Meet the Texas Abortion Provider Who Refuses to Cave in to Anti-Choice Extremists

Human Rights

Amy Hagstrom Miller has defended her group of Texas clinics, Whole Woman’s Health, all the way to the Supreme Court despite tremendous personal cost. Here’s why.

Amy Hagstrom Miller will face the Supreme Court today in defense of her group of abortion clinics, Whole Woman’s Health. Hagstrom Miller is a mission-driven small business owner, inspired, she says, by her commitment to human rights and justice, a desire to be deeply present with women facing hard decisions and shaping their own futures with intention.

But in recent years, Hagstrom Miller’s goal of maintaining a safe, supportive oasis for the “whole woman” has become almost impossible. For almost a decade, she and her staff have jumped through hoops as the Texas legislature imposed more and more TRAP laws (Targeted Restriction of Abortion Providers), bogus “safety” laws aimed at driving clinics out of business and eliminating abortion access. But after each costly accommodation, Religious Right politicians imposed yet another demand.

In 2013, the Texas legislature passed House Bill 2 which bans abortions after 20 weeks, severely restricts access to medication abortion, forces doctors to seek (otherwise unnecessary) hospital admitting privileges, and requires that all abortion care take place in a surgical center. Under the law, staff are forced to walk a woman into an operating theater before handing her two abortion pills and a glass of water.

Next week, the Supreme Court will hear a challenge to that law, with Whole Woman’s Health as the lead plaintiff. One way or another, the litigation will be over by summer. What has life been like during years of never-ending legal battles? In the following interview Hagstrom Miller talks about the experience.

Valerie Tarico: You’ve spent the better part of a decade simultaneously accommodating and fighting regulations that have little to do with women’s health and everything to do with putting you out of business.

Amy Hagstrom Miller: One objective of the opposition is to make abortion seem more scary, complex and complicated than it actually is. For the patient, that shows up in the language of health and safety, and the physical plant which is built for surgery. The intent is to make a 5- to 10-minute abortion procedure seem dangerous, and that is exactly what it does. Women who have heard this rhetoric come in and ask, Will I ever be able to have a child again? Are you going to cut me? Do you use knives?

In addition to the fear, women often say that they are the only one they know who has had an abortion. They say, I’m Catholic. I’m Christian. I’m a mother. And we let them know, “The majority of our patients are Christian. The majority are mothers already.”

Tarico: It didn’t used to be this way, back when you first started providing abortion care. Tell us more about the changes.

Hagstrom Miller: In the 1990s antagonism to abortion focused on the external part of the clinic. It took the form of physical threats, invasions, and shooting physicians—like the murder at Brookline. Since that time opponents have moved inside the clinic. They penetrated the walls by using the regulatory and legal system as a way to attack women and providers.

Women are forced to look at an ultrasound, forced to listen to a script, forced to endure a waiting period. All of this puts forward the notion that women are stupid, that they have undertaken a difficult decision without having thought about it. The regulatory attack on the provider makes it difficult to stay open, but it also paints us as careless rather than caring, as unsafe and in need of constant oversight instead of as the compassionate medical professionals that we are. In the Texas regulatory system, you are guilty until proven innocent. So abortion foes file anonymous complaints about us and other providers, and we are put in the position of proving they are not true.

Not only that, we are in the position of being forced to explain and enforce laws we disagree with. We were required to make fetal development booklets with misinformation and pay for the production of those materials. Abortion providers are being assessed the fee to produce this propaganda that the state is requiring us to give out.

Tarico: It sounds absurd.

Hagstrom Miller: Women see right through it. Sixty-five percent of the women we serve have one or more children. They’ve all seen an ultrasound before and yet we force them to watch another as if they don’t know what’s growing inside of them. They know, and they are committed: What do I have to watch? How long do I have to wait? I need an abortion, so what do I have to do to get one? It’s almost like an Onion article.What wall do I have to climb? How long do I have to stand on my head? Just tell me what I need to do.

