By the end of the year Texas may have even more restrictions on the ability to get an abortion after its Republican governor Greg Abbott quietly signed into law new restrictions banning the mail order provision of abortion medication seven weeks into pregnancy.
The law prevents providers from prescribing abortion-inducing drugs more than seven weeks into pregnancy, instead of ten weeks, the current limit. It takes effect on December 2.
Abbott signed the law with no meaningful fanfare on Friday and news about the event only broke later, triggering outrage from reproductive rights advocates who warned the move was another devastating blow to pregnant people in the state.
"Anti-choice politicians in Texas are launching their attacks on abortion access from every angle imaginable," said Adrienne Kimmell, Naral Pro-Choice America acting president, in a statement.
Even before the legislation, known as Senate Bill 4 (SB4), was signed, Texas had some of the most restrictive abortion laws in the country amid requirements for a 24-hour waiting period, ultrasound imaging, admitting privileges for doctors, parental consent for minors.
Another controversial bill, Senate Bill 8 (SB8), was passed by the Texas legislature in May that sought to stop abortions in the state beyond six weeks, often before many people know they are pregnant. That law effectively rendered abortion in the state almost impossible and triggered widespread condemnation when the supreme court refused an emergency request to block the law.
"The most recent one, in terms of mail-order prescriptions, simply adds one more barrier," said Mark Jones, a professor of political science at Rice University.
The sweep of anti-abortion measures will likely prove popular among Abbott's Republican base, but may not gain wider approval within Texas. About a third of Texans want to see abortion ended entirely, except when pregnancy threatens the life of the pregnant person. But about half of Texans want abortion to remain legal, Jones said.
Will Metcalf, a Texas state representative, tweeted last month that the bill sought a "crackdown on unsafe 'mail order' abortions" and to increase reporting requirements for medical complications. The Texas legislature approved SB4 in a special session ending 2 September.
Those who "intentionally, knowingly, or recklessly" violate the law by providing medication through the mail will now face criminal penalties - as much as $10,000 in fines and two years in prison - including providers from out of state, the Dallas Morning News reported.
Although the law also applies to international organizations providing abortion medication through the mail, such a state-level law could prove difficult to enforce.
Soon after SB8 went into effect, there were indications that self-managed abortions were rising, with a sharp increase in traffic to sites providing abortion drugs in the mail.
The supreme court did not block SB8 from going into effect in Texas, but said in its decision the challengers raised "serious questions" about the constitutionality of the law. A physician who challenged the law, Alan Braid, is now being sued for providing an abortion after six weeks in Texas.
"Now you actually do have somebody whose rights are being violated, who is being sued for doing something that the supreme court has said is constitutional and legal," Jones said. It may prove whether extreme laws such as SB8 and SB4 will stand in higher courts, he said.
In the meantime, women's rights and health organizations are working to provide better access to contraception in the wake of Texas' severe restrictions.
People in Texas and other states "deserve access to the full range of reproductive options, which includes abortion", Angela Maske, who works with the #FreeThePill Youth Council. "As we're seeing these increasing attacks on abortion access, it's really more important than ever that we improve access to birth control."