“As a young woman, I was out there demonstrating for access to contraceptives and access to abortion. … That ties in to what’s going on with the voting rights debate right now. Those of us from that era of time—we can’t believe that we’re having to do this all over again.”
—Texas state Rep. Donna Howard (D)
It’s been a little over a week since Texas Democratic state legislators decamped to Washington, D.C., in protest over Gov. Greg Abbott’s uncompromising agenda during the state’s special legislative session. Republican attempts to pass extreme voter suppression legislation are taking up the bulk of media attention—understandably. But the fight isn’t just for voting rights: It’s also about reproductive rights, which are under unprecedented attack in the Lone Star State.
Even though the Texas Democrats have effectively derailed extreme legislation in the House for now, the Texas Senate is rounding the bend on passage of many Republican priorities for the special session. (Note: To become a law, a bill has to pass both the House and the Senate, and be signed by the governor; with the Democratic legislators in Washington, D.C., the Texas House lacks a quorum to conduct business.)
One bill that passed through the Texas Senate on Friday, Senate Bill 4, bans medication abortion after seven weeks and is seen by many as a de facto ban on medication abortion—which accounts for about 40 percent of abortions performed annually. Although the FDA has approved use of mifepristone—the key medication used for miscarriage and abortion care—for up to 70 days gestation, the bill at issue would severely shorten that to just 49 days in Texas.
Texas state Rep. Donna Howard is one of the Democrats that fled the state. As a registered nurse and current chair of the Texas Women’s Health Caucus, Howard has spoken out against S.B. 4, as well as S.B. 8—one of the nation’s most extreme abortion bans that criminalizes abortions after just six weeks gestation and deputizes private citizens to enforce the law. The law is set to take effect on September 1—though a broad coalition of Texas abortion providers, doctors, clergy, abortion funds and support networks filed a lawsuit against the bill last Tuesday.
Howard has also repeatedly advocated for and filed a bill to make anyone enrolled in the Children’s Health Insurance Program (CHIP) eligible to receive free birth control, a measure that has proved to reduce both the number of teenage pregnancies and abortions in states like Colorado. The bill stalled in the House and looks unlikely to pass.
Howard spoke to Ms. late last week to discuss the flawed assumptions behind the Republican push to restrict abortion access in Texas and the real-life impact of these laws on everyday Texans.
Roxy Szal: Before we talk about women’s health, I don’t want to skip over this very real fight for voting access that you and your colleagues are currently waging.
Can you tell us what your D.C. reception has looked like and felt like so far? Who have you met with in the Senate? What did those conversations cover?
Rep. Donna Howard: Everywhere we’ve gone, people have been supportive of our efforts to draw attention to the freedom to vote, and the underlying foundation of our democracy. There’s so many of us here—which is what has allowed us to deny quorum—that we’ve divided up a lot of the meetings.
I myself met with [Sen. Chuck] Schumer [(D-N.Y.)], [Sen. Amy] Klobuchar [(D-Minn.)], [Sen.] Jeff Merkley [(D-Ore.)], [Sen. Raphael] Warnock [(D-Ga.)], [Sen.] Sherrod Brown [(D-Ohio)], [Sen. Kirsten] Gillibrand ([D-N.Y.)], [Sen.] Elizabeth Warren [(D-Mass.)] and then, of course, we all were in a meeting with the vice president.
There was a small group of senators and representatives who met [on Friday] with Senator Manchin—one of the key people holding up the carve-out of the filibuster—and I understand that the meeting was very productive and felt like there was some headway made there. It was an encouraging meeting.
Continuing our work on The Hill today to ensure fair and equal access to the polls by all eligible voters. Met w/ @ewarren @SenAmyKlobuchar @SenSherrodBrown @SenGillibrand. #txlege #LetThePeopleVote. pic.twitter.com/pD792yTeQc— Donna Howard (@DonnaHowardTX) July 15, 2021
Szal: What was the breaking point for you? And what do you hope to accomplish in D.C.?
Howard: We denied a quorum using the rules of the House of Representatives to do everything we could to ensure the freedom to vote for all Texans—and in fact, all Americans.
[Prior to the Democratic walkout,] hundreds of people came from all over the state to testify—the vast majority of them in opposition to the Republican bill. They didn’t even get to start testifying till 1:30 in the morning.
