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Up until a few weeks ago, the website for the University of Texas at Austin’s health center laid out three options for pregnant students to possibly pursue: they can carry the pregnancy to term and raise the child, put the baby up for adoption or terminate the pregnancy.
When the state enacted a law in September that prohibited abortion after about six weeks, the website added language making note of the restriction.
But two weeks after the U.S. Supreme Court overturned Roe v. Wade, the landmark case that asserted abortion access as a constitutional right for nearly five decades, the university removed the entire text about pregnant students’ options from its website. What remains are vague instructions.
“If you are pregnant, our Women’s Health providers can discuss options and help connect patients to appropriate resources,” the website now reads.
UT-Austin officials did not respond to questions explaining why they removed the paragraph about pregnant students’ options from its site. But the timing illustrates how public university health centers are rethinking how they can and should communicate with students about reproductive health care amid a vague and rapidly changing legal landscape in Texas.
“It’s put people in a position where they don’t know what they can offer in student health centers, because they don’t know exactly how the law is going to fall out — or even what the law defaulted to after Roe was repealed,” said Gretchen Ely, a social work professor at the University of Tennessee Knoxville who focuses on access to reproductive care.
Yet the stakes are high because college students fall in the age group that has historically received the largest percentage of abortions in Texas annually, which puts university health centers on the front lines of providing reproductive health information and services in the form of wellness exams and birth control.
So far, Texas universities have remained silent about the Supreme Court’s ruling. The vast majority did not respond to The Texas Tribune’s requests for comment or provided vague answers about what kind of information and resources health centers will share with students who become pregnant in this new era of reproductive care in the state.
“Each student’s circumstances dictate our counsel regarding medical care,” Cecilia Jacobs, a spokesperson for Stephenville-based Tarleton State University, said in a statement. “[F]or students seeking non-emergency assistance that’s not readily available we provide information on how to find it” through internet searches, health insurance resources or local health care entities, she added.
Students say they are also frustrated — but unsurprised — that university leaders have not spoken out about the Roe v. Wade reversal or proactively communicated about how they plan to handle conversations about abortion access moving forward. At some universities, students have recommitted to sharing abortion access resources through student organizations, as well as providing deliveries of free emergency contraception to students anonymously. Last week, a group of student leaders at UT-Austin signed a list of demands calling on administrators to support students’ reproductive health care and advocate for students’ rights with the Texas government. The university has not responded to the students as of Tuesday.
“During times when the rights of marginalized communities are under attack, our university succumbs to silence to avoid criticism from said politicians. However, it is the university’s responsibility and priority to protect the rights and health of their students, staff, and faculty,” the petition read. “Therefore, we call upon the university to advocate for reproductive health care access through its influential position within Texas politics to protect and uplift its students, faculty, and staff.”
As health care professionals try to figure out how to move forward in a post-Roe world, some students say they are now hesitant to ask questions or share details of an unexpected pregnancy with university health centers, unsure where the role of a health professional ends and a state-funded university employee begins.
“It’s too much of a gray area at this point,” said Nikita Kakkad, a junior at UT-Austin. “And it’s not the practitioners. It’s the structure.”
Preexisting information gaps about abortion
Even before Roe v. Wade was overturned, few Texas universities mentioned abortion as an option for pregnant students on their public-facing websites and very few listed places like Planned Parenthood as a community resource. Students said it is also difficult to access information about abortion and comprehensive sex education on their campuses.
Most Texas universities state that they offer wellness exams, birth control and pregnancy tests and will provide referrals to pregnant students for off-campus prenatal care. That often includes referrals to OB-GYNs.
A few universities across the state, including Prairie View A&M University and Tarleton State, also include crisis pregnancy centers as resources for pregnant and parenting students on their websites under Title IX resources. Pregnant students have protections under Title IX, the federal law that prohibits sex-based discrimination.
Research has shown that crisis pregnancy centers often inaccurately present themselves as health clinics — some offer free ultrasounds and provide free baby supplies — even though they are religiously affiliated nonprofits largely staffed by nonmedical professionals who cannot diagnose patients. They often discourage abortion in sometimes manipulative and deceptive ways. Neither Prairie View A&M nor Tarleton State responded to questions as to why they include these centers as potential resources for pregnant students.
In addition to information gaps, one university health center leader told the Tribune the facility had already adjusted how its health care providers advise pregnant students about their options. The center made the changes after the state passed a law last year that allows private citizens to file a lawsuit against anyone who “aids or abets” an abortion after about six weeks of pregnancy.
“We interpreted that as [our] providers can’t really help people find that service,” said Martha Dannenbaum, director of student health services at Texas A&M University in College Station and an OB-GYN. “I don’t see this dramatically changing … how we will manage and support the students who come to us with these questions. Where we will be mindful is that we’re not going to be making direct referrals to an [abortion] provider. Mainly because we don’t have any. We’re not going to have any.”
