This is not a drill. Kentucky is on the verge of closing the last abortion clinic in the state.

While attention is focused on the threat to women’s health at the federal level — everything from the Supreme Court nominee’s position on reproductive rights and “defunding” of Planned Parenthood — states are quietly passing abortion restrictions and targeting abortion providers to try to shut them down. We can’t fall for this head fake. The states are running amok, and Kentucky is the most drastic recent example. Come Monday, unless a federal court intervenes, Kentucky will close the last abortion clinic.

How did this happen?



Out of the blue, on March 13, Kentucky sent a letter to EMW Women’s Surgical Center, the last remaining abortion clinic in Kentucky, claiming there were technical issues with some of the clinic’s paperwork. The state had inspected the clinic just last year and renewed EMW’s license. But all of sudden the state decided that EMW’s agreements with a local hospital and ambulance service were no longer sufficient. For example, the state argued that a different person at the hospital was supposed to sign the agreement. Suspiciously, the letter was sent days before a court hearing in EMW’s challenge to Kentucky’s new abortion restriction that requires doctors to perform an ultrasound and describe it to a patient, even if she objects.

Coincidence?

Basically, the state concocted new criteria, without any medical justification, as a thinly veiled attempt to shut down the clinic. While shocking, it shouldn’t really come as a surprise. Kentucky has been picking off clinics one by one and passing abortion restriction on top of abortion restriction. This latest maneuver fits squarely into the governor and the statehouse’s goal: banning abortion in the state.

But the Constitution is on our side, and this is an easy case. States cannot close an abortion clinic — especially the last remaining clinic — for a bogus reason. Just this past June, the U.S. Supreme Court ruled in Whole Women’s Health v. Hellerstedt that a Texas law, similar to Kentucky’s, that required clinics to have business arrangements with hospitals served no medical purpose and, in fact, harmed women by decimating access to abortion in the state.

If Kentucky shuts down the only abortion provider in the state, Kentucky women will suffer. There is no doubt that women will be forced to carry their pregnancies to term. Recent research has shown that women who are unable to obtain a needed abortion are more likely to be trapped in the cycle of poverty and tethered to abusive partners. For other women, inability to obtain an abortion means dashed dreams for their future and their family’s future. Some women may try to induce abortion themselves without medical supervision.

Women who have the money may try to travel out of state to get care. But the poverty rate in Kentucky is one of the highest in the nation, and poor and low-income women account for 75 percent of abortion patients nationally. Unsurprisingly, women often lack the money to pay for an abortion, let alone for transportation costs to another state. Women often delay an abortion while they try to raise funds to pay for the abortion and attendant costs, such as transportation and childcare. This pushes many women later into their pregnancies, and when they are finally able to gather the money, the cost and health risks have increased.

Although Kentucky is a drastic example, it is not alone in launching extreme attacks on access to women’s health care. Since the 2010 elections, states have quietly passed over 300 laws that restrict access to abortion. These laws have no medical justification and are designed to force clinics to close their doors, to intimidate abortion providers, and to shame women seeking an abortion. Right now, at least five other states have only one abortion clinic: Mississippi, Missouri, North Dakota, South Dakota, and Wyoming. Other states have also piled on the restrictions, such as Arizona, Wisconsin, and Indiana. As a result of these restrictions, many women in the United States live in a community where it is as if the Supreme Court never decided Roe v. Wade. For too many women, the ability to access abortion is dependent on their zip code and their income.

There will be more attacks to come that range from benign-sounding-but-pernicious in practice to the in-your-face-extreme. We need to be vigilant at both the state and the federal level. We must protect the overall right guaranteed by Roe v. Wade by asking Supreme Court appointees tough questions about how they view that decision and fighting the Trump administration’s efforts to roll back reproductive rights.



But at the same time, we cannot lose sight of what is happening in the states, namely the quiet, slow strategy to stop a woman who needs an abortion from getting one. If each and every one of these attacks is not met with our fury, we will wake up one day to a country where the right guaranteed by Roe exists on paper but will be out of reach for even more women than it is today.