It’s been one year since the Supreme Court issued its landmark decision in Whole Woman’s Health v. Hellerstedt, the case that ruled that the severe restrictions on abortion that Texas had established under House Bill 2 in 2013 were unconstitutional.

In a 5-3 vote, the Court announced that clinics didn’t need to have admitting privileges at nearby hospitals or be outfitted like ORs in order to administer a medical procedure that’s widely considered to be safer than a colonoscopy. Justice Ruth Bader Ginsburg took special issue with the claim that Texas had passed such limitations for women’s sake, insisting in her opinion that it was “beyond rational belief” that lawmakers had written HB2 in the name of women’s health.

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But here we are: 52 weeks, one presidential election, and what feels like a million new indignities for women to suffer later, the debate over a legal medical practice rages on; not only in Texas, but nationwide. And despite the decisive win for healthcare providers the Court delivered, those who seek to undermine women’s access to care have only ramped up their efforts. The past 12 months have witnessed over 400 newly vindictive proposed and passed reproductive healthcare restrictions in Arkansas, Missouri, Indiana, West Virginia, Mississippi, and, of course, Texas, among others.

365 days after the Whole Woman’s Health decision, RBG and her fans would likely be unsurprised to find that Texas has mostly abandoned “women’s health” as a pretense for its most draconian policies. Instead, the state has pursued strategies that seem to discount women’s existence entirely, sometimes to the point of putting their lives at risk. “They’re flying in the face of the Supreme Court [decision],” says Heather Busby, executive director of NARAL Pro-Choice Texas. “And I think [Texas lawmakers] are emboldened by Trump getting elected and what that will mean for the Supreme Court, if he does have a chance to appoint a justice and shift the balance on the bench. It really does prove that our rights are more threatened now than ever before.”

Busby contextualizes these moves within Texas’ already inadequate healthcare system, particularly for women, and for black women most of all. Over the past two years, maternal mortality rates in the state have doubled, now the highest in the developed world. Busby estimates that around 50 percent of women are unable to access reproductive healthcare during their first trimester, putting them and their babies in danger.

Here, a rundown on what’s happened to reproductive healthcare in Texas since Whole Woman’s Health.

July 2017

Gov. Greg Abbott will convene a special session in July to allow state lawmakers to finish up some final orders of business beyond their usual 140-day session, including reaching a compromise on a bill that would prevent the closure of the critical state service providers and, of course, pushing for more abortion restrictions.

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June 2017

Abbot signs into law Senate Bill 8 (SB 8), a new and sweeping anti-choice bill set to go into effect in September 2017.

The law, which the Center for Reproductive Rights has vowed to take to court, will restrict access to the procedure on multiple fronts and potentially punish women and physicians for seeking. It will:

  • Ban what it deems “dismemberment abortions”—the term with which anti-choice protestors have branded abortions performed via the dilation and evacuation method, most common (and perfectly safe) in second-trimester abortions. Only 11 percent of abortions nationwide take place after the first trimester, but, of those, the Guttmacher Institute estimates that 95 percent are done via dilation and evacuation, which ostensibly means abortion will be illegal in Texas after 13 weeks, a point at which some women don’t even know they’re pregnant.
  • Ban “partial birth” abortions, which doesn’t make a lot of sense as the Supreme Court already banned them over 10 years ago.
  • Reserve the right to bring criminal charges against not only physicians, but also anyone who helps a woman get any abortion that’s now illegal under SB 8. Everyone from a clinic receptionist to the friend who drove her to the appointment could face a felony charge and up to two years in prison.
  • Ban fetal tissue donation, which women can currently choose to donate to scientific research. “By banning fetal tissue donation just for women who have had abortions—and not other patients—the state is singling out those women to shame them and send a clear message that the state does not approve of their decision to have an abortion,” said the Center for Reproductive Rights in a press release. FYI: Fetal tissue has helped develop vaccines for diseases like Ebola and drugs to combat HIV/AIDs.
  • And, drumroll, require that women have funerals for their aborted fetuses. The law stipulates that abortion providers must dispose of fetal tissue remains by cremating, burying or “entomb[ing]” them. And because the bill is equal-opportunity terrible, hospitals will be forced to cremate or bury miscarried fetuses, too. Now, Texas has tried this nonsense before, and in January, a federal court ruled that the state’s fetal burial regulation was unduly burdensome, imprecise, and violated the 14th Amendment to boot! Texas couldn’t enact it. So, instead, they’ve passed this new, basically identical provision. Makes sense. Just kidding; it doesn’t at all. Presumably, this measure, specifically, is headed for its own special day in court.

Plus, in the midst of all this, the state toys with testing out a new Trump administration rule that will allow Texas to receive federal Medicaid funds for a women’s health initiative expressly created to exclude Planned Parenthood. Technically, that’s against federal law, but Trump has attempted to skirt it by rolling back a rule that the Obama administration instituted before he left office that banned state and municipal governments from blocking federal money from healthcare providers that offer family-planning and healthcare-related services.

May 2017

Before the Supreme Court could overturn HB2 in Texas, the law successfully reduced the number of clinics in Texas from 40 to 19. At the end of April, Whole Woman’s Health reopened one of them, its Austin clinic. It’s only the second clinic to reopen since the Whole Woman’s Health decision, which means that Texas is still missing around half of the clinics it once had.

“Right now, [women] don’t make it important to be personally responsible because they know that they have a backup of ‘Oh, I can just go get an abortion.'”

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