Abortion Law Pushes Texas Clinics to Close Doors

McALLEN, Tex. — Shortly before a candlelight vigil on the sidewalk outside, employees of the last abortion clinic in the Rio Grande Valley in South Texas shut the doors early Thursday evening, making legal abortion unavailable in the poorest part of the state in the wake of tough new restrictions passed last year by the Texas Legislature.

The closings on Thursday of two clinics operated by Whole Woman’s Health — the one here in McAllen and another in the East Texas city of Beaumont — are part of a wave of clinic closings brought on by the new law.

There were 44 facilities that performed abortions in Texas in 2011, abortion providers said. After the two closings on Thursday, there are now 24, they said. When the law is fully implemented in September, that number is expected to drop to six.

“It’s heartbreaking for us,” said Amy Hagstrom Miller, the chief executive of Whole Woman’s Health, which has challenged provisions of the law in court. “It’s been a very difficult decision. I tried everything I can. I just can’t keep the doors open.”

Anti-abortion groups said some of the reasons for the clinic closings were “deplorable conditions,” violations of state safety regulations and high staff turnover, accusations the operators denied. Still, abortion opponents expressed satisfaction that the two clinics, which together treated nearly 3,000 patients annually, were shutting their doors.

“We are pleased that women will never again receive substandard care from either of these abortion facilities,” said Joe Pojman, executive director of Texas Alliance for Life.

Abortion was a heated political issue last year in Texas, when Republican lawmakers, backed by Gov. Rick Perry, passed some of the toughest restrictions in the country, despite a marathon filibuster that turned State Senator Wendy Davis into a national political figure. The politics have since been toned down. Ms. Davis did not attend the clinic closings on Thursday and has not emphasized the issue in her campaign for governor.

But the real-world impact has played out in the months since the law passed.

In McAllen, the shuttering of the city’s only abortion clinic has increased the costs, the time and the travel distance for women seeking abortions. Women have been making a roughly four-hour, 240-mile trip to San Antonio or a five-hour, 310-mile trip to Austin to get abortions. There had been only two clinics that performed abortions in the Rio Grande Valley, but by the end of the day Thursday there were none. The other one in nearby Harlingen closed days ago.

Activity at the McAllen clinic had slowed recently. It stopped performing abortions last year after parts of the law went into effect. On Tuesday, the aftercare room, where women who had received abortions were taken to recuperate, was cluttered with boxes of files as workers prepared for Thursday.

“Sometimes on my lunch break, I’ll come back here, and I’ll just sit here,” said Lucy Carreon, the clinic’s patient advocate, who is moving to San Antonio to work at the Whole Woman’s Health facility there. “It’s very sad. I can’t believe it.”

The leaders of Whole Woman’s Health, which operates clinics in Texas and two other states, said they closed the ones in McAllen and Beaumont in large part because of one restriction in the law: the requirement that doctors who perform abortions have admitting privileges at a hospital within 30 miles.

Ms. Miller said that nearly all their doctors were unable to obtain admitting privileges at nearby hospitals, and that some hospitals declined to even provide doctors with applications for admitting privileges.
 

Another part of the law, which takes effect in September, requires clinics to meet surgical-center standards, meaning all abortions, including nonsurgical procedures, must take place in hospital-style operating rooms. It is that requirement that abortion providers say will probably reduce the number of clinics in the state to six and that Ms. Miller said played a role in the decision to close the McAllen and Beaumont clinics.

Republican supporters of the law said it would protect women’s health and hold abortion clinics to safer standards. Opponents said that it was an unconstitutional attempt by Republicans at a backdoor ban on abortion and was designed to force clinics to close. Mr. Perry has stated that one of his goals in office is to “make abortion, at any stage, a thing of the past,” and another Republican leader, Lt. Gov. David Dewhurst, suggested last year on Twitter that shutting clinics was part of the purpose of the law, known as House Bill 2.

In a statement, Ms. Davis, who is running for governor against Attorney General Greg Abbott, a Republican who has defended the law in court, pointed out the other services the clinics provided, beyond abortions, that were now unavailable to many women.

“These health centers provide lifesaving preventive care, cancer screenings and birth control to Texan women,” she said. “Politicians like Greg Abbott are forcing their personal political agenda and threatening the health of women across the Rio Grande Valley.”

Even before the full regulations kick in, women in rural areas have already had more difficulty getting abortions than those living in urban centers like Houston and Dallas.

In the West Texas city of Lubbock, Planned Parenthood closed the only clinic there providing abortions, sending many women on a five-hour trip to Dallas or to Albuquerque, some 320 miles away. The closing of the clinic in Beaumont has made Houston the nearest option, more than an hour’s drive away. A clinic in Corpus Christi, which is closer to McAllen than San Antonio but is still more than two hours away, is closing in September because of the surgical-center requirements.

In McAllen, the problems associated with traveling 240 miles to San Antonio one way — including additional costs for gas, lodging or child care — have caused some women to go to Mexico to buy a widely available “abortion pill” that can induce miscarriages and that abortion providers and advocates said poses significant health risks. Ms. Carreon, the patient advocate, said she believed 30 to 40 women who had contacted the clinic since last year had decided on their own to take the pill.

Some women interviewed at the McAllen clinic said they had considered taking the 30-minute trip to Mexico to get the pill — a drug called misoprostol known by the brand-name Cytotec — but ultimately decided against it.

“Honestly, I think they’ll go south of the border, if they have to,” said a 23-year-old woman who was one of the last patients to be seen at the clinic and who went to San Antonio for an abortion last month. “It’s cheaper and it’s closer. To go to San Antonio is so much more of a hassle and costs a lot more.”

On the day of her appointment in San Antonio, the woman, who asked that her name not be used, said she left with a friend at about 3 a.m. to arrive at the clinic by 8 a.m. She had to spend the entire day there waiting to be seen. The San Antonio clinic, it turned out, was packed with patients from the Rio Grande Valley area.  NYTimes