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Report: Nearly 2 percent of Texas women say they tried to induce abortion

The Hilltop Women's Reproductive Clinic in El Paso, where two abortion clinics in the city are expected to shut down if abortion restrictions passed in 2013 by the Texas legislature are allowed to take effect. (Juan Carlos Llorca/AP)

Poverty and lack of access to reproductive health services have led nearly 2 percent of Texas women to try to induce their own abortions using medicine, teas, vitamins and other measures, according to researchers examining the impact of abortion laws in the state.

In a report released Tuesday, the researchers say new laws that have shuttered abortion clinics and otherwise reduced access to abortion could be partially to blame for the statistic, along with easy access to the drug misoprostol, which can effectively terminate early pregnancies and is available without a prescription across the border in Mexico.

However, the primary reason women resort to self-abortion, the report said, appears to be poverty.

The report was based on a survey of 779 Texas women, ages 18 to 49, conducted over five months in 2014 and 2015; 1.7 percent reported trying to induce an abortion during their lifetime outside of a medical setting. Researchers said self-induced abortion seemed more prevalent in predominantly Latino communities along the Mexico border, and among those who reported "barriers accessing reproductive health service."

The report was accompanied by a second brief that included interviews with 18 women, who reported four primary reasons for resorting to self-abortion:

  • Inability to travel to a clinic or afford a clinic-based procedure
  • The local clinic had closed
  • A friend or relative recommended self-induction
  • Social stigma against abortion

"No single one of these reasons was sufficient for a woman to consider self-induction," the report said. "While women in our study were diverse in many ways, a common thread was that poverty layered upon one or more additional obstacles left them feeling that they had no other option."

The report was prepared by the Texas Evaluation Project, a joint project by the University of California at San Francisco, the University of Texas at Austin and several other institutions. It is a five-year effort to document and analyze the effect of measures affecting reproductive health bills in Texas.

Researchers said it is not clear how the 1.7 percent figure compares to other states. Texas has long had a high rate of poverty, particularly in the colonias along the Mexican border, and its vast geography often makes access to heath care of any kind problematic.

Abortion rights advocates, however, immediately seized on the results, arguing that a 2013 Texas law had driven women to attempt their own abortions. HB2 imposed restrictions and safety standards on abortion clinics throughout the state. Although parts of the law have been temporarily blocked by the courts, it has been blamed for the closure of some 20 clinics statewide.

Earlier this week, the U.S. Supreme Court agreed to hear challenges to the law's requirement that abortion clinics meet the hospital-like standards of ambulatory surgical centers, as well as a rule that physicians performing abortions have admitting privileges at nearby hospitals. It will be the first abortion-related matter to be considered by the court in nearly a decade.

Self-abortion in the modern era is a far cry from the illegal back-alley procedures and "coat hanger" techniques that were common in 1973, when the Supreme Court legalized abortion in the landmark Texas case Roe vs. Wade.

But it doesn't always work, and some methods still pose a danger to the woman and the developing fetus, said Daniel Grossman, a professor of obstetrics and gynecology at the University of California at San Francisco and co-investigator of the Texas Evaluation Project.

Misoprostol, for example, is safe when used properly, but can pose a danger if taken improperly, at too high a dosage or late in pregnancy, he said. It can also cause fetal malformations if the abortion is unsuccessful and the child is carried to term, he said. The herbs, vitamins and hormone pills used by others can be dangerous while also of questionable effectiveness, he said.

"It’s certainly not ideal that women are doing this on their own when they don’t want to do this on their own, and they want to access clinic-based care," Grossman said.

Correction: This article has been updated to correct the name of the co-investigator of the Texas Evaluation Project. He is Daniel Grossman, not David Grossman.