After hours of emotional debate, the Senate late on Tuesday evening approved omnibus legislation to tighten abortion restrictions.

“My objective first and foremost, second and third, is to raise the standard of care,” said state Sen. Glenn Hegar, R-Katy, the author of Senate Bill 5, which passed 20-10 and now heads to the House for approval.

SB 5 includes three abortion regulation measures that failed to reach the floor of either chamber during the regular legislative session: a requirement that abortions be performed in ambulatory surgical centers, which state Sen. Bob Deuell, R-Greenville, has filed as SB 24 in the special session; a requirement that doctors who perform abortions have admitting privileges at a hospital within 30 miles of the abortion facility; and a requirement that if doctors administer the abortion inducing drug, RU-486, they do so in person, which state Sen. Dan Patrick, R-Houston, has proposed separately in SB 18 in the special session.

In a debate that lasted late into the evening, conservative Republican legislators who supported the measure argued it was designed to protect women and improve the standard of care for abortion services. Most Democratic senators, however, contended the abortion bill was designed to curry favor with GOP primary voters and that it amounted to an attack on women's constitutional rights to access health care.

Hegar early in the debate offered an amendment, which was accepted, that removed the so-called preborn pain provision that would have banned abortion at 20 weeks of gestation. Although he strongly supported the 20-week ban on abortion, which he filed separately as SB 13, Hegar said he felt it was necessary to remove the provision from SB 5 so that the House would have adequate opportunity to debate the bill. He denied an insinuation by state Sen. John Whitmire, D-Houston, that he had compromised his “pro-life position for political expediency.”

“It appears to me at this point, this committee substitute seems the most practical and logical way for us to talk about standard of care, while also trying to protect innocent life,” Hegar said.

With time running out for lawmakers to respond to Gov. Rick Perry's call to approve abortion regulations — the special session will end next week — the Senate briefly adjourned, then reconvened, to approve SB 5 on final passage. The House has a committee hearing scheduled to consider abortion legislation on Thursday. To reach the governor, the bills must be approved in both chambers before the special session concludes Tuesday.

Many Texans are “afraid, genuinely afraid, of how this Legislature treats women,” state Sen. Kirk Watson, D-Austin, said before the final vote on SB 5. He said the bill would create obstacles to safe, legal abortion services and “creates a back room process to negate women’s constitutional rights over their own bodies.”

He said that each of the proposals included in SB 5 failed to pass during the regular session because the Senate did not have enough votes to consider the legislation under the two-thirds rule — which Lt. Gov. David Dewhurst chose not to apply in the special session.

“It’s wrong to try to resurrect them now through a loophole,” Watson said. “If this is going to be our new process — using the special session to ram through any partisan red meat that fails in the regular session — it makes a mockery of the traditions that so many on this floor brag about.”

State Sen. Dan Patrick, R-Houston, said he was personally offended by the insinuation that GOP support of the abortion regulations were politically motivated. “We tried to craft a bill that we could all support,” during the regular session, he said. “We were a vote short. You could have worked with us then.”

State Sen. Eddie Lucio Jr., D-Brownsville, the lone Democrat to vote in favor of SB 5, said he could not separate politics from his faith. “It’s not about choice; it’s about a child,” he said.

The Republican-led Senate tabled all of the amendments to SB 5 offered by Democrats, including a measure to exempt drug-induced abortions from the requirement that abortions be performed at surgical facilities, a proposal to push the effective date of the surgical facility requirements from 2014 to 2015 to allow existing clinics more time to comply with the regulations, and a provision to exempt abortion facilities located more than 50 miles from another facility that primarily serve rural communities. The Senate also rejected proposals by Democrats to increase financing for women’s health services, expand Medicaid coverage to poor adults and reduce unwanted pregnancies by offering evidence-based sexual education in public schools.

“Truly, this isn’t about making women safe,” said state Sen. Wendy Davis, D-Fort Worth. She highlighted legislative testimony by medical experts, such as the American Congress of Obstetricians and Gynecologists, who argued the abortion regulations in SB 5 would endanger women by requiring the use of outdated medical protocols and decreasing access to legal abortion services. “It’s about political primaries and making sure you’re feeding the red meat of the people who will be voting in those primaries,” she said.

According to the Department of State Health Services, the most recent death in Texas related to an abortion procedure occurred in 2001 from a drug-induced abortion. The most recent death from a surgical abortion occurred in 2000.

Deuell, a family physician, denied Davis’ assertions that the abortion legislation was “red meat” for GOP primaries and defended the provisions in SB 5.

“Medicine has found out that when you adhere to certain standards for certain surgical procedures that the outcomes are better — there’s less infection, there’s less bleeding, there’s less complications,” he said. Deuell also argued that abortion providers have the money to improve their facilities to meet the regulatory standards in SB 5 and SB 24, and he said the legislation would result in more than 30 clinics becoming ambulatory surgical centers.

State Sen. Leticia Van de Putte, D-San Antonio, a pharmacist, offered an amendment, which was rejected, that would have removed a requirement in SB 5 that physicians follow the FDA regimen for drug-induced abortions. She argued that the regimen the FDA developed 13 years ago is outdated and that most doctors currently follow an evidence-based protocol backed by medical associations to induce abortion with lower doses of the medication.

“Why would we endanger a women with three times the dose of that drug when that’s not the way it’s currently used?” Van de Putte asked Hegar. “It’s more toxic. It’s got more side effects, and if this is really about women’s health, why would you do that?”

Hegar defended the drug regimen required by the bill, saying that the “FDA has not signed off on these additional evidence-based methods that you mentioned.” Later, he accepted an amendment offered by Deuell to allow evidence-based protocol for the administration of drug-induced abortions.

Weighing in on the debate, state Sen. Jane Nelson, R-Flower Mound, chairwoman of the Senate Health and Human Services Committee, said that if a woman is facing the difficult decision of having abortion, “in the very least, we need to make sure that she is receiving proper care in a safe environment.” She said several doctors had testified during committee hearings that the regulations in SB 5 would make women safer.

In response to questions from Davis about why the rules in SB 5 would only be applied to abortion procedures — not other surgical services or similar procedures used to treat ectopic pregnancy or partial miscarriage — Nelson said that abortion procedures were special.

“What makes this procedure special as opposed to a vasectomy or a plastic surgery is that we’re ending a human life,” she said.

Dewhurst, who sent a letter to Perry asking him to add abortion regulations to the special session agenda, was absent for a significant portion of the five hour-long debate. He confirmed upon his return to the Senate that he was at a local restaurant with a consultant.