Abortion in Texas

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Abortion in Texas is illegal after 2 weeks post-fertilization. As of September 1, 2021, abortion is prohibited in Texas once a fetal heartbeat can be detected, which may be as early as 6 weeks into a woman's pregnancy, due to the Texas Heartbeat Act enacted by the Republican-controlled 87th Texas Legislature during its regular session. The Act, introduced as Senate Bill 8 (S.B. 8), was signed into law by Texas Governor Greg Abbott on May 15, 2021.

Abortion providers have described SB 8 as a de facto ban on abortions, as it covers abortion once "cardiac activity" in the embryo can be detected, which is earlier than most women know that they are pregnant.^[1][2] The characterization "de facto" is incorrect, however, because the ban on abortions based on cardiac activity (as opposed to viability) is de jure, and as such expressly outlaws most abortions. The only exception for abortions past six weeks is in response to a medical emergencies. The law makes no exception for pregnancies resulting from rape or incest, though they may be terminated before fetal heartbeat detection. The law can only be enforce through private lawsuits.

The Act took effect September 1, 2021 after the U.S. Supreme Court declined to enjoin it.^[3][4] Prior to this date, elective abortions were allowed up to 20 weeks post-fertilization.^[5] The Texas Heartbeat Act is the strictest abortion law in the United States that is currently in force, though it follows a trend also seen in other states.^[2] In addition to measures passed by the Texas Legislature, there have been anti-abortion efforts at the local level, with 30 cities in Texas have enacted local abortion bans.^[6]

The constitutionality of SB 8 is a matter of intense legal controversy.^[1] Several legal challenges are currently pending on state and federal courts.^{[7] [8]}

Abortion was illegal in the state in 1900, with a therapeutic exception put in place in 1950. In the early 2000s, the state passed a parental notification law. In 2007, the state passed a mandatory ultrasound bill, and then started funding women's reproductive health programs that did not include abortion services and tried to cut off any state funding to facilities for reproductive services if they offered abortion services. Attempts to ban abortion in all cases were underway by 2007. By 2009, the legislature was actively trying to defund Planned Parenthood. Fetal heartbeat ban attempts were underway by 2013 when Phil King introduced such a bill on July 18, 2013, in the wake of Rick Perry signing Texas Senate Bill 5 into law. On February 7, 2019, Briscoe Cain, a member of the Texas House of Representatives, introduced a fetal heartbeat bill entitled the Texas Heartbeat Bill. It was jointly authored by Representatives Phil King, Dan Flynn, Tan Parker, and Rick Miller. As of February 26, 2019, HB 1500 had 57 sponsors or cosponsors of the 150 members of the Texas House of Representatives.^{[citation needed]} Texas abortion laws have resulted in a number of cases that have gone before the Texas Supreme Court or the US Supreme Court. They include 1973's Roe v. Wade, 1975's Jacobs v. Theimer, and 2016's Whole Woman's Health v. Hellerstedt.^{[citation needed]}

The number of abortion clinics in the state has been steadily declining, going from 128 in 1982 to 79 in 1992 to 64 in 1996 to 40 in 2011 to 28 in 2014 to 19 in 2016. The number of legal abortions has also been on the decline in Texas in recent years, going from 97,400 in 1992 to 89,240 in 1995 to 91,270 in 1996 to 54,148 in 2014 to 53,940 in 2015. Rosie Jimenez is the first woman known to have died due to an illegal abortion after the Hyde Amendment was passed, dying in 1977 from an illegal abortion in McAllen, Texas.^{[citation needed]}

The state is home to an abortion rights activist community. They have founded organizations like Jane's Due Process, been involved in events commemorating Rosie Jimenez Day every October 3, and participating in protests. The state is also home to an anti-abortion rights community, with Operation Rescue's national director befriending Norma McCorvey as part of their efforts, resulting in McCorvey announcing she was "pro-life" in 1995. They have also created organizations like Human Coalition. Anti-abortion rights activists have also been involved in violence in the state. This include arson attacks, butyric acid attacks and an attempted bombing. Harris County, which includes Houston, has been home to the most abortion violence in the United States as of 2000 with 10 acts of violence being experienced by clinics.^{[citation needed]}

Terminology[]

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The abortion debate most commonly relates to the induced abortion of an embryo or fetus at some point in a pregnancy, which is also how the term is used in a legal sense.^{[note 1]} Some also use the term "elective abortion", which is used in relation to a claim to an unrestricted right of a woman to an abortion, whether or not she chooses to have one. The term elective abortion or voluntary abortion describes the termination of pregnancy before viability at the request of the woman, but not for medical reasons.^[9]

Anti-abortion advocates prefer to use terms such as "unborn baby", "unborn child", or "pre-born child",^[10][11] and see the medical terms "embryo", "zygote", and "fetus" as dehumanizing.^[12][13] Both "pro-choice" and "pro-life" are examples of terms labeled as political framing: they are terms which purposely try to define their philosophies in a way that will gain public support.^[14] The Associated Press encourages journalists to use the terms "abortion rights" and "anti-abortion".^{[15][page needed][citation not found]}

Reflecting is nature and legislative intent, the Texas Heartbeat Act uses the term "unborn child" for the fetus or embryo irrespective of the gestational phase in the definition section: "Unborn child" means a human fetus or embryo in any stage of gestation from fertilization until birth." Texas Health and Safety Code Sec. 171.201(7).

