founder and CEO of Whole Woman’s Health, which operates abortion clinics in Texas, the lead plaintiff in the landmark case Whole Woman’s Health v. Hellerstedt. She has worked in abortion care since 1989.
In the most significant victory for abortion rights in a generation, the Supreme Court has struck down provisions of a sweeping anti-choice law in Texas. Justice Anthony Kennedy joined Justice Stephen Breyer and all three women justices on the Supreme Court, condemning the restrictions as an undue burden on access to abortion. We speak with lead plaintiff Amy Hagstrom Miller about the historic victory and what it will take for shuttered clinics to reopen.
AMY GOODMAN: In the most significant victory for abortion rights in a generation, the Supreme Court has struck down provisions of a sweeping anti-choice law in Texas. Justice Anthony Kennedy joined Stephen Breyer and all three women justices on the court, striking down the restrictions as an undue burden on access to abortion. The lead plaintiff in the case, Amy Hagstrom Miller of Whole Woman’s Health, celebrated the ruling outside the Supreme Court.
AMY HAGSTROM MILLER: Today’s decision marks a turnaround for Texas and for our country. But let me be clear, a win doesn’t mean the struggle is over. First, clinics don’t reopen overnight. We have a daunting task ahead of us to determine whether and how to reopen our health centers that were forced to shut their doors over the past several years, renewing leases, hiring staff and working with the communities that we previously served to help us reopen for care. And second, this decision only addressed two of the many, many restrictions that women face to get abortion care in Texas. Now we must redouble our efforts across the country to end similar restrictions across the states that push abortion out of reach for so many women.
AMY GOODMAN: Nancy Northup of the Center for Reproductive Rights also spoke outside the Supreme Court.
NANCY NORTHUP: The decision was a complete and total vindication of the plaintiffs’ claims. And we’re not surprised, because the trial record was strong, the facts are there. It is clear this law was passed with the intent to shut down clinics. It had that devastating effect. And we are very pleased that the Supreme Court could see through what was happening, and make clear. And this is going to make a difference. There are cases and cases across the nation in which this is—we have been attacking these kind of underhanded laws. And today’s victory is going to make a huge difference in being able to push this back. And we hope that politicians who have been passing these underhanded laws will start to do the responsible thing and let women have their health and rights in their states.
AMY GOODMAN: The Texas Legislature passed HB 2, the sweeping anti-choice law, in 2013, despite a people’s filibuster led by an 11-hour stand by Texas State Senator Wendy Davis. In Monday’s ruling, the Supreme Court rejected provisions requiring abortion clinics to meet the costly standards of hospital-style surgery centers and mandating doctors obtain admitting privileges at a nearby hospital. Already about half of Texas’s more than 20 abortion clinics have closed; more than 40 abortion—more than half of the 40 abortion clinics have closed in Texas. If the provisions had been allowed to come into full effect, advocates warned it would have left Texas with about 10 abortion clinics, clustered in four metropolitan areas. On Monday, in her concurring opinion, Supreme Court Justice Ruth Bader Ginsburg wrote, quote, "It is beyond rational belief that H.B. 2 could genuinely protect the health of women, and certain that the law 'would simply make it more difficult for them to obtain abortions.'"
Monday’s ruling means similar restrictions in other states are most likely also unconstitutional. Kansas, Oklahoma and Wisconsin all have current laws blocked by courts. In the South, courts have also blocked admitting privileges laws in Alabama, Arkansas, Louisiana and Mississippi.
For more, we go directly to Washington, D.C., where we’re joined by Amy Hagstrom Miller, the founder and CEO of Whole Woman’s Health, which operates abortion clinics in Texas, the lead plaintiff in this landmark case known as Whole Woman’s Health v. Hellerstedt. Miller has been working in abortion care since 1989.
Amy Hagstrom Miller, welcome back to Democracy Now! First, your reaction to this historic Supreme Court ruling?
AMY HAGSTROM MILLER: Oh, I’m just beyond elated. Not only did we get a victory for the women and families all across Texas, but the ruling was broad enough to give relief all across the country, which is what we hoped all along that we would be able to do. We really were able to illustrate the undue burden that’s put upon people by onerous regulations like this, and tell the stories of the women and families all across the state who were truly affected directly. And so I’m proud of being able to lead the lawsuit and proud of being able to tell those stories and bring them to the forefront.
AMY GOODMAN: So, tell us exactly what this means in Texas. What effect did these restrictions have that were passed in 2013?
AMY HAGSTROM MILLER: So, these restrictions, as you said, Amy, you know, closed down many facilities. And what that means is that women have rights on paper that doesn’t actually really exist for them in reality. Women had to travel hundreds of miles in order to obtain basic healthcare. They had to take multiple days off work, go through multiple visits. The vast majority of women we serve are already mothers, and so they had to get childcare and arrange for transportation—and all of this in order to obtain a right that they’re supposed to have on paper. And so, what happened is you had many women, you know, having to spend more, having to travel longer, and then some people just having to take matters into their own hands, who were blocked from accessing the healthcare that they wanted through the professional medical people that used to be in their community.
