A judge in Oklahoma on Tuesday upheld a law that requires a 72-hour waiting period for women seeking abortions, the latest in a wave of state-level legislation that restricts access to abortion. Prior to the ruling, Oklahoma already had among the most restrictive laws for abortion access.

The nearly 70,000-square-mile state has only four abortion clinics, according to the Guttmacher Institute, a research organization focused on reproductive health. By comparison, there are 50 in Washington, a similarly sized state.

Women seeking an abortion in Oklahoma must undergo counseling with "information designed to discourage her from having an abortion," according to Guttmacher. After that, the 72-hour waiting period begins. Women under the age of 18 must also receive parental or guardian consent.

Because there are only four clinics in the state, women could have to travel up to four-and-a-half hours for their first appointment only to drive back home during the waiting period. Because of this, the law disproportionately impact low-income, rural families, said Elizabeth Nash, a senior states-issue manager at Guttmacher, in an email to CBS News.

"Waiting periods are designed to create delays," Nash said. "Patients may have to delay the appointment because of logistics such as getting time off of work, arranging travel and child care."

In November 2015, Oklahoma passed a measure that increased the mandatory wait time to 72 hours from 24. The legislation was immediately challenged by the Center for Reproductive Rights, an international women's advocacy group. Tuesday's ruling declined the Center's request.

"This patronizing law implies that women are not good decision makers," said Autumn Katz, a staff attorney at the Center for Reproductive Rights, in an email to CBS News. "Oklahoma politicians are telling women that they don't know what's best for themselves."

Oklahoma Attorney General Michael Hunter praised the judge's decision: "Studies have shown that women who have the benefit of a reflection period like this change their minds in a significant percentage of cases, saving precious unborn lives," Hunter wrote in a press release shared with CBS News.

"Waiting period laws are unnecessary because studies show that over 90% of patients have made up their mind before making the appointment for the abortion," Nash said, disagreeing with Hunter. "The idea that a patient hasn't thought through the decision and needs a period of reflection is simply false."

While other state-level measures aimed at limiting abortion access have been deemed unconstitutional, mandatory waiting periods have had success in the courts. In 1992, the United State Supreme Court upheld a 24-hour waiting period that Pennsylvania had enacted. Since that decision, 27 other states, including Oklahoma, have created similar laws, with wait periods ranging from 72 hours down to 18 hours, according to Nash. Lawmakers in Louisiana, Missouri, North Carolina, South Dakota and Utah have passed laws requiring 72-hour waiting periods for women seeking abortions, though a federal judge has blocked Louisiana's measure.

"[The Oklahoma] court and many others have failed to recognize the significant burdens that mandatory delay laws impose on women," said Katz. "While these laws may not succeed in preventing women from obtaining an abortion altogether, they impose a variety of harms by stigmatizing women who seek abortion care."

Even though abortion is federally protected by Roe v. Wade, many states have taken steps to regulate the procedure. In ballot measures during the recent midterm elections, Alabama and West Virginia voters agreed on laws banning abortion coverage on state-funded insurance plans. Constituents in both states also voted to clarify that their state constitutions banned abortion, readying themselves for a potential overturning of Roe v. Wade overturn.

This month, a state senator in Oklahoma introduced the Abolition of Abortion in Oklahoma Act, which would criminalize abortion, making it akin to homicide and punishable by life in prison. It is unlikely to pass, said Nash.

"Oklahoma seems hellbent on coming up with new ways to ban abortion," said Nash. "It is also one of the states that other states look to for ideas for abortion restrictions."