A group of abortion providers who had just flown home to California from a conference with colleagues huddled together in the airport to process the news. In Washington, D.C., reproductive justice activist Renee Bracey Sherman cried on the metro. On a farm in Illinois where she raises goats while coordinating travel for abortion patients in the region, Alison Dreith took half a Xanax and went to bed, understanding that she needed to be rested for the next day—for the next decade.

For abortion rights activists, the confirmation that the fall of Roe v. Wade is imminent felt at once inevitable and unthinkable. “We have all—as a movement and as an organization—been working toward this moment because we knew it was possible,” Marisa Falcon, founder of Apiary, an organizing hub for groups that coordinate practical support for abortion patients, told me in an e-mail. “But I have to admit, it still hurts to see it in writing.”

For many abortion providers and activists, this moment confirms an implicit understanding they have had for years—that absent any uncharacteristically aggressive action from a Democratic Party that seems more interested in campaigning on the loss of Roe than taking meaningful action to address it, mitigating the unimaginable desperation that is about to descend on this country will be almost entirely their responsibility.

“Where is Joe?” crowds outside the Supreme Court Building chanted Tuesday, the day after the news of the leaked Supreme Court decision broke—a day Biden spent promoting Javelin missiles at a Lockheed Martin facility and deflecting questions from reporters about whether Democrats should end the filibuster to save Roe. Thousands gathered outside the court; some, like Bracey Sherman, stayed there for more than 12 hours. “We know what this moment means because we know what having access to our abortions meant to our lives,” she told me.

That same day, Oklahoma, the destination state for about half of abortion patients leaving Texas due to the six-week ban there, enacted its own six-week abortion ban, forcing patients further afield to Kansas and elsewhere. Dr. Christina Bourne, medical director of Trust Women, which runs clinics in Oklahoma and Kansas, said staff in Wichita are bracing themselves. “We have hired a bunch of new staff; we are creating a call center; we have bought a bunch of new equipment,” Bourne said. “We have shifted what we view as a normal day.”

Meanwhile, reproductive justice advocates in the state said they are not giving up on the fight to win back the right to legal abortion.

“We feel like we are in day one [of] getting abortion back in Oklahoma,” Tamya Cox-Touré, cochair of Oklahoma Call for Reproductive Justice and executive director of the ACLU of Oklahoma, said. Cox-Touré said organizers are discussing ideas including proactive constitutional amendments or legislation, and a renewed focus on elections in the state.

Meanwhile, an enormous logistics operation is underway, as many of the most visionary activists across the movement dedicate vast amounts of energy to figuring out how to move people across entire regions of the country that are about to go dark on abortion access. Activist groups across the country are holding trainings and publishing videos, subway ads, and infographics to spread the word about how people can safely self-manage an abortion with pills ordered online. Practical support organizations and abortion funds have spent months methodically planning for the incomprehensible. Apiary convenes regular meetings for these groups to coordinate with each other about how to get people to clinics.

“The work of practical support—of helping abortions seekers manage the travel costs and logistics, and all the other things that inevitably creep in when you have to travel (food, babysitters, pets)—is the silent backbone of access and is going to be leaned on more heavily than ever before,” Falcon said. “We are here to make sure those organizations have the tools they need to do this work quickly, effectively, and safely.”

At least one state offers a preview of the post-Roe logistical challenges.

Because of existing restrictions, “basically everybody” seeking an abortion in Missouri has had to travel out of state already, according to Mallory Schwarz, executive director at Pro-Choice Missouri. Missouri requires a 72-hour waiting period and a medically unnecessary pelvic exam before a medication abortion, a practice that the sole remaining clinic refused to engage in because they view it as state-sanctioned sexual assault. Instead, clinics in the area have set up a Regional Logistics Center to help facilitate access to care in other states, Schwarz said.

Many of these Missouri patients who are forced to travel wind up reaching Dreith at her Illinois goat farm. She said her work not only involves working out bus and train lines for cities she’s unfamiliar with but also talking with people who are scared to travel, have never flown before, and need to travel alone because many times organizations cannot afford to pay for a support person’s airfare. Already, her organization, Midwest Access Coalition, has had to cap the amount it can give each patient to $1,000 because of a surge in need for help. Dreith’s work is about to get more intense, but it likely won’t look all that different. For the foreseeable future, she’ll keep asking people the same set of intake questions: What is your name? How old are you? What clinic are you going to?

Have you faced any problems or barriers in accessing abortion care?