A women's clinic in Louisville, joined by Planned Parenthood of Indiana and Kentucky, is in federal court on Wednesday morning to demand that a U.S. District judge strike down rules that the Kentucky government, led by its vocally anti-choice Republican governor, is trying to use to shutter the state's only remaining abortion provider.

"In 37 years providing abortion, I've seen more than a dozen clinics close down in our state, and now ours is the last clinic standing in the entire state," said Ernest Marshall, a doctor and EMW Women's Surgical Center founder. "The very right to access legal abortion in the state of Kentucky is on the line."

EMW and Planned Parenthood are challenging state requirements that clinics providing abortions must have "transfer agreements" with a hospital and ambulance service. The state has used the rules to deny Planned Parenthood a license, and is now attempting to revoke EMW's license, claiming the clinic's existing agreements—which, until this March, had been deemed sufficient for several years—do not meet state requirements.

Citing the U.S. Supreme Court ruling that last year struck down similar restrictions imposed by a Texas law, lawyers for the clinic argue the requirements are not only unconstitutional, but also unnecessary, because federal law requires local hospitals to accept any patient in an emergency, and Louisville Metro Emergency Medical Services will transport patients without such agreements.

District Judge Greg Stivers temporarily blocked Kentucky's effort to revoke the EMW's license in the spring, and he will now hear the clinic's case challenging the constitutionality of the state's requirements. The trial began at 8:30am on Wednesday in the U.S. District Court in Louisville, and is expected to last two to three days.

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Planned Parenthood joined the lawsuit because it alleges that Gov. Matt Bevin and "his administration waged a 'campaign of fear and intimidation'—including a threat to block millions of dollars in public funds from University of Louisville Hospital—to prevent Planned Parenthood from getting a license," the Courier-Journal reports.

Although EMW retains its license for now, the Louisville clinic sees anti-choice protests almost daily, and requires assistance from volunteer escorts to enable patients to safely access the office.

Protests at the clinic made national headlines in late July, when Operation Save America (OSA), a fundamentalist Christian anti-choice group, descended on Louisville to launch city-wide demonstrations and a troubling campaign that included publicizing personal information about EMW employees.