According to the Population Institute’s latest report card, the United States overall is just scrapping by with a passing grade when it comes to reproductive rights.

Rating each state based on a number of key factors — how many pregnancies are unintended, access to comprehensive sex ed and emergency contraception, affordability of birth control, and restrictions on abortion and family planning services — the report concludes that the country’s grade dropped from a C to a D+ in the last year. Nineteen states — mostly in the south and midwest — failed entirely, compared to 15 last year.

The steady expansion of those red swaths is the result of the record-breaking number of new anti-choice state laws that the Guttmacher Institute has documented over the last few years. And their latest tally shows the trend continues: Last year, 57 state abortion restrictions were enacted, bringing the total since the 2010 midterm elections up to 288. That means that states have adopted nearly as many abortion restrictions during the last five years as they did during the entire previous 15 years.

If this unrelenting march back to the dark ages keeps up, the Population Institute may need to come up with a new grading scale.