Abortion pill use spikes in Texas as thousands of patients circumvent state’s ban



The state’s health agency reported earlier this month that abortions in the state dropped by 51 percent in September 2021 — the first month after the law took effect — compared to September of 2020. Anti-abortion-rights activists seized on the data to tout that the state was on its way to being “abortion free” and that the six-week ban is “saving lives.”

Yet based on the data from Aid Access as well as reports from clinics in Oklahoma and other neighboring states of an influx of Texas patients seeking to terminate a pregnancy, Aiken and her fellow researchers believe the overwhelming majority of people blocked from having an abortion after six weeks of pregnancy in a Texas clinic are finding other ways to do so.

State data shows a drop of 2,149 clinic-based abortions in September of 2021. In the same month, Aid Access received 1,831 requests for pills from Texas patients — which would account for over 85 percent of the decrease.

“I don’t want to say the law hasn’t forced anyone to remain pregnant,” Aiken stressed. “But I think it’s very likely that out-of-state care and self-managed abortion have made up the majority of the difference.”

Planned Parenthood, which operates clinics in nearly all of the states surrounding Texas, reported Thursday that it has seen a nearly 800 percent increase in Texas patients looking to get the procedure in the fall and winter of 2021, after the new rule went into effect, compared to the same time period the previous year.

Clinics in Oklahoma, New Mexico, Kansas, Colorado and Missouri have reported the biggest jumps, but people are also traveling to Louisiana, Alabama and Arkansas.

Planned Parenthood clinics in Oklahoma, for example, reported that prior to the six-week ban’s enactment, less than 10 percent of their patients were from Texas. Now, they make up more than 50 percent. In Colorado, Planned Parenthood clinics have seen a more than 1,000 percent increase in abortion patients with Texas ZIP codes, compared to previous years.

Independent providers unaffiliated with Planned Parenthood have seen surges as well. On a Thursday call with reporters, clinic administrator Kathaleen Pittman from the Hope Medical Group For Women in Shreveport, La., said that 18 percent of their patients were from Texas before the state law went into effect. Now, it’s 64 percent.

“This is in a state where we’re already struggling because we’re down to just three abortion clinics,” she said. “The staff is exhausted. The phone calls are nonstop. We are seeing women coming to us later in their pregnancies because it’s so hard for people to get an appointment.”

Abortion providers on the press call stressed that many pregnant people in Texas are unable to travel out of state for a host of reasons, from a lack of child care to pandemic fears to an immigration status that would put them at risk crossing state lines.

Teens also fell into that category, they said. The abortion rights advocacy group Jane’s Due Process said that abortions for minors in the state have fallen between 70 and 90 percent since the restrictions were enacted. One exacerbating factor is that Texas has a parental consent law and it can take up to three weeks for teens to obtain a judicial bypass if they don’t have their parents’ permission, causing many to pass the six-week mark.

Texans’ options became further limited when the state barred the mailing of abortion pills earlier this year — one of several states to do so after the Biden administration moved to lift longstanding federal restrictions on telemedicine prescription and mail delivery of the drugs. Yet because Aid Access and other online providers are sending the medication to patients’ homes in discreet packaging, and some are based outside of the country and can’t be targeted for violating the law, the state has not yet been able to prevent the practice.

“Short of going through people’s mail, I don’t know how it would be enforced,” Aiken said. “It may, however, have a chilling effect on people mailing a pill to a friend from out of state.”

Clinics’ challenge to the state’s six-week ban was back in court on Thursday, this time arguing before the Texas Supreme Court that the state shouldn’t be allowed to strip medical licenses from doctors accused of performing an abortion after the six-week cutoff. This is the narrow sliver of their challenge left by the U.S. Supreme Court, which blocked most of their other legal avenues in December. Now, even if the clinics win on this point, the ban itself will remain in effect and any member of the public will still be allowed to sue abortion providers and anyone accused of helping a patient violate the law.

Federal relief for the clinics is not likely, either.

The Senate is preparing to vote Monday night on the Women’s Health Protection Act, a bill that would bar states from passing abortion restrictions like Texas’ and codify Roe v. Wade into federal law. But the bill is almost certain to fall well short of the 60 votes it needs to advance, given across-the-board opposition from Republicans as well as a handful of more conservative Democrats.

Despite the new data showing many Texans are finding ways to evade the state’s restrictions, advocates are still pessimistic about the future of abortion access as the Supreme Court prepares to issue a ruling that would determine whether more states can follow Texas’ lead.

“There is no end in sight to this nightmare,” attorney Marc Hearron with the Center for Reproductive Rights, who argued the case before the state Supreme Court, told reporters. “This is a preview of what will happen on a much larger scale if Roe falls.”



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