- Texas abortion clinics can no longer provide abortions after 6 weeks since lawmakers passed SB8.
- The clinic staff acts as trauma counselors to people who cannot get abortions because of legal or financial obstacles.
- Patients who have to travel outside the state to get abortions can receive advice, logistical and financial support from the clinics.
Marva Sadler is not used to telling patients “no.” Since Senate Bill 8, Texas’ six-week abortion ban, took effect, she now feels like she’s saying it all day.
Sadler is the director, clinical services, at Whole Woman’s Health Fort Worth. She said that patients are conscious of the new law when they arrive at the clinic. Abortion beyond six weeks is now illegal. There are no exceptions for incest and rape. The clinic is unable to help them.
“We’re seeing shock. Absolute shock,” Sadler said. “They know the law but don’t expect to hear from us that there are no other options other than leaving the state.”
As streams of patients continue to show up seeking procedures they can no longer receive, abortion clinics in Texas have become more like trauma centers — places where people are coming in severe emotional crisis.
“There is anger, fear and sadness,” Sadler said. Being there to help patients process these feelings is not easy work, Sadler said, calling it a “wear on anyone’s mental stability.”
For patients they can’t treat, clinic staff offer to schedule appointments with providers out of state. Whole Woman’s Health Fort Worth has not taken up the offer to date. Sadler stated that most people are shocked by the offer. To get to her clinic, they have already had to miss work, find childcare and transportation, and even cook for their families.
“It’s not just the financial piece, but about jumping up and leaving home without having the time or expectation to plan,” She said. “100 percent of our patients have left here with an ‘I don’t know what’s next for me.’ They’re leaving the clinic without a plan because there are no plans.”
Sadler acknowledged that SB 8 is particularly difficult for low-income and people of colour, but she is also concerned for minors. One such case was the 17-year-old girl who learned that she was pregnant at 13 weeks. This was after she said that she had been raped by a close friend. On September 1, when the law became effective, she called the clinic to find out what the clinic could do for her.
“I felt so horrible for her,” Sadler said. “What we could recommend and refer her to is so limited.”
Doris Dixon, the director of patient access at Planned Parenthood Gulf Coast in Houston, said the days preceding and following SB 8 taking effect have “been nothing short of an emotional roller coaster.”
Dixon said she and her colleagues have gone from being people who help schedule health care appointments to staffers at “a crisis center.” They’re providing emotional support, referrals and logistics in lieu of actual abortion services.
“[I’m] thinking about how we can provide resources, financial resources, get patients out of state just to get care,” Dixon said. “That’s where I’m at right now. I just try not to cry. It’s really, really hard sometimes.”
Dixon said that within 24 hours of SB 8’s passage Dixon met a patient who was six weeks pregnant and needed a specific type of abortion due to scarring from a previous Cesarean Section. This procedure could have been performed easily at Planned Motherhood Gulf Coast on August 31. The patient arrived at the clinic on September 2, just two days after SB 8 was implemented. She learned that she would need to seek out care in another state. The Planned Motherhood Gulf Coast staff found a New Mexico doctor through a network of providers from across the country who worked together to find the best way to treat patients across state lines.
Finding a qualified provider was just one part of the solution.
“She had two children and no day care,” Dixon agreed. “Her sister was trying to figure out how to take off from her job to drive her, because the patient had never been on a plane before and is terrified to fly.”
Dixon stated that the patient cried for 30 consecutive minutes after Dixon helped her.
Dixon also spoke to another patient who found out that she was pregnant on the day SB 8 became effective. She also discovered that she was positive for COVID-19. This meant that she could not be seen by a provider for an abortion for 14 more days. The woman had been pregnant for six weeks. Dixon advised her that she would need to travel to Texas to have her procedure.
Tonya Capson is the regional director of Planned Parenthood of Greater Texas. She oversees clinics located in Austin and Waco. Capson is also struggling with how SB 8 has affected her work and the lives of her patients. Her clinics used to only see patients by appointment. They are now accepting walk-ins for the ultrasounds that determine gestational ages. Patients need to be informed immediately whether they are legally allowed to have an abortion.
Capson stated that 40% of patients at her clinics showed signs of cardiac activity, which means they are no longer eligible for abortions. Some of these patients were referred by Capson to clinics in other states that could legally offer abortion. Others were “so upset that they don’t even know what to choose at this time.” Capson said she spoke with one patient who had just started a new job, and taking time off work to travel to New Mexico or Oklahoma to get an abortion simply wasn’t an option.
“She said she would lose her job if she took off more time,” Capson stated. “She already had to take time off just for this appointment. It’s very disheartening to have to deal with how upset patients are when they can’t get the services they need and want.”
Capson explained that although most patients she’s seen are aware SB 8, many don’t realize the small window of time they have. The six-week ban actually amounts to two weeks. Most people don’t know they are pregnant until they have missed a period. She stated that many of her patients, even though they are six weeks pregnant, still have heart activity on ultrasound.
“What’s most difficult for patients is they feel like they’re reaching out and seeking services in a timely manner, but the window is too small,” She said. “They’re devastated.”
Many patients cannot bear the idea of being forced to end a pregnancy. Capson counseled a patient, who was a recent immigrant and did not speak English, the same week that SB 8 was in effect. The patient had no awareness of SB 8 at all and had several small children at home, telling Capson about the financial hardships she would face if she had another child. She was already receiving the most assistance she could from the government. Her family would have to take care of one more child.
“We had to tell her that in the state of Texas, she couldn’t get an abortion because we saw cardiac activity,” Capson agreed.
She’s not the only one: Plaintiffs who sued to block SB 8 say the law has prevented between 85-90 percent of abortions in the state. This is because so few abortions are performed before six weeks gestation. Clinics have limited options when it comes to offering abortions.
“I have the equipment and medications and staff and providers,” Sadler said, “but now that’s all just collecting dust.”
Disclosure: Planned Parenthood has been a corporate sponsor of The 19th.