In Texas, where abortion is already a crime, more roadblocks to access could be coming

Look closely and a faint outline of the "Whole Women's Health" sign is all that remains of the only abortion clinic in McAllen, Texas.

It was forced to close last summer. The building is now owned by a group of anti-abortion supporters — a literal symbol of the end of Roe v. Wade and a woman's right to choose in the state.

"I'm numb," said Cathy Torres from Frontera Fund, an organization that used to help 30 to 40 people a month travel within Texas or to nearby states to get abortions.

"People have always had abortions," Torres said. "And they're going to keep having them. It's just a matter of how and where."

After the U.S. Supreme Court overturned constitutional protections for abortion in the Dobbs ruling of June 2022, Texas's trigger ban outlawed nearly all abortions in that state a month later.

As a new legislative session begins in Texas, anti-abortion lawmakers are saying their work restricting access is not over.

"I am concerned about restrictions on travelling for abortion care. I think that's what they're going to come after next. I just feel it in my bones," Torres said.

Now, a Trump-appointed federal judge in Texas is set to decide whether mifepristone, a drug used in medical abortions, could be made illegal nationwide.

"I am concerned about these battles we're going to see moving forward," said Rochelle Garza, president of the Texas Civil Rights Project. "[Battles] on medication abortion, Plan B, access to basic birth control."

CBC went to Texas's Rio Grande Valley to see the realities of what restricted access looks like.

Among the most restrictive laws in U.S.

The Rio Grande Valley in southern Texas has long been at the centre of the fight for abortion access. Until June 2022, Whole Women's Health serviced the vast area and a population of more than a million, including mostly Latina and many undocumented women.

Frontera Fund is part of a U.S. federal class action lawsuit filed days after the Texas trigger ban was enacted asking for an injunction against possible prosecution for helping people access legal abortions in other states.

"There's just a lot of risk, criminal risk, actually. I'm literally not even exaggerating," Torres said.

Frontera Fund has re-opened its helpline, but limits what it can tell callers to information available online. Torres said she is worried about legal ramifications if she provides too much information.

"We say that it's Google with compassion, because we're not just a random search engine. We've done this work before, so we have knowledge of what information people are looking for.

"You know, we understand that people are scared."

Texas passed some of the most restrictive abortion laws in the United States before the Dobbs decision. Senate Bill 8 was passed in 2021 restricting abortions after six weeks of pregnancy and the detection of cardiac activity.

A law also passed in 2021 stated that 30 days after Roe v. Wade was overturned, a 1925 law would be reinstated, making all abortions in Texas illegal — except when the mother's life is at risk There is no exception for rape or incest.

However, there are networks trying to help women in restricted states like Texas.

Crossing the border for pills

Sandra Cardona of Necesito Abortar, a volunteer organization in Monterrey, Mexico, said 400 women reached out to her in December looking for help. Networks in Tijuana and Guanajuato City are also active.

Cardona helps women access abortion pills in Mexico and coordinates getting medication into the United States. Mexico decriminalized abortion in 2021.

"We accompany them in their processes, in their decisions. We are with them and we listen," she explained.

Last year, her organization spent more than $8,000 US on misoprostol, a drug that can be used to induce a miscarriage. It is often used in combination with mifepristone for medical abortions.

"Most of those who ask about the legal situation, they are somewhat afraid."

WATCH | How people are navigating a near-total ban on abortion: 

In Nuevo Progreso, Mexico, a few minutes walk across the border with Texas, people can purchase misoprostol over the counter with no prescription. Typically used to treat ulcers, so not illegal in Texas, the World Health Organization says misoprostol is 70 to 90 per cent effective and safe for self-managed abortions, depending on how far along the pregnancy is.

Dozens of pharmacies line the streets, selling everything from Xanax to Ozempic. CBC News purchased multiple boxes of misoprostol, with prices varying from $30 to $80 US a box.

The instructions varied too; one pharmacist told us to ask our doctor how to take it, another said a pregnant woman should keep taking the pills every few hours until she starts to bleed. Pharmacists also told us more women are coming to the area purchasing misoprostol.

In April 2022, Lizelle Herrera, a 26-year-old woman in the Rio Grande Valley, was charged with murder after nurses at a local hospital in the Rio Grande Valley suspected her of inducing an miscarriage. The charges were eventually dropped.

"'I'm worried about the criminalization of pregnancy outcomes we've seen in our communities," said Nancy Cárdenas Peña of the National Latina Institute for Reproductive Justice.

"How people can get jailed for pregnancy outcomes like miscarriages or abortion medication."

Legislative battle continues

Peña is spending this legislative session in Austin, Texas, tracking bills that are being filed concerning healthcare and abortion access. So far more than 25 abortion-related bills have been filed, she says.

"We have some deep concerns over some bills that we've been seeing. We have a push from the state to sort of embolden district attorneys from other districts to prosecute cases outside of their own districts," Peña said.

Two bills in particular, she explained, are meant to counteract promises of district attorneys in five counties and districts, such as Dallas, San Antonio and Corpus Christi, to not press charges on abortion crimes.

Democrats are also filing bills, like SD 227 to repeal all laws prohibiting abortion, or SB 122 to include an exception for abortion in the cases of rape or incest.

The current abortion ban, however, has complicated things for doctors and emergency physicians treating pregnant people.

"We're now in a position where in the course of practicing medicine, we could be charged with felonies and crimes that our malpractice insurance wouldn't cover," said Dr. Alison Haddock, board nember of the American College of Emergency Physicians.

The group released a statement when Roe v. Wade was overturned, worried about ramifications when treating pregnant patients.

"That creates a really difficult scenario for all physicians, where they are like, 'OK, I know their health is at risk. At what point is their life at risk?'" said Haddock.

In Texas, there have been cases of pregnant women miscarrying or experiencing pregnancy loss, and physicians sending them home from emergency. Some have become septic.

"You could get to the point where, yes, their life is at risk and the disease has progressed too far and you can't treat it safely anymore," Haddock said.

"So I do worry that pregnant people will lose their lives over this."

Anti-abortion lawmakers celebrating

The Texas Freedom Caucus is a group of Republican lawmakers pushing for even harsher measures against abortion. Texas State Representative Matt Shaheen is a member.

"We have a lot to celebrate in the state of Texas," Shaheen said.

The Texas Freedom Caucus sent threatening letters to a Texas law firm that was offering to help pay for employees travelling out of state for abortion care.

"We wanted to make them aware that they need to seriously take a look at what they're doing and make sure they're not in violation of the state statute," Shaheen said.

"We provided provisions to ensure that physicians outside the state of Texas weren't providing like abortion pills and those types of things as well."

Shaheen said he would also support a move toward recognizing fetal personhood in the state.

Alabama, Arizona, Georgia and Missouri already have such laws that have seen women charged with endangering the life of a child when miscarrying or consuming illegal substances.  Advocacy group Pregnancy Justice documented 1,331 such cases from 2006 to 2020. Charges are often laid against low-income women of colour.

"Texas has always been an example for the Conservative movement and for pushing these very radical laws,"  said Rochelle Garza, who ran for Texas State Attorney General in the 2022 midterms. She lost to Ken Paxton, the Republican incumbent.

"I don't think they're stopping," Garza said.

"I think it's very clear where the anti-choice movement is going. And they want to make sure that every state bans access to abortion care, that every state stops someone from leaving to access that care in a different state. They're not going to stop and we have to fight back."

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