Cheryl Nelson went to Planned Parenthood when she was a teenager and didn’t know anything about sex education or birth control. She returned when she was ready to have a baby, and later, when that baby grew up and needed testing for a possible infection.
Nelson was devastated when Roe v. Wade, the landmark court decision that provided a constitutional right to abortion, was overturned in 2022 — not just because it meant people couldn’t get legal abortions in Texas but because it caused Planned Parenthood health centers to close and staff to relocate to other states.
At the time, Texas had already passed the “Heartbeat Act” a year prior, banning abortion once cardiac activity could be detected, usually around six weeks of pregnancy. After the Roe reversal, referred to by most physicians as “Dobbs” in reference to Dobbs v. Jackson Women’s Health Organization, Texas implemented an even stricter near-total criminal ban, prohibiting almost all abortions except in limited medical emergencies.
But Planned Parenthood didn’t go away, although some people will be surprised to hear that. In Texas alone, the national non-profit still serves more than 100,000 people a year at 22 healthcare centers in Houston, Dallas, Fort Worth, Waco, Austin, Lubbock and El Paso.
Dr. Anitra Beasley, Planned Parenthood’s Houston-based associate medical director, has been with the nonprofit since 2010 and has seen it go from a well-known abortion provider that drew weekly protests to a healthcare resource fighting to raise its public profile so it can stay in business.
“I don’t think that is an accident,” she says. “All of the attacks against Planned Parenthood are very purposeful, so if the message can get out that we are closed, that’s the message some people want. We are still here and we still care. One of our slogans is ‘Planned Parenthood cares, no matter what.’ We’re here to give evidence-based, unbiased, patient-centered care.”
Last September, Planned Parenthood Gulf Coast, which served Texas and Louisiana, folded, prompting the closure of all the Planned Parenthood offices in Louisiana and two Houston healthcare centers, including the 78,000-square-foot Prevention Park. There are still four offices — Northville, Northwest, Spring and Stafford — in the Houston region.
Autumn Williams, communications director for Planned Parenthood of Greater Texas, says that ultimately, since the nonprofit no longer offers abortions and staff was reduced, some centers were too big for the operations that remained.
“It was a long process, death by a thousand cuts, basically,” she says. “It’s a super-challenging landscape, particularly because Planned Parenthood Gulf Coast was rooted in two different states, so there were two different legislative threats and two different defunding scenarios.”
Despite the obstacles, Planned Parenthood Greater Texas took over the four remaining Houston centers and oversees those in addition to the ones in North, Central and West Texas. An affiliate, Planned Parenthood of South Texas, is based in San Antonio and serves patients in the Rio Grande Valley.
Pro-choice advocates continue to speak out against Texas’ near-total abortion ban four years after Roe v. Wade was reversed. Credit: Screenshot
Planned Parenthood receives no state or federal funding, and Medicaid funding was withdrawn from the nonprofit in 2021. The agency operates primarily on private donations. It has always offered more than birth control pills, IUDs and abortions, Williams says. It provides pregnancy testing and can “give people accurate information about their pregnancy options,” Williams says.
Planned Parenthood centers employ doctors and nurses and offer gynecological exams, sexually transmitted infection testing, breast exams and cervical cancer screening. They also provide gender-affirming care and hormone therapy for adults over the age of 18. Hormone therapy isn’t just for the transgender population; it has become increasingly popular among perimenopausal and menopausal women, Williams adds.
“Access to sexual and reproductive healthcare has been diminished greatly in Texas over the past 15 years, with pretty devastating consequences, particularly for communities that already face systemic barriers to care and education,” Williams says, noting that most Planned Parenthood patients are uninsured.
Federal Legislation on Mifepristone
Although Planned Parenthood can’t prescribe or distribute abortion drugs, they are permitted by law to refer people to abortionfinder.org, a clearinghouse of resources for abortion pills by mail and in-person procedures in states where it is legal.
So Williams says she’s keeping an eye on a looming Supreme Court debate over Mifepristone, a popular abortion pill that accounts for two-thirds of American abortions and, when used with Misoprostol, can also manage miscarriages.
Earlier this month, the ultra-conservative 5th U.S. Circuit Court of Appeals blocked a 2023 Food and Drug Administration regulation that allowed Mifepristone to be obtained by mail. Until recently, Texans were able to get around the abortion ban by securing Mifepristone prescriptions through telehealth appointments from states where abortion is legal. In the biggest jolt to abortion policy since Dobbs, the 5th Circuit’s ruling states that Mifepristone may only be obtained in person.
Supreme Court Justice Samuel Alito issued a temporary halt to the 5th Circuit’s reversal last week, an action that pleased pro-choice advocates, but the “stay” only lasts a week and expires today, Monday, May 11. The temporary hold also raises questions about what exactly the Supreme Court is “teeing up” in terms of whether Texans will have access to Mifepristone in the future or the matter will be tied up in a federal court system for years, says University of Houston Law Center professor Seth Chandler.
The Mifepristone debate covers three major issues, Chandler says, noting that the most troubling matter is Louisiana’s desire to file suit because “a federal policy has an indirect effect on its pocketbook.”
“The first is abortion — still the most consequential social policy question on the court’s docket,” Chandler says. “The second is standing — when can a state drag the federal government into court over a regulation that does not directly require the state to do anything? The third is remedy — can a single court of appeals effectively shut down a federal rule nationwide? Cases that bundle one such issue are [worthy of review by a higher court]. This one bundles all three.”
Planned Parenthood supporters advocate at a 2023 rally. Credit: Screenshot
The New Orleans-based 5th Circuit is composed of justices who were all appointed by Republican presidents and is considered to be the most conservative federal appeals court in the United States. Although it only hears cases from Louisiana, Texas and Mississippi, banning an abortion drug and overturning an FDA ruling has national implications.
