Without fanfare, Planned Parenthood of Greater Texas has resumed abortion services in Waco, more than three years after state laws forced it to close.

The abortion clinic at 1121 Ross Ave. opened in mid-April, the result of a U.S. Supreme Court decision last year that overturned provisions under Texas House Bill 2 that the Waco clinic was unable to meet. The Waco clinic got a new license last fall.

The abortion clinic, which opened in 1994, had served about 800 women a year until it closed in 2013 because of its inability to meet the HB2 standards of “ambulatory surgical care” and hospital admitting privileges. The closure left a gap of abortion services between Austin and Dallas-Fort Worth, and Planned Parenthood clinics haven’t seen a corresponding increase in numbers.

“We saw an increase in travel distance for the patient to access her right to a safe, legal abortion,” PPGT spokeswoman Stephanie Mabry said. “We saw increased wait times for the patient. We saw women who were needing to take off several days of work, and to find child care for those they left behind. A lot of times we saw that women went from needing an abortion in the first trimester to needing one in the second trimester because of the distance and wait time. That not only increases cost but complications when you wait longer.”

The Waco abortion clinic is adjacent to Planned Parenthood’s longstanding women’s health clinic, which provides family planning and health screening service, but the clinics are physically and operationally separate, Mabry said.

Anti-abortion activists have been protesting the return of abortion services since February, before the clinic opened, posting signs, signing petitions and running advertisements vowing “Never again in Waco.”

Pro-Life Waco director John Pisciotta said the news of the reopening confirmed his fears.

“Certainly, it’s a big disappointment that this has happened, that abortion has returned to Waco,” Pisciotta said. “We had hoped that maybe they would reconsider their decision.”

He said the group would “pivot” back to fighting Planned Parenthood of Greater Texas, both in Waco and in Austin. He said the group will also call out businesses that are friendly to the nonprofit organization.

“For any business that publicly supports Planned Parenthood, we’re going to make the public aware of their decisions,” Pisciotta said. “Our goal is to have Planned Parenthood shut down completely in our city.”

Open by appointment

Mabry said the clinic will be open by appointment on certain days of the month and will be served by a doctor who travels here from another city.

The cost of the abortion is borne by the patient or by private donors, with no public money going to the procedure, Mabry said.

She said the state of Texas has cut off major sources of funding for women’s health services, and she expects to ultimately see the elimination of federal Title X and Medicaid funding for family planning and preventive health services.

“When you hear the term, ‘defund Planned Parenthood,’ what you’re really hearing is defunding birth control, defunding breast and cervical cancer screenings, defunding sexually transmitted disease infection testing and treatment,’ ” she said. “There’s no defunding happening on abortion services. Those services are intact. If you limit access to birth control you increase the number of unplanned pregnancies.”

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