Whole Woman's Health Clinic in downtown McAllen is the only abortion provider in a region with more than 1 million people that spans over four counties. A slab of concrete protects the clinic's doors, and when it's open, security guards have to as well.
On Sept. 1, clinic leaders say a new Texas abortion law will almost completely strip peoples’ access to its services.
"Many people never think they’re going to need an abortion until they do," said Amy Hagstrom Miller, founder of Whole Woman's Health. "And so when they find out we’re available, and we’re able to help them, it’s a huge relief for many people in the community."
The next nearest clinic, Miller says, is some 200 miles away. She says she's heard from many people concerned about the new law, Senate Bill 8.
"They hear, you know, the word ‘legal' and they hear the word ‘ban' and they get scared," Miller told TPR. "And so we’ve had people for almost two months already before the law even goes into effect, asking us lots of questions about whether abortion is still legal, if they can access it, etc. It’s really heartbreaking to see how these kinds of laws affect people so deeply, especially in a pandemic."
On Monday, Whole Woman's Health joined other abortion providers in Texas asking the Supreme Court to block the law.
What's in the law?
Governor Greg Abbott signed SB 8 into law on May 19, 2021 and it's one of the most restrictive in the country.
It reduces the deadline in which a woman can get an abortion from 20 weeks to 6.
"Most of our patients barely know they’re pregnant when they’re just six weeks from their last period," said Miller. "There’s going to be a lot of people affected by design."
Abortion rights lawyers call it a ban.
Additionally, unlike other "Heartbeat Bills", the Texas law leaves enforcement to civilians by allowing almost anyone to sue those who help with or provide abortions.
"Anybody can be sued for helping anyone get an abortion in Texas, and they can be sued by anyone in the country," explained Zaena Zamora, the executive director of Frontera Fund. That group helps people pay for abortions, including travel and lodging costs.
Zamora said SB 8 could put Frontera Fund and other abortion funds in legal peril, and that potentially endless legal battles will put a serious strain on abortion assistance throughout the state.
"It kind of makes our job kind of impossible, because we’re always going to be putting ourselves at risk of getting sued," said Zamora.
And if the person suing happens to win, organizations like Frontera Fund or people like Zamora will have to pay the plaintiff at least $10,000
Impact in the Rio Grande Valley
Lawmakers have been escalating abortion restriction in Texas, creating more and more barriers for people seeking to terminate their pregnancy. In the Rio Grande Valley, Miller said these obstacles are stark.
For one, abortion prices at the McAllen provider are some of the highest in the state.
The main factor driving these costs is a shortage of people who can perform abortions. The clinic has to bring in physicians from other Texas cities and even outside the state.
"Considering the demographic of people that we serve, and just the economics that people face down here, it’s just really expensive to get an abortion in the Valley," said Zamora.
McAllen's Whole Woman's Health also serves non-immigrant visa holders who can't go past border patrol checkpoints to San Antonio. Undocumented people also depend on the clinic.
Zamora says the cost, documentation barriers and travel expenses already make abortions more inaccessible to this population.
According to Zamora, the majority of people who contact Frontera Fund are parents.
"They (lawmakers) don’t care about what they’re doing to those people’s families, and how they’re hurting those families by passing laws like this," she said.
According to a University of San Francisco study that documents the downstream effects on people who wanted abortions but were unable to get one, women unable to access this service have "four times greater odds of living below the poverty level."
Additionally, these people are more likely to suffer from anxiety and experience poorer physical health.
"There were also adverse outcomes for the children that they had in terms of meeting developmental milestones," said Dr. Kari White, the lead investigator of the Texas Policy Evaluation Project. Her work focuses on reproductive policies and their effects on people.
"What we know based on our prior research is that folks in the lower Rio Grande Valley, and people who are living on lower incomes are going to be some of those who are most affected by this new law," said White.
Since the law restricts people's ability to access legal abortions, White believes people will turn to alternative methods, particularly in the Rio Grande Valley and West Texas where people have access to pharmacies in Mexico.
"One of the challenges with some of these approaches, kind of depending on where they’re getting the medications, will be whether or not they have accurate information about how to use those medications," she said.
If used incorrectly, these medications may cause excessive bleeding or may not even terminate the pregnancy. And if they don't terminate the pregnancy, women may end up aborting further along in their pregnancy through riskier methods.
"I think it’s always disheartening to see that policies are being passed that are inconsistent with scientific evidence," said White.
What happens next?
Texas is one of several states that have passed so-called "heartbeat bills" but judges blocked the others.
As of Monday, no attempt to block the Texas bill has been effective and abortion rights activists have asked the Supreme Court to block the law from going into effect.
"I think a lot of folks are really worried about what’s going to happen to Texas on Sept. 1 if the court doesn’t step in and block the law," said Heather Shumaker, the director of state abortion access at the National Women’s Law Center.
"We’re seeing all kinds of bans passed at the state level, not just in Texas, but across the country," said Shumaker.
According to the pro-abortion access Guttmacher Institute, states passed more than 90 related restrictions in 2021. The group called it "the worst year ever for U.S. abortion rights."
Shumaker said that the conservative-leaning shift in the Supreme Court has encouraged many states to pass restrictive abortion bills — both to eradicate abortion statewide and eventually federally.
Historically, the Supreme Court has knocked down these proposed laws as unconstitutional because Roe v. Wade declared abortion a constitutional right.
But if the Supreme Court upholds any of these bans, it could restrict abortion access on a federal level or completely overthrow Roe v. Wade.
"I think for one of the first times since I’ve been doing this work, there is a real concern that with the makeup of the court, things could look different," said Shumaker.