The impact of the Supreme Court’s decision to overturn a 1973 case guaranteeing the constitutional right to an abortion was all but immediate: By 2 p.m. Friday, at least eight states had banned abortion with limited exceptions.

Those states included Alabama, Kentucky, Louisiana, Missouri, South Dakota, Texas, Arkansas and Utah, according to Elizabeth Nash, principal policy associate of state issues for the Guttmacher Institute, a reproductive rights research group that advocates for access to legal abortion.

“As the dust settles and we find out which states banned abortion, we will see where we have to move the needle so that we can work to ensure people have access,” Nash said.

Although the decision made in Dobbs v. Jackson Women’s Health Organization of Mississippi effectively overturned Roe v. Wade and the federal right to abortion, where exactly abortion will be allowed to continue will be a changing landscape in the days to come, with states making changes immediately, in a few days, or after a month or more depending on the language in their statutes.

One thing is certain: Abortion access in the U.S. will be heavily restricted across wide swaths of the country for the foreseeable future, especially for low-income people who can’t travel to states like New York and California, where abortions are legal.

“This ruling is going to cause chaos in the courts and on the ground as states try to enforce and pass the most extreme abortion bans possible,” said Julie Rikelman, senior director of litigation at the Center for Reproductive Rights. “I can’t emphasize enough what a cataclysmic change this will be, how much chaos we will see in the coming days and months.”

Guttmacher estimates that 26 states are likely to ban abortion in some capacity, leaving 36 million women of reproductive age in abortion deserts. That would include 13 laws “triggered” to take effect automatically or by quick state action if Roe no longer applies.

Exactly how many clinics closed Friday is unclear, said Jay Thibodeau, communications director at Abortion Care Network, during a call with reporters.

“I don’t know right now how many clinics in how many states have stopped providing care or paused providing care, and I do this work eight hours a day every day and live and breathe this work, and I’m connected to abortion clinics regularly,” she said.

‘Trigger laws’

Still, changes were felt almost immediately, with clinics in states like Texas, Arizona, Idaho, Louisiana, Missouri, Alabama and Tennessee announcing they could no longer offer abortions or could only provide them in cases of rape and incest where allowed by state law.

“Unfortunately, the recent Supreme Court decision has made it impossible for our clinic to continue providing abortion services at this time,” Austin Women’s Health Center in Texas said on its website Friday. “We will continue to connect patients with abortion services in places where it is still available.”

Texas, which already bans abortions after six weeks of gestation, will be one of the states to become an abortion desert this summer. According to Guttmacher, a Texan seeking an abortion would need to travel an average of 525 miles one way to access an abortion in another state.

The state’s so-called trigger law that passed last year was to take effect in 30 days, but Attorney General Ken Paxton tweeted that “abortion is now illegal” in the state, sparking confusion about whether people could still access the procedure.

The state’s law would make it a felony to perform any abortion. The only exceptions would be to save the pregnant person’s life or prevent substantial impairment.

Speaking at a June 16 event hosted by the Heritage Foundation, Catherine Glenn Foster, president and CEO of Americans United for Life, said the first step after overturning Roe will be lifting injunctions against abortion bans that are currently blocked.

“That’s going to be absolutely critical, that’s job one,” she said. “And No. 2, we’re going to be looking at congressional actions on the national scene.

“Just remember that after Roe, not only is there no longer a federal constitutional right to abortion, but that there isn’t a whole lot on the subject at all.”

States brace for influx

But abortion rights supporters are also preparing their own strategy. Nonprofits and clinics in states where abortion will remain legal, like California, New York and Illinois, have been preparing for the fall of Roe, expecting an influx of patients from other states.

Elevated Access, a new Illinois nonprofit organization that connects abortion patients with free flights to seek care, sought donations and volunteers to transport patients across state lines. National Network of Abortion Funds, which accepts donations to help pay for abortions and costs associated with travel and lodging, said it experienced a site outage Friday because of high website traffic.

“Knowing this moment would come does not make it any less devastating,” said Alexis McGill Johnson, president of the Planned Parenthood Action Fund. “But in stripping away our rights, the Supreme Court and anti-abortion politicians have also unleashed a movement. We are a movement that will not compromise on our bodies, our dignity, or our freedom. We are a movement that will show up at every town hall, every legislative session, and every ballot box to demand we are treated like equal citizens.”

The decision is likely to pour gas on the fire of abortion spending before the midterms this fall.

“Today marks an historic human rights victory for unborn children and their mothers and a bright pro-life future for our nation,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America. “Every legislature in the land, in every single state and Congress, is now free to allow the will of the people to make its way into the law through our elected representatives.”

Her group announced a $2 million digital ad buy on Thursday in eight Senate battleground states ahead of the decision. The ads, airing in Arizona, Georgia, Florida, Michigan, North Carolina, Nevada, Pennsylvania and Wisconsin, say abortion regulations should be left to the states. SBA Pro-Life America and its affiliates have pledged $78 million this election cycle.

Even before the ruling, some clinics had already begun canceling appointments or shifting away from abortion, spurred by the leak of a draft ruling reported on last month. South Dakota’s only clinic stopped performing abortions earlier this month.

Melissa Fowler, chief program officer of the National Abortion Federation, said the group has a national network of case managers who work with member clinics to be able to reschedule patients they may not be able to see today or this weekend.

The overturning of Roe could lead to the closing of more than 200 abortion clinics across 26 states, “decimating” access for people living in the Midwest and South, according to a recent report from Advancing New Standards in Reproductive Health.

Self-managed abortions

Patients have already expressed confusion about where abortion is legal and whether they can access medication abortions in their state or through a mail-order pharmacy.

Advocates say the decision will likely lead to a rise in self-managed abortions, which refer to medication abortion pills taken in conjunction with consulting online resources or an abortion care hotline.

Attorney General Merrick B. Garland warned Friday that states cannot ban the use of mifepristone, which is used to terminate early pregnancies and for miscarriage management.

“The FDA has approved the use of the medication Mifepristone. States may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy,” he said in a statement.

Daniel Grossman, director of Advancing New Standards in Reproductive Health, a part of the University of California, San Francisco’s department of Obstetrics, Gynecology and Reproductive Sciences, said the risks associated with a self-managed abortion are very low.

“We do have real concerns that the maternal mortality and pregnancy-related mortality will increase if Roe is overturned, but that’s not because of people using unsafe methods to self-manage their abortion. It’s because continuing pregnancy to term and childbirth is inherently more dangerous than having an abortion,” he said during a June 1 briefing before the decision.