The American Medical Association and three other major health groups warned Thursday patients across the nation could suffer irreparable harm due to the shattered legal landscape left in the wake of the Supreme Courts decision to overturn Roe v. Wade.

In a statement , co-authored with the American Pharmacists Association, the American Society of Health-Systems Pharmacists and the National Community Pharmacists Association, the groups said they were deeply concerned by state efforts to limit access to medically necessary medicine. Ongoing questions about state laws are already impacting patients, and language in newly enacted rules is vague, unclear and disrupting care, they said.

Physicians, pharmacists, and other health care professionals face a confusing legal landscape due to state laws lack of clarity, confusing language, and unknown implementation by regulatory and enforcement bodies, the statement reads. Without such guidance, we are deeply concerned that our patients will lose access to care and suffer irreparable harm.

The groups pointed to reports that some hospitals had prioritized caution over healthcare, others that have removed emergency contraceptives from kits for victims of sexual assault and pharmacies that have imposed burdensome steps for prescriptions.

The statement comes amid ongoing efforts by Republicans to rein in Americans access to abortion.

In the two months since the Supreme Courts conservative bloc voted to overturn Roe v. Wade, more than a dozen states have banned or restricted access to abortion. Around 17 million women in America have completely lost access to the procedure since the decision, and millions of others have limited access.

These bans mean that every one of these millions of people, should they need an abortion, will have to overcome extreme logistical and financial barriers to access care, Elizabeth Nash, a principal policy associate at the Guttmacher Institute, said in a statement last month.

The GOPs plans have galvanized Democratic voters and given the party renewed support heading into the midterm elections. In Michigan, the states Supreme Court said a proposal to protect abortion rights in its constitution would be allowed on the ballot in November.

But the AMA and other groups said Thursday they were deeply concerned about patients health, pointing to reports many women are unable to access medication and decisions that compound trauma for victims of sexual assault.

As physicians and pharmacists, we view patient wellbeing as paramount and are deeply troubled that continuity of care is being disrupted, they said. We call on state policymakers to ensure through guidance, law, or regulation that patient care is not disrupted and that physicians and pharmacists shall be free to continue to practice medicine and pharmacy without fear of professional sanction or liability.