Eight US states have worked to try and halt abortions entirely during the pandemic as clinics report a rise in demand

A woman in Texas was isolating with her family. She was frightened and carried a secret: she was eight weeks pregnant.

Even under normal circumstances, obtaining an abortion in Texas is described as “mostly impossible”. But during the Covid-19 pandemic, politicians in Texas and seven other states have worked to try to halt abortions entirely. They have undertaken costly lawsuits to restrict abortion in the name of health and safety, even as doctors lined up against them.

Experts have described the order as the most chaotic 30 days since 2013, when Texas imposed severe restrictions on abortion clinics, later overturned by the supreme court.

Alabama, Arkansas, Iowa, Louisiana, Ohio, Tennessee and West Virginia have all seen confusion and intermittent bans as anti-abortion state politicians categorized abortion services as non-essential, and included abortion clinics in bans on elective surgical procedures. The orders have left women desperate, as appointments were cancelled, rescheduled and cancelled again subject to court rulings.

“I am scared to go outside,” said the Texas woman, who the Guardian is not naming because her family is not aware she is pregnant and seeking an abortion. Her story was provided by We Testify, a group which collects women’s stories of seeking abortions. “I just saw the news about Ohio and that scared me that I can’t get an abortion in time,” she said about restrictions in that state. “Now, they did it in Texas. I don’t know what to do.”

Facebook Twitter Pinterest A group gathers to protest abortion restrictions at the state capitol in Austin, Texas, on 21 March 2019. Photograph: Eric Gay/AP

Abortion clinics across the US face existential threats under normal circumstances. Providers and clinics routinely face state harassment, angry protesters and threats of violence.

Abortion providers said Covid-19 has exacerbated this fight, with some states claiming abortions need to be stopped during the pandemic to preserve hospital beds and personal protective equipment for workers.

“No one is exempt from the governor’s executive order on medically unnecessary surgeries and procedures, including abortion providers,” said the Texas attorney general, Ken Paxton, early in the pandemic. “Those who violate the governor’s order will be met with the full force of the law.” Paxton did not return a call for comment.

The American Medical Association, the country’s largest association of physicians, has described such regulations as “exploiting” the Covid-19 pandemic.

“Instead of saying, for example, ‘There should be no abortion’... [abortion opponents] are trying to create uncertainty about what the reality on the ground is,” said Mary Ziegler, a law professor at Florida State University and an expert on reproductive rights.

Imagine being forced to carry and deliver a baby in the middle of this pandemic Very Reverend Katherine Hancock Ragsdale

At the same time, clinic directors have anecdotally reported a rise in demand amid the myriad uncertainties raised by the pandemic. More than 26 million Americans have lost jobs, with more unemployment claims expected, and at least 55,000 people have died as a result of the virus. One clinic in Wichita, Kansas, reported an almost threefold increase in patients, CBS reported.

“People are delaying all kinds of medical care to stay out of hospitals. You can’t put a pregnancy on pause, so imagine being forced into that position – it must be terrifying”, said the Very Reverend Katherine Hancock Ragsdale, president and CEO of the National Abortion Federation said

Texas politicians’ decision to ban abortion set off a month-long ping-pong of court battles. As Covid-19 spread ferociously in the US in March and April, federal court rulings restored, then abolished, abortion access multiple times, sometimes just hours apart.

On 23 March, the Texas governor, Greg Abbott, issued an executive order halting all elective surgical procedures, specifically calling out abortion. Abortion providers sued on 25 March, a federal court agreed with them and blocked the state’s order on 30 March.

But the reprieve lasted only 21 hours. The fifth circuit court of appeals in New Orleans, Louisiana, reinstated Texas’s executive order on 31 March. The court’s bench is arguably the most conservative in the nation, and is outwardly hostile to abortion rights.

“They were open one day, and they were closed the next day, and they were allowed to do medication abortions one day, and not the next day,” said Nikiya Natale, statewide manager of the Texas Equal Access Fund, which helps women pay for abortions.

“We’ve had to cancel hundreds of appointments … and numerous times,” said Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, which operates clinics in Texas and four other states. Whole Woman’s Health sued Texas to continue providing abortions. “Women are sobbing on the phone, begging,” she said. The process, she said, felt like “abuse”.

Facebook Twitter Pinterest The Whole Woman’s Health sued Texas to continue providing abortions. ‘Women are sobbing on the phone, begging,’ said the CEO. Photograph: Tony Gutierrez/AP

At one point, only four abortion clinics in Texas were open to serve a population of 5.8 million women of reproductive age, she said. Three of them were Whole Woman’s Health locations. That has left clinics across the state with a month’s worth of patients on a waiting list.

In other states, similar situations have played out. An epileptic woman in Tennessee with twins, premature infant daughters and a two-year-old son told a federal court of her attempt to get an abortion, when she was caught up in that state’s ban.

To prevent another pregnancy, she underwent a tubal ligation and used condoms as well. She was in disbelief when both failed. “I feel science failed me,” she told the court.

When she tried to obtain an abortion, arguments were already under way in court. One Friday in April, it was legal to get an abortion. But by Monday, before she could go to the clinic, it was banned.

“I was terrified again,” she told the court. “Caring for a toddler and two twin babies alone, while exhausted from and deeply anxious about an unwanted pregnancy, worrying every day that the pregnancy will suddenly leave me unable to care for my kids, and managing all of this in the midst of a pandemic.”

Monied interests have also come to support the bans. In just one example, one of Donald Trump’s personal attorneys, Jay Sekulow, bragged about his faith-based not-for-profit legal centers support for Texas’s abortion ban.

Jay Sekulow (@JaySekulow) BREAKING: The @ACLJ has helped secure a huge victory for life in the Fifth Circuit Court of Appeals out of Texas. The Court agreed with our argument, concluding that there’s “no constitutional right to any particular #abortion procedure.” https://t.co/NDG66plP0n



“The [American Center for Law and Justice] has helped secure a huge victory for life in the Fifth Circuit Court of Appeals out of Texas,” Sekulow tweeted.

The back and forth has forced women, at least the few with means, to travel at an exceptionally dangerous time, boarding planes or driving out of state and violating stay-at-home orders.

“We had someone who flew in from Texas,” said Renee Chelian, founder of Northland Family Planning Clinics in Detroit, Michigan. “She had family here, but she got on a plane and flew. None of the rest of us are flying.”

When workers from Whole Woman Health’s called to reschedule patients, some were in the car driving to neighboring Oklahoma and New Mexico. The women would ask, are you sure we should turn around? Is 5am too early to come in?

As restrictions have gone into place, interest has grown in self-managed abortions. Plan C, a website which provides information on self-managed abortions, saw daily visits grow 20% in April and 11% in March, around the time states enacted bans.

“There’s no reason in the world that a great number of abortions can’t be done through telemedicine,” said Ragsdale. “Talk to your doctor, or video conference, and have the drugs delivered to your home. The FDA regulations don’t allow that – it’s time they do.”

Facebook Twitter Pinterest The operating room at the Whole Woman’s Health clinic in Fort Worth, Texas. On 30 March the fifth circuit court of appeals reinstated the state’s executive order to restrict abortions during the pandemic. Photograph: Tony Gutierrez/AP

Even in states supportive of abortion clinic directors have said protesters have become more antagonistic during the pandemic, flouting social distancing guidelines.

“These people are standing out in front of abortion clinics, harassing women, refusing to wear masks,” Chelian said.

Some of Chelian’s clinic protesters, who are reliable regulars week-in and week-out, have joined pro-gun, anti-social-distancing rallies at the Michigan capitol of Lansing. “At the end of March, they were claiming as Christians they won’t get the virus”, she said.