What does abortion in Texas really look like after Roe?

We recently celebrated one year since Roe v. Wade was overturned and one year of all preborn children being protected from elective abortion from the moment of fertilization in Texas. Every abortion facility in the Lone Star State has shut its doors or has erased abortion from its offerings. Taken alone, the data from the Department of Health and Human Services (HHS) indicates that abortion in Texas has dropped from over 160 every single day before the Texas Heartbeat Act to just a few medically-necessary abortions per month since Dobbs

However, even though abortion has certainly taken a nosedive in Texas, this is not the full picture. We do not want to deny that some women are traveling out of state for abortion, and some are ordering pills online from both foreign and national distributors. This is why House Bill 2690 by Representative Steve Toth (R–The Woodlands) was a Pro-Life Priority Bill during the Regular Session of the 88th Legislature. This bill would have targeted internet service providers that furnish these illegal abortion pill distribution websites. While this bill did not advance at the time, we plan to continue pushing for laws that target these websites during future sessions.

Claims about how many abortions are actually prevented by Pro-Life laws vary wildly. Some say that the numbers are exactly as HHS reports. Others claim that abortion has not decreased significantly due to the Texas Heartbeat Act and Trigger Law, if at all. The latter are unfounded, almost entirely speculative, and are sourced from old data and faulty assumptions.

So how effective are Texas Pro-Life laws in reality, and what is the best way to determine this effectiveness? Let’s examine the available data.

Abortion Pills Ordered Online

The largest source of ongoing illegal abortion in Texas is from abortion pills ordered online and shipped into the state. The main distributor of online abortion pills is Aid Access, the second is Las Libres, and a few dozen others together make up a small portion of the shipments of abortion pills.

Those who claim that abortion is occurring at the same rate in Texas now as before the Texas Heartbeat Act cite a November 2022 study conducted by insiders of Aid Access. The study shows how requests for abortion pills increased in the two months following the Dobbs decision. In these two months, there were just over 5 requests per week per 100,000 women in Texas, which amounts to 336 requests per week.

The study never claims that every request was fulfilled, or that the pills were actually taken for every fulfilled request. The claim that abortions are still happening at the same rate in our state rests on both of these assumptions. The main purpose of this study, however, was simply to demonstrate that requests increased in states where abortion bans were instituted and that the bans were listed as a main reason for many of the requests. 

An article from The New York Times indicates that Aid Access fields 46% of abortion pill requests nationwide, Las Libres takes 35%, and the other 19% is made up by other sellers. But this split is nationwide, not just for Texas. Again, it is only requests, not shipments. Also, not all of the sellers are seeing the consistent uptick that Aid Access is seeing. Requests to Las Libres dropped by half between December 2022 and March 2023. 

Overall, we cannot equate the number of requests for abortion pills to the number of self-administered abortions actually happening in the state. These numbers and studies give us an idea that some chemical abortions are taking place, though the estimate is impossible to even approximate. This is why the Pro-Life movement cannot ignore this innovative and destructive new attack on life.

Texans obtaining out-of-state abortions

The data we have on out-of-state abortions are even less clear. The only formal study was conducted in March 2022, covering the four months after the Texas Heartbeat Act. The report says that an average of 1,391 Texans per month obtained abortions at out-of-state facilities in Arkansas, Colorado, Kansas, Louisiana, Mississippi, New Mexico, and Oklahoma.

This study covers data that are over a year old and does not cover any time following Dobbs and the Trigger Law taking effect. Those who overestimate the number of Texas women still getting abortions out of state extrapolate the data to post-Dobbs, assuming the numbers are staying the same. This would mean that tens of thousands of women are leaving Texas and that is having no effect on other states.

There are many reasons that this is an absurd leap in logic. We know that abortion clinics in other states reported being overwhelmed by Texas women following the Texas Heartbeat Act, so much so that they were seeing fewer residents of their own state. It is faulty to assume that these same states that supposedly could not handle the women denied abortions by the Texas Heartbeat Act would be able to handle those denied abortions post-Dobbs.