Context[]

Free birth control correlates to teenage girls having a fewer pregnancies and fewer abortions. A 2014 New England Journal of Medicine study found such a link.  At the same time, a 2011 study by Center for Reproductive Rights and also found that states with more abortion restrictions have higher rates of maternal death, higher rates of uninsured pregnant women, higher rates of infant and child deaths, higher rates of teen drug and alcohol abuse, and lower rates of cancer screening.^[16]

According to a 2017 report from the Center for Reproductive Rights and Ibis Reproductive Health, states that tried to pass additional constraints on a women's ability to access legal abortions had fewer policies supporting women's health, maternal health and children's health.  These states also tended to resist expanding Medicaid, family leave, medical leave, and sex education in public schools.^[17] According to Megan Donovan, a senior policy manager at the Guttmacher Institute, states have legislation seeking to protect a woman's right to access abortion services have the lowest rates of infant mortality in the United States.^[17]

According to The NCBI, women of lower socioeconomic status and women of color have higher rates of abortion in the United States. Abortion opponents argue that abortion providers are exploited these women which is why regulations are needed to protect them. There are many reasons for the abortion disparity among different races and socioeconomic classes in the United States, such as lack of access to contraception, lack of education, and lack of access to health care.^[18]

History[]

Female political support[]

One of the biggest groups of women who oppose legalized abortion in the United States are southern white evangelical Christians.  These women voted overwhelmingly for Donald Trump, with 80% of these voters supporting him at the ballot box in 2016. In November 2018, during US House exit polling, 75% of southern white evangelical Christian women indicated they supported Trump and only 20% said they voted for Democratic candidates.^[19] A 2019 study found that the implementation of restrictive abortion laws in 2014 increased the number of second-trimester abortions by restricting women's access to abortion services.^[20]

Legislative history[]

By the end of the 1800s, all states in the Union except Louisiana had therapeutic exceptions in their legislative bans on abortions.^[21] In the 19th century, bans by state legislatures on abortion were about protecting the life of the mother given the number of deaths caused by abortions; state governments saw themselves as looking out for the lives of their citizens.^[21] In 1854, Texas passed an abortion law that made performing an abortion, except in the case of preserving the life of the mother, a criminal offense punishable by two to five years in prison.  The law, found in Articles 4512.1 to 4512.4, had a proviso that anyone who provided medication or other means to assist in the performing an abortion was an accomplice who could also be charged.^[22]

1990s[]

Following the US Supreme Court ruling in Roe v. Wade in 1973, the State of Texas decided not to repeal abortion laws that were on the books and had become unconstitutional and unenforceable.^[22] A law passed in 1992 said that only Texas licensed physicians could perform an abortion in the state.^[22] A law passed in 1997 gave physicians, nurses, health care provider employees and hospital employees who objected to abortions the ability to refuse to participate either directly or indirectly in the procedure.  All private hospitals were allowed to refuse the use of their facilities to provide abortion services unless a physician determined that the pregnant woman's life was in immediate danger.^[22]

Twenty-one abortion related bills were introduced in the Texas legislature in 1997. Five were eventually enacted: TX SB 407 (1997), TX SB 1534 (1997), TX HB 1 (1997), YX HB 39 (1997), and TX HB 2856 (1997). TX SB 86 (1997) reached a floor vote but did not pass.^[22] TX SB 407 allowed for the Texas Department of Health to immediately suspend the license of an abortion facility if health and safety of people using the facility was threatened. This bill was introduced by Senator Harris on February 5, 1997, and passed on February 18, 1997, by a voice vote. It then continued to the House, where it passed by a voice vote on April 18, 1997, before being signed into law bi Governor Bush on May 1, 1997.^[22]  TX SB 1534 dealt with funding, stating that no state funding could be used to support, either directly or indirectly, abortion or abortion related issues.  Introduced by Democratic Senator Barrientos on March 20, 1997,  the wording about abortion was only added to the legislation during negotiations between the House and the Senate, with the amended version passing both houses in mid-May 1997.^[22] TX HB1 said that funds allocated for the Department of Health for family planning services could not be used by the Department of Health or any organizations it provides money to in support of abortion services, either directly or indirectly. This included a proviso that said this was organization wide, not just as it relates to specific facilities.^[22] Representatives Republican McCall, Democrat Van de Putte, Democrat Gray, Democrat Greenberg and Republican Solomons introduced TX HB39 on January 28, 1997.  Originally only about genetic testing with no mention of abortion, the legislation was amended by the Senate, stating that genetic testing of a fetus could not be done on a fetus without the consent of the mother, and that the results of any subsequent genetic testing could not be used to compel or coerce a woman into getting an abortion, including having an insurance company threaten the eligibility of health care coverage. These changes were then passed by the House and the bill was signed into law by Governor Bush on June 20, 1997.^[22] TX HB 2856 put in new requirements for abortion clinics, inspection procedures of clinics and a clinic's ability to advertise.  It said the Texas Department of Health had to assign each licensed abortion clinic a unique number, clinics needed to have this number in any advertising materials, and created a 1-800 toll free number so people could call up and check the status at any time of a clinic's license.  Information on the toll free number had to be provided to women seeking abortion services by the facility offering them at the time of appointment.  This law underwent some changes before being passed by voice vote in the House on May 13, 1997, and by a vote of 31 - 0 in the Senate on May 26, 1997. It was signed into law by Governor Bush on June 19, 1997.^[22] TX SB 96 reached a floor vote but was eventually removed from consideration following a point of order on May 27, 1997.  It would have required minors seeking abortions without parental consent to have the procedure first approved by an physician not located at an abortion clinic certifying the need of the abortion because of physical, sexual or emotional harm caused by continuing the pregnancy. It would have also required minors to wait 48 hours before being able have an abortion after her physician contacts her parents to notify the parents of approval for the procedure.^[22]

