The number of abortions performed throughout Texas dropped after a 2013 law forced the closure of clinics in all but the largest cities, and the decline was steeper the farther a woman lived from one of the remaining clinics, a study found.
The U.S. Supreme Court last year struck down Texas' tougher abortion regulations -- known as HB2 -- but not before more than 20 clinics closed, including nearly all that served rural and midsized cities. None have reopened since.
A study published Thursday in the Journal of the American Medical Association suggests that the law affected Texas' abortion numbers before it was overturned. Researchers say the steepest declines in abortions occurred among residents of the Rio Grande Valley along the U.S.-Mexico border and in a wide swath of West Texas, where the closest clinics were more than 100 miles farther away after nearby facilities shuttered.
The study found that abortions among women from those areas in 2014 plummeted by 50 percent -- from 4,589 in 2012 to 2,279 in 2014 -- compared to the year before HB2 went into effect. The numbers in the study reflected both medical and surgical abortions performed by a doctor.
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No explicit connection is made in the study between increased travel times to clinics and fewer abortions, which are in decline nationwide. Abortions also significantly fell nearly 16 percent in the six Texas counties that still have abortion clinics and where longer drives weren't an issue. The study acknowledged that factors other than distance could have played a role.
"Distance matters, and at some point the geographic barriers become insurmountable and constitute an undue burden," said Daniel Grossman, a study co-author and a member of a University of Texas research team that studies the impacts of the state's anti-abortion laws.
The study examined data from the Texas Department of State Health Services and was partly funded by the Susan T. Buffett Foundation, a major supporter of Planned Parenthood and other abortion-rights groups. Grossman was also an expert witness for the plaintiffs in the HB2 trial.
Before HB2 was struck down, Texas had argued that nearly 9 in 10 women would still live within 150 miles of an abortion provider under the law and that some women could be served by clinics in neighboring states. Texas Republicans say the regulations were needed to protect women's health.
Texas had 41 abortion clinics in 17 counties the year before the law took effect and 21 clinics in 6 counties the year after -- making Dallas, Fort Worth, Houston, Austin, San Antonio and El Paso the only cities with abortion providers. Most of the more than 53,000 abortions in Texas in 2014 were among women living in those big cities.
HB2 had required doctors who perform abortions to have admitting privileges at nearby hospitals and forced clinics to meet hospital-like standards for outpatient surgery. The Supreme Court declared the law unconstitutional in a 5-3 ruling last summer.