The fight against stricter regulations on Texas abortion clinics goes to court again Monday. This time lawyers will argue on behalf of two clinics located near the United States-Mexico border.
Those clinics have shut their doors, unable to meet new rules passed by state lawmakers last year. As a result, women who seek an abortion may have to travel hundreds of miles for treatment.
When the Texas legislature debated tougher regulations for abortion clinics last year, tens of thousands of people flooded the capitol. Internet gawkers across the globe watched as Democratic state Sen. Wendy Davis, now a candidate for governor, filibustered against the rules for 13 hours in a pair of pink sneakers.
Despite the filibuster, the bill passed during a special session. Now all but one of the main components of that bill have gone into effect. Those include a ban on abortion after 20 weeks of pregnancy, new rules on taking abortion medication, and a mandate that all doctors who provide abortions have admitting privileges at a nearby hospital. A fourth provision, requiring clinics to meet the standards of an outpatient surgical center, goes into effect next month.
"What we've seen is that approximately a third of clinics have shut down," said Esha Bhandari of the Center for Reproductive Rights.
Bhandari is the lead attorney challenging the new law in a federal district court in Austin. She will argue the new rules are medically unnecessary and impose unreasonable financial hardship.
Her case will focus on two shuttered clinics in El Paso and McAllen, which served a population of more than two million people. The clinics closed in the last nine months, significantly reducing the options for an abortion in the border region.
"We've heard increased reports of self-induction of abortion in the Rio Grande Valley," Bhandari said. "We've heard from community workers that women are often resorting to using drugs that come across the border from Mexico."
In March, the Fifth Circuit Court of Appeals struck down a similar challenge to the new Texas law. This latest argument is different since lawyers say they can now prove there is an undue burden specifically for women who live along the southern border. These women now have to travel up eight hours round trip to get an abortion.
But Joe Pojman, executive director of the Texas Alliance for Life, said that's normal.
"The reality of living in a state like Texas which is geographically very large, is that people have to travel to get medical procedures," he said.
Pojman's organization is a nonprofit that advocates against abortion. He argues that it's not unheard of for Texans to travel to cities like Houston and Dallas for specialized medical care. And he added, there are other options.
"The one abortion facility in McAllen was just one block away from the McAllen Pregnancy Resource Center which provides compassionate alternatives to abortion," he said. Alternatives like adoption.
Other supporters of the new regulations claim they make abortion clinics safer. Abortion is already considered a safe procedure by most medical standards. But complications do occur. Tissue can be left behind inside a woman's uterus after an abortion.
"That could cause infection later on and it could also cause continued bleeding which could actually end up being a hemorrhage," said El Paso pediatrician Dr. Christine Smith.
On a Thursday afternoon the waiting room of a crisis center in El Paso was busy. Social worker Virginia Rueda said the women most impacted by the abortion clinic closures are poor and in desperate situations.
She recently counseled a single mother of three who became pregnant after she was raped by a stranger.
"It was a lot of turmoil," Rueda said. "She just couldn't, she said 'I can't. I cannot see myself going through nine months of this.'"
Even when offered alternatives the woman chose to abort. Rueda had to help her apply for financial assistance to travel 540 miles round trip to Albuquerque for the procedure.
"When they don't know where to go it does become a big burden for them," she said. "Especially when they are in that crisis, it's something that can't just wait."
Meanwhile the phone continues to ring at an empty clinic that served El Paso for 34 years. The clinic’s former administrator is taking 15 to 20 calls a day and referring patients elsewhere. The only other abortion clinic in El Paso told a local newspaper it will close next month.
