The day after America elected Donald “punish women who get abortions” Trump, Planned Parenthood President Cecile Richards went on MSNBC’s Rachel Maddow Show to debrief.

Maddow ran through Vice President–elect Mike Pence’s history of perverse anti-abortion positions: He wants to ban abortion even in cases of rape or incest; he governed a state that sentenced Purvi Patel to 20 years in prison on “feticide” charges for allegedly self-inducing an abortion; and he backed and signed an Indiana bill, now blocked by a federal court, that would have required women to hold funerals for their aborted fetuses and banned abortions sought for fetal abnormalities.

With Congress in the hands of Republicans and a likely conservative majority on the Supreme Court, Maddow reasoned, prospects for women’s health care under Trump look grim. “Is there a doomsday plan for a time like this?” Maddow asked Richards. “Do you see this as a doomsday scenario for reproductive rights?”

Richards assured Maddow that Planned Parenthood has survived for a century and is committed to sticking around for longer than that. “Our doors stay open,” she said, echoing the quasi-comforting motto the organization is using to galvanize reproductive-health advocates in the pre-Trump months. Supporters brought baked goods for employees at Planned Parenthood centers around the country on Wednesday, Richards noted. Most Americans support legal abortion, and Donald Trump promised in his victory speech to govern on behalf of all Americans. “I hope that includes women, because of course women overwhelmingly did not vote for him, particularly women of color,” Richards said. “The right to safe and legal abortion is a right women have had in this country for more than 40 years, and it is supported by people of all parties. … We will absolutely be fighting for a justice to the Supreme Court who supports this right for women.”

“I don’t think you will get a justice to the Supreme Court who supports this right for women,” Maddow countered.

“Well, that’s what we fight for. That’s what we fight for every single day,” Richards said with a tight smile.

The prospect of this uphill fight is a devastating mirror image of the progress many hoped to achieve under a Hillary Clinton administration. With her vocal support for funding abortion through Medicaid by scrapping the Hyde amendment, and the Democratic Party platform’s sign-on to that agenda for the first time, Clinton was ready to be the most aggressive supporter of women’s rights and access to reproductive health care the White House had ever seen. Now, Planned Parenthood and other reproductive-rights organizations will have to fight like hell just to hold onto smaller victories they secured years ago.

Besides the very real specter of a conservative Supreme Court majority overturning Roe v. Wade, one of the gravest threats Trump and Pence pose to reproductive health is their promise to scrap the Affordable Care Act. Obamacare made contraception free, relieving poor and marginalized women of a major financial burden and making it easier for them to prevent unwanted pregnancies that would otherwise end in abortion. Even without the support of Congress, Trump as president could gut the Affordable Care Act just by dropping the Obama administration’s appeal of House v. Burwell, which held that the federal government was spending money Congress hadn’t appropriated to reimburse insurers for offering discounted coverage to low-income policyholders. He and his appointees could also refuse to enforce the provisions of the act, rendering it nearly ineffective.

This means that birth control coverage is no guarantee once Trump takes office. Richards told Maddow that Planned Parenthood has already been getting calls from new patients who want appointments to get long-acting reversible contraception, like intrauterine devices and implants, before they lose that coverage. LARCs are a particularly good option here because they’re exceptionally effective and could last patients through the end of a Trump presidency: A hormonal IUD can remain effective in a patient’s uterus for up to five years, and a copper one can last for up to 12. That means a single birth control device could last through, Satan forbid, a second Trump term and the end of his reign, unless he decides he wants to stay in office until his last breath and Paul Ryan licks his shoes and makes it happen.

Some anti-abortion legislation has even sought to ban some kinds of birth control under the argument that a just-fertilized egg is a human being. In a truly apocalyptic Trump administration scenario, contraceptives that aren’t barrier methods like condoms—which Pence thinks are too modern and don’t work anyway—could be prohibited or harder to get. Paired with attacks on abortion rights and access, barriers to contraception could mean a sharp resurgence of teen births and unwanted pregnancies.

That’s one reason why concerned women should get their long-term contraception plans in order now, if they can. Here’s another: The Food and Drug Administration is a political entity with the capacity to affect how and if patients can access drugs like emergency contraception and the abortion pill. In 2005, during George W. Bush’s administration, the FDA refused for months to decide whether Plan B, the morning-after pill, could be sold over the counter. When a top FDA official resigned because she felt the administration was infecting medical decision-making with anti-woman politics, Clinton and Sen. Patty Murray, D-Wash., blocked Bush’s pick to head the agency until it made a ruling on emergency contraception. In the day and a half since Trump’s election, women have encouraged one another on social media to stock up on Plan B before the president-elect’s inauguration, both for themselves and for others who might need it.

Mike Pence has spent his entire career on an obsessive mission to keep women from getting reproductive health care. In 2011, he became the first person in Congress to try to defund Planned Parenthood, even threatening to shut down the government over it. He once tried to delineate a difference between rape and “forcible rape,” with the intention of banning victims of the former from accessing abortion care. Trump has proved that he’ll promote the most extreme positions on abortion his Republican friends will allow. The forthcoming adminstration will surely set reproductive health care back. The only question is how far it’ll go, and whether two months’ advance notice will let women adequately prepare for the onslaught.