Texas has released data showing a marked drop in abortions at clinics in the state in the first month under the nation's strictest abortion law, but that only tells part of the story.
A study released Friday showing a jump in requests from Texans for abortion pills by mail is helping complete the picture, as will learning more about the number of women who went to clinics outside the state, and how many who were unable to get abortions ended up giving birth.
“I think a big question is: What’s the new composition of how people are accessing abortion care?” said Abigail Aiken, an associate professor at the University of Texas at Austin who studies reproductive health and who led the study looking at requests for abortion medication by mail.
Here's a look at what the numbers that have been released so far do — and don't — tell us:
WHAT DO THE RECENTLY RELEASED NUMBERS SHOW?
Nearly 2,200 abortions were reported by Texas providers in September, the month the state's new law took effect that bans the procedure once cardiac activity is detected, which is usually around six weeks into a pregnancy. There are no exceptions in cases of rape or incest.
That's a 60% drop from the month before.
Researchers note, though, that the number of abortions reported in August — over 5,400 — was higher than usual for that month, likely because clinics were rushing to get women in before the law took effect. So, they say, it's also useful to compare September's data to the same month a year earlier, which shows a drop of 51%.
The Texas Health and Human Services Commission, which released the September figures this month, is releasing data on abortions on a monthly basis.
WHAT DID ABORTION PROVIDERS EXPECT?
Abortion providers had predicted that the law would bar at least 85% of abortions in Texas since, traditionally, most women were at least six weeks into their pregnancy when they had an abortion. And figures from the state show that in 2020, only about 15% of abortions were done at less than six weeks.
So why wasn't there an even bigger drop in abortions in September?
Researchers say a combination of factors were apparently at play, including women scrambling to schedule appointments as soon as possible rather than when it might be most convenient.
“We see people coming to us before they’ve even done a pregnancy test, before they even know if they’re pregnant, because they’re so afraid that they might be pregnant and they will be denied an abortion,” said Amy Hagstrom Miller, president of Whole Woman's Heath, which operates four abortion clinics in Texas.
Also, researchers say, the attention drawn to the new law resulted in an influx of funds to help women pay for out-of-state travel and medical fees.
“We don't see as many people being pushed further into pregnancy because they're trying to figure out how to pay for the abortion,” Hagstrom Miller said.
HOW MANY WOMEN ARE GETTING ABORTION PILLS BY MAIL IN TEXAS?
The number of Texas women who are going online to get abortion pills by mail from the overseas nonprofit Aid Access sharply increased after the law took effect, according to the study led by Aiken.
“We can’t say to what extent exactly as a percentage the gap has been filled, but I think we can say that self-managed abortion has been important in filling it," Aiken said.
The study, published Friday in the medical journal JAMA Network Open, found that Aid Access got 1,831 requests for the pills from people in Texas in September.
During the first week of September, requests per day jumped to about 138 compared to a previous average of 11, the study said. Over the subsequent weeks in September, requests averaged 37 a day. Then, through December, the average was 30 per day.
“It’s another demonstration of the fact that just because you restrict abortion, the need for abortion does not magically go away,” Aiken said.
The study's authors, who note they can’t determine if all the requests resulted in abortions, said it’s likely the initial dramatic spike was due to confusion as the law went into effect and some who requested pills may have ended up going to a clinic.
Though a Texas law banning the delivery of such abortion-inducing medication by mail took effect in December, experts say there would be difficulty in stopping providers and suppliers outside of the state and country.
The law says the person taking the pills obtained by mail isn’t criminally liable.
“It’s not illegal to be the one that orders the pills and uses the pills,” said Sara Ainsworth, senior legal and policy director for If/When/How: Lawyering for Reproductive Justice.
She added that “it's unclear whether or not that Texas law could be used to go after somebody who mailed drugs into Texas from somewhere else.”
HOW MANY WOMEN ARE GOING TO CLINICS OUT OF STATE FOR ABORTIONS?
Abortion clinics from states surrounding Texas have reported sharp increases in the number of patients from Texas since the new law took effect, so much so at times that residents of those states must seek abortions elsewhere.
One clue comes from a research letter published in the Journal of the American Medical Association looking at what happened when Republican Gov. Greg Abbott all but banned abortions for about a month in the early stages of the COVID-19 pandemic in 2020.
Kari White, an associate professor at the University of Texas at Austin who leads the Texas Policy Evaluation Project, which studies the impact of reproductive health policies in Texas, said the research found that during that time the number of women going out of state increased to about 950 compared to about 160 previously.
Planned Parenthood said Thursday that from September through December last year, states surrounding Texas saw a nearly 800% increase in abortion patients from Texas. It declined to provide the actual number of patients that made up that increase.
HOW MANY PEOPLE WHO SOUGHT ABORTIONS HAD TO GIVE BIRTH?
That's unclear, too. Comparing the usual number of births in Texas with the number of births this year may eventually shed some light.
“I think that’s a big unknown," White said, "and we won’t know it for some time."
WHAT DO THE NUMBERS SAY ABOUT THE FUTURE?
In a ruling expected later this year, the U.S. Supreme Court has signaled a willingness to weaken or reverse the landmark Roe v. Wade decision guaranteeing a right to an abortion, and more than 20 states already have laws on the books to ban or dramatically restrict abortion if it's overturned.
Restrictions or bans in states surrounding Texas could mean residents would have to travel even farther.
“It could be that Texas is just a taste of what’s to come,” said Rachel K. Jones, principal research scientist at the Guttmacher Institute, a research organization that supports abortion rights.
Meanwhile, anti-abortion groups in Texas have been celebrating the lives they say have been saved by Texas' law, and anticipating the possibility of Roe v. Wade being overturned.
“Our impact is only just beginning,” said Texas Right to Life spokeswoman Kimberlyn Schwartz.