At the end of the hearing, Democratic members proposed amendments to take into account testimony that had been provided and things they were concerned about to make this a better bill, and all of those amendments were rejected. It was at that point, that I think it became clear: There are no options for us [in Texas] to do anything to stop the railroading of this legislation that is going to infringe on the right to vote, and that was when the decision was made to deny quorum.
Taking it to the nation’s capital became our only recourse here—it was to encourage our federal government, our Congress, to step up and pass voting rights legislation that would protect Texans from what the Texas legislature was about to pass.
[The elections bill that] was presented to us [last Monday] was filled with obstacles to people being able to access the ballot box, and certainly, it disproportionately impacts people of color.
It also disproportionately impacts women. We heard from the Houston elections administrator that 60 percent of those who utilized drive-through voting were women. This is an option available to women—who are most often the caregivers of children—so they can actually get to the polls and not have to deal with getting child care, or loading and unloading a carful of children to take them along to wait in long lines to be able to vote.
It also, of course, impacts those who work in the service industry or those who work hours different from those who work 9-to-5 jobs. I’m a nurse. The typical workday for a nurse is a 12-hour shift. If you are getting off of work at 7 at night or 7 in the morning, you need to have a poll that’s open for you to drive by and vote before you go home and go to sleep to get up and go to work again. Because of the pandemic, service providers and health care providers were our lifeblood, literally in many senses, but they kept things going for us so that we could protect ourselves. They often do double shifts.
These are the folks that were being helped by what happened in Harris County—and this is exactly the innovations to improving access to the polls that were being stripped away in this legislation.
“It became clear: There are no options for us [in Texas] to do anything to stop the railroading of this legislation that is going to infringe on the right to vote, and that was when the decision was made to deny quorum.”
Szal: What is the end goal when it comes to voting rights?
Howard: The number one goal is to have preclearance—because that would help us establish if there is discriminatory intent with what was going on. That is what was shown over and over again had been happening already, and what would be exacerbated if this law was passed.
We did it because the Republicans were imposing barriers to access to the polls, and we came to Washington to encourage our Congress to take the necessary steps to ensure the Voting Rights Act is passed.
Several #txlege House Democrats met today with @SenSherrodBrown to discuss passing For the People & John Lewis Acts. Sitting in front of window in Sen Brown’s office that was broken by insurrectionists entering Capitol on Jan 6. Lest we forget. https://t.co/MaDvSaBlJH pic.twitter.com/wCU22ZsWUE— Donna Howard (@DonnaHowardTX) July 15, 2021
One such bill, as outlined on Gov. Abbott’s agenda for the special session, is essentially a ban on medication abortion, which accounts for about 40 percent of abortions performed annually. The bill in question would prohibit doctors from prescribing medication abortion by mail or delivery. It would also toughen laws related to reporting abortions performed in the state.
Can you talk a little bit about this medication abortion bill in particular?
Howard: Medication abortion is the simplest, safest, most effective practice that we have for providing abortion health care and it’s widely used. It is the kind of health care we should be seeking, in terms of getting the safest, most effective, doctor-recommended health care delivery.
The fact is that just this last session, we passed the so-called “heartbeat bill,” or the forced pregnancy bill, which in essence, is a ban on abortions presumably around six weeks gestation—so it’s already been established that in Texas you may not get an abortion after approximately six weeks gestation.
[The medication abortion legislation] appears to be legislation just for the sake of having legislation for ideological, political purposes—it’s beyond redundant.
What it’s doing, though, is limiting the terms of delivering for other types of medical care where this medication is used. [Mifepristone] is used for inducing labor—approximately 30 percent of deliveries use this medication to induce labor at the time of delivery—so what you’re doing with this kind of prohibition on this medication being used after seven weeks gestation, rendering it a medication that is not able to be used at the end of a pregnancy, at full-term delivery, without the physician having to worry about being arrested.
If they had talked to any ob-gyns about this, if they had talked to any fetal-maternal health physicians, they would have, obviously, uncovered this very basic bit of information. It’s very disingenuous, all of this is. The heartbeat bill, not talking to the scientists, not talking to the physicians, the fact that the author of the bill couldn’t even answer questions about it.
