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"Way bigger than we expected": Texas women had only 10% fewer abortions after passage of new law

AP Photo/Jacquelyn Martin

Gaze upon this data and behold the future of American abortion politics in microcosm. As red states scramble to make abortions harder to obtain locally, pregnant women — not all, but many — will hit the road. In a post-Roe landscape, that means there’ll be fewer abortions nationally but certainly nothing like a 100 percent decline. So long as blue states are free to operate clinics, women from blue and red states will keep them in business.

Which means the future of American abortion politics is Republicans wrestling with imposing federal restrictions on the practice the next time they control the government, undercutting 50 years of “let the states decide” rhetoric.

The Times’s new report is a follow-up to last month’s news that abortions in Texas dropped precipitously after passage of the new “heartbeat law,” S.B. 8, last fall. That law exposed abortion providers to civil actions if they performed a termination after six weeks, spooking many Texas providers into avoiding the practice. Within one month, the number of abortions performed in the state dropped by 60 percent. But that left us with a mystery, whether pregnant women in Texas were now carrying their pregnancies to term or whether they were seeking out abortions in neighboring states instead.

New studies suggest that many of them did choose to cross state lines and abort. Tough new legal restrictions deterred some abortions but nowhere near 60 percent.

In the months after Texas banned all but the earliest abortions in September, the number of legal abortions in the state fell by about half. But two new studies suggest the total number among Texas women fell by far less — around 10 percent — because of large increases in the number of Texans who traveled to a clinic in a nearby state or ordered abortion pills online…

“The law has not done anything to change people’s need for abortion care; it has shifted where people are getting their abortion,” said Kari White, principal investigator of the university’s Texas Policy Evaluation Project and the lead researcher on the new out-of-state abortion study. She expressed surprise at how few abortions were prevented by such a sweeping set of restrictions: “The numbers are way bigger than we expected. It’s pretty astounding.”…

Each month in the period between September 2021, when the Texas law went into effect, and the end of the year, an average of 1,400 women went to one of seven nearby states, according to one of the new studies, released Sunday. That was 12 times as many as typically sought abortions out of state before the law.

The studies cited looked at only 34 of 44 clinics in neighboring states so the true number of abortions had by Texas women was likely higher.

Some pro-lifers celebrated the news, pointing out that a 10 percent reduction in abortion is a lot of lives saved. But I’d guess that most abortion opponents expect more bang for their legislative buck once Roe is gone. You don’t fight a 50-year legal war to end the killing of babies for the sake of a 10-percent improvement. On the other hand, there’s reason to believe that the decline in abortion will be much steeper post-Roe, when red states across the U.S. inevitably move to ban the practice entirely or impose Texas-style laws. Women in Texas don’t have to travel far at the moment to find a provider out of state, just across their own border, but if the entire south bans abortion later this year travel will become more onerous and expensive. Appointments will also become harder to find; in fact, some women who live in states neighboring Texas have reportedly had to travel to find abortions themselves because their local clinic is overwhelmed with women from Texas.

If abortion suddenly becomes unobtainable in half the country, blue states will struggle (for awhile) to cope with national demand. The total number of abortions will inevitably fall.

Although, again, maybe not as much as we expect. That’s because American women are increasingly turning to abortion pills, not surgical terminations, to end their pregnancies. In 2020, with Americans stuck at home because of COVID and many afraid to visit the doctor, a majority of abortions were carried out with pharmaceuticals. Unsurprisingly, after the new Texas law passed last year, many women there went looking for drugs to perform a DIY termination. Texas law bans doctors from prescribing abortifacients after the seventh week of pregnancy but the statute has a loophole big enough to drive a truck through: It applies only to doctors, and of course only those based in Texas. It’s legal for pregnant women in Texas to take the pills. If they order from a doctor overseas, there’s practically nothing the state can do to stop them.

Which is what various women in Texas have done since September:

A friend who had recently terminated her pregnancy with the help of Aid Access told Lupe that the nonprofit’s Dutch founder, Dr. Rebecca Gomperts, could meet with her virtually and prescribe a pair of medications—mifepristone and misoprostol. Both are approved by the U.S. Food and Drug Administration to induce miscarriage for a woman who has been pregnant for ten weeks or less. Lupe paid $105 for the pills, which were manufactured in India. “I had been paying close attention to the laws Texas was putting in place over the past year because they made me nervous,” she says. “Having, or not having, a baby is a huge decision. I didn’t want to find myself in a position where that decision had already been made for me.”…

Dr. Gomperts of Aid Access told CBS News last September that she planned to continue offering abortion-pill prescriptions to Texans, regardless of the new restrictions, which she said are “not based on any scientific evidence, human rights, or common sense.” Remote providers likely have little fear of prosecution in Texas, as the enforcement mechanisms of the law are murky at best. Elisa Wells, cofounder and codirector of Plan C, a Portland-based project that provides information about medication abortion access, says Texas can ban medicated abortion “all they want, but what are they going to do about it? They can’t patrol every mailbox. It’s impossible.”

Aid Access is based in Austria, where their business is legal, so good luck trying to have someone like Gomperts extradited. One of the new studies being tracked by the Times found that the number of Texas women requesting abortifacients from Aid Access has more than tripled after the passage of S.B. 8. Immediately after the law took effect, the number of requests for pills rose 12-fold.

I’d guess we’ll be seeing and hearing a lot from the American left about overseas outfits like Aid Access over the next year as pro-choicers undertake a public education campaign about abortion options. Relatively few women, especially poor women, are aware that those overseas outlets exist, I assume, and probably only a small fraction realize that it’s still legal to take abortifacients in Texas, just not to provide them. Blue America won’t have enough clinics to meet demand once Roe is gone and many women won’t have the time and money to travel across the country for an operation, so if they can’t go get an abortion anymore, pro-choicers will make the abortion come to them. That’s also the future of American abortion politics — legal battles over regulating abortifacients, which are destined to become the method of choice in states where the practice is heavily restricted. Exit question: Will red states be willing to take the fateful step of criminalizing the use of abortion drugs, not just the prescribing of them, and sending pregnant women to prison? That may be the only way to seriously dent demand.

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