ALBUQUERQUE, N.M. — On a Friday afternoon outside Southwestern Women's Options in Albuquerque, N.M., a protester grips a cardboard box overflowing with small, plastic baby figurines. A man reclines in the driver's seat of a truck, a baseball cap over his eyes.
Inside, there is not a single empty chair in the pale pink waiting room of the clinic.
One woman covers her face, quietly sobbing. Another wearing a shirt that barely buttons over her belly calmly fills out paperwork.
Many patients here have traveled from other states because this clinic offers abortions later in pregnancy.
Since Senate Bill 8 (SB 8) went into effect in Texas last year, restricting abortions after six weeks of pregnancy, the clinic has gone from seeing about 40 patients per week to more than 100. Almost all of those patients are in the second or third trimester.
The assistant director of the clinic, Cristina — who requested that only her middle name be used because she fears harassment — says the clinic has changed the way it does things in order to meet that higher demand.
For example, the clinic now works more closely with regional abortion access funds that pay for the procedure and travel expenses for women who cannot afford care themselves. Also, Southwestern Women's Options has been hiring more staff, such as administrative support.
She worries that now that Roe v. Wade has been overturned, it will simply be impossible to see all of the patients who seek care at Southwestern Women's Options.
"We can only do what we can do," says Cristina. "We can only do so much."
Now that abortions are no longer available in many states, later abortion will be more common because it will take patients longer to get care. While they book flights, save up money and deal with longer waits for appointments, their pregnancies will — of course — progress.
Finding a clinic to perform later abortions can be a challenge
One patient, Beth Vial, traveled from Oregon for the procedure after she was unable to find a provider in her hometown.
After a false negative on a home pregnancy test, a positive result during a regular physical and a visit to a crisis pregnancy center that tried to dissuade her from ending the pregnancy, she learned she was 26 weeks along. Vial had unstable housing and no family support. She knew she needed an abortion.
Her doctor in Oregon told her about Southwestern Women's Options, which had an open appointment. But the cost of the procedure along with travel expenses would add up to about $15,000.
"At that point, I thought abortion was out of the question," says Vial.
It took four abortion support networks and the help of a family friend to get the the money together, but within a week Vial was able to make the journey to Albuquerque.
Vial spent most of that time in the hotel watching MTV between appointments at the clinic. "It was the only thing my brain could manage," she says.
On the day of the procedure, she was induced to go into labor. But she had some complications and ended up at the clinic for 20 hours. Her doctor and nurse stayed the entire time.
"One of them slept on the chair next to me," says Vial. "It was a kind of compassion I had never experienced before."
Few states allow abortions beyond the second trimester
There are six states — Alaska, New Jersey, New Mexico, Colorado, Vermont and Oregon, plus the District of Columbia — where abortion is legal at any point in pregnancy, but it isn't always available past 28 weeks.
There have always been reasons why someone might need an abortion so late: fetal abnormalities, life-threatening health risks or women who don't have access to health care until late in pregnancy. But now with fewer clinics doing abortions, that list of reasons will be longer.
Dr. Curtis Boyd has been performing abortions since the 1960s. He started providing this medical care in rural eastern Texas through the Clergy Consultation Service — a group of religious leaders who aided women seeking abortions before Roe became the law of the land in 1973.
Boyd has been performing abortions in New Mexico since 1972, but as laws became more restrictive in Texas and providers faced more serious harassment, he spent more of his time in New Mexico. He began performing third trimester abortions there in 2010.
Boyd says the patients he sees later in pregnancy often are devastated to end a wanted pregnancy.
"These are tender moments. They're hard decisions," says Boyd. "Women are devastated. They want to view the baby. They want blessings. They've lost their baby. They want that acknowledged."
Abortions after 28 weeks account for less than 1% of all procedures, and they require more specialized care. Boyd says the doctors who provide them face harassment. He regularly sees fires set outside his clinic, has had his car broken into and is often screamed at by protesters as he walks into his clinic.
"We're accustomed to that," he says.
Providing abortions is a calling for some
Boyd is not only a doctor, he's also a Baptist minister.
Even though the anti-abortion movement is supported by many in Boyd's faith, providing abortions aligns with his religious belief the he should be of service to those most in need.
"We're committed to each other," says Boyd. "We are compassionate towards each other's situations and needs."
This is a core belief for Boyd: to give to others all he can to help them succeed. Abortion care is what he has to offer.
In fact, when Boyd was approached by a girl in his hometown who needed an abortion in the 1960s, it was his deep belief that he "must be of service," which drove him to give her the care she needed.
At the time, abortion was illegal and he could have ended up in jail.
Even though New Mexico has laws protecting abortion, Boyd isn't certain the procedure will always be legal there.
But he is certain about the implications for women. He says without the right to the procedure, women will never have the liberty promised to them in the Constitution.
"They will never have equality," Boyd says, "if they cannot decide for themselves whether or not they are going to continue their pregnancy"
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