July 13, 2013

Texas abortion clinics fear closures, patient backlogs

Texas passes requirements for abortions that appear to conflict with the 1973 Supreme Court decision.

By RAMIT PLUSHNICK-MASTI/The Associated Press

(Continued from page 1)

Howard Novick
click image to enlarge

Dr. Howard Novick says he would have to come up with up to $1.5 million to upgrade his Houston abortion clinic if new restrictions become law.

The Associated Press

WHAT THE NEW RESTRICTIONS MEAN

AUSTIN, Texas - Texas lawmakers passed new abortion restrictions that will make the state one of the toughest places in the country to get an abortion.

THE BILL

The bill includes four restrictions on when, where and how a woman may obtain an abortion. The first provision requires doctors who perform abortions to have admitting privileges at a hospital within 30 miles of the clinic. Another bans abortions after 20 weeks unless the health of the woman is in immediate danger. If a woman wants to induce an abortion by taking a pill, the state will require her to take the pills in the presence of a doctor at a certified abortion facility. Lastly, all abortions must take place in an ambulatory surgical center.

THE EFFECT

According to the Texas Department of State Health Services, 72,500 abortions are performed in Texas annually. Currently, only five out of 42 abortion clinics in Texas qualify as ambulatory surgical centers, and there is some question whether the others can ever meet the infrastructure requirements such as hallway-width and ventilation standards. Most doctors do not have admitting privileges at a hospital, and it's unclear how many have such privileges at the remaining clinics in Houston, Dallas, San Antonio and Austin. If more surgical centers do not offer abortions, the remaining five would need to perform on average 43.5 a day to meet current demand.

-- The Associated Press

Novick says the law is medically unnecessary. The Texas Medical Association, the Texas Hospital Association and the American College of Obstetrics and Gynecology agree.

For Houston, though, the bigger problem may be that its two remaining surgical centers will have to treat women from areas that will no longer have their own clinic.

Rochelle Tafolla, a spokeswoman for the Planned Parenthood Center for Choice in Houston, said between the travel, the 24-hour waiting period and the lack of available clinics, the 20-week deadline could create time constraints.

"I don't think it's unreasonable to think that it's going to have a significant impact on when women can get the care that they need," she said.

About 72,500 abortions are performed annually in Texas, according to the state Health Department. The busiest clinics do up to 4,000 a year. Now the remaining surgical centers will have to conduct about 14,400 each year.

Some, such as the four-bed facility Hagstrom Miller runs in San Antonio, cannot accommodate those numbers.

"With more restrictions, we see more abortions happening later in the pregnancy," she said, adding that since the 24-hour waiting period was implemented, more terminations occur in the second trimester, and now some may miss the 20-week timeline.

IMPACT ON REMOTE AREAS

The situation will be most dire for women in remote areas, she said.

In McAllen in the Rio Grande Valley, Hagstrom Miller said she will likely close her clinic because architects have estimated it would cost $1.4 million to retrofit a 4,000-square-foot facility to meet all the requirements that come with transforming it into a surgical center. To build a new facility would cost $3 million, she said.

Women treated in the McAllen clinic already face significant challenges, said Andrea Ferrigno, Whole Woman's Health director of service excellence. They struggle to pay and to arrange for transportation, childcare and days off from work.

After the 24-hour waiting period was instituted, the facility saw a spike in women trying to end their own pregnancies by purchasing prescription drugs at Mexican pharmacies across the border, Ferrigno said.

Another facility owned by Hagstrom Miller in the southeast town of Beaumont is the only clinic between New Orleans and Houston and serves a 350-mile radius. It will close because the patient load does not justify the cost of moving the facility, which cannot be renovated, she said.

In West Texas, two clinics in Lubbock and Midland serve a population of more than 656,000 people in a 300-mile-wide area. The Planned Parenthood Women's Health Center in Lubbock sees women who travel from New Mexico, Kansas and Oklahoma.

The clinic normally performs about 60 procedures a month. Most of the women are poor and a trip to San Antonio, Dallas or Houston -- each more than 350 miles away -- would be too expensive, director Angela Martinez said.

The clinic estimates the cost to retrofit just one room would be as much as $500,000, more than it can afford.

"People are really discouraged," Martinez said.

 

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