What a Sham

An increasingly widespread brand of abortion regulations restricts women’s fundamental rights under the pretext of protecting their health.


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“Why is there an RV in our parking lot?” Amy Hagstrom Miller, owner of Whole Woman’s Health, remembers thinking one morning as she looked out the window of her Austin, Texas, clinic.

This was last fall, not long after Texas HB2—a sweeping Texas law targeting abortion providers—took effect, forcing the closure of dozens of clinics across the state. The medically unwarranted and politically motivated restrictions had forced Hagstrom Miller to shutter three of the six clinics she operates. Thousands of women were newly stranded without access to safe, legal abortion care, and Hagstrom Miller—with the Center for Reproductive Rights at her side—was gearing up to combat the legislation in court.

It turned out the RV belonged to a family from the Dallas area—a married couple and their three children. With so many clinics closed, there was a wait of up to four weeks at the one closer to their home. The couple didn’t feel they could delay that long, so they did what they could—packed up their kids and made the three-hour trek to Austin in their RV.

Due to a state mandated waiting period, patients must be seen twice at the clinic in order to receive an abortion. The family spent the night in the clinic parking lot. Hagstrom Miller remembers the husband playing with his kids on the clinic lawn while his wife was inside. 

“Both of them had fulltime jobs, so making the trip was tough,” says Hagstrom Miller, “but it was really important to them to get the timely care they needed. Knowing that the reason they had to come all this way and make the sacrifices they were making was because of political maneuvering was incredibly frustrating. It feels crazy to close a clinic for no reason other than politics.”

But for the last few years this is exactly what has been happening across the United States as anti-choice state legislators, unable to overturn Roe v. Wade, have devised cunning ways to limit women’s access to abortion and force clinics to close. Because politicians can’t openly push these measures for what they actually are—anti-abortion, anti-woman—the restrictions are duplicitously trumpeted as protecting women’s health, despite the fact that abortion is one of medicine’s safest procedures.

Amy Hagstrom Miller notes that in ten years, only two patients out of thousands at her Austin clinic have required follow-up at care at a hospital. Neither stayed overnight.

“There is no health crisis HB2 is fixing,” she says of the Texas law that threatens to shut down 80 percent of the state’s clinics. “There have been 40 years of safe abortion in Texas. This law is a solution without a problem.”

It is precisely this sham that the Center for Reproductive Rights is mobilizing against in Texas and around the country. We have fought the underhanded provisions in courts at all levels—including at the U.S. Supreme Court last October, where we were granted an emergency order that stopped Texas from enforcing key provisions of HB2 and allowed a number of clinics to temporarily reopen. Last week, before the Fifth Circuit Court of Appeals, the Center will continued its challenge to the restrictions with the goal of permanently overturning Texas’s destructive measure.

One of the anti-clinic provisions of HB2 requires that abortion providers obtain admitting privileges at a hospital within 30 miles of their clinic. Although this regulation might sound harmless—even prudent—on its face, the fact is that admitting privileges have nothing to do with doctors’ qualifications and are largely a business arrangement. Because abortion patients so rarely require hospitalization, granting privileges to abortion providers is usually not financially advantageous to the hospital. As a result, many abortion providers have found it impossible to obtain these privileges.   

Another part of Texas’s sham law mandates that licensed abortion clinics transform into mini-hospitals known as ambulatory surgical centers (ASCs). The required renovations—which do nothing to improve safety—involve expanding hallway widths and ceiling heights, adding locker rooms and parking spaces, and upgrading HVAC systems. Retrofitting the existing facilities to meet ASC regulations can cost millions and force clinics to close.

Both the American Medical Association and the American College of Obstetricians and Gynecologists oppose these types of restrictions because they are medically unnecessary and do nothing to promote women’s health. In many cases, the restrictions are simply obstacles to safe, basic care.

Although Texas had more than 40 licensed abortion clinics when HB2 was enacted, fewer than ten clinics open today could satisfy the law’s requirements. If the law is allowed to stand, nearly a million women will have to travel at least 150 miles to reach the nearest abortion provider. Particularly for low-income and immigrant women for whom transportation is a significant barrier, the law puts abortion care essentially out of reach.

Not only are these restrictions dishonest and discriminatory, they are also dangerous.

“When HB2 took effect, we saw the real impact of these onerous restrictions within a few days,” says Hagstrom Miller. She and her staff were alarmed—but not surprised—by an immediate spike in the number of inquiries from women asking about black market pills and do-it-yourself methods to induce abortion.

While extremist politicians play with false science and sneaky maneuvering, we know this is no game. Women’s basic rights and safety hang in the balance, and the Center is intent on exposing these laws for the shams that they are, as well as promoting genuinely pro-woman policies such as the federal Women’s Health Protection Act.