Texas: Land of freedom (for men only), by @DavidOAtkins

Texas: Land of freedom (for men only)

by David Atkins

Yesterday Digby posted a second update to a reproductive rights post that I wanted to bring to fuller attention. Lindsay Beyerstein how the functional elimination of abortion services in Texas is leading to rates of unsafe do-it-yourself abortions seen in the developing world:

WWHM is the only abortion clinic in this border city of 134,000. Right now, according to WWHM's Fatimah Gifford, if a woman in the Rio Grande Valley needs an abortion, she has to travel 240 miles north to San Antonio. Though Texas' standard 24-hour waiting period is waived for women who live more than 100 miles from the nearest clinic, that allowance applies only to surgical abortions. To reach San Antonio via Highway 281, a woman has to pass through the Falfurrias border checkpoint, where the Texas Border Patrol will likely grill her about her immigration status, a daunting prospect for an undocumented woman seeking abortion care. Gifford says most of her undocumented patients won't risk the trip.

A woman seeking a medication abortion must make three trips to San Antonio. A medication abortion, also known as a pill abortion, uses two drugs to induce a miscarriage in the first trimester. Under the new law, the first trip is for the ultrasound, consultation and the first pill, then she must return to the clinic 48 hours later for her second pill. Doctors who offer pill abortions in other states routinely give patients the second dose of pills to take home, but Texas law doesn’t allow it. Finally, she has to go back to the clinic 14 days later for a follow-up visit so that the same doctor can check to make sure that the drugs worked. Many abortion providers travel to clinics across the state or the country, which makes it difficult to ensure that the same doctor will be available for all three steps.

Planned Parenthood argued in court that this provision makes it so difficult for women to obtain abortions that it is equivalent to a ban, which has serious implications for the rights and health of women with existing conditions that make drug-induced abortion the only safe option.

Some women resort to self-induced medication abortions with the ulcer drug misoprostol, widely used in Latin America to terminate early pregnancies. Though it is available only by prescription in the United States, misoprostol can easily be purchased at pharmacies across the border in Mexico or at flea markets in the Valley. WWHM saw about one failed misoprostol self-induced abortion a day.

Andrea Ferrigno, WWHM's vice president, said that if a woman arrives at the clinic after taking the pills for weeks and is still bleeding, doctors will typically complete the abortion if she's still pregnant or clean out any residual tissue, as they would for a spontaneous miscarriage. Misoprostol is 85 percent effective, if administered properly, which suggests that many more women self-terminate and don’t need further medical attention.
Focusing on one constantly harried abortion provider, the piece concludes:

Legally, he says, he can't tell women where to get misoprostol, but he doesn't have to. The pills work about two-thirds of the time, he says, and the remaining third must have outpatient surgery to complete the miscarriage. Minto estimated that by mid-December, he had seen about 200 women since the law went into effect and that roughly 100 of them returned to have him complete their abortions.

"I hope our politicians are made aware of how many girls are self-aborting in the Rio Grande Valley," Minto says. "This law is backfiring."
Texas is not a free state. It's a pseudo-libertarian theocracy. Those are very different things.


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