On June 27, 2016, the Supreme Court ruled 5-3 in the Whole Woman’s Health v. Hellerstedt case, striking down two provisions put in place by Texas’ House Bill 2, or HB2, a sweeping abortion law that went into effect in 2013. Although the law was overturned, more than half the abortion clinics in the state were closed while the case was being decided. Women’s access to abortion has declined dramatically since 2013 and the fight over access to abortion in south Texas remains heated.
The two provisions that the court struck down were that clinics must meet ambulatory surgical center requirements--the codes required of hospitals and surgical facilities--and physicians must have admitting privileges at nearby hospitals. The justices ruled that neither regulation was necessary to protect women’s health and placed an undue burden on their constitutional right to obtain an abortion.
However, by the time the ruling came down, the damage to Texas’ abortion provider network had already been done. Of the 40 or so clinics that were providing abortions in Texas prior to HB2, half remained. The aftermath of HB2 is not just seen in closed clinics and the huge expanses that sit between rural communities and the closest open clinics. It is seen in the lives of women on both sides of the debate fighting for what they feel is right.
Sofia Peña was in a rocky relationship with a boyfriend when she became pregnant with her daughter. She desperately wanted an abortion, but her boyfriend was vehemently against it. She continued the pregnancy. She took to parenting, much to her surprise, but struggled to raise her daughter without the father’s consistent involvement. Before being able to get out of the relationship, she became pregnant again. This time she got an abortion--with some financial help from Lilith Fund and her ex-boyfriend--realizing she was not able to financially support a second child, having a cashier’s job. Now she runs La Frontera Fund, which helps to fund travel to and from clinics for women in Texas seeking abortions who cannot afford them. Because of the restrictions put in place in Texas, women often travel incredible distances to get access to care, she said.
“HB2 took all of the things that were already barriers, heightened them times a thousand, and created new ones,” Sofia said. “It did, but for a lot of people those barriers were already there.”
“Folks in Texas think this is normal, but it is not normal,” Dr. Bhavik Kumar said of Texas’ abortion regulations.
It was good to know that people [who get abortions] aren’t alone in the confused shame we feel, because sometimes we don’t even know where it comes from. It is so ingrained in us to be ashamed of our sexualities and ashamed of anything surrounding our sexualities, but I also always tell people that what I felt was relief and empowerment afterward. It very much changed from ‘Why did I get myself in this situation?’ to ‘I am so happy that it is over.’
Unfortunately, with the work I’ve been doing with La Frontera Fund, I see or I hear a lot from these women saying ‘I have no one. There isn’t anybody.’ I ask, ‘Are you sure there is nobody?’ ‘No, I can’t tell anybody.’ And it goes back to stigma. Being in the Rio Grande Valley, everyone is very Catholic. We’re not unique in that way, but it does present problems that are very specific to really religious areas, such as the shame around women’s sexuality in general. We don’t talk about sex. Families are not going to tell their girls to get birth control.
Support is really necessary and stigma is a really big deal here in the Rio Grande Valley, even for people like me. In high school I already knew about contraceptives...but I wasn’t really taught about the emotional and physical abuse that led to me not really standing up for my rights, even though I knew them.
-Sofia Peña, La Frontera Fund
Crisis pregnancy centers, or CPCs, are religious organizations that usually do not have medical professionals, but provide pregnancy tests and ultrasounds and discourage women from getting abortions. Women seeking abortions often come to CPCs not realizing the difference.
Hundreds of crisis pregnancy centers have appeared across Texas in recent years. A good number of them belong to the Texas Pregnancy Care Network, which contracts with the Texas Health and Human Services Commission under the Alternatives to Abortion (A2A) education program, which seeks to help women choose to continue their pregnancies.
Legislators have been increasingly generous to A2A, allocating $18 million to it in the current two-year budget, more than triple the amount given in its first biennium. Some CPCs receive funding from Healthy Texas Women, a state-funded program launched last year and made necessary after the federal government withheld Medicaid dollars from Texas because it illegally kicked Planned Parenthood out of a special health care program for low-income women.
