SAN ANTONIO — The woman stared up at the ceiling, taking slow, deep breaths, as the doctor examined the flickering dot on the ultrasound screen.
The woman cried as the reality sank in.
By the time she arrived for an appointment in Oklahoma, abortion could be banned there, too.
As soon as Texas enacted its six-week ban, people started fleeing the state for abortions. And while Texas patients have fanned out to abortion clinics all over the country, experts say no state has absorbed more of them than neighboring Oklahoma, where abortions remain legal until the 22nd week of pregnancy.
But that could change soon. As Oklahoma’s Republican-led legislature has rushed in recent days to cut off what GOP leaders have called a “sickening” patient pipeline from Texas — seeking to enact a raft of new restrictions — doctors and patients have faced mounting complications, with doctors preparing for a sudden end to abortion access and patients racing to schedule appointments before it’s too late.
An all-out ban, which passed the legislature last week, could take effect this summer if the Supreme Court rolls back its landmark Roe v. Wade decision protecting abortion rights. More worrisome to abortion rights advocates is the likelihood that Oklahoma moves as early as next week to enact a Texas-style ban, which has thus far survived court challenges. If Oklahoma’s clinics stop providing abortions, or are limited to providing care only before the six week mark, Texas and Oklahoma patients will be pushed farther afield, to Louisiana, Kansas, or New Mexico, where clinics are already fully booked.
The urgency of the moment is acutely felt at the clinic in San Antonio, Alamo Women’s Reproductive Services, and its sister clinic in Tulsa, both of which are owned by Braid, who made national headlines in September for performing an illegal abortion on a patient and writing about it in an opinion piece published by The Washington Post, hoping to prompt lawsuits that would help overturn the law.
Since the Texas ban took effect, Braid has traveled to Oklahoma at least once a month, performing abortions for some of the patients he has had to turn away in Texas.
“At least there was an alternative,” said Braid. If a ban takes effect in Oklahoma, he said, “I will feel totally helpless.”
Braid and his staff recently decided to start telling patients about the pending legislation in Oklahoma.
“Are you aware of the Oklahoma law?” the receptionist in San Antonio asked for the third time that morning, as she scheduled an appointment for another woman who was too far along to get an abortion in Texas.
“What?” said Nejmin, a 25-year-old mother of two, who, like other patients interviewed for this story, spoke on condition that only her first name be used to protect her privacy.
Nejmin had only just learned about the abortion ban in Texas.
Oklahoma’s law “is also changing?” she asked.
“We’re not sure yet,” the receptionist said. “If it changes, we’ll call you.”
By 9 a.m. on a recent Thursday, almost every seat in the waiting room at the Tulsa Women’s Clinic was taken.
The women gathered there that morning looked like they could have been going to a sleepover. They wore tie-dye joggers, plaid pajama pants, fuzzy slippers, crocs with thick wool socks. Several curled up in hard-backed chairs, feet on the seat, head burrowed in their knees, as a TV at the front of the room spouted news about Ukraine.
“People are just really tired when they get here,” said Andrea Gallegos, who is Braid’s daughter and the clinic’s executive administrator. She flies back and forth between the clinics in San Antonio and Tulsa. “Some have driven all night to be here first thing in the morning.”
A few miles from downtown Tulsa, the abortion clinic faces a park owned by the local Catholic diocese. Antiabortion protesters gather here every day, lining up with their rosaries in front of a towering white cross.
“Save your baby,” they yell at patients as they pull into the parking lot.
On that Thursday, a third of the cars outside the clinic had Texas plates.
Tulsa Women’s Clinic started seeing a sharp uptick in Texas patients as soon as the law took effect in the fall, said Gallegos. In August, they treated 28 patients from Texas. By November, that number had soared to over 300.
Of the thousands of patients who left Texas to access abortion between September and December, 45 percent traveled to Oklahoma, according to a study from the University of Texas at Austin, far more than have gone to any other state, with New Mexico coming in a distant second.
