In a Texas abortion clinic, about a dozen women waited Friday to see the doctor, already aware that they would not be able to end their pregnancies there.
A day after a federal appeals court allowed most of the state's new abortion restrictions to take effect during a legal challenge, about a third of Texas' clinics were barred from performing the procedure, including five North Texas clinics.
Thursday's ruling made Texas the fourth and largest state to enforce a provision requiring doctors who perform abortions to have admitting privileges in a nearby hospital. In places such as the Rio Grande Valley and rural West Texas, the mandate put hundreds of miles between many women and abortion providers.
Anti-abortion groups welcomed the court's surprise decision, which they insisted would protect women's health. The ruling came just a few days after a lower federal court put the law on hold.
If women did not know about the ruling before they arrived at Reproductive Services of Harlingen, clinic administrator Angie Tristan told them. Abortions are a two-day process in Texas. On Fridays, women arrive here for their initial consultation with the doctor. On Saturdays, they return for the procedure.
Despite Tristan's explanation that they would not be able to have abortions on Saturday, some women decided to stay on the slim hope that something would change.
In North Texas, all three of the clinics that had provided abortion services in Tarrant County could no longer do so Friday, including Whole Woman's Health on Lackland Road near Interstate 30.
We've actually had a couple women scream out when they were told what’s going on," said Marva Sadler, clinic administrator. “They feel like they're being pushed or forced into motherhood when they're not ready."
The staff may soon be out of work because of the court ruling.
"Our staff is completely devastated," Sadler said. "They have families to care for, and right now their futures are up in arms."
A panel of judges at the 5th Circuit Court of Appeals in New Orleans ruled that Texas can enforce the law while a lawsuit challenging the restrictions moves forward.
The law that the Legislature passed in July also bans abortions at 20 weeks and, beginning in September 2014, requires doctors to perform all abortions in surgical facilities.
But it's the provision about admitting privileges that has idled Dr. Lester Minto's hands here in Harlingen, near the Texas-Mexico border.
After the law was adopted, the clinic began preparing to close, shredding old patient records and drawing down their inventory, ordering only enough supplies to keep going for a month at a time.
Minto, who has been performing abortions for 30 years, predicted the women he sees would take dangerous measures in their desperation. He made clear he would not perform abortions Saturday if they remain prohibited, but he did not rule out taking other steps in the future.
"I'm going to continue helping girls somehow," he said.
Without access to his services, "they'll do drastic things," Minto predicted. "Some, they may even commit suicide."
He said he has seen women take various concoctions hoping to end pregnancies. Others have been beaten by boyfriends who pounded their abdomens with bats.
The communities Minto serves are among the nation's poorest. On top of that, many of his patients cross the border from Mexico, where abortion is illegal in most places. Others live in the U.S. illegally.
If this clinic and one in nearby McAllen are forced to close, women seeking abortions would be faced with taking days off work, finding childcare and paying for hotels in cities such as San Antonio, Austin or Houston.
That's more than many can afford, including a 39-year-old woman from Willacy County who was waiting Friday to see Minto. She spoke on condition of anonymity because she was fearful of the judgment she would face in her small, rural community.
The woman said she and and her husband are happily married but already have several children. They're just getting back on their feet financially after her husband recently found work. The pregnancy was not planned.
"I just can't afford to have another one," she said, crying. But the money to travel north for an abortion isn't there either.
"It's so unfair. It's just politics," she said. "It's my decision. It's not anybody else's."
Asked what she would do if the clinic were not allowed to perform her abortion, she said: "I think I will have to go through with the pregnancy. I don't have the finances to travel."
Among the clinics that could not perform abortions under the current restrictions are those of Whole Woman's Health, which, in addition to Fort Worth, has locations in McAllen and San Antonio.
"Women who need our care will now have nowhere to turn, and the staff and physicians in our clinics now face furlough and likely unemployment," Amy Hagstrom Miller, the agency's CEO and president, said Friday in a statement. "This law affects real people, real lives and real families."
The Supreme Court prohibits legislatures from banning most abortions, acknowledged Joe Pojman, executive director of Texas Alliance for Life. But, he said in a statement, "states should have the right to protect women from dangerous abortion procedures."
Texas follows Utah and Tennessee in enforcing the admitting privileges law. Similar laws are under temporary court injunctions in Alabama, Kansas, Wisconsin, North Dakota and Mississippi, which also falls under the 5th Circuit Court of Appeals. The appeals court has left in place the temporary injunction against the Mississippi law.
If lifted, the Mississippi injunction would force the state's only remaining clinic to stop providing the procedure. The Supreme Court has ruled in past decisions that lawmakers may not pass laws that would effectively end abortions in a state because that would put an undue burden on women trying to exercise their right to end a pregnancy.
In Thursday's opinion, appellate Judge Priscilla Owen noted that the Texas law would not end the procedure, only force women to drive a greater distance to obtain one.
Almost all Republican lawmakers who make up the majority in both chambers of the Texas Legislature are vocally anti-abortion and have repeatedly pledged to try to stop abortion. Gov. Rick Perry has also dedicated himself to making abortion illegal, saying late Thursday that his administration would continue "doing everything we can to protect a culture of life in our state."
Editor's Note: A previous version of this Associated Press story incorrectly stated that a Kansas law requiring doctors who perform abortions to have admitting privileges at a nearby hospital was in effect. A state judge has issued a temporary injunction blocking enforcement of the law pending a trial on its constitutionality.
NBC DFW's Ken Kalthoff contributed to this report.