2000s[]

Texas passed a statute requiring parental notification in the early 2000s. This law resulted in a 21% increase in 17-year-old girls seeking abortions in the second trimester.^[23][24][25] In 2003, the legislature passed a law that required all abortions after 16 weeks take place in an outpatient surgery center and required a 24-hour waiting period before women could get an abortion.  Clinics were also required to give women "Woman's Right to Know" pamphlet which included factually incorrect medical information.^[26] The 79th Legislature in 2005 enacted several laws related to abortion.  One was a parental consent law.  The rest dealt with funding aspects.^[26]

The 79th Legislature in 2005 enacted several laws related to abortion. One was a parental consent law. They also passed a "late-term" abortion ban.  Other laws dealt with funding aspects of abortion and family planning, trying to prevent money for women's reproductive health going towards organizations that provided information about abortions or provided abortion services.^[26]

The state was one of 23 states in 2007 to have a detailed abortion-specific informed consent requirement.^[27] In the informed consent materials given to women in Idaho, Oklahoma, South Dakota and Texas required by statute, the materials used graphic and inflammatory language. The law also required the woman be told how far advanced her pregnancy was.^[28] Some states, such as Alaska, Mississippi, West Virginia, Texas, and Kansas, have passed laws requiring abortion providers to warn patients of a link between abortion and breast cancer, and to issue other scientifically unsupported warnings.^[28][29][30] The informed consent materials in South Dakota, Texas, Utah and West Virginia given to women seeking abortions include counseling materials that say women who have abortions may have suicidal thoughts or they may experience "post abortion traumatic stress syndrome." The latter syndrome is not recognized by American Psychological Association or the American Psychiatric Association.^[28] Informed consent materials about fetal pain in Texas says the ability for the fetus to feel pain does not exist until 20 weeks, before later going on to conclude that it is unknown if a fetus can feel pain at 12 weeks.^[28] The legislature tried to pass a "mandatory ultrasound"  bill but it failed to pass in 2007.^[26]

2010s[]

As of March 2012, 20 states require women seeking an abortion to have an ultrasound before being allowed to have the procedure. Mandatory transvaginal ultrasounds have been particularly controversial.^[31] In Texas, for instance, even if previous ultrasounds had indicated severe congenital defects, a woman seeking an abortion was required under a 2012 law to have another ultrasound done, "administered by her abortion doctor, and [she had to] listen to a state-mandated description of the fetus she was about to abort", though state-issued guidelines later eliminated the ultrasound requirement if the fetus had an "irreversible medical condition".^[32] In 2013, state Targeted Regulation of Abortion Providers (TRAP) law applied to medication induced abortions and private doctor offices.^[33]

A fetal heartbeat bill was previously introduced in Texas by Phil King on July 18, 2013, in the wake of Rick Perry signing Texas Senate Bill 5 into law.^[34] The bill was not passed.^[35] Supporters of Texas Senate Bill 5, which included requirements for abortion clinics to meet ambulatory surgical center regulations and for abortion clinic doctors to have hospital admitting privileges, said the bill improved health care for women and babies. Opponents of the bill said it created unnecessary regulations for the purpose of reducing access to abortions. At the time of the bill's signing into law in 2013, five of the state's forty-two abortion clinics met the law's requirements. Courts had blocked enforcement of similar laws in some other states, pending lawsuits challenging their constitutionality.^[36] A federal district judge determined this law to be unconstitutional, finding that the admitting privileges requirement placed an undue burden on a person seeking to have an abortion;^[37] however, this decision was reversed by the Fifth Circuit Court of Appeals, resulting in the immediate closure of all but seven abortion clinics in the state, all of these in urban areas.^[38] For patients in Texas's Rio Grande valley, the nearest clinic is now 300 miles away.^[39]

Cities like Baltimore, Austin, and New York passed legislation to require Crisis Pregnancy Centers (CPCs) to disclose their status and that they did not offer abortion services, but organizations representing the CPCs have been successful in courts challenging these laws, principally on the argument that forcing the CPCs to post such language violated their First Amendment rights and constituted compelled speech.^[40][41] Whereas the previous attempts at regulating CPCs in Baltimore and other cities were based on having signage that informed the patient that the CPC did not offer abortion-related services, the FACT Act instead makes the patient aware of state-sponsored services that are available rather than what the CPCs did or did not offer.^[42] The law went into effect January 1, 2016.^[43]

