— The state Senate has given final legislative approval to a bill that imposes new regulations and restrictions on abortion providers.

Senators voted 32-13 Thursday evening, sending the measure to Gov. Pat McCrory, a Republican who has said he will sign the measure as it was passed.

Best known among the bill's provisions is a requirement that the Department of Health and Human Services develop regulations for abortion clinics similar to ambulatory surgical centers. Similar language in other states has required abortion clinics to pay for hundreds of thousands of dollars worth of upgrades.

Only one abortion clinic in North Carolina meets those guidelines. Although the House added language that those rules should be written without "unduly restricting access," opponents of the bill said that line was merely a legislative fig leaf.

"This bill is coming back to us in a form that's not fundamentally changed," said Sen. Floyd McKissick, D-Durham. "It's still a deprivation of the rights of women."

Other provisions in the bill include:

Requires physicians to be "present" for the entire surgical abortion procedure.

Allows any health care provider, not just doctors and nurses, to opt out of participating in abortion procedures.

Prohibits health plans offered on the exchange established under the federal Affordable Care Act from offering coverage for abortion.

Prohibits cities and counties from offering coverage for abortions in health plans they offer their employees.

Prohibits abortions for the purpose of selecting the sex of a child.

"This bill simply seeks to ensure that we protect women," said Sen. Thom Goolsby, R-New Hanover. "What is wrong with reasonable standards?"

The abortion measures has had a tumultuous path through the General Assembly.

Just before July 4, the state Senate originally attached the measure to a bill dealing with applying foreign law in family courts. The House did not take up that measure but tacked a nearly identical package of abortion restriction onto a motorcycle safety measure. That combined motorcycle safety and abortion measure was the bill before the Senate Thursday night.

Controversy about the bill is unlikely to end this week. During the 2012 campaign, McCrory pledged not to sign any bills further restricting abortions. Most impartial observers believe signing this bill would violate that pledge. It will also be an agency overseen by McCrory and his political appointees that will be responsible for writing abortion clinic rules.

Advocates began pressuring McCrory almost as soon as the bill cleared the Senate Thursday night.

"We trusted Gov. McCrory to be honest when he said he would not sign a single new restrictions on women’s health. It’s time he keep his word," said Melissa Reed, vice president of public affairs at Planned Parenthood Health Systems.

Advocates on the other side of the issue claimed victory.

"SB 353 also protects the health and safety of women by implementing common-sense and reasonable safety standards for abortion facilities," Tami Fitzgerald, executive director of the North Carolina Values Coalition, said in a statement. "This comprehensive bill outlaws the practice of aborting unborn children just because they are the 'wrong' sex, protects taxpayers from funding abortions and allows all health care workers and hospitals the right to refuse to perform abortions because of their moral, ethical or religious beliefs."

Debate gets intense

The abortion measure sparked intense debate in the Senate, provoking lawmakers to ask one another pointed questions.

"Have you ever witnessed a woman who did not go to an abortion clinic but whose body was mutilated by coat hangers?" Sen. Gladys Robinson, D-Guilford asked Goolsby.

Goolsby responded "no" but referenced the infamous Kermit Gosnell case from Philadelphia, in which an abortion provider was charged with murder due to running a horrifically unsafe clinic.

"I care about women, I think my record shows that," Goolsby said in reply. "If you can show me something in there that is unreasonable, that is wrong, that hurts women, I will not vote for this...I'm just not finding it offensive."

Robinson said the bill will send women "into the streets" to seek abortion because the measure will limit access to clinics.

Two previous abortion floor debates in the House and Senate have taken place in front of packed galleries full of both opponents and backers of the bill. Thursday night, the Senate gallery was populated mostly by the usual cadre of lobbyists, lawyers and others typically in the legislative orbit. That may be because the bill was not on the calendar at the beginning of the day, as the Senate began to wind down its business for the year.

"Is there anywhere in state law where we restrict the kind of health care that men can get?" Sen. Angela Bryant, D-Nash, asked Goolsby.

Opponents of the abortion bill say they object to making a state law that targeting the health care provided to women.

Goolsby paused, then said, "I'm just not sure what you are asking."

Bryant and Goolsby traded a few more unfruitful questions before Sen. Ralph Hise, R-Mitchell, interjected, asking if there was anywhere else in state law where taxpayers were asked to fund "an elective" procedure.

"I'm not aware of any, no...That's a good point," Goolsby replied.

Backers of the bill pointed to the closings of abortion clinics in Charlotte, Durham and Fayetteville as signs tighter regulations were needed. Others said those regulations were signs that existing regulations were working well.

"There's no clinic that's going to be closed down over this," Sen. Buck Newton, R-Nash, said.

Newton said the bulk of the bill concerned safety and making sure that health care workers who didn't want to participate in abortions didn't have to do so.

"This is common sense," he said. "If we're going to have abortion, we want it to be under the right circumstances."

Democrats insisted the bill was an intrusion against women's rights.

"It's not your business to tell (women) what's good for them and what's bad for them," Sen. Martin Nesbitt, D-Buncombe, said, adding that the clinics that provide abortion also provide other health services, such as mammograms and family planning.

"You're shutting down these clinics, so they can't get anything," he said.