Though Texas’ six-week abortion ban has triggered alarm and distress for abortion patients and providers throughout the state, in some ways, not much has changed for El Paso.

Since Sept. 1, Senate Bill 8 has sent countless people out of state to end unwanted pregnancies. For El Pasoans wanting abortions, that trip across state and even international lines is nothing new.

SB 8 prohibits abortions as soon as cardiac activity can be detected in an embryo. That’s usually as early as six weeks, the strictest legal time limit in the country. SB 8 doesn’t directly punish abortion patients for violations, however. Instead, it allows private citizens to sue anyone who, intentionally or not, “aids or abets’‘ them.

In targeting those who “aid or abet,” SB 8 has ushered in a new reality for El Paso’s reproductive justice groups, forcing them to adapt their services and in some cases restrict the help they provide.

Three days after the new Texas law took effect, the small staff at West Fund — an El Paso nonprofit that helps finance abortions for people throughout West Texas — came to a unanimous decision. “(W)e are temporarily closing our helpline starting today,” the group wrote in an Instagram announcement on Sept. 4. “We need some time to regroup and will be back.”

Under SB 8, West Fund, its staff members and even its volunteers could be sued for $10,000 by any number of private citizens, located anywhere in the country. Aiding and abetting, according to SB 8, can include “paying for or reimbursing the costs of an abortion through insurance or otherwise.”

That provision puts Texas abortion funds in direct crosshairs of the law. Even if West Fund were to win their case, under SB 8, the group would not be able to recover the legal fees spent defending themselves.

Cost can be one of the biggest barriers to abortion access for low-wage earners and people of color. Closing the helpline meant that West Fund would not take calls or texts from anyone who needed help paying for an abortion.

The decision did not come lightly. “All of us were just really angry,” said Alexis, West Fund’s helpline manager, who uses they/them pronouns. (West Fund staff now withhold their last names in interviews with journalists and on their website and social media, Alexis said, as a matter of safety.) 

West Fund expected their helpline’s pause to last just two weeks. It lasted nearly six.

“Where’s our provider?”

By the time SB 8 went into effect, El Paso, a county of 865,000 people, had already gone without an abortion provider for nearly 18 months. Between 2019 and 2020, the number of abortions in El Paso County dropped by 60%, according to Texas Health and Human Services data.

Though some in El Paso could travel to nearby abortion clinics in Sunland Park and Las Cruces, New Mexico, for surgical or medical abortions, or buy cheap abortion medication over the counter at pharmacies in Ciudad Juárez, this wasn’t an option for everyone.

And with more Texans making appointments at out-of-state clinics, Alexis worried that costs might increase for people in El Paso and West Texas. As a general rule, the farther along someone is in a pregnancy, the more an abortion can cost. The procedures can range anywhere from $250 to $9,000, Alexis noted.

Increased wait times can also take a heavy physical and emotional toll, they added. “Even if it’s just a couple months, if you don’t want to be pregnant that’s still very traumatizing for your body and for your mental health.”

The situation has raised a long-simmering frustration for Alexis. “Our El Paso Planned Parenthood here — where’s our (abortion) provider?” they asked.

El Paso Planned Parenthood remains open and continues to offer services such as sexually transmitted infection testing and gender-affirming care, but it stopped offering abortions in March 2020.

Before then, the clinic had flown in doctors twice a month to perform abortions. But concerns about COVID-19 infections ended those flights, said Autumn Keiser, a spokesperson for Planned Parenthood of Greater Texas. The El Paso clinic has struggled to recruit a new doctor.

“I don’t know, do your job — make El Paso sound fancy, pay your doctors more,” Alexis said.

“We’re frustrated too,” Keiser said. “But we’ve never stopped seeking (a provider) even knowing that SB 8 was on the way. I think we’ve just been in a protracted period of enormous challenge with the pandemic, and now with SB 8. I do feel that hopefully we will find some relief in the near future.”

The organization also hopes to recruit an on-the-ground provider, someone who will not need to be flown in periodically.