In 2017, the state was one of six where the legislature introduced a bill that would have banned abortion in almost all cases.  It did not pass.^[44] Among those who believe that abortion is murder, some believe it may be appropriate to punish it with death. While attempts to criminalize abortion generally focus on the doctor, Texas state Rep. Tony Tinderholt (R) introduced a bill in 2017 and 2019 that may enable the death penalty in Texas for women who have abortions,^[45] and the Ohio legislature considered a similar bill in 2018.^[46] On February 7, 2019, Briscoe Cain, a member of the Texas House of Representatives, introduced a fetal heartbeat bill entitled the Texas Heartbeat Bill.^[47] The bill (HB 1500) is joint authored by Representatives Phil King, Dan Flynn, Tan Parker, and Rick Miller.^[48] As of February 26, 2019, HB 1500 had 57 sponsors or cosponsors of the 150 members of the Texas House of Representatives.^[49] Former State Senator Wendy Davis said HB 1500 is "the most dangerous I've ever seen."^[50] In 2019, Texas had some of the most restrictive abortion laws in the country.^[51] In mid-May 2019, because of judicial rulings, abortion was effectively banned after week 22.^[52]

On June 7, 2019, Texas Governor Greg Abbott signed new abortion legislation that was set to go into effect on September 1.  This legislation said that local governments could not do business with any organization that provided abortion services, including through the offering of tax breaks or in leasing municipal owned buildings to such organizations.  The legislation also prevents local governments from  "advocacy or lobbying on behalf of the interests of an abortion provider or affiliate."^[53] An exception was provided for non-abortion clinics that perform fewer than 50 abortions a year, such as doctor offices, hospitals or ambulatory services.^[53]

2020s[]

In May 2021, Texas lawmakers passed the Texas Heartbeat Act, banning abortions as soon cardiac activity can be detected, typically as early as six weeks into pregnancy and often before women know they are pregnant. In order to avoid traditional constitutional challenges based on Roe v. Wade, the law provides that any person, with or without any vested interest, may sue anyone that performs or induces an abortion in violation of the statute, as well as anyone who "aids or abets the performance or inducement of an abortion, including paying for or reimbursing the costs of an abortion through insurance or otherwise."^[54]

The Heartbeat Act thus authorizes lawsuits not only against abortion providers, but also against abortion funders, employers, and insurance companies that defray the costs of an abortion, along with anyone else who "aids or abets" an unlawful abortion by providing referrals, transportation, or any type of logistical support.^[55] Anyone who is successfully sued for violating the Act can be found liable for a minimum of $10,000 for each abortion performed (or assisted) in violation of the Act, plus costs and attorneys' fees.^[56]

At the same time, the Act specifically prohibits state officials from enforcing the Act, leaving enforcement entirely in the hands of private litigants who will sue those who violate the statute.^[57] The law was written this way to prevent abortion providers from challenging the constitutionality of the statute before it takes effect in the ordinary manner, which involves injunction suits against state officials charged with enforcement in federal court. Instead, abortion providers must wait until someone sues them for violating the statute, and then assert their constitutional claims defensively.^[58][59][60]

The Act was challenged in courts, but no full formal hearing took place before its September 1, 2021 effectiveness date. Whole Woman's Health and other abortion providers sought an emergency injunction from the U.S. Supreme Court to stop the law from coming into effect, but the Court denied the application. Although the order itself was unsigned, Chief Justice John Roberts and Justice Stephen Breyer wrote dissenting opinions joined by Justices Elena Kagan and Sonia Sotomayor that they would have granted an injunction on the law until a proper judicial review.^[61][62] Sotomayor also wrote a stinging dissent of her own.

Judicial history[]

In 1971, Norma McCorvey, then an unmarried pregnant woman who would later be known as Jane Roe, decided to challenge the Texas law that said it was a crime for doctors to perform elective abortions and that women could only have abortions if their lives at stake.^[63] The US Supreme Court's decision in 1973's Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester.^[21][63][64]

On February 19, 1975, the Texas Supreme Court's ruling in the case Jacobs v. Theimer made Texas the first state in America to declare a woman could sue her doctor for a wrongful birth.^[65][66][67] That case involved (later Dortha Biggs), who caught rubella while pregnant and gave birth to Lesli, who was severely disabled.^[67][65] Dortha and her husband sued her doctor, saying he did not diagnose the rubella or warn them how it would affect the pregnancy.^[67]

Low-Income Women of Texas v. Raiford was filed in the Texas District Court on March 10, 1993, to challenge the Texas state constitutionality of denying state funding for abortions when a physician deems the abortion medically necessary.^[22]

In 2003, Norma McCorvey filed suit in the U.S. District Court in Dallas with a goal of overturning the Roe v. Wade decision of which she was a participant.^[64] In September 2004, a federal appeals court rule on Targeted Regulation of Abortion Providers (TRAP) law put into place in Texas law, which would ultimately result in many abortion clinics in the state being forced to shut down.^[16]

