When I consider what the United States would look like if Donald Trump were to be elected president, the thing that worries me most is how his policies would affect the women of this country. As an ob/gyn I am confronted daily with the complexities of women's healthcare—medical, emotional, financial. Under a President Trump it would only get worse, and more dangerous.

Trump has asserted that he will be pro-life, yet some people continue to believe he is not really against abortion and it is all just posturing for votes. After all, Trump has held multiple opinions on both abortion and Planned Parenthood not just over the years, but over the course of this election cycle. Surely, then, an assault on choice is just another pompous claim, like a wall. Right? It’s not.

Make no mistake about it: Donald Trump is an anti-abortion candidate. He has recently stated that he believes abortion is only acceptable in cases of rape, incest, or where the life of the mother is in jeopardy. I say that anyone who thinks abortion, emergency contraception, and even IUDs won’t be legislated out of existence if Trump is given executive power is wrong or lying to themselves. Here’s why.

Trump’s Agenda is anti-choice and anti-science.

In 1999 Trump said, “I am very pro-choice,” but views evolve and what Trump says he will do now is what matters. What he says now is summarized for public consumption in a letter he wrote to pro-life leaders dated September 2016. His first four goals are:

Nominating pro-life justices to the Supreme Court

Making abortion illegal at 20 weeks unless the life of the pregnant person is in danger

Defunding Planned Parenthood

Making the Hyde Amendment permanent

This is a very anti-choice agenda. Let’s take it point by point.

On Supreme Court Justice nominees: Trump has released a list of 21 potential nominees for the Supreme Court—all are conservative and many come with a strong anti-reproductive rights portfolio. A ninth Supreme Court Justice who is anti-choice is not even a subtle invitation for a direct challenge on Roe v. Wade. Without the federal protection of Roe v. Wade, states are free to legislate as they please; currently 19 states have laws that would outlaw or severely restrict abortion, which would immediately go into action if the protection of Roe were removed.

On late-term abortions: Signing the Pain-Capable Unborn Child Protection Act into law will essentially stop abortions at 20 weeks. Everything about the law is offensive, from its flawed foundational principle that a 20-week fetus can feel pain—in fact, a 20-week fetus does not have the hardware to feel pain (laws that ignore science are a particular concern as I find the idea of a post-factual society frightening)—to the “rape exception” that requires reporting a rape to law enforcement in order to legally terminate a resulting pregnancy. In addition to harming women seeking abortions for personal reasons, the Act would put many more at risk. Pregnant women who are very sick at 21 weeks with ruptured membranes and an infection may have their life-saving abortions delayed until their fetus dies in utero. Yes, there is a provision for the life of the mother, but doctors don’t know how to apply those laws. Trust me, I’m a doctor and I don’t know. What if a zealous district attorney thinks you made the wrong call? Malpractice insurance doesn’t cover criminal charges. A pregnant woman in Ireland, Savita Halappanavar, died because of a similar law, as the medical team waited too long. Waiting for a woman to be at death’s door is bad medicine. Making doctors afraid to practice medicine: also bad. This is a blueprint for maternal deaths.