United States: The last couple of years have seen Houston Women’s Reproductive Services reduce its size from nearly 5,000 square feet to an 800-square-foot location.
Moreover, the Texas clinic laid off nearly fifteen full-time employees, leaving only a medical director and three part-timers as staff members.
It could no longer conduct abortions but still managed to adapt to the change and continues to operate.
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According to Kathy Kleinfeld, the clinic administrator, “I was willing to make whatever sacrifices needed to be made to keep our head above water, just keep the doors open and the lights on, and be able to provide care to these people who desperately need our help,” as CNN Health reported.
It is one of the changes that have occurred in the country’s abortion landscape since the high court’s Dobbs ruling that overturned federal abortion rights two years ago.
Since then, 14 states, to be precise, have enacted near-total bans on abortion, and other southern states also advocate similar legislative measures. Legal restrictions have deprived clinics of their ability to offer abortions in over a quarter of all US states.
Now, while the actual number of clinics that carry out abortions in the US remained relatively stable – only a few dozen have shut down altogether – it is often the change in the number of closures that does not tell the full story.
More changes perceived after the abortion ban
States that have passed abortion bans usually had few abortion clinics to begin with. Since the Dobbs decision, some have thought about going back to work but have also sought other places where they could give care while patients could be required to travel some miles.
Other clinics are fully functional but are not operating in the same manner as they did before the closure, as CNN Health reported.
Kleinfeld’s clinic in Houston began focusing on general women’s reproductive health as well as support for those after abortions and or self-induced abortions in other states.
Before the Supreme Court’s Dobbs decision, about 3000 patients came to Houston monthly for abortions and Kleinfeld said she understood that this demand would persist even after Texas’ trigger law prohibited abortions.
Kleinfeld, while stating about the state of her clinic in Houston, said, “There were a lot of different ways it could have gone; most of all would have involved closing,” and, “That was just not something I was willing to do.”
Lesser abortion clinics now
In the US, in 2021, there were around 750 abortion clinics, as per the data obtained from the University of California San Francisco’s Bixby Center for Global Reproductive Health.
Only less than a tenth, i.e., about 60 of them, were lying across 14 states that have since banned abortion.
According to Caitlin Myers, an economics professor at Middlebury College, “The reason that banned states did not have many facilities, to begin with, is that they were hostile to abortion and put up barriers to providing abortion services even before Dobbs,” as CNN Health reported.
Her studies are based on the US abortion situation, and she has been following the distance traveled to the abortion centers.
These states had measures such as mandatory waiting periods and parental involvement in the decision-making to access abortion, making it difficult for those seeking the procedure, besides making it difficult logistically for the providers in states like Texas.
Myers added, “This is basic economic theory.”
As strict regulatory scenarios build high costs environment for the providers, thereby leaving space for only few those who could optimally level their services up, high enough to survive, she added.
In Texas, Dobbs’s decision was not the first time that abortion clinics worked through the question of their survival.
It was not the first time abortion clinics in Texas faced that future when they came to the United States Supreme Court to challenge the Dobbs decision.
In 2013, half of its abortion clinics shut after the state legislature enacted a law that demanded that abortion clinics must observe some hospital-like measures. Even after the US Supreme Court helped overturn those restrictions, dozens of doors closed still remained.
Kleinfeld added, “Having lived through that, I knew all the other clinics – the very few that were left – I knew they were going to close” after the Dobbs decision, as CNN Health reported.