An appeals court in New Orleans ruled on Wednesday that a 2014 anti-abortion law will be upheld in the state of Louisiana. According to abortion rights groups, this order will lead to the closure of three out of four of Louisiana’s remaining abortion clinics.

HB 388 was signed into law by then-governor Bobby Jindal in 2013. This January a federal district judge ruled that the law violated Roe v. Wade by making it too difficult for a woman to get an abortion. Now that the law has been upheld by the US Court of Appeals for the 5th Circuit, all but one of the state’s abortion clinics must be closed.

The state law poses a steep challenge to abortion providers by requiring abortion doctors, who generally operate out of small clinics, to have special privileges to treat patients in hospitals. The hospital must be within 30 miles of the doctor’s clinic. The law’s impact makes abortion nearly impossible for low volume clinics in rural areas. Not all clinics are within 30 miles of a hospital. Many do not have enough patients to be given special privileges. Some hospitals view these doctors as too controversial and do not wish to be involved.

Two Louisiana clinics, Bossier City and Baton Rouge, will close because doctors have not obtained hospital privileges. The other two clinics in the state share a doctor who travels between them. This doctor does have special privileges in Shreveport and New Orleans but sources say one of the two will probably shut down.

For many women, the closest clinic will be in Jackson, Mississippi, which, as of 2012 has been the only remaining clinic in that state.

Nancy Northup, president of the Center for Reproductive Rights in New York says, “The decision is likely to have an effect on a whole range of laws that pretend to be about women’s health but actually are designed to close clinics.”

The law is an example of what has seemed thus far to be a successful strategy for the anti-abortion movement–that is, shifting the focus away from the rights of the unborn and onto the health of the woman. Lawmakers in several states have whittled away access to abortions by creating hurdles under the pretense of interest in the woman’s safety and they have been met with much less opposition than they faced when trying to make sweeping reforms against Roe v. Wade.

Anti-abortion advocates have claimed that this law ensures that women are safe if they experience complications from abortions and need to be hospitalized. Reproductive rights proponents argue that this concern is absurd. Less than a quarter of 1% of women experience a complication from an abortion, which is much less than many other simple outpatient procedures doctors perform in small clinics. Additionally, they see no reason why a doctor needs an established relationship with a hospital, when any woman having a medical emergency would be admitted into a hospital through the emergency room regardless.

The Center for Reproductive Rights released a statement right away that they would take this ruling to the Supreme Court.

Nationwide, abortion clinics are closing at the fastest rate seen since 1973, the year that abortion became legal by Supreme Court decision. 162 clinics have closed since 2011 with only 21 new clinics opening. The women most affected by these closures are low-income women in rural areas who often can’t afford to travel.