It’s only been 19 days since the U.S. Supreme Court overturned Roe v. Wade—not even long enough for a woman to know she’s pregnant if she conceived on June 24, 2022. Yet the repercussions of the death of that landmark 1973 ruling are already noticeable in Colorado, one of just 20 states in the country that have laws protecting abortion.

Wait times for abortion services at local clinics have increased substantially. At Planned Parenthood of the Rocky Mountains (PPRM) clinics in Colorado wait times have ballooned from roughly two or three days to approximately two weeks. At Denver’s Comprehensive Women’s Health Care clinic, the wait has gone from less than seven days to up to three weeks.

Patients who are Denver-area residents are sometimes having to travel to other Front Range clinics to find care because people with unwanted pregnancies (including those who are nonbinary and transgender) are flying into DIA to access clinics in the Mile High City. And people who live in neighboring states with so-called trigger laws that went into effect as soon as Roe fell, particularly Oklahomans, are visiting providers in Colorado, too. “It’s a monumental task to serve all the people who are coming our way,” says Neta Metzler, strategic communications manager for Planned Parenthood of the Rocky Mountains.

People with uteruses have long seen Colorado as a paragon of reproductive care because of its limited restrictions on abortion. That status has only been strengthened in the past few months. Governor Jared Polis signed the Reproductive Health Equity Act—which protects the right to an abortion; declares eggs, embryos, and fetuses lack standing under the law; and forbids public entities from restricting access to contraceptives or abortions—in early April, and he subsequently signed an executive order adding further protections on July 6. That order adds safeguards for people and organizations that provide abortions, as well as for individuals seeking an abortion, including those who have traveled to Colorado from states where the procedure has been or is likely to be criminalized.

The order also states that the governor “will exercise the full extent of [his] discretion to decline requests for the arrest, surrender, or extradition” of any individual facing charges from another state for obtaining reproductive health care in Colorado, unless the person’s actions are also illegal in the Centennial State. “The order Polis signed is a big deal from Planned Parenthood’s perspective,” Metzler says. “It says if you are seeking care here, you are safe. It says if you are providing care here, you are safe, too. We have entered into a new legal landscape where we don’t know if one state’s laws can cross borders. Now we know that our state will not bow to that.”

That doesn’t mean, however, that accessing care in Colorado will be easy. Metzler says the ripple effects, while not yet fully understood or realized, likely will be vast. For instance, Metzler says that if PPRM needs to shift toward providing more abortion services—which accounts for about 10 percent of the services it provides in Colorado—that will mean that other local health care providers will need to increase access to care for other reproductive and sexual health care needs, like sexually transmitted infection testing, routine pelvic exams, and prescriptions for birth control. Dr. Rebecca Cohen, an obstetrician-gynecologist who provides abortion services at Comprehensive Women’s Health Care, says her clinic has already seen an increase in people who are interested in getting tubal ligations, intrauterine devices, and other pregnancy-preventing implants. “People are telling me that they just can’t risk an accident after the fall of Roe,” she says.

Another long-term impact could be that in states where abortion is now illegal, medical schools may no longer teach their students how to perform pregnancy-ending procedures. Not only could that compound the current shortage of providers, but it could also mean that as the years go by and older physicians retire, there are fewer and fewer people who know how to teach the procedure to others. “We are wondering if we need to start to integrate education into what we do,” Metzler says. “We already participate in clinical research, but we may need to find ways to train doctors who want to provide this care.”

Cohen agrees. Since June 24, her clinic has been working on training some of the midwives it already has relationships with to perform abortion services. She also says her practice is looking at ways that it could offer medical residents from other states training in the procedures. “That’s something that would be in the future,” she says, “but we’re already thinking about it.”

Right now, though, PPRM and providers like Cohen are just trying to respond to the surge in the need for care. “We want to be proactive,” Metzler says, “by expanding hours and hiring new providers, but that takes time. For now, we’re just trying to keep up. Our call center was on a 90-minute wait on the Monday morning after the ruling.” People were ringing in, Metzler says, with so many questions. They wanted to know if their procedures were still scheduled. They wanted to understand what the ruling really meant. They wanted to know how and when they could get care in Colorado. Metzler says that people can count on Colorado, but that as more surrounding states—like Wyoming, Utah, Arizona, and Kansas—possibly enact restrictions or bans it will get harder for providers here to keep up. “We’re keeping an eye on our neighbors,” Metzler says. “We hope it doesn’t get worse.”

(Read More: The Past, Present, and Future of Abortion in Colorado)