and was promptly sued by two men, both out of state. Is this going to be the mechanism that will break up the logjam and force this issue to progress in the courts?
Dr. Braid chose to do what many of us have wanted to do all along. I admire him for it, and I am thankful he did. We all thought this law was unjust from Day One—prohibiting us to care for the folks we are trained to help, blocking us from living our own moral duty to provide care and compassion as we have promised to do. He stepped up in a way that I think shines a bright light on the bravery, integrity, and deep commitment to human rights that you will see from abortion providers across this country. And, at a time when so many among us navigate multiple layers of trauma, discrimination, and oppression, it is not lost on me that he—someone with positional power and privilege—used it for good. He is a board certified, white, male, OB-GYN who owns his own clinics—and he put that all on the line and broke this law. To me, this is integrity in action.
One of the things I have heard you say a lot is how maddening it is to keep hearing that SB 8 was “clever”—which has been a word virtually everyone has used to describe it at some point in print. Can you say more about that?
I am so tired of people’s fandom on this brutal law. So many people want to talk with me/us about how clever the statute is, the many angles it has at play, how unusual it is, and how it is a “first of its kind” and I am like WHAT?!?! This is not creative or interesting—don’t ask me about if I think it is the new trend, if I think it will be copied in other states, as though it is some trendy TikTok star to follow. SB 8 is cruel, mean, scary, and puts incredible power into the hands of people who have terrorized us and our patients for decades. What needs to be covered is the impact SB 8 has on Texans—on families, communities, health care providers. On every one of us who has loved someone, helped someone, or supported someone to have an abortion or who may need an abortion. This law is about all of us—women, men, families—all of us who have benefited from abortion. It is a horror tale, not the cool new thing.
What is the thing you most want people to understand, in terms of how this has affected Texans in just a few weeks?
SB 8 comes on top of layers and layers of restrictions on people’s access to abortion in Texas and the compounding effect is staggering. For the past two decades, Texas politicians have passed dozens of restrictions on abortion—forced ultrasounds, a ban on using Medicaid or insurance, two visit requirements, 24-hour waiting period, regulatory schemes that hinder clinic operations, a ban on D&E, gestational limits, ASC requirements, etc., etc. With each restriction more and more people are left behind, unable to get the abortion care they need, Black women, women of color, and young people are the most impacted. And maternal mortality in Texas is now on par with developing countries, in a race for the bottom in the U.S. alongside Mississippi.
The fact is, SB 8 does not reflect Texas values or the feelings and beliefs of most Texans. Most Texans support abortion rights, the data is supported by many polls, and this has been true for years. For too long the powerful few have worked to decimate abortion access—and to what end? What is their vision of the future? I think it is high time for us to ask ourselves: Who benefits from restrictions on safe abortion care from quality providers? Why are these far-right, mostly white men doing this? Who benefits from banning abortion?