A slew of trigger bans across three US states kicked in on Thursday as Tennessee, Texas and Idaho join eight other states that have formally outlawed abortion since the supreme court overturned Roe v Wade in June.

Depending on the state, trigger laws are designed to take effect either immediately following the overturn of Roe or 30 days after the supreme court’s transmission of its judgment, which took place on 26 July.

Currently, nearly one in three women between the ages of 15 to 44 live in states where abortion has been banned or mostly banned. According to data obtained by the US census, that is nearly 21 million women affected.

“More people will lose abortion access across the nation as bans take effect in Texas, Tennessee and Idaho. Vast swaths of the nation, especially in the south and midwest, will become abortion deserts that, for many, will be impossible to escape,” Nancy Northup, CEO of the Center of Reproductive Rights, said in a statement.

“Evidence is already mounting of women being turned away despite needing urgent, and in some cases life-saving, medical care. This unfolding public health crisis will only continue to get worse. We will see more and more of these harrowing situations, and once state legislatures reconvene in January, we will see even more states implement abortion bans and novel laws criminalizing abortion providers, pregnant people, and those who help them,” she added.

Thursday’s trigger bans strip away the right to abortion access for millions of women in Tennessee, Texas and Idaho and in certain cases punish doctors and healthcare providers for performing the procedure.

In Tennessee, the state’s previous abortion law that bans the procedure after six weeks of pregnancy has been replaced with a stricter law. Aside from the exception of preventing the mother’s death or permanent bodily injury, the law bans abortion completely. It does not make any exceptions for victims of incest or rape.

The law, called the Human Life Protection Act, makes it a felony for those who are caught performing or attempting to perform an abortion. Consequences include fines, prison time and the loss of voting rights.

According to the law, abortions are prohibited from being performed based on mental health claims, including claims that the woman may “engage in conduct that would result in her death or substantial and irreversible impairment of a major bodily function”.

Texas, which already passed one of the nation’s strictest abortion laws last yearbanning the procedure beyond six weeks of pregnancy and offering no exceptions for incest or rape, will see a new trigger law take effect that makes the provision of abortion a first-degree felony. Consequences include life sentences and a civil penalty of $100,000 for each violation.

“The criminal penalties will further chill the provision of care to women who need it,” Elisabeth Smith, director of state policy and advocacy for the Center of Productive Rights, told the Washington Post.

Texas’s trigger ban comes a day after a federal judge in the state blocked an order from the Biden administration issued in the wake of the supreme court’s overruling of Roe that required hospitals to provide emergency abortions.

According to Judge James Hendrix, a Donald Trump-appointee, the US Department of Health and Human Services overreached in its guidance interpreting the Emergency Medical Treatment and Active Labour Act. The 1986 law, also known as Emtala, requires people to receive emergency medical care regardless of their ability to pay for the services.

“That guidance goes well beyond EMTALA’s text, which protects both mothers and unborn children, is silent as to abortion, and preempts state law only when the two directly conflict,” Hendrix wrote in a 67-page ruling.

The White House press secretary, Karine Jean-Pierre, condemned the decision, calling it a “a blow to Texans”, and adding, “It’s wrong, it’s backwards, and women may die as a result. The fight is not over.”

Abortions in Idaho were previously limited to a six-week period into pregnancy. However, Thursday’s trigger law completely prohibits abortion with the exceptions of reported cases of rape and incest and to prevent the death of the mother – but not necessarily to safeguard her health.

The ban makes performing an abortion in any “clinically diagnosable pregnancy” a felony that is punishable by up to five years of jail time.

Despite the sweeping ban, an Idaho judge barred the state at the 11th hour from enforcing its abortion ban in medical emergencies, making the ruling the exact opposite of Hendrix’s decision in Texas. The ruling from federal judge Lynn Winmill on Wednesday evening says that the state cannot prosecute anyone who performs an abortion in an emergency medical situation.

“At its core, the supremacy clause says state law must yield to federal law when it’s impossible to comply with both. And that’s all this case is about,” Winmill wrote. “It’s not about the bygone constitutional right to an abortion,” he added.

With such conflicting rulings, both cases could be appealed and the supreme court may be asked to intervene.