She said in instances in which a pregnant student wanted information about their options to keep or terminate a pregnancy, she would share how students could find additional information themselves, either through health insurance or on the internet.
“Our role is, as the health care providers particularly in a college health setting, is to provide … the student with factual information and answer any of their questions about it and provide them nonjudgmental care,” she said.
Rachel Mack, a spokesperson for the American College Health Association, said abortion bans and other restrictions can put health care providers at risk of civil liability or arrest.
“Many of these laws are not just restrictive — they are also vague, which creates fear and confusion among both patients and health care providers,” she said in a statement. “The vagueness of these laws also could result in students being isolated from trusted supports in their most vulnerable moments.”
Dannenbaum at Texas A&M said she does anticipate an uptick this fall in the number of students trying to access more effective contraception, such as intrauterine devices (IUDs), in response to a “trigger law” passed last year that was set to go into effect and ban abortion from the moment of fertilization if the Supreme Court overturned Roe. The trigger law will likely go into effect in mid- to late August, though the procedure is already illegal in Texas due to a near-total ban on abortion passed in the 1920s that went back into effect after the Supreme Court repealed Roe v. Wade.
She also said she expects to have additional conversations with Texas A&M lawyers and the university’s health care providers ahead of the fall semester to make sure everyone understands how to provide factual information to students while remaining within the confines of state law. But she remained confident the health center could maintain its quality of care.
“There are many things that happen that change processes of how you have to do things in health care and in other industries. This is another one of them. It doesn’t help patients, students, providers, to get panicked about it,” she said. “In the college health setting, I’m here to support them to be successful students, regardless of whether they parent, whether they adopt out, whether they choose termination. We’re here to support them.”
Yet Dannenbaum said she and her team haven’t discussed if the university’s health care providers would suggest that students can reach out to abortion funds to learn about ways to possibly travel out of state to access abortion care.
She said she would likely direct students to the student assistant services department, which can provide some short-term financial support for medical services to students without requiring detailed information about a diagnosis.
“It’s really dependent on whether you have a needed medical service and … a financial need,” she said.
More access to contraception
Students involved in reproductive justice advocacy on college campuses said they would largely advise students who are considering terminating their pregnancies to reach out to abortion funds rather than going to the university health center for information.
“Students themselves are not comfortable with going anywhere beyond surface-level questions,” Hairou Yi, a UT-Austin junior and vice president of UT Students for Planned Parenthood, told the Tribune about health centers. “Because they don’t know the legal ramifications that can come with [it].”
Experts, such as Ely at the University of Tennessee, said health centers should not just be ready to provide information, but be prepared for the possibility that some students might come into the center with complications from a self-managed abortion.
But Ely said she’s cognizant of the tightrope that health care providers at publicly funded institutions must walk.
“That’s a very real concern, both at the individual level for the student in terms of confidentiality and then for the student health centers in public universities in states where abortion is criminalized,” she said.
With all that in mind, Ely said, university health centers should increase their work to provide accessible reproductive health information and have emergency contraception available for free or low cost. While many Texas universities currently offer Plan B emergency contraceptives in their pharmacies, it can cost $25 to $35.
Kakkad, the junior at UT-Austin, has been pushing the university to make emergency contraception more accessible by installing a vending machine on campus that dispenses Plan B contraceptives. She said talks with university officials have been productive, but action hasn’t been taken toward making the proposal a reality. The list of demands sent to UT-Austin administrators last week included adding a vending machine, as well as eliminating mandatory attendance, a policy that students say hurts those who are pregnant or have children.
Student groups say they can offer a safe space for students to figure out where they can go for information about their specific situations, but they have their limits.
Nimisha Srikanth is a rising senior at Texas A&M University and president of the group Feminists for Reproductive Equity & Education, or FREE Aggies, on campus. She said now that Texas allows people to sue those who help a person get the procedure, there is confusion about what constitutes helping someone get an abortion, which can make people hesitant to share information.
The trajectory of limiting abortion access has led many in her group to prepare for the state to also criminalize providing information about abortion, which also makes them hesitate about how much information they should share.
“The best thing a person could do at this point is contact an abortion fund because they’re the ones on the ground doing the work,” she said. “We run the risk of having really complicated legal stuff if we were to get more involved.”
We want to hear from Texas college students about their experiences accessing reproductive health care at their on-campus health centers and how they’re getting information about abortion access in the wake of the reversal of Roe v. Wade. Email reporter Kate McGee at firstname.lastname@example.org. We will not publish any information without first contacting you.
Disclosure: Planned Parenthood, Prairie View A&M University, Texas A&M University and University of Texas at Austin have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
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Clarification, July 22, 2022: An earlier version of this story stated that a ban on abortion passed last year will go into effect around the start of the fall semester. The story has been updated to note that the procedure is already illegal in Texas due to a near-total ban on abortion passed in the 1920s that went back into effect after the Supreme Court repealed Roe v. Wade.