As abortion access evaporates, many Texans aren’t able to find care, new studies show

Several new studies show that not everyone denied access to abortions in Texas can travel out of state, but more people than ever before are seeking ways to self-manage abortions with medication at home.

click to enlarge A sign taped to the front of Houston Women’s Clinic on June 24 says the clinic is no longer providing abortions after the Supreme Court’s decision to overturn Roe v. Wade. - Texas Tribune / Justin Rex
Texas Tribune / Justin Rex
A sign taped to the front of Houston Women’s Clinic on June 24 says the clinic is no longer providing abortions after the Supreme Court’s decision to overturn Roe v. Wade.
The number of abortions performed monthly in Texas declined from a few thousand to less than 10 after the state implemented a near-total ban on the procedure this summer, new data shows.

Texas, already operating under significant abortion restrictions, accounted for more than half of the national decline in abortions after the U.S. Supreme Court overturned Roe v. Wade.

A trio of new studies indicate that some people in states that restrict abortion have found other ways to terminate their pregnancies, by traveling out of state or self-managing at home. But these alternatives have not fully compensated for the in-state declines.

One study from national abortion data group #WeCount and the Society of Family Planning found that at least 10,000 people nationally did not obtain in-clinic abortions due to new state bans like the one in Texas.

“Substantial research has documented grave consequences of not being able to obtain a wanted abortion that persist for years,” the study’s authors wrote. “Those who seek but are unable to obtain a desired abortion experience a variety of negative outcomes, including increased economic insecurity, poorer physical health and continued exposure to violence from the man involved in the pregnancy.”

New data, same outcome

When the Supreme Court overturned Roe v. Wade in June, Texas was already under the nation’s strictest abortion law, banning most abortions after about six weeks of pregnancy.

That state law, which went into effect more than a year ago, led to a precipitous decline in abortions in Texas. The year before, there were about 55,000 abortions in Texas; in the six months after, there were less than 14,000.

More Texans traveled out of state for abortions after the law went into effect, but that increase didn’t fully balance out the decline in in-state abortions, according to data from the Texas Policy Evaluation Project at the University of Texas at Austin.

The UT-Austin study, separate from the #WeCount data, found a 33% decline in abortions obtained by Texans, in state or out of state, in the six months after the six-week ban.

The study also found that Texans who traveled out of state were more likely to get abortions later in pregnancy, in part because neighboring states couldn’t keep up with the surge in demand.

Arkansas, Louisiana, New Mexico and Oklahoma, combined, typically saw only 40% of Texas’ annual abortion volume.

“It was not uncommon to hear that wait times at facilities in neighboring states were three or four weeks away before people could get an appointment,” said lead researcher Kari White. “And we have heard that this could be even longer than that in facilities elsewhere.”

Now, three of those four neighboring states have joined Texas in banning nearly all abortions. Abortions in eight southern states — Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee and Texas — declined 96% after the overturning of Roe v. Wade, according to the #WeCount study.

This leaves many Texans in a vast abortion desert, White said, with the impact felt most acutely by people who are poor, already have children, or are at higher risk of maternal mortality and morbidity, especially Black Texans.

“People are going to still have unwanted pregnancies or because of medical reasons need to obtain an abortion,” said White, who also serves on the #WeCount steering committee. “But it is just going to become more burdensome.”

Some Texans who cannot cross several states to make it to brick-and-mortar clinics will likely try to self-manage by seeking abortion-inducing medication outside the health care system. A new study from UT-Austin researcher Abigail Aiken found demand for these medications spiked after the overturn of Roe v. Wade.

Aid Access, an international telemedicine nonprofit that mails abortion-inducing medication, received about 83 requests a day before the Supreme Court decision. When a draft of the opinion leaked in May, requests increased to about 137 a day. After the decision, it was more than 200 a day.

The largest increase in demand came from states that had implemented near-total bans on abortion, like Texas.

Disclosure: The University of Texas at Austin has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

The Texas Tribune is a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government and statewide issues.

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