AMNA NAWAZ: Today, on the steps of the Texas state capitol, a group of women said they are suing the state after they were denied abortions, a ban that in some cases presented grave risks to their lives.

Texas' near-total abortion ban is just one of many ways reproductive health care has been restricted in the Lone Star State in recent years.

In a separate case, a Texas federal judge has also limited young people's access to birth control.

Kaiser Health News correspondent Sarah Varney reports on the impact of that ruling in a story co-produced with Kaiser Health News.

SARAH VARNEY: Victoria and Richard Robledo's days are filled with work and looking after their two sons.

It's a far different life from when the couple first started dating in high school a decade ago in Corpus Christi, Texas.

VICTORIA ROBLEDO, Texas: I was 14, and he was 15.

We were in the same ROTC program together.

SARAH VARNEY: Who went after who first?

RICHARD ROBLEDO, Texas: She went after me.

SARAH VARNEY: Oh.

(LAUGHTER) SARAH VARNEY: When they started having sex, Victoria, now 24, decided to get on birth control.

But she couldn't turn to her mother, a devout Catholic, for advice.

VICTORIA ROBLEDO: We were, I guess, a typical, like, Hispanic household.

And so, usually, in households like mine, they don't want to talk about boyfriends or sex or anything like that.

SARAH VARNEY: You couldn't talk to her about it?

VICTORIA ROBLEDO: Yes, I couldn't talk to her.

I couldn't talk to her about boys.

I couldn't talk to her about becoming sexually active.

SARAH VARNEY: Under state law, teenage girls in Texas have long needed their parents' permission to get prescriptive contraception, but, online, Victoria found a special federal program that did provide contraception without parental consent.

Known as Title X, it was established in 1970 with broad bipartisan support to provide family planning services to low-income people, including minors.

WOMAN: There is no set fee.

The cost depends upon family income.

SARAH VARNEY: With the goal of reducing teen pregnancy.

The clinic Victoria found was less than a mile away from her high school.

VICTORIA ROBLEDO: I would take the bus home.

And so I skipped the bus that day, and I walked over to the clinic, and then I was able to get, like, my birth control for free.

SARAH VARNEY: In the vast Texas Panhandle, patients often drive for hours to reach Haven Health in Amarillo.

It's one of 3,200 Title X clinics around the country.

DR. STEPHEN GRIFFIN, Haven Health Clinics: What are you doing for birth control right now?

SARAH VARNEY: They come here for birth control, pregnancy and STD testing, and cervical cancer screening in English and Spanish.

But in a federal court case in December, a judge ruled that these clinics violate Texas state law and federal constitutional rights to direct the upbringing of one's children.

CAROLENA COGDILL, CEO, Haven Health: And now we can't even provide contraception for a gynecological issue.

SARAH VARNEY: Carolena Cogdill is the head of Haven Health.

The ruling applies to the national Title X regulations, but, for now, it is only being followed in Texas.

CAROLENA COGDILL: Just recently, we had a young lady come in who had abnormal bleeding, and we wanted to prescribe contraception to help control that bleeding.

And we couldn't do it because she was 16.

SARAH VARNEY: And she was unable to have that conversation with her parents?

CAROLENA COGDILL: Exactly.

She was fearful that her mom wouldn't understand if she was going to get on birth control, because, if she's going to get on birth control, then she's going to go out and have sex.

And she just didn't want to go there.

SARAH VARNEY: The case was brought by a conservative Christian father, Alex Deanda, who lives here in Amarillo, Texas.

He said that just the possibility that his daughters might access prescription contraception without his permission violated the tenants of his Christian faith.

Neither Mr. Deanda, nor his attorney responded to our interview requests.

ELIZABETH SEPPER, University of Texas at Austin: And we filed them in Amarillo because... SARAH VARNEY: Elizabeth Sepper is a law professor at the University of Texas at Austin.

ELIZABETH SEPPER: We have seen religious arguments increasingly, I think, come into the courts dressed up as legal arguments.

SARAH VARNEY: In his opinion, U.S. District Judge Matthew Kacsmaryk wrote -- quote -- "The use of contraception, just like abortion, violates traditional tenets of many faiths, including the Christian faith plaintiff practices."

Kacsmaryk references Catholic catechisms and 4th century religious texts.

"Does Onan, the second son of Judah, imagine that we approve of any sexual intercourse except for the procreation of children?"

Sepper says the decision marks the rising influence of conservative Christian theology in the courts.

ELIZABETH SEPPER: I think we're seeing a movement that maybe began with a religious exemption, saying let me structure my health care to suit my morals, and we're moving toward an agenda that says, let me structure all of health care according to my morals, that federal family planning programs need to reflect conservative Christian beliefs.

SARAH VARNEY: Christi Covington lives in Round Rock, Texas, an Austin suburb.