Teresa Haring, who has operated Allied Women’s Center since 1994, declines state funding, depending instead on donations from churches and donors.
“I don’t want to tie my hands with state regulations,” she said
“We try to save the baby, that is our goal,” said volunteer Yolanda Perez Rittamann of the Allied Women’s Center, a CPC in San Antonio. Clients who are “abortion-minded” are sent to a physician in the Medical Center, who performs a free ultrasound and further tries to convince the woman to keep her baby, she said.
“This is one of our saved babies,” Rittamann said, picking up Zoey Divin, a two-year-old. Her mother, Shirley Divin, showed up at Allied Women’s Center seeking an abortion, because she worried her health problems would make it difficult for her to parent. A 37 year-old single mother with a 20 year-old son, she lived on a monthly disability check. She was shown a gruesome video about abortion during her visit to the center. “It scared me,” Divin said. “I realized this was about life, and I couldn’t take a life.” She continues to receive assistance from the center in the form of diapers, clothes, and money.
Abused and molested as a child, Mercedes Soto ran away from home at age 16, earning money as a tattoo artist and getting heavily involved with drugs. She married Orlando Sanchez at age 17 and moved with him to Pennsylvania for a year so he could finish college. When they returned to McAllen, Soto reentered the drug and tattoo scene, to her spouse’s dismay. Still, they stayed married for 14 years, having two children, a son and a daughter.
But three years ago, Orlando filed for divorce, tired of Soto’s wild living. She moved in with her mother, and the kids mostly stayed with Sanchez. One night, members of a rival gang raped Soto. The assault left her depressed, suicidal. She moved into a women’s shelter as police pursued her attackers.
When Soto discovered the rape had impregnated her, she tried to self-abort, ingesting 15 misoprostol pills she was able to get without a prescription. She drank toxic teas. She even had fellow gang members punch her in the stomach.
When none of that worked, she made an appointment at Whole Woman’s Health, sobbing as she walked in for her counseling and ultrasound. On the way in, a protester, the woman who runs the nearby crisis pregnancy center, caught her eye.
“She was saying that Jesus loved me, that I didn’t have to kill my baby,” said Soto, an animated woman who cries often as she recounts her story, her body still decorated with gang tattoos.
Laying on the ultrasound table, Soto had a sudden change of heart. “I ran out of that clinic knowing that I really wanted my baby. It was the only way to get my family back. I had lost everybody.”
After running out of the clinic, I think “I’m all alone. I’m embarrassed and I have nobody, so I am in a shelter and now I’m pregnant.” So I am like, “Oh great. How am I going to care for this baby?”
After that, I go to a church I used to always go to and that is where my journey with God started. I let them know what happened to me and that I believe in God as my lord and savior. I just really want to belong. I need to belong. I told them everything and they showed me lots of love. They told me I belonged. That means a lot to me because I have never really belonged anywhere. I have always had to fight for myself.
-Mercedes on finding her faith during her pregnancy
“If I can keep my baby after being gang raped, anyone can,” Mercedes said. “You got pregnant on a bad date, or with somebody you love? There’s just no excuse. If you lay with a man and get pregnant, that’s your fault. To murder your unborn baby is a sin against humanity.”
Now Mercedes has put her energy towards trying to “save babies from the abortion mill.” Because of her numerous tattoos, more women can relate to her when they would not be as likely to relate to other pro-life women trying to save them, she said. She approaches these women outside of Whole Woman’s Health or when they come to the nearby CPC seeking an abortion and tries to convince them not to go through with the procedure. After praying over them and sharing her own story, she promises that she will help to support the woman through her pregnancy.
Patricia is an example of that. Patricia, who has had an abortion and several children in the past but lost custody, now looks to Mercedes for car rides to appointments, emotional support, frequent taco lunches, and other forms of assistance. In return, she goes with Mercedes to pro-life rallies and protests as an example of what life is like as a saved woman.
