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   Ever since Texas passed HB2 in 2013, the omnibus abortion law at the heart of a pivotal case the Supreme Court will review early next year, more than half of the state’s 41 abortion clinics have been forced to close. As these closures have mounted, advocates in the state have worried that the decline in abortion access could lead to a rise in the number of women trying to terminate pregnancies by themselves. 
   
   A new study quantifies some of those fears: At least 100,000 Texas women—and as many as 240,000—between the ages of 18 and 49 have attempted to self-induce abortions, according to a report released today by the Texas Policy Evaluation Project (TxPEP). The study also found that it is possible that the rate of women attempting to self-induce abortions is rising in Texas as a result of the state’s additional restrictions on abortion care. The report points to previous studies that have explored the correlation between a rise in abortion restrictions and the prevalence of self-induced abortions. A 2008 national study found that about 2 percent of women reported that they tried to terminate pregnancies on their own. In 2012, a year after Texas passed several new abortion restrictions, a study of Texas women seeking care at an abortion clinic found that about 7 percent reported attempting to end their pregnancies without medical assistance before seeking clinic care. 
   
   “This is the latest body of evidence demonstrating the negative implications of laws like HB2 that pretend to protect women but in reality place them, and particularly women of color and economically disadvantaged women, at significant risk,” said Dr. Daniel Grossman, one of the study’s co-authors and a professor in the department of obstetrics, gynecology, and reproductive sciences at the University of California-San Francisco, in a press call Tuesday morning. 
   
   Amy Hagstrom Miller, the president and CEO of Whole Woman’s Health, an independent abortion provider in Texas and the lead plaintiff in the HB2 case currently before the Supreme Court, reiterated that Texas has seen a rise in self-induced abortions since abortion restrictions like HB2, and that terminating a pregnancy with DIY methods is not healthy for women. “Nobody should be denied safe and compassionate care based on her zip code,” said Hagstrom Miller. “But that’s exactly what’s been happening. 
   
   These findings come from a survey of nearly 800 women, ages 18 to 49, conducted by TxPEP over two months in 2014 and 2015. The women were asked if they knew or suspected that their best friend had ever self-induced an abortion, and if they’d ever done so themselves. Overall, 1.7 percent of respondents said they had tried to self-induce an abortion, while 4.1 percent of women said they knew or suspected their best friend had done so. Applying these proportions to the nearly 6 million women of reproductive age in Texas, the researchers concluded that an estimated 100,000 to 240,000 Texas women ages 18-49 have attempted to end a pregnancy alone. 
   
   The study identifies two populations where histories of self-induced abortion were most prevalent: Latina women living in a county that borders Mexico—a more rural area of the state that has seen several clinic closures—and women who reported difficulty gaining access to reproductive health care in the past. 
   
   The study also determined that the two broad categories of methods used by women to end their pregnancies were home remedies such as herbs, teas, vitamins, or medications—primarily misoprostol—obtained in Mexico without a prescription by women traveling there. 
   
   Typically, a medication abortion in the United States requires that two drugs—misoprostol and mifepristone—be taken about 24 hours apart. But most doctors say misoprostol alone can be an effective way to induce an abortion if the combined regimen is not available. Most of the women who reported obtaining misoprostol had a complete abortion after using the drug, but used different doses and methods of administration. Many reported intense symptoms throughout the abortion—intense cramping and bleeding, for instance—and some talked about being unsure whether these symptoms were normal or healthy. 
   
   Most women cited one or more of four reasons for choosing to self-induce: They lacked the money to travel and/or pay for the procedure; their local clinic had closed; a close friend or family member had recommended self-induction; or the women feared the stigma associated with going to an abortion clinic. 
   
   But Grossman pointed out that among these specific reasons, “a common layer was that poverty layered on one or more of these obstacles led women to self-induce.” ||||| A BILL TO BE ENTITLED 
   
   AN ACT 
   
   relating to the regulation of abortion procedures, providers, and 
   
   facilities; providing penalties. 
   