On August 29, 2014, US District Judge Lee Yeakel struck down as unconstitutional two provisions of Texas' omnibus anti-abortion bill, House Bill 2 that was to come into effect on September 1. The regulation would have closed about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion, all located in major cities. Judge Lee Yeakel ruled that the state's regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women living in west Texas and the Rio Grande Valley.^[68]

In the case of Whole Woman's Health v. Hellerstedt, 579 U.S. ___ (2016), the US Supreme Court in a 5-3 decision on June 27, 2016, swept away forms of state restrictions on the way abortion clinics can function. The Texas legislature enacted in 2013 restrictions on the delivery of abortions services that created an undue burden for women seeking an abortion by requiring abortion doctors to have difficult-to-obtain "admitting privileges" at a local hospital and by requiring clinics to have costly hospital-grade facilities. The Court struck down these two provisions "facially" from the law at issue—that is, the very words of the provisions were invalid, no matter how they might be applied in any practical situation. According to the Supreme Court, the task of judging whether a law puts an unconstitutional burden on a woman's right to abortion belongs with the courts, and not the legislatures.^{[69][70][71][51]}

In August 2018, the dilation & evacuation (D & E) passed by Texas and Alabama were working their way through the federal courts appeal process.^[72]

Funding history[]

As a result of Administrative Code tit. 25, § 29,1121 from January 1997, women in Texas cannot use any state funds for abortion services unless their life is in danger or the pregnancy is a result of rape.^[22] The US 1998 Department of Labor Appropriations Act Pub. L. No 105.78, Title V, §§ 509, 510 was a federal law that barred states who participated in Medicaid from refusing to use federal funds to pay abortions in cases of pregnancy as a result of rape or incest, or when continuing the pregnancy would harm a woman's health.^[22]

The 79th Legislature in 2005 enacted several laws related to abortion.  Another put funding restrictions on family planning clinics as part of legislative efforts to force Planned Parenthood clinics in the state to close.  The state created a state-funded program titled Alternatives to Abortion Program.  Money for the program came from funding existing programs to support family planning.^[26] Additional funding was allocated for the in 2007.^[26]

The state legislature continued in its effort to deny funding to Planned Parenthood in 2009.  These efforts failed.  Another attempt to pass mandatory ultrasounds before women could get abortions also failed.^[26] Efforts by lawmakers to try to get Planned Parenthood out of the state continued in 2010.  These efforts were successful in defining all Planned Parenthood clinics as abortion clinics, even if a clinic did not perform abortions and only offered family planning services.  This was intended to deny Planned Parenthood funding to clinics that didn't provide abortion services.^[26] In 2010, the state had three publicly funded abortions, of which were three federally funded and none were state funded.^[73]

In 2011, the state was one of six where the legislature introduced a bill that would have banned abortion in almost all cases.  It did not pass.^[52] In 2011, the state legislature voted to defund family planning funding, including for Women's Health Program; these programs were replaced by state funded programs that only offered abortion alternative programs that only provided limited contraceptive supplies. That year, the state also successfully passed mandatory ultrasound screening before a woman could get an abortion.^[26][74] In practice, this led to Planned Parenthood being unable to receive any Title X funding.^[74]

The Alternatives to Abortion supported clinics, many of which have religious affiliations, have not always fared well, despite the state of Texas giving them hundreds of thousands of dollars in grants.^[75] Heidi Clinic, run by the Heidi Group, is one such clinic.  It opened in April 2018, and staff members engaged in daily prayers while other materials around the facility encourage people to read the Christian Bible and to pray more.  It was closed in September 2018 as the clinic served only 5% of the total number of patients they had predicted they would serve. The Heidi Clinic had promised the state they could serve 69,000 people, including men and undocumented immigrants, with their reproductive health services. This was more than the local Planned Parenthood clinic served. The state had documentation going back several years showing the Heidi Group had contract violations, and misuse of taxpayer dollars that had occurred over several years when the state was pouring money into them and similar organizations.  Despite these problems, the State of Texas renewed their contract with the Heidi Group for two additional years. The state was only able to get back some of the funding it had allocated to the group for services they failed to provide.^[75]

In September, 2019, the city of Austin amended its 2020 budget to include $150,000 in funds to support logistical and support services for abortion access. These services could include child care, case management, and transportation needs. The amendment passed with a 10-1 majority supporting the measure, including mayor Pro Tem Delia Garza who introduced the measure. This is the first practical support for abortion measure passed in any U.S. city.^[76] A legal challenge to the local policy had made its way to the Texas Supreme Court.^[77]

Clinic history[]

Between 1982 and 1992, the number of abortion clinics in the state declined by 49, going from 128 in 1982 to 79 in 1992.^[22] During a six-year stretch in the 1980s, ran a number of abortion clinics in Austin; she later shuttered these after she had a "come to Jesus" moment.^[75]

