Friday’s U.S. Supreme Court ruling overturning Roe v. Wade is creating confusion and may be limiting access in Michigan’s largest hospital system, even though a judge in the state has already said abortion should remain available while legal disputes over its status work through Michigan courts.

It’s one more sign of how far-reaching the ruling’s impact has been. It’s also a reminder of how much access to abortion in some states could depend on the outcome of November’s elections.

Michigan is one of those states where courts had long blocked enforcement of an old abortion ban because it violated Roe v. Wade. Earlier this year, as a U.S. Supreme Court ruling invalidating Roe seemed imminent, Democratic elected officials and abortion rights advocates asked the state courts to act once again ― this time, by declaring the 1931 ban incompatible with guarantees of personal liberty in Michigan’s state constitution.

Last month, one of those appeals prevailed with a lower court judge, who issued an injunction blocking enforcement until state courts could rule definitively on the 1931 ban’s constitutionality.

Providers like Planned Parenthood are continuing to provide abortion as before, while top state officials including Democratic Gov. Gretchen Whitmer have said repeatedly that abortion remains legal in the state while the injunction is in place.

But on Friday evening, the chief executive officer of BHSH Health System emailed staff to say that the network of hospitals and providers was suspending abortions, except to save a mother’s life, in order to comply with the 1931 law. The memos ― first reported by Crain’s Detroit Business and the Detroit News ― prompted an outcry on social media, including from doctors and Democratic elected officials citing their understanding that abortion in Michigan remains legal, at least for now.