Riding through the colonia in a van, Lucy Felix shouted through a megaphone at the passing homes, “We’re inviting all the women and, to the kids, bring your mothers so all can be informed about women’s health! We will also have free bingo, dinner, and haircuts! Completely free!”
Lucy and her fellow community outreach coordinators call themselves and the women they help “Las Poderosas,” which roughly translates to “the strong women.” Much of her philosophy about reproductive healthcare issues reflects her belief that when women think of themselves as strong, they bring everyone up with them, she said. To her, this is a generational issue.
We want to have a better Texas. We have a strong Texas, but we want a better Texas. Who's gonna fix it? Is it gonna be the politicians? We are gonna fix it!
Respect for individuals' rights brings peace and that is what we want. We want peace in the Rio Grande Valley. We want peace and that is why we are remembering that we have to have respect. And this month precisely we are going to talk about respect. The respect that every woman should have to make decisions about her body, to decide for herself when she wants to interrupt or carry out a pregnancy, that she should have access to clinics and access to abortion services when she needs them. And somebody might say, "Ugh, what does that have to do with me? I have my family. I already planned." But it does matter, even if you do have your family, it does matter. When the clinics close down that effects us when we hear that a woman is denied her right to make a decision about her body. This affects us, because that means that they are not respecting our rights. They are violating our human rights. And that hurts us.
We have been fighting for one purpose. Fighting so our families, our communities here in Texas, have access to healthcare services. We know that when our communities do not have access to healthcare services that affects our families. That hurts our mothers, that hurts working women like all of us. We have to fight every day against these barriers, but the import thing is that all of us are getting organized...We know that there are barriers, but we also know that our voice matters. That our voice has to be heard.
-Lucy Felix, National Latina Institute for Reproductive Health promotora speaking in Spanish to families at the junta in La Fruita colonia in the Rio Grande Valley
“Many of these women are facing difficult situations that they have lived through and they are not going to be interested in a conversation about reproductive healthcare,” Lucy said. To get around that, she offers them dinner, bingo and free hair cuts. She explained that they play bingo in their homes, so when you play bingo with them, they start to feel more comfortable--like they are with family. That is when they will start to listen to her educate them not only on reproductive healthcare, but also about immigration rights, employment opportunities, unrelated healthcare problems, and other issues that pertain to them and their communities.
The drive between Del Rio and San Antonio consists of vast expanses of farm land speckled with tiny towns. One such town along the way is Hondo, Texas, which welcomes passersby with a huge wooden sign that states, “Welcome: This is God’s Country. Please don’t drive through it like Hell.” By the time Kristen passed that sign on her journey to get an abortion, she had been riding a Greyhound bus for nearly four hours. Living in Del Rio, the closest open clinic was the Whole Woman’s Health in San Antonio.
Jess, a 25-year-old waitress, knows that road as well. Although her driving time to the clinic from Del Rio was made shorter in a car, her full journey was longer than Kristen’s. Trying to avoid taking time off work, Jess and her mother Aisme tried to self-induce an abortion first.
Aisme twice drove Jess into Mexico to get illegal abortion pills. She got an ultrasound in the back of a store in Acuña, Mexico, which she described as also selling fruit and purses, to see how far along in the pregnancy she was. Then she purchased misoprostol pills--an ulcer drug known to induce miscarriages--from the store, which she inserted vaginally. When the pills did not work, she returned to the store in Acuña and had the pharmacist who sold her the original pills insert two more, because she thought she had inserted them incorrectly. Dr. Kumar suggested that, because the Acuña pharmacy was not regulated, the pills she bought may not have had the right type or amount of medicine. Although she was 9 weeks and could still opt for a medical abortion at Whole Woman’s Health, she and Dr. Kumar decided that, because the misoprostol from Mexico did not work, she would be a better candidate for a surgical abortion.