The state ranked sixth  in the total number of abortion clinics lost between 1992 and 1996, dropping by 15 to 64 total clinics.^[78] The rate of closures of abortion clinics in Texas is increasing as more clinics are forced to close because of increased regulatory requirements.^[79][80] In a one-year period, in 2011, 85 abortion clinics closed.^[75] Between 2012 and 2016 the number of abortion clinics in Texas dropped from 40 to 19^[80] as a result of the state's House Bill 2, which was struck down by the US Supreme Court in June, 2016.^[79] After TRAP laws came into effect in Missouri and Texas, women had to travel even greater distances to be able to visit an abortion clinic.^[72]

In 2014, there were 28 abortion clinics in the state.^[81] In 2014, 96% of the counties in the state did not have an abortion clinic. That year, 43% of women in the state aged 15 – 44 lived in a county without an abortion clinic.^[72] As a result of TRAP legislation passed in 2014, several abortion clinics in Texas were forced to close.^[82] In 2017, there were 35 Planned Parenthood clinics, of which 6 offered abortion services, in a state with a population of 6,621,207 women aged 15–49.^[83] Southwestern Women's Options was one of the abortion clinics open in 2019.^[84] A 2019 study found that the TRAP law increased the number of second-trimester abortions by restricting women's access to abortion services.^[20]

The passage of the June 7, 2019 legislation around local governments ability to do business with abortion service providers impacted Planned Parenthood in East Austin. This was because the East Austin had signed a 20-year lease agreement in November 2018 with Planned Parenthood, with the rent being $1 a month. The East Austin clinic was impacted even though it provided no abortion services because its parent organization, Planned Parenthood, does offer such services.^[53]

Statistics[]

In the period between 1972 and 1974, Texas and the District of Columbia had the highest illegal abortion deaths ratio and rates in the United States with rates of 62 and 21 deaths per million live births respectively.^[85] In the period between 1972 and 1974, Texas and New York State had the largest number of illegal abortion deaths.  Texas recorded 14 in this period while New York had 11 in a period where 63 deaths from illegal abortions were reported nationwide. In 1972, Texas had 8 illegal abortion deaths.  In 1973, it had 5.  In 1974, the state recorded 1 illegal abortion death.^[85] In 1990, 2,041,000 women in the state faced the risk of an unintended pregnancy.^[22]

The highest number of legal induced abortions by state in 2000 occurred in  New York City with 94,466, while Florida was second with 88,563, and Texas was third with 76,121.^[86] In 2001, New York City had the highest number of induced abortions with 91,792, while Florida was second with 85,589, and Texas  was third with 77,409.^[87] In 2003, the state of New York had the highest number of legal induced abortions with 90,820. Florida was second with 88,247, while Texas was third with 79,166.^[88]

In 2012, 73.2% of all abortions were performed in the first trimester, at or before 8 weeks. 12.2% of all abortions were performed during week 9 or 10. 1.2% of all abortions occurred between week 17 and week 21. 0.5% of all abortions occurred after week 21.^[89] Most abortions performed in 2012 were done at abortion clinics, accounting for 78.4% of all abortions.  The rest were performed either at out-of-state facilities, at physician officers, hospitals or ambulatory surgery centers.  The majority of abortions performed in 2012 on Texas residents used the Suction Curettage method, accounting for 65.6% of all abortions.  The next most common procedure was a medical-non surgical procedure accounting for 27.7% of all abortions for Texas residents.  The third most popular procedure was dilation and evacuation, accounting for 6.6% of abortion procedures.^[89]

In 2013, among white women aged 15–19, there were 2,020 abortions, 1,810 abortions for black women aged 15–19, 3,150 abortions for Hispanic women aged 15–19, and 400 abortions for women of all other races.^[90] In 2014, 45% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.^{[91][failed verification][citation needed]} In 2017, the state had an infant mortality rate of 5.9 deaths per 1,000 live births.^[17]

Number, rate, and ratio of reported abortions, by reporting area of residence and occurrence and by percentage of abortions obtained by out-of-state residents, US CDC estimates

Location	Residence			Occurrence			% obtained by out-of-state residents	Year	Ref
	No.	Rate^	Ratio^^	No.	Rate^	Ratio^^
Texas				97,400	23.1			1992	[78]
Texas				89,240	20.5			1995	[78]
Texas				91,270	20.7			1996	[78]
Texas	70,003				13.0	185.5		2011	[89][92]
Texas	66,098			68,298	12.1	172.8		2012	[89][93]
Texas	54,401	9.6	136	54,148	9.6	135	1.9	2014	[94]
Texas	54,194	9.4	134	53,940	9.4	134	1.8	2015	[95]
Texas	53,567	9.2	135	53,481	9.2	134	2.1	2016	[96]
^number of abortions per 1,000 women aged 15-44; ^^number of abortions per 1,000 live births

