The Disparate Impact of Texas’ Abortion Ban on Low-Income and Rural Women

February 24, 2022 by Lindsay Johnson

In September 2021, Texas Senate Bill 8 (SB8) took effect. SB8 prohibits abortion in the state after six weeks—before many women are aware they are pregnant. It is well known that abortion restrictions disparately impact low-income and rural women and increase illegal abortion[1], and Texas in particular has a long and disturbing tradition of low-income women dying from illegal abortions.[2]

Rosie Jiménez was a 27 year old Latina college student and the first known woman to die in Texas because the Hyde Amendment denied her insurance coverage for safe abortion care. [3] When she died in 1977, Rosie was a single mother to a five-year-old daughter and just six months shy of graduating with a teaching credential.[4] She went to a doctor in her hometown of McAllen, Texas, but her doctor would not perform an abortion because Medicaid would not cover the procedure anymore.[5] Rosie was so determined to finish her education and build a better life for her and her daughter that she refused to use a $700 scholarship check to pay for an abortion out of pocket, and instead went to Mexico and obtained a cheaper, illegal, and unsafe abortion.[6] Immediately following the procedure, Rosie began cramping and bleeding profusely. The scholarship check was still in her purse when she died seven days later of septic shock.

In 1977, the CDC reported that five women sought treatment from hospitals in Texas for bleeding and infection following abortions in Mexico.[7] Three of the women, including Rosie Jimenez, had Medicaid cards in their wallets.[8] Prior to the Supreme Court’s 1973 decision legalizing abortion nationwide, Texas consistently had the highest illegal abortion death ratio and rates in the United States.[9]

SB8 will close a significant number of abortion clinics across the state and will increase the average one-way driving distance to an abortion clinic by fourteen-fold, from 17 miles to 247 miles.[10] If driving nonstop at 70 miles per hour, this means the average drive time will increase by almost 3.5 hours each direction and could require an overnight stay.[11] Considering just the average increase in distance, a minimum wage worker (earning $7.25 per hour) would have to pay $34.50 for gas, or five hours’ wages, driving a car that gets twenty miles per gallon at three dollars per gallon.[12] This would be more than a full day’s earnings just to pay for the additional gas for a round trip. Neighboring states like Louisiana and Oklahoma require multiple visits to an abortion provider, so costs for women traveling to either state for an abortion are even higher. In addition to the cost of gas and the cost of the abortion, a woman from Texas driving to Louisiana or Oklahoma may have to factor in child care, lodging, and lost wages from time off work amongst a host of logistical considerations.

This increase in distance disproportionately impacts low-income women and women of color, who may lack the financial capacity to travel out of the state. Black reproductive justice activist Marcela Howell notes that SB8 would be the latest attack on women of color in Texas.[13] She explains that a disproportionate number of Black women rely on Medicaid and live in low-income households, and notes that even when low-income women in Texas are able to secure financial aid through abortion funds to cover the procedure’s cost, many still lack access to care because they cannot afford related travel costs or childcare.[14] These financial and logistical barriers take time to resolve, and many women are unable to resolve them within six weeks as required by SB8.[15]

Finally, there is the issue of high teen birth rates in the state of Texas and this population’s vulnerability to unsafe abortion. The World Health Organization (“WHO”) reports that pregnancy and childbirth complications “are the leading cause of death globally for adolescent girls aged 15 and 19.”[16] Pregnant teenagers are more likely than older women to develop pre-eclampsia, a life threatening condition, and are more likely also to have preterm deliveries, small babies, and stillbirths.[17] Accordingly, the Committee on the Rights of the Child urges countries to decriminalize abortion and ensure that girls have access to safe abortion services.[18] Texas has the seventh highest teen birth rate of states in the country, as well as the highest teen repeat birth rate.[19] Hispanic and Black girls in particular have higher rates of teen pregnancy, as do girls with low educational attainment, girls living in rural areas, girls in foster care, and girls living in poverty.[20] Teen girls with children are significantly more likely to stop their education and experience unemployment, and 65% of children who are born to young parents in Texas are in poverty.[21] These children are more likely than the children of non-teenage parents to be in poor health and have low levels of education.[22]

Low-income women and women of color already face numerous, challenging barriers in accessing abortion care and outright bans on the procedure only increase existent barriers in addition to increasing the risk of serious health complications or death. Women seeking abortions in Texas already deal with widespread misinformation, lack of in-language support, and social stigma, and SB8 further isolates these women by making the procedure itself wholly inaccessible.[23] In fact, in the wake of SB8, clinics in nearby states are already struggling to meet surging demand, and care for their own residents is being delayed to accommodate women making long trips from Texas. In Oklahoma City, a Planned Parenthood clinic reported that at one point more than 60% of the 219 appointments over the next two weeks were booked by women from Texas.[24]

In examining the disparate effects of SB8 on women in Texas, it is clear the new law will increase and strengthen pre-existing obstacles to abortion for low-income women, women of color, and women living in rural areas of the state. Subsequently, SB8 will lead to more negative outcomes for young women in terms of health, employment, and education. Finally, with a disturbing irony for a law purportedly designed to save lives, SB8 will lead to preventable deaths as a result of risky birth complications and women in Texas being forced to seek alternative, illegal, and dangerous abortions.


To support women in Texas seeking abortions and/or to learn more about abortion funds, please visit the Texas Equal Access Fund website.


[1] See Amy Roeder, The negative health implications of restricting abortion access, Harvard School of Public Health (Dec. 13, 2021)

[2] See Willard Cates Jr. and Roger Rochat, Illegal Abortions in the United States 1972-1974, 8 Family Planning Perspectives 86, 88 (1976).

[3] Remembering Rosie Jiménez , Honoring Her Life Through Our Work, National Network of Abortion Funds(Oct. 3, 2011)

[4] Id.

[5] Id.

[6] Id.

[7] Id.

[8] Id.

[9] See Illegal Abortions in the United States 1972-1974, supra note 2, at 88.

[10] Impact of Texas’ Abortion Ban: A 14-Fold Increase in Driving Distance to Get an Abortion, Guttmacher Institute (August 4, 2021),

[11] Id.

[12] Id.

[13] Deena Zaru, Texas abortion law alarms reproductive justice advocates: ‘We are forcing people into generational poverty,’ ABC News (Sept. 2, 2021),

[14] Id.

[15] Id.

[16] Adolescent pregnancy, World Health Organization (Jan. 31, 2020),

[17] Roni Caryn Rabin, Texas Abortion Law Complicates Care for Risky Pregnancies, The New York Times (Nov. 26, 2021),

[18] Reproductive Rights Under the Convention on the Rights of the Child, Center for Reproductive Rights (last accessed Dec. 2, 2021),

[19] European Parliament resolution of 7 October 2021 on the state law relating to abortion in Texas, USA, European Parliament (last accessed Oct. 16, 2021),

[20] Id.

[21] Id.

[22] See Id.

[23] See S.B.8 Disproportionately Impacts Women of Color, Including Low-Income and Immigrant AAPIs in Texas, National Asian Pacific American Women’s Forum (Nov. 1, 2021),

[24] Paul J. Weber and Jessica Gresko, Explainer: The Texas abortion law’s swift impact, and future (October 7, 2021),