In a setback to abortion rights advocates, the U.S. Supreme Court on Tuesday paved the way for Republican-backed restrictions on medication-induced abortions to take effect in Arkansas that could lead to the shuttering of two of the state’s three abortion clinics.

The nine justices, with no noted dissents, declined to hear an appeal by abortion provider Planned Parenthood of a lower court ruling that had revived the state law, which sets regulations regarding the RU-486 “abortion pill,” after it was earlier struck down by a federal judge. The law had remained blocked pending the outcome of the appeal to the Supreme Court.

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The high court’s action may not be the final word on the matter. Planned Parenthood can still ask a judge to reimpose the injunction blocking the law.

The Supreme Court in 1973 legalized abortion nationwide, but many Republican-governed states have passed laws seeking to impose a variety of restrictions, some so demanding that they may shut down abortion clinics and make the procedure far more difficult to obtain.

The justices, in a 2016 ruling, struck down a restrictive Republican-backed Texas law that had targeted abortion clinics and doctors in a decision that was seen as reaffirming and fortifying legal protections for abortion rights. Planned Parenthood had claimed the appeals court ruling in the Arkansas case had disregarded the precedent set in the Texas case.

Reporting by Lawrence Hurley; Editing by Will Dunham