In response to SB 8, Keiser said Planned Parenthood of Greater Texas clinics, including El Paso, have sought to increase access to birth control and emergency contraceptives, offering sliding-scale prices for those who can’t afford them.

PPGT has also provided funding for patients to travel out of state for abortions and hired new health navigators to help people with unwanted pregnancies negotiate the increasingly complicated logistics and costs of obtaining an abortion after six weeks.

The legal landscape

For a brief moment on Oct. 6, staff at West Fund allowed themselves to celebrate. Though West Fund’s helpline was still paused, at the request of the U.S. Department of Justice, U.S. District Judge Robert Pitman of Austin issued a temporary injunction against SB 8, removing the state’s six-week abortion ban.

“From the moment S.B. 8 went into effect, women have been unlawfully prevented from exercising control over their lives in ways that are protected by the Constitution,” Pitman wrote at the end of a scathing 113-page ruling against the State of Texas. “That other courts may find a way to avoid this conclusion is theirs to decide; this Court will not sanction one more day of this offensive deprivation of such an important right.”

His words seemed to anticipate what came next: The state of Texas swiftly challenged the injunction with the conservative-leaning U.S. 5th Circuit Court of Appeals in New Orleans. In less than 48 hours, a three-judge panel reversed Pitman’s decision, and the ban again went into effect. The panel on Thursday reinforced its earlier ruling and said the law could stay in effect as it considers the facts of the case.

Whatever the outcome at the 5th Circuit, legal analysts widely expect this case or other lawsuits against SB  8 to make their way to the U.S. Supreme Court, which in December will hear arguments for a Mississippi case that explicitly asks the court’s 6-3 conservative majority to overturn Roe v. Wade, the landmark 1973 ruling that legalized abortion in the United States.

Depending on how the Supreme Court rules on the Mississippi case — a decision that will not come down until the summer of 2022 — the lawsuits against SB 8 could become a non-issue. This legislative session, Texas passed a “trigger law” that would immediately outlaw abortions in the state if Roe v. Wade is struck down.

“People are scared”

Amid the legal whiplash, Rachel, West Fund’s president, has worried that one overriding message has gotten lost: “As the person seeking abortion care, you’re not really the one liable, whether SB 8 is in place or not. SB 8 is really designed to target the people providing assistance.”

After SB 8 went into effect, Alexis saw calls to the group’s helpline, which still received voice messages, plummet — to about 40 in a five-week period, compared to a typical month of 60 to 100. Alexis believes that drop in calls resulted from more than just West Fund’s announcement of the helpline’s pause; at least one other abortion fund also experienced declines even as out of state clinics reported an increase in Texans seeking appointments.

“People are scared,” they said.

To continue funding abortions despite the paused helpline, Alexis set up a new referral system with clinics in New Mexico and Colorado, which would contact West Fund if patients needed help financing an abortion. To avoid legal liability, they asked those clinics to withhold information about their patients’ home state or location.

But so long as their procedures occurred out of state, Alexis said West Fund would still finance Texans who received abortions past the six-week timeframe.

On Oct. 9, West Fund reopened its helpline. Once staffed by three to four volunteers, the helpline will now be manned by only Alexis until volunteers can receive legal training. Instead of providing their personal cell phone number to callers, they will communicate using a secure messaging app, or return phone calls from a line that provides no caller ID.

“Before Sept. 1st, I was handing out my number to everybody and just being like, ‘You need me, call me, text me.’ I would follow up with them, and we would talk for a little bit,” they said. The security changes “take away that interpersonal connection between us and the callers.”

For Alexis, those interpersonal connections have been one of the most meaningful parts of their job.

In the few days since the helpline’s return, they’ve noticed that callers seem more stressed. Alexis is too.

“I’m glad to be back on the helpline, but at the same time, I’m not going to lie and say that I’m not like, ‘Oh my God, who’s going to sue me?’”

Cover photo: An abortion rights march moved under the Bridge of the Americas on Oct. 2 to protest Sentate Bill 8, the Texas law that effectively bans abortions after six weeks of pregnancy. (Corrie Boudreaux/El Paso Matters)