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A federal judge has allowed North Carolina’s 12-week abortion ban to take effect starting July 1, a decision that could significantly undercut access to abortion across the South.

Judge Catherine Eagles’ decision would block a provision requiring doctors to document in a medical record “the existence of an intrauterine pregnancy” when performing abortions for patients until July 14. Other components of the law are permitted to take effect.

Previously, abortion was legal in the state for up to 20 weeks. In addition to the ban on abortions after 12 weeks, the new law also adds an in-person visit requirement to its 72-hour waiting period. Before the law, patients were able to have their first visit over the phone, then go to the clinic several days later. 

The state’s Planned Parenthood clinics sued to challenge the law, arguing that parts of it were vague or impossible to comply with. Eagles heard arguments from clinicians and Republican state lawmakers earlier this week, and on Tuesday the state legislature passed new legislation meant to address confusing elements of the ban, such as clarifying that it did not ban the use of medication abortion earlier than 12 weeks of pregnancy. Democratic Gov. Roy Cooper signed that bill into law Thursday night. 

The 12-week limit and in-person requirements will make it far more difficult for people from other states to travel to North Carolina for an abortion, clinicians told The 19th. In the year since Roe v. Wade was overturned, the state has emerged as a regional hub for people in the South seeking care, recording the third-largest increase in the number of abortion patients, per one study. Only Florida and Illinois have reported bigger numbers.

The 12-week ban means clinics cannot provide care to patients who learn they are pregnant later on, or who require more time to gather the money and resources to travel to a clinic for an abortion. The in-person waiting period, clinic leaders worry, could complicate how they schedule patients — potentially reducing the number of people they are able to see — and make the trip to North Carolina clinics more expensive by adding on multiple car trips or hotel rooms. 

Already, Charlotte-based clinic A Preferred Women’s Health Center has started doing both abortion visits in person; clinic director Calla Halle said it’s too soon to say how that switch will affect their patient load.

This law will have vast impacts across the South. Alabama, Louisiana, Mississippi and Tennessee have near-total abortion bans, and Georgia permits them up to only six weeks, before many people realize they are pregnant. Florida and South Carolina are the only other states in the region to allow abortion past six weeks of pregnancy, with Florida permitting the procedure up to 15 weeks and South Carolina up to 22. Both have 24-hour waiting periods, though in South Carolina, patients can complete the first visit over the phone. 

Access in those states is also tenuous. Florida and South Carolina recently passed six-week abortion bans. Pending state supreme court rulings, those bans could take effect later this summer. That would leave Virginia, Washington, D.C., and Illinois as the closest options for people in the South seeking abortion.