The state's new ban on dilation and evacuation (D&E) abortion procedures leaves doctors and patients with few options, says one of the state's few full-time abortion providers.
"We know that about 95 percent of abortions in the second trimester are performed using the D&E procedures," Dr. Bhavik Kumar with Whole Woman's Health says. "So, the alternatives are not really real alternatives."
State lawmakers outlawed D&Es during the regular legislative session. Two weeks ago, abortion providers filed a lawsuit – landing the state back in court over an abortion restriction.
"Ultimately what this is doing is really restricting us to options that are less safe and options that a lot of doctors aren't trained in," Kumar says.
He says all the second-trimester abortions he performs are done using D&Es. The ban, which hasn't been enforced yet, will leave his patients in a tough spot.
"Obviously, it would be a conversation that I would need to have with my patients," he says. "We'd have to assess what the options are, be real about what we know and don't know, and help my patients make the best decisions for them."
Another concern for Kumar is what this means for him as a medical provider, having to perform less common and safe procedures.
"It would be difficult to practice substandard medicine out of fear from persecution from the state," he says.
Kumar says if the ban goes into effect there could be a spike in medical complications.
The ban comes as women in Texas are having more second-trimester abortions.
"What we know in terms of second-trimester abortions in Texas is that there was a big jump ... in procedures between 2013 and 2014," says Dr. Daniel Grossman, an investigator with the Texas Policy Evaluation Project.
He says there was a roughly 27 percent increase in second-trimester abortions in 2014. That was the first full year House Bill 2 was in effect. The Supreme Court struck down parts of the sweeping abortion bill last year.
When the law went into effect, though, many abortion providers were forced to close in Texas.
Grossman says it's hard to prove a causal link, but the women he spoke to about the clinic closures did provide some insight.
"We heard from them about how it took time to even find which clinics were open," he says. "It took time to get money together to pay for transportation, to find someone who could drive them, to get time off from work, to arrange childcare. And all of those things ended up creating delays. And some women then were pushed even into the second trimester."
Grossman says wait times at the clinics that were still open also got longer. In some cases, he says, wait times were weeks long, which could also push a woman into a second-trimester abortion.
The number of second trimester abortions aren't steadily climbing anymore, but Grossman says the numbers have stayed pretty high.
The ban has been a longtime priority for anti-abortion groups in Texas who say the method of abortion is gruesome. Courts have overturned similar attempts by other states to outlaw D&Es.