Abortion providers and women’s rights groups will ask the US supreme court to consider Texas’s anti-abortion powers after federal appellate court on Tuesday upheld the most restrictive provisions of a law that could leave the second largest state in the US with fewer than 10 abortion clinics.



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A three-judge panel on the fifth US circuit court of appeals, one of the nation’s most conservative courts, found that Texas could require abortion clinics to meet hospital-level operating standards, which opponents say are too expensive for small providers and clinics. The state argued in a challenge brought by abortion providers that the law’s building and equipment regulations are meant to protect women’s health.

Opponents of the Republican-backed, anti-abortion law, among the most restrictive in the US, say