The fear is palpable. My patient looks up at me slowly, expectantly, wide-eyed, while nervously toying with her hair-tie. She is about to get an IUD inserted. “Will this hurt?” she asks me. The answer is that yes, there will be cramping. However, the deeper pain that you and I are feeling won’t go away anytime soon. It will probably only get worse.

It is still difficult to swallow that Donald Trump is the new US president. As a women’s healthcare provider for a well-known reproductive health institution, it is even harder to swallow. Since the election results were declared, we have been wondering how to make sure that our patients continue to get the care they need?

During the election campaign, Trump declared that he intended to repeal the Affordable Care Act, better known as Obamacare. Since the election, the President-elect has indicated he might keep a couple of provisions of the law like having children stay on their parents’ insurance plans till the age of 26 and preventing insurance companies from denying coverage because of pre-existing conditions. But, what most fear will get the axe is the provision that mandates contraceptives be covered at no cost to patients because they are preventative healthcare.

Trump has been so bold to proclaim that women should be punished for having abortions – something even most staunch conservatives disagree with. Where does this leave the millions of women we serve?

No insurance, no contraception?

Fortunately, many women have figured out their best contraceptive bet is the intrauterine device. The IUD is a small device that is inserted into the uterus during a one-time procedure. An IUD maybe effective anywhere between three years and 10 years, depending on the type. These are among the most effective contraceptives since they are not prone to user error and a woman does not need to keep going back to a pharmacy to buy them. IUDs are also very safe and for women with medical conditions, they may be the only viable contraception.

Since Trump has been elected, I have seen my office inundated with women coming in to have IUDs placed. I have listened as they have talked about how they are afraid that they will lose their insurance come January 20, when Trump is sworn in as President.

These women do not want unplanned pregnancies. They want a method of contraception they can control and that someone cannot take away from them. They know that IUDs are one of the most effective methods out there, but also one of the most expensive ones.

Without insurance, the cost of an IUD can run from several hundred to even more than $1,000. So many women have decided to be proactive and get contraception while they have the insurance to cover the cost, and that will hopefully outlast a Trump presidency.

Women’s healthcare workers rally

In this time of uncertainty, there has also been a low hum among medical providers wondering what to do when patients no longer have access to reproductive care. I have seen many numerous social media discussions by fellow providers, urging friends to get their IUDs while they can. Healthcare workers also share in the hope that even the shortest duration IUD will outlast Trump in the White House.

Should the Affordable Care Act be repealed and access to contraceptives decreased, reproductive healthcare workers are likely to put up a fight to give patients as much access to care as they can.

In 1916, Margaret Sanger, the founder of Planned Parenthood, was imprisoned for her efforts to get contraception to women. While in prison, she educated her fellow inmates on how they could prevent unwanted pregnancy. No matter what laws are passed, many reproductive healthcare providers will continue to find ways to give patients the care they need. What the healthcare community fears is that the people that need it most, will not be able to find necessary aid in time because the barriers placed in front of them will be too high and hard to overcome.

While it hurts that a man who has openly made comments that are racist, xenophobic and bigoted has been elected to lead one of the most powerful nations in the world, healthcare providers seem resolved to help patients get through it. At the end of our visit, after I have successfully finished placing my patient’s IUD, she smiles and says “That wasn’t as bad as I thought it would be.” I reply “It’s different for everyone. But it’s best to prepare for the worst, and hope for the best.”

The author is a reproductive and contraceptive healthcare provider in Philadelphia in the United States.