Republican lawmakers in Oklahoma City have been paying close attention to that surge.
“A state of emergency exists in Oklahoma,” said state Senate President Pro Tempore Greg Treat (R), the leader of the Senate, referring to the number of abortions that have been performed in Oklahoma since the Texas law took effect.
“It’s sickening,” Treat said. “And that’s the reason we’re making every effort to get our laws changed.”
Treat has been fighting to end abortion access since he was elected over decade ago. For him and other Oklahoma legislators, he said, antiabortion policies are “at the core of who we are.”
Sen. Julie Daniels (R), who sponsored a measure this session modeled after the Texas ban, said she deeply empathizes with women who find themselves pregnant unexpectedly. She agrees with her Democratic colleagues that lawmakers need to do more to support those women, she said. But she believes they should limit abortion access at the same time.
“I believe in saving the children even as we work on those other things,” Daniels said.
Daniels has been drawn to the novel legal strategy behind Texas’s abortion ban, which empowers private citizens to enforce the law through civil litigation.
To many abortion providers in Oklahoma, the Texas-style bill is even more concerning than the abortion ban that passed on Tuesday, Gallegos said, because it could take effect any day.
If an immediate ban is approved, Gallegos said, she imagines she might get a call from the clinic’s lawyers in the middle of the work day, as doctors are performing abortions, with a waiting room full of patients who have driven hours to get there. At any moment, she said, the lawyers might tell her it all has to stop.
Several abortion clinics in the state stopped scheduling appointments in late March in preparation for that bill to pass. While the Tulsa Women’s Clinic has continued to book appointments through the end of April, Gallegos said, they have wrestled with that decision.
“Every day I’m like, ‘do we stop scheduling?’” she said. “There are times when I’m like, ‘absolutely not,’ and other times I’m like, ‘I don’t know.’”
Gallegos doesn’t want to turn away patients if her clinic can still offer abortion care, she said. But she dreads having to call each patient on the schedule and inform them that the law has taken effect.
Patients have already been struggling to book appointments in Oklahoma. Faith, 24, said she’d tried to schedule an abortion at the clinic where she lives in Oklahoma City. Then she tried a few clinics in Kansas, she said, and she couldn’t get in there quickly, either.
When she couldn’t get an appointment, she said, she opened a private browser and started googling “alternatives to abortion.”
“I googled the other methods of ending a pregnancy,” said Faith. “Things like, inserting sharp objects, consuming high amounts of things.”
She was relieved when she was finally able to get an appointment at the Planned Parenthood in Tulsa, she said. But if she hadn’t been able to access legal abortion in her region, she said, she still would have found a way to terminate her pregnancy.
“I’m definitely the kind of person if someone tells me ‘no’ one way, I’m going to go find all the alternative ways to do things,” Faith said.
The vast majority of patients at Tulsa Women’s Clinic haven’t heard anything about the looming abortion bans in Oklahoma, said Joey Banks, a doctor who flies in from Montana to provide abortions at the clinic once a month.
Bianca, a 29-year-old from San Antonio, first learned about the Oklahoma laws after she found out she was too far along to get an abortion in Texas.
“It made me feel like I am just not in the loop,” she said. “Things are happening too quickly.”
Worried that Oklahoma would pass the law before she got to the clinic, Bianca took the first available appointment. On Sunday and Monday, she made the 18-hour round trip drive to Tulsa.
When she found out about Oklahoma, Bianca said, she couldn’t help wondering what state was next. If Oklahoma banned abortion, the receptionist told her she could try New Mexico.
“But if this whole law passes again in New Mexico, then what?” she said.
Two days after Bianca returned home from Tulsa, Oklahoma’s house committee on public health met to discuss the Texas-style abortion ban that could take effect immediately.
Only one lawmaker, Rep. Ajay Pittman (D), asked any questions about the bill.
“Can the health department or hospital association talk to the impact that this will have on patients?” she said.
“At this point I would probably request not to,” said Rep. Todd Russ (R), one of the bill’s sponsors.