Here's How Damn Hard It Is To Provide Abortion Care In Texas

On Wednesday, the Supreme Court began hearing oral arguments on one of the most important abortion cases in decades, with the potential to fundamentally change the landscape of abortion care in this country.

In question is a controversial Texas law, HB-2, which requires that abortion care providers have admitting privileges at local hospitals, and that clinics upgrade their facilities to strict surgical standards -- measures that have resulted in the shuttering of nearly half of the state's abortion clinics.

Opponents, including the American College of Obstetricians and Gynecologists, have argued vigorously that the measures are wholly unnecessary. "Barriers to care -- under the guise of concerns about patient safety -- are bad medicine," the group said in a statement on Wednesday. "Other needed forms of health care are not subject to these unfounded restrictions and attacks."

To find out what the realities of providing abortion care in Texas look like right now, The Huffington Post spoke with staff members from Planned Parenthood of Greater Texas, which has 20 health centers in the state, three of which provide abortion care. Here, they talk about the challenges of simply doing their jobs in a state with robust abortion restrictions and widespread, unmet reproductive health care needs -- and what it would mean to them if the law stands:

The hardest part of my job are the mandates, by Texas, that are not informed by medical evidence. And they're constantly changing. Here in Texas, the physician who performs an abortion has to be the same one to do an ultrasound at least 24 hours before. So even if a woman is referred to me by her doctor, and has already had an ultrasound, I have to repeat it. I also have to read a medically unnecessary script, which is mandated by Texas. The state's restrictions on medication abortion have had a huge impact on our patients. To get one now requires four visits. It's very frustrating to tell women, "Yes, that is a safe option, but here in Texas we cannot offer that to you." The women are upset, and I can't blame them. No physician should ever be forced into that position.

Women would be better served if I could simply practice the evidence-based medicine that I was trained to provide. These medically-unnecessary mandates create barriers to providing care; they do not create better care, or safer medicine. I became an OB-GYN because I love taking care of women through all stages in their lives, and abortion is a part of many women's lives. I see women of all ages, from teens to women in their 40s. They are most often moms, and they come from all walks of life. They make the decision thoughtfully, and with love -- for the family they have now, or the one they hope to have in the future.

The case before the Supreme Court puts so much at stake for women across America, and Texas women -- particularly those with the fewest resources -- are the most vulnerable. Personally, I will continue to go to work every day, providing the care they need.

-- Anonymous, Staff Physician

My team is responsible for scheduling appointments at our health centers around the state, and giving callers basic information about the services we provide. Our biggest challenge is trying to help women who feel they don't have access to the care they need. Recently, we received a call from a young woman who was looking for assistance with a medication abortion, but Texas law mandates she have four separate visits to our health center. After unsuccessfully trying to schedule those visits, she went to Mexico and purchased the pills for a medication abortion. Then she called our contact center to ask if our staff could assist her in carrying out the abortion at home. We advised her we wouldn't be able to, and encouraged her to make an appointment so we could give her safe, supervised abortion services -- but she declined. She said she would figure it out on her own, and hung up before we could convince her to come in. That's incredibly upsetting.

With the new restrictions, we have seen a five- to six-fold increase in patients calling from hundreds of miles away from our health centers, which creates an economic burden. Many of them are overwhelmed and distraught. How will they be able to arrange and afford transportation and lodging, plus child care and time off from work?

I do this because I want to help make sure [women] have access to safe, professional healthcare -- including abortion. I want our patients to know that they are not alone, and they will not be judged for their decisions. My fear is that patients will seek abortion services in unregulated, unsafe environments, and put their health at risk.

-- Kathy, 48, Contact Center

Nearly every day, I provide medically-accurate, age-appropriate sex education to groups in my community. Most people think I discuss abstinence, STIs and birth control and I'm on my way, but while it's true that we discuss all of those things, we also talk about puberty, healthy relationships, navigating through media messages, gender and orientation, consent and boundaries and so much more.

Texas does not require sex education in schools, and if a district chooses to include it, there are no requirements that it be comprehensive -- or even medically accurate. The myths young people are being exposed to about pregnancy prevention, STIs and even just general hygiene are harmful.

The challenge I face every day is the thought that I might be the only person these young people -- or even adults -- get to talk to about sexual health. It's more challenging in the current political climate because of the questions I'm now asked. People hear lies, and intentionally misleading information, which then has to be clarified so that they can feel comfortable reaching out for the healthcare they need.

-- Colton, 24, Community Health Educator

These accounts have been edited and condensed for length and clarity.