The U.S. Supreme Court has ruled to overturn Roe v. Wade, eliminating the constitutional protection for abortion and allowing states to set their own laws regulating the procedure. In Texas, due to a so-called trigger law, that will mean a ban on all abortions from the moment of fertilization.
The Texas legislature passed House Bill 1280, dubbed the “Human Life Protection Act,” in 2021. The law prohibits abortions with narrow exceptions: to save the life of a pregnant patient or prevent “substantial impairment of major bodily function.” A violation of the law is a first-degree felony “if an unborn child dies as a result” and could result in a civil penalty of at least $100,000 and potential criminal charges. The law is expected to go into effect within the next 30 days.
The federal ruling and the state trigger law have left healthcare professionals across Texas reeling. But in largely rural areas like Hays County, where abortion providers and women’s health clinics are few and far between, the effect is less obvious.
“It’s always probably been much harder for people in Hays County to seek out that kind of care, and I think that’s probably the case in most rural counties in Texas,” said Oona Mekas, president of the board of directors for the Hill Country Women’s Health Collective. “That’s why we created our organization in the first place — because there seemed to be a lack of community based healthcare.”
The Hill Country Women’s Health Collective, a 501(c)(3) public charity, is one of the few organizations in Hays County that provides women with access to free and discounted health and mental health services. The women’s collective includes doctors, nurses, midwives, medical students, herbalists, mental health advocates and educators.
“There’s been a lack of abortion care in this county for a long time; the big difference is that the Supreme Court decision cements the fact there is basically a total ban,” Mekas continued. “Some of the women I work with are home birth midwives in Hays County… If someone has an anomaly or a miscarriage that doesn’t fully finish, she’s going to need to go to the doctor. Now, doctors might be afraid to offer care that they wouldn’t have hesitated to offer earlier.”
Access to abortion care is about more than terminating an unwanted pregnancy, said Allison Royal, a family nurse practitioner in Hays County. It often involves those that do want to have children but, for whatever reason, cannot carry to term, she explained.
“From a medical perspective, there’s a ton of things we need access to abortion care for,” Royal said. “Women that experience ectopic pregnancies may end up dying within the gray areas of this legislation. A septic uterus, presence of an infection within the womb, concurrent pregnancies, something as simple as a miscarriage which has not spontaneously aborted… those have to be solved with a D&C (a dilation and curettage procedure), which is the same method used for many abortions.”
Royal said she worries the ban on abortion will have negative effects on women’s healthcare beyond abortions and miscarriages.
“There was a hard stop within the medical community, with many immediately shuttering services because they didn’t know what it was we could actually provide out of concern for our livelihood,” Royal said. “I’m not exactly sure what there will be in terms of access. I think a majority of healthcare entities are going to err on the side of caution, but the clock will continue ticking on those pregnancies that are proceeding through that time.”
“I’m tremendously concerned about what the implications are moving forward with this,” Royal continued. “I think it’s going to decrease access to everyone, locally, because [many women’s health] organizations are going to shutter until they can figure out what they can actually provide.”
If women’s health organizations close and remain closed, the demand will be significantly greater on the remaining entities, many of which already expect higher numbers of patients following the ban.
“I expect an influx,” said Debi Wehmeier, executive director of the Heart of Texas Pregnancy Resource Center. “But that’s still to be seen. We are ready, and we pray that women will come our way so we can show all we have to offer them.”
The Heart of Texas PRC provides free resources to women in east Austin and Dripping Springs, including pregnancy testing, options counseling, community referrals, a baby and maternity boutique, parenting classes and support groups.
“We’re just continuing to help moms, dads and babies like we always have,” Wehmeier said. “We’re excited and thankful that we can continue to offer hope and help to all that come through our doors. We’ll be there for them in all different ways: physically, emotionally and spiritually — if they want that.”
