Texas clinics on Saturday canceled appointments they had booked during a 48-hour reprieve from the most restrictive abortion law in the U.S., which was back in effect as weary providers again turn their sights to the Supreme Court.

The Biden administration, which sued Texas over the law known as Senate Bill 8, has yet to say whether it will go that route after a federal appeals court reinstated the law late Friday. The latest twist came just two days after a lower court in Austin suspended the law, which bans abortions once cardiac activity is detected, usually around six weeks, before some women know they are pregnant. It makes no exceptions in cases of rape or incest.

The White House had no immediate comment Saturday. For now at least, the law is in the hands of the 5th U.S. Circuit Court of Appeals, which allowed the restrictions to resume pending further arguments. In the meantime, Texas abortions providers and patients are right back to where they’ve been for most of the last six weeks.

Out-of-state clinics already inundated with Texas patients seeking abortions were again the closest option for many women. Providers say others are being forced to carry pregnancies to term, or waiting in hopes that courts will strike down the law that took effect on Sept. 1.

There are also new questions — including whether anti-abortion advocates will try punishing Texas physicians who performed abortions during the brief window the law was paused from late Wednesday to late Friday. Texas leaves enforcement solely in the hands of private citizens who can collect $10,000 or more in damages if they successfully sue abortion providers who flout the restrictions.

Texas Right to Life, the state’s largest anti-abortion group, created a tip line to receive reports of violators. About a dozen calls came in after U.S. District Judge Robert Pitman suspended the law, said John Seago, the group’s legislative director.

Although some Texas clinics said they had briefly resumed abortions on patients who were beyond six weeks, Seago said his group had no lawsuits in the works. He said the clinics’ public statements did not “match up with what we saw on the ground,” which he says include a network of observers and crisis pregnancy centers.

“I don’t have any credible evidence at the moment of litigation that we would bring forward,” Seago said Saturday.

Texas had roughly two dozen abortion clinics before the law took effect. At least six clinics resumed performing abortions after six weeks of pregnancy during the reprieve, according to the Center for Reproductive Rights.