If you’re a woman in South Texas trying to get a safe, legal abortion, your options are limited. If you’re undocumented, it’s now almost impossible thanks to a wall of roving border patrol checkpoints that stand between you and the remaining abortion clinics.

Last week, the United States Court of Appeals for the Fifth Circuit decided that in the name of “patient safety” Texas can legally require all abortion clinics to meet hospital-style equipment and staffing standards — a decision which closed 13 clinics overnight, including the last remaining clinic in the poverty-stricken Rio Grande Valley.

For undocumented women in the region, crossing an inland border patrol checkpoint to get an abortion means risking deportation. Two years ago, 41 abortion clinics operated in Texas, including four which were accessible without crossing an inland checkpoint. But after restrictions passed by a Republican-led legislature were enacted, only eight clinics remain in the whole state and none fall below the wall of checkpoints.

The Government Accountability Office (GAO) found there were 18 moving “tactical checkpoints” stationed within 100 miles of the Mexico-Texas border on roads leading north. In addition, permanent checkpoints are stationed on major highways, including US-281, the highway a woman would take to make the four-hour journey from the Rio Grande Valley to the nearest clinic that remains open in San Antonio.

“Even if, in the slim chance they could travel hundreds of miles, if they could find childcare, get a day off work, assuming that is all possible, undocumented women are terrified of crossing a border checkpoint,” said Kimberly Inez McGuire, a spokesperson for the National Latina Institute for Reproductive Health, an organization that provides resources for women seeking abortions in the Rio Grande Valley.

When we asked Customs and Border Protection for comment on our story, they noted there is a temporary humanitarian parole program that could allow a woman to enter the country for a short period of time if she agreed to return immediately after. Customs officials don’t know how many women seeking abortions have ever used the program, however. Each application costs upwards of $100 and can take up to 120 business days to process. Advocates say this isn’t a real option for most of the women they work with.

An estimated 1.65 million undocumented people live in state of Texas, with a heavy concentration of unauthorized immigrants residing in the Rio Grande Valley, where about one-third of the population also live under the poverty line. The four counties that make up the Rio Grande Valley are overwhelmingly Latino.

In last week’s ruling, the three-judge panel agreed with the state’s lawyers who argued there was little to prove that a large portion of women seeking abortions would find an “unconstitutional burden” due to the closing of the 13 clinics. One in six women would have to drive more than 150 miles for an abortion, the judges concluded.

“This is nowhere near a ‘large fraction,’” they wrote in their opinion.

Inez McGuire of the National Latina Institute for Reproductive Health called the judges’ ruling “shockingly out of touch.”

“I would invite anyone who doesn’t see this as an ‘undue burden’ to try to step into the shoes of a woman trying to access abortion care in South Texas,” she said.

The Whole Woman’s Health clinic in McAllen, Texas was the last to remain open in the Rio Grande Valley. The center was forced to close for several months with the passage of the new restrictions, and then reopened for about a month after a favorable decision from a federal judge.

“The first day we reopened our doors in McAllen, we helped over 20 women,” said Andrea Ferrigno of Whole Woman’s Health. “What we have to remember is that even though six months ago [the new law] shuttered our doors, it did nothing to take the need away.”

Without safe, legal abortions, women in the region have been forced to turn to alternatives — the best known of which is a hexagonal pill known as “misoprostol” or “Cytotec” which can be purchased at informal flea markets called pulgas.

On Tuesday, lawyers from the Center for Reproductive Rights filed an emergency appeal to the U.S. Supreme Court, citing the “400 to 500 mile round trip” that women of the Rio Grande Valley now face to obtain an abortion.

Inez McGuire says they will continue fighting the Texas law and other laws like it around the country.

“As we say in Spanish ‘que siga la lucha,’” Inez McGuire said. “The struggle continues.”