   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 
   
   SECTION 1. (a) The findings indicate that: 
   
   (1) substantial medical evidence recognizes that an 
   
   unborn child is capable of experiencing pain by not later than 20 
   
   weeks after fertilization; 
   
   (2) the state has a compelling state interest in 
   
   protecting the lives of unborn children from the stage at which 
   
   substantial medical evidence indicates that these children are 
   
   capable of feeling pain; 
   
   (3) the compelling state interest in protecting the 
   
   lives of unborn children from the stage at which substantial 
   
   medical evidence indicates that an unborn child is capable of 
   
   feeling pain is intended to be separate from and independent of the 
   
   compelling state interest in protecting the lives of unborn 
   
   children from the stage of viability, and neither state interest is 
   
   intended to replace the other; and 
   
   (4) restricting elective abortions at or later than 20 
   
   weeks post-fertilization, as provided by this Act, does not impose 
   
   an undue burden or a substantial obstacle on a woman's ability to 
   
   have an abortion because: 
   
   (A) the woman has adequate time to decide whether 
   
   to have an abortion in the first 20 weeks after fertilization; and 
   
   (B) this Act does not apply to abortions that are 
   
   necessary to avert the death or substantial and irreversible 
   
   physical impairment of a major bodily function of the pregnant 
   
   woman or abortions that are performed on unborn children with 
   
   severe fetal abnormalities. 
   
   (b) The legislature intends that every application of this 
   
   statute to every individual woman shall be severable from each 
   
   other. In the unexpected event that the application of this statute 
   
   is found to impose an impermissible undue burden on any pregnant 
   
   woman or group of pregnant women, the application of the statute to 
   
   those women shall be severed from the remaining applications of the 
   
   statute that do not impose an undue burden, and those remaining 
   
   applications shall remain in force and unaffected, consistent with 
   
   Section 10 of this Act. 
   
   SECTION 2. Subchapter A, Chapter 171, Health and Safety 
   
   Code, is amended by adding Section 171.0031 to read as follows: 
   
   Sec. 171.0031. REQUIREMENTS OF PHYSICIAN; OFFENSE. (a) A 
   
   physician performing or inducing an abortion: 
   
   (1) must, on the date the abortion is performed or 
   
   induced, have active admitting privileges at a hospital that: 
   
   (A) is located not further than 30 miles from the 
   
   location at which the abortion is performed or induced; and 
   
   (B) provides obstetrical or gynecological health 
   
   care services; and 
   
   (2) shall provide the pregnant woman with: 
   
   (A) a telephone number by which the pregnant 
   
   woman may reach the physician, or other health care personnel 
   
   employed by the physician or by the facility at which the abortion 
   
   was performed or induced with access to the woman's relevant 
   
   medical records, 24 hours a day to request assistance for any 
   
   complications that arise from the performance or induction of the 
   
   abortion or ask health-related questions regarding the abortion; 
   
   and 
   
   (B) the name and telephone number of the nearest 
   
   hospital to the home of the pregnant woman at which an emergency 
   
   arising from the abortion would be treated. 
   
   (b) A physician who violates Subsection (a) commits an 
   
   offense. An offense under this section is a Class A misdemeanor 
   
   punishable by a fine only, not to exceed $4,000. 
   
   SECTION 3. Chapter 171, Health and Safety Code, is amended 
   
   by adding Subchapters C and D to read as follows: 
   
   SUBCHAPTER C. ABORTION PROHIBITED AT OR AFTER 20 WEEKS 
   
   POST-FERTILIZATION 
   
   Sec. 171.041. SHORT TITLE. This subchapter may be cited as 
   
   the Preborn Pain Act. 
   
   Sec. 171.042. DEFINITIONS. In this subchapter: 
   
   (1) "Post-fertilization age" means the age of the 
   
   unborn child as calculated from the fusion of a human spermatozoon 
   
   with a human ovum. 
   
   (2) "Severe fetal abnormality" has the meaning 
   
   assigned by Section 285.202. 
   
   Sec. 171.043. DETERMINATION OF POST-FERTILIZATION AGE 
   
   REQUIRED. Except as otherwise provided by Section 171.046, a 
   
   physician may not perform or induce or attempt to perform or induce 
   
   an abortion without, prior to the procedure: 
   
   (1) making a determination of the probable 
   
   post-fertilization age of the unborn child; or 
   
   (2) possessing and relying on a determination of the 
   
   probable post-fertilization age of the unborn child made by another 
   
   physician. 
   