Tarico: It’s taken a decade of Right Wing ratcheting, piling one absurd “safety” regulation on top of another. What does that do to you? 

Hagstrom Miller: I have a rigorous quest internally and philosophically to not let this onslaught change who we are. My commitment is to holistic care: one-on-one counseling; physical surroundings that are warm and comforting with fleece blankets and herbal tea and lavender walls; and freedom to talk about spiritual or cultural concerns. I am committed that these aspects of care not get sacrificed. We will comply with whatever we have to comply with and challenge whatever we have to challenge. But the hearts and minds of women are at the center of who we are.

Tarico: What is it like from an emotional standpoint? I could imagine it being quite the roller coaster.

Hagstrom Miller: I feel really proud as a plaintiff, that we are standing in the light and welcoming this conversation. But internally, it’s been extremely disruptive, for my staff and for me as a small business owner trying to provide a stable environment for nurses and other team members who work for me and who deserve it. When the state forces us to close doors on a clinic, it feels heartbreaking because we know what that means for the women of that community.

Tarico: Does it wear you down?

Hagstrom Miller: In my nature I’m extremely resilient. I’m super hopeful. But as a byproduct of all of this I’ve developed the skill of putting things in little boxes in my head. This could happen . . . but I can’t worry about that. I can’t have my feelings in advance. Sometimes I’m scared of how good I’ve gotten at this, but it contributes to my ability to lead. It lets me do what I can rather than sitting back and freaking out about the unknowns.

Tarico: How do you try to support your staff?

Hagstrom Miller: There is a depth of connection with us at Whole Woman’s Health because of how much we’ve been through together—a deep sense of trust and respect for each other that has sustained us through a whole lot. Our clinic in McAllen on the Texas-Mexico border had to close and reopen, and we laid people off twice. It’s the only clinic south of San Antonio, the only one for 250 miles in any direction. When we re-opened in 2014, most of our former employees had other jobs, but they all came on the day we opened, even if they had to take sick leave. These are just medical assistants with an hourly wage and a couple of kids. Their justice commitment feeds all of us.

Tarico: How do you take care of yourself?

Hagstrom Miller: I have really supportive family and close friends. I have an absolutely fabulous partner. We’ve been married since 1992 and together since 1988.  My parents are in their 80s. They are very proud of what I do, as are my in-laws. They’re proud of my standing up for what’s right, that I’m taking on bullies, that we are speaking on behalf of those who don’t have a voice.

I’m someone who relaxes by doing things. I swim. It’s a very physical way that I maintain my breath, because if you don’t breathe when you’re swimming, you drown. I also spend a lot of time with my family, going to my kids’ soccer games and cooking. Thanks to the pressures, I’ve become quite the gourmet chef in the last couple of years.

Tarico:Would you say that this work has a spiritual dimension for you?

Hagstrom Miller: Absolutely. I was raised in a liberal Christian tradition, and I come to the work because of that background, not in spite of it. The Jesus that I was taught about would be holding the hands of women inside the clinic; he wouldn’t be screaming at them. Acting on Christian principles is holding the hands of people at difficult times in their lives, and being supportive and nonjudgmental and kind. That is very much what we bring to the work. I don’t know how to say it more clearly than that.

Tarico:What can other people do to support you?

Hagstrom Miller: People need to understand that this isn’t just about Texas. All over the country politicians are trying to take away women’s ability to make decisions about ending a pregnancy. In the last five years, anti-abortion politicians in states across the country quietly passed 288 laws very similar to these Texas laws, making it harder for a woman to get an abortion.

So if people want to support us, speak up and show up so each of us can get the care we need with dignity and respect. Question the false narrative that TRAP laws serve a state interest in women’s health and safety. Ask who is benefiting from the stigma and challenge it when you hear it. Talk about why access to safe abortion with dignity is important to you personally, whether you have had an abortion or not.

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