Plunging numbers of Texas abortions: Are clinic closings behind decline?

Editor's note: In advance of the recent Supreme Court hearing, The Christian Science Monitor examined abortion in Texas in a three-part series looking at those most affected by the Texas law, the 'pro-life' answer to abortion clinics, and how hard it is to get an abortion in the state.

Texas abortion clinics performed 9,000 fewer abortions in the first full year after the state enacted tough new regulations on abortion clinics, providing some of the first hard data in what the Supreme Court has called the state’s “controlled experiment” in tightening abortion access for American women.

The plunging number of Texas abortions comes amid a notable drop in abortions around the US.

In general, states with open access to abortion are seeing declines similar to states with laws curtailing clinic access. But while the Associated Press found that abortions decreased by 12 percent across the US since 2010, the Texas rate dropped by 30 percent in the same span.

The only other state to come close to Texas's sharp drop was North Carolina, with a 24 percent decline over that time.

Americans' views on abortion remain divided, nuanced, and intensely personal. For example, polls show that last year, more Americans identified as pro-choice than pro-life. Yet according to the General Social Survey, only 42 percent of Americans believe that a woman should have an abortion because she feels like she can’t afford another kid.

Critics say a raft of new abortion-restrictive laws are pushing the statistics down, highlighting how those lost in the legal and cultural jumble tend to be the most vulnerable residents, including so-called “Janes”: poor, rural women and teenagers.

“Access to abortion is becoming more difficult,” the Atlantic’s Emma Green wrote last year, “but that doesn’t necessarily explain why women aren’t getting the procedure.… Americans are moving away from embracing abortion, not toward it.”

Even so, the abortion decline in Texas is sharpening the constitutional focus on whether creating requirements that clinics can’t meet constitutes an “undue burden” on a women’s right to choose – especially given that 30 US states have enacted nearly 300 abortion restrictions since 2011.

Last week, the Supreme Court heard arguments in Whole Woman’s Health v. Hellerstedt, an appeal of a lower court ruling that found the Texas law constitutional. (Another federal circuit court found a similar law in Michigan unconstitutional.)

In a likely landmark case, the Supreme Court is looking primarily at whether increasing travel times and costs for women seeking abortion constitutes a “substantial obstacle” to getting one – a constitutional standard the court set when it upheld Roe v. Wade in 1992. A lower federal court last year ruled that the “obstacle” standard applies “within states,” meaning that states can’t force clinics to close and then depend on other states to guarantee abortion access. That case focused on Mississippi, which has only one remaining clinic.

The Texas law at issue, signed by Gov. Rick Perry in 2013, requires abortion clinics to adhere to hospital surgical standards and mandates that doctors have admitting privileges to a nearby hospital – a difficult standard since many clinics use out-of-state doctors to perform the abortions, given lingering stigma.

Critics say 26 Texas clinics have since closed, leaving 10 still operating. Lawmakers say the laws are intended to protect women’s health, but abortion rights activists call them an attempt at “making abortion legal in name only so that it is a right on the books and is not a procedure that patients can effectively access,” as abortion rights advocate Jessia Pieklo recently told Uprising Radio 

Texas officials say the Texas abortion drop means that “demand for abortion is decreasing as a whole … and that’s a positive thing,” as Cynthia Meyer, a spokeswoman for Texas Attorney General Ken Abbott, told the Dallas Morning News.

But the new data suggests that the picture is more complex. For one, Louisiana is one of only two states to see an increase in abortions since 2010 – due largely to a spike in out-of-state patients from neighboring Texas.

Establishing causality between the Texas law and the abortion decrease is made more difficult by gradual cultural shifts around the use and availability of abortion.

For example, pro-life groups say state laws mandating that women seeking abortion need to look at their fetal sonogram has helped humanize the initial blossoming of life, thus discouraging the procedure.

Others say increased availability of birth control devices primarily in more liberal “blue” states have led to much of the national abortion decrease, a fact that proponents say offers an alternate path toward minimizing abortion while honoring the rights of women to oversee their own reproductive affairs.

See the Monitor's three-part series:     

Part 1: In Texas, a side of abortion debate few ever see
Part 2: Inside the 'pro-life' answer to abortion clinics
Part 3: How difficult is it to get an abortion in Texas?