Abortion on the Border

Amy Hagstrom Miller, CEO of Whole Woman’s Health and one of the most important advocates for abortion access nationwide (Courtesy of Whole Woman’s Health)

This summer, after nearly two decades of operating abortion clinics in Texas, the fall of Roe v. Wade and the state's near-total ban on abortion (the "trigger law" that automatically took effect after the Dobbs decision) forced Whole Woman's Health to close its doors. They've initiated a move to New Mexico to keep serving patients from Texas, but relocating an abortion clinic is no small effort. Medical equipment needs to be stored somewhere. Property has to be sold, leases negotiated. To help cover all of these expenses, WWH launched a fundraising campaign. All the while, staff has continued to answer the phone, providing guidance and funds to Texans seeking abortions outside of the state.

We caught up with Amy Hagstrom Miller, CEO and Founder of Whole Woman's Health, to get an update on the move and what her team is doing to continue to support Texans. Here is that conversation, lightly edited for length and clarity.

Austin Chronicle: How close are you to opening doors in New Mexico?

Amy Hagstrom Miller: We've been looking for the right spot in New Mexico and have looked in lots of different communities. We've encountered some resistance in some of the communities that are on the border that are closest to Texas. When we're looking for a property, we're thinking, where are the underserved areas of New Mexico for the local people?

For us, taking on a lease is pretty difficult. Sometimes landlords get freaked out. They're afraid of attracting attention, or that other tenants don't want to share space if you have protesters. So, we've had to pivot towards a building purchase, ideally a freestanding building where we would be the only tenant.

AC: To fund the move, you all set up a GoFundMe campaign earlier this year with the goal of raising $750,000. It looks like you're about $400,000 short of that goal. What's the status on that effort and what will those funds pay for?

AHM: There have been thousands of donors who contributed to that GoFundMe campaign. But we will need more money than we've earned already in order to pull this off.

The resources will be spent on a down payment on the building. We have to move all of our stuff, which has been in storage for months now. … So, we've got to move equipment and we hope to be able to relocate some Texas staff. It's pretty far, and our staff are rooted in their local communities, so that may be challenging, but we've got to bring physicians in. So there are lots of things that we need those funds for.

AC: Have you been able to sell any of your Texas property? What about the medical equipment?

AHM: We have our building listed in Fort Worth. It's been for sale now for a few months. We just sold our building in McAllen, Texas, a couple of weeks ago. Our other two properties were leased. Unfor­tun­ately, in McKinney we had to do a lease buyout where we had to offer money to buy ourselves out of the lease. And that landlord actually required us to return the space to its former structure. So we had to rebuild a wall and take away the front desk we built – all this stuff in order to get out of that lease. And honestly, we're still negotiating with the Austin landlord. Unfortunately, they're trying to hold us to some lease payments that are a little overwhelming.

And we did sell some of our medical equipment to Julie Burkhart – she has an organization [Wellspring Health Access] that had a clinic in Wyoming that was firebombed by anti-abortion folks earlier this year. So, we've been able to work with her to help furnish her reopening.

AC: Once the New Mexico clinic is open, how many Texans do you expect to be able to serve?

AHM: So, we have never stopped serving Texas. We had to close our clinics here, but we've been answering the phones without any disruptions this whole time for all four of our Texas clinic phone numbers. Our staff are still working remotely. We're helping a lot of people, either with the logistics or with funding either for travel or for the actual abortion [sometimes through WWH's Stigma Relief Fund, which helps patients travel to WWH clinics in other states].

In terms of numbers, prior to SB 8 [Texas' Senate Bill 8, a six-week ban to be enforced by vigilantes filing civil suits against abortion providers], the state of Texas had 55,000 abortions annually, whereas New Mexico has around 4,500 abortions annually. If you compare those numbers, we know that even if a small fraction of Texans can make it to New Mexico, it's going to have a huge impact and there will be a need for extra providers.

