The day after the Presidential election, Anne Davis, a physician at Columbia University Medical Center and an associate professor of obstetrics and gynecology, went to work feeling like someone had died. She overheard two medical secretaries talking: the clinic had already received multiple phone calls from women who wanted to get I.U.D.s. “They’d had an immediate gut feeling that Trump’s victory wasn’t going to go well for them, and they needed to take care of business, fast,” Davis said.

Google searches for I.U.D.s spiked on election night; women urged one another on social media to think about long-term birth control. As news of Hillary Clinton’s disappointing performance in the Midwest rolled in, my text messages pinged: “She lost Ohio,” followed by “Do we need to get IUDs?” Women’s-health providers have received an influx of requests for the devices, which, once implanted within the uterus, are ninety-nine per cent effective at preventing pregnancy for up to ten years, depending on the model. For a woman who has sex with men and doesn’t wish to become pregnant—in other words, the majority of reproductive-age women at any given time—the I.U.D. is her bluntest weapon. Of course women would turn to it when preparing for life under a President with unprecedented disregard for their bodily autonomy. A man bragged about grabbing women by the pussy and got elected to the highest office in America; many women understood what they most needed to defend.

At Columbia, Davis and her colleagues had felt a powerful sense of hope and possibility at the prospect of a Clinton Presidency—particularly after Clinton, in the final debate, delivered a heartfelt, uncommon defense of reproductive freedom. “The government has no business in the decisions women make with their families in accordance with their faith, with medical advice,” Clinton said. “And I will stand up for that right.” Davis, who is also the consulting medical director at Physicians for Reproductive Health, had imagined that her profession would be able to build on recent progress. “There’s a common misconception that birth control has been free under the Affordable Care Act, which it hasn’t—it’s not like I have a basket of I.U.D.s that I got from Barack Obama that I give away,” she said. Rather, under Obamacare’s mandates, insurance companies are prohibited from charging women additional costs for birth-control coverage, and more women are insured. “Now we have the lowest abortion rate and teen birth rate in decades,” Davis said. “Who is saying that that’s bad news?”

The worry that birth control will become less accessible and more expensive is compounded by a fear that access to abortion will soon become even more circumscribed. Roughly three hundred new state-level abortion restrictions were passed in the past five years, under a Democratic President; those now at the top of the federal executive branch and in control of both houses of Congress have gone on the record as wanting to restrict abortion even further. (Vice-President-elect Mike Pence, who frequently uses the term “the unborn,” has vowed that Roe v. Wade will be “consigned to the ash heap of history.”) Being pregnant against your will during a Trump Administration could be a nightmare. Doctors described an atmosphere of deep anxiety. “That Wednesday, patients were bawling in the waiting room,” Davis told me. “Everyone’s blood pressure was up.”

I spoke to Taraneh Shirazian, an obstetrician and gynecologist at N.Y.U. Langone, who noted that some of her patients were asking for early I.U.D. replacements. “We’ve gotten many phone calls from women who want to replace their five-year Mirena, even if it’s good for another three years,” Shirazian said. “Medically, that’s not advisable. But they’re questioning if they’ll be able to afford an I.U.D. replacement two years from now.”

Under Obamacare, for many women, the I.U.D. had become an affordable option for the first time. The up-front expense of an I.U.D. without insurance can reach four figures, which is part of the reason why the I.U.D. has been relatively unpopular in America: less than ten per cent of women choose it. (Although, tellingly, that number rises to forty per cent among women’s-health providers themselves.) By 2015, eighty-seven per cent of women could get an I.U.D. without a co-pay, up from forty-two per cent of women in 2012. We don’t yet have precise usage statistics from the past few years, but the trend over the past decade shows I.U.D.s growing steadily more popular, and a 2015 University of Pennsylvania study documented a sixty-eight-per-cent drop in the average cost of an I.U.D. in the first year of Obamacare alone.

There’s an immediate public-health benefit to I.U.D. usage. The American Academy of Pediatrics has recommended long-acting birth control, meaning I.U.D.s and implants, as a “first-line” option for teen-agers. (On election night, a popular related search term to “IUD” on Google was “How old do you have to be to get an IUD?”) When a Colorado initiative offered teen-agers free I.U.D.s and birth-control implants, pregnancy and abortion rates dropped by forty and forty-two per cent, respectively, from 2009 to 2013. Long-acting birth control is reversible, and it does not require daily attention or a dedicated routine. But if an I.U.D. costs eight hundred dollars, its benefits are, for many, out of reach. “I’m having different conversations since the election,” Davis said. “The question I always put front and center was, ‘What’s the best method for you?’ Now I’m asking, ‘What are you going to be able to afford if your insurance changes?’ ”

Pence recently said, on “Fox News Sunday,” that a repeal of the Affordable Care Act will be Trump’s focus “right out of the gate.” Even so, the birth-control provision in Obamacare won’t vanish immediately after Trump’s Inauguration. It would take up to a year, the Times_ _has suggested, for the Trump Administration to wrest the no-additional-cost birth-control mandate away. Still, the instinct that many women feel to protect their bodies against their future President is reasonable. Pregnancy will be more dangerous under an Administration that opposes abortion; an increase in birth-control costs will have consequences. I keep thinking about how I felt a decade ago—a responsible teen-ager, with a college scholarship and a part-time job, still perpetually terrified of running out of money before the monthly window when my insurance would allow me to purchase a new sixty-dollar pack of pills.

For employees of Planned Parenthood, the largest provider of reproductive-health services in America, the situation feels particularly dire. Congress voted to defund the organization eight times from 2015 to 2016. Though it has received more than two hundred thousand individual donations since Trump’s election—about a quarter of them offered, in protest, in the name of Mike Pence—Planned Parenthood is imperilled, as are the prospects for low-income women who depend on the organization’s subsidized care. I spoke to a nurse practitioner at Planned Parenthood who requested anonymity on account of threats that she has received recently. She’d started seeing twenty-seven patients a day instead of twenty. Women are coming in feeling anxious and angry and grateful, asking for a year’s care all at once.

She, too, has been talking with patients about what they’ll be able to afford in a worst-case scenario. The mood in her clinic was exhausted but passionate. “We’ve been fighting every day, and the fight starts again tomorrow,” she said. Her colleagues were bracing for the next congressional attempt to defund the organization. “I came home the day after the election and I thought, My job is going to suck until they take it away from me,” she said. “And I still love it.”