How Texas’ restrictive abortion law puts pressure on clinics in Western states

Patients are turning to places like New Mexico and Colorado for care.


Protesters gathered outside the Texas State Capitol to oppose a new bill that effectively bans nearly all abortions.“If Roe is gutted, there are 26 states that will very quickly start going dark for abortion care. There are 25 million potential patients who live in those 26 states who will not be able to access abortion care in their home state,” Vicki Cowart, president and CEO of Planned Parenthood of the Rocky Mountains said.
Sergio Flores/The Washington Post via Getty Images

Vicki Cowart’s life was very different prior to 2003, when she became the president and CEO of Planned Parenthood of the Rocky Mountains. A geophysicist and scientist, she worked in the oil and gas industry and served as the Colorado state geologist for a decade. In a recent phone interview, she said, “There is something about being in a heavily male dominated field that radicalized me.” As a result, she spent increasing amounts of her spare time advocating for women’s issues and reproductive rights. “I was so aware that a woman’s ability to engage fully in society depended on her ability to choose whether or when to have children.”

For nearly two decades now, she’s worked at Planned Parenthood of the Rocky Mountains, which operates clinics in New Mexico, Colorado, Nevada and Wyoming, and watched as lawmakers attacked access to reproductive health and legal abortion across the country.

The onslaught of anti-abortion legislation has only increased in recent years, culminating in a near-ban in Texas that was implemented Sept. 1. The U.S. Supreme Court refused to block the bill, which gives private citizens the right to sue anyone who helps a woman attempt to get an abortion after “cardiac activity” is detected, which happens at around six weeks of pregnancy. That “anyone” includes doctors, friends, family members — even Uber drivers.

High Country News spoke with Cowart, who is based in Denver, Colorado, about how this new law will affect New Mexico and other Southwestern states where Texas residents are increasingly seeking care.

This conversation has been edited for length and clarity

High Country News: How has the abortion ban impacted the clinics that you operate?

Vicki Cowart: I think we might make the analogy to a flood: We’re seeing the early stages of a flood, and the water is rising. And it’s rising a little bit more every day and every week. We’ve always seen a handful of patients from Texas; we see patients from almost every state in the country and particularly those that are adjacent or near us — “near” being a relative term for the West. We’ve always seen folks coming from Arizona, Utah, Idaho — places where it’s difficult to access an abortion. Consequently, there may not be very many abortion providers in those states, so they turn to places where abortion access is easier.

A day before the law went into effect, we got calls from Texas patients beginning to come, and so that was the first rise of the water. And it’s continued to go up and up; it’s going to get worse before it gets better.

HCN: What barriers does this ban pose for people who don’t have the means to travel across state lines?

VC: As hard as it is for a patient to make a decision to fly or take days off and drive, it’s impossible for some people. If you don’t have a working car, what are you going to do? If you don't have any days off from your job, what are you going to do? If you’re a single mom, with two or three kids, what are you going to do? You’ve got to have resources, you’ve got to have gas money, you’ve got to have a working car, you’ve got to have the time. I mean, it’s a big long list of worries. And so this law is so cruel and inhumane for everybody, but particularly for people who are struggling the most in our society. If you think about COVID and what people have been through in the last almost-two years, it’s really terrible to contemplate.

Vicki Cowart, President and CEO of Planned Parenthood of the Rocky Mountains, pictured at a 2016 event. Coward has served in the role for nearly two decades.
Jennifer Graylock/WireImage

HCN: You mentioned that this is going to get worse before it gets better in terms of seeing more people having to travel out of state. How are you preparing for that? What are the challenges for your organization?

VC: We have patients here, and our system is built for the patients that we see in our states, with a little bit extra from other places. Currently, about 10% of our patients come from other places. This is going to be more than that. If a bunch of Texas patients come in and fill the slots for our Albuquerque center, then the woman who figures out that she’s pregnant in Albuquerque calls in and is like, “Oh, there are no appointments for three weeks. All right, I’ll go to Santa Fe. Oh, Santa Fe’s full, OK, I’ll drive to Durango, Colorado.” So it just goes outward, right?

And what are we doing about it? Well, it is a tough time to be in the health-care business. Health-care folks have just worked their tails off in the last 18 months (during the pandemic). There’s a lot of stress providing health care through a mask to folks, and our people are tired. I know, personally, that everybody’s doing their darndest to be there for all the patients. When a patient comes in, they are a patient — it doesn’t matter where they come from. But the reality is there are still only so many hours in the day, and we still only have so many people working. We are hiring as much as we can, but that’s not instantaneous. You have to train people.

The biggest thing that we’ve done, though, is in the last year we’ve moved a lot of our services to telehealth. If we can see someone remotely and then overnight their pills to them or overnight their STI (Sexually Transmitted Infection) tests, we will do that as much as possible. We want to accommodate patients, and if they want to come in, we will see them. If they are willing to do telehealth, we’ll do that.

“This law is so cruel and inhumane for everybody, but particularly for people who are struggling the most in our society.”

HCN: There has been a lot of attention on this near-ban on abortion in Texas. Are any Western states moving to limit or ban abortion access?

VC: First of all, 600 laws were introduced this last year to restrict or ban abortion, and about 100 of them passed. It’s been an all-out war against abortion and against access to reproductive rights. Idaho, Utah and Wyoming have passed a thing or two; those are the ones in the West that are the most problematic. Arizona, I expect, would do something foolish.

HCN: Going forward, what does it mean for places like New Mexico or Colorado, states that have wider access to abortion, if more states around them begin to restrict access?

VC: If Roe is gutted, there are 26 states that will very quickly start going dark for abortion care. There are 25 million potential patients who live in those 26 states who will not be able to access abortion care in their home state, and many of them already have few providers. The abortion-provider community has been watching this and getting ready for it and doing a lot of collaborative work to build up our capabilities. 

HCN: Having worked in reproductive rights for so long, could you put this current legislative environment around abortion access in context? 

VC: It’s really gotten bad since the 2016 election, because a lot of signals have been sent, not the least of which are three openly anti-abortion Supreme Court justices appointed during the Trump presidency. That has made a whole bunch of people who want abortion to be illegal for everybody pretty energized and excited. 

It’s not just the “red states” where this takes place. It’s in every state. In Colorado, we see these same anti-abortion laws introduced into the Colorado Legislature. But right now, we have a Legislature and a governor who believed in abortion access, and so they turn these laws down.

Jessica Kutz is an assistant editor for High Country News. We welcome reader letters. Email her at [email protected] or submit a letter to the editor. See our letters to the editor policy.

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