   Sec. 171.044. ABORTION OF UNBORN CHILD OF 20 OR MORE WEEKS 
   
   POST-FERTILIZATION AGE PROHIBITED. Except as otherwise provided by 
   
   Section 171.046, a person may not perform or induce or attempt to 
   
   perform or induce an abortion on a woman if it has been determined, 
   
   by the physician performing, inducing, or attempting to perform or 
   
   induce the abortion or by another physician on whose determination 
   
   that physician relies, that the probable post-fertilization age of 
   
   the unborn child is 20 or more weeks. 
   
   Sec. 171.045. METHOD OF ABORTION. (a) This section 
   
   applies only to an abortion authorized under Section 171.046(a)(1) 
   
   or (2) in which: 
   
   (1) the probable post-fertilization age of the unborn 
   
   child is 20 or more weeks; or 
   
   (2) the probable post-fertilization age of the unborn 
   
   child has not been determined but could reasonably be 20 or more 
   
   weeks. 
   
   (b) Except as otherwise provided by Section 171.046(a)(3), 
   
   a physician performing an abortion under Subsection (a) shall 
   
   terminate the pregnancy in the manner that, in the physician's 
   
   reasonable medical judgment, provides the best opportunity for the 
   
   unborn child to survive. 
   
   Sec. 171.046. EXCEPTIONS. (a) The prohibitions and 
   
   requirements under Sections 171.043, 171.044, and 171.045(b) do not 
   
   apply to an abortion performed if there exists a condition that, in 
   
   the physician's reasonable medical judgment, so complicates the 
   
   medical condition of the woman that, to avert the woman's death or a 
   
   serious risk of substantial and irreversible physical impairment of 
   
   a major bodily function, other than a psychological condition, it 
   
   necessitates, as applicable: 
   
   (1) the immediate abortion of her pregnancy without 
   
   the delay necessary to determine the probable post-fertilization 
   
   age of the unborn child; 
   
   (2) the abortion of her pregnancy even though the 
   
   post-fertilization age of the unborn child is 20 or more weeks; or 
   
   (3) the use of a method of abortion other than a method 
   
   described by Section 171.045(b). 
   
   (b) A physician may not take an action authorized under 
   
   Subsection (a) if the risk of death or a substantial and 
   
   irreversible physical impairment of a major bodily function arises 
   
   from a claim or diagnosis that the woman will engage in conduct that 
   
   may result in her death or in substantial and irreversible physical 
   
   impairment of a major bodily function. 
   
   (c) The prohibitions and requirements under Sections 
   
   171.043, 171.044, and 171.045(b) do not apply to an abortion 
   
   performed on an unborn child who has a severe fetal abnormality. 
   
   Sec. 171.047. PROTECTION OF PRIVACY IN COURT PROCEEDINGS. 
   
   (a) Except as otherwise provided by this section, in a civil or 
   
   criminal proceeding or action involving an act prohibited under 
   
   this subchapter, the identity of the woman on whom an abortion has 
   
   been performed or induced or attempted to be performed or induced is 
   
   not subject to public disclosure if the woman does not give consent 
   
   to disclosure. 
   
   (b) Unless the court makes a ruling under Subsection (c) to 
   
   allow disclosure of the woman's identity, the court shall issue 
   
   orders to the parties, witnesses, and counsel and shall direct the 
   
   sealing of the record and exclusion of individuals from courtrooms 
   
   or hearing rooms to the extent necessary to protect the woman's 
   
   identity from public disclosure. 
   
   (c) A court may order the disclosure of information that is 
   
   confidential under this section if: 
   
   (1) a motion is filed with the court requesting 
   
   release of the information and a hearing on that request; 
   
   (2) notice of the hearing is served on each interested 
   
   party; and 
   
   (3) the court determines after the hearing and an in 
   
   camera review that disclosure is essential to the administration of 
   
   justice and there is no reasonable alternative to disclosure. 
   
