Two more reproductive health clinics—one an abortion provider—in underserved areas of Texas closed their doors this week, as the effects of the omnibus anti-abortion access bill passed last summer with the support of conservative lawmakers continue to unfold across the state.
Both now-shuttered clinics, in McAllen and Beaumont, are part of the Whole Woman’s Health group, which once had five facilities in Texas: in Fort Worth, Austin, San Antonio, McAllen, and Beaumont. As of this week, the organization will be down to three locations. And come September, when abortion providers are required to meet the standards of ambulatory surgical centers, there will be just one Whole Woman’s left, in San Antonio. At that time, it will be one of six abortion providers left in a state that, according to data from Texas Department of State Health Services, sees about 70,000 legal abortion procedures performed each year.
“It’s hard for me to feel like I’m giving up, letting people down,” Whole Woman’s Health CEO Amy Hagstrom Miller told RH Reality Check. But when her doctors can’t get admitting privileges in socially conservative communities, and she can’t afford the million-dollar retrofitting required to turn her small clinics into hospital-like surgical centers, she said, “there’s no miracle way to pay the bills.”
The two shuttered clinics were both located in communities where poverty rates are high and many residents are un- or under-insured. The Beaumont facility, in southeast Texas, was the only provider between Houston and Louisiana, while the McAllen facility, in the Rio Grande Valley, served clients in the poorest city in the United States.
“Both of those communities have had safe, legal abortion since Roe v. Wade,” said Hagstrom Miller, until the passage of HB 2 last summer started a wave of clinic closures across the state. The four-fold law puts heavy restrictions on the prescription of medication abortion, bans abortion after 20 weeks, requires abortion-providing doctors to have admitting privileges at hospitals within 30 miles and mandates that abortion facilities meet the standards of ambulatory surgical centers.
While the McAllen clinic stopped providing abortion care last November when the admitting privileges provision of HB 2 went into place, abortion care at the Beaumont Whole Woman’s clinic continued until the end of February, when Hagstrom Miller ultimately decided she couldn’t sustain the facility in the wake of HB 2. The Beaumont clinic’s OB-GYN, who has provided legal abortion care since Roe and who Hagstrom Miller jokes has “delivered half the town,” had admitting privileges, but Hagstrom Miller says there’s no way she could turn the clinic into an ambulatory surgical center come September. It became time, she said, to “rip the Band-Aid off” and close both the McAllen and Beaumont clinics.
The conservative lawmakers who pitched HB 2 with the help of Gov. Rick Perry, who called two special sessions to pass the bill, claimed that it would improve the standard of care for Texans seeking abortions. Instead, a Whole Woman’s employee who worked in Beaumont for two-and-a-half years told RH Reality Check that women in the area will now have a harder time than ever accessing not only abortion, but the affordable contraception and cancer screenings that Whole Woman’s helped them find.
“We’ve been well aware that Texas has been against us and on us for many, many years,” said Marva Sadler, a regional director at Whole Woman’s. “But I did not think I would see a day where they would have put up such barriers that now that we’re actually closing clinics, and they’re essentially taking away the right to fair and safe comprehensive health care that all women, not only in the state of Texas, deserve to have.”
Sadler describes experiencing the clinic closures as a “grieving process,” fraught with anger and frustration at onerous laws that do little to prevent the need for abortion in the first place, or increase access to quality reproductive health care.
“It’s not just a plan on a piece of paper anymore,” said Sadler. “It just seems like breathing gets a little harder every day.”
Patients seeking legal abortion in Beaumont now face a 90-minute drive to Houston or a three-hour drive to Baton Rouge, Louisiana, for their procedures, while Valley residents face a three-and-a-half hour drive to San Antonio or a two-and-a-half hour drive to Corpus Christi, where the city’s sole abortion provider will close in September after the surgical center regulations go into place.
The lengthy drive is just one barrier to accessing legal abortion care; an estimated 61 percent of patients seeking abortions are already parents, which means they must find child care in addition to taking time off work, and in many cases, finding a place to stay overnight.
Amy Hagstrom Miller told RH Reality Check that she’s now turned most of her attention toward trying to find ambulatory surgical centers (ASCs) in Austin and Fort Worth where her doctors might be able to provide legal abortion care, perhaps through leasing the facilities on nights and weekends. But her luck, so far, has not been good.
“I’ve cold-called every ASC in the book,” she said. But even when she finds sympathetic landlords who don’t fear anti-choice protesters turning their sidewalks into soap boxes or harassing their patients, she also finds that there are barriers that keep her from operating, such as land “covenants” in formerly Catholic hospital-owned ASCs that prevent doctors in those locations from performing vasectomies or tubal ligations or providing abortion care.
“It’d be a miracle if I could pull it off in those two communities,” said Hagstrom Miller, of finding ASCs in Austin or Fort Worth. But, she said, “if anyone’s going to figure it out, I’m going to figure it out.”
Marva Sadler said she thinks often of the patients who have come to the Beaumont clinic over the past decade, and those who will soon find the clinic’s doors shut.
“I’m grieving for the women,” said Sadler. “I know the day after we close our clinic, they’ll call and that line is not going to have anyone on the other end to answer their questions. Where are they going to go? What are they going to do?”
To mark the closure of the McAllen clinic, the Whole Woman’s Health staff has invited the community to come to a candlelight vigil outside the downtown facility on the evening of Thursday, March 6, while a private event will be held for staff in Beaumont.