Michigan women will face new obstacles to legal abortion after Republican Gov. Rick Snyder signed into law wide-ranging restrictions in the last hours of that state’s legislative session Friday.

Under the new law, private medical offices where abortions are performed will be required to be licensed as surgical facilities; women seeking an abortion must first meet with a health-care professional to ensure they aren’t being coerced into the procedure; health-care providers can refuse service if their conscience so dictates; and new regulations will be imposed on how fetal remains are disposed.

Snyder surprised many by vetoing related legislation that would only allow insurance coverage of abortions through rider policies that companies could deny. A Planned Parenthood spokeswoman called this a “victory” amidst the package of new restrictions.

“Those three issues were our top issues: conscience, insurance, and regulation and reform,” Ed Rivet, a spokesman for Michigan Right to Life, told the Detroit Free-Press. “That we’re doing them all simultaneously is pretty remarkable.”

Critics, though, call the bill confusing, contradictory, and over-broad. Policy watchdog RH Reality Check deemed it “one of the most extreme pieces of anti-choice legislation in the country.”

“It is a sad day for Michigan women,” said State Senator Rebekah Warren. “They will pay for this legislation with their dignity, health, and ultimately some even with their lives.” Warren was Michigan’s affiliate NARAL director for seven years before being elected to office.

While President Obama carried the state by nine percentage points in November, Republicans control both houses of the legislature, as well as the governor’s office. Snyder signed the abortion bill on the final day of an unusually busy lame-duck session of the legislature, before new lawmakers, including a few more Democrats, take office next year. Snyder also recently signed a controversial bill that made Michigan, the spiritual home of the American labor movement, a “right-to-work” state, for both public and private-sector workers.

In a statement, Cecile Richards, president of Planned Parenthood, said the bill “was meant to ban abortion in Michigan, and it was pushed through in a lame-duck session by legislators who were voted out of office because of their extreme views on women’s health.”

The provisions of the Michigan bill, such as banning telemedicine for a medication abortion, often used by women in rural areas without easy access to a health-services provider, will likely be imitated by other states with Republican legislatures, said Guttmacher Institute policy analyst Elizabeth Nash. In a medication abortion, providers administer two FDA-approved pills—mifepristone and misoprostol—which when taken in succession are designed to terminate a pregnancy in its first nine weeks. The bill prohibits a doctor from consulting via a webcam as a woman takes the second pill, a method that had simplified the procedure for many rural women.

Warren noted that the ban came even after state legislators in both parties approved an expansion of other types of telemedicine—a pressing issue in Michigan, a state with a large landmass and relatively few population centers.

At least nine of the state’s 24 abortion clinics offer medication abortion. Nash said providers discovered through research and practical application that, in most cases, administering the first pill on site and then allowing women to give themselves the second pill later at home is effective and recommended.

Warren added that access to basic gynecological care is already difficult in a state where one-fourth of counties lack a OB/GYN provider. About 1.9 million women of reproductive age live in the state, according to recent Census data.

During the debate over the bill, Democratic Representatives Lisa Brown and Barb Byrum were banned from the statehouse shortly after the house bill’s passage—Brown for using the word “vagina,” and Byrum for speaking out of turn—during a heated argument.

Republican Rep. Bruce Rendon, one of the bill’s sponsors, called it both “ambitious” and “common sense.” “It addressed really the fact that abortion in Michigan has been unrestricted. It’s just been free rein out there,” he said, adding that “a lot of these facilities have never been inspected.”

Warren disputed that claim, saying that clinics that take federal money and have labs on site that are already subject to annual inspections. “We’d happily talk about clinic regulations that make sense,” she said.

While the law could face legal challenges from opponents, it’s expected to take effect March 31.

“Some say that we’re doing away with abortion in Michigan,” said Rendon. “But isn’t our goal to have less abortions?”