With sympathy in their voices, receptionists at the University of New Mexico Reproductive Health Center relayed the same news over the phone over and over Wednesday morning.
“We expect about four weeks.”
People on the other end of the line, mostly women in Texas, have been told that those four weeks could mean they become ineligible for abortion medication instead of a procedure, or they may have to spend two days at the Albuquerque clinic instead of a .
The university’s clinic is one of three offering abortion procedures in New Mexico, which has become the destination state for many Texans wishing to terminate a pregnancy.
In addition to breaking the news of growing wait times, the front desk responsibilities of what was once a quiet clinic have grown to include referring out-of-state patients to possible sources. funding that could cover the hundreds of dollars they will have to pay. of pocket. Receptionists also help people overcome logistical hurdles so that patients can miss as little work as possible or line up as little childcare as possible.
“She’s less than eight weeks old, for an 8 a.m. appointment,” a clinic worker whispered to her colleague while on the phone with a patient from Texas. “But the last flight (from Albuquerque) is at 5:25 p.m., do you think she would make that flight?”
Another employee walked in to tell receptionists not to count a woman who was supposed to be at the clinic about an hour earlier as a no-show. She was on her way, the staffer said, still driving from Oklahoma.
Prior to September, the university clinic performed a relatively low number of abortions. With about 2 million residents in the state, New Mexico’s handful of abortion clinics and providers performed fewer than 6,000 abortions in 2020, according to the Guttmacher Institute, about a tenth of those performed in Texas. .
The clinic was instead able to focus more on its training program for medical students and residents, and it was more available to provide birth control services and other reproductive health care, according to doctors at the clinic. .
But when Texas banned abortion at about six weeks gestation last year, their patient numbers skyrocketed. Demand for abortion care is only expected to rise after the U.S. Supreme Court ended abortion rights last week, quickly followed by Texas and a growing number of states that ban nearly all abortions.
“It’s a different job now,” Dr. Eve Espey said Tuesday evening, sitting in her quiet, stucco-covered home after a long day at the clinic. “I would say 75% of our patients have been from Texas for several months.”
Doctors said more people have recently come from Oklahoma, which banned abortions in late May. And more are starting to arrive from places like Kansas and Arizona. But the clinic is still preparing for the potential impact of Roe v. Wade.
“There’s not much we can do,” said Espey, chair of the university’s OB-GYN department and founder of the clinic. “We are booking until the end of July because we cannot book more patients in one day.”
Beyond an overwhelming increase in the number of out-of-state patients, doctors at the clinic said of even greater concern is the increase in the number of patients who are further along in their pregnancies.
Espey said that since September, local clinics have performed abortions for more than double the number of patients they would have seen before Texas’ six-week ban. What has increased even more is the number of patients more than 14 weeks pregnant, and even more for those between 18 and 20 weeks.
“If they could have gone to Dallas and they live near Dallas, they could go tomorrow,” said Dr. Amber Truehart, the clinic’s medical director. “But they have to figure out how to travel here, get childcare and funding, and all of that is holding them back.”
“It’s not ideal for abortions because it puts you a bit further away and things can get a bit more complicated,” she added.
A mother’s decision
Early Wednesday morning, Truehart met with nurses, medical assistants, interns and a newly hired medical assistant to hear details about the dozen or so aborted patients scheduled for the morning. At least half were from Texas, a point staff noted since, unlike New Mexicans, Medicaid and private insurance won’t pay for their abortions.
One of the patients was a 23-year-old woman with two children aged 4 years and 7 months.
“The reason I decide to do this is just because financially I can’t afford it,” she said while awaiting an ultrasound on Wednesday, her silky brown hair trailing over her petite waist. “I’d rather not put myself in a difficult situation where I know I could become homeless because I’m trying to support three children.”
She’s originally from Las Cruces, so she originally planned to go to El Paso for an abortion, about 30 minutes from the southern New Mexico town. But, with abortion bans in Texas, she instead took the day off and her partner drove her about 3 1/2 hours to Albuquerque the night before.
Based on the timing of her last period, which she recognized as irregular since she was still breastfeeding, the mother and clinic staff estimated that she would be more than 10 weeks pregnant. But, after Truehart scanned her uterus and measured the size of the embryo, she determined that the patient was less than eight weeks old.
“Oh, that’s so much better,” she sighed in relief on the table.
At eight weeks, she can safely have a medical abortion, Truehart told her, instead of an outpatient procedure. She was taking two pills within 48 hours to induce an abortion, with symptoms similar to a miscarriage.
Back in the waiting room with the news of her ultrasound, the Las Cruces woman visibly relaxed. She laid her head on the shoulder of the father of her 7 month old son. They spoke in low voices, often interrupted by him kissing the top of her head.
Still, she said she was upset about Texas’ abortion ban and the overturning of Roe v. Wade, not only for herself, but for so many others like her.
“There are a lot of women who choose to do these things,” she said, her arms wrapped protectively around herself in the ultrasound room. “Either financially they can’t afford to care for a baby or, if you’re a rape victim – and I am a rape victim – if you get pregnant, it could lead to suicide.”
An unknown state
Their priority is their patients, but leading abortion care physicians in New Mexico have other concerns during this time of upheaval in their field.
They worry about staffing shortages, already pervasive in the burnout that much of the health care industry has struggled with during the crush of the pandemic. And they worry about a chilling effect among health care providers in abortion-banning states, who might not take steps to save a pregnant person’s life for fear of criminal prosecution.
In Texas, the state-imposed abortion ban does not allow exceptions for rape or incest, only allowing an abortion if the pregnant person’s life is in danger.
“Even in cases where exceptions would be allowed, who wants to give their heads for that,” Espey said. “Everyone is afraid to help and encourage.”
And, in New Mexico, abortion rights advocates and providers worry that new clinics seeking to provide more care to patients across the country are paying inappropriate attention to a condition that typically goes unnoticed in the world. rest of the country.
“When people come from out of town, there’s a fear that they’ll upset the political balance and community relations,” Espey said, noting that local abortion rights groups have been working for decades to cultivate an acceptance of abortion care.
“I think these organizations and, frankly, me too, would prefer to have New Mexicans providing that care,” she added. “That said, there is a big gap. It would be one thing if we could fill that gap, but right now we can’t.
New Mexico hasn’t implemented major restrictions on access to abortion, but it’s a poor, largely rural state that often fails to provide reproductive health care to its people. own residents.
All three clinics in New Mexico that offer abortion procedures are in Albuquerque. A handful of other clinics provide abortion medication for early-stage pregnancies, but, as evidenced by the backlog at Espey and Truehart’s clinic before Roe’s overthrow, doctors say the state has need more abortion providers.
But the new spotlight makes them wary of the longevity of the state’s new role as a haven for abortion care.
“They’re scared of this,” Truehart said, walking around the clinic in a purple lab coat and Crocs. “It (the new providers) is going to draw too much attention to New Mexico as an abortion hub, and then the tide is going to change and then, bam, New Mexico dies out too.”
Jolie McCullough reports on criminal justice issues and politics for The Texas Tribune. She came to the Tribune in early 2015 from the Albuquerque Journal.