In April, a pro-abortion group called The Society for Family Planning released a report covering nationwide abortion numbers in the six months following the Dobbs decision. This report shows 32,260 fewer abortions in the nation since Dobbs. This is likely an underestimate of the number of lives saved by Pro-Life laws, as it does not account for the decrease caused by the Texas Heartbeat Act or Oklahoma abortion ban before the decision, nor does it account for the continuing rise of abortion in pro-abortion states before Dobbs

If around 60% of the women denied abortion in Texas and its bordering Pro-Life states just went elsewhere for abortion, as some posit, this would show up on national reports of legally performed abortions in other states. But it doesn’t.

Increase of births in Texas

As illustrated, we have no way to reliably estimate the number of illegal abortions that continue to occur in Texas. But we do have another method of determining the effectiveness of Pro-Life laws. Those pregnancies that do not end by abortion or by miscarriage must end by live birth. If our Pro-Life laws did not work, then we should see the live birth rate as normally predicted. But if in fact the Pro-Life laws are working, then there should be more births.

With the birth data we currently have (through 2022), we can examine the effects of the Texas Heartbeat Act, but it won’t tell us much about Dobbs. This is because Dobbs was decided in late June 2022. In Texas, the only legal abortions happening at this time were at around 6 weeks’ gestation or before. So, the babies who would have been vulnerable to abortion under Heartbeat but were protected by Dobbs wouldn’t start being born until around February 2023. 

A study released on June 29, 2023 predicted that there were around 10,000 more births than expected in 2022 for the months that babies saved by the Texas Heartbeat Act would be born. However, this analysis does not necessarily equate to 10,000 fewer abortions or 10,000 children born, due to some of the circumstances described above.

It is true that birth data fluctuates greatly, and so critics may attempt to explain away the increase as normal variance. However, while birth rates fluctuate semi-regularly, the jump in births between 2021 (373,594 births) and 2022 (389,533 births) was the largest positive percent change that Texas has seen in the last 20 years.

Raw birth numbers could be explained by an increase or decrease of the fertile population. This is why fertility rate, defined as the number of births per 1,000 women aged 15-44, is even more helpful. Each year, the fertility rate has decreased by an average of 2 percent, from 79.2 births per 1,000 fertile women in 2007 to just 60.7 in 2021. But in 2022, the fertility rate saw about a 3 percent increase, a very sharp reversal from the trend. This means that there were certainly more children born than expected.

Clearly, our Pro-Life laws are working and they are saving lives. But we do not want to deny that there are still some gaps. 

In the first legislative session after the reversal of Roe, it was a priority for Texas Right to Life to hold prosecutors to account when they place political ideology over enforcing the law and protecting preborn children. If we let this problem persist for too long, it will become the status quo. 

There are some who would suggest that the best way to fix this problem is to increase criminal penalties, particularly for the mothers. As it stands, this would not solve the root problem we are currently seeing with enforcement of Pro-Life law. Prosecutors who are unwilling to do their jobs by enforcing the already-strong laws we currently have are unlikely to switch course, to say the least.

We made only a little progress on this issue during the Regular Session of the 88th Texas Legislature, so there is still more to do. It is indeed important to remove those officials who are either actively flouting our laws or promising to do so. However, removal alone would be like cutting the head off a Hydra — two more equally dangerous heads will grow back in its place. This is why we need a mechanism to circumvent these negligent prosecutors. 
There is still time for unfinished life-saving items to be added to an upcoming Special Session call. Please join us in urging Governor Abbott to add these crucial priorities to the call by clicking HERE. Texas has made great strides in protecting preborn children, but our work is not yet finished. While there is still more work to do, Texans can be proud of the thousands of preborn children we are saving through our strong Pro-Life laws. The laws we have in place are not in vain – they are effectively stopping abortions and saving lives.