A federal judge has temporarily prevented the closure of dozens of abortion clinics in Texas. Our map shows how a state appeal against the ruling would leave hundreds of thousands of women without access to services

Abortion rights advocates in Texas are celebrating a judge’s ruling late last week that struck down two key provisions of a controversial new abortion law, but are wary that the decision is merely a temporary roadblock in the state’s plan to close dozens of clinics.

US district judge Lee Yeakel stayed the closure of dozens of abortion clinics across the state. He declared unconstitutional a requirement set to go into effect on Monday 1 September, which would have forced all Texas abortion clinics to either close down or meet strict new building regulations.

Yeakel’s decision granted a temporary reprieve to hundreds of thousands of women who would have been left without nearby access to abortion services. Women in El Paso, for instance, would have a faced a 550-mile, seven-and-a-half-hour trip to the nearest clinic, in San Antonio.

The state on Saturday filed an emergency appeal to the fifth circuit court of appeals, which last year overturned a similar ruling from the same judge. The appeals court declined the state’s immediate appeal, but has scheduled a hearing for next Friday, September 12.

If the state’s appeal is successful and Yeakel’s ruling is overturned, here’s what Texas’s law would mean for abortion providers and the women seeking abortions.

Texas geography of abortion map Graphic by Feilding Cage, Kenan Davis and Nadja Popovich

At the center of Friday’s ruling was a provision in Texas’s HB 2 – a much publicized omnibus abortion law passed last summer – that all abortions clinics meet the same building standards as ambulatory surgical centers.

ASCs handle higher-risk outpatient surgical procedures and frequently employ general anesthesia, which is not necessary for abortions. Such centers must adhere to specific building code requirements, such as wider hallways and different ventilation systems, than most clinics currently employ. Such a requirement would be prohibitively costly to implement for many clinics.



Judge Yeakel, who was appointed to the bench by President George W Bush, concluded that the upgraded facility requirement, combined with an already in-effect admitting privileges mandate from the same omnibus law, “creates a brutally effective system of abortion regulation” and “a statewide burden” for women seeking abortion care, and declared it unconstitutional.



But while the ruling may have temporarily stayed the closure of clinics in Texas, not all pro-choice activists are convinced the decision will stick.

“What I learned from last time in the fall, when the first round of HB2 provisions went into effect, is … not to rely too much on the court system,” says Lenzi Sheible of Fund Texas Choice, a non-profit organized in response to HB2 that helps pay travel costs incurred by low-income Texas women who are seeking an abortion.

HB2 – which supporters say is intended to make abortions safer for women but opponents charge is meant to close clinics and limit access to abortion – contains four provisions: a shortened, 20-week time frame for legal abortions, a hospital admitting privileges requirement for all abortion providers, restrictions on how to administer medicated abortions, and the structural requirement that would require all clinics meet the same building standards as ambulatory surgical centers. These provisions have been rolled out in stages.

Since the admitting privileges provision was enacted last November, 14 women’s reproductive health centers have suspended abortion services or closed their doors entirely across the state, according to non-profit Fund Texas Choice. That includes the only two clinics that served south Texas’s Rio Grande Valley. The ambulatory care center standard would have closed more than a dozen additional clinics en masse, including the only abortion provider left in El Paso, a city with more than half a million residents.

What’s next for Texas is uncertain. Yeakel delivered a similar decision over an initial challenge to HB2’s admitting privileges provision last year but was quickly overturned by the fifth circuit court of appeals. Texas attorney general Greg Abbott has now appealed Yeakel’s latest ruling before the same court.

Though many states have some combination of similar laws on the books, The Guttmacher Institute’s Elizabeth Nash says Texas has become “a poster child” for the current abortion rights battle because of the pace at which the impacts of HB2 have unfolded.

“We’re very quickly seeing the number of clinics decrease [thanks to HB2]. The Texas case study is unfolding in weeks and days, as opposed to years like we’re seeing in other places,” says Nash, who is state issues coordinator for the reproductive health and abortion rights non-profit.

If the fifth circuit overturns Yeakel’s latest decision, pro-choice activist like Amy Hagstrom Miller, chief executive of Whole Women’s Health, which runs a group of reproductive health clinics in Texas, says it would be a “healthcare crisis” for women in the state.

“This law didn’t do anything to prevent the need for abortion. It just made abortions less available,” she says.

Many – including judge Yeakel and pro-choice activists – worry such laws will effectively make abortion illegal in Texas.

“I can tell you from experience that a lot of people in Texas don’t know whether abortion is still legal or not here in the state,” says Fund Texas Choice’s Sheible. “That is something that will have long term effects whether this challenge is successful or not. It’s a culture shift initiated by the powers of the government.”

The graphic was amended on 10 October 2014 to remove reference to the Planned Parenthood clinic in Lubbock, Texas. The clinic closed only in part due to HB2.