(Illustration by Hannah Perry)
One of the most significant moments in the battle for U.S. reproductive rights is currently playing out in the Lone Star State, and it could change the legality of abortion across the country for years to come. In May 2021, Texas Governor Greg Abbott signed a bill that prohibits abortions after the 6-week gestation mark. Meant to circumvent the precedent established by 1973’s landmark Roe v. Wade decision, Senate Bill 8 makes it illegal to abort a pregnancy once a fetal heartbeat is detected—before most people even know they’re pregnant. This effectively makes abortion illegal across a state where restrictions have already made accessing the procedure difficult and, in many cases, prohibitively expensive.
Texas abortion providers quickly filed an emergency request for the Supreme Court to block the bill, but the Court issued a shocking order refusing to do so. In response to the controversial 5-4 vote, the Department of Justice filed a lawsuit against the state, calling SB 8 “clearly unconstitutional under longstanding Supreme Court precedent.” In the meantime, abortion providers and those needing their services are left with few options and several real dangers.
What makes this “heartbeat bill” different from others attempted in the past is that this new law makes this a civil issue. In order to challenge the country’s longstanding abortion laws, the Texas Legislature has banked on citizens snitching on abortion seekers for hefty bounties. Counselors, nurses, doctors, abortion doulas, and anyone else who assists with an abortion can also be sued. With Texas deputizing private citizens to enforce this law, SB 8 dubiously attempts to sidestep existing federal abortion law—and, eventually, to outlaw abortion entirely.
Once the bill went into effect on September 1st, Planned Parenthood and other reproductive-health clinics across the state were forced to turn away the majority of patients seeking abortions. Texans are now left with few choices: traveling to out-of-state clinics, continuing an unwanted pregnancy, attempting to secure an illegal-yet-safe medication abortion, or trying more dangerous home-abortion techniques, such as consuming caustic substances or inserting implements into the uterus. None of the options are ideal, but there are few other alternatives under the restrictive changes to state abortion law.
And unfortunately, those most impacted by these changes are members of already marginalized communities: the poor, the undocumented, trans individuals, Black and brown people, and the disabled. When disabled people are mentioned in discussions about abortion, it’s usually in reference to birth defects. Proponents of pro-choice ideology often misuse valid concerns from the disability community as anti-abortion rhetoric—for instance, weaponizing the claim that selective abortion bans lead to the elimination of disabled people. Anti-abortion advocates also argue that access to prenatal testing and genetic counseling lead to the “death” of “disabled babies.” This stance isn’t just untrue, it isn’t even really meant to help disabled people. Co-opting the disabled community’s valid fears about eugenics is just another way for abortion foes to limit information and bodily autonomy.
It’s clear that this anti-abortion talking point doesn’t come from a place of sincere care for the well-being of actual disabled people: If it did, it would acknowledge that it’s actually disabled adults—not hypothetical disabled fetuses—who bear the brunt of anti-abortion legislation. Disabled people sometimes have sex; and disabled people sometimes get pregnant. Disabled people sometimes choose to get abortions, and, when seeking them, disabled people often face extra obstacles.
One such obstacle is the financial strain of the procedure. The disparity in income between disabled people and non-disabled people is significant: In 2016, U.S. Census Bureau American Community Survey found that the median yearly earnings for non-disabled people was about $68K. The same survey found that the median for disabled people was only about $43K. This $15K difference is compounded by the reality that disabled people often have increased financial demands because of healthcare costs. Greater medical expenses—such as higher insurance premiums, frequent doctor’s visits, hospitalizations, medical necessities, and medication costs—plus lower incomes put disabled individuals in an especially stressful spot when it comes to affording an abortion.
Co-opting the disabled community’s valid fears about eugenics is just another way for abortion foes to limit information and bodily autonomy.
Some insurance plans cover the cost of abortion, but Medicare—which insures more than 10 million disabled Americans—does not, meaning that many disabled people must pay the full cost out of pocket. The average cost of a first-trimester abortion in America is about $500, and the further along a pregnancy is, the more expensive it is to terminate. When adding lost wages and travel to clinics, ending a pregnancy can force disabled people to sacrifice necessities like medication and food. Then there’s the barrier of accessibility. Scheduling an abortion is already a hurdle in many places: In Texas, patients are required to have two separate appointments at least 24 hours apart before they can legally have an abortion. But finding clinics that accommodate the needs of disabled patients is a significant challenge. Patients with mobility challenges often find that not all clinics are accessible; and clinics may not have the staff or tools needed to facilitate clear communication with patients who are blind or deaf.
SB 8 serves as a reminder that abortion is a disability issue. I know this from personal experience: I had an abortion 3 weeks before the new bill was upheld by by the Supreme Court. I learned about my pregnancy at around 5 weeks gestation. Complications brought on by my disability made finding an accommodating clinic a challenge: I have fibromyalgia, and one of the side effects I experience is extremely powerful menstrual cramps. I was not aware that my birth-control method—an IUD—can be displaced by powerful cramps; by the time I realized there was a problem with my IUD, it became embedded in my uterus and I became pregnant.
The IUD’s displacement made a medication abortion impossible, and some clinics couldn’t even attempt a physical procedure with this complication. I visited 3 separate clinics before finding one equipped to perform my abortion; at each one, the initial consultation cost $100 to $150. All told, I paid a total of $800: $250 for the consultations, and $530 for the abortion. The challenge of finding a clinic that approved the procedure, meanwhile—along with more general difficulties with time, money, and mobility—meant that it was a full month before I could have the procedure, though I started the process before the 6-week gestational mark. Had the termination been held up a few weeks longer, my options would have been those dictated by the new law.
“Heartbeat bills” aren’t limited to Texas; 11 other states have signed them into law since 2019, and while most have been temporarily blocked by court injunction, SB 8 offers a blueprint that is likely to be adopted by other states. Since it’s estimated that 1 in 4 people in the United States are disabled, the Texas law will impact a community that already faces widespread medical discrimination. While the complexities of fetal disability intersect with both pro-choice and anti-abortion beliefs, actual disabled people are increasingly endangered by restrictive and punitive abortion laws—and it’s up to us to make sure that society understands that abortion is as much a healthcare issue for us as for any other citizen.