They were clever enough to put in the language of the bill: a heartbeat or “cardiac activity.” What, in essence, happens at approximately six weeks gestation, is there is cardiac tissue with electrical activity that will eventually be developing into a heart, but there is no heart. There’s no pumping heart. That is not happening. What’s happening is there is electrical activity that’s being picked up by a monitor and made into a whooshing sound by that monitor. It is not a heartbeat—but that’s not of interest to them. They’re not interested in the facts. They’re not interested in working with the physicians and the scientists who actually have the real information about what’s going on.
They’re going for gut reactions and sensationalism. It’s all about the ideology, and ultimately, a total ban on abortions. That is the end goal. And in Texas, it’s been an incremental process from before I got there—I’ve been there for over 15 years now—and basically, it’s been one thing after another since I’ve gotten to the legislature to chip away till we are where we are now, which is legislation that is basically banning abortion health care in Texas.
Perhaps Republicans just don’t care that it impacts other aspects of health care delivery such as inducing labor—when we’re talking about the medication abortion bills.
Perhaps they don’t care that there are those with pregnancies that are not viable for some reason, in terms of the fetal development, and that the person carrying that fetus wants to terminate rather than going through with the delivery of what will be an unviable life.
Maybe they just don’t care—because what they are doing is disregarding any of those kinds of options and scenarios. They’re disregarding what someone would go through that’s been raped, especially in cases of incest, which I think makes most of us cringe, the thought of that. Maybe they don’t care that we actually have children that get impregnated by incest. Children. I’m talking 10 and 11 years old. I don’t want to say it’s not well thought out—maybe they just don’t care.
“They’re going for gut reactions and sensationalism. It’s all about the ideology, and ultimately, a total ban on abortions. That is the end goal. … I don’t want to say it’s not well thought out—maybe they just don’t care.”
Szal: Can you talk a little bit more about how S.B. 8, the six-week bill, came to be? About the bill’s sensationalism?
Howard: It is extremely strategic. This has been a long-term plan and with the heartbeat bill, someone had enough information to recognize that there is cardiac activity and that people will viscerally respond to hearing a heartbeat signifying life, and even if it’s not a viable life, even though it’s still the size of maybe a fingertip, the very, very tip of a finger, extremely small cells at that point in time.
Maybe it’s because, in pregnancies that are wanted, it’s a joyous thing to hear a heartbeat even before it’s actually a heart—all of these things brought together give a strong visceral, emotional response. Even when someone is supportive of a woman’s right to choose, there’s still a visceral response from all of us, and that is played upon.
Szal: What will be the real-life impact of these anti-abortion laws on Texans seeking abortion care, particularly Texans of color?
Howard: The time factor being such that it is, some may not even know they’re pregnant until the deadline occurs or, certainly, until there’s not much time to put everything in place that the laws currently require you do in order to obtain an abortion.
Six weeks gestation, which is when you can have this electrical activity, is basically four weeks of pregnancy—the vast majority of pregnancies are actually two weeks less than what the gestational age that is used. It’s important to recognize six weeks gestation is a four-week developing embryo.
So you may not even know you’re pregnant yet, and then you have no choice because you’ve missed the deadline. Let’s say you find out somehow. Maybe because you have really regular periods and you notice that you have not started your next period, or you have some reason to believe something happened—contraceptive methods failed, for example. So you go ahead and immediately get a pregnancy test. There’s several hoops you have to jump through that can take weeks and multiple visits: sonogram, 24-hour waiting period, pre-appointment counseling, and so on. None of these are medically necessary.
Add on top of that: transportation needs. Let’s say you don’t live close to a facility, and you have to juggle your work and child care schedule to come back and forth for multiple visits. Even if you live in a city that has a clinic, you still have to figure out: How do you get off work for these multiple visits? How do you arrange for child care—because the large number of abortions are for people who already have children?
All the logistics are impediments to what should be access to a safe medical procedure.
These are real-life consequences for women who have less resources, and in our society that falls more disproportionately on women of color. But quite frankly, even though women with resources have always been able to have more options, they are going to be impacted with this legislation because of the timing of things—they’re not going to have enough time to get everything done before the deadline hits, which is why this is a de facto abortion ban.
Szal: What do you wish people understood about abortion?
Howard: I’m a mom and I’m a grandmom. I’m also someone who came of age before Roe v. Wade, and all of those things impact how I look at this.
