With the coronavirus pandemic worsening — the state announced 40 new positive tests of COVID-19 Thursday and an additional death — access to abortion care gets increasingly complicated.

Democratic Governor Michelle Lujan Grisham, who supports reproductive health care, has allowed abortion clinics to remain open in New Mexico during the public health emergency. But abortion access has become more challenging in many areas of the country and that affects New Mexico, according to advocates.

So far, two states—Oklahoma and Texas—have restricted abortions unless the pregnancy puts the life of the pregnant person at risk, when announcing emergencies in their state over COVID-19. In four additional states–Ohio, Kentucky, Alabama and Louisiana–abortion during the pandemic has become contentious, according to Rewire News. Abortion appeared to be restricted in Iowa, but after abortion rights groups filed a legal challenge earlier this week, an agreement was reached on Wednesday, according to the Des Moines Register. Anti-abortion groups in additional states with Republican governors, such as Florida, are applying pressure for restrictions. The anti-abortion groups and lawmakers are arguing abortion is not essential, but the World Health Organization and The American College of Obstetricians and Gynecologists have said abortion care is essential and should remain available.

What some abortion rights activists call a targeted threat to close abortion clinics appears to have backing from the White House. One anti-abortion leader tweeted late last month that she was on a conference call with Vice President Mike Pence. According to NARAL Pro-Choice America President Ilyse Hogue, Pence used the phone call to strategize with anti-abortion groups on how to use the COVID-19 crisis to their advantage.

But it’s Texas’ abortion restriction that is having the most impact on New Mexico Religious Coalition for Reproductive Choice, according to Joan Lamunyon Sanford, the executive director. Her organization is a nonprofit that provides help for people who are getting an abortion in Albuquerque. Lamunyon Sanford said her organization is seeing an increase of calls for help from people in Texas. 

Republican Texas Governor Greg Abbott restricted abortion as part of his public health emergency order on COVID-19 last week. Abortion rights groups challenged the law. On Monday of this week a Texas court sided with the abortion rights groups—but the next day an appellate court reversed the lower court’s decision and the restriction went back into effect Tuesday.

Many abortion rights advocates say that even a temporary closure of an abortion clinic can put the clinic out of business permanently. Author Katha Pollitt wrote for The Atlantic Monthly that start up costs for abortion clinics are often too great. Texas passed a law in 2013 which forced many abortion clinics to close and although the U.S. Supreme Court later struck the law down, many abortion clinics in Texas never reopened, Pollitt reported.

Lamunyon Sanford and Eloisa Lopez, the committee chair of Abortion Fund of Arizona, both say they are hearing from local clinics that they are under greater stress. Some abortion rights advocates said that anti-abortion protestors are not adhering to the social distancing rules and have continued to gather in groups of more than five outside of the clinic in Albuquerque despite Lujan Grisham’s public health order. At least one anti-abortion group put out a post on Facebook encouraging residents to call Lujan Grisham’s office to pressure the governor to close abortion clinics in New Mexico.

Nora Meyers Sackett, the governor’s press secretary, said the governor’s office is getting those calls but, she said, the governor’s office gets similar calls “literally year-round.”

But adding a public health crisis and a volatile economy with millions of Americans out of work to the difficulty of having an unintended pregnancy adds additional layers of stress, said Lamunyon Sanford.

“We have more callers. And they’re more urgent,” Lamunyon Sanford said. “They’ve had their appointment canceled (at clinics in other states). They may have taken some time off, gotten childcare and then they have to make all those arrangements again.”

Lamunyon Sanford said New Mexico Religious Coalition for Reproductive Choice’s resources have been stretched thinner. And due to the need for visitors who fly in from out of state to self-quarantine for 14 days, the way in which her organization provides help has had to change.

Prior to the pandemic, volunteers with New Mexico Religious Coalition for Reproductive Choice sometimes hosted people traveling to Albuquerque for an abortion in their homes. But part of Lujan Grisham’s public health order includes that travelers who fly to New Mexico must self-quarantine for 14 days, so that is no longer possible. Now, New Mexico Religious Coalition for Reproductive Choice provides hotel vouchers to all the people they help to get an abortion in New Mexico.

The restrictions also mean that the group provides more care packages with snacks and groceries. Volunteers will drive the person with the appointment to the clinic and back, but otherwise, the person getting the abortion is “really isolated,” Lamunyon Sanford said.

The Navajo Nation, which is struggling with an outbreak of COVID-19, has ordered a curfew from 8 p.m. to 5 a.m. as part of its efforts to slow the spread of COVID-19. The National Guard is setting up roadblocks during the curfew hours in order to enforce the new rule, according to Lopez.

This will impact Navajo people traveling to Albuquerque for an abortion, Lopez said. Lopez said that some of those who live on the Arizona side of the Navajo Nation travel to Albuquerque for an abortion, instead going to Phoenix.

Rachael Lorenzo, co-founder of the grassroots organization Indigenous Women Rising, which provides abortion funding for Native people, is worried about how the curfew will impact Navajo people who need an abortion.

“I’m not sure what kind of restrictions or things they’ll have to navigate if they come up against law enforcement or anything like that,” Lorenzo said.

Lorenzo said IWR heard from two callers this week who needed help getting an abortion because their appointments in other states were canceled due to COVID19.  One of those calls came from Arizona, Lorenzo said.

Lopez said that as the pandemic continues to spread, there could be situations where individuals who need an abortion have tested positive for COVID-19 and will need to self-quarantine until they recover and then go through the difficulties of seeking an abortion.

That can increase the cost and the complexity of the abortion, Lopez said. And some states, such as Arizona, have gestational bans. Lopez said Arizona bans abortion after 24 weeks. That could lead to more people trying to travel to Albuquerque for their care, she said.

Although Utah has not restricted abortion due to the pandemic, Republican Utah Governor Gary Herbert signed a bill into law this week that forces people to receive a document when getting an abortion in Utah asking what they want to do with the aborted tissue, according to the Deseret News. Such laws shame and traumatize people who get abortions, say abortion-rights supporters.   

According to the Guttmacher Institute, a research and policy analysis organization, about a quarter of all U.S. women get an abortion at some point in their lives.

“Hustle and hassle have no place in healthcare,” Lamunyon Sanford said.