Texas healthcare leaders grapple with end of abortion services

In a short time, virtually all abortions will be outlawed in the state of Texas.

Even now, abortion access is very limited. A court ruling last week temporarily restored a state law allowing women to obtain an abortion up until six weeks of pregnancy, a time when some women aren’t aware they’re pregnant.

In about two months at most, a more restrictive law will be in effect, The Texas Tribune reports. The law will prohibit abortion in virtually all cases, except to save the life of the mother or to prevent a serious health complication.

Healthcare organizations, in Texas and around the country, largely denounced the U.S. Supreme Court ruling that found there’s no constitutional right to an abortion.

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Gary Floyd, president of the Texas Medical Association, spoke out against the ruling when it was issued.

In a phone interview with Chief Healthcare Executive last week, Floyd said, “We don’t need the government or third parties in our exam rooms.”

Floyd said the association is still working to analyze the impact of the law and what physicians can do. “We’re going to help our doctors try to take care of their patients,” he said.

“We’re trying to analyze what laws are going to be on the books,” he said. “We’re going to obey the state law.”

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The Texas state capitol building in Austin.

Understanding when doctors can act

Under the law as written, patients won’t be prosecuted for obtaining an abortion. However, doctors who perform abortions illegally could face a sentence of life in prison.

Five Texas district attorneys, representing some of the state’s largest cities, have signed a letter with other prosecutors from around the nation saying they won’t pursue criminal charges for those who provide abortion care.

The Texas law allows doctors to perform an abortion to save a patient or if there’s a “substantial impairment of major bodily function.”

When asked for more specifics about what type of health crisis would allow a doctor to perform an abortion without the prospect of facing criminal charges, Floyd said doctors and health systems will have to make that determination.

“I think it’s going to have to be left up to the physicians’ best medical judgment. That is left in discussions in options with the patients,” Floyd said.

“It’s going to require a lot of dialogue between our organization and lawmakers to not delay needed care for patients,” he added. “That’s what you fear in cases like this, that needed care might be delayed, and if delayed could cause more problems.”

As the medical association has a better grasp of the scope of the law, the organization will be working to educate doctors, Floyd said.

“Our physicians are law-abiding citizens,” he said. “They want to stay in practice. They’re going to obey the laws.”

• Related story: After Supreme Court upends Roe v. Wade, medical schools weigh impact on training doctors

‘Unintended consequences’

The Texas Association of Obstetricians and Gynecologists issued a statement saying it recognizes that “thoughtful members hold a variety of positions with respect to abortion ethics.” But the group said it “strongly opposes any measures that interfere with the patient-physician relationship, especially under the threat of felony.”

“We are gravely concerned that recent state laws and now the reversal of Roe v. Wade will have unintended consequences that will potentially increase maternal risk and further worsen health disparities among our society,” the ob/gyn group said. “We also believe the best way to decrease unintended pregnancy is through prevention, including improved access to contraception.”

The group said it hopes to work with policymakers to create or revise laws relating to reproductive healthcare.

John Hawkins, president and CEO of the Texas Hospital Association, said in a statement after the Supreme Court ruling that hospitals will “stay abreast of the new laws and work with their patients to promote the healthiest outcomes.”

“As hospitals, we are committed to protecting patient health, first and foremost, as well as the availability of equitable access to safe health care services,” Hawkins said. Most abortions in Texas don’t occur in hospitals.

While the medical association criticized the ruling for interfering with the physician-patient relationship, Floyd said the Supreme Court ruling has elicited a mix of opinions from doctors.

“We have physicians on both sides,” he said. “Some are elated and some are devastated.”

• Related story: Attorney General Merrick Garland vows to ensure access to abortion services

Hoping patients reach out to doctors

When asked about the impact of the ruling possibly deterring some doctors from practicing in Texas or dissuading some students from attending medical schools in Texas, Floyd said that’s difficult to predict.

“I just don’t know,” Floyd said. “Most medical students will go where they get in, knowing the lay of the land.”

“Whether a person would decide to not come here or practice here, based on the restrictions to reproductive healthcare, I don’t know,” Floyd said. “Time will tell. Is that a concern? It could be a concern. We’ll just have to wait and see.”

Texas is well-known for being a conservative state, so Floyd said he would hope doctors coming to the state would be aware of that fact.

In light of the Supreme Court ruling, Floyd said he’s concerned that patients won’t go to their doctors.

“Where patients should start if they have concerns or need to be cared for, they need to start with their physician,” Floyd said. “They should not be impeded from consulting a physician.

“Our physicians are there to discuss their needs,” he said. “We support our physicians using their best medical judgment to deliver care in a timely manner.”