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Impact of Texas’ Abortion Ban: A 20-Fold Increase in Driving Distance to Get an Abortion

11 Mar 2020

The bodies of thousands of aborted and miscarried babies were incinerated as clinical waste, with some even used to heat hospitals, an investigation has found.

Ten NHS trusts have admitted burning foetal remains alongside other rubbish while two others used the bodies in ‘waste-to-energy’ plants which generate power for heat.

Last night the Department of Health issued an instant ban on the practice which health minister Dr Dan Poulter branded ‘totally unacceptable.’

At least 15,500 foetal remains were incinerated by 27 NHS trusts over the last two years alone, Channel 4’s Dispatches discovered.

The programme, which will air tonight, found that parents who lose children in early pregnancy were often treated without compassion and were not consulted about what they wanted to happen to the remains

One of the country’s leading hospitals, Addenbrooke’s in Cambridge, incinerated 797 babies below 13 weeks gestation at their own ‘waste to energy’ plant. The mothers were told the remains had been ‘cremated.’

Another ‘waste to energy’ facility at Ipswich Hospital, operated by a private contractor, incinerated 1,101 foetal remains between 2011 and 2013.

They were brought in from another hospital before being burned, generating energy for the hospital site. Ipswich Hospital itself disposes of remains by cremation.

“This practice is totally unacceptable,” said Dr Poulter.

“While the vast majority of hospitals are acting in the appropriate way, that must be the case for all hospitals and the Human Tissue Authority has now been asked to ensure that it acts on this issue without delay.”

Sir Bruce Keogh, NHS Medical Director, has written to all NHS trusts to tell them the practice must stop.

The Chief Medical Officer, Dame Sally Davies, has also written to the Human Tissue Authority to ask them make sure that guidance is clear.

And the Care Quality Commission said it would investigate the programme's findings.

Prof Sir Mike Richards, Chief Inspector of Hospitals, said: “I am disappointed trusts may not be informing or consulting women and their families.

“This breaches our standard on respecting and involving people who use services and I’m keen for Dispatches to share their evidence with us.

“We scrutinise information of concern and can inspect unannounced, if required.”

A total of one in seven pregnancies ends in a miscarriage, while NHS figures show there are around 4,000 stillbirths each year in the UK, or 11 each day.

Ipswich Hospital Trust said it was concerned to discover that foetal remains from another hospital had been incinerated on its site.

A spokeswoman said: “The Ipswich Hospital NHS Trust does not incinerate foetal remains.”

She added that the trust “takes great care over foetal remains”

A spokesman for the Cambridge University Hospitals NHS Foundation Trust said that trained health professionals discuss the options with parents ‘both verbally and in writing.’

"The parents are given exactly the same choice on the disposal of foetal remains as for a stillborn child and their personal wishes are respected,” they added.

In May 2021, Texas Gov. Greg Abbott (R) signed legislation (S.B. 8) to ban abortion at six weeks of gestation, so early in pregnancy that many people may not even know that they are pregnant. If courts do not intervene, this law is set to go into effect on September 1, 2021. Among other harms, it could force many people to travel dramatically longer distances to obtain abortion care.

The law has made national news as it comes with a new, uniquely cruel twist that allows anyone who is opposed to abortion—regardless of where they live or whether they have any association with a patient—to sue an abortion provider or anyone who helps a patient obtain an abortion, such as by providing financial help or transportation.

A Cruel New Twist

While it is called a “six-week” abortion ban, in reality the Texas law is a near-total ban on abortion. Patients would have to contend with many logistical, legal and financial hurdles in the small window of time they might have between realizing and confirming they are pregnant and then scheduling and obtaining their abortion—all while navigating myriad other abortion restrictions.

Twelve other states have enacted bans on abortion early in pregnancy, but all have been blocked from going into effect as they are blatantly unconstitutional. While any six-week abortion ban is a radical and immensely harmful measure in its own right, Texas went much further. Abortion restrictions typically rely on the state for enforcement. S.B. 8 is designed to be insulated from federal court intervention by leaving enforcement up to individuals, and even gives people financial incentive to do so.

The legislation allows anyone, anywhere to sue people involved in providing abortion care or practical support to patients in Texas and win judgments of $10,000 or more. This would open the floodgates for lawsuits, bury clinics under frivolous court cases and legal fees, and likely make it impossible for many providers to remain open and for most patients to get care before the six-week cutoff. This has been aptly dubbed the “sue thy neighbor” law by abortion rights supporters.  

Huge Increase in Driving Distances

The law is intended to shut down most, if not all, legal abortion care in Texas and if allowed to go into effect, it would likely succeed. The consequences would be enormous, and one major impact would be that any Texas resident unable to get an abortion in the state would have to travel considerably farther for services. This in turn would escalate the financial and logistical barriers many abortion patients already have to confront and would likely increase the number of people unable to get the abortion they need.

There were seven million women of reproductive age in Texas as of 2019, and if most or all legal abortion care in the state were shut down, the average one-way driving distance to an abortion clinic would increase from 12 miles to 248 miles, 20 times the distance. Put another way, that would increase the drive time by nearly 3.5 hours each way on average (if driving nonstop at 70 miles per hour) and could necessitate an overnight stay.

The bodies of thousands of aborted and miscarried babies were incinerated as clinical waste, with some even used to heat hospitals, an investigation has found.

Ten NHS trusts have admitted burning foetal remains alongside other rubbish while two others used the bodies in ‘waste-to-energy’ plants which generate power for heat.

Last night the Department of Health issued an instant ban on the practice which health minister Dr Dan Poulter branded ‘totally unacceptable.’

At least 15,500 foetal remains were incinerated by 27 NHS trusts over the last two years alone, Channel 4’s Dispatches discovered.

