A federal judge in Wisconsin on Friday ruled that the state’s effort to beef up patient safety at abortion clinics is unconstitutional because of its unequal impact on women. The ruling is a poignant rebuff to a potent antiabortion strategy that has already begun to shutter abortion clinics in the South and Midwest.

The offending law, which was signed by Gov. Scott Walker in 2013, required Wisconsin’s four abortion clinics to get admitting privileges at local hospitals. But that requirement proved unworkable for two clinics, including one in Milwaukee, where hospitals didn’t want to get involved in the nation’s often-heated and protest-filled abortion debate.

US District Judge William Conley, who had stayed the law last year as he deliberated its constitutionality, conceded that safety is a legitimate concern when it comes to abortion clinics, but ultimately ruled that the law’s remedy far exceeded any problem since so few abortions involved complications.

"In particular, the State has failed to meet its burden of demonstrating through credible evidence a link between the admitting privileges requirement and a legitimate health interest,” Judge Conley wrote in a 92-page ruling.

Federal judges have either put on hold or struck down similar laws in Alabama and Mississippi, although 14 states now have variations of the law on the books. In Texas, similar legislation has drastically reduced the number of abortion providers, and look-alike laws are set to take effect in Louisiana on Sept. 1 and Oklahoma on Nov. 1.

The moves have become a flashpoint in a long-running abortion rights debate in the US, particularly because of how successful they have been in reducing access to the procedure. It also comes ahead of a looming abortion fight in the 2016 presidential debate, where a Republican winner could change the make-up of the US Supreme Court to the point where the ultimate abortion rights ruling, Roe v. Wade, could once again be up for debate.

Admitting laws “are part of a wave of state bills … driven by a conservative shift … as well as a change in strategy on that part of antiabortion activists” that focuses on reducing access to abortion in order to curb its use, the Washington Post’s Sandhya Somashekhar wrote last year.

The laws were boosted by the 2013 murder trial of Philadelphia abortion doctor Kermit Gosnell after investigators found appalling conditions at his clinic.

Antiabortion advocates say the bottom line is that abortion remains widely available in the United States. In that light, they say, it makes no sense for women’s health that surgical clinics that perform invasive procedures have a policy of simply dropping patients off at the emergency room if something goes amiss.

The problem with that argument, at least in Judge Conley’s eyes, is that the practical aspects of the law are too closely tied to advocacy against abortion. Indeed, Conley, in his ruling, wrote that the “sudden adoption” of the requirements, which gave clinics only three days to secure the proper paperwork, “compels a finding that [the law’s] purpose was to impose a substantial obstacle on women’s rights to abortions in Wisconsin.”

Nearly 58 million abortions have been performed in the US since 1973. But the nation’s abortion rate is at its lowest in 40 years – in part due to wider use of birth control, but also, a recent report found, due to legislative efforts to reduce access to clinics.

Indeed, Texas has seen the number of clinics halved in the last year, and the fate of Mississippi’s sole remaining abortion clinic remains in limbo as a federal court continues to ponder that state’s law.

“Politicians, not doctors, crafted this law for the sole purpose of shutting down women’s health care centers and preventing women from getting safe, legal abortions” said Louise Melling, deputy legal director of the ACLU, in a statement.

The legal fight by abortion advocates to keep clinics open in conservative Southern and Midwestern states could play into the 2016 election cycle, where abortion, some political analysts say, may affect voter turnout.

Aside from the uncertainty over how future Supreme Court nominations could affect abortion rights, a Senate fight last week gave a glimpse into the looming debate, and even “galvanized outside groups ahead of the 2016 elections,” writes The Hill’s Jordain Carney.

Democrats balked at Republicans tying the Hyde Amendment, which bans federal funding of abortions, to a human trafficking bill.