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Dr. Rebecca Cohen now recognizes Texas area codes calling the Comprehensive Women’s Health Center in Denver.

In recent weeks, pregnant people have found their access to legal abortion increasingly compromised by the COVID-19 crisis. And many are looking to Colorado—an abortion care oasis—in desperation.

“The things people are going through to get here … on one hand, it is absolutely a testament to the human spirit,” Cohen told Rewire.News, “and on the other, it’s absolutely infuriating that this is the best option that they have.”

Texas’ COVID-19 abortion ban, which will reportedly stay in place even as the state allows “elective” surgeries to resume, has forced patients to travel to western states like Colorado, New Mexico, and Nevada, for care. Planned Parenthood clinics in those three states saw 129 patients from Texas between March 23 and April 14, compared with 16 patients from Texas in February, a more than sevenfold increase, NPR reported.

On March 22, Texas Gov. Greg Abbott (R) signed an executive order curtailing all “nonessential” medical procedures. The state’s indicted attorney general, Ken Paxton, subsequently clarified the order extended to abortion, leaving experts, patients, and providers uncertain as to its limits.

Days later, U.S. District Court Judge Lee Yeakel issued a temporary stay of the order, only to be overruled by a panel of federal judges. Upon appeal, another court kept the order in place, but narrowed its scope, ruling that Abbott’s executive order could stay in place, but that some patients would be permitted to proceed with abortion care, including those who would go beyond the legal gestational limit while the order was in place, as well as patients planning to undergo medication abortion.

As the courts have played ping-pong with the constitutional right to abortion, pregnant people in Texas have been taking trips that would be burdensome in even the best of circumstances. Many have headed to Colorado, a journey of nearly 800 miles one way, underscoring the lengths people are going to access care.

Sarah Lopez, program coordinator at Fund Texas Choice, a nonprofit organization that finances travel to abortion clinics for Texans, told Rewire.News that the number of patients the group is sending out of state has surged. “The only clients who have been able to be seen in Texas in March [and] April are those who have been able to get to a clinic for medication abortion appointments in the slim windows of time that [the] bans have been lifted,” Lopez said.

Along with New Mexico, Oregon, and Vermont, Colorado has no gestational limit on abortion and has stood out as a safe haven for those seeking abortion later in pregnancy. But, while the need for later abortion care is expected to rise due to COVID-19 restrictions, the most common needs are among those seeking first- or second-trimester abortion care.

While restrictions implemented by Republicans throughout the country mean it’s not unusual for patients to travel long distances and to cross state lines to secure abortion care, the influx of patients from Texas is occurring even as many flights have been canceled and travel by car, bus, and train have become increasingly more difficult due to the social distancing restrictions put in place by COVID-19.

At one of Cobalt’s partner clinics in Denver in recent weeks, 12 of the 14 out-of-state patients who sought treatment have been from Texas, according to Cobalt, formerly NARAL Pro-Choice Colorado, which changed its name this year after splitting from the national organization. Similar trends are taking place at other clinics the group works with, said Amanda Carlson, director of the Cobalt Abortion Fund.

Officials at Planned Parenthood of the Rocky Mountains (PPRM), which operates across Colorado, New Mexico, southern Nevada, and Wyoming, told Rewire.News the clinic has seen a 25 percent increase in calls from Texas as a result of Abbott’s order.

“This dynamic is not new to us. Here in the Rocky Mountains, we’ve always been a safe haven for care for patients coming to us from out-of-state because they are unable to access care at home,” said Adrienne Mansanares, PPRM’s chief experience officer. Within a ten-day period in April, PPRM had 54 patients from Texas across its 24 health centers in the region.

In Denver, the Comprehensive Women’s Health Center has implemented what Cohen describes as a “triage” system prioritizing second-trimester patients to ensure the clinic can accommodate as many patients as possible; the waiting period is usually two weeks. “It’s a little bit longer than we wish it were, but a lot better than what Texas is doing,” she said.

Another abortion provider in the Denver area, who did not wish to be identified due to safety reasons, called the fallout of COVID-19 abortion bans “emotionally wrenching.”

“Being pregnant when you don’t want to be is so stressful,” they told Rewire.News. They described a typical patient coming into their office from Texas as “frustrated and exhausted” from what is usually a 15-hour drive. “[They’re] worried about being in a doctor’s office because everybody’s wearing masks and staying six feet away from each other. And [they don’t] want to … go home with COVID,” the provider said.

Many from Texas, the provider said, drive all night, come for their appointments in the morning, then make the trip back home.

For those whose care necessitates a hotel stay, their journey further exposes them to anyone who has accompanied them to COVID-19.

“We have to operate in sort of a reactive phase right now. … We don’t know what new changes are going to  come or if the ban is going to stay or not. … We just have to be really flexible,” Cobalt’s Carlson said. She recalled a recent patient who came to a Cobalt partner clinic in Boulder, Colorado, with two children but did not have access to groceries from her hotel because delivery services had been overwhelmed, as in much of the country.

It was Carlson who delivered groceries to the woman and her family.

The provider in Denver echoes the challenges of the current climate. “I’ve got the stress of people who want to kill me, wearing a bulletproof vest, death threats, protesters,” they said. “[And] for my primary care patients, I’m wearing a mask and gown and meeting [them] in the parking lot to try and keep them out of the building. [And] I’m trying to not bring COVID home to my family.”

Forcing patients to travel long distances during a pandemic puts many at risk, abortion rights advocates said.

“People are … seeing no other option than to travel, and risk exposure for themselves and those around them,” Lopez, of Fund Texas Choice, said. “The fact that abortion clinic staff have been given the heartbreaking task of canceling appointments for patients … is appalling. We deserve better.”