AUSTIN, Texas — Starting Tuesday, it will be illegal for Texas' 42 abortion clinics to provide later-term abortions — after 20 weeks — to the roughly 400 women in the state who seek them annually. That portion of the law was upheld Monday despite a last-minute ruling by Judge Lee Yeakel of the Western District Court that struck down the part of the law requiring that doctors have admitting privileges at a nearby hospital.
The decision was seen as a partial victory for abortion-rights groups who said the measure served no medical purpose and would have shut down one-third of the state's abortion clinics, pushing abortion access out of reach for 22,000 women.
On Tuesday, Texas Attorney General Greg Abbott, a Republican who is running for governor of Texas in 2014, asked an appeals court to reinstate the admitting privileges measure, furthering the tense legal battle.
Although it struck down that restriction, the court upheld another part of the law which will require abortion clinics to adhere to a specific drug protocol when conducting medication-induced abortions — guidelines enforced by the U.S. Food and Drug Administration, which doctors will have to follow unless the life or health of the woman is in danger. The new restriction mandates a stronger dosage than what clinics currently use as well as an extra in-person clinic visit.
The Center for Reproductive Rights, the American Civil Liberties Union and Planned Parenthood providers had hoped to block the restrictions on medication-induced abortions. But Judge Yeakel said that the medication directive does not place an undue burden on women seeking an abortion. He ruled that only women for whom it was not medically safe to have a surgical abortion could receive a lower-dosage, medication-induced abortion. Currently, about 39 percent of Texan women choose the medication abortion option.
Amy Hagstrom Miller, founder of the abortion provider Whole Woman's Health, told Al Jazeera: "We are disappointed that Judge Yeakel did not also block the severe restrictions on medication abortion. Nearly 40 percent of the women we serve at Whole Woman's Health choose medication abortion, and now Texas is preventing these women from the advances in medical practice that other women across the United States will be able to access. These restrictions are not based on sound medical practice."
The 20-week abortion ban provision of the bill was not challenged in federal court, though it isn't without controversy. Bill authors based the restriction on studies concluding that 20-week-old fetuses have sufficient neural connections to transmit pain. For this reason, the bill authors argued, the state of Texas has a "compelling state interest" in protecting them.
But the American College of Obstetricians and Gynecologists (ACOG) has disputed the research bill authors cite. In a stinging open letter to Texas legislators this summer, ACOG President Jeanne A. Conry and the chair of the organization's Texas chapter said in part: "Recent and rigorous scientific reviews have concluded that there is no evidence of fetal perception of pain until 29 weeks at the earliest."
Those most likely to be affected by the 20-week ban are women whose pregnancies endanger their health, women who only discover fetal anomalies at the 20-week ultrasound scan, and low-income women who could not raise enough cash in time to pay for an earlier and less costly abortion.
A poll conducted for Planned Parenthood Federation of America in August found that once voters understood reasons for having an abortion at 20 weeks, such as the discovery of fetal anomalies, the majority of Americans are against bans on later-term abortions.
Elizabeth Graham, Director of Texas Right to Life, said in release that "the abortion crowd knows that they can't win arguments about killing babies who feel pain, but these extremists are desperate to keep playing fast and loose with women's health, resisting all increased health and safety standards required by [the bill]."
G. Sealy Massingill, an obstetrician-gynecologist in the Dallas-Forth Worth area has first-hand experience with patients whose health or the health of the fetus has forced them to terminate pregnancies after 20 weeks.
"This bill is all about ideology, about appeasing the right," Massingill told Al Jazeera. "To dress this up as health and safety for women is the most horrific kind of claptrap. These women are desperate and have desperate choices to make."
Rick Gipprich, Jr., of the Texas Association Against Sexual Assault warned that rape survivors are also likely to be affected by the 20-week ban. He noted that 5 percent of rapes in the U.S. result in pregnancy, and some rape survivors only report the crime long after the fact.
"Restricting access to abortions for rape survivors re-victimizes women and impedes their physical, psychological, and spiritual recovery," he said. "The 20-week abortion ban will disproportionality hurt them," he added.
Bill authors assert, however, that 20 weeks is adequate time to decide whether to have an abortion. The majority Republican legislature, which successfully quashed Democratic state Sen. Wendy Davis' filibuster of the bill this summer, rejected Democratic efforts to include exceptions for victims of rape or incest. Davis, like Abbott, will run for governor next year.
Eight other states have abortion bans at 20 weeks gestation (or at 22 weeks of pregnancy), according to research from the Guttmacher Institute. Courts in Arizona, Idaho and Georgia have blocked laws banning abortions at 20 weeks. Similar restrictions on medication-induced abortions were blocked this year in Oklahoma and North Dakota.
A fourth provision of the law, requiring abortion clinics to make costly upgrades to their facilities in line with ambulatory surgical care centers, goes into effect in September 2014. Abortion providers argue that small abortion clinics will be unable to meet the cost of the upgrades and will cause all but five of Texas' largest clinics to shut down. Women's health advocates are expected to file a court challenge closer to its effective date.