Navigating a new reality

Navigating a New Reality

As state lawmakers continue their assault on abortion access in Texas, a growing group of activists isn't ready to give up the fight.

At 17 years old, Lenzi Sheible was kicked out of her home in Houston. She lived on friends’ couches before moving in with her boyfriend; neither of them had much money. She had one year of high school left before she would move to Austin for college and a fresh start. Then came the pregnancy scare. Sheible remembers two weeks of uncertainty and dread. She wasn’t actually pregnant, but she said that if she had been, and hadn’t had the option of an abortion, she probably wouldn’t have gone to college and would’ve had a child she wasn’t ready for. “An unexpected pregnancy would have derailed me,” she said four years later.

Sheible brought her story to the Capitol in 2013, when she testified before a legislative committee as lawmakers spent weeks debating a bill that eventually forced more than half of the abortion clinics in Texas to close. She was still a student at the University of Texas, but the hours of debate, filibuster, and stories of women struggling to get an abortion spurred her to act. In November 2013, as the law took effect and the first handful of clinics closed, she founded Fund Texas Choice, an organization that raises money to pay for bus tickets, flights and hotel stays for women who can’t afford the trip to another city or state for their procedure.

“At any point in my life, I could have been someone calling my own hotline,” said Sheible, now a 21-year-old mother and law student. “I think that because these laws are directed at me, as someone who doesn’t have a lot of money, who doesn’t have a lot of family support, who doesn’t have a lot of resources, that I am the intended recipient of this legislation. The people who call our hotline are so familiar to me.”

Fund Texas Choice is part of a growing network of volunteer-led organizations that has coalesced in recent years as access to abortion services in Texas erodes. The network fits no mold. Some volunteers are in their 20s. Some are in their 30s. Some are self-described “gray-haired feminists.” Some are in college. Some have just graduated and are working their first jobs. Some are working in reproductive health organizations; others are new to the movement. Most are women, but there also are young men who see this work as their way to fight for equality and justice. Some groups are more structured; others are more loosely organized and new on the scene.

Natalie St. Clair
Natalie St. Clair

There’s no official affiliation, but they work in tandem, each filling a specific need women may face as they navigate the cumbersome barriers to abortion access in Texas. They answer phones. They give rides. They raise money to pay for bus tickets. They help pay for abortions when women can’t afford them. They’re also a source of support, comfort and information.

The 2013 legislation requires doctors who perform abortions to have admitting privileges at nearby hospitals. It places new structural demands on abortion clinics, bans abortion after 20 weeks of pregnancy and complicates the use of the medical abortion pill. Its chief architect, state Rep. Jodie Laubenberg (R-Parker) argued during legislative debate that it was designed to “protect the health and safety of women.” Meanwhile, groups such as the American College of Obstetricians and Gynecologists and the American Medical Association deemed the law unnecessary. After it passed, physicians who performed abortion services were denied admitting privileges by faith-based hospitals, and the costs to upgrade clinics to surgical-center standards proved to be prohibitive. Since then, 23 of 41 abortion clinics in Texas have shuttered, and only seven of Texas’ 254 counties have an abortion provider.

Meanwhile, a coalition of abortion providers is challenging the law in court. They claim its restrictions place an “undue burden” on Texas women, but they face an uphill battle. The U.S. 5th Circuit Court of Appeals, which is hearing the case, repeatedly has ruled against challenges to Texas’ abortion restrictions. Should the court do so again, Texas will have fewer than 10 clinics, all clustered in five urban counties, to serve more than 5 million women of reproductive age (15 to 44). Researchers at the University of Texas at Austin estimate that at least 1 million Texas women would live more than 100 miles from an abortion provider if the courts uphold the entire law and the clinics close. Many of these women also struggle to afford basic necessities, including housing, food and childcare. Shouldering the cost of an abortion plus filling up the gas tank or buying a round-trip plane or bus ticket to get to another city may be out of the question.

