A Weekend At The Last Abortion Clinic In McAllen, Texas

by Hannah Smothers


The walk from the rear parking lot at Whole Woman’s Health to the entrance on Main Street is 100 feet down a sidewalk. The clinic is located in southwest McAllen, Texas at the corner of Main and Houston Streets — both of which are busy thoroughfares that run through the old medical area where Whole Woman’s is. People driving by on those streets have been honking their horns at patients and volunteers outside the newly re-reopened clinic all day.

Next to the clinic is an empty lot filled with wooden signs that say things like, “Abortion, The Ultimate Child Abuse.” This is the same lot where protesters recently built a miniature cemetery for unborn babies. A group of picketers follows each patient from the protection of the parking lot to the door. The sidewalk is public property and it’s the anti-choice picketer’s last chance to, maybe, change a mind. Stepping behind the concrete wall that hides the heavily tinted glass door entrance to the clinic’s waiting room feels like sanctuary. No one on Main Street can see in there — it’s safe. For the woman walking to the front door of a clinic that’s been empty for six months, the wait is almost over. She stands at the door until someone in the waiting room lets her inside.

The patients who came to Whole Woman’s Health McAllen this past weekend had been waiting a long time for assistance. On March 6, two Whole Woman’s Health locations — the one in McAllen and another in Beaumont, Texas — closed because they could no longer afford to stay open without being able to provide abortions.

House Bill 2, a Texas bill that went into effect on October 29, 2013, places highly restrictive provisions on abortion procedures, much like existing legislation in Mississippi. When HB2 went into effect last October, Whole Woman’s McAllen was among over 20 Texas clinics that had to either stop providing abortions or close. The bill has been opposed most prominently by Wendy Davis, the Democratic candidate for Texas’ upcoming gubernatorial election. Davis recently released a memoir describing her own abortions.

Texas is suffering. With every added provision, more clinics are forced to close. Before HB2, Texas had 42 abortion clinics. Currently, counting the recently re-opened McAllen clinic, there are 20. Another Fifth Circuit hearing on September 12th could make Texas a state with over 26 million people and only seven abortion providers. This makes receiving an abortion in Texas devastatingly difficult for anyone living outside of Houston, Dallas or Austin. For women living in the Rio Grande Valley, it’s almost impossible.

* * *

HB2 and the Texas border

When Wendy Davis gave her filibuster wearing pink sneakers in the Texas Capitol Building last summer, the voices of patients from the Rio Grande Valley were heard. At one point during the marathon speech, Wendy read aloud anonymous journal entries from abortion patients. Some of these entries came from Whole Woman’s Health McAllen, where journals are made available to patients before and after their procedure.“Sometimes they’re beautiful poetry,” says Andrea Ferrigno, the corporate vice president of Whole Woman’s Health, about the entries, “Sometimes they’re a beautiful letter to the clinic or to their potential child.”

In the lobby of McAllen’s Casa De Palmas Renaissance Hotel, Andrea told me about the clinic’s re-opening weekend and her year of fighting against the tough abortion legislation. Whole Woman’s Health has five clinics around Texas, including the one in McAllen where Andrea got her start. Since then she’s worked in all of the organization’s clinics, and on the night of the filibuster, she sat with Whole Woman’s staff from all over the state, listening to the stories of the women they’d helped.

At the time of the filibuster, the Texas abortion bill was called Senate Bill 5. After Governor Rick Perry gave his official approval, it became House Bill 2, or simply HB2. Supporters of the legislation say it’s meant to increase safety and health standards for abortion procedures. Opposers say it makes abortion practically illegal in Texas.

The provisions of HB2 are the toughest of any abortion related legislation in the country. When the bill went into effect on October 29, abortions past 20 weeks were made illegal. Abortion-inducing drugs had to be used with old FDA regulations, which requires that most women in Texas make four doctor appointments for a medical abortion. The fatal provision for the McAllen clinic was the one that requires all physicians who perform the procedure to have admitting privileges at a hospital within 30 miles of their clinic. This provision exists in other states as well, but only in Texas is the hospital also required to have an OB-GYN department.

