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What happens next for abortion law in Texas

The Texas Tribune has been covering the fight over abortion rights for years. Here’s what you need to know about the ruling and how it will affect Texans.

By Texas Tribune Staff

Friday's  decision by the U.S. Supreme Court that there’s no constitutional right to abortion will radically change the reproductive health landscape in Texas.

The state's Republican leadership has long sought to ban abortions, but Roe v. Wade has kept lawmakers from doing so. With that 49-year-old case now overturned, a trigger law will go into effect in 30 days that bans all abortions from the moment of fertilization, except in rare cases to save the life of a pregnant patient or prevent “substantial impairment of major bodily function.”

The Texas Tribune has been covering the fight over abortion rights for years. Here’s what you need to know about the ruling and how it will affect Texans:

Here's what you need to know

The overturning of Roe v. Wade will virtually eliminate abortion access in Texas.

Last year,  the Legislature passed a so-called “trigger law” that would go into effect 30 days after the Supreme Court overturns Roe v. Wade, making performing abortion a felony.

The law would make an exception only to save the life of the pregnant patient or if they risk “substantial impairment of major bodily function.” Doctors could face life in prison and fines up to $100,000 if they perform abortions in violation of the law. People who had abortions would not be prosecuted under the law.

Tens of thousands of people got abortions in Texas each year

Around 50,000 to 55,000 Texans obtained abortions each year from 2014-21. Before that, more than 60,000 abortions were obtained yearly. These totals account only for abortions performed legally in Texas and don’t include people who went out of state or obtained abortion-inducing medication without a prescription.

Some big-city district attorneys say they will not prosecute abortion doctors

The end of Roe v. Wade could turn district attorneys’ offices into the next abortion battlegrounds. Five Texas district attorneys — from Dallas, Travis, Bexar, Nueces and Fort Bend counties — have publicly promised that they will not pursue abortion-related criminal charges if Roe v. Wade is overturned. Others are expected to quietly decline to take these cases.

In other jurisdictions, though, district attorneys may take an opposite approach, either due to personal anti-abortion leanings or political pressure. Earlier this year,  a woman in Starr County was charged with murder after a “self-induced abortion.” Advocates worry other cases could pop up, even though the trigger law prohibits prosecution of the person who got the abortion. And a state representative has promised to author a bill that would allow district attorneys to prosecute cases outside their counties.

A law passed last year already significantly cut access to abortion in Texas

Last year, the Texas Legislature passed a law, Senate Bill 8, that banned the procedure at around the sixth week of pregnancy. The law used a unique enforcement mechanism that relied on private citizens to enforce it, since Roe v. Wade was still in effect when it passed.

When the law went into effect,  abortions plummeted by half.

Some women’s health care providers worry that an abortion ban will hurt maternal care

New state abortion restrictions, including Senate Bill 8,  have made pregnancy care more challenging than ever, providers say. They worry that a total ban will make it worse.

Advocates and experts also warn  that the state isn’t prepared to support an increase in need for low-income mothers and children. Pregnant women in Texas are more likely to be uninsured and less likely to seek early prenatal care than the rest of the country. They’ll give birth in one of the worst states for maternal mortality and morbidity. Teens are  already more likely to give birth more than once here than in any other state. And low-income new parents will be kicked off of Medicaid sooner than in many other states.

“When you say ‘social safety net’ in Texas, it sounds like a joke,” said D’Andra Willis of the Afiya Center, a North Texas reproductive justice group. “Everything they could have set up or increased to protect people if they really cared, they’re not doing it here.”

Texans have been at the forefront of the anti-abortion movement

Texas organizations have played an  outsized role in bringing the national anti-abortion movement to this critical juncture — but the old guard and new leaders do not always agree on methods.

Some Texans have already begun traveling to Mexico to obtain abortion drugs

Cheap regulated and unregulated medication is available over the counter at Mexican pharmacies, just a short walk away on the other side of the border. Rio Grande Valley residents and people from all corners of the state often cross into Mexico to get dental work or stock up on anything from daily vitamins and epinephrine to Valium and Xanax.

And then there’s misoprostol, a medication taken orally to prevent stomach ulcers — or terminate pregnancies.

Texas regulates abortion-inducing drugs like misoprostol more strictly than federal regulations require; they can be prescribed and dispensed only in-person by a doctor through the first seven weeks of pregnancy.

Just over the border, though, it’s a different story.

With the constitutional protection for abortion on the line in the U.S., reproductive rights  advocates expect to see more Texans traveling to Mexico to get abortion-inducing drugs they can’t obtain legally at home. The Tribune spoke  with one person who did earlier this year.