Justice Alito’s temporary hold was in response to a request from Mifepristone manufacturer Danco Laboratories. Chandler predicts the stay will be extended past Monday, and the matter will likely go before the full Supreme Court for a more extensive review when a new term begins in October.
“The 5th Circuit ruling is very difficult to understand,” Chandler says. “Its position seems very much at odds with several Supreme Court precedents. The 5th Circuit cited its own precedents but ignored the decisions of the Supreme Court that narrowed those rulings. I find the 5th Circuit’s decision on Louisiana’s standing to sue to be very suspect.”
Chandler says the Supreme Court may say that it’s appropriate in this context for a federal court of appeals to issue a ruling that affects people across the country but the issue of standing — whether Louisiana has the right to sue — is what bothers him the most.
Mifepristone was approved by the FDA in 2000, with generic versions going on the market in 2019 and 2025. Pro-choice advocates say the drug is proven to be safe and effective. However, Texas and Florida are suing the FDA, saying the agency did not conduct proper safety evaluations.
Critics say Mifepristone is designed to end lives and can also be dangerous to the pregnant woman, noting that in most cases, a doctor is not present when the drug is taken. Lila Rose, founder of the anti-abortion group Live Action, said in a statement that the “reckless mail order abortion pill scheme has fueled a surge in chemical abortions.”
Texas’ “bounty hunter law” was approved last year and allows residents to sue prescribers and distributors of abortion-inducing drugs for up to $100,000 per case. However, 22 states where the medication is prescribed have “shield laws” that provide civil and criminal protections for healthcare providers who assist people in states like Texas.
The outcome of the Mifepristone matter concerns Planned Parenthood because its staff is charged with providing accurate information on pregnancy options, Williams says. Although Planned Parenthood is no longer directly involved in abortion, it can distribute morning-after pills such as Plan B, an emergency contraception to prevent ovulation or pregnancy. Such medication is available over the counter and by prescription and is legal for anyone who needs it, Williams says.
“If someone is seeking abortion care, we would refer them to resources about where they can seek that elsewhere,” she says. “You don’t have to be undercover about it. There’s nothing illegal about sharing information about where abortion is available and legal, and what those options are.”
Amid the abortion debates that have gained national attention, Williams says that some Texas anti-abortion activists and elected officials attempt to sow fear and confusion.
Attorney General Ken Paxton led an effort last year to criminally charge midwives and their associates for helping pregnant women access healthcare, threatening them with up to 99-year prison sentences.
Acknowledging that some pregnant women are afraid to seek care, Williams says they “still deserve medically accurate information about what [their] options are, and Planned Parenthood is still that resource.”
What Does Planned Parenthood Do Now?
Beasley says that Planned Parenthood is “really just a place where you can feel safe when you’re talking about contraception and sex.”
Some women in their 40s who haven’t seen a gynecologist since they gave birth are making their way back to Planned Parenthood because they’re dating again after a divorce or loss of a spouse, Williams says. “They can still get pregnant and they still need to protect against STIs.”
“We’re still serving thousands and thousands of patients in all of these communities with essential care, even more essential now that abortion is no longer an easy, accessible service,” she says. “Regardless of the political aspects here in Texas, this state has far too few resources for healthcare in general, and it is particularly acute for populations and communities that are already facing systemic barriers because of race, ethnicity, gender identity, disability or because they live in a rural area and there’s no healthcare or hospital close to them.”
Brandon Nelson and his mother Cheryl have supported Planned Parenthood for decades. Credit: Screenshot
Planned Parenthood accepts most insurance and provides assistance for eligible patients who can’t afford healthcare. Protesters don’t frequent the centers the way they did in the 1990s and early 2000s, but there are still people who don’t like the idea of a healthcare center handing out birth control and providing gender-affirming care. And there are many, Williams says, who don’t know how much the nonprofit has to offer.
In addition to being able to book a doctor appointment online for the next day, Planned Parenthood offers telehealth consultations and a smartphone application for prescription refills.
“One of my favorite stories is when the huge statewide ice storm happened in 2021, someone had a UTI, and she was desperate and uncomfortable, so she filled out a form on the app and she was able to walk down to CVS, which was open, and get her prescription,” Williams says.
Austin resident Kathy Carr said in a 2023 promotional video for Planned Parenthood that she first visited a healthcare center when she was 19 and had no insurance. “Planned Parenthood welcomed me no matter what my status was,” she said. Carr’s daughters have since gone to Planned Parenthood for birth control or checkups.
The video also features a letter from an 83-year-old grandmother who went to Planned Parenthood for birth control and later bore four healthy children. “I am aware that you were all younger people, but the work and spirit of Planned Parenthood is still the same. My life was and is better because of your care,” the woman said in her letter.
Beasley says she has many dedicated patients who have stuck with Planned Parenthood for decades, even after federal rulings and state laws prompted the agency to change the way it does business. She adds that it’s devastating to see teen pregnancy, sepsis and maternal and infant death rates rising since the Dobbs decision.
“It feels like the state of Texas is, unfortunately, always against us,” Beasley says. “The state doesn’t make it any easier. None of the changes, the laws, the restrictions make it easier or safer for patient care.”
As for Nelson, her son Brandon went on to become Planned Parenthood Greater Texas’ senior director of philanthropy in Fort Worth. He says that when he asked his mom what she thought of him going to work for the nonprofit, she told him that Planned Parenthood was a place where she was educated, and “at the times when there was a need, Planned Parenthood was there.”
“Thirty-something years later, we’re still here,” Brandon Nelson says. “Planned Parenthood transcends generations.”
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