Arizona’s highest court on Tuesday upheld an 1864 law that bans nearly all abortions, a decision that could have far-reaching consequences for women’s health care and election-year politics in a critical battleground state. The 1864 law, the court said in a 4-2 decision, “is now enforceable.” But the court put its ruling on hold for the moment, and sent the matter back to a lower court to hear additional arguments about the law’s constitutionality. The Arizona Supreme Court said that because the federal right to abortion in Roe v. Wade had been overturned, there was no federal or state law preventing Arizona from enforcing the near-total ban on abortions, which had sat dormant for decades.

The ruling could prompt clinics in Arizona to stop providing abortions and women to travel to nearby states like California, New Mexico or Colorado to end their pregnancies. Until now the procedure has been legal in Arizona through 15 weeks of pregnancy.

The ruling concerned a law that was on the books long before Arizona achieved statehood. It outlaws abortion from the moment of conception, except when necessary to save the life of the mother, and it makes no exceptions for rape or incest. Doctors prosecuted under the law could face fines and prison terms of two to five years.