Texas has been become a battleground for abortion rights in the U.S., and in many ways seems like a test for what conservative lawmakers would like to see happen across the country. The War on Women, as NARAL Pro-Choice America famously dubbed it, is going strong with advocates going head-to-head, slinging all manners of political maneuvers at each other at an accelerated pace. But it's the sneaky "TRAP" (Targeted Regulation of Abortion Providers) laws that perhaps reveal the most about what lengths anti-abortion lawmakers and advocates are willing to go to push their agenda. And these same TRAP laws have a widely disproportionate effect on low-income women of color.
The Texas abortion saga has been particularly action-packed in recent months. Senator Wendy Davis's (D-Texas) now-famous 11-hour filibuster failed to block HB 2, and although pro-choice advocates managed to block some of the strictest provisions from the law in October, a federal appeals court put them back a week later. Now Planned Parenthood has filed an emergency stay with the U.S. Supreme Court, giving Texas lawmaker until November 12 to respond.
HB 2 went into effect last Friday and provisions will remain in place through November 12. Already an estimated one third of clinics have stopped providing services. In, El Paso one clinic halted abortion services because none of it's doctors have hospital admitting privileges--among the regulations passed as part of the law. Should all of El Paso's clinics stop providing services, those seeking abortions would have to travel 550 miles away to San Antonio for services. Such long distances put an additional strain on low-income women who bear the brunt of increased travel and lodging expenses, as well as potentially finding childcare and taking time off work.
Texas is only one of 27 states across the nation with TRAP laws that make abortions increasingly harder to come by, but it represents a tipping point in an upsurge of abortion-restrictive legislation that doesn't seem to be gaining momentum. What happens in Texas could determine whether other states follow the TRAP train, and adopt similar back-door approaches to abortion bans.
Abortion recipients are split nearly evenly along ethnic and racial lines when looking at sheer numbers, although white women account for the highest overall. But have higher rates of abortions because they are more likely to have an unwanted pregnancy, which experts say is directly connected to their access to reproductive healthcare, education, and contraceptives, among many other issues. Coupled with barriers created by limiting access to abortion, and the potential increase in cost that could come from recent regulations, low-income women of color will likely have a harder struggle in Texas and states across the country that appear to be following in Texas' footsteps.
Over the past two years policy analysts and advocates have seen an uptick in the use strategy from anti-abortion proponents who have done things like provide model legislation, and make it that much easier for conservative law-makers with anti-choice agendas to get these laws passed. TRAP laws are sneaky and successful at limiting access to abortions, and have been responsible for shuttering clinics in many states, most notably Mississippi where there is currently only one operating clinic.
As the ACLU has similarly pointed out, these TRAP laws are gaining momentum around the country. Over the past year more than 300 abortion restriction bills have been introduced in states across the nation, and there are several states expected to consider such bills in their next legislative sessions. Wisconsin, West Virginia, Michigan. South Carolina, Florida, Pennsylvania and Georgia are states where pro-abortion advocates haven't yet exhausted restrictive abortion policy options, which are of top concern for advocates as they gear up for local legislative sessions nationwide.
Angela Hooton, state policy and advocacy director for the Center for Reproductive Rights, is among those paying close attention to how the Texas saga pans out, and says recent events underscore what is at stake for women.
"Nationally, Texas tells a bigger story and puts a different spotling on how these seemingly innocuous regulations that are supposed to be for women's health, what they do is they shut down and put good providers out of business," she says. "And when good providers go out of business, what do they do, where will they go for abortions? That scares us all."
Hooton also points out how TRAP laws are politically and ideologically-driven regulations masquerading as laws to protect women, that add additional layers to existing abortion restrictions and deterrents meant to shame women into choosing not to have an abortion. But because the compounding effects of TRAP laws can force clinics to close or doctors to stop providing abortions, they can effectively cut off access particularly to the most vulnerable populations--poor women of color, particularly those living in rural communities.