The programme, which will air tonight, found that parents who lose children in early pregnancy were often treated without compassion and were not consulted about what they wanted to happen to the remains

One of the country’s leading hospitals, Addenbrooke’s in Cambridge, incinerated 797 babies below 13 weeks gestation at their own ‘waste to energy’ plant. The mothers were told the remains had been ‘cremated.’

Another ‘waste to energy’ facility at Ipswich Hospital, operated by a private contractor, incinerated 1,101 foetal remains between 2011 and 2013.

They were brought in from another hospital before being burned, generating energy for the hospital site. Ipswich Hospital itself disposes of remains by cremation.

“This practice is totally unacceptable,” said Dr Poulter.

“While the vast majority of hospitals are acting in the appropriate way, that must be the case for all hospitals and the Human Tissue Authority has now been asked to ensure that it acts on this issue without delay.”

Sir Bruce Keogh, NHS Medical Director, has written to all NHS trusts to tell them the practice must stop.

The Chief Medical Officer, Dame Sally Davies, has also written to the Human Tissue Authority to ask them make sure that guidance is clear.

And the Care Quality Commission said it would investigate the programme's findings.

Prof Sir Mike Richards, Chief Inspector of Hospitals, said: “I am disappointed trusts may not be informing or consulting women and their families.

“This breaches our standard on respecting and involving people who use services and I’m keen for Dispatches to share their evidence with us.

“We scrutinise information of concern and can inspect unannounced, if required.”

A total of one in seven pregnancies ends in a miscarriage, while NHS figures show there are around 4,000 stillbirths each year in the UK, or 11 each day.

Ipswich Hospital Trust said it was concerned to discover that foetal remains from another hospital had been incinerated on its site.

A spokeswoman said: “The Ipswich Hospital NHS Trust does not incinerate foetal remains.”

She added that the trust “takes great care over foetal remains”

A spokesman for the Cambridge University Hospitals NHS Foundation Trust said that trained health professionals discuss the options with parents ‘both verbally and in writing.’

"The parents are given exactly the same choice on the disposal of foetal remains as for a stillborn child and their personal wishes are respected,” they added.

Just looking at the average increase in distance alone, someone making minimum wage ($7.25 an hour in Texas) would have to put more than 3.5 hours’ worth of earnings toward the cost of gas to cover the additional one-way cost of travel (for a car that gets 25 miles per gallon, with gas prices around $2.80 per gallon, as they were in Texas as of early August 2021). That amounts to a full day’s earnings solely to pay for the additional amount of gas for each round trip. For anyone traveling to a state that requires multiple trips to an abortion provider, the financial burden is even higher. Beyond the cost of gas, a person who needs to travel for an abortion may also have to factor in lodging, child care, lost wages from time off work and other logistical expenses, in addition to the cost of the abortion.

For the vast majority of Texas women of reproductive age, their next nearest abortion clinic would be in states that also have policies hostile to abortion (Louisiana for 60% of them and Oklahoma for 32%), where patients already struggle to receive care and are subjected to those states’ punitive and burdensome restrictions. Due to the many barriers to abortion care in Oklahoma and Louisiana—including a two-visit requirement in Louisiana and the fact that each state has very limited capacity to absorb an influx of new patients—some people traveling from Texas likely would need to go even farther than one state away for care.

A Long Legacy of Harm in Texas

Texas has a long history of trying to shut down abortion care by implementing a variety of restrictions and has been one of the states considered hostile to abortion for many years.

Texas has enacted 26 abortion restrictions in the past decade, including this year’s six-week abortion ban and a ban on abortion that would go into effect if Roe v. Wade were overturned. During this time, the number of abortion clinics in the state has been reduced from 46 clinics in 2011 to only 21 clinics in 2017.

Texas has an enormous list of abortion bans and restrictions actively on the books. Among other medically unnecessary and punitive directives, patients must receive state-mandated counseling that includes information designed to discourage them from having an abortion, and then wait 24 hours before receiving care. Furthermore, people in Texas are banned from using telehealth to see their provider for a medication abortion, which means patients not only have to physically come into a clinic for care, but most have to make two separate trips.

Additionally, patients are banned from using their own health insurance—either public or private—to cover the cost of their abortion except in extreme situations. And that’s not all; patients are forced to undergo medically unnecessary ultrasounds, patients who are minors have to obtain parental consent before having an abortion and there is a 22-week abortion ban in effect. Furthermore, there are facility requirements that make abortions after 15 weeks of pregnancy difficult to obtain. The state also requires abortion clinics to meet unnecessary and burdensome standards related to their physical building, equipment and staffing.

A Nationwide, Coordinated Campaign

Because of the coordinated and creeping nature of antiabortion tactics, it appears likely that hostile lawmakers in other states may try to pass similar legislation to S.B. 8 in the near future. That poses new dangers for abortion rights, because this type of legislation is a new and untested approach that we may see used in ever more insidious ways to circumvent or challenge U.S. Supreme Court rulings upholding abortion rights.

The year 2021 is already a defining one in abortion rights history. The 97 abortion restrictions enacted through July already surpass the count from 2011, previously the worst year on record, when 89 restrictions were enacted. In total, state legislatures have enacted 1,327 restrictions in the 48 years since Roe v. Wade was decided, including 580 restrictions enacted since 2011.

Compounding the state-level attacks, the U.S. Supreme Court, which now has a 6-3 antiabortion majority, agreed to hear a case involving Mississippi’s 15-week abortion ban. But as lawyers for the state made clear in their July 22 briefing to the Court, the ultimate goal of that case is, and always has been, to overturn Roe and ban abortion altogether.

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