On Tuesday afternoon, as the country was coming to grips with a stunning leak from the Supreme Court indicating a majority of justices support a full overturn of Roe v. Wade , Oklahoma Gov. Kevin Stitt (R) quietly signed the Oklahoma Heartbeat Act, which went into immediate effect.

The hugely restrictive bill bans abortion at around six weeks, or whenever embryonic cardiac activity can be detected. There are no exceptions for rape or incest , and private citizens are empowered to bring lucrative lawsuits against anyone who facilitates an abortion in the state.

Texas passed a similar law last year and, in the months since, Oklahoma has been a refuge for some people from the Lone Star State who needed abortion services.

Now that refuge has disappeared. Providers are once again being forced to pick up stakes and move their services as the options for legal abortion in much of the country dwindle even before the coming Supreme Court decision in Dobbs v. Jackson Womens Health Organization , the case threatening Roe.

Months before Texas enacted its now infamous six-week abortion ban, Dr. Iman Alsaden knew access was likely to be decimated there. Alsaden quickly got to work preparing clinics in Oklahoma for the influx of patients they were about to receive. She trained new clinic staff in Tulsa, helped restart procedural abortion services in Oklahoma City, and provided abortion care herself traveling to the Sooner State one to two weeks a month from her home state of Missouri.

Alsaden, the medical director of Planned Parenthood Great Plains, is somehow doing it all over again. This time, in Kansas.

It does feel like a weird dj vu moment, Alsaden told HuffPost by phone last week, as the governor prepared to sign the bill. I dont know that you could really be prepared, but we do know how to expand our services rather quickly because we had to do exactly the same thing about a year ago. I hate to say this, but were experts on this sort of thing.

Anti-abortion lawmakers in the Oklahoma Legislature have always been hellbent on banning abortion in their state. Earlier this month, lawmakers passed an unconstitutional bill that makes performing an abortion a felony punishable by up to 10 years in prison. Stitt recently signed the bill into law and it goes into effect in August.

And theres still about a month left in the legislative session leaving room for other extreme measures to pass, even if they are ultimately redundant given the wave of anti-abortion bills already becoming law. Under consideration: a total ban on abortion with a Texas-style private right of action clause; a ban on abortion 30 days after a persons last menstrual cycle; and a proposed constitutional amendment that would declare there is no right to abortion in the state of Oklahoma.

Hardened by experience, providers like Alsaden knew what to do. She and her team at Planned Parenthood Great Plains, which serves Arkansas, Kansas, Missouri and Oklahoma, began adding Kansas clinic staff, expanded appointment availability in Kansas clinics, increased the number of physician fly-ins from other states, and beefed up logistical services to help Texans and Oklahomans travel to Kansas.

The only difference this time is that providers know that unlike the Texas ban, which many initially believed would be temporary, the Oklahoma abortion ban will likely stay in effect. Using the Texas-style enforcement mechanism, an Oklahoma ban could successfully skirt court challenges, or the Supreme Court could overturn Roe v. Wade in just a few months. The preparation in Kansas isnt for a temporary surge, but possibly a permanent one.

We thought it [the six-week ban] would be an emergency where we could step up and provide care to more people, and soon care would be restored in Texas, said Emily Wales, Planned Parenthood Great Plains CEO. Now, this is happening in Oklahoma and the fear is that it could go on and on, maybe for an indefinite period of time. Weve seen the Texas case go back to the Supreme Court a few times with no intervention, no stop.

Its already extremely dangerous to carry a pregnancy to term in Oklahoma. The state has one of the highest maternal mortality rates for Black people in the entire country. Banning or severely restricting abortion in Oklahoma would also deeply impact Texans, who have been traveling in droves to Oklahoma to receive abortion care since September.

Kansas only has four abortion clinics left. Its hard to imagine those four clinics will be able to accommodate patients from Texas and Oklahoma, as well as Kansans themselves. New Mexico and Colorado will likely also see an influx of patients, but only those who have the resources to travel longer distances.

Oklahoma House Minority Leader Emily Virgin (D) is feeling her own bit of dj vu, but not from the Texas ban. After 12 years in the legislature, shes seen her GOP colleagues try to pass every type of abortion restriction there is. Their fervor for ending access in her state is not new, but the changing national landscape on abortion is.

The Texas-style ban is something thats new, but in terms of this notion of fetal heartbeat and punishing doctors those things are not new, said Virgin.

What makes it different now is that we dont have the backstop of the United States Supreme Court upholding precedent, she added, referring to the 6-3 conservative majority on the high court and the upcoming decision expected to overturn or gut Roe v. Wade . While the policies have only changed a little bit in terms of what the anti-choice movement is doing, it feels heavier now because we know theres a reality in which this procedure could become illegal in Oklahoma.

Virgin, a vocal supporter of reproductive freedom, made clear that abortion is still legal in Oklahoma, and that wont change without a fight from her and her colleagues. But voters need to step up, too.

For far too long, we got a little bit complacent with this issue. We didnt necessarily vote based on this issue because of the Supreme Courts precedent, she said. But now its more important than ever to make sure that we vote based on this issue. Because it is very real and it has the potential to affect so many people that we know and love.