NASHVILLE, Tenn. (AP) — Women seeking abortions in Nashville will now have to travel hours outside the city after the only clinic offering abortions in the region has temporarily halted its services.

Tereva Parham, a spokeswoman for Planned Parenthood of Tennessee and North Mississippi, confirmed Monday the Nashville-based clinic stopped offering abortions last week but is still open for all other health services.

“At this time, abortion services have been halted and we’re undergoing a period of quality improvement,” Parham said.

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It’s unknown how long abortion services will be suspended at the Nashville clinic and what specifically led to the suspension. Parham said a lack of abortion providers was part of the reason for the announcement and added the clinic hopes to resume abortion services soon. The change was first reported by The Tennessean.

Planned Parenthood is now referring patients to clinics in Knoxville and Memphis, which are both almost 200 miles (321 kilometers) away from Nashville.

In August, another Nashville abortion provider — The Women’s Center — abruptly closed after its building was sold and has yet to reopen despite announcing it was looking for a new location.

In a Facebook post, anti-abortion group Tennessee Right to Life wrote that their Nashville office had received “an increase of calls from women seeking abortions” and that they were providing “life-affirming support and referrals” to pregnancy centers offering free services.

The closures come as Republican state lawmakers have passed several significant abortion restrictions in Tennessee in recent years.

Republican Gov. Bill Haslam signed a bill passed earlier this year by the GOP-led Legislature this year seeking federal approval to ban TennCare payments for non-abortion services to any provider of more than 50 abortions in the prior year, including Planned Parenthood. TennCare is Tennessee’s Medicaid program.

State and federal law already ban Medicaid abortion funding. Some exceptions include rape, incest or risk of the mother’s death.

TennCare spokeswoman Sarah Tanksley says the agency has followed that law and submitted its waiver application, and federal health officials are reviewing it.

In 2015, lawmakers passed a restriction that required abortion clinics to meet hospital-level surgical standards. That law was permanently halted in spring of 2017 because of a federal lawsuit.

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In the same lawsuit, the state is still defending a 2015 restriction that requires counseling and a 48-hour waiting period for women seeking abortions.

Under Monday’s announcement, women from middle Tennessee seeking abortions may need to take two trips to Memphis or Knoxville to fulfill the 48-hour waiting period or find a way to stay in the area the entire time.

In spring 2017, Haslam signed a law that bans abortions after 20 weeks on fetuses that are determined to be viable.

The changes came after Tennessee voters in 2014 approved an amendment that says nothing in the state constitution “secures or protects a right to abortion or requires the funding of an abortion.” The amendment also empowers state lawmakers to “enact, amend, or repeal statutes regarding abortion.” A lawsuit questioning how votes in that election were counted was dismissed in a 2018 federal appellate decision.

According to the Tennessee Department of Health Services, roughly 9,700 abortions were performed in Tennessee in 2016. That’s down from 14,250 in 2008.