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Abortion Providers Decline in Texas While CPCs Proliferate; State Finalizes Clinic Rules

Abortion Providers Decline in Texas While CPCs Proliferate; State Finalizes Clinic Rules

January 3, 2014 — Crisis pregnancy centers in Texas "are feeling optimistic" about the state's health care landscape amid new laws that have forced many abortion providers to close or stop offering the procedure, Al Jazeera America reports.

CPCs in Texas do not have to comply with state or federal safety regulations or undergo state health department inspections, even if they offer ultrasounds and market themselves as pregnancy medical clinics. The antiabortion-rights group National Institute of Family and Life Advocates offers legal advice and staff training for clinics that want to "go medical" by offering ultrasounds. In Texas, more than 70 have done so.

These unregulated medical clinics outnumber abortion providers. For example, in the Dallas area, there are seven NIFLA-affiliated CPCs, while two abortion clinics closed in November. The Texas Panhandle has no abortion providers and at least four CPCs, while three abortion clinics have closed in San Antonio, where there are two CPCs.

According to Al Jazeera America, all of the NIFLA-affiliated clinics offer no-cost pregnancy tests and ultrasounds, which can be especially appealing to low-income women who have had their access to regulated providers decline since state budget cuts in 2011.

Further, the unregulated clinics have received $30 million in state funding since 2005 as part of an effort to convince women to continue pregnancies rather than obtain abortions. Under the Texas Alternatives to Abortion program, the clinics are self-inspected and "paid by the state to distribute scientifically inaccurate information about abortion risks," according to Al Jazeera America.

Use of Ultrasounds Questioned

A counselor at the McAllen Pregnancy Center CPC told Al Jazeera America that it does not have a doctor on staff because the ultrasounds it conducts are for "seeing the baby," not for medical purposes.

Such practices are criticized by medical experts, including the American Institute of Ultrasound in Medicine and the American Congress of Obstetricians and Gynecologists, which warn that women could receive misinformation about their health and the health of their fetus. They note that women whose fetuses show signs of abnormalities have no guarantee of receiving necessary follow-up care (Jones, Al Jazeera America, 1/2).

State Finalizes Abortion Clinic Rules

In related news, the Texas Department of State Health Services on Dec. 27 finalized new abortion regulations that will require facilities to adhere to stricter standards, the Austin Chronicle reports.

The new rules are part of an omnibus abortion bill (HB 2) passed during a special session of the Legislature, which requires abortion providers to have admitting privileges at nearby hospitals, restricts medication abortions, prohibits abortion after 20 weeks and requires facilities that perform abortions to meet standards for ambulatory surgical centers. The ambulatory surgical center rules took effect Jan. 1, but facilities will not be penalized for violating the rules until September (Smith, Austin Chronicle, 1/3).

Rules are Constitutional, State Argues

In announcing the adoption of the new rules, state officials argued that none of the 19,000 public comments on the rules provided evidence that they are unconstitutional. They wrote, "The department is aware of no comments that explain how particular abortion-seeking patients will face unconstitutionally long travel distances, unconstitutionally long wait times or unconstitutionally high costs for abortion services in any particular part of the state."

The announcement added that claims that the rules would force abortion clinics to close "proved to be overstated because multiple providers that allegedly would be forced to close nonetheless received admitting privileges and either stayed open or reopened" (Aaronson, Texas Tribune, 12/27/13).

Carrie Williams, spokesperson for DSHS, noted that most of the comments were negative. They included complaints that DSHS removed an existing grandfather clause for the ambulatory surgical center regulations, which would require only newly built facilities to be subject to the rules (Austin Chronicle, 1/3).

Women's Health Providers Respond

Amy Hagstrom Miller -- executive director of Whole Woman's Health, which operates five abortion clinics in Texas -- wrote in an email, "Women can still decide to terminate a pregnancy, but thousands of them can no longer actually access safe, professional medical care to receive that termination." She added, "A right is meaningless if you cannot act on it. Without providers, the right to an abortion is an abstraction that does not exist for thousands of Texan women."

Sarah Wheat, vice president of community affairs for Planned Parenthood of Greater Texas, said, "These restrictions will do nothing to protect women's health and safety, which is why doctors and leading medical groups -- as well as thousands of Texans -- opposed them" (Texas Tribune, 12/27/13).