On the morning of the coming into force of Texas’ restrictive new abortion law, an ultrasound of Marva Sadler’s first patient showed fetal heart activity, rendering the woman ineligible for a legal abortion.
Sadler, senior director of clinical services for Whole Woman’s Health, said the woman was a single mother of two and had just started a new job. She had no one to care for her children and could not leave her job to travel to another state to have an abortion.
“It was the first real shot of ‘I really can’t fix this.’ How do you respond to that? And that conversation quickly got us into figuring out how to get her prenatal care, ”Sadler said.
In the 48 hours leading up to September 1, Whole Woman’s Health in Fort Worth, Texas performed an average of 66 abortions per day. But during the first three days of the law coming into force, the clinic performed an average of 11 abortions per day.
“Women who not only live in this state – but who work, pay taxes, vote, pray and raise the future leaders of this community – are denied their basic right to health care,” Sadler said.
In Houston, Doris Dixon, director of patient access at Planned Parenthood Gulf Coast, said call centers for abortion services have evolved into helplines, where staff members “guide people. patients through this new law ”and help them“ navigate where they can go. “
“The patients are struggling and the staff are struggling,” Dixon said.
Since the law came into effect, Ms Dixon has said most of the patients she observed seeking care at the Planned Parenthood Center for Choice in Houston were not eligible for an abortion.
“Some of these activities are just outside of our ability to help,” Dixon said. they would be gone for two or three days. The problem is far bigger than just finding the resources to go elsewhere. “
“People will fall through the cracks and eventually have to carry their pregnancies to term,” she added.
The new law prohibits abortions once heart activity is detected, usually around six weeks pregnant, before most people know they are pregnant. The law does not allow any exceptions for rape or incest. Texas is the first state to effectively ban abortion at this stage of pregnancy since Roe v. Wade.
Many will not be able to have an abortion outside of Texas due to financial or circumstantial issues, including the cost of travel, difficulty taking time off work or providing child care.
Abortion rights advocates and providers say Senate Bill 8, as the new law is known, will likely lead to an increase in the number of patients with unintended pregnancies to term. As a result, many will feel the financial and health impacts of being turned away from a clinic for years to come.
Denial of abortion causes economic hardship
While people of all socioeconomic and ethnic backgrounds have an abortion, about half of all people who get one live below the federal poverty line. When someone already in financial difficulty is denied care, it puts them in an even more difficult economic situation, said Diana Greene Foster, professor of obstetrics, gynecology and reproductive sciences at the University of California. in San Francisco.
Foster is the leader of the Turnaway Study, a national project that examined the long-term effects of an abortion or refusal. The study found that people who were denied an abortion were almost four times more likely to be below the federal poverty line.
When people are prevented from getting care, she said, they are more likely to have difficulty paying for basic expenses like food, shelter and transportation.
Meanwhile, people who carried unwanted pregnancies to term experienced a 78 percent increase in debt that was past due for a month or more after birth and an 81 percent increase in bankruptcy reports, deportations and tax privileges, compared to others who had access to abortion care. People who are denied an abortion are also three times more likely to be unemployed than those who have had one.
“Laws that limit access to abortion have a huge economic impact,” said Kate Bahn, director of labor market policy at the Washington Center for Equitable Growth. “It’s not only the year-over-year financial hardships associated with having children, but it also affects people’s career paths.”
“If you are unsure about family planning, you are much less likely to get a better paying job and complete your education,” Bahn added.
A probable increase in consequences on mental and physical health
Being refused an abortion can dramatically increase mental health problems such as anxiety, depression, and low self-esteem in the months following the denial of an abortion and can lead to life-threatening physical health problems that last for many years. years.
Before the law came into effect, Dr Bhavik Kumar, a staff physician at the Planned Parenthood Center for Choice in Houston, typically saw 20 to 30 abortion patients per day. On September 1, he only saw six, and half had exceeded the new legal limit and had to be turned away.
Kumar warned that patients denied care could face “lifelong consequences.”
“The people who will suffer from it will be low-income people who already have limited access to health care, and people of color, especially black women,” he said.
An analysis of data from the Turnaway study, which examined the physical health of those who terminated and did not terminate their pregnancies five years after seeking abortion care, found that patients who did newborn babies were more likely to describe their health as “poor” and reported higher rates of chronic pain.
The physical and mental toll of childbirth play a role in these adverse health effects, said Dr. Nisha Verma, a member of Physicians for Reproductive Health and OB-GYN who provides abortion care in the Washington area, DC. Those who complete term could face excessive bleeding during childbirth, postpartum depression, gestational diabetes, and high blood pressure.
“When we think of people’s health care, their pregnancies and their lives, every person is different, and no law like [S.B. 8] can take into account every unique situation, ”said Verma.
Carrying an unwanted pregnancy to term is much more risky for a person’s physical health than having an abortion. In the United States, about 700 people die each year from complications related to pregnancy or childbirth, according to the Centers for Disease Control and Prevention, and the maternal mortality rate is 20.1 deaths per 100,000 births alive. The total rate of abortion complications is estimated to be around 2%, and death occurs in less than one in 100,000 abortions.
Domestic violence is also common among people seeking abortions, with between 6 and 22 percent reporting recent violence from an intimate partner. Those who refuse to have an abortion are more likely to stay in contact with an abusive partner and they are more likely to raise the child alone.
“These are personal and intimate decisions, and if the government interferes, it changes the ability of people to take care of themselves, their children and even to have future children in better circumstances,” Foster said. . “It’s not just political maneuvering; it’s the lives of real people.”