Whole Woman’s Health’s four Texas clinics have closed down. While their medical equipment waits in storage, the organization is looking for a New Mexico town to lay new roots. (Courtesy of Whole Woman’s Health)

It's hard for us to model how many patients are going to come. We expect it to be not as busy as all four of our Texas clinics were combined, but maybe as busy as one of our clinics in Texas was. That's how we're setting it up. Our Fort Worth clinic was our highest-volume clinic in Texas and we cared for upwards of 4,000 people annually.

AC: First there was SB 8, then there was Dobbs, and finally, the trigger law. In between, there were countless lawsuits. The overlapping legislation has led to significant anxiety and confusion. So, when Texans call your clinic today, what can (and can't) you do for them?

AHM: We can absolutely help anybody who calls our clinic get an abortion in a state where abortion is legal. Texans can have abortions in places where it's legal. And there's nothing about that which is restricted. People who have abortions in New Mexico or Colorado or Kansas, they're Kansas patients, Colorado patients, New Mexico patients. They're not Texas patients. Whole Woman's Health is working really hard to be sure that people aren't stigmatized because of where they come from. We want to be sure we're not overcompliant [to laws that make "aiding and abetting" abortions illegal] from this place of fear.

So we are making referrals, we are guiding people with transportation advice, we're giving people gas gift cards, or helping them with flights or hotels, and helping them if they can't afford the abortion. We're still getting hundreds of phone calls from people who are still calling our phone numbers. Our staff are doing a lot of case management and advocacy.

AC: Those services you're describing are all part of WWH's Abortion Wayfinder Pro­gram. What is that service?

AHM: It's called that because we help people find a way to an abortion. We started it during Gov. Abbott's executive order in April of 2020. This was when Gov. Abbott and Lt. Gov. Dan Patrick successfully banned abortion in Texas for three weeks during a pandemic.

The program took even greater shape during SB 8, when many people were denied access to safe abortion because they were over six weeks into their pregnancy. And initially we were referring to New Mexico and Oklahoma and Louisiana and Arkansas. But then those clinics in close proximity to Texas had a four- to six-week wait within a couple of weeks of SB 8 becoming law, and so our patients started going all over the place.

AC: SB 8 is still on the books and allowed private citizens to sue abortion providers and those who "aid and abet" abortions. So, our question is: How are you able to do what you're doing?

AHM: SB 8 was about aiding and abetting an illegal abortion in Texas. We're not aiding and abetting any illegal abortions. We're only helping people get legal abortion in places where abortion is recognized as essential medical care and is still preserved and still legal. That's the distinction. You're right to ask about this, because SB 8 and the "aiding and abetting" trope has gotten way too much press and people are scared of it.

I worry that we're overcomplying with the law, which social scientists describe as the first sign of authoritarianism: when you pre-comply with something that isn't actually the law.

AC: How is your staff doing?

AHM: I appreciate that question. My staff has a lot of grief. There's a lot of despair. There's been sort of cloudy thinking and confusion about, "What should we do? How should we do it?" It's stressful, because we know people still need access to safe abortion. And we are highly trained to provide it and we can no longer provide it. And so that knowledge and that expertise is excruciating.

AC: And what can Austinites do to support your work?

AHM: I would ask Austinites to talk about the positive value of abortion in our community and in our lives. Talk about abortion in a different framework than I think it's oftentimes covered. "Because I had access to abortion, I have been able to do X," or, "Somebody I love had an abortion" – just talking about it through an aspirational framework. Access to safe abortion has allowed our communities to be healthier, our families to be healthier, has allowed the status of women to increase tremendously over the 50 years that access to safe abortion was preserved.

And let's not use all these euphemisms like "choice" and "bodily autonomy." People don't call my clinic and say, "I'd like to make a choice." By not using the word "abortion," progressives alienate the very people who've had abortions. They don't see themselves in our words and in our language. They feel othered. They know that euphemism is covering something up, and underneath that is shame and stigma. … Shifting that narrative is super important.

Also, of course, donations would be very helpful for the Wayfinder Program, for us to pay some of these expenses, like getting out of our leases. And I want people to know that Whole Woman's Health is still here, even though we don't have a building. We are still answering the phones, we are still helping all the people in Texas get abortions, and we will continue to do that.