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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 
 
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– "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.)