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Anti-abortion pregnancy centers are working to adapt during the fight against COVID-19 as social distancing restrictions are limiting access to health services and narrowing the window of time to receive them.

That pressure has made unintended pregnancies more nerve-racking.

“An unintended pregnancy is stressful anyway -- you add a pandemic and economic collapse onto that, and it’s even worse for them,” said Leslie Salazar-Carrillo, CEO of Pathway Health Clinic in San Diego, California.

The National Institute of Family and Life Advocates (NIFLA), an affiliate network of more than 1,500 centers, sampled about 350 of their clinics and reported that 21 percent saw an increase in clients and patients, while 42 percent saw an increase in women seeking or open to abortions.

Jennifer Shelton, executive director at Real Options, said her health clinic in Allen, Texas, saw a 20-25 percent increase from the typical week in the number of calls she received from women determined to have abortions. Heartbeat International, which serves nearly 3,000 affiliates, said calls to its crisis pregnancy hotline have increased by 30 percent during the pandemic.

In interviews with Fox News, several pregnancy centers, which offer women health services and alternatives to abortion, and national anti-abortion organizations described how the coronavirus left women vulnerable to potential health complications and economic insecurity created by job loss.

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“[The] coronavirus is creating a sense of crisis for sure, for a lot of these women,” said Joanna Hyatt, who leads strategic partnerships at the anti-abortion group Live Action.

In Ohio and Texas, which have banned performing abortions because they are considered elective surgeries, women have been forced to seek out facilities like Real Options. Abortions are deemed elective during the pandemic because they could siphon needed equipment from the COVID response. Pregnancy centers, meanwhile, focus on routine health services like ultrasounds, pregnancy tests, and other non-surgical procedures, and are protected under the legal umbrella of essential services.

Fox News previously reported on a woman in Texas who sought out other services after the ban forced Planned Parenthood to cancel her appointment. Shelton similarly reported that several women decided to keep their babies after contacting her center.

Planned Parenthood maintains that abortions are essential, pointing to an American Medical Association statement opposing state bans on the procedure.

Compounding women’s stress is the shifting nature of these bans, which often bounce between various courts -- sometimes changing abortion access overnight. As abortion proponents have noted, abortion is a “time-sensitive” procedure since women learn about their pregnancies at different stages and legal restrictions preclude termination at varying points of gestation.

Medication abortions generally allow clinics to avoid surgical procedures, even though they require at least some PPE, according to former Planned Parenthood director Abby Johnson. But proponent groups argue doctors performing abortions do not require the same PPE needed by those fighting coronavirus.

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Depending on where a woman lives, the nearest clinic providing abortions might be hours away, while those nearby could offer only limited services. According to Savannah Marten, who leads the Pregnancy Center of Greater Toledo, the state's ban on elective procedures gave donors the mistaken idea that abortions weren't taking place in the city. In reality, one clinic continued providing medication abortions, which are non-surgical and generally limited to the first trimester.

Pregnancy centers also have worked to leverage the federal coronavirus stimulus for their benefit. Earlier in April, Heartbeat International scheduled a webinar for its centers, designed to advise them on how to use stimulus package funds. According to NIFLA, President Trump’s stimulus maxed out large charitable gift deductions at 100 percent of individuals’ gross adjusted income. The deductions for smaller gifts and corporate donations increased as well.

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Altering service to accommodate pandemic-related restrictions

Pregnancy centers are adapting to the pandemic by using options like telehealth for providing care.

Women might fear going to hospitals where facilities are handling an influx of coronavirus patients. Bella Clinic in Colorado told Fox News at the end of March that its telemedicine clients went from 0 to 51 percent in 11 days. Another NIFLA report from April 17, sampling around 230 centers, showed a near-even split between those who said they implemented telehealth or teleconferencing (51 percent) and those that didn’t (49 percent). Only a small percentage reported completely shuttering operations, according to NIFLA.

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Pregnancy centers provide myriad services, including materials like diapers and wipes, life skills and parenting classes, and a general source of community for women who might otherwise face unintended pregnancies alone. With remote technology, centers have been able to continue offering classes and consults while maintaining social distancing.

Dr. Karen Poehailos, who serves as regional medical director at ThriVe Central VA Women's Healthcare, told Fox News that her center has moved postpartum support and other groups online.

