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Texas Women’s Health

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Tenaha High School students fill in the blanks of their “Choosing the Best Life” workbooks on Nov. 11, 2022, as an instructor from a nonprofit that provides abstinence-based sex education reads out information on STDs. Tenaha ISD is in Shelby County in Deep East Texas. A homemade billboard along Farm to Market Road 83 outside of Hemphill on Dec. 30, 2022. In this region of the state, religion is entangled in community life and conversations about sex education. While in Lufkin for a checkup, Walker went into labor with Everleigh. Her proximity to medical staff in the city proved lifesaving for her daughter, who was born with her umbilical cord wrapped around her neck Labor and delivery nurse Ginger Kalafatis spends time with her children at her mother’s home on Dec. 30. Kalafatis’ parents were health care workers who moved to Jasper to open the hospital. Now, her children are following in her footsteps and becoming nurses too. Williams holds 3-month-old Ire’Lynn inside her home in Pineland. Williams gets her daughter Indya, 5, ready for bed.
About the Project

As the nation began to grapple with the radically redrawn landscape of abortion access, The Texas Tribune embarked on an immersive project exploring East Texas as a case study in the consequences of life without access to comprehensive reproductive health care. The International Women’s Media Fund financially supported some logistical aspects of reporting such as travel, but this series was written and edited entirely by Tribune staff.

East Texas is a vast rural region of the state secluded “behind the pine curtain,” is a place where the promise of Roe v. Wade was never fully fulfilled, and women’s reproductive choices have long been made for them, by dint of geography, religion, politics and culture.

Women in East Texas have always had to travel hundreds of miles or turn to illegal means to access abortion care, if they see termination as an option at all. Post-Roe, East Texas was cut off even further — surrounded on all sides by states that ban abortion.

The region is also home to some of the most virulent anti-abortion state legislators and behind-the-scenes puppetmasters of the movement, who have dedicated decades of work to closing abortion clinics their constituents and neighbors have never even had easy access to.

Meanwhile, they have all but abandoned the myriad other aspects of reproductive health care that affect women every day. The Tribune’s deeply reported stories published in early 2023 follow the life cycle of a womans’ reproductive journey in East Texas in three parts:

Comprehensive sex education and contraception are proven to prevent teen pregnancy. But in a religious stretch of deep East Texas students receive little to no sex education and don’t know how to access contraception.

When a hospital in deep East Texas shuttered its labor and delivery unit, already vulnerable women were left without pre and postnatal care, or a place to safely deliver babies. The area’s struggle to restore women’s health services shows the limitations on rural health care in Texas.

Finally, one mother’s experience the year after she decided to keep her third pregnancy demonstrates how ill prepared Texas is to support the families it currently has, let alone the surge of mothers and babies expected as a result of the state’s near-total abortion ban. As motherhood plunges parents deeper into poverty, Texas does little to help.

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