Number of abortions for Texas residents by race and year

County	Total	Asian	Hispanic	White	Black	Native American	Other	Unknown	Year	ref
Texas	77,811	3,238	28,721	26,677	18,235	237	442	261	2007	[97]
Texas	78,330	3,181	29,320	25,047	19,708	174	557	343	2008	[98]
Texas	74,835	3,184	28,327	23,595	18,570	139	534	486	2009	[99]
Texas	74,959	3,345	28,817	22,651	18,623	112	729	682	2010	[100]
Texas	70,003	3,110	26,392	21,645	17,336	124	721	675	2011	[92]
Texas	66,098	3,023	24,800	19,986	16,545	104	1,030	610	2012	[93]
Texas	61,912	2,850	24,063	16,969	15,719	194	2,062	55	2013	[101]
Texas	53,882	2,845	19,654	15,833	14,515	143	632	260	2014	[102]
Texas	55,287	3,051	20,591	16,203	14,398	150	567	327	2015	[103]

Number of abortions in Texas based on facility type and procedure hide

Procedure	Total	Abortion Clinic	Physician's office	Hospital	Ambulatory Surgery	Other / Unknown	Year	ref
Vacuum aspiration	61,824	58,507	98	30	3,063	126	2007	[104]
Non-Surgical medication induced	14,328	12,751	6	132	1,426	13	2007	[104]
Dilation and evacuation	4,711	2,968	0	26	1,673	44	2007	[104]
Intrauterine	10	0	0	10	0	0	2007	[104]
Dilation and curettage	117	53	0	44	19	1	2007	[104]
Hysterotomy/Hysterectomy	4	0	0	3	0	1	2007	[104]
Other / Unknown	85	55	0	14	8	8	2007	[104]
Total	81,079	74,334	104	259	6,189	193	2007	[104]
Vacuum aspiration	60,371	56,761	101	23	3,350	136	2008	[105]
Non-Surgical medication induced	16,560	15,139	4	71	1,333	13	2008	[105]
Dilation and evacuation	4,460	2,598	0	25	1,800	37	2008	[105]
Intrauterine	3	1	0	2	0	0	2008	[105]
Dilation and curettage	45	19	0	8	3	15	2008	[105]
Hysterotomy/Hysterectomy	4	2	0	2	0	0	2008	[105]
Other / Unknown	148	101	2	4	17	24	2008	[105]
Total	81,591	74,621	107	135	6,503	225	2008	[105]
Vacuum aspiration	57,454	54,880	36	19	2,393	126	2009	[106]
Non-Surgical medication induced	16,009	14,842	4	94	1,052	17	2009	[106]
Dilation and evacuation	4,298	2,998	0	34	1,204	62	2009	[106]
Intrauterine	4	0	0	4	0	0	2009	[106]
Dilation and curettage	29	15	0	9	3	2	2009	[106]
Hysterotomy/Hysterectomy	2	0	0	2	0	0	2009	[106]
Other / Unknown	54	18	0	23	0	13	2009	[106]
Total	77,850	72,753	40	185	4,652	220	2009	[106]
Vacuum aspiration	54,476	47,408	60	13	6,938	57	2010	[106]
Non-Surgical medication induced	19,195	17,673	0	114	1,392	16	2010	[106]
Dilation and evacuation	3,846	2,294	0	29	1,490	33	2010	[106]
Intrauterine	7	3	0	3	0	1	2010	[106]
Dilation and curettage	40	7	0	21	0	12	2010	[106]
Hysterotomy/Hysterectomy	1	0	0	1	0	0	2010	[106]
Other / Unknown	27	11	0	5	1	1	2010	[106]
Vacuum aspiration	49,008	37,187	35	29	11,688	69	2011	[107]
Non-Surgical medication induced	18,902	15,990	0	100	2,803	9	2011	[107]
Dilation and evacuation	4,474	2,667	0	32	1,739	36	2011	[107]
Intrauterine	4	0	0	4	0	0	2011	[107]
Dilation and curettage	20	5	0	6	7	2	2011	[107]
Hysterotomy/Hysterectomy	4	0	0	3	0	1	2011	[107]
Other / Unknown	58	27	0	10	0	21	2011	[107]
Total	72,470	55,876	35	184	16,237	138	2011	[107]
Vacuum aspiration	44,577	34,574	43	53	9,864	43	2012	[108]
Non-Surgical medication induced	19,081	16,187	0	104	2,778	12	2012	[108]
Dilation and evacuation	4,541	2,808	0	18	1,691	24	2012	[108]
Intra-Uterine	3	0	0	3	0	0	2012	[108]
Dilation and curettage	61	23	0	10	28	0	2012	[108]
Hysterotomy/Hysterectomy	4	0	0	4	0	0	2012	[108]
Other/Unknown	31	0	0	13	0	18	2012	[108]
Total	68,298	53,592	43	205	14,361	97	2012	[108]
Vacuum aspiration	42,512	32,073	41	8	9,809	581	2013	[109]
Non-Surgical medication induced	16,756	13,521	0	83	3,148	4	2013	[109]
Dilation and evacuation	4,405	2,878	0	22	1,501	4	2013	[109]
Intrauterine	4	0	0	4	0	0	2013	[109]
Dilation and curettage	71	28	0	12	31	0	2013	[109]
Hysterotomy/Hysterectomy	1	0	0	1	0	0	2013	[109]
Other/Unknown	100	3	0	3	2	92	2013	[109]
Total	63,849	48,503	41	133	14,491	681	2013	[109]
Vacuum aspiration	45,685	30,948	46	10	14,057	624	2014	[110]
Non-Surgical medication induced	5,044	4,351	0	66	604	23	2014	[110]
Dilation and evacuation	3,999	2,417	0	18	1,555	9	2014	[110]
Intrauterine	4	0	0	1	2	1	2014	[110]
Dilation and curettage	61	11	0	4	46	0	2014	[110]
Hysterotomy/Hysterectomy	2	0	0	2	0	0	2014	[110]
Other / Unknown	107	7	0	2	1	97	2014	[110]
Total	54,902	37,734	46	103	16,265	754	2014	[110]
Vacuum aspiration	43,823	22,191	45	34	21,212	341	2015	[111]
Non-Surgical medication induced	6,029	3,873	0	55	2,076	25	2015	[111]
Dilation and evacuation	4,386	1,764	0	31	2,572	19	2015	[111]
Intrauterine	3	1	0	1	0	1	2015	[111]
Dilation and curettage	68	6	0	7	54	1	2015	[111]
Hysterotomy/Hysterectomy	4	0	0	4	0	0	2015	[111]
Other / Unknown	974	7	0	7	0	960	2015	[111]
Total	55,287	27,842	45	139	25,914	1,347	2015	[111]

