Jillian Dworin participates in a protest against the six-week abortion ban at the Capitol in Austin, Texas, in Sept. 2021. Jay Janner/Austin American-Statesman via AP, File

AUSTIN, Texas (AP) — Samantha Sorsby-Jones watched friends at her Texas high school go to great lengths to get birth control: Secretly arranging rides to clinics that didn’t require parental consent and hiding phones in bushes in case parents were tracking them.

Starting Tuesday, access to reproductive health care is likely to command fresh scrutiny before the Republican-controlled Texas Capitol, where new restrictions are on the table in the first session since a stringent statewide abortion ban took effect.

Texas’ abortion ban is one of the nation’s strictest, allowing no exceptions in cases of rape or incest, and Republican leaders have been noncommittal about adding carveouts over the next five months. Nationwide, reproductive rights is poised to remain a dominant issue in other U.S. statehouses, where a patchwork of policies has spread nationwide following the fall of Roe v. Wade.

“The right to bodily autonomy is being taken away in so many different ways, it is really devastating,” said Sorsby-Jones, 20, who as a high school student three years ago was able to get birth control at a federally funded clinic in Texas after her parents refused to help her.

But a December ruling by a federal judge in Amarillo has suddenly closed that avenue to other Texas teens. U.S. District Judge Matthew Kacsmaryk ruled that allowing minors to obtain free birth control without parental consent at federally funded clinics, under a program known as Title X, violated parental rights and state law.

Such clinics offer an array of family planning services and served more than 182,000 people in 2020 in Texas, according to Every Body Texas, which administers the funds for the state. A bill filed by a Democrat in response to Kacsmaryk’s ruling could face resistance from Republicans, who have controlled the Texas Legislature for two decades and padded their majority in the fall midterms.

For Republicans, new proposals include penalizing companies that help their Texas employees seek abortions elsewhere, limiting access to abortion-inducing drugs by mail and dispensing emergency contraception. Anti-abortion groups are also pushing lawmakers in the wake of Texas’ abortion ban to spend more money on services for pregnant and parenting Texans, including expanding Medicaid coverage for mothers.

As Texas lawmakers returned to the Capitol, Republican Gov. Greg Abbott and other GOP leaders did not mention further restrictions in ceremonial speeches on the opening day of session, where the Uvalde massacre and how to spend a more than $30 billion budget surplus are also poised to be major issues.

John Seago, president of the anti-abortion group Texas Right to Life, said he doesn’t see enough GOP support to create exceptions in the state’s abortion ban. “If we don’t respond to it this session, it kind of becomes the status quo,” Seago said.

After getting help from a Title X clinic, Sorsby-Jones said she spent years helping other teens find the resources to make independent reproductive health care decisions. In high school, she said, some of her peers had to hide their phones in bushes at a nearby fast food restaurant or leave them at school because of parental geolocation apps.

When she volunteered with a nonprofit that helps teens access reproductive health resources, Sorsby-Jones said clients included minors in abusive households and those who faced cultural barriers in seeking parental permission for birth control. Though the main focus was contraceptive care, Sorsby-Jones said for many teens, it had to do with accessing medication without stigma for conditions such as endometriosis, which caused them to miss school due to severe abdominal pain.

Rosann Mariappuram, executive director of Jane’s Due Process, said their organization’s hotline immediately began getting calls and texts with questions from Texas teens after the court decision in December. “When this ruling came down, it basically cut off reproductive rights for teenagers in Texas overnight really,” Mariappuram said.

At least 13 states have also banned abortion at all stages of pregnancy, with various exceptions, with many set to discuss ways to limit or expand access as legislatures go back into session across the country. Several existing bans, plus others that are less restrictive, are being challenged in court.

State Rep. Ana-Maria Ramos, a Democrat from Dallas, filed the proposal that would combat the Title X ruling. She was a recipient of Title X contraceptive care herself after having a child as a teenager.

“What this bill does is empower teens to make decisions for their own healthcare, but also for their future,” Ramos said.