An abortion advocacy group has released a report remarking that independent abortion facilities have been closing at an “alarming rate,” with 145 locations shutting down over the past five years.

The Abortion Care Network, whose website features a poster art series to “celebrate abortion care,” outlines that independent abortion facilities can be defined as those that are not affiliated with Planned Parenthood or any hospital chain.

So far this year, 10 independent facilities have shuttered their doors, with 19 abortion locations closing in 2016. 33 independent abortion facilities closed in 2015 and 23 in 2014, while 40 facilities closed in 2013. There were 20 closures in 2012.

The most closures took place in Texas, with 20 facilities closing their doors over the past five years. Next in number is California and Michigan, which both saw 15 independent abortion locations close since 2012. 11 facilities closed in Florida and 9 in Ohio.

According to the report, in 2012, there were 510 independent abortion providers in the United States, a figure that has now been lowered to 365. The tally does not include the hundreds of facilities operated by Planned Parenthood. Planned Parenthood has closed over 20 of its 600 facilities this year alone, but some of the locations do not perform abortion.

The Abortion Care Network attributes the closures to the passage of hundreds of new abortion restrictions and regulations, the activism of pro-life proponents outside of abortion facilities, and the number of states that prohibit Medicaid funds from covering abortions.

“Because of financial and political forces—including low reimbursement rates, unconstitutional 20-week bans, and politically-motivated bans on certain safe medical procedures—clinics that provide abortion care beyond the first trimester of pregnancy are particularly vulnerable to closing,” it remarked in a statement.

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The group also asserted that independent abortion facilities are needful because they often provide abortions after the first trimester (over three months gestation), and some perform late-term abortions.

“Of the 56 independent clinics closed over the last two years, only nine provided care exclusively before 13 weeks gestation; 24 provided care between 13 to 19 weeks; 10 provided care between 19 to 22 weeks; and 11 provided care after 22 weeks,” the report noted. “With more than 80 percent of total closures shuttering clinics that provide care after the first trimester, it is clear that as independent abortion clinics close, abortion care becomes increasingly difficult to access as pregnancy progresses.”

Read the report in full here.

As previously reported, abortion was strongly condemned in early America. Philadelphia legal writer, educator and Christian apologist Francis Wharton penned an entire chapter on abortion in his 1855 book “American Criminal Law.”

Wharton called abortionists “persons who are ready to degrade their humanity to this occupation” and stated in regard to abortion in general, “Such conduct cannot be too strongly condemned, and is the more deserving of receiving the punishment awarded for the criminal offense in question.”

In an introductory lecture to his course on obstetrics in 1854, Philadelphia Dr. Hugh Lennox Hodge likewise explained that if a woman were to come to a medical doctor in pursuit of an abortion, “he must, as it were, grasp the conscience of his weak and erring patient and let her know in language not to be misunderstood that she is responsible to her Creator for the life of the being within her.”

“The procuring abortion is ‘a base and unmanly act,’” Hodge also said, quoting in part text from a court ruling of his day. “It is a crime against the natural feelings of man, against the welfare and safety of females, against the peace and prosperity of society, against the divine command ‘Thou shalt not kill.’ It is murder.”