   Sec. 171.048. CONSTRUCTION OF SUBCHAPTER. (a) This 
   
   subchapter shall be construed, as a matter of state law, to be 
   
   enforceable up to but no further than the maximum possible extent 
   
   consistent with federal constitutional requirements, even if that 
   
   construction is not readily apparent, as such constructions are 
   
   authorized only to the extent necessary to save the subchapter from 
   
   judicial invalidation. Judicial reformation of statutory language 
   
   is explicitly authorized only to the extent necessary to save the 
   
   statutory provision from invalidity. 
   
   (b) If any court determines that a provision of this 
   
   subchapter is unconstitutionally vague, the court shall interpret 
   
   the provision, as a matter of state law, to avoid the vagueness 
   
   problem and shall enforce the provision to the maximum possible 
   
   extent. If a federal court finds any provision of this subchapter 
   
   or its application to any person, group of persons, or 
   
   circumstances to be unconstitutionally vague and declines to impose 
   
   the saving construction described by this subsection, the Supreme 
   
   Court of Texas shall provide an authoritative construction of the 
   
   objectionable statutory provisions that avoids the constitutional 
   
   problems while enforcing the statute's restrictions to the maximum 
   
   possible extent, and shall agree to answer any question certified 
   
   from a federal appellate court regarding the statute. 
   
   (c) A state executive or administrative official may not 
   
   decline to enforce this subchapter, or adopt a construction of this 
   
   subchapter in a way that narrows its applicability, based on the 
   
   official's own beliefs about what the state or federal constitution 
   
   requires, unless the official is enjoined by a state or federal 
   
   court from enforcing this subchapter. 
   
   (d) This subchapter may not be construed to authorize the 
   
   prosecution of or a cause of action to be brought against a woman on 
   
   whom an abortion is performed or induced or attempted to be 
   
   performed or induced in violation of this subchapter. 
   
   SUBCHAPTER D. ABORTION-INDUCING DRUGS 
   
   Sec. 171.061. DEFINITIONS. In this subchapter: 
   
   (1) "Abortion" means the act of using, administering, 
   
   prescribing, or otherwise providing an instrument, a drug, a 
   
   medicine, or any other substance, device, or means with the intent 
   
   to terminate a clinically diagnosable pregnancy of a woman and with 
   
   knowledge that the termination by those means will, with reasonable 
   
   likelihood, cause the death of the woman's unborn child. An act is 
   
   not an abortion if the act is done with the intent to: 
   
   (A) save the life or preserve the health of an 
   
   unborn child; 
   
   (B) remove a dead, unborn child whose death was 
   
   caused by spontaneous abortion; 
   
   (C) remove an ectopic pregnancy; or 
   
   (D) treat a maternal disease or illness for which 
   
   a prescribed drug, medicine, or other substance is indicated. 
   
   (2) "Abortion-inducing drug" means a drug, a medicine, 
   
   or any other substance, including a regimen of two or more drugs, 
   
   medicines, or substances, prescribed, dispensed, or administered 
   
   with the intent of terminating a clinically diagnosable pregnancy 
   
   of a woman and with knowledge that the termination will, with 
   
   reasonable likelihood, cause the death of the woman's unborn child. 
   
   The term includes off-label use of drugs, medicines, or other 
   
   substances known to have abortion-inducing properties that are 
   
   prescribed, dispensed, or administered with the intent of causing 
   
   an abortion, including the Mifeprex regimen. The term does not 
   
   include a drug, medicine, or other substance that may be known to 
   
   cause an abortion but is prescribed, dispensed, or administered for 
   
   other medical reasons. 
   
   (3) "Final printed label" or "FPL" means the 
   
   informational document approved by the United States Food and Drug 
   
   Administration for an abortion-inducing drug that: 
   
   (A) outlines the protocol authorized by that 
   
   agency and agreed to by the drug company applying for authorization 
   
   of the drug by that agency; and 
   
   (B) delineates how a drug is to be used according 
   
   to approval by that agency. 
   
   (4) "Gestational age" means the amount of time that 
   
   has elapsed since the first day of a woman's last menstrual period. 
   
   (5) "Medical abortion" means the administration or use 
   
   of an abortion-inducing drug to induce an abortion. 
   
   (6) "Mifeprex regimen," "RU-486 regimen," or "RU-486" 
   
   means the abortion-inducing drug regimen approved by the United 
   
   States Food and Drug Administration that consists of administering 
   
   mifepristone and misoprostol. 
   
