OKLAHOMA CITY — On a windy Tuesday morning, the parking lot outside a small brick building on the Southside of Oklahoma City was filling up fast. The first to arrive, a red truck shortly before 8 a.m., was from Texas. So was the second and the third.
The building houses one of Oklahoma’s four abortion clinics, and at least two-thirds of its scheduled patients now come from Texas. So many, in fact, that it is trying to hire more staff members and doctors to keep up. The increase is the result of a new law in Texas banning abortions after about six weeks, a very early stage of pregnancy. As soon as the measure took effect this month, Texans started traveling elsewhere, and Oklahoma, close to Dallas, has become a major destination.
“We had every line lit up for eight hours straight,” said Jennifer Reince, who works the front desk phones at the clinic, Trust Women Oklahoma City, describing the first week the measure was in force.
The effects of the new law have been profound: Texans with unwanted pregnancies have been forced to make decisions quickly, and some have opted to travel long distances for abortions. As clinics in surrounding states fill up, appointments are being scheduled for later dates, making the procedures more costly. Other women are having to carry their pregnancies to term.
Marva Sadler, senior director of clinic services at Whole Woman’s Health, which operates four clinics in Texas, said she believed that many patients were not able to arrange child care or take time off work without losing their jobs to travel to other states.
“I think a majority of women are being sentenced to being parents,” she said.
The law is the latest in a string of successes by the anti-abortion movement, which for years has pushed for more conservative judges and control over state legislatures. Now, the Supreme Court is preparing to take up an abortion case — the first to be argued before the court with all three of former President Donald J. Trump’s conservative appointees — that has the potential to remove federal protection for abortion altogether.
In Texas, the new state law has effectively accomplished that, at least for now.
Samerah was just five weeks pregnant when she lay on an examining table in Houston to get an ultrasound. It was Aug. 31, the day before the law went into effect. She had heard about it on the news and knew that it banned abortions after cardiac activity was detected. But when the doctor performed the ultrasound, there was no sound, and she was told to come back the next day for her procedure.
When she returned, and lay again in a darkened room, staring up at a set of paper dancers hanging from the ceiling, the doctor got a different result.
“He said ‘take a deep breath’ and budoom, budoom, budoom, all you hear is a heartbeat,” said Samerah, who is 22. “In that same breath, all the things I had been crossing my fingers about just came out, and I just bawled and bawled and bawled.”
She walked into the hallway, her mind racing, and saw other women there too.
“We were all just crying in the hallway like, ‘What are we going to do?’”
The answer for many women in her position has been to race to get an abortion in a different state. About half the patients at Hope Medical Group for Women in Shreveport, La., are now from Texas, up from about a fifth before the law. At Little Rock Family Planning Services, in Arkansas, Texas patients make up 19 percent of the caseload now, compared with less than 2 percent in August.
Oklahoma does not require two trips to a clinic to get an abortion in most cases, so it has been a common choice. Trust Women had 11 Texas patients in August; it has 110 so far in September. Patients come from as far away as Galveston and Corpus Christi. Some drive through the night, in time for a morning appointment. The high demand from Texas has meant that the clinic’s schedule is full for weeks. Last week, the earliest appointments were for mid-October.
Samerah, who requested that her last name not be published, arrived last Monday from Beaumont, a city near Houston, where she lives with her partner and their 2-year-old son.
The news of her pregnancy, she said, threatened the life they had built for him.
Their financial circumstances had only recently stabilized. She had gotten a customer service job. Her partner was driving a van for a medical service. They moved out of his family’s house into their own apartment. Their son has his own room. She bought new furniture: a sectional and a bed.
“This was our first time actually buying a brand-new out-of-the-box mattress, not off of Facebook or something,” she said.
She felt proud to be able to give her son attention, toys, a stable home, things she said she never had herself. But she could not afford to do that for two. “I don’t want to be that parent,” said Samerah, whose mother was a teenager when she was born. “I don’t want to bring my kid into something that I can’t afford to take care of, because they don’t deserve it. I grew up in that kind of reality. And I know what it does to people.”
Samerah said she had gotten an abortion once before, the year after her son was born, for similar reasons. She said she made an appointment to get an IUD immediately after her procedure on Tuesday.
As states pass more abortion restrictions, it increasingly is poor women who must grapple with their effects. Half of American women who got an abortion in 2014 lived in poverty, double the share from 1994, when about a quarter of the women who had abortions were low-income, according to the Guttmacher Institute, a research group that supports abortion rights. Theories for why include demographic change, increased funding for abortions for low-income women, and higher-income women having more access to highly effective contraception.