One of the most onerous of the so-called TRAP restrictions is a requirement that facilities meet Ambulatory Surgical Center (ASC) standards. These standards require clinicians to regulate (seemingly arbitrary) things such as temperature, parking lot size, and doorway widths. According to the American Congress of Obstetricians and Gynecologists (ACOG), who strongly oppose Texas's new abortion legislation, say requiring abortion facilities to meet ASC standards exceeds the standards needed for more invasive procedures than abortions. They also say ASC standards necessary for abortion procedures, which are typically non-surgical and have extremely low rates of complications--only 0.5 percent--and could unduly burden service providers.
"This is kind of as extreme as TRAP gets," Hooton says. "Because you are creating unattainable standards for how clinics are set up. You are essentially requiring them to tear down and rebuild. And legislators know that."
Elizabeth Nash is the state issues manager at the Guttmacher Institute. She's been with Guttmacher for 14 years, and she also sees the growing TRAP law trend as the most worrisome develop of recent years, and show just how much power individual states have in dramatically reducing women's access to abortion services.
"People think a woman's right to an abortion is etched in stone. And it isn't," she says.
Among those regulations commonly included in TRAP laws are standards for clinic's physical structure, staffing requirements, hospital admitting privileges, and specific protocols for emergency procedures. And Nash agrees with Hooton that the requirement clinics to adhere to ASC standards is perhaps the most comprehensive way to put an abortion clinic out of business, and is concerned about what this could mean in particular for women who already lack access to reproductive health services. The increased costs to meet ASC standards could also increase the already high costs for women seeking abortions.
"Women without resources, either through health care or financial, it's much more difficult for them to access abortion care. The average first trimester abortion is $500. That's a lot of money," she says. "It's clear why women with fewer resources have less access to abortions. When you add restrictions, and clinics start to close, you can see where the burden will lie. It will lie with those with the fewest resources."
A similar ASC requirement TRAP law was also passed in North Carolina in July, and has already caused a clinic to shut-down in that state. In Texas, the ASC provision is expected to go into effect in September 2014, during which time advocates would have the opportunity to appeal. But it's the intent behind such a law that seems deliberately nefarious. Medical professionals have asserted that it's far from necessary for abortion providers to have the tools provided by an ASC, and the insistence points back to politics and ideology--not women's health.
As Colorlines Editor Akiba Solomon pointed out in her dispatch from Texas last year, some of the most vulnerable populations of women of color in Texas, lack access to contraception necessary to prevent pregnancy. In it, she made a statement that rings particularly true right now:
All women--hell, all people--should be able to get the medical attention they need in an environment that makes them feel as safe as possible. By turning something as personal as gynecological care into a political battleground, Texas provides us with a blueprint for what doesn't work.
In many ways what happens in Texas, particularly now that it's gone to the Supreme Court, could become the roadmap to whether other states in the country attempt such restrictive abortion legislation. And women of color will likely bear the brunt of increased restrictions on reproductive healthcare.
Over the past decade, there has been a sharp increase among the number of women receiving abortions who live below the poverty line--currently at 4 in 10. Megan Peterson is the deputy director for the National Network of Abortion Funds (NNAF), which helps organize independent foundations across the country who provide support for women who can't afford abortion services.
She says the demand for their services paints a clear picture of the need women have, and how TRAP laws and other existing abortion restrictions are increasing that need nationwide. Among those funds is Texas Equal Access Fund in North, who said that while they calculated the need for their services in Texas to be at about $10,000 they can provide about $3,200 in services. Peterson says this lines up with what they see all over the country. Last year NNAF served 22,000 women nationwide out of an estimated 200,000 who needed assistance paying for abortion services.
In Texas in particular, Peterson says they received a record number of requests from individuals seeking to raise funds in Texas since July, and that across the country a trend is emerging in how people help women afford abortions.
"One of the effects we're seeing from the TRAP laws, in this new wave of them, is we are getting a lot more request for support and assistance around creating travel and lodging networks," she says.
The reproductive justice landscape and proliferation of TRAP laws are a top concern for advocates and policy advocates nationwide, particularly considering the political maneuvers we've seen in Texas. But as some have pointed out abortion is not a new phenomenon, and resourceful women often find ways to do what is needed for themselves and their families. Perhaps the real concern lies in the lengths women will go to get in order to get a needed abortion when all other options have been taken.