As planned, HB2 shut down over half of the clinics in the state. Another Fifth Circuit hearing to be held on September 12 could close even more. Entire regions of the second biggest state in the country are now located hundreds of miles away from the nearest clinic, but the Rio Grande Valley faces challenges unlike any other part of the country.

When the McAllen clinic stopped providing abortions, the nearest clinic to the Valley region was in San Antonio, located 250 miles (a four-hour drive) away. This distance alone isolates women in the Valley from abortion care.

U.S. Highway 281 will take you out of McAllen, through about 200 miles of private farmland, up to San Antonio. But about an hour into the drive, you arrive in Falfurrias, Texas — a small town known for housing one of the toughest U.S. Border Patrol Interior Checkpoints in the country and nothing else. The checkpoints, located within 75 miles of the Mexico-United States border along major highways, are meant to catch narcotics or undocumented immigrants who made it past the stations located at the actual border. The only way around the checkpoint in Falfurrias is to cut through private farmland.

If you live south of the checkpoint and don’t have proper documentation, trying to drive the 250 miles to San Antonio could result in arrest or deportation. For undocumented women living in the Valley, access to a safe abortion doesn’t exist.

Even with proper documentation, 500 miles round-trip is an expensive journey on top of the high procedure costs. Aside from being so geographically isolated it might as well be an offshore island, Hidalgo County, which houses most of the cities in the Valley, is among the lowest income counties in the U.S. Many women have a difficult time affording the procedure costs alone. Add gas money, multiple physician payments, care for any children she may already have, several days off of work, and hotel costs that may be required thanks to Texas’ mandatory waiting period on abortions, and the cost of the procedure becomes at least five times more expensive.

* * *

Six months of emptiness

On the night of March 6, a candlelight vigil was held at Whole Woman’s to mourn the death of the clinic and commemorate the women it has helped for over thirty years. The same journal entries Wendy Davis read almost a year before were passed out to the large crowd that gathered there. The entries were read aloud by candlelight. Afterwards, everybody left and didn’t return until this past Thursday, exactly six months later.

The clinic was forced to stop providing abortions when HB2 went into effect on October 29. The provision that killed the McAllen clinic is the one requiring admitting privileges at a nearby hospital. “That’s the biggest problem we’ve had in McAllen.” Andrea says. “We applied at every possible hospital. We needed a local physician to agree to be our emergency backup in writing and submit the application to the hospital, and none of them wanted to do that. Some of the doctors just did not want to be part of abortion care.” She also says some local doctors personally agreed and wanted to help the clinic, but didn’t want to risk losing patients by supporting abortion. When one physician finally did request admitting applications from a hospital board, the clinic was rejected immediately. “They didn’t explain why,” Andrea says. “They simply said it has nothing to do with our medical abilities.”

With no other option, Whole Woman’s Health was forced to stop providing abortions. Patients who had followed all of Texas’ other rules — like a mandated sonogram and in-person physician counseling session at least 24 hours before the abortion — showed up at the clinic for their procedures, not knowing their rights had changed overnight. “They would point to the doctor and say, “He’s right there, why aren’t you going to see me, he’s right there,” Andrea recalls. “We had to explain that this had nothing to do with the doctor being here, the law just changed.”

For five months, the clinic remained open, providing other routine services like pap smears, well-woman exams and prenatal care. But Whole Woman’s specialty is abortion — it’s the largest service the clinic provides. “Abortion is a specialized service not because the medicine is too difficult — because it’s not,” Andrea says. “We chose abortion because it’s a very stigmatized subject surrounded by lots of controversy. Women feel alone because nobody’s talking about it. And we love to have those conversations.”

