Above: If only
There’s never good news when we are talking Texas politics. That very much includes its war on women.
It’s possible that, even if Planned Parenthood is defunded at the federal level by current Republican efforts, funding might be restored by subsequent legislation. But Texas provides a startling example of how quickly the women’s-health landscape can be wrecked by a withdrawal of resources—and how lasting that wreckage can be. Within months of the family-planning budget getting slashed in Texas, more than sixty women’s-health clinics had closed. Such effects can take years to undo, even if laws are reversed. In 2016, the Supreme Court overturned a Texas law that had halved the number of abortion clinics in the state. Only two clinics have reopened. The sprawl of Texas is almost incomprehensible—it’s the same distance from Houston, my home town, to El Paso as it is from Houston to Kansas City—and that sprawl means that rural clinic closures bring immediate and catastrophic consequences for poor women and women without cars. Teen abortions and teen births have both been increasing in Texas since 2011, and the maternal mortality rate in Texas doubled from 2010 to 2014. It’s now 35.8 deaths per hundred thousand live births—the worst maternal mortality rate you can find in the developed world.
Last week, I spoke to Caroline Coyner-Such, a clinician who has been working in health care for forty-three years, twenty-seven of those at Planned Parenthood. She now works at a clinic in North Austin, one of three in the Austin area that collectively serve nearly nineteen thousand patients each year. “Twenty or thirty years ago,” she told me over the phone, “we saw mainly women under the age of thirty-five. These days, as Texas women lose access to other options, we’re seeing more women, and a wider range of women—preteens up to women in their fifties and sixties.” The previous day, a homeless patient had come in. The North Austin clinic provides well-woman exams, S.T.I. screenings, cervical-cancer screenings, breast-cancer screenings, and birth-control counselling, among other things. It does not provide abortion services, but the surgical center at the South Austin location, thirty minutes away, does.
As clinics in other areas have been forced to close, the Austin-area clinics have begun seeing more and more patients from farther away. “Yesterday, I saw a patient from Elgin, which is an hour away,” Coyner-Such said. “We see people from Killeen, which is another hour away. This means people have to take a whole day off from work to drive to Austin to get basic services—which often used to be available in their communities—and go back. We routinely send prescriptions out in a seventy-five-to-one-hundred-mile radius.” The Austin-area clinics have a base of private donors and local grants that they’ve been able to draw from as they’ve scrambled to replace public funding; small clinics often lack this piecemeal buffer, and rely more heavily on Title X, which is Planned Parenthood’s other federal funding source.
“People are fearful,” Coyner-Such told me. “The summer is usually lower in terms of patient numbers, but not this year.” The news is a constant presence in her workplace, she said, with patients showing up afraid that their insurance will be taken away, and with new regulations from the legislature rolling in. “We have to be constantly monitoring in order to know what we’re going to lose and what we have to recoup,” she said. “It takes a lot of effort to stay on top of—I can’t believe I’m even using this term, but—the fake news.” Patients are sometimes openly surprised that the clinic is clean and professional, or that Coyner-Such has specialty certifications. She knows the kind of campaigning she’s up against. “Years ago, I had a Planned Parenthood bumper sticker, and someone slashed my tires,” she said. “After that, I quit doing bumper stickers—it’s not worth the tire replacement.”
This is the goal of the national GOP. Making sure women die of cancer and from illegal abortions, ensuring that they are punished for sex by unwanted children who will grow up in poverty and then creating major taxpayer burdens when that poverty leads to incarceration is real life Republican policy. It hardly needs to be said around here, but that is why this blog has so little tolerance for pointless third party vanity campaigns. They contribute to people’s death when they allow Republicans to take office.