Texas is a case study of how abortion bans have a chilling effect on both healthcare workers and patients

Emmy Amash has always been the friend that people would go to with questions about sex, birth control and women’s health issues. It’s what called her to work as a birth doula and go to nursing school.

But during rotations around Austin, she’s noticed a shift in the trust between patients and healthcare providers, and it’s been happening under Texas’ Senate Bill 8, which bans abortion after six weeks of pregnancy.

“What I've seen working in the emergency room with women who are coming in experiencing complications after or during a miscarriage is a lot of what feels to me like mistrust and hesitancy to be sharing complete histories of what's going on,” Amash said.

Over the last 10 months, SB 8 has had a chilling effect on healthcare workers and patients that’s endangering people’s lives, says a new study by the Texas Policy Evaluation Project in the New England Journal of Medicine. It also offers a glimpse at how the Supreme Court’s decision to overturn Roe v. Wade—which is expected to outlaw or restrict abortion in almost half of the states—will make the risks to patients more common.

The study shared findings based on interviews with Texas clinicians and 20 people who had medically complex pregnancies and sought care under SB 8. The law—which bans abortion before many even know that they are pregnant—is aimed at those providing abortion care. But researchers say that, to the detriment of patients, it has an effect on other health care workers.

For example, a woman who took part in the study reported receiving a fetal diagnosis of trisomy 18, a rare condition lacking a cure that causes most babies to die before they are born. But the woman’s physician didn’t inform her about termination options.

“When you already have received news like that and can barely function, the thought of then having to do your own investigating to determine where to get this medical care and to arrange going out of state feels additionally overwhelming,” the woman said.

On the health provider side, Amash understands the frustration and secrecy of patients, citing Lizelle Herrera’s case as an example of the kind of situation patients may worry about running into.

Herrera, a 26-year-old in the Rio Grande Valley, was arrested on a murder charge in April for a self-induced abortion. She was held in jail for three days on a $500,000 bond until a local district attorney dropped the case.

But there could be more instances like Herrera’s, and Amash talked about what it’s been like to continue working amid added restrictions on abortion rights. It’ll only continue given that Texas and a dozen other states have a trigger law making abortion illegal after the repeal of Roe v. Wade. In Texas; it’ll go into effect within 30 days.

“I feel like I've been holding my breath,” Amash said. She went on to describe “feeling powerless to this larger system that's making these choices that's so far removed from the actual lives of individuals.”

But local officials are taking action in light of the high court's decision. Austin City Council will hold a special meeting the week of July 18 on a resolution aimed at decriminalizing abortion. Submitted by council member Jose "Chito" Vela, it would direct the police department to make criminal enforcement, arrest and investigation of abortions its lowest priority. But for Central Texans, it may only allow for a patchwork system in which only abortions within the city escape criminalization.

“That's nice, and also, it's just not enough,” Amash said. “Not enough for how big Texas is for us to have one little area. There's a lot of people here that need care and aren't going to have access to it.”