How a Texas clinic raced to provide abortion care before law went into effect

By Alexandra Svokos

As the clock ticked toward midnight, staff at an abortion clinic in Texas rushed to provide service for their patients while they still legally could.

"Honestly, there was no rhythm. There was no rhyme. It was a pure push to get everyone that walked in that door yesterday completed before 11:59 p.m.," Marva Sadler, Whole Woman's Health director of clinical services, told ABC News.

Sadler was at the Whole Woman's Health location in Fort Worth until midnight Tuesday assisting the push to serve patients before the most restrictive abortion law in decades went into effect.

While she said she felt proud to be able to provide care for the patients Tuesday night, when she returned to the office early Wednesday, that feeling "was immediately replaced by the thought that we were going to come in this morning and have to turn so many women away," Sadler said.

Tony Gutierrez/AP, FILE

In this Sept. 4, 2019, file photo, a staff member walks in the front door of the Whole Woman's Health clinic in Fort Worth, Texas.

Texas' Senate Bill 8 went into effect at midnight after the Supreme Court did not respond to providers' request for an emergency injunction in the midst of a legal challenge to the law. It still remains to be seen how the Supreme Court will react.

The law bans physicians from providing abortions "if the physician detects a fetal heartbeat," including embryonic cardiac activity, which can be as early as six weeks into a pregnancy. The law prohibits the state from enforcing the ban, instead authorizing private citizens to bring civil suits against anyone who "aids or abets" an abortion.

Whole Woman's Health and other independent abortion providers, as well as Planned Parenthood clinics, are still providing abortion care in Texas in strict adherence to the new law. However, because the ban is so soon after a person may be able to detect a pregnancy -- let alone book an appointment -- "the tragedy is that we can only provide abortion for about 10% of the people that we could provide abortion for yesterday," Amy Hagstrom Miller, founder and CEO of Whole Woman's Health, said on a press call Wednesday.

Darren Abate/Reuters, FILE

In this Feb. 9, 2016, file photo, Whole Woman's Health founder Amy Hagstrom Miller speaks to members of the press during a media tour of the Whole Woman's Health clinic in San Antonio, Texas.

Patients seeking abortions had heard about the upcoming law, Sadler said, and so in Fort Worth, "the schedule was full, because patients knew it was their last resort."

"They made those appointments and were willing to come in and wait with us and to be patient with us, in almost a desperation to be seen," Sadler said.

Clinic staff hustled to see those patients, completing 67 in-office procedures and upward of 50 follow-up appointments for medication abortions. On a typical day, the office sees more like 15 procedures and 20 medication abortion patients, according to Sadler.

The last procedure was at 11:56 p.m.

L.M. Otero/AP

A signs hangs outside the Whole Women's Health Clinic in Fort Worth, Texas, Sept. 1, 2021.

The clock wasn't the only added pressure for clinic staff. Anti-abortion protesters were working until midnight, too, standing outside the clinic shining flashlights on the parking lot as patients entered and exited, Sadler said.

The protesters took extra efforts to slow down work Tuesday, Sadler and Hagstrom Miller claimed, calling both the police and fire department on the clinic.

Usually, the office has clinic escorts to shield patients from protesters as well as a security guard, but with the last-minute rush did not have those resources. Staff stood in place of the security guard into the night, Sadler said.

This is the third time Whole Woman's Health, which operates four abortion clinics in Texas and was behind a landmark 2016 Supreme Court case that protected the right to abortion, has had to shutter operations due to laws in the last decade. The first was after the law that led to the Supreme Court case was enacted, and the second was last year when the state ordered abortion services to temporarily stop due to the COVID-19 pandemic.

"It's a place I think we find ourselves in here in Texas often," Sadler said. "And you would think that we would get used to it, but, I don't know that you can ever get used to people being so mean."

Tony Gutierrez/AP, FILE

In this Sept. 4, 2019, file photo, Director of Clinical Services Marva Sadler, prepares the operating room at the Whole Woman's Health clinic in Fort Worth, Texas.

She said she and the staff felt pressed to action because "they don't sleep on the other side."

"I'm tired, there is no doubt about that. I'm not sure how I'm getting my body to move, but I do know this: I do know that even though this is horrible and I don't have the best answers to give my patients, I am still -- my staff, my team, the wonderful abortion care workers in this state are still the best people to help these women navigate the hardest decisions of their lives," Sadler said.

"And we can't give up because Texas kind of beats us up, because a woman is still going to get pregnant and not want to be pregnant today," she said. "So it hurts. It's hard, it's heavy, it seems impossible many times, but if not us, then who?"

Her voice choked with emotion, Sadler asked to share this message with patients: "We won't give up, we have their back, and we're going to continue to do everything we can to support them in their time of need."

ABC News' Devin Dwyer contributed to this report.