Abortion providers in GOP states fear what’s next after the Texas law goes into effect

Robin Marty woke up Thursday morning hoping for a miracle, but preparing for a crisis.

Marty, director of operations for the West Alabama Women's Center, wondered whether the divided U.S. Supreme Court might block Texas's new abortion law, which bans the procedure as early as six weeks into pregnancy.

When her husband alerted her that the court decided late Wednesday night to let the Texas law stand while the legal battle over the statute continues, Marty began shaking in her kitchen as she thought about what the news meant for her Tuscaloosa, Ala., clinic — one of just three places regularly performing abortions in the state — and those in other conservative states.

The immediate answer: fear.

"I had been predicting an outcome like this might happen, but I never would have thought it would have happened like this," Marty, the author of "Handbook for a Post-Roe America," told The Washington Post. "I thought someone would swoop in and save this from happening. I am worried, that's an understatement — and I feel ill."

Marty's concerns are echoed by abortion providers across the country, who fear a future of increasingly strict restrictions that look a lot like the law in the Lone Star State.

» READ MORE: Texas 6-week abortion ban takes effect, with high court mum

The dread among providers is heightened in Southern states with Republican-led legislatures that have already enacted restrictive laws, many of which have been blocked by courts. Southern providers interviewed by The Post worry that their state leaders may try to copy the Texas law, further chipping away at the landmark 1973 decision in Roe v. Wade.

When Laurie Bertram Roberts, cofounder of the Mississippi Reproductive Freedom Fund and executive director of the Yellowhammer Fund, found out that the Supreme Court would not block the Texas law at 1 a.m. Thursday, she threw her phone in disgust.

"It's not a matter of whether that could be the end of Roe; it would be the end of Roe," Roberts said. "What's going on in Texas and Mississippi is that they are showing their hands. It's a clear tell as to where the end game is."

Roberts and others are also worried about a Supreme Court case coming up this fall, focused on a Mississippi law that would ban nearly all abortions after 15 weeks. If the court's conservative majority permits the law to stand, it could deal a major blow to abortion rights, potentially overturning the precedent set in Roe v. Wade.

Many states, including Texas, have passed "trigger bills," which would almost immediately outlaw all abortions within their borders if Roe is overturned. One of them is Louisiana, which is expected to see even more Texas patients make the hours-long drive for abortion care.

At Hope Medical Group for Women in Shreveport, La., one of three abortion clinics in the state, about 1 in 5 patients that visit the provider each year are from Texas, said Kathaleen Pittman, the clinic's administrator. The state saw about 8,000 patients in 2020, she said. Pittman played an active role in a Supreme Court decision last year that saw the court strike down a Louisiana law that placed strict restrictions on abortion providers.

But the Texas law was different for Pittman, who said she hasn't had "a decent night's sleep" since May, when Gov. Greg Abbott, R, signed the law that took effect at midnight Wednesday. When she found out about the ruling, she said she uttered things that could not be printed in The Post in what she called "a moment of disbelief."

"This Texas law is so bizarre and so at odds with everything in place over the last 50 years that I surely thought the Supreme Court would want to know more about it. I was wrong," Pittman said. "I thought it couldn't get any worse. I woke up the next day and it was worse."

» READ MORE: Biden blasts Supreme Court’s failure to block Texas abortion ban

Stories of combativeness between officials and abortion providers have played out throughout the South. Shortly after moving to the state to be a physician at West Alabama Women's Center, Leah Torres had her temporary medical license mistakenly revoked by the Alabama State Board of Medical Examiners after it claimed she provided fraudulent answers on her application. Torres eventually earned her permanent license, but not after incurring $115,000 in legal fees to fight the state.

In Alabama, which has a state-mandated 48-hour waiting period before someone can receive an abortion, Gov. Kay Ivey, R, recently added her name to a list of Republican governors asking for the Supreme Court to overturn Roe. Torres, who works at a clinic that sees between 2,000 to 3,000 patients annually, told The Post she hoped abortion providers in Alabama and across the region would not be "intimidated out of medicine" because of the Texas law.

"What's happening now in Texas is parallel of what happened to me, but is instead sanctioned by law and encouraged by the culture," she said. "People will suffer because of what's happening. People will be hurt."

Abortion politics have played an active role in Georgia, where Gov. Brian Kemp, a Republican, in 2019 signed a "fetal heartbeat" bill into law, a measure that banned the procedure as early as six weeks, before many women know they are pregnant. The bill was blocked by the courts, thanks in part to providers like Kwajelyn Jackson, executive director of the Feminist Women's Health Center in Atlanta. The clinic sees about 4,500 patients a year for women's services that include abortions, and regularly takes in patients unable to get care from other states.

While the number of patients spilling over into Georgia and other Southern states might increase, Jackson emphasized that clinics have been stressed by taking on out-of-state patients. She said her focus is not just on those who need immediate abortion care but who needs the immediate care the most. Jackson noted she wasn't surprised by the Supreme Court's inaction given what she said was a history of "so frequently falling short" for people of color.

“For Black folks, for Latinx folks, for people dealing with all the other structural issues preventing them from living the lives that they want — these are the folks going to get hit the hardest by this Texas law,” Jackson said. “They are thus to have to deal with the consequences of unwanted, unplanned pregnancies that might cause them harm in other ways.”

Over in Tennessee, Jennifer Pepper is "quite terrified" of what Republicans in the state could do in potentially copying the Texas law and restricting access to abortions for women. Pepper, executive director of Choices, an abortion provider and women's reproductive health center in Memphis, pointed to how Tennessee Gov. Bill Lee, R, also signed a six-week "heartbeat" bill into law last year that was blocked by the courts.

The clinic, which performed nearly 2,400 abortion procedures last year, was founded in 1974, shortly after Roe. Pepper said there was a heightened sense of anxiousness among the provider's 43 employees and the patients who have come in this week. When she rolled out of bed after hearing the news, Pepper tried to wipe away the "profound sadness" that had overwhelmed her.

"Having to manage these great disappointments while also remaining determined in the mission to provide health care can be stressful," she said. "People get into this work because they want to help people, so not being able to do that for people you know who need it is heartbreaking."

Although some providers think the Texas law has the potential to replicate itself in Republican-led legislatures across the South, they echo one thing they can control: They still have a job to do. And it just potentially got a lot harder.

“It’s going to be a long day,” Pepper said.