   (7) "Physician" means an individual who is licensed to 
   
   practice medicine in this state, including a medical doctor and a 
   
   doctor of osteopathic medicine. 
   
   (8) "Pregnant" means the female reproductive 
   
   condition of having an unborn child in a woman's uterus. 
   
   (9) "Unborn child" means an offspring of human beings 
   
   from conception until birth. 
   
   Sec. 171.062. ENFORCEMENT BY TEXAS MEDICAL BOARD. 
   
   Notwithstanding Section 171.005, the Texas Medical Board shall 
   
   enforce this subchapter. 
   
   Sec. 171.063. DISTRIBUTION OF ABORTION-INDUCING DRUG. 
   
   (a) A person may not knowingly give, sell, dispense, administer, 
   
   provide, or prescribe an abortion-inducing drug to a pregnant woman 
   
   for the purpose of inducing an abortion in the pregnant woman or 
   
   enabling another person to induce an abortion in the pregnant woman 
   
   unless: 
   
   (1) the person who gives, sells, dispenses, 
   
   administers, provides, or prescribes the abortion-inducing drug is 
   
   a physician; and 
   
   (2) except as otherwise provided by Subsection (b), 
   
   the provision, prescription, or administration of the 
   
   abortion-inducing drug satisfies the protocol tested and 
   
   authorized by the United States Food and Drug Administration as 
   
   outlined in the final printed label of the abortion-inducing drug. 
   
   (b) A person may provide, prescribe, or administer the 
   
   abortion-inducing drug in the dosage amount prescribed by the 
   
   clinical management guidelines defined by the American Congress of 
   
   Obstetricians and Gynecologists Practice Bulletin as those 
   
   guidelines existed on January 1, 2013. 
   
   (c) Before the physician gives, sells, dispenses, 
   
   administers, provides, or prescribes an abortion-inducing drug, 
   
   the physician must examine the pregnant woman and document, in the 
   
   woman's medical record, the gestational age and intrauterine 
   
   location of the pregnancy. 
   
   (d) The physician who gives, sells, dispenses, administers, 
   
   provides, or prescribes an abortion-inducing drug shall provide the 
   
   pregnant woman with: 
   
   (1) a copy of the final printed label of that 
   
   abortion-inducing drug; and 
   
   (2) a telephone number by which the pregnant woman may 
   
   reach the physician, or other health care personnel employed by the 
   
   physician or by the facility at which the abortion was performed 
   
   with access to the woman's relevant medical records, 24 hours a day 
   
   to request assistance for any complications that arise from the 
   
   administration or use of the drug or ask health-related questions 
   
   regarding the administration or use of the drug. 
   
   (e) The physician who gives, sells, dispenses, administers, 
   
   provides, or prescribes the abortion-inducing drug, or the 
   
   physician's agent, must schedule a follow-up visit for the woman to 
   
   occur not more than 14 days after the administration or use of the 
   
   drug. At the follow-up visit, the physician must: 
   
   (1) confirm that the pregnancy is completely 
   
   terminated; and 
   
   (2) assess the degree of bleeding. 
   
   (f) The physician who gives, sells, dispenses, administers, 
   
   provides, or prescribes the abortion-inducing drug, or the 
   
   physician's agent, shall make a reasonable effort to ensure that 
   
   the woman returns for the scheduled follow-up visit under 
   
   Subsection (e). The physician or the physician's agent shall 
   
   document a brief description of any effort made to comply with this 
   
   subsection, including the date, time, and name of the person making 
   
   the effort, in the woman's medical record. 
   
   (g) If a physician gives, sells, dispenses, administers, 
   
   provides, or prescribes an abortion-inducing drug to a pregnant 
   
   woman for the purpose of inducing an abortion as authorized by this 
   
   section and the physician knows that the woman experiences a 
   
   serious adverse event, as defined by the MedWatch Reporting System, 
   
   during or after the administration or use of the drug, the physician 
   
   shall report the event to the United States Food and Drug 
   
   Administration through the MedWatch Reporting System not later than 
   
   the third day after the date the physician learns that the event 
   
   occurred. 
   
