Ohio and Texas -- two states that have looked to limit abortion rights recently -- have opted to include abortions among non-essential surgical procedures that the states are temporarily delaying as coronavirus cases flood the health care system.
On Monday, Texas Attorney General Ken Paxton confirmed that abortion was included in Republican Texas Gov. Greg Abbott's order that health care providers "postpone all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient."
"We must work together as Texans to stop the spread of Covid-19 and ensure that our health care professionals and facilities have all the resources they need to fight the virus at this time," Paxton said in a statement. "No one is exempt from the governor's executive order on medically unnecessary surgeries and procedures, including abortion providers. Those who violate the governor's order will be met with the full force of the law."
Violating the order, the statement noted, could result in fines of up to $1,000 or 180 days imprisonment.
Kathy Miller, president of the abortion rights group Texas Freedom Network, accused Paxton of "push(ing) his ideological agenda."
"There are many reasons women decide to have an abortion in the already limited time window state law allows, and a delay means denying them the constitutional right to make those decisions in a safe, timely manner with the help of their doctors," she added.
Texas law bans abortion past 20 weeks except to save the life or health of the pregnant woman.
Joe Pojman, executive director of the anti-abortion group Texas Alliance for Life, lauded the move for prioritizing the coronavirus response. He said that the group was "tracking the compliance of abortion providers statewide," asking the public to send documentation of any abortions performed in Texas while the order was in effect. Abortions are still allowed in the state during this time if they are "medically necessary to preserve the life or health of the mother," per Paxton's press release.
In Ohio, Deputy Attorney General Jonathan Fulkerson sent letters on Friday and Saturday to three abortion providers -- Women's Med Center in Dayton, Planned Parenthood of Southwest Ohio and Preterm clinic in Cleveland -- directing them comply with the state health director's executive order to stop performing non-essential procedures to preserve protective supplies that are becoming increasingly precious as the coronavirus pandemic worsens. A similar warning letter was also sent to an Ohio urologist.
"On behalf of the Department, you and your facility are ordered to immediately stop performing non-essential and elective surgical abortions," state the letters sent to the three abortion providers, which were reviewed by CNN. "Non-essential surgical abortions are those that can be delayed without undue risk to the current or future health of a patient."
The letter also warns that the department will "take all appropriate measures" if the providers do not stop performing elective abortions immediately.
Bethany McCorkle, communications director for the Ohio Attorney General's Office, said in a statement that they sent the letters after the state health department received complaints about the facilities.
"This is not an abortion issue," she said.
But two of the clinics disagreed, asserting that they would comply with the order but continue to provide abortions.
Iris Harvey and Kersha Deibel, the presidents of Planned Parenthood of Greater Ohio and Planned Parenthood Southwest Ohio Region, said in a statement Saturday that they were complying with the order and that the PPSWO's attorney had "immediately responded" to the letter to convey that.
"Under that order, Planned Parenthood can still continue providing essential procedures, including surgical abortion, and our health centers continue to offer other health care services that our patients depend on," the statement read.
Preterm said Monday that it would remain open and had communicated to state officials that it was adhering to the terms of the order.
"In compliance with the order from the Ohio Department of Health, our physicians will be making individualized determinations to ensure each person gets the health care they need and that all health care providers across the state have access to the supplies needed during this pandemic," the clinic wrote.
Women's Med Center did not immediately respond to CNN's request for comment.
Both Texas and Ohio have looked to restrict abortion rights and access beyond federal levels. In July, a federal judge temporarily blocked Ohio's "heartbeat" bill, which would have banned abortions as early as six weeks into a pregnancy.
In Texas, lawmakers considered a bill in April that would allow abortion patients to possibly be charged with capital murder, a crime punishable by death in the state, and multiple Texas cities have recently declared themselves "sanctuary cities for the unborn" and adopted unenforceable ordinances that claim to outlaw abortion within city limits.
At least 25 states have opted to heed a federal recommendation to delay elective surgical procedures, citing efforts to prevent unnecessary exposure and preserve protective resources.
White House coronavirus task force member and Centers for Medicare and Medicaid Services Administrator Seema Verma made the recommendation during a White House press briefing last week, and Surgeon General Jerome Adams wrote an op-ed Sunday urging hospitals to delay "cancel or delay nonessential elective procedures." Neither Adams' nor Verma's office responded to repeated requests for comment from CNN as to whether they included abortions in their definitions of non-essential surgery.
The American College of Obstetricians and Gynecologists put out a statement the same day as Verma's announcement calling for providers to not to classify them as "elective and non-urgent."
"Abortion is an essential component of comprehensive health care," the group said. "It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person's life, health, and well-being."
Other states with Republican governors, however, have moved not designated abortion in halting non-essential surgeries.
The Maryland Health Department's order to halt elective surgeries does not include abortions, according to Mike Ricci, communications director for Republican Maryland Gov. Larry Hogan.