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People were waiting at abortion clinics across Texas on Tuesday when the state’s COVID-19 abortion ban went back into effect, a day after U.S. District Court Judge Lee Yeakel granted a temporary restraining order against the ban.

Conservative judges on the U.S. Court of Appeals for the Fifth Circuit ruled Tuesday afternoon that the anti-choice ban would be reinstated, and in less than 24 hours, Texans were again stripped of their right to safely access abortion care.

Abortion providers were forced to tell patients they wouldn’t be able to move forward with their decision—something staff already had to do the week prior, when Texas Gov. Greg Abbott (R) announced he would stop most abortions as part of the state’s response to COVID-19.

“I was super excited going into work [Tuesday],” one abortion counselor, who preferred to withhold their identity, told Rewire.News. “My boss and I even did a little celebratory dance when I got there.”

She was relieved to see patients who were forced to reschedule as a result of the initial order, and enthused to see patients visiting for the first time. 

But after the Fifth Circuit’s ruling, patients learned at the last second they wouldn’t be able to have an abortion.

Some cried. Some seemed frustrated and angry, the abortion counselor said. Some didn’t understand why this was happening.

“It didn’t help that I didn’t have definite answers or timelines to give them,” the counselor said. “The state could extend the executive order at any time, citing coronavirus precautions.” Some patients noted the COVID-19 pandemic as their reason for needing abortion care. “That’s the excuse the state is using to deny their abortion care,” the counselor said. “It’s just so cruel and calculated.”

Flyers with information about out-of-state abortion care, practical support organizations for patients, and abortion funds are typically given to patients who are over the gestational limit to have an abortion in Texas, but because of Tuesday’s ruling, the counselor’s clinic provided all patients with this information.

“It was so surreal handing [the resource flyer] to every patient, knowing that going out of state during a public health crisis could be dangerous or too expensive,” the counselor said. “Patients should have access to abortion care in their own communities. They shouldn’t have to risk their health to travel for such a simple and safe procedure.”

One Texan recently traveled all the way to Colorado for a medication abortion—something that could have been accessed through telemedicine had it not been outlawed in Texas. Fund Texas Choice, a practical support organization serving Texans traveling to abortion clinics, said people with pregnancies of varying gestational ages have considered traveling out of state since Abbott’s order first went into effect.

Robin Marty, communications director for Yellowhammer Fund, an abortion fund serving people in Alabama, told Rewire.News that while the organization hasn’t talked to Texans traveling to Alabama for care, one abortion clinic in the state reported an “influx of callers” from Texas following the COVID-19 abortion ban.

Providers in Texas have talked to patients considering traveling out of state too. 

“I had one patient who’d originally scheduled an appointment at our clinic, then rescheduled at a clinic in another city out of state, then rescheduled back to us when we reopened,” one provider said on the condition of anonymity so they could speak openly about the effects of the ban. “She was very frustrated at the whole process. I went over a map we have of the U.S. that has clinic locations in other states, brainstorming where would be the best place for her to go.”

But traveling out of state would mean navigating the various travel restrictions among the pandemic, longer wait times to get in the clinic, and it “required a flight she didn’t feel comfortable taking at this time.” 

Another Texas provider told Rewire.News that scheduling was tight on Tuesday in an effort to see patients following Monday’s temporary restraining order against the COVID-19 abortion ban—most of whom had appointments delayed last week. One clinic staffer pushed back their lunch break in order to process payments so people could be seen by the doctor before the legality of abortion in Texas changed. 

They were relieved to return to work, something “resembling normal,” but nervous things would take a turn for the worst. Things did. 

“I found out [about the order] when I got back to the office [from lunch and] I felt absolutely devastated when I heard,” the clinic staffer said. “It was a sadness beyond tears. I had to spend a bit just sitting and forcing myself to breathe because I knew the next step was talking to patients, and I didn’t want to cry in front of them—I wanted to be able to tell them the truth, that we hoped we could reopen and continue their appointment.”

Most patients cried when they were told abortion had been outlawed in Texas. 

Like other providers, they’ve spoken to patients considering traveling out of state for an abortion but emphasized nearby states, like New Mexico, have long wait times as the extent of these impacts affect people all over Texas. One patient considered continuing the pregnancy. “Most of our patients already can’t afford to have a baby, but when you add cut hours, a lack of insurance, and job loss to that—it’s an impossible situation,” the clinic staffer said. “Plus, any trip to a doctor’s office carries a chance of exposure to COVID-19, and continuing a pregnancy requires far more visits to a doctor’s office than getting an abortion does, which no anti-choice people seem to acknowledge is a risk. Anytime you leave the house in a pandemic, you risk exposure. Abortion is safer than having a baby more now than ever.”

Aster Dyer, a nurse at an abortion clinic in central Texas, told Rewire.News they haven’t provided direct patient care in nearly two weeks as a result of Abbott’s abortion ban.

“I’m hurting just thinking about the people we have to turn away, and what they might do or experience without access to safe abortion care. We have seen time and again that people will do whatever it takes not to be pregnant when access is restricted,” said Dyer, pointing to Rosie Jiménez—a young Chicana living in Texas at the time—and others who have died from unsafe abortions following anti-choice legislation. “We will only see more of that when clinics get shut down.”