Texas governor's ban on abortions last spring led to out-of-state treks, more second-trimester procedures

Gov. Greg Abbott's order pausing abortion care at the outset of the pandemic resulted in larger numbers of Texas women going out of state for the procedure or delaying it until the second trimester, according to a new study.

The Republican governor's order, enacted March 22 over the objections of professional medical associations, paused all surgeries not deemed "medically necessary" — including abortions. Abbott, a staunch abortion opponent, argued the hold would preserve PPE and ensure medical resources remained available for COVID-19 patients.

The new study — published in the peer-reviewed JAMA — found that the number of in-state abortions decreased during Abbott's order, while out-of-state abortions increased. After the order was lifted in May, the number of second-trimester abortions also jumped significantly.

Both increases suggest Texas women didn't view abortion care as "medically unnecessary," said study author Dr. Kari White, an associate professor of social work and sociology at the University of Texas at Austin.

"We have seen in Texas, time and time again, that the decisions that are made around reproductive health care — especially abortion — have nothing to do with public health or scientific evidence," said White, who's also lead investigator for UT's Texas Policy Evaluation Project.

By forcing women to travel for a simple medical procedure that could have been done in-state, the order exposed them to additional risk amid the worsening pandemic, according to White. And, although second-trimester abortions are safe, they may require additional visits compared those earlier in the term and tend to have higher costs for patients.

What's more, abortion procedures do not significantly tie up medical facilities that would be used for COVID-19 patients or require large amounts of PPE, White added.

According to the study:

• The number of abortions in Texas declined 38% in April 2020 compared to the same month a year prior.
  
• Texas residents receiving care at out-of-state facilities in the study increased from 157 in February 2020 to 947 in April 2020.
  
• After Abbott’s order expired, the number of second-trimester abortions in the state increased by 61%.
  

Ultimately, Abbott's order resulted in a morass for patients and healthcare providers in midst of a health and economic crisis, according to White.

"It created confusion and stress during an incredibly stressful time for patients who were just trying to make a healthcare decision," she said.

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