The longer women have to wait, the more expensive their procedures become. Abortions at Trust Women range in cost from $650 for earlier stages to $2,350 for later stages. Financial assistance is also available.
Sarah, who works at a roofing company, found out she was 13 weeks pregnant on Aug. 23. But then the law went into effect, and she raced to find a clinic in another state.
“It has just been a scramble to get this taken care of, especially since I just ran out of time so quickly,” said Sarah, 21, who asked that her last name not be published to protect her privacy.
She finally got her abortion at the Oklahoma City clinic on Sept. 20. She had to put off a car payment to cover her part of the $1,550 charge. Her partner, a police officer, split the cost and drove her the three hours from Dallas where they live.
Understand the Texas Abortion Law
The most restrictive in the country. The Texas abortion law, known as Senate Bill 8, amounts to a nearly complete ban on abortion in the state. It prohibits most abortions after about six weeks of preganancy and makes no exceptions for pregnancies resulting from incest or rape.
Citizens, not the state, will enforce the law. The law effectively deputizes ordinary citizens — including those from outside Texas — allowing them to sue clinics and others who violate the law. It awards them at least $10,000 per illegal abortion if they are successful.
Patients cannot be sued. The law allows doctors, staff and even a patient’s Uber driver to become potential defendants.
The Supreme Court’s decision. The Supreme Court refused just before midnight on Wednesday to block a Texas law prohibiting most abortions, less than a day after it took effect and became the most restrictive abortion measure in the nation. The vote was 5 to 4, with Chief Justice John G. Roberts Jr. joining the court’s three liberal members in dissent.
She said she had been on her own for some time. Her mother died in a car crash when she was 9, and her father died of cancer when she was 19. And though she feels much more financially stable now than in her teens — she was putting herself through college studying criminal justice until the coronavirus pandemic — she said she could not support a baby.
“I would have to put my life on hold,” she said. “I don’t know if I would be able to go back to school.”
Sarah had never been pregnant before, but she said she knew her decision was right. Still, it was difficult. In the weeks that she waited for her appointment, she said it was impossible not to think about what was growing inside her. The ultrasound confirming her pregnancy, which she received at a center run by an anti-abortion group, was performed by a woman who typed ‘Hi, Mommy,’ and ‘Hi, it’s me,’ into the screen and gave Sarah the printout.
“It’s hard not to have the instinct to want to form a bond with it,” Sarah said. “And just having to remind myself every day, you can’t do it. Like it’s just not the time for you. So that’s been the hardest part.”
Trust Women draws anti-abortion groups too. An R.V. operated by anti-abortion activists that advertises free pregnancy tests and ultrasounds sometimes parks across the street at Rancho Village Food Mart.
Raymundo Marquez, 23, a cashier there, said his brother, an owner of the shop, allows it. But Mr. Marquez has conflicted feelings. He believes that abortion is wrong: When his girlfriend got pregnant in high school, they did not consider it. But he said it was hard to judge someone else for doing it, because he knows there are children who are homeless and neglected.
“It’s sad both ways,” he said.
By Tuesday afternoon, one protester had appeared, standing tall in a green flowered jacket and green flats, praying and looking toward the clinic’s security booth. Inside, Louis Padilla, the security guard, was watching her. She is a regular, and sometimes he walks outside to debate her.
Mr. Padilla said that he was Catholic and Republican, but that he was won over to the cause of the clinic after working there for a while. Each woman has her own story, he said, and who are men like him to judge them? He mows the clinic’s lawn, puts up its flag and sometimes fixes appliances because repairmen refuse to come to an abortion clinic.He even bought a drone with his own money to watch the protesters outside.
The situation in Texas may be temporary. A hearing on Oct. 1 will give the law’s opponents another chance to convince a judge to suspend it. But other restrictions are looming. In Oklahoma there are five, including a law that requires abortion providers to be board-certifiedobstetricians. If it takes effect as scheduled on Nov. 1, four of the eight doctors licensed to work at Trust Women could no longer do so.
Samerah made it to the Oklahoma clinic with the help of financial assistance funds, which covered plane tickets for her and her son. Her abortion was covered too. But her partner had to pay his own way there. He was fired, she said, when he asked for time off. And she lost several days’ pay.
She does not believe that the people who passed the law considered the consequences for women like her. Those officials, she said, go to their jobs in “their car that doesn’t have problems starting up, with a tire that is not flat.”
Meanwhile, she and her partner and her son will go back to Texas to a real fear that they may not be able to pay rent for October.
“I have to go home and figure out what to do in the next month, and the next month is in a couple of weeks. Like what am I going to do, you know?”
Clare Toeniskoetter contributed reporting. Sheelagh McNeill contributed research.