Women in Texas contend with state political leaders who treat legal abortion more like a sin and a crime. The Texas legislature convenes only once every two years, but that usually means things are going to get worse for women seeking reproductive services. Politics and religion, more than science or medicine, have driven most of the new restrictions on abortion here since 2011.

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“We in Texas are in a bad place,” said Jeffrey Hons, president and chief executive of Planned Parenthood South Texas in San Antonio and the Rio Grande Valley. “For decades now, the right wing of Texas has known that it could not make abortion illegal, so they have worked to make obtaining an abortion impossible. They’ve been very successful.”

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For the 90 percent of the 8 million adult women who live outside the state’s biggest metro areas — Dallas-Fort Worth, Houston, San Antonio, Austin and El Paso — seeking an abortion, or even an ideology-free family planning consultation, has become an almost insurmountable hurdle.

It’s even worse for the state’s population of undocumented women and legal residents who are brown-skinned and Spanish-language-dominant. The fear of detention and deportation is preventing many from seeking good health care, health-care professionals say. Women of Mexican and Central American origin are afraid to leave home, even to seek birth control.

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Only a handful, perhaps 10, of the state’s 254 counties have a clinic offering abortion services. State legislators cut family planning funding in 2011 from $111 million to $38 million in a direct attack on Planned Parenthood, leading to closure of 82 family planning clinics by 2014. One-quarter of the state’s clinics were shuttered, two-thirds of them not even operated by Planned Parenthood. Statewide, only about 20 clinics offering abortion remain open.

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Amarillo, Lubbock, Midland and Odessa are among the West Texas cities that lost clinics earlier in the decade. Remember, this is Texas: It’s nearly 450 miles from Amarillo to El Paso. Flights between the cities first head east to Dallas, so air travel is expensive and can take as long as the Greyhound bus ride. Think Boston to Washington without Amtrak.

That’s where Fund Texas Choice comes in, an Austin-based nonprofit that pays for transportation and lodging costs for women who must travel from their hometowns to another city for an abortion. Some women are actually routed to clinics in neighboring New Mexico or Colorado because they are closer.

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“We were founded around 2013, shortly after the legislation passed that shut down clinics all over Texas,” said Sarah Lopez, the Fund Texas Choice program coordinator who works directly with women reaching out for help. “Our founders saw a need: Texas is so huge. How are we going to get people from where they live to the few remaining clinics in the big cities?”

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The nonprofit, one of at least six in Texas helping individuals gain access to abortion, serves an average of 20 to 30 people a month. The cost per patient can be as little as $50 for road-trip gas to as much as $1,200 for last-minute airfare.

Abortion basically is denied to low-income people because of its cost. A medical abortion, which involves taking oral medication in the first trimester, or up to seven to 10 weeks after a woman’s last period, costs $450 to $500 in Texas. A second-trimester abortion will cost $650 to $800 or more. Clinics typically require cash or a credit card.

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The 1976 Hyde Amendment outlaws Medicaid reimbursements for abortion except in cases of rape or incest. The Texas legislature passed a ban on private insurance coverage of abortion in 2017. Which means, for many women, help from outside is the only way to terminate a pregnancy.

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For border residents and others desperate enough to take the risk, the proximity and lower cost of an illegal abortion clinic in Mexico attract many, even though safety and hygiene standards and the quality of professional staff are a far cry from that found in Texas clinics. The result, said Planned Parenthood’s Hons, is a failure of democracy and politics in the state. “People should not have to leave Texas, but gerrymandering and voter suppression has stopped the will of people becoming the policy of the state,” he said.

Women in Texas fighting to regain control of their reproductive rights can only see red right now. The best chance for change lies in 2020, when voters can end Texas’s 25-year run as a one-party state.