AMY GOODMAN: So, let’s go back to 2013, when Texas’s anti-abortion bill was passed. But first, it was temporarily blocked by a filibuster by State Senator Wendy Davis, who spoke for nearly 11 hours. I want to go to the clip of Senator Davis speaking at a rally after the victory.
SEN. WENDY DAVIS: Now, I know a great number of us have felt discouraged about the current state of affairs here. Some of us have felt mad. Today is different, though. Don’t you feel it? We feel hope. We’ve had an opportunity to be inspired by each other’s actions in our democracy. And we’ve witnessed how much we can accomplish when we reclaim our power and require accountability.
AMY GOODMAN: So, State Senator Wendy Davis stands on the floor for 11 hours, and they run the clock out—people, hundreds of people, if not a thousand, in the Texas Capitol. The law couldn’t pass that night. But Governor Perry then called a special session of the Legislature, and they passed it. Amy Hagstrom Miller, what happened next, in this three years? The third anniversary was Saturday of the filibuster.
AMY HAGSTROM MILLER: Yeah, yeah. There were thousands and thousands of people in the Capitol that day. And what happened next is that the law went into effect a few months later, and half of the clinics closed when just the admitting privileges requirement went into effect. A few months later, the ambulatory surgical center requirement went into full effect, and we went all the way down to only six facilities that were able to be open throughout the state. And this is the second-largest state, both in population and in land mass. We’re talking about 5.4 million women of reproductive age who had no access to healthcare, because they had to travel hundreds of miles. For that time period when the law was in full effect, there were only six facilities, and, like you said, they were in the major metropolitan areas—Dallas-Fort Worth, Austin, Houston, San Antonio. And previously, there was a distribution of clinics that were local, in the people’s communities, where people needed to access them, without the onerous burdens of further transportation.
We were able to get an injunction that blocked the ambulatory surgical center requirements from going into effect, and that also blocked the admitting privileges from going into effect, on behalf of women in the Rio Grande Valley and El Paso, because we were able to demonstrate that this law had a disproportionate effect on those populations. And so, that was the first step that restored some access, that preserved upwards of about 20 clinics to be able to stay open for these last few years.
And now, today, with the victory that we had yesterday, we have, on paper, the ability to reopen the facilities that were shuttered by this sham law initially. Like I said in my statement yesterday, it’s going to take some time to restore the fabric of healthcare that was destroyed by this law. It’s going to take some time to rebuild those clinics. Most of us had to let our leases go. We had to—I had to sell a building, because you can’t pay a mortgage on a facility for three years when you don’t have any patients, and you can’t—you’re blocked from, you know, offering healthcare services. So our physicians have gotten other work, our staff have other jobs. And so, the rebuilding of the facility and the relicensing of the facilities now is going to take some time for us to be able to rebuild the community. But the victory is here. Not only do we have the ability to reopen facilities, but we have stopped this wave of anti-abortion legislation that’s really spread all across the Midwest and the South for years now. And I think that sends a really strong signal that politicians can’t go this far and can’t interfere with women’s ability to access the healthcare with the dignity that they deserve.
AMY GOODMAN: I want to turn to a clip from the film Trapped, which premiered at the Sundance Film Festival. In this clip, we hear Marva Sadler, the director of clinical services at Whole Woman’s Health, your center, as she walks us through an ambulatory surgery center and shows all the regulations the clinic had to comply with under the provisions struck down Monday by the Supreme Court.
MARVA SADLER: We can’t have any freestanding oxygen machines. The suction has to be in the wall. And that is for every bed in pre-op, and then you’ll also notice it for every bed in PACU or aftercare. I don’t know that we’ve ever used any of these things in the walls in this clinic ever.
This is our pharmacy here, which has to be locked up. The drugs always expire, because we never use them. And to replace those drugs, I would say, a month, we spend about $1,100, throwing out expired medications and replacing them.
Another thing you’ll see here that you don’t see in the clinics are the linen buckets that we have here. We have to—we have to have a linen company come out. We can’t use disposables. So, usually, in a clinic, because it’s such a quick procedure, she undresses from the waist down, and that’s all. Here, she has to get completely undressed and into a hospital gown before she can go into the OR.
And this is our operating room. And the question we hear from patients all the time is "Are you going to cut me? Am I being cut?" Because that’s what an operation is, you know? We hear that more times than not, unfortunately. This is the same exact building and the same exact setup that you would bring someone who’s having open-heart surgery. No different. No different. Same exact setup.
AMY GOODMAN: Viewers can stream the film online for free for a limited time at PBS.org/independentlens/watch-video. And then, in this clip in Trapped, Marva Sadler of Whole Woman’s Health talks about having to turn away a patient seeking an abortion.
