An abortion doula comforts a patient who traveled from Mississippi to Arkansas in 2019 to receive services. Because of Texas’ new abortion law, Memphis clinics are seeing patients who might not be able to get care in the Lone Star state. Photo by Andrea Morales for MLK50

Sue Burbano has a word to describe conversations with her patients at CHOICES Memphis Center for Reproductive Health, where she’s a patient educator for people getting abortions. After consulting with a doctor, they go to her office to schedule a second appointment at least 48 hours later, which is when the procedure is legally allowed. There, patients sometimes share their stories; to Burbano, they “undrown.”

“A lot of them do want to get their story out. Or they just want to talk to somebody about it,” Burbano said. “So there’s a term we use in Spanish that’s called ‘desahogándote,’ which means like, if you will, undrowning, or getting something off your chest.” 

About two weeks ago, Burbano met her first patient from Texas, a woman in her mid-30s who had just left a violent relationship. After the required initial consultation, which included lab work and an ultrasound, the patient and Burbano talked for around 15 minutes, and Burbano listened as the woman undrowned herself.

“(She) was the first person that I’ve helped from Texas – not the first person that we’ve seen from Texas, but the one that I touched. This was my patient. I think hearing her out, seeing her there, it made it all real, with what’s going on in Texas, and not only that, but also what could potentially happen here,” Burbano said. “It was so sad, but also scary.”

In the wake of Texas’ abortion law, Memphis-area abortion advocates such as CHOICES and SisterReach, which provide funding for people seeking abortions, are working to help Texas organizations and patients access care. That work continues even as they prepare for an upcoming series of possible – if not likely – restrictions to abortion in their home state.

The Texas law, one of the nation’s most restrictive, took effect Sept. 1. It bans abortions after cardiac activity is detected, which is usually around six weeks of gestation, before people often know they’re pregnant. It also allows individuals to sue people and organizations providing abortions, as well as those helping people obtain abortions after six weeks. President Joe Biden’s administration has sued the state over the law; the case will be heard in federal court Friday. 

Since the beginning of September, CHOICES has seen four patients from Texas, said Jennifer Pepper, executive director at the center. Of those four patients, two received abortions. In 2020, CHOICES only had three abortion consultations with Texas patients, two of whom received abortions, according to a clinic spokesperson. 

Burbano’s patient, whom CHOICES did not identify but who allowed the clinic to share her story,  is a mother. The woman discovered she was pregnant shortly after she had decided to leave an abusive relationship. She feared what the man might do if he knew she was pregnant, Burbano said the patient told her, and she wasn’t financially secure enough to have another child.

She drove more than 12 hours to CHOICES, the closest clinic with availability and stayed the two nights with a friend, Burbano recalled. 

An exam room at CHOICES Memphis Center for Reproductive Health. Since the beginning of September, CHOICES has seen four patients from Texas, said Jennifer Pepper, executive director at the center. Photo by Hannah Grabenstein for MLK50

Many people wouldn’t be able to clear those financial and logistical hurdles, said Cherisse Scott, founder and CEO at SisterReach, a community health and reproductive justice organization that focuses on women and girls of color and other vulnerable groups. They’ve connected with local advocates in Texas to offer support, including access to their Tennessee Repro Access Fund, which pays for childcare, lodging, food and transportation. Though the money was originally raised for Tennesseans seeking abortions, Scott said financial aid is available for Texans who need to travel to Tennessee to seek care. 

SisterReach also has an advantage in being an out-of-state organization and is therefore not liable under the controversial lawsuit portion of the Texas law. They’re working on ways to alert Texans to the available aid without going through Texas organizations that could be sued.

“What’s really unfortunate is the undue burden that it places on low-income people to cross state lines and have to figure out child care and lodging and transportation and gas … even if that means coming as far as Tennessee or even further,” Scott said. “Folks in Texas are going all over the country right now, wherever they can get an appointment to meet their abortion care needs.”

Scott and Pepper both emphasized that the people most affected by Texas’ restrictions are those who are already vulnerable, including undocumented immigrants, those in domestic violence situations and those without disposable incomes.

Pepper also said that as Texas patients look for the nearest available clinic, they may end up filling appointments in other communities. Although Pepper has not analyzed patient data, she suspects that the ripple effect of Texas’ law means that some of CHOICES’ patients could be people who would have otherwise been seen at a Little Rock abortion clinic, two hours west of Memphis, or in north Mississippi. 

“There’s only so many clinics, and there’s only so many providers, and the system hasn’t increased to accept more patients. And so it puts a burden on everybody across the country seeking abortion,” Pepper said.

The two Memphis Planned Parenthood clinics have seen several Texas patients over the past two weeks, said Savannah Bearden, director of communications for Planned Parenthood of Tennessee and North Mississippi, though she didn’t have an exact figure. People seeking care may be more likely to travel to closer locations, she said, including a clinic in Colorado, which she’s noted has seen an uptick.

Planned Parenthood is also directing people who need aid to abortion funds in the South and connecting them with national resources, she added. And they’re preparing, too, for a series of possible abortion restrictions, including a trigger ban that will go into effect in Tennessee should the Supreme Court rule in favor of a Mississippi law, which bans most abortions after 15 weeks. That’s currently not being enforced in accordance with a lower court ruling.

Tennessee legislators passed the trigger ban in 2019, which would take effect if the Supreme Court were to overturn the decades-long precedent of legal abortions set by Roe v. Wade. And other restrictive laws are being heard by the courts.

“Texas is not an outlier. This law in Texas is part of a larger trend of anti-abortion advocacy and legislation that is happening across the United States, particularly in the South, and the ultimate goal is to ban abortion outright. And so this impacts all of us, whether we live in Texas or not.”

Jennifer Pepper, executive director of CHOICES Memphis Center for Reproductive Health

Currently in Tennessee, abortion is allowed up to 20 weeks of gestation with only few exceptions after that. There are eight abortion providers in the state, with three in Memphis, according to Healthy and Free Tennessee, a reproductive rights network.

Like Planned Parenthood, CHOICES is preparing for the possibility that abortions might become significantly less accessible or even impossible in Tennessee in the near future. In that event, they would likely shift their abortion-related services to providing support for people to travel to other states, such as Illinois, which would be the closest option for west Tennesseans, Pepper said.

“Texas is not an outlier. This law in Texas is part of a larger trend of anti-abortion advocacy and legislation that is happening across the United States, particularly in the South, and the ultimate goal is to ban abortion outright. And so this impacts all of us, whether we live in Texas or not,” Pepper said.

SisterReach has a variety of contingency plans if abortions are made illegal in Tennessee, though many of those plans are confidential for the moment, said Scott. For now, their goal is to continue to help people who need abortions access them.

“I think it’s just important for (people) to try their best not to panic. And we have their backs as much as we can,” Scott said. “The law of the land, Roe v. Wade, still stands. And abortion care is still legal in the country.”