Salazar-Carrillo's center also started providing baby items so that clients don't have to risk exposure at stores. “We follow all protocol[s] -- we sanitize it … they text us when they get here. We mask up, glove up, set it down, back away. They get out of their car, and come and get it,” she said.

Abortion proponent groups like NARAL have accused pregnancy centers of keeping women in the dark about their actual options.

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“Anti-choice organizations are and have always been consumed with ending legal abortion by any means necessary, and that they're exploiting the COVID-19 pandemic to push their unpopular agenda illustrates there is no low they will not sink to,” NARAL spokesperson Amanda Thayer said, according to Vice.

“Amid a global pandemic, they are actively pushing disinformation and bucking science to suggest that abortion is not essential or time-sensitive care.”

NIFLA President Thomas Glessner, whose organization was involved in a Supreme Court case over the issue, maintains that deception is “never an option” for his affiliates. “They must be truthful and honest at all times,” he said.

Salazar-Carillo told Fox News that the point is not to tell women what to do, but "really to get them to slow down that thought process. Because when somebody’s in a crisis, they think in a circular thought process and really get them to think in a linear thought process.”

Anti-abortion centers are aware that women may worry COVID-19 could impact their pregnancy. But according to Harvard Medical School and Mass Gen, the small amount of research on COVID-19 hasn’t proven a heightened risk for pregnant women and their unborn children.

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Still, women may face sexually transmitted infections (STI) that can harm them as well as their unborn children. One pregnant mother in Missouri tested positive for syphilis, but the health department that administered the test was unable to contact her remotely. Instead, the department reached out to her through LifeChoices Health Network.

NIFLA has heard many stories about local health organizations referring patients to pregnancy centers as the system was stretched thin due to demands surrounding COVID-19.

In San Diego, Pathway Health Clinic started limiting its intake to women considering or determined to have an abortion, and referring other patients to another organization.

Schrage’s center, LifeChoices Health Network, has a mobile medical unit that functions as an exam room and travels to patients' homes.

“People who have never seen us before have come in for emergency help with diapers, wipes and formula because they’re unemployed now,” Poehailos said.  

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Keeping staff and patients safe during the outbreak

Amid COVID-19, there are protocols and guidelines that pregnancy centers must follow to maintain compliance.

That’s could prompt clinics like Real Options in Texas to seek help from large affiliates like Care Net and NIFLA to help ensure safety at their centers.

“We’re following [Centers for Disease Control] guidelines, OSHA guidelines in order to protect our employees,” said Anne O’Connor, NIFLA’s vice president of legal affairs. “They’re all using PPE, the latest guidelines said even their patients coming in need to be wearing a mask, so we just implemented that with them,” she added.

Poehailos said that although her region isn’t COVID-intensive, “we’ve been very careful about our practices as far as handwashing and deep cleaning between patients at the centers.” She added that while her staff has remained healthy, she’s ready to rotate in a replacement for an employee who catches the virus and therefore needs to be quarantined.

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More than 95 percent said they continued serving their communities, but only a fraction (11 percent) said they were operating with the same staff and hours, NIFLA’s April 9 polling found. Shelton’s clinic has mostly continued providing sonograms, but with a limited staff and targeted toward women seeking abortions. Most of her nurse volunteers are in a high-risk elderly category, and therefore have to stay at home.

The virus also has forced clinics to innovate with spacing. Shelton’s clinic, for example, rearranged its furniture so patients could remain 6 feet away from each other.

Poehailos told Fox News that she offers masks for patients.  She’s also emailed intake forms so woman arrive with paperwork completed. The goal is to limit client exposure and save on PPEs. “If we can minimize the time in their center and the number of people who are interacting with them, we can try to save the gloves and masks,” she said.

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Carrillo's at-home staff has started remotely providing counseling through secure virtual visits, so the on-site personnel can focus on medically oriented follow up. NIFLA’s survey revealed that 34 percent said they were working remotely. And 52 percent said they are operating with modified staff and hours.  

Schrage told Fox News that she’s had to stagger her staff schedule on a bi-weekly basis. “We’ve chosen to rotate out our essential health care to make sure that there will never be a time when we don’t have a team ready,” she said.

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She added that many who were told to work from home were “very upset” that they couldn’t offer care within the clinic itself.

“We essentially had to reposture the conversation to say, ‘hey, you are the designated survivor if and when something would happen … so that we have a full fresh medical team to rotate back in',” she said.