This article was originally published at Prism

At a time when abortion care providers are already overburdened, clinics across the country are struggling to operate amid staffing shortages caused by COVID-19 outbreaks among staff. Simultaneously, abortion funds are reporting that more people are seeking financial support for their procedures than they did last year, and patients who test positive for COVID-19 are having to push procedures back in order to quarantine. The omicron surge adds another slew of challenges for people in Texas who have to travel to another state for care because of the state’s restrictive new law, Senate Bill 8, which bans abortions as early as six weeks. Abortion advocates in Oklahoma, where many Texans travel for care, say the omicron surge has created even more obstacles as they juggle a spike in patients, directly impacting already vulnerable populations including people of color and low-income communities.

Dr. Christina Bourne, a family medicine physician who travels to Kansas and Oklahoma to perform abortions and a fellow with Physicians for Reproductive Health, said abortion clinics exist at an intersection where many restrictive policies that predominantly affect marginalized people coalesce. Senate Bill 8 and targeted restrictions on abortion providers, or TRAP laws, which are designed to close down clinics instead of making them safer, produce obstacles for abortion care providers and anyone in need of the procedure. Bourne said Omicron just puts even more burdens on their plate.

“Folks are out of jobs; capitalism is failing everybody, our health care systems are failing everybody,” Bourne said. “Our whole health care system was founded on racism and paternalism. All of these things are intersecting, and omicron is the cherry on top. [The system] was already so tenuously put together, and [omicron] is the small little flick that’s been needed for this whole system to collapse.”

To meet the surge in patients from Texas, an organization that opens abortion clinics in underserved communities, the Trust Women Foundation, has been hiring more staff at their locations in Oklahoma City and Wichita, Kansas. Bourne, who is also the medical director for the organization, says that most of their patients have been from Texas.

“There’s just more people coming out of Texas than there’s capacity to absorb,” said Zack Gingrich-Gaylord, the communications director for the Trust Women Foundation. “We don’t have enough clinics in Oklahoma or Kansas either.”

In 2017, Texas provided about 55,000 abortions, meaning there are about 1,100 Texans per week now who are no longer able to get care and have to travel to surrounding states. According to Gingrich-Gaylord, they see 50 to 100 of those patients between two of their clinics every week.

“We’re needing to essentially provide health care for Texans,” Bourne said. “Oklahoma has pretty much turned into a Texas clinic.”

The need for more staff has increased in recent months because of omicron. Everyone in the company is mandated to be fully vaccinated, but just last week they had to close the Oklahoma City clinic after multiple staff members tested positive for COVID-19 or had symptoms from high-risk exposures with other staff members.

“The safest thing to do for our staff and for our patients was to close the clinic,” Bourne said. “I don’t think that has ever happened before. This surge has affected us more than past surges.”

The staffing shortages and care delays that abortion care providers are facing are no different than what has happened to almost every industry across the country, but considering the time-sensitive nature of abortion care, providers say they are doing everything they can to keep their doors open.

“There are individuals traveling for medical care and individuals needing to access timely medical services,” said Dr. Kristina Tocce, the vice president and medical director for Planned Parenthood of the Rocky Mountains, which operates clinics in New Mexico, Colorado, and Nevada. “We know the impact of canceling a session on our patients is so significant, so over the past few weeks we have really made heroic efforts to keep the doors open and have enough staff to do that.”

Tocce said she has also seen a significant increase in patients traveling from Texas for care since September. As a result of how omicron has impacted the country’s greater infrastructure, including flight schedules and the ability to travel, patients are facing organizational and logistical hurdles for care.

“There’s cancellations all the time,” Tocce said. “There’s always the fear of, ‘Are there enough employees in any sector currently and are patients going to get their medications on time?’ We have to rely on other industries as well. Hopefully, this wave will decrease in the next few weeks, and we will get through without having to further limit abortion access.”

To mitigate the difficulties with travel, Tocce has been advocating for patients to receive medication abortion, which the FDA permanently allowed to be distributed by mail as of December 2021. If patients have a mild case of COVID-19, they can utilize the direct-to-patient service and receive the medication abortion remotely.

In Alabama, the Yellowhammer Fund, which helps people pay for abortion care, reports that calls from people seeking abortion funding doubled in the past year from 56 in the first week of January 2021 to 101 during the first week of January this year. Kelsea McLain, the health care access director, said they received a total of 54 calls on Jan. 10 and 11. She estimates they will receive up to 80 calls for the second week of January alone. McLain believes the surge is a direct result of the financial burdens caused by omicron. Job closures and the lack of paid leave, despite mandatory quarantine periods, have pushed already vulnerable people to seek financial assistance for crucial medical procedures like abortion.

“I keep hearing COVID over again on these phone calls, and I haven’t been hearing that for probably the last six-to-eight months,” McLain said. “The real epidemic right now is in the availability of funds and resources for people to pay for these procedures as they navigate not having an active income or already existing on a budget.”

According to the Guttmacher Institute, low-income women are statistically more likely to receive an abortion than people living above the federal poverty line. Now that Omicron has forced jobs to temporarily shutter for quarantine periods, working-class people who live paycheck to paycheck may not be able to afford the (on average) $650-$750 procedure.

“Many patients are not making a living wage and do not have paid time off,” McLain said. “That is what’s really hitting people and why people are having trouble accessing abortion during this new stage of the pandemic.”

Despite staffing issues, abortion care providers insist that patients seek out care as soon as possible and know that they are doing everything they can to keep the doors safe and open.

Prism is a BIPOC-led non-profit news outlet that centers the people, places, and issues currently underreported by national media. We’re committed to producing the kind of journalism that treats Black, Indigenous, and people of color, women, the LGBTQ+ community, and other invisibilized groups as the experts on our own lived experiences, our resilience, and our fights for justice. Sign up for our email list to get our stories in your inbox, and follow us on Twitter, Facebook, and Instagram.