While providing gynecological services is necessary, without the ability to provide their primary service, the clinic could no longer sustain itself financially. Whole Woman’s locations in McAllen and Beaumont closed their doors on March 6. A livestream video feed joined the two clinics as they mourned the loss together with candlelight vigils.

While the clinic was closed, volunteer efforts around the region helped over a dozen women access care in other cities. But Andrea says that many women, when left with no other option for almost a year, began seeking illegal abortion drugs in Mexico. McAllen may be 250 miles from San Antonio, but the Mexican city of Reynosa is only 10 miles away. Misoprostol, one of the two medications used in a pill-induced abortion, can be carried back into the country because its main use is treating gastric ulcers. It’s sold in Mexico in 28-pill bottles for a mere $19.50. That’s less expensive than transportation to San Antonio alone. Andrea says that when “everybody knows that if there’s not an abortion clinic in McAllen and you can’t go to San Antonio, you can try to get the pills from Mexico.”

While that works for some lucky women, it doesn’t work for everyone. If taken incorrectly, the complications range from a simple stomachache to excessive bleeding, incomplete abortion, infertility and death. Andrea has seen some of these women at the McAllen clinic — they were fortunate enough to see a physician in time. That’s why the clinic is so crucial for women in the Valley: it was the only safe place they could turn to for the care they need.

* * *

The first weekend back

Good news came to the Valley on August 29 when a district court in Austin overturned the admitting privileges provision of HB2. Shortly after the ruling, Whole Woman’s McAllen announced they would open again in two weeks in order to meet the incredible demand in the region. Former staff members came from all over the state to McAllen to set up a clinic that’s been sitting empty since they left.

“By the time I got to the clinic there was already a group of volunteers waiting for us — they had heard the news that we were going to reopen and just showed up,” Andrea says. She was still calling old staff members on the drive down from San Antonio, where she now lives. She says she had to come back home for something like this, something this huge.

Many of the old staff members returned to the McAllen clinic to help women like they did in the “old days” before HB2, as Andrea calls them. All weekend long, the clinic was full of energy. Over 20 women booked appointments for opening day, and 25 made appointments for Saturday. The regular hours are 9 a.m. to 5 p.m., but Andrea, the staff and a team of volunteers were there past 9 p.m. both Friday and Saturday night. Andrea says the late hours aren’t a problem. “We’ve gone through so much sorrow, stress, heartbreak in the last year, to finally catch a break and be able to do this and say yes and welcome everybody in, it’s wonderful. We weren’t going to say no to anybody.”

On Saturday morning, the McAllen clinic opened to a full schedule and a horde of over 20 protesters standing on the sidewalk a few inches away from the edge of the property. “They’ve always been there,” Andrea says. “Some of the worst picketing Whole Woman’s has had is in McAllen.” The clinic built a wooden security fence on two sides of the backside parking lot to protect its patients, but the sidewalk is still public. As patients pulled into the lot, protesters stuck pamphlets with gruesome and inaccurate images of aborted and miscarried fetuses through the fence and yelled at the patients all the way to the clinic doors.

The staff of the McAllen clinic were prepared. Standing on the edge of the property, just inside the fence and boundary that separates the protesters from picketing and trespassing, were five volunteers in t-shirts with slogans like “Vigilantes” and “Fight With Texas.” All between the ages of 22 and 33, their main job was to escort the patients down the sidewalk and up to the shrouded front door. They’re there to protect the patients from the picketers. One of the volunteers is Sofia, a 26-year-old social work student at The University of Texas Pan-American and a mother to a five-year-old girl. She says earlier that morning, several especially aggressive picketers had her cornered against a wall. At one point, a 22-year-old volunteer named Sam, stood between a yelling picketer and the car window of a patient. Facing directly towards the gruesome, glossy poster the picketer was holding up, Sam stood unmoving until the patient exited her car and walked into the clinic.

