Almost daily, the Reproductive Health Services clinic in Montgomery, Alabama, receives several versions of the same call: “Are y’all still doing abortions? Have they outlawed it in Alabama? Where can I go?”

The confusion is understandable. In May, Gov. Kay Ivey signed into law the Alabama Human Life Protection Act, which aimed to outlaw abortions in all cases except when the mother’s life was at risk. The passage of the strictest anti-abortion measure in the country made national news.

But despite the headlines about a “near-total ban,” abortion remains legal in Alabama. The details of the law may have been lost behind a larger message, according to June Ayers, the owner of the Montgomery clinic.

“Once you’ve hit a wall, it’s a little hard to see the brick,” Ayers said. “All [people] saw was that it’s been banned in Alabama in every case.”

The measure, which was not scheduled to go into effect until November, is already ensnarled in a legal battle brought by the American Civil Liberties Union and Planned Parenthood on behalf of the three clinics in Alabama still offering abortion services. The plaintiffs in the suit have asked the district court for a preliminary injunction, which would stop the law from going into effect while the case weaves through the U.S. judicial system. There is also the chance of a temporary restraining order that would halt the law from being implemented until May 2020.

Even advocates for the Alabama Human Life Protection Act have called it unconstitutional. Ivey, who inked it into law, said the ban will likely be “unenforceable,” signaling that a legal battle — part of a larger push to overturn Roe v. Wade — was the point all along.

However, even though it’s at a standstill, the legislation is already having impacts. Clinics and advocates told FRONTLINE that the law caused a surge of confusion. “Women immediately thought that abortion was illegal,” said Gloria Gray, clinic director of West Alabama Women’s Center in Tuscaloosa. “We got numerous calls wanting to know if we were still open and that went on for a couple of weeks before women realized that abortion was still legal.”

Experts told FRONTLINE that new restrictions to abortion access — in Alabama and elsewhere — are coupled with waves of confusion. Dalton Johnson, owner of Alabama Women’s Center for Reproductive Alternatives in Huntsville, said that every time the laws around abortion access change his clinic is “overwhelmed” with calls from people asking if their appointments will be canceled or if the procedure is still legal. He even fields questions from physicians calling to get information for their patients.

“These women are being scared to death,” Johnson said. “If we see ten patients in one day, at least two to three are asking: ‘How much longer is it going to be legal in Alabama? What does this mean for you guys? When are you guys going to have to close? Where are the women going to go after me?’”

Johnson also said protestors outside his clinic were “invigorated” and that protests have increased after the law’s passage — the clinic sees picketers six days a week, including on Saturdays, when the clinic is closed.

The situation in Alabama recently drove two women to call Knoxville Center for Reproductive Health, across the border in Tennessee, about receiving abortion care. Although the women knew they could obtain services in Alabama, they told staff they didn’t want to wade through the “nonsense” at home, according to clinic co-director Corinne Rovetti.

Tennessee has not been part of the wave of restrictive abortion laws, but Knoxville Center for Reproductive Health still gets calls “all the time” asking if abortion is still legal – questions the clinic says it has been getting for years as more and more restrictions have passed.

Poll data revealed in 2018 that about 200 people in a pool of 1,000 U.S. voters either didn’t know whether abortion was legal in their state or thought it was illegal.

“Living in a state with abortion restrictions was also associated with lower levels of knowledge,” wrote Guttmacher’s Rachel K. Jones, who wrote the survey question. “Abortion restrictions not only make it harder for individuals to terminate their pregnancies, but attention around them may have the secondary effect of making people question whether abortion is even legal.”

Clinics and advocacy organizations have adopted messaging strategies to assure people they can still get abortions. “We’re seeing public awareness campaigns that abortion is still legal,” said Elizabeth Nash, senior state issues manager at Guttmacher.

Planned Parenthood Southeast saw legislative bans pass this year in the three states it covers: Alabama, Georgia and Mississippi (none have been implemented so far). The organization’s call center was so flooded, according to president and CEO Staci Fox, that it was preventing staff members from making appointments for patients. The organization had to establish a separate phone line.

“At first it was mostly people, ‘Can I still come in for my appointment?’” Fox said. “And any future patients, we’re trying to remind them of where we are in the process: abortion is still legal and available, we’re fighting this in the courts, there’s nothing to be worried about right now.”

“But I’m really worried about people who aren’t calling,” Fox said.

Beyond conversations about access, clinic owners Ayers and Johnson and director Gray said they have been talking politics with people, from voter registration to vetting candidates for their views on bodily autonomy.

There are also contingency plans in the works among members of the reproductive health care field. Johnson said his clinic is preparing for what would happen if the Alabama law is allowed to take effect.

“We have made a commitment that if the law does go through several years from now that we are going to be here,” Johnson said. “We might not be performing the procedure itself, but we are looking at a roadmap to be able to get women to where they need to go to receive care — which looks like the closest state would be Illinois.”

Despite the legal environment and current risks to access in Alabama, there will likely be increased availability of abortion in the state in coming months. Planned Parenthood is renovating its Mobile health center and building a new facility in Birmingham. According to Fox, Planned Parenthood will be “back to providing abortion care early this fall.”

“I think one of the things that’s exciting despite these bans in all three states is that we’re expanding care,” Fox said. “We’re moving forward. We’re building buildings. Our doors stay open no matter what.”

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