AMES, Iowa (AP) — Iowa’s law banning most abortions after about six weeks of pregnancy goes into effect Monday, a drastic change that enrages — but doesn’t surprise — Sarah Traxler.

When Traxler, an OB-GYN based in Minnesota and the chief medical officer of Planned Parenthood North Central States, went to high school in a conservative Louisiana town in the 1990s, she saw abortion rights losing ground even then, decades before the U.S. Supreme Court and Iowa’s high court would say there isn’t a constitutional right to abortion.

“The protections of Roe have just been chipped away at slowly through time,” she said.

At 8 a.m. Monday in Iowa, the state will join more than a dozen others where abortion access has been sharply curbed in the roughly two years since the Supreme Court overturned Roe v. Wade.

Iowa’s Republican-controlled Legislature approved the law last year, but a judge blocked it from being enforced shortly after it went into effect.

The Iowa Supreme Court reiterated in June that there is no constitutional right to an abortion in the state and ordered the hold to be lifted with July 29 as the first day of enforcement.

The law prohibits abortions after cardiac activity can be detected, which is roughly at six weeks of pregnancy and before many know they are pregnant. There are limited exceptions for crime and health issues.