Inside the clinic, away from the protesters, the atmosphere was optimistic and energetic, despite the full schedules and long hours. Ruth Arick, a consultant with Choice Pursuits, a company that focuses on consulting and training in women’s healthcare services, came to McAllen to help Whole Woman’s through their opening weekend. Ruth, who now lives in Florida, has worked all over the country in abortion services since 1975. She’s been involved with or worked in over 300 facilities in the country, including the Whole Woman’s clinic in McAllen. She says the mood inside the McAllen clinic this weekend was “tail-waggin’ happy” until the very last patient of the day left sometime after 9 p.m.

* * *

The future

On September 12th, the Fifth Circuit court will meet to decide whether or not to enforce the HB2 provision that requires all abortion providers to meet the same standards as an ambulatory surgical center. This would close the McAllen clinic back down. HB2 would leave only seven clinics open in the state of Texas.

For now, the team at the McAllen clinic remains hopeful. Ruth says she just keeps picturing the party that the clinic will have when the legislation is overturned on the 12th. That’s how she makes it through the hard days.

With the McAllen clinic open again, the Rio Grande Valley has much better access to care than they did only a week ago. Undocumented women are able to receive care at Whole Woman’s. Women no longer have to travel to San Antonio, or take on the risks of self-administering misoprostol pills. With organizations like the Lilith Fund, Fund Texas Choice and Whole Woman’s own action fund, procedure costs are much more manageable for even low-income women in South Texas. At least for now, life is much safer for women living in the Valley.

The women in the Rio Grande Valley have ways of taking care of each other. Andrea still calls the McAllen clinic home and couldn’t stay away throughout the reopening. Staff members convened from all over to be back providing the care they love to give to community women. Ruth shows her compassion by crying with patients who feel lost or confused; it comforts them to feel like they’re not alone.

The young volunteers also all belong to various grassroots feminist groups in the region. They say feminism in the Valley looks a little different than it does in the rest of the country. “We’ve always been feminist, just a different kind of feminist,” Sofia says of the Valley. “It’s the radical notion that every women who stays at home and takes care of the family is feminist, or can be feminist.”

In the Valley, feminist movements come in the form of attending a candlelit vigil when the last clinic for 250 miles closes. They come in the form of a self-organized group of volunteers standing in a hot, Texas parking lot, getting berated by their own community members from the sidewalk. They come in the form of a human shield surrounding a frightened abortion patient walking to the doors of Whole Woman’s, aggressive protesters following close behind. They come in the form of a group of women opening up a clinic they’d had to abandon six months ago with just a few day’s notice.

It’s this distinct type of feminism that Andrea, Ruth, and the volunteers say must be acknowledged when discussing reproductive rights in the Rio Grande Valley. “People don’t understand that this is a way of life for people who live here,” says Melissa, a volunteer. “For Chicana women in the Valley, we are all about intersectionality. We can’t talk about reproductive justice without talking about undocumented folks, we can’t talk about it without talking about faith.”

In the continuing saga of HB2, there’s no way to predict what the court will decide on September 12th, or how long the clinic could be open. It could be only one more weekend, or it could be indefinitely. The only plans now involve seeing as many patients as they can with the time they have. And if the clinic is closed down again, Andrea, Ruth, and the volunteers will keep fighting like they have been since last summer.

Of course, a clinic closure would leave the Valley isolated once again, and abortion essentially illegal — 40 years after Roe V. Wade — in a southern corner of the United States. “They say you can never overturn Roe V. Wade,” Andrea says, “but they were successful in McAllen. When you don’t have access, abortion is illegal.” If the new legislation is passed, the McAllen clinic, along with 12 other Texas clinics, will be forced to close. If the legislation is overturned, you’ll be able to find Ruth, Andrea, the staff of Whole Woman’s McAllen and a team of volunteers throwing the party Ruth pictures in her head every day, celebrating the freedom of women in Texas, the Rio Grande Valley, and beyond.

Hannah Smothers is a writer in Austin, Texas. She was previously homecoming princesss at Kingwood Park High School in 2008.