Illegal abortion death[]

Rosie Jimenez is the first woman known to have died due to an illegal abortion after the Hyde Amendment was passed.^{[112][113][114]} Jimenez died at age 27 in 1977 from an illegal abortion in McAllen, Texas.^[115] At the time she was a student who would have earned a teaching credential in six months, as well as the single mother of a five-year-old daughter.^[114][116]

Abortion rights views and activities[]

This section needs to be updated. Please help update this article to reflect recent events or newly available information. (September 2021)

Organizations[]

is a Texas-based organization to assist minors in the state in going through the judicial-bypass process to secure an abortion without parental consent.^[84]

Activities[]

Since 1995, the Abortion Access Project has organized Rosie Jimenez Day every October 3, as well as sponsored speak-outs and other events every year that month to remember her.^[116]

Protests[]

People from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.^[117] On May 23, 2019, women went to the Texas Capitol Rotunda in Austin to express opposition to SB8. They dressed in red, referencing The Handmaid's Tale.^[118]

Pro life views and activities[]

Organizations[]

Human Coalition is a Texas anti-abortion organization that operates women's reproductive health clinics that do not provide abortions and try to actively dissuade women from having them.^[119]

Activities[]

The Marriage Vow or "The Marriage Vow - A Declaration of Dependence Upon Marriage and Family" is a political pledge created by Bob Vander Plaats, a former candidate for Iowa governor, and the Iowa-based conservative group; The Family Leader, a public advocacy organization affiliated with the Iowa Family Policy Center, that he heads.^[120] The two most notable signatures came from Rick Santorum and Michele Bachmann. Rick Santorum was the first presidential candidate to contact The Family Leader after the organization publicly announced the pledge. Michele Bachmann also contacted The Family Leader to sign the pledge, and became the first Candidate to send her signed document to the organization.^[121] Although Newt Gingrich did not sign the pledge, he wrote a lengthy letter in which he upheld many of the principles of the pledge including personal fidelity to his wife, respecting the marital bonds of others, enforcing the defense of marriage act, to support a federal marriage amendment, and to oppose any definition of marriage outside of "one man and one woman."^[122] The pledge was also signed by former Texas governor Rick Perry.^[123]

Violence[]

There was an arson attack in 1980 at an abortion clinic in Texas. It caused around $320,000 USD in damage.^[124] 1998 saw 6 arson attacks, 4 bombings, 1 murder and 19 acid attacks take place at abortion clinics in the United States. The butyric acid attacks took place between May and July in Florida, Louisiana and Texas.^[124]

By 2000, an act of violence had taken place at an abortion clinic in Eastland County, Texas.^[124] Harris County, which includes Houston, has been home to the most abortion violence in the United States as of 2000 with 10 acts of violence being experienced by clinics.^[124] A package left at a women's health clinic in Austin, Texas, on April 25, 2007 that contained an explosive device capable of inflicting serious injury or death. A bomb squad detonated the device after evacuating the building. Paul Ross Evans (who had a criminal record for armed robbery and theft) was found guilty of the crime.^[125]

City ordinances[]

As of July 11, 2021, 30 cities in Texas have outlawed abortion within their city boundaries and declared themselves "sanctuary cities for the unborn."^{[6][unreliable source?]} The first city to do so was the city of Waskom, Texas, which enacted its local abortion ban on June 13, 2019.^[126]

The city of Lubbock enacted its local abortion ban through a popular referendum on May 1, 2021.^[127] Planned Parenthood of Greater Texas was performing abortions in Lubbock when the ordinance was adopted, and it sued the city in an attempt to block the ordinance from taking effect.^[128] But a federal district court dismissed the lawsuit on June 1, 2021, ruling that Planned Parenthood lacked standing to sue the city because the ordinance would be enforced solely through private civil lawsuits rather than by city officials.^[129] In response to this ruling, Planned Parenthood has ceased performing abortions in Lubbock and is complying with the ordinance.^[130]

Footnotes[]

References[]