McALLEN -- Undocumented immigrants who live in the Rio Grande Valley and are seeking an abortion after 16 weeks face a hurdle beyond Texas' strict laws. They must make a long drive north and face internal border checkpoints.

Since 2003, Texas has required women seeking abortions in their second trimester to go to ambulatory surgical centers, and none exist in the Valley.

Health providers in the Valley say that many such women find out too late that they are pregnant, discover fetal anomalies or are too poor to obtain an abortion in the first 16 weeks. They say the only other option for some is to cross into Mexico for an illegal procedure or to acquire abortion-inducing drugs from unregulated pharmacies.

Kristeena Banda, the director of Whole Woman's Health in McAllen, one of two abortion clinics in the Valley, said her clinic recently tried to refer a woman in her second trimester to a surgical center in San Antonio, about 200 miles away. To get there, she would have to pass a checkpoint in Falfurrias, north of Hidalgo County, where authorities have detained 12,000 undocumented immigrants in the last year.

"She broke down and told us she didn't have the papers to cross over," said Banda, who did not know the woman's fate or that of others who come in every month under similar circumstances because they often provide false information.

It is unclear how many undocumented immigrants are seeking second-trimester abortions, but noncitizens accounted for 27 percent of the 220,899 Medicaid-financed births in Texas in 2010, state health officials said. Rick Pauza, a U.S. Customs and Border Protection spokesman, said those seeking health services, including abortions, were allowed to apply for legal entry and could get a pass to go through the security checkpoints.

"CBP will review each request on a case-by-case basis and determine if it meets the criteria for a humanitarian parole or waiver of documents," Pauza said in an e-mail.

But some people say there should be no exceptions for women seeking treatment for an elective procedure.

"As long as they're not in labor, they should be taken into custody, and deportation procedures should begin," said Shannon McGauley, an abortion opponent and the president of the Texas Minutemen, a nonprofit group that supports causes opposing illegal immigration. "They shouldn't be given a pass because they're pregnant. If you play, you've got to pay."

Opponents of abortion rights say they sympathize with the women's plight but that the women should seek a different solution.

"Abortion in any context is not okay," said Catherine Hake, the executive director of the McAllen Pregnancy Center, which provides support services for pregnant women. "There's so much aid and people willing to help. It's a lot more difficult to offer aid to women who are illegal, but there are still options."

Dr. Lester Minto, who owns Reproductive Services of Harlingen, the Valley's other abortion clinic, said that before Texas began requiring women seeking abortions after 16 weeks to go to the surgical centers, he was able to perform the procedure on women who were 18 weeks into their pregnancy.

"Normally they're crying and begging me to do it," Dr. Minto said. "It's sad when I know I can do it. I can do it properly."

For his patients who are citizens, traveling such a long distance is an inconvenience, but they do not fear the checkpoints. For his patients who are undocumented, the terrorist attacks of Sept. 11 further complicated travel for those who needed specialized care outside the area, Dr. Minto said. Until then, "I could write a letter and they'd let them go through the checkpoints," he said. "Since then, it's changed."

The Valley abortion providers said that when time, resources and geography were not on the patients' side, they could advise them only to seek prenatal care and consider adoption.

This story was made possible by a grant from Atlantic Philanthropies and was produced as part of New America Media's Women Immigrants Fellowship Program. It was edited to conform with New America Media's style guidelines.

This story also appeared in The New York Times.

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Read Thanh Tan's first NAM Women Immigrants Fellowship story, "Looking to Mexico for an Alternative to Abortion Clinics."