The impact of Texas’s near-total ban on abortions is being felt in states as far away as California and Maryland, according to new research.

In the weeks since SB8, which outlaws most abortions after six weeks of pregnancy, went into effect, Texas residents have undergone abortions in more than one dozen states and Washington, D.C., according to research from the Guttmacher Institute, a reproductive rights organization.

In addition to traveling to states that border Texas to seek abortion care, residents have traveled to states that are hundreds or thousands of miles away. One abortion provider in Tennessee has had twice as many patients from Texas since September, when SB8 went into effect, than in all of 2020, according to the Guttmacher Institute.

“What we’re talking about is a total disruption of the abortion care network,” said Elizabeth Nash, interim associate director of state issues at the Guttmacher institute. “And if the Texas ban stays in effect and other states are able to follow suit, then we will continue to see a real disruption among abortion clinics across the country.”

The Texas law bans abortion once the rhythmic contracting of fetal cardiac tissue can be detected. That’s usually around six weeks, before some people may even know they’re pregnant.

Most of the abortions performed nationwide are after six weeks of pregnancy.

The U.S. Supreme Court heard oral arguments earlier this month about SB8, which is enforced by private citizens who are allowed to bring lawsuits against anyone who “aids or abets” an unlawful abortion.

The justices are expected to rule soon on whether abortion rights advocates and the federal government have the ability to sue Texas over the law given the way it’s designed.

In the meantime, abortion rights advocates say they worry that the far distances people are having to travel to seek abortion care means the most vulnerable people, such as those without the financial resources to travel, are being left behind.

Jessica Pinckney, executive director of Access Reproductive Justice in California, said the organization’s Healthline, which helps people with funding and logistics for abortion care, has only seen a small uptick in callers from Texas since SB8 went into effect.

The organization’s clinic partners in California, however, are reporting caring for two to three patients from Texas per day, according to Pinckney.

“This likely indicates that the people who are leaving Texas to access abortion care have the financial means to do so and, potentially, are not calling on Access for financial support,” Pinckney said, adding that her organization is preparing for even more of an influx of people from Texas as abortion care in closer states becomes harder to obtain, whether because of increased restrictions in those states or an increased demand for abortions.

An earlier Guttmacher Institute analysis found that when a person from Texas has to travel out of state for an abortion, it increases the trip by an average of nearly 3.5 hours each way.

The cost of some abortions can range anywhere from zero dollars to $1,500 based on where a person lives and what types of health insurance and financial support programs they may have access to, according to Planned Parenthood.

As the pregnancy progresses, it gets more expensive. Abortion in the second trimester can cost as much as $3,500 — and that is before factoring in costs like travel, child care and time off of work — according to Brigitte Winter, board vice president of the Baltimore Abortion Fund (BAF), a nonprofit organization that provides financial support to people seeking abortion care in Maryland.

“Over the last two years, BAF has seen the barriers to access for the people calling our confidential helpline get significantly steeper — even before the passage of SB8 in Texas — as more people struggle financially due to the ongoing public health crisis, and more abortion patients travel to Maryland from states with restrictive abortion regulations,” Winter said. “Many of our callers will have to call multiple abortion funds, coordinate needs like travel and child care, and do their own fundraising, telling their personal stories over and over again, in order to fully cover the cost of their abortion procedures, sometimes up until the day of their appointments.”

“When callers aren’t able to fully fund their abortion care, they have to reschedule, making their procedures exponentially more expensive and less accessible the longer they have to fundraise,” she said.

Winter said BAF has received only a handful of calls from Texas residents since SB8 went into effect, though she said that does not show the full picture of people likely accessing care.

“Traveling all the way from Texas to Maryland for an abortion procedure is expensive and logistically challenging, especially factoring in costs like air travel, lost wages, hotel accommodations, meals and child care,” she said. “Because we only hear from patients who have a financial need, it is very unlikely that we have spoken to every person coming to a Maryland abortion clinic from Texas since the passage of SB8.”

Nash, of the Guttmacher Institute, said the fallout in other states from SB8 has shown how one state’s abortion law can “have an impact across the entire country.”

She said clinics in states where abortion access is available are reporting being so inundated with out-of-state patients that local residents have to drive somewhere further away for care.

The impact of the Texas law is also being felt as U.S. Supreme Court Justices are scheduled to revisit Roe v. Wade in a separate case from Mississippi set for December.

“This feels like a very precarious time for abortion rights,” Nash said. “In states across the country, there is already very limited access to abortion. To add more patients is a real stressor on this network.”