Analysis of Texas Senate Bill 5

SB 5, a Texas Senate bill that was introduced on June 11, 2013 and passed by both chambers of the legislation on June 24, is, “an act relating to the regulation of abortion procedures, providers, and facilities; providing penalties” (2013). Under this act, abortions at or after 20 weeks of post-fertilization are illegal. Abortion providers, whether providing the abortion through a surgical procedure or through medication, must be licensed physicians with hospital admitting privileges, and the places where an abortion is performed must be licensed as an ambulatory surgery center. Patients are also required to have two in-person visits with a doctor prior to receiving an abortion, and the doctor is compelled to determine the age and utero location of the fetus.

Enacting the bill will have more economic impact on clinics and healthcare providers than on the legislation. The Texas Medical Board is responsible for enforcing the act, but the burden of the cost is on clinics that would either need to upgrade to become ambulatory surgery centers or shut down. Many reports on the issue, including that cited by The New York Times, notes that only five centers in Texas meet the requirement, and while no exact figure is given, “The bill’s opponents said it would most likely cause all but 5 of the 42 abortion clinics in the state to close, because the renovations and equipment upgrades necessary to meet surgical-center standards would be too costly” (Fernandez 2013). 

The issue of resource allocation for Texas SB5 is not as important as the issue of resource availability. If only five clinics able to perform abortions remain in the state of Texas after this bill is put into effect, those five clinics will be overwhelmed with patients seeking abortions. For women who are too far away from a major city with a clinic that offers abortion services, they will not have access to a safe medical abortion procedure.

Nurses will be impacted in two ways. First, with the likely closure of 42 clinics, it will translate into a loss of hundreds of nursing jobs. Nurses in rural areas may have more difficulty finding work. For the nurses who are at a clinic that will remain open, they will face challenges of time, resource, and patient management as the demand will likely quickly outpace capacity.

Even for healthcare workers who oppose abortion procedures or who wish for more regulation and oversight in an effort to provide the best possible care, this bill will likely have unintended negative consequences that will affect the health and well-being of many Texas residents that far outstrips the claimed health benefits. Complications from abortion procedures that require serious medical intervention such as a patient needing admittance to a hospital or requiring emergency surgery is less than 0.5% (Weitz et al 2013). Therefore, the legislation is misguided if its aim is to just improve women’s safety during the abortion procedure. By shutting down 42 clinics that offer other medical services in addition to abortions, thousands of women could lose access to healthcare, and those seeking abortions will now do so under more stressed environments. 

It is more likely that the bill was passed to legally curb the number of abortions performed in Texas without being in conflict with Roe v. Wade. Therefore, this bill is less concerned with medical issues than it is with moral ones. As a healthcare provider, I could not support this bill because of the wasted cost and decreased level of healthcare this bill would create as a result of its passing.

References

An act relating to the regulation of abortion procedures, providers, and facilities; providing penalties. 2013. TX Legislative Session 83. Retrieved from http://www.capitol.state.tx.us/tlodocs/831/billtext/html/SB00005I.htm

Fernandez, Manny. (2013, June 25). Filibuster in Texas Senate tries to halt abortion bill. New York Times. Retrieved from http://www.nytimes.com/2013/06/26/us/politics/senate-democrats-in-texas-try-blocking-abortion-bill-with-filibuster.html?_r=0

Weitz, T.A. (2013). Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver, American Journal of Public Health, 103, 454-461.