Emergency contraception marks a new battle line in Texas

ByDonald L. Leech

Apr 28, 2022

COLLEGE STATION, Texas – “Mysterious Dolphin” needed an emergency contraceptive pill left on a porch outside of town.

Allison Medulan, a sophomore at Texas A&M University who had just finished a biology course, saw the request on her cell phone via an anonymous hotline. She retrieved a box of single-dose contraceptive, a pregnancy test and some condoms from her apartment and walked over to her. Inside a bewildering development of modest townhouses, Medulan stowed the plastic delivery bag next to the doormat.

Closing the car door, she looked ahead and took a breath. Medulan, 20, did not know the woman’s real name. It had been converted to a nickname by another volunteer who operated the hotline.

“I did what I could,” she said.

In this college town about two hours north of Houston, Medulan and other volunteers from Jane’s Due Process, an Austin-based nonprofit, are trusted allies to panicked young women scrambling to find a solution after contraceptive failure or unprotected sex.

Sexual health advocates have long sought to expand access to emergency contraception – over-the-counter drugs that prevent fertilization if taken within days of sex – in a bid to prevent pregnancies unplanned that can derail the educational and professional goals of women and adolescent girls. A bill recently passed by the Illinois General Assembly would require public universities to offer emergency contraception through vending machines, and volunteer distribution networks exist in many states, including Pennsylvania, Alabama and Georgia.

But in Texas, these local efforts in College Station, Lubbock, Austin and the Rio Grande Valley took on heightened urgency after state lawmakers banned nearly all abortions after around six weeks of pregnancy. The demand for emergency contraception has exploded. Nurx, an online prescription company, saw a 173% increase in orders from Texas in September 2021, the month the law went into effect, compared to the previous month. Every Body Texas, an Austin-based group that provides federal funding for birth control, received more than 200 requests for emergency contraception in the first week its website began taking orders.

“There’s anxiety around these laws and the feeling that you’re going to be punished for having sex and pregnancy is that punishment,” said Graci D’Amore, 33, program and operations manager. at Jane’s Due Process.

Jane’s Due Process is reaching out to teens on Instagram and Facebook with digital ads that clarify misconceptions about who can buy emergency contraception and where. Minors in Texas and nearly two dozen other states, including teenage mothers already raising a child, must have parental consent to obtain a prescription for hormonal birth control.

Emergency contraception, which is available without a prescription, is exempt from these restrictions. But the drug can be hard to find in rural Texas. And many pharmacies that sell it keep it in locked cases or behind the pharmacy counter, requiring shoppers to request access. At a cost of $35 to $50 per pill, the drug is unaffordable for some young people.

Jane’s Due Process “reproduction kits,” delivered free to those who request a pill via text or phone call, include a booklet that lists the nearest abortion clinic, often hours away for Texans outside metropolitan areas of the state.

“It’s a teenager’s right in Texas to buy emergency contraception, pregnancy tests and condoms,” D’Amore said. “Not only are we trying to provide access, but also education.”

In many ways, these groups operate in an educational desert when it comes to abortion, contraception, and even sex. In Texas, many family planning clinics and other sexual health clinics that helped an earlier generation of women are long gone, replaced by hundreds of crisis pregnancy centers that advise women against abortion and do not offer of birth control.

As Texas has veered sharply to the right in recent decades, anti-abortion politicians have vowed to drive Planned Parenthood out of the state, enacting a cascade of restrictions. In 2011, Republican lawmakers cut funding for the state’s family planning program by 66 percent, and more than 80 family planning clinics closed.

The impact was quick. Researchers found that between 2011 and 2014, the number of women using the most effective forms of contraception – IUDs, implants and injections – fell by a third in counties served by a Planned Parenthood affiliate, while births to poor women on Medicaid increased 27% in those counties. The state has partially restored funding in recent years, but many clinics have never reopened.

To fill this gap, join a network of volunteer groups, almost all made up of women, young and old. With abortion and contraception policies converging, they know they are the next target. Many people who seek to completely ban abortion in Texas also want to ban emergency contraception. They argue that life begins at fertilization and that any drug that interrupts this process violates their religious beliefs.

Texas religious activists have been at the forefront of this effort, mobilizing state and local governments in their mission. Texas is the only state that does not pay for any form of emergency contraception for low-income women and girls in its family planning program. Local councils in at least 40 cities in Texas have passed an ordinance declaring them “sanctuary cities for the unborn.” The movement, which began in Waskom, Texas, along the Louisiana border, criminalizes abortion and bans emergency contraception.

Other states are taking similar action.

In Arizona, Arkansas, Georgia, Idaho, Illinois, Mississippi and South Dakota, pharmacists can refuse to dispense emergency contraception if it conflicts with their religious beliefs, and Arkansas and North Carolina exclude the drug of mandatory contraceptive coverage, according to the Guttmacher Institute, a research group that supports abortion rights. Alabama lawmakers have introduced legislation that would prohibit the state health department from using state funds to pay for emergency contraception.

Many conservative Catholics and evangelical Protestants argue that the pills – marketed under the brand names Plan B and Ella – and intrauterine devices are forms of abortion. But emergency contraception is totally different from drugs prescribed to induce abortions.

Plan B is a hormonal drug that prevents pregnancy by delaying the release of an egg from the ovary or preventing fertilization. It does not harm an existing pregnancy. IUDs generally work by preventing sperm from reaching an egg, and some forms make the lining of the uterus inhospitable to attaching a fertilized egg.

For Nimisha Srikanth, a public health specialist at Texas A&M in College Station, fending off this conservative tide has become an ethical crusade. “People have sex because they feel good, not because they want a kid,” she said, sitting at the kitchen table in her tidy off-campus apartment. “Taking it away from them is morally incorrect.”

A 21-year-old girl with dark, hip-length hair, Srikanth keeps boxes of Plan B, condoms and donated pregnancy tests under her bed. As president of Feminists for Reproductive Equity and Education, known as FREE Aggies, she runs an emergency contraception hotline and provides free pills to any A&M student who contacts her, usually meeting with them. at the student center and handing them a brown paper bag.

Since she started leading FREE Aggies, she’s rooted out spies from campus anti-abortion groups who planted online meetings and moved to the private chat platform Discord. “If A&M asks for our match, Discord can’t give it to them,” she said.

Emergency contraception deliveries by volunteers with FREE Aggies and Jane’s Due Process are legal, but their clandestine nature fuels the stigma that young people who take care of their sexual health are shamed, said Holly Musick, who dated Texas A&M in the late 1970s, a few years after abortion became legal nationwide.

“It was a much more liberal time,” she told Medulan when they recently met at the student center. “There was a Planned Parenthood on the north side of town, and students could walk to get birth control pills.”

Now Musick, 64, is volunteering for Jane’s Due Process hotline, dropping pills all over town. The precariousness of women’s access to sexual health care scares her. She signed up for a delivery that had been requested for a short window of time at a specific location. “It got canceled right before I left my house, and I’m like, ‘That poor girl.'”

Medulan overflows with anger. She was raised to believe she could be anything in life, but sees how Texas abortion politics has circumscribed her world. Her boyfriend often accompanies her to make deliveries. He fears that an anti-abortion radical will try to kill her. He was asked to leave the pills under a car, under a doormat, in a fake plant outside a house.

“It shouldn’t be shameful,” she said. “It shouldn’t be something you have to hide in a bush and make sure no one sees you grabbing that unmarked bag.”

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