Raised in a large evangelical family, she's passing those teachings on to her three children.

How does your faith influence how you're raising your family?

CHRISTI COVINGTON, Texas: It's everything, because I believe We're all made by God.

he's the one who created the order in nature itself.

SARAH VARNEY: Covington says, leaving aside religious objections to birth control, the family unit should be respected.

CHRISTI COVINGTON: God designed the world for there to be parents, and then we have our offspring, and that the parents care for those children.

And that is design.

And we do see that reflected in nature.

I have to give consent all over the place for my children's other medical care.

Why would we decide that this one area is exempt?

SARAH VARNEY: At Haven Health in Amarillo, we put this question to Dr. Stephen Griffin, an assistant professor at Texas Tech University and a practicing OB-GYN.

Why is access to birth control different, in your mind?

DR. STEPHEN GRIFFIN: It's a safety issue.

It also, unlike a cold or aches and pains, does have lifetime consequences attached to the other side of it.

SARAH VARNEY: Half of teenage mothers receive a high school diploma, compared to 90 percent of teenage girls who do not give birth.

And teen births often lead to poor outcomes for the next generation.

Children of teenage mothers are more likely to drop out of high school and end up in jail or prison during adolescence.

Griffin says parents underestimate their teenagers' sexual activity.

DR. STEPHEN GRIFFIN: We know that people who identify as regular church attenders are more likely to underestimate their child's risk-taking behavior in terms of sex.

We know that parents who feel they have open lines of communication with their children also are more likely to underestimate that risk.

SARAH VARNEY: Decades of research show that teens are more likely to seek sexual health care if they can do so confidentially.

Rebecca Gudeman at the National Center for Youth Law says a majority of teens involve their parents in decisions around contraception.

REBECCA GUDEMAN, National Center for Youth Law: And they do that not because the law requires them to do that, but that they do that because that's what they want to do.

SARAH VARNEY: But, she says, some young people simply can't involve their parents or guardians.

REBECCA GUDEMAN: This isn't just about voluntary sexual activity.

Almost 40 percent of young people who are homeless will say that they have been sexually abused either before they left home or when they were on the street.

Almost 50 percent, 50 percent of young people in foster care will be sexually assaulted either before care or while they're in care.

SARAH VARNEY: Evangelical mother Christi Covington believes the law shouldn't make exceptions even in the hardest cases.

CHRISTI COVINGTON: Everybody would want their child to feel that they could come to them.

SARAH VARNEY: Sure.

But what do you do about the many, many children who just don't have that situation?

CHRISTI COVINGTON: Absolutely.

But there's other social ills within family units.

But we don't just totally erode the family unit to fix this problem.

It feels like a Band-Aid.

It feels like a Band-Aid.

Let's give them -- let's give them birth control.

And then we don't actually have to deal with what's happening in our society where these teens are getting pregnant so quickly.

SARAH VARNEY: Texas has one of the highest rates of teen pregnancy in the nation and the highest rate of repeat teen pregnancy.

Experts say the court decision banning access to contraception is likely to increase those numbers, and it follows other restrictions on reproductive health care in the state.

STEPHANIE LEBLEU, Every Body Texas: Abortion is illegal in Texas.

Kids aren't getting comprehensive sexual education in schools.

We have a very large population of folks that are uninsured and not eligible for any other programs.

SARAH VARNEY: Stephanie LeBleu is the acting director of Every Body Texas, the administrator of the state's more than 150 Title X clinics.

The Biden administration appealed the Texas decision in February, but, in the meantime, LeBleu says there is no safety net left here for teens.

STEPHANIE LEBLEU: What we don't know is not having that control over their lives and their bodies, what impact that will have to them over the long haul.

VICTORIA ROBLEDO: Let me see.

SARAH VARNEY: Victoria and Richard Robledo now live across the Texas border in Clovis, New Mexico.

Had you not been able to get birth control when you were teenagers, would you have not had sex?

(LAUGHTER) VICTORIA ROBLEDO: Absolutely not.

(LAUGHTER) SARAH VARNEY: Victoria says being able to protect herself from pregnancy when they were teenagers changed the course of both of their lives.

VICTORIA ROBLEDO: You know, we both were able to go out and live our own lives.

You know, he was able to join the military, and I was able to go to college.

It gave us, like, the confidence that we needed to make the right decisions for our reproductive health.

RICHARD ROBLEDO: Very important for us to say like we want a kid now.

We're comfortable enough to have a kid now.

VICTORIA ROBLEDO: On our terms.

RICHARD ROBLEDO: Yes.

SARAH VARNEY: Victoria wonders what teenage girls in Texas will do now.

For the "PBS NewsHour" and Kaiser Health News, I'm Sarah Varney in Clovis, New Mexico.