   Sec. 171.064. ADMINISTRATIVE PENALTY. (a) The Texas 
   
   Medical Board may take disciplinary action under Chapter 164, 
   
   Occupations Code, or assess an administrative penalty under 
   
   Subchapter A, Chapter 165, Occupations Code, against a person who 
   
   violates Section 171.063. 
   
   (b) A penalty may not be assessed under this section against 
   
   a pregnant woman who receives a medical abortion. 
   
   SECTION 4. Section 245.010(a), Health and Safety Code, is 
   
   amended to read as follows: 
   
   (a) The rules must contain minimum standards to protect the 
   
   health and safety of a patient of an abortion facility and must 
   
   contain provisions requiring compliance with the requirements of 
   
   Subchapter B, Chapter 171. On and after September 1, 2014, the 
   
   minimum standards for an abortion facility must be equivalent to 
   
   the minimum standards adopted under Section 243.010 for ambulatory 
   
   surgical centers. 
   
   SECTION 5. Section 245.011(c), Health and Safety Code, is 
   
   amended to read as follows: 
   
   (c) The report must include: 
   
   (1) whether the abortion facility at which the 
   
   abortion is performed is licensed under this chapter; 
   
   (2) the patient's year of birth, race, marital status, 
   
   and state and county of residence; 
   
   (3) the type of abortion procedure; 
   
   (4) the date the abortion was performed; 
   
   (5) whether the patient survived the abortion, and if 
   
   the patient did not survive, the cause of death; 
   
   (6) the probable post-fertilization age of the unborn 
   
   child [ period of gestation ] based on the best medical judgment of 
   
   the attending physician at the time of the procedure; 
   
   (7) the date, if known, of the patient's last menstrual 
   
   cycle; 
   
   (8) the number of previous live births of the patient; 
   
   and 
   
   (9) the number of previous induced abortions of the 
   
   patient. 
   
   SECTION 6. Section 164.052(a), Occupations Code, is amended 
   
   to read as follows: 
   
   (a) A physician or an applicant for a license to practice 
   
   medicine commits a prohibited practice if that person: 
   
   (1) submits to the board a false or misleading 
   
   statement, document, or certificate in an application for a 
   
   license; 
   
   (2) presents to the board a license, certificate, or 
   
   diploma that was illegally or fraudulently obtained; 
   
   (3) commits fraud or deception in taking or passing an 
   
   examination; 
   
   (4) uses alcohol or drugs in an intemperate manner 
   
   that, in the board's opinion, could endanger a patient's life; 
   
   (5) commits unprofessional or dishonorable conduct 
   
   that is likely to deceive or defraud the public, as provided by 
   
   Section 164.053, or injure the public; 
   
   (6) uses an advertising statement that is false, 
   
   misleading, or deceptive; 
   
   (7) advertises professional superiority or the 
   
   performance of professional service in a superior manner if that 
   
   advertising is not readily subject to verification; 
   
   (8) purchases, sells, barters, or uses, or offers to 
   
   purchase, sell, barter, or use, a medical degree, license, 
   
   certificate, or diploma, or a transcript of a license, certificate, 
   
   or diploma in or incident to an application to the board for a 
   
   license to practice medicine; 
   
   (9) alters, with fraudulent intent, a medical license, 
   
   certificate, or diploma, or a transcript of a medical license, 
   
   certificate, or diploma; 
   
   (10) uses a medical license, certificate, or diploma, 
   
   or a transcript of a medical license, certificate, or diploma that 
   
   has been: 
   
   (A) fraudulently purchased or issued; 
   
   (B) counterfeited; or 
   
   (C) materially altered; 
   
   (11) impersonates or acts as proxy for another person 
   
   in an examination required by this subtitle for a medical license; 
   
   (12) engages in conduct that subverts or attempts to 
   
   subvert an examination process required by this subtitle for a 
   
   medical license; 
   
   (13) impersonates a physician or permits another to 
   
   use the person's license or certificate to practice medicine in 
   
   this state; 
   
   (14) directly or indirectly employs a person whose 
   
   license to practice medicine has been suspended, canceled, or 
   
   revoked; 
   
   (15) associates in the practice of medicine with a 
   
   person: 
   
