Last night, a federal judge in Texas issued a highly anticipated ruling to suspend the FDA’s 23-year-old approval of mifepristone. That’s the first of two medications used to end pregnancies — since the “abortion pill” is really two pills, mifepristone and misoprostol. In a 67-page opinion, he sided with anti-abortion plaintiffs who argued the FDA quickly approved the abortion medication and chose “politics over science” decades ago.

The ruling wouldn’t go into effect for seven days — so mifepristone is still available. In the meantime, the DOJ and mifepristone manufacturer Danco Laboratories quickly said they’d appeal. And, a bigger twist: Less than an hour after the Texas ruling, a federal judge in Washington ruled in a different case involving mifepristone — and ordered the opposite result by directing the FDA to “preserve the status quo” in the 17 states (plus DC) where Dems had sued to keep the pill on the market. Now, the conflicting rulings make it more likely that the issue will make its way to the conservative-leaning SCOTUS — and that the future of the US’s most popular abortion method is in limbo.

Last month, we spoke to Dr. Colleen McNicholas — Chief Medical Officer of Planned Parenthood of the St. Louis Region and Southwest Missouri — about the Texas case. Here’s what she had to say.

Q: How could the Texas ruling impact people across the country?

In these states where abortion has been banned or even further restricted, clinics that were holding down the fort for folks have been forced to close. We have a huge number of folks who are trying to navigate logistics to get to so few clinics … One of the consequences of this decision is that if folks are unable to access medication abortion, those [in-person] wait times will continue to go up even further.

Q: What happens to the abortion pill if mifepristone is pulled from the market?

If that medication is no longer available, we would be forced to move to a medication abortion regimen that consists of only one medication, misoprostol … So we are now talking about a huge number of people who either won't have access to their preferred method or the most effective method for medication abortion. They will then be forced to choose, do I want to continue with a medication approach — misoprostol only — that, although it is safe, is slightly less effective? … Or, do I now have to choose the approach to abortion that wasn’t my first pick and choose procedural abortion? I think [the ruling] has the potential to have some pretty dramatic impacts on access.