Two Planned Parenthood clinics in Cincinnati will be the first to close as a result of a new Trump administration policy which blocks healthcare providers that refer patients for abortions—or perform the procedure with their own money—from receiving federal family planning grants. The Springdale and Western Hills clinics’ final day of services will be September 20, according to ABC News.

Planned Parenthood withdrew from the Title X grant program last month, forgoing roughly $60 million dollars in federal funding in order to continue providing abortion referrals and care. The decision put Planned Parenthood health centers across the country at risk of closure, including those, like the two in Cincinnati, that don’t provide abortion care.

Such is an inevitable side effect of the new Trump rule: While on paper the policy may appear to be laser-focused on abortion, in practice it limits people’s access to the full spectrum of reproductive healthcare, including birth control, STI testing, and breast and cervical cancer screenings.

In Cincinnati, the need for these services is thought to be particularly urgent, as the city reports the highest rates of chlamydia and gonorrhea in the state, and Ohio already ranks 48th in the country for access to publicly funded reproductive health services.

“While we’ve been battling sky-high STI rates, [Republican] politicians...have spent years relentlessly working to chip away at Ohioans’ reproductive health care,” said Kersha Deibel, the president and CEO of Planned Parenthood Southwest Ohio Region, in a statement on Monday. “This is the world they want to see: one where women lose access to birth control, where information about how to access abortion is held hostage, and where, if you don’t have money, it’s almost impossible to access an STI test or a cancer screening.”

Planned Parenthood officials say access to reproductive health services in Ohio has been precarious long before the recent Title X change, but the new rule accelerated the closure of these two clinics. Between 2010 and 2015, about half of Ohio’s abortion clinics shuttered, and in 2016, then-Governor John Kasich signed legislation that cut funding to the STI screening services Planned Parenthood provided for free.

“We’re already seeing the impact [of these policies] across the state,” said Erica Sackin, the senior director of communications at Planned Parenthood Action Fund. “There’s no doubt that the combination of all of these restrictions, on top of the administration creating a hostile environment for reproductive healthcare, is forcing … thousands of people in Cincinnati to lose their trusted providers.”

Though two Planned Parenthood clinics are the first victims of the revised Title X policy, independent clinics—that is, those that aren’t affiliated with national organizations like Planned Parenthood—continue to be the most vulnerable to federal attacks on reproductive healthcare providers.

“Anytime there’s an attack [on abortion rights], it hurts all clinics,” Jay Thibodeau, the communications director for the Abortion Care Network, told VICE News on Tuesday. “But indies don’t always have the same sort of resilience and safety net that Planned Parenthood or hospitals have.”

And once reproductive health centers close, it’s an uphill battle to reopen, even if the policies that forced them to shutter are eventually rolled back. When a Texas law requiring abortion clinics to have hospital admitting privileges went into effect in 2013, it shuttered more than half of the abortion clinics in the state. The Supreme Court overturned the law three years later in the landmark Whole Woman’s Health v. Hellerstedt case, but many of the clinics still haven’t reopened, including some in the Whole Woman’s Health network.

“Laying off a fabulous nurse, telling them they no longer have a job because of political interference is one of the hardest things we’ve ever done,” Whole Woman’s Health CEO Amy Hagstrom Miller told VICE in June, when Missouri’s last abortion clinic came close to shuttering. When staff members get laid off, “they’ll have to get other jobs, making it very difficult to reopen and rebuild [later on],” she continued. “It might not be something you can afford to do.”

Catherine Romanos, an Ohio-based abortion provider and fellow at Physicians for Reproductive Health, said she worries that the nurses and doctors who once served at the Cincinnati locations may not find a new place to provide reproductive healthcare in Ohio. She said she knows of three doctors who, in the last year, have left Ohio due to the constraints of the existing restrictions on abortion in the state, which she said have only been exacerbated by the new Title X policy.

“Not only are we closing clinics and limiting access, but we’re creating an environment where no one wants to practice here,” Romanos said. “And then where are we? It’s hard to imagine Ohio residents’ health status would improve. We seem to be going backwards.”

Sign up for our newsletter to get the best of VICE delivered to your inbox daily.