As a young woman, I was out there demonstrating for access to contraceptives and access to abortion. We fought hard for those things, and it made a huge difference when it happened in terms of educational and employment opportunities for myself and other women of my generation that we wouldn’t have had otherwise. Like many women of my age, we’re dumbfounded that we’re facing this again.
That ties in, actually, to what’s going on with the voting rights debate right now, too. Those of us from that era of time—we can’t believe that we’re having to do this all over again.
We are fighting to allow all Americans access to the voting booth because that’s where your voice is. Without a vote, you have no voice, and so that’s why this is so critical. That’s why we’re here in D.C. right now. That is the foundation of everything.
I don’t want to go back. I know that there has always been abortion and there always will be. It doesn’t matter what laws we put into place. Women and those that get pregnant, their individual situation is as varied as there are people, and the circumstances surrounding that pregnancy and what the implications are for that particular person’s life can only be known by that person. This is a safe medical procedure that is legal, at this point in time, that can allow a person to have autonomy, not only over their own body, but their own life.
I don’t think you have to be a woman to understand this—just like you don’t have to be a woman to be a gynecologist. But at the same time, men have no true understanding of what it means to carry another life within your own body as if you are a vessel. You are a carrier, and even though for many of us, it is a beautiful thing, a wonderful thing, a miracle of life that we treasure and want, when that’s not what’s going on in your life, when it represents what may be even viewed as the end of anything you’ve ever dreamed of for yourself, knowing that you can never have control over your own self, that’s beyond comprehension for many. For men, in particular, it’s just hard to know what that’s like.
“Men have no true understanding of what it means to carry another life within your own body as if you are a vessel. … Even though for many of us, it is a miracle of life that we treasure and want—when that’s not what’s going on in your life, when it represents what may be viewed as the end of anything you’ve ever dreamed of for yourself, knowing that you can never have control over your own self, that’s beyond comprehension for many.”
And the other thing that is worrisome to me now too: If the government can tell you that you have to be pregnant, the government could also tell you that you can’t get pregnant, which is what is happening with Britney Spears through a government-imposed conservatorship. This is the government, and by virtue of the majority that men have, men have a say over a person who can get pregnant—[her] body as if it is property.
So, I’ve been one that’s been harping for years in these debates with my colleagues, please work with me. Let’s try to decrease the need for abortion. Abortion has to always be available because there are always going to be times when abortion is needed. But let’s reduce the need by investing more in access to contraceptives. You want to work with me on that? Let’s work on that. That will make a huge difference.
We saw what happened in Colorado when they made contraception available to high school students—it significantly dropped teenage pregnancy as well as abortion rates. There are things we can do here. If you’re serious about this, if you want to get off of the ideological-political bent here and do something that’s actually policy-related that makes a difference, let’s do that. And yet, despite all of their rhetoric, I have had the same bill [fail] session after session.
Texas is one of two states that does not allow for [Children’s Health Insurance Program] coverage of contraceptives for youth who are on CHIP. Let’s do something like that. Let’s allow this coverage to happen and make sure these youth who are sexually active have protection.
Let’s support women and what they choose to do here, if you’re saying that you want them to have these babies despite their hardships, and they make the choice to do that, then we’re letting them die because you die at a higher rate due to pregnancy than you do due to abortion, which is hardly any at all, whereas the death rate from maternal mortality is, in Texas, is one of the highest, so help us there.
Help us there—and what did they do? They finally gave us a crumb, and we, even though the state sanctioned a task force on maternal morbidity [and] mortality, has been recommending for several years now that their number one recommendations for addressing maternal morbidity and mortality is to expand the Medicaid coverage from two months postpartum to at least a year postpartum—because half the deaths occur after the two-month period when women are kicked off of Medicaid and oftentimes do not have another provider. Instead of giving us the full twelve months, they held us hostage to pass some of their other legislation by giving us six months.
We hailed it as a success because it was movement, but do you know what we’re talking about here? Forty million dollars to expand health care coverage beyond six months to twelve months.
And we just got a revised revenue estimate from our comptroller, which said that we’re going to have a surplus over this next biennium with the budget we passed of almost $8 billion—and yet we were told that we didn’t have enough money to do this expansion to 12 months.
Ramona Flores provided editorial assistance and research for this article.