That’s where Fund Texas Choice comes in. From November 2013 to March, the group had paid for and planned 158 trips for women, more than 100 of whom traveled long stretches of Texas highway—sometimes hundreds of miles—to cities with open clinics. The rest went to other states. The organization can afford to pay up to $5,000 in transportation and accommodation costs per month. A trip for one woman can range from $35 by bus to $1,000 by plane.

Natalie St. Clair, a 22-year-old college graduate and the group’s sole employee, returns hotline calls and plans trips at her home office in Austin. On a recent afternoon, St. Clair settled down at her desk, iPhone ready and MacBook computer screen lit up by a colorful Excel spreadsheet. She’s planning trips for two women—one from Lubbock and another from Houston—to Albuquerque, New Mexico. The caller from Houston is more than 20 weeks into her pregnancy, so under the 2013 law a legal abortion in Texas isn’t an option. The caller from Lubbock, also more than 20 weeks along, will have to go to Albuquerque anyway because it’s the closest clinic to her hometown since the Planned Parenthood facility there closed.

“Sometimes, I have the urge to just say, ‘I’ll drive you,’” St. Clair says after a phone call to a hotel in New Mexico. “When we’re planning trips so fast, everything translates into urgency.”

But even if St. Clair could drive every patient, transportation is where Fund Texas Choice’s job ends. Women need other help once they get to the clinic. An abortion in Texas can cost from $400 to several thousand dollars, depending on how far into her pregnancy a woman is. The 1976 federal Hyde Amendment bars Medicaid, the health insurance program for the poor, from covering abortions, and many poor women can’t cover the out-of-pocket cost without help.

St. Clair can’t help with the cost of the procedure, but she knows who can. When a recent caller’s life depended on securing that help, she reached for a reliable, familiar answer:

“Have you tried the Lilith Fund?”

The next evening, in his first-floor east Austin apartment, 15 miles northeat of St. Clair’s home office, Drew Stanley, a volunteer with the Lilith Fund, sits down to a list of names and phone numbers of women who have left messages with the organization, hoping to get some help paying for their abortions.

“Hi, this is Drew from Lilith,” he says to a caller. “How are you? I see you left us a message needing some funding. Is that correct?”

Sarah Frankie Linder
In abortion law’s wake, a patchwork of services rises.

A muffled female voice on the other end of the line confirms that yes, she did.

“OK, let’s see if we can get you some funding tonight.”

Founded in 2001 by a group of friends in their mid-20s and early 30s, the Lilith Fund has grown to include one paid hotline coordinator and 40 volunteers across Central and South Texas who work three nights a week returning phone calls from women seeking financial help. The Lilith Fund provides small stipends to women in Central and South Texas who cannot afford their abortions. The Texas Equal Access Fund does the same for North Texas women, and the small but burgeoning West Fund, which cropped up in 2013, helps El Paso women.

On this night, 23 women wait for Stanley, who works full time for NARAL Pro-Choice Texas and volunteers with the Lilith Fund, to call back. He has $1,400 to divvy up, typically in $50 to $200 increments.

Sarah, whose name has been changed to protect her privacy, has an abortion scheduled one week from the day she and Stanley speak. She’s 19 weeks pregnant, and her procedure has a price tag of $1,800. The 20-year-old from a small town southeast of Houston already has one daughter and, because she and her boyfriend are both living on her $10-an-hour income, she can’t afford another child. She’s borrowing money from family to cover part of the abortion, and she plans to use a few hundred dollars from her upcoming paycheck to cover more of it. Stanley’s callback ensured she would get $150 in extra help.“I was almost speechless, just because of how much that really does help,” Sarah told the Observer after she spoke with Stanley. “I didn’t know that there was any kind of fund like that to help me out.”

