Abortion in Texas
One year after the Supreme Court decision we survey how hospitals and private citizens are responding to legalized abortion.
There are other options to an unwanted pregnancy, but none is so controversial. How available are abortions today, where are they done, and what has legalizing them meant?
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A general anesthetic is used. The cervix is dilated, and a curette is inserted and used to gently scrape the uterine wall to dislodge the fetal and placental material, which is then removed from the uterus with forceps.
D&C for abortion purposes has proved safe as an office procedure in most cases, if emergency care and followup check are available.
Repeated curettage of the uterine wall can lead to buildup of scar tissue which impairs the ability of the uterus to expand in pregnancy.
DILATION AND CURETTAGE IN COMBINATION WITH VACUUM ASPIRATION
This procedure must be done in a hospital. It is not a common one, but is sometimes used to terminate pregnancies between 12 and 14 weeks.
A general anesthetic is used and the cervix is dilated by use of metal rods or seaweed. Ring forceps (a long scissor-handled instrument with metal rings at the end) are inserted into the uterus and are used alternately with the cannula and vacuum suction to remove fetal and placental material. The uterine lining is then checked with a curette to make sure all fetal material has been removed.
An overnight hospital stay may be required and costs may be twice that of a simple vacuum aspitation.
SALINE INJECTION
Saline injection, also called “salting out,” is performed from 16 to 24 weeks (the legal limit for voluntary pregnancy termination). At least an overnight hospital stay is required.
To do a saline injection, the doctor anesthetizes an area of the abdomen and inserts a long needle through the abdomen into the uterine cavity. Some of the amniotic fluid is removed and replaced with an equal amount of a strong, sterile salt solution. This induces labor (contraction of the uterus) and within 24 to 48 hours, the fetus is expelled. Sometimes, it takes longer for the fetus to be expelled. A follow-up curettement (D&C) may be required to remove retained placental fragments which might cause infection.
By the beginning of the second trimester (about 13 weeks), the fetus looks definitely human; the emotional impact of salting out is greater and many physicians prefer not to perform this procedure, although it is done at some clinics. The cost ranges up to $450.
UTERINE INDUCTION
Done for pregnancies which are between 15 and 19 weeks, uterine induction is similar to saline injection. A catheter is inserted into the uterus and an enzyme called prostaglandin F2 is injected. The uterus will begin to contract after about 18 hours and the fetus and placenta are expelled. Usually, a follow-up D&C is performed.
The cost for uterine induction is about the same as for a saline instillation. A hospital stay is required.
HYSTEROTOMY
Hysterotomies are used after 16 weeks and only in cases where saline instillation or uterine induction is contraindicated. A hysterotomy is equivalent to a Caesarean section—it is major surgery requiring a hospital stay of several days and requiring general anesthesia.
An incision is made in the lower abdomen and a second incision is made in the uterine wall. The fetus and placental material are removed and the incisions are closed.
A hysterotomy can cost up to $1200. Future births must be by Caesarean section.
COMPLICATIONS
If an abortion is done during the early weeks of pregnancy, and if the procedure is medically supervised, complications seldom develop. The later in pregnancy the abortion is performed, the more complications are likely to occur.
Infection is the most frequent complication. A statistically lesser risk is hemorrhage or perforation of the uterus; in case of the latter. hospitalization is required. Serious complications occur at the rate of three or four per 1000 medically supervised abortions.
Repeated abortions may also be dangerous. Repeated forceful dilation of the cervix may lead to cervical incompetence. a condition in which premature spontaneous dilation of the cervical opening in pregnancy results in miscarriage. Repeated cutettage of the uterine wall can also impair the ability of the uterus to carry a pregnancy to term. There is no agreement on how many abortions constitute a danger to future pregnancies.
Abortion not supervised by a licensed physician is extremely risky. Untreated infection of the uterus or uterine hemorrhage can quickly lead to death.
WHERE TO GET HELP
A WOMAN WHO HAS A problem pregnancy has several alternatives from which to choose: carrying the child to term and giving it up for adoption; keeping the child either alone or with a partner; and abortion. All Texas cities have facilities where a woman can get help. It is always advisable to go to a counselor who can help one make the decision. Reliable places in most Texas cities are Planned Parenthood and Clergy Consultation. In some towns, like Dallas and Houston, Right to Life groups are geared to help the pregnant woman who does not choose abortion. It is not usually advisable to call numbers listed on billboards along freeways; often, these “services” are referral agencies which charge as much as $50 to tell a woman something she can find in the telephone book.
AUSTIN
There are no outpatient abortion clinics in Austin. There are several counseling agencies and one maternity home. If you need help call:The People’s Free Clinic, at the Congregational Church, 408 W. 23rd, 478-1746: Pregnancy tests, problem pregnancy counseling, referral. Treatment is free if you don’t have any money.