Due to Texas’ abortion regulations, Dr. Kumar was required to do a second ultrasound, offer to share the image and the sound of the fetal heartbeat, and describe the image to her. In addition to this ultrasound, Kumar was required to read a state-mandated pamphlet called “A Woman’s Right to Know”, which the medical community has said contains a number of falsehoods, such as a link between abortion and breast cancer. Then she went through a mandatory counseling session to confirm her desire to get the abortion. Because she came to the clinic from more than 100 miles away, her waiting period between her ultrasound and consultation and the procedure was reduced to two hours.
Kristen, however, did not know about the waiting period rule, so she did not know to tell the clinic staff that she was also coming from over a hundred miles away. As a result, she had to endure the 24-hour waiting period between the consultation and the procedure that all Texas women seeking an abortion at a clinic within 100 miles have to endure.
When her period was a week late, she and her boyfriend, who is 20, “freaked out.” They’d been dating about three months; he’s also in the military. Neither made enough money to afford a child. But beyond that, Kristen wasn’t ready for parenthood. She has big dreams, planning to use money from her military service to go to college and become a psychologist.
Since she had to stay for two nights, she said the cost of the bus tickets for the nine-hour trip, hotel fees, cabs between the clinic and hotel, food, and the procedure itself, added up to more than a thousand dollars. For an 18-year-old, that is a lot of money, even being employed.
“I often am asked, ‘Why am I having to wait here?’ They’ve already made their decision when they come in,” Dr. Kumar said of the waiting period. “It really hurts the folks who are most marginalized.”
This waiting requirement, in addition to being medically unnecessary, erected added barriers for women, especially those who might struggle to pay for child care or transportation or arrange time off from work, abortion rights advocates argue.
“There are 54,000 abortions here a year,” Joe Pojman, executive director of Texas Alliance for Life, said. As for women having to travel further to obtain an abortion, “Texas is a very large state geographically, so it’s not unusual for people to travel significant distances to get medical care. If I lived in the Rio Grande Valley, I’d have to drive quite a distance to Houston to get cancer treatment at MD Anderson (Cancer Center).”
The Supreme Court’s decision to strike down the two main parts of the law did little to deter Texas lawmakers, who in the legislative session that ended in May submitted more than 50 bills that sought to regulate and restrict abortion. The major bill that passed and became law requires fetal remains from abortion to be buried or cremated, bans a common procedure used in second trimester abortions, bans so-called partial birth abortion, which is already illegal under federal law, and forbids the sale or donation of fetal remains for research purposes. The sale of fetal tissue is already illegal in Texas.
Three abortion bills that died in the regular session have been placed on the docket for a special session that begins on July 18. They would, respectively, ban private insurance coverage of abortion, impose new reporting rules on abortion providers, and further defund Planned Parenthood.
Amanda Allen with the Center for Reproductive Rights, the group that filed the lawsuit on behalf of five Texas clinics that overturned HB2, said the new law — Senate Bill 8, or SB8 — reveals a change in tactics that lawmakers are using to restrict abortion.
“We knew all along the end game (of legislators) was to close clinics and block access, and the Court agreed,” she said. “The strategy now is to shift completely away from protecting women’s health to protecting the fetus. But what this is really about is stigmatizing and shaming women. It’s about robbing them of their constitutional right to autonomy.”
The Center is considering all the options, Allen said, including taking the fight all the way to the Supreme Court once again.
John Seago, legislative director for Texas Right to Life, said his group advocated hardest for the second-trimester procedure ban during the legislative session — opponents call it “dismemberment” abortion, because doctors remove parts of the fetus with instruments. The medical community roundly opposes the ban.
“This is an element of abortion jurisdiction that needs to be re-examined,” he said. “This part of SB8 differs from HB2 in that it’s built on a state’s interest in fetal life, rather than maternal health.”
Allen, with the Center, said the state of Texas racked up $4.5 million in legal fees in its failed attempt to save HB2. It stands to spend millions more in this next fight over SB8, which likely will end up before the nation’s highest court.
“There was a lot of commentary on the House floor that went, ‘Can we please stop wasting taxpayer dollars passing laws that will not pass constitutional muster?’” she said. “Can we spend money instead on improving women’s health in Texas, which has the highest maternal death rate of anywhere in the developed world?”