Volunteers with the Lilith Fund and the Texas Equal Access Fund have been on the other end of the phone since the early 2000s, listening to women’s frustration, confusion and pleas for help. In 2003, the Legislature passed the Woman’s Right to Know Act, which imposes a mandatory consultation and 24-hour waiting period before an abortion. A 2011 law championed by Lt. Gov. Dan Patrick when he was a state senator requires a woman to get an ultrasound 24 hours before her procedure. The clinic closures since 2013 have made wait times at the remaining clinics longer, and women have to schedule their appointments weeks in advance and further into their pregnancies, which makes the procedure more expensive.

The economic barriers to abortion tend to disproportionately impact African-American and Hispanic women. In 2014, 83 percent of the women who called the Lilith Fund’s hotline were women of color, said Susy Hemphill, president of the Lilith Fund.

As the maze has gotten tougher to navigate, the fund has increased its minimum stipend by $100. Still, with fewer places to go and escalating costs, Hemphill worries about the women who never call her hotline.

“We’re concerned about an increase in back-alley abortions, self-abortions, and deaths among women seeking abortion, and unintended pregnancies carried to term,” she said. “All those things happen when you close clinics. It’s a very dangerous situation.”

Beverly McPhall
Beverly McPhall

Nearly every week, Beverly McPail, 56, carves out time for complete strangers. The University of Houston social work professor will tidy up the inside of her gray Volkswagen Tiguan, put a bottle of water in the cup holder, fill up her gas tank, pick up a client and take her to an appointment at a Houston clinic.

McPhail is one of a dozen or so volunteers with Clinic Access Support Network, a group founded by 31-year-old math teacher Angie Hayes that offers rides for women who otherwise can’t get to their appointments. McPhail has one of the more flexible schedules of the group; others work more traditional hours as teachers, law enforcement officers and attorneys. Still, when they can, they navigate the concrete jungle of Houston to give someone a lift. The Bridge Collective does the same for women in Austin, and the Cicada Collective serves women in North Texas.

Even before the 2013 law, Hayes noticed taxi cabs dropping off patients outside the abortion clinic where she volunteers as an escort. After she spotted a Facebook post from a woman in a suburb who needed a ride into town, Hayes got creative.

“I thought, ‘OK, I’m teaching, but I know lots of people,’” she said. After texting a few friends, she found someone who could give the woman a ride. “We saw that this was a real need, so me and a few other volunteers talked and decided we should help.”

The group mostly gives rides to women who live in Houston or surrounding suburbs, but as the effects of the 2013 law play out across the state, more women reach out to Hayes—either through a clinic or another support organization—for rides from bus stations or even from nearby towns. Occasionally, Hayes will pay for someone’s bus ticket herself.

The cabin of McPhail’s small SUV is a safe haven where she listens as women tell stories of their children, their jobs and the fear they feel in telling their mothers, husbands or friends about their abortion. On a recent trip, McPhail drove a patient who was afraid to ask her mother or sister for a ride.

“It becomes a very intimate space,” McPhail said. “Women tell me about their uneasiness with their decision, and how lots of times they’re pushed economically into this and can barely afford the kids they have. A lot of them are still struggling with the feeling that other people will judge them for their choice.”

Before he left office, Gov. Rick Perry unapologetically declared that he wants to see abortion eliminated in Texas. “To be clear, my goal, and the goal of many of those joining me here today, is to make abortion, at any stage, a thing of the past,” he said at an anti-abortion rally in 2012. Gov. Greg Abbott and Lt. Gov. Dan Patrick have echoed Perry’s sentiment.

Lawmakers have filed dozens of anti-abortion bills this spring, leading abortion rights advocates to worry that things may get worse before they get better. Still, despite the hurdles, Sheible, St. Clair, Lilith Fund volunteers and Hayes and her team of drivers continue to provide seemingly simple resources that go a long way toward a woman’s ability to access an abortion in Texas.

“We fight on our own terms,” said Sheible. “Giving up is not an option. That’s why you can’t stop. After a while it gets really tiring … In the end Texans are not just going to sit here and let this happen to us.”

Alexa Garcia-Ditta is a staff writer (and former intern) covering women's health, reproductive health and health care access.

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Published at 12:59 pm CST