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Getting an Abortion in Texas Is Harder if You Don't Live Near a Clinic, Go Figure

Last week, Texas officials emphatically denied any ties to a study published in a prestigious medical journal about the effects of ousting Planned Parenthood from the state's Women's Health Program in 2013.

They seemed to have fun with that, but now state lawmakers have a new study to rail against.

On Thursday the Texas Policy Evaluation Project, at the University of Texas at Austin — a group of researchers who have been examining the on-the-ground effects of an onslaught of laws passed by the Texas Legislature in 2011 and 2013 that either curtailed reproductive rights or slashed funding to family planning programs — published a study in yet another prestigious journal showing what happened when the state's strict abortion law, House Bill 2, forced abortion clinics across the state to close their doors in 2013.

The newest study, called "Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Texas Law," was published in the American Journal of Public Health (a peer-reviewed, well-respected journal established in 1911). This time the research focused particularly on hardships placed on women who live near an abortion clinic versus the burdens of women who lived farther away from a clinic.

Researchers surveyed more than 400 women seeking abortions at ten Texas clinics — both the Planned Parenthood ones that state lawmakers love to hate and the independent ones as well — in 2014 to find out what it was like for women trying to get an abortion post-HB2. 

The answer? Not easy and in fact, it got increasingly more difficult for a woman to end a pregnancy the farther away she was from a clinic, the study found. 

First there was the most obvious issue of distance. In 2013, before HB2 went into effect, the average distance to an abortion provider was about 15 miles, according to the study. By July 2014, the average distance to an abortion clinic had increased by about 20 miles. Women whose nearest clinic had closed were having to travel about 85 miles on average to get to an abortion provider. In some parts of the state, including South Texas, West Texas and the Panhandle, women now live more than 100 miles from the nearest in-state clinic

After the problem of traveling, there were four other issues women seeking abortions were likely to have to deal with, according to the research: high out-of-pocket costs (in this case, anyone who spent more than $100), having to stay overnight, having trouble getting a quick appointment and not being able to use a preferred method to get an abortion.  

Women who had to travel longer distances to get abortions also ended up having to stay overnight more often and having to spend more money. They also had more trouble getting a medical abortion, a method many women prefer since it involves taking two types of medication instead of going through surgery, Fuentes says. 

The only time location didn't matter in terms of being near a clinic was in getting appointments. Women across the board reported they weren't able to get clinic appointments as quickly as they wanted to. 

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This study is part of a larger research project being conducted by the Texas Policy Evaluation Project that is seeking to understand the full impact of HB2 in Texas, Liza Fuentes, the senior project manager with the organization, says. “It's important to understand the current state of access to women's health in this state. When the types of policies that have been passed here were put in place, we didn't have a lot in the public health literature about what we could expect from them,” Fuentes says. “This work is collecting data that allows us to understand what we can expect when such policies are put in place.” 

Normally researchers would wait for state statistics to pile up before they'd start digging into an issue, but researchers didn't have that luxury after HB2 was passed. Instead, they have gathered data by working with the clinics directly. “It's an interesting academic question, but this research has real policy implications, and we wanted to do this research in a timely way so that these findings could play a role in the case,” says Dr. Daniel Grossman, an investigator at the Texas Policy Evaluation Project who testified for the clinics in the case against HB2. 

They're also hoping that the data will help persuade the U.S. Supreme Court, which heard the case on HB2 at the beginning of March, to rule against the law.

“The data really speaks for itself in terms of the impact this is having on clinics, on doctors, on women. Texas can continue to say what it wants, but the evidence is there and I hope the Supreme Court will look at the evidence of what this law's impact is," Grossman says. 

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