MARVA SADLER: In order to see her, I need to put her to sleep. And in order to do that, I need a nurse anesthetist. And because of this crazy law, it is impossible to find people to work for us. She’s 13 years old, and she is a victim of rape, and she drove four hours from McAllen to San Antonio. And we had to turn her away, and there was nothing I could do to save her. And so, now, if she has a procedure—and that "if" is huge—she’ll have to go all the way to New Mexico and pay $5,000 and get there and spend three days. It will never happen. We know it won’t.
AMY GOODMAN: So, Amy Hagstrom Miller, that clip from Trapped, which premiered this year at Sundance and is now playing on PBS. This means all of that stops now, as a result of the Supreme Court, in Texas?
AMY HAGSTROM MILLER: So, I’m so proud of Marva. It was so delightful to talk to her yesterday. She was in Texas, and we had everybody on speakerphone from all of our clinic sites, and it was just a big celebration. What this means is that we are no longer forced to provide abortion care in the ambulatory surgical center environment only. We are allowed to resume care in clinics, where we can have the appropriate physical plant and the appropriate environment for the abortion services. And the things that Marva talked about—the onerous physical plant regulations, the extra medicines, the sort of, you know, complicated medical setup that doesn’t really apply to abortion care services—are no longer going to be required. We’ll be able to offer tea to our patients in the recovery room. We’ll be able to offer the ability for women to bring their loved ones into the procedure room with them and into the recovery room with them—kinds of things that we’re able to do in our clinic-based settings that were prohibited in the ambulatory surgical center environment.
AMY GOODMAN: So there were 40 abortion clinics in Texas before this began. Now the state is down to 20. You say that it’s going to take time. What do you expect? Do you expect that—how quickly do you expect there to be more clinics, overall, not only your own, Whole Woman’s Health?
AMY HAGSTROM MILLER: Yeah, yeah. So, currently, there’s 19 facilities open. Nine of them are ambulatory surgical centers, and there’s 10 clinic facilities that have made it through these last three years of—you know, we call it at Whole Woman’s Health the age of uncertainty, where people have opened and closed and had to deal with privileges and preparing physical plant requirements, etc. Most of us, like I said, who had the other facilities that had to close, have had to let the facility go, have had to, you know, sever the lease or sell the buildings. And so, I think what we’re going to see is many of us, Whole Woman’s Health included, trying to figure out where will we be able to reopen, what will the process be for finding a lease and finding a building and restoring the staffing and the physicians. And the second part will be: What’s the process going to be now for us to apply for a new license for abortion services in the state of Texas after we’ve had this win? How is that process going to be for us? And I think, you know, none of us really know how it’s going to be. And so, I think we’ll see a couple—a couple of us probably try as soon as we could. And, you know, I think it’s important to also realize that part of the abortion facility work is operational, and it’s healthcare—you know, Healthcare 101. And so, we have to figure out how to raise funds for acquiring the equipment, acquiring the medicines and the staffing and those kinds of things, in order to run a top-notch facility. And that isn’t something that can happen overnight.
AMY GOODMAN: And finally, Amy Hagstrom Miller, what does this mean for other states? For example, in Mississippi, it has an admitting privileges law that could shutter the last abortion clinic in the state.
AMY HAGSTROM MILLER: Correct. This was the—you know, we wanted to bring this suit, because it was the right thing to do and to stand on the right side of history, to stand up against these politicians that lied to the Texan public and lied to the American public. And one of our hopes was that we could get a good legal standard that would allow relief beyond the Texas borders, to our sisters and brothers in Mississippi, Alabama, Wisconsin. Yesterday I was surrounded by other independent providers who were from those states, who made the pilgrimage to D.C. yesterday and to stand arm in arm as we talked. And so, we were with some of the people you’ve seen in Trapped: Dr. Parker, Gloria Gray, my friend Tammy from North Dakota, my friend Renee from Michigan and my friend Claire from Pennsylvania—a lot of these people who have gone through this kind of onerous regulation across the country.
And to all of us, this ruling has meaning, because what we saw is the Supreme Court take a stand and say this burden has gone too far, and give us a definition of "undue burden" and really eviscerate the idea that health and safety was at the purpose of what the Texas Legislature was up to. And they really shed light on the sham and really took our evidence and took the evidence of science and fact, and put it forward in this decision in a way that’s going to give relief to many people.
AMY GOODMAN: Amy Hagstrom Miller, we want to thank you for being with us, founder and CEO of Whole Woman’s Health, which operates abortion clinics in Texas. She is the lead plaintiff in the landmark case Whole Woman’s Health v. Hellerstedt. Miller has been working in abortion care since 1989. Tomorrow on Democracy Now!, we’ll speak with a woman who argued the case before the Supreme Court. It was her first time at the court. Stephanie Toti will be our guest. Stay with us.