   (A) whose license to practice medicine has been 
   
   suspended, canceled, or revoked; or 
   
   (B) who has been convicted of the unlawful 
   
   practice of medicine in this state or elsewhere; 
   
   (16) performs or procures a criminal abortion, aids or 
   
   abets in the procuring of a criminal abortion, attempts to perform 
   
   or procure a criminal abortion, or attempts to aid or abet the 
   
   performance or procurement of a criminal abortion; 
   
   (17) directly or indirectly aids or abets the practice 
   
   of medicine by a person, partnership, association, or corporation 
   
   that is not licensed to practice medicine by the board; 
   
   (18) performs an abortion on a woman who is pregnant 
   
   with a viable unborn child during the third trimester of the 
   
   pregnancy unless: 
   
   (A) the abortion is necessary to prevent the 
   
   death of the woman; 
   
   (B) the viable unborn child has a severe, 
   
   irreversible brain impairment; or 
   
   (C) the woman is diagnosed with a significant 
   
   likelihood of suffering imminent severe, irreversible brain damage 
   
   or imminent severe, irreversible paralysis; [ or ] 
   
   (19) performs an abortion on an unemancipated minor 
   
   without the written consent of the child's parent, managing 
   
   conservator, or legal guardian or without a court order, as 
   
   provided by Section 33.003 or 33.004, Family Code, authorizing the 
   
   minor to consent to the abortion, unless the physician concludes 
   
   that on the basis of the physician's good faith clinical judgment, a 
   
   condition exists that complicates the medical condition of the 
   
   pregnant minor and necessitates the immediate abortion of her 
   
   pregnancy to avert her death or to avoid a serious risk of 
   
   substantial impairment of a major bodily function and that there is 
   
   insufficient time to obtain the consent of the child's parent, 
   
   managing conservator, or legal guardian ; or 
   
   (20) performs or induces or attempts to perform or 
   
   induce an abortion in violation of Subchapter C, Chapter 171, 
   
   Health and Safety Code . 
   
   SECTION 7. Section 164.055(b), Occupations Code, is amended 
   
   to read as follows: 
   
   (b) The sanctions provided by Subsection (a) are in addition 
   
   to any other grounds for refusal to admit persons to examination 
   
   under this subtitle or to issue a license or renew a license to 
   
   practice medicine under this subtitle. The criminal penalties 
   
   provided by Section 165.152 do not apply to a violation of Section 
   
   170.002 or Subchapter C, Chapter 171 , Health and Safety Code. 
   
   SECTION 8. Effective September 1, 2014, Section 245.010(c), 
   
   Health and Safety Code, is repealed. 
   
   SECTION 9. This Act may not be construed to repeal, by 
   
   implication or otherwise, Section 164.052(a)(18), Occupations 
   
   Code, Section 170.002, Health and Safety Code, or any other 
   
   provision of Texas law regulating or restricting abortion not 
   
   specifically addressed by this Act. An abortion that complies with 
   
   this Act but violates any other law is unlawful. An abortion that 
   
   complies with another state law but violates this Act is unlawful as 
   
   provided in this Act. 
   
   SECTION 10. (a) If some or all of the provisions of this 
   
   Act are ever temporarily or permanently restrained or enjoined by 
   
   judicial order, all other provisions of Texas law regulating or 
   
   restricting abortion shall be enforced as though the restrained or 
   
   enjoined provisions had not been adopted; provided, however, that 
   
   whenever the temporary or permanent restraining order or injunction 
   
   is stayed or dissolved, or otherwise ceases to have effect, the 
   
   provisions shall have full force and effect. 
   
   (b) Mindful of Leavitt v. Jane L. , 518 U.S. 137 (1996), in 
   
   which in the context of determining the severability of a state 
   
   statute regulating abortion the United States Supreme Court held 
   
   that an explicit statement of legislative intent is controlling, it 
   
   is the intent of the legislature that every provision, section, 
   
   subsection, sentence, clause, phrase, or word in this Act, and 
   
   every application of the provisions in this Act, are severable from 
   
   each other. If any application of any provision in this Act to any 
   
   person, group of persons, or circumstances is found by a court to be 
   
   invalid, the remaining applications of that provision to all other 
   
   persons and circumstances shall be severed and may not be affected. 
   
