We can’t discuss a patients’ care with their loved ones, but now complete strangers are supposed to get involved? 

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I’m an Ob-Gyn, and Texas’ Anti-Abortion Law Is Even More Nonsensical Than You Think
Credit: Adene Sanchez/Getty Images

On Wednesday evening, the Supreme Court declined to hear a case to block an illegal abortion ban from taking immediate effect in Texas. But their actions did a lot more than effectively ban abortion — they created an entirely new way of even thinking about abortion.

Anyone needing, providing, or even talking to someone about abortion in Texas is at risk of absolute financial and mental health ruin — and people are terrified. How do I know this? Because the handful of doctors providing that care in Texas and the army of activists who fought this ban nationwide are my close friends.

As an ob-gyn specialist in family planning, I hear the closed door conversations from these people, and it's terrifying. On the surface, this seems like just another of the hundreds of illegal and medically unfounded bans that anti-choice legislators have incessantly pushed over the last decade. Upon closer look, however, this law is unbelievable.

In addition to banning abortion after six weeks of pregnancy (before many people even realize they are pregnant), the Texas law encourages anyone — including anti-abortion activists — to enforce the state's ban by suing abortion providers and anyone who helps a person obtain an abortion. In other words, it actively enlists bounty hunters. 

Uniquely ironic here is the fact that in all aspects of healthcare, there exists a privacy standard called HIPAA (the Health Insurance Portability and Accountability Act of 1996) which prevents anyone involved in your medical care from discussing identifying information with anyone outside of your medical care. When Joe-Anti-Abortion-Extremist and his posse of HIPAA-violating trolls decide to report you for seeking medical care, are they not breaking the law themselves? How on earth would complete strangers be privy to any of the personal medical information required (patient's name, date of medical service, medical services received) to file these reports?

In just the day following this ruling, websites (which I will not link to here) have popped up around social media with fill-in forms asking for any and every suspected act of abortion assistance. If, for example, someone  suspects you of driving your friend to the clinic to get an abortion, they can turn you into authorities. They can then sue you for up to $10,000, plus the cost of legal fees (obtaining and hiring a lawyer to defend your case and represent you in court). If you ignore the suit, the case is automatically awarded to the person who filed the claim and you must pay them $10,000 plus the cost of their legal fees. 

For the doctors providing abortion care in Texas, the law has trigged immense stress. This is why you aren't hearing from them directly as much. Not only are they terrified of being hunted, they're not doing so great emotionally. They were, up until 11:56pm Texas time on Tuesday night, scrambling to provide compassionate care for every single patient they could before time ran out. They're exhausted from months of not only working long hours in a clinic but also fighting with politicians who had no interest in addressing their constituents' pleas to halt the law. 

Imagine now what their distress looks like in the midst of the pandemic, providing care in a state that refuses to employ mask and vaccine mandates, and where healthcare providers on the frontlines have faced a recent surge in physical and verbal attacks. This law is intentionally designed to intimidate emotionally and physically depleted essential workers. And then, because they're too burnt out and broken down to fight as hard as they'd want to, prevent people from accessing care.

Remember that the worst case scenario for someone who provides, assists in, or even recommends abortion is not that one vigilante would sue them for $10,000 plus legal fees, but that tens of thousands of vigilantes all over the country would simultaneously (through these new websites) sue them for $10,000 plus legal fees. Anyone who is imagined to have taken any part in securing an abortion after six weeks in Texas could face financial ruin, or worse. I don't know how anyone has the financial security or mental strength to continue working under those impossible conditions — and that's exactly the point of this unconstitutional ban. 

In chatting with friends over the last few days, this is what gives me a silver lining of hope: There are a handful of organizations raising funds for people in Texas who need abortions right now and for people who will inevitably need abortions in the future. The law makes it illegal for these funds to assist people in obtaining abortions in Texas, but not to travel out of state to do so elsewhere. 

Texans who have the resources and support to travel outside the state to seek abortion care will likely make ends meet, but remember that due to decades of racist economic policies, the poverty rate for Black and Latinx women in Texas is disproportionately high, meaning they will be most impacted by this ban. Requiring them to navigate a range of financial and logistical barriers, such as taking time off work, arranging for childcare, and finding transportation, will push abortion care out of reach for many people. It already has over the decades that this has been the GOP's exact strategy to undo abortion access. Now, they're going after providers to really make this type of health care cease to exist. 

As a physician who provides abortion care, I see first-hand how politically motivated restrictions on abortion hurt people and families. Every person should be able to make their own decisions about their health and their bodies — including about abortion, in consultation with their loved ones and health care providers. No one should have their most personal medical decisions controlled by politicians, much less neighbors or complete strangers who are harming them just to make a buck.