It is perhaps the most controversial health care issue in United States history – one that makes supporters and opponents’ blood boil, and sometimes even spill.  Since before the landmark Roe vs. Wade decision was made in 1973 by the United States Supreme Court, legalizing the procedure, abortion has provided a ceaseless battleground for clashes over women’s rights, morality and constitutionality.

Factors like legislation, restricted access to abortions and the severe cultural and societal stigmas the procedure still carries have made a seemingly tough decision even harder.

The so-called “anti-abortion law,” House Bill 2, was imposed in 2013, leading more than half of our state’s 40 abortion clinics to close. Most of the bill has since been overturned, but many clinics remain shuttered.

El Paso has two abortion clinics, Hilltop Women’s Reproductive Clinic and Reproductive Services. The latter has been around since 1977 and used to have seven clinics across Texas, but is now down to one.

Jerrie Laster, administrator for Reproductive Services, cited excessive financial and emotional burdens some of the anti-abortion legislation places on women.

“Legislation is attempting to put abortion out of women’s reach,” she said. “It’s a constant battle and it puts an undue burden on women.”

 The facility not only has a licensed physician who’s been performing abortions there for 25 years; they also have family planning service and an adoption affiliate.

Laster said the social and cultural stigmas are “age old” and not limited to the women who get the procedure done,  pointing out that doctors have been killed over their choice to perform abortions.

“[Our doctor] has weathered it,” she said. “She’s even had to wear a bullet-proof vest.”

Laster said the pro-life movement doesn’t consider the consequences of the lives born into adverse situations.

“They’re not pro-life, they’re just anti-abortion,” she said. “Once they persuade someone to come over to their side and not terminate and they have the baby, then what? Do they help the mother find a family for her baby?  Now there are two lives that are affected.”

Gina Lawrence is the communications director for West Fund, a local volunteer-driven agency that works to make abortion more accessible. She said there are a lot of misconceptions about the kind of women who undergo abortions.

“Abortion is incredibly stigmatized in the United States, but especially in Texas and on the border,” she said. “Many people stereotype people who have abortions as people who are irresponsible, but in reality, people who have abortions are usually responsible people who are making a choice that is best for them.

“The average patient that the West Fund helps is 26 years old, and 75 percent of our patients already have children, so they know the work and care it takes to raise kids in this world and are having an abortion because it is their best choice.”

Lawrence said the abortions that are most stigmatized are the ones that occur after 20 weeks.

Referred to as “late-term abortions,” she said those make up less than 1 percent of abortions. Women sometimes wait this long because of their limited access to abortions, Lawrence suggested.

“Texas has made it very difficult to get an abortion. Most of our patients are forced to drive an average of 405 miles round-trip to access their closest clinic,” she said. “Couple that with finding childcare, getting time off work, finding reliable transportation and getting to the appointment.”

She also cited the “incredible expense” of abortions ranging from $550 to an average cost of $2,122.

“If Texas laws were friendlier to clinics, we believe that later term abortions would go down,” she said. “Patients would be able to affordably access their abortions closer to home in a more reasonable amount of time.”

Indeed, the closest Texas clinic that will offer procedures to women who are past 14 weeks pregnant is in San Antonio. This leaves many women in rural west Texas in the lurch when it comes to easily accessing abortions.

There is one clinic each in Albuquerque and Santa Fe. They serve clients who are up to 29 weeks pregnant.

Another state-mandated obstacle is the requirement of parental consent for minors or judicial bypass in order to get an abortion, which as Lawrence said can be dangerous for teens who are domestic violence or incest victims.

There aren’t many qualified practitioners who perform abortions, and Laster said there’s no hope on the horizon for recruiting more.

 “It’s hard to recruit any doctors, especially if they’re in a practice with someone who’s against it,” she said.

Laster said fewer doctors are electing to become abortion providers due to a couple factors.  State-funded medical schools have eliminated instruction on abortion. Doctors’ lives are also sometimes at risk due to anti-choice terrorism.

West Fund president Sam Romero said the stigma associated with getting an abortion prevented her from divulging her decision to even her closest family members.

“It’s why I didn’t tell anyone for a very long time,” she said. “It took me a year to start telling anyone, including my family.”

The decision to begin telling her story was sparked after her work with the Wendy Davis campaign, which found her in a conservative, pro-life environment in East Texas.

After Davis’ loss for the governor’s seat in 2014, Romero’s decision became something bigger than a personal issue.

“After she lost, I recognized that I really believe in people’s right to choose and in my decision,” she said. “That’s when I decided I would start telling people about my abortion. People in El Paso really need to start talking about this.”

She also believes the procedure is too expensive for many women in this area, thus limiting their access to the procedure. Her own abortion cost $1,100.

“I really have no idea why it was so expensive,” she said. “I literally used all of my life’s savings to pay for it.”

For Lawrence, groups like the West Fund have their work cut out for them as state lawmakers show no signs of loosening the reins on the abortion issue.

“With an anti-choice House and Senate, we do anticipate anti-abortion legislation will be tacked on to many bills,” she said. “We are definitely watching closely as the year unfolds to see what they try to do to limit people’s constitutional right to a safe and legal abortion.”