At Whole Woman's Health in Austin, Texas, clinic staff prep for patients like any other day. But right now, this is a medical facility stuck in legal limbo caused by the most restrictive abortion law in the nation. Patients are still showing up and seeking care, but it's not the care the clinic is always able to provide.
"It's absolutely been a rollercoaster ride," said Marva Sadler, senior director of clinical services at Whole Woman's Health. "It's gone from being really busy right before September 1st to having a sudden decrease, in senses, and it being really slow and quiet in the clinic."
Sadler and Sonja Miller, the clinic's director of people and culture, are on the front lines of supporting patients who don't know what rights they still have.
"They are feeling confused," Sadler said."They don't know where they stand. They don't know who qualifies, who doesn't." She added there is a heightened sense of desperation to figure out if they are pregnant sooner because of the law, known as S.B. 8.
The staff at Whole Woman's Health face immense pressure to comply with the regulations while still providing compassionate care for patients.
"It's really hard," said Miller. "The staff in our clinics are shouldering a really big burden in having to be the enforcers of a law that they don't agree with."
S.B. 8, went into effect at the beginning of September, banning abortion in the state once fetal cardiac activity could be detected. This is typically around six weeks of pregnancy, but that time frame may not be enough time for many women.
"By the time you realize that you've missed your period and your period is late, we're already at about the three- to four-week mark at that time," said Sadler. "Then by the time [they] get to the doctor to confirm that pregnancy, or [they are] able to figure out how to confirm that pregnancy, we're already crept up to the six-week mark."
Any patient whose ultrasound shows a heartbeat must go out of state to seek an abortion, which means Whole Woman's Health has only been able to provide this kind of care to about 20 percent of people who have come through their doors. The clinic hands out a list of other organizations that provide abortions in the states that share borders with Texas, but none of them are particularly close. The closest one is in Shreveport, Louisiana – which is a five-and-a-half-hour drive from Austin.
"For some women, just knowing that going out of the state is not an option for them kind of takes the choice of abortion off of the table for many women from the beginning," said Sadler.
Texas is the testing ground for attempts to outlaw abortion in conservative states. What happens in this state could shape policy across the country. But clinic staff warn that even closing their doors won't change the choices people make when facing an unwanted pregnancy.
"Abortion is not going to go away," said Miller. "History tells us that. Abortion has been around for thousands of years." 
"People who are pregnant will do what they need to do in order to live their best lives or even to survive," she added.
At least for now in Austin, despite the emotional turmoil for patients and staff and the barriers to seeking abortion care, organizations like Whole Woman's Health are there to help. Abortion is still legal and access is still available for those who qualify. And even for those who don't qualify, the clinic is available to help women plan out their next steps.
"What I do know for certain is that we continue to fight," said Sadler. "There's no way that we could be a beacon in the community for our patients and for our communities and continue to be here and be accessible to them, but not fight for what's right for them."
Shawn Klein and HyoJung Kim contributed to this story.
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