   All constitutionally valid applications of this Act shall be 
   
   severed from any applications that a court finds to be invalid, 
   
   leaving the valid applications in force, because it is the 
   
   legislature's intent and priority that the valid applications be 
   
   allowed to stand alone. Even if a reviewing court finds a provision 
   
   of this Act to impose an undue burden in a large or substantial 
   
   fraction of relevant cases, the applications that do not present an 
   
   undue burden shall be severed from the remaining provisions and 
   
   shall remain in force, and shall be treated as if the legislature 
   
   had enacted a statute limited to the persons, group of persons, or 
   
   circumstances for which the statute's application does not present 
   
   an undue burden. The legislature further declares that it would 
   
   have passed this Act, and each provision, section, subsection, 
   
   sentence, clause, phrase, or word, and all constitutional 
   
   applications of this Act, irrespective of the fact that any 
   
   provision, section, subsection, sentence, clause, phrase, or word, 
   
   or applications of this Act, were to be declared unconstitutional 
   
   or to represent an undue burden. 
   
   (c) If Subchapter C, Chapter 171, Health and Safety Code, as 
   
   added by this Act, prohibiting abortions performed on an unborn 
   
   child 20 or more weeks after fertilization is found by any court to 
   
   be invalid or to impose an undue burden as applied to any person, 
   
   group of persons, or circumstances, the prohibition shall apply to 
   
   that person or group of persons or circumstances on the earliest 
   
   date on which the subchapter can be constitutionally applied. 
   
   (d) If any provision of this Act is found by any court to be 
   
   unconstitutionally vague, then the applications of that provision 
   
   that do not present constitutional vagueness problems shall be 
   
   severed and remain in force. 
   
   SECTION 11. (a) The executive commissioner of the Health 
   
   and Human Services Commission shall adopt the standards required by 
   
   Section 245.010, Health and Safety Code, as amended by this Act, not 
   
   later than January 1, 2014. 
   
   (b) A facility licensed under Chapter 245, Health and Safety 
   
   Code, is not required to comply with the standards adopted under 
   
   Section 245.010, Health and Safety Code, as amended by this Act, 
   
   before September 1, 2014. 
   
   SECTION 12. This Act takes effect immediately if it 
   
   receives a vote of two-thirds of all the members elected to each 
   
   house, as provided by Section 39, Article III, Texas Constitution. 
   
   If this Act does not receive the vote necessary for immediate 
   
   effect, this Act takes effect on the 91st day after the last day of ||||| Joseph E. Potter Principal Investigator 
   
   Welcome to the Texas Policy Evaluation Project!
target: – "It was the worst cramping I've ever had and probably one of the worst pains I've gone through. And … there's always that slight uncertainty of ... I don't really know what I'm doing." This interview with a 24-year-old Texas woman, part of a University of Texas report on reproductive legislation released Tuesday, underscores the measures women in the Lone Star State are taking as access to abortion facilities is restricted, the Guardian reports. Findings of the Texas Policy Evaluation Project are startling: Between 100,000 and 240,000 Texan women ages 18 to 49 have taken matters into their own hands and tried to induce an abortion at home, with, as the Guardian puts it, "varying degrees of success and differing medical consequences." The report asked an online sample of 779 women if they or their best friends had ever tried to self-induce an abortion, with 1.7% saying they had and 4.1% saying their best friend had or they suspected she had, the Atlantic reports. Extrapolating those figures to the nearly 6 million women of reproductive age in Texas is how researchers came to the final numbers, Mother Jones notes. In terms of methods used to attempt an abortion, the drug misoprostol was the most commonly cited, with others including "herbs or homeopathic remedies," alcohol, illegal drugs, hormonal pills, and "getting hit or punched in the abdomen," per the Atlantic. Texas restrictions on abortions are among the strictest in the US: The 2013 HB2 law has shut more than half the state's 41 abortion clinics. The CEO of a gynecology and abortion care organization tells the Guardian that the result is "tremendously disrespectful. Abortion is legal in this country," she says. "And so every woman deserves to have access to whatever method for terminating her pregnancy safely she might choose in her local community." (The Supreme Court will hear arguments over a provision that could leave just 10 or so abortion clinics open in Texas.)