Vickki & Jane, 454-1795: A telephone service for women who need help regarding pregnancy, rape, and VD. Vickki & Jane volunteers are women who have had problem pregnancies and who can give you information on all alternatives to problem pregnancy. They will counsel with women by phone 24 hours a day, seven days a week, and will refer them to agencies which can help. Vickki & Jane hopes to go statewide by this summer.
Clergy Consultation, 474-5321: Problem pregnancy counseling and referral by a group of Austin ministers who volunteer their time. The service is non-denominational. Women’s Problem Pregnancy Counseling, 2434 Guadalupe, 478-0452 (if no answer, 472-9246): Problem pregnancy counseling and referral by a women’s group.
Model Cities Family Planning Clinic, 1601 E. 6th, 474-1526: Problem pregnancy counseling and family planning services for residents of the Model Cities area. No abortion referral. Clients must have a Brackenridge clinic card.
Home of the Holy Infancy, 510 W. 26th, 472-9251: Residential maternity home run by the Roman Catholic Church. Children given up for adoption are sent to Roman Catholic families.
DALLAS
Clergy Consultation, 691-1282: Clergy group similar to Austin’s. There is a nominal fee for counseling.
Birthright, 691-8881: Counseling and referral for alternatives other than abortion.
Planned Family Clinic, Inc., M-2055 Campbell Centre, 8350 N. Central Expressway, 692-1022: Commercial abortion clinic. Abortions up to 19 weeks. Prices range up to $350. Call for appointment.
Reproductive Services, Inc., 2339 Inwood, Suite 37, 350-7026: Non-profit abortion clinic. Abortions up to 10 weeks. Bring proof of pregnancy. $150.
Dr. Curtis Boyd and Associates, 2921 Fairmont, 742-9310: Private clinic run by physician. 12-week pregnancy limmit. $150. Call for appointment.
EL PASO
There are no private abortion clinics in El Paso. Abortions can be done by private physi- cians at Providence Hospital.
Planned Parenthood, 542-1919: A reliable source of information on problem pregnancies and family planning.
Booth Memorial Home, 3918 Bliss Ave., 565-4638: A residential maternity home. A special feature at Booth is a program which allows the woman who wishes to keep her child to continue living there with her child up to two years. During this time, the woman will learn to care for the child and can finish school, get job training, and so forth.
FORT WORTH
There are no private abortion clinics in Fort Worth, but women who choose abortion can go either to their private physicians or to one of the clinics in Dallas. A good source of information is Planned Parenthood, 332-9101.
The Edna Gladney Home, 2110 Hemphill, 926-3304: One of the best residential maternity homes in the state. Counseling, educational services and high standards.
Catholic Social Services, 921-3023: Counseling are referral for alternatives other than abortion.
HOUSTON
Planned Parenthood of Houston, 3601 Fannin, 522-3976: Both an abortion clinic and a counseling service. Vacuum aspiration up to 8 weeks, pregnancy tests, birth control information, follow-up care. Abortions are priced at $145.
Cullen Women’s Center, 7443 Cullen, 733-9391: Abortions up to 20 weeks, all tests, some counseling. No appointment necessary for pregnancy tests between II a.m. and 5 p.m. Monday through Saturday. Prices start around $145.
Southwest Women’s Center, 6565 DeMoss, 771-0611: Abortions up to 12 weeks. “The River Oaks of abortion clinics” charges $265 for complete vacuum aspiration procedure. Care is said to be excellent.
Villa Maria Center, 119 Lovett Blvd., 526-4611: Sponsored by Catholic Community Services, Villa Maria is a residential maternity home which also provides care on an out-patient basis.
Florence Crittenden Home, 5107 Scotland, 869-7221: Formerly housed in a 40-year-old firetrap of a building, the Florence Crittenden home has a brand new building for residential maternity care. The 46-bed facility has some extra space which the board is thinking of devoting to care of non-pregnant women who need help. Facilities are very nice, but there’s no swimming pool.
Birthright, 529-7273: Counseling and referral for alternatives other than abortion.
SAN ANTONIO
Reproductive Services, 48 10 San Pedro, 826-6336: Menstrual extraction, vacuum aspiration up to 12 weeks. Cost around $ 150. Call for appointment and check the address—this clinic has a reputation for moving around.
Bexar County Hospital, 696-5007: Abortions up to 20 weeks. Hospital charges are added to procedure charges, making the cost about double that of private clinics. Accepts medicaid, health insurance.
Planned Parenthood of San Antonio, 224-6163 : Counseling and referral.
Methodist Mission Home, 696-2410: Residential maternity home run by the Methodist Church. You do not have to be a Methodist.
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