“I had to sit down when I got that call,” Dr. Dermish said last week. “I couldn’t believe it.”

Dr. Dermish said she had to tell the 10 remaining patients at the clinic, all waiting for ultrasounds, that she could not schedule their abortions. One woman had a diagnosed fetal anomaly. Another was starting school to become an ultrasound technician. Dr. Dermish said they referred women to clinics outside the state, but also warned them that travel during the pandemic could be risky.

For weeks, even medication abortion was banned — a common type involving pills that is done early in pregnancy and uses one single nonsterile glove, Dr. Dermish said. The unexpected ruling Monday night from the U.S. Court of Appeals for the Fifth Circuit undoes that restriction, at least for now.

But lawyers for clinics say that the ban remains on nearly all surgical abortions, a substantial portion of the state’s total, and that the Fifth Circuit is still actively weighing the case.

Overwhelmingly, abortions happen in clinics, not hospitals, but the clinics have also changed their rules to account for the coronavirus. A 24-year-old college student from Arlington, Texas, said in court papers that before an ultrasound she sat alone in her car in the parking lot of a Fort Worth clinic for two hours. She said protesters stood about 10 feet away with signs “and screamed at me and other patients.”

The night before she was scheduled to go in for her medication abortion, she got a call from the clinic saying her appointment had been canceled. She ended up driving 12 hours to Denver with a friend and wiping down surfaces in the cheap Airbnb they stayed in. On the way back they drove into the night.

“We didn’t want to take breaks or rest because I was worried about having my abortion in the car,” she said in court papers filed by lawyers for clinics in Texas.

Not every clinic closed right away. The Houston mother found one that squeezed her in for an ultrasound. But when she parked in front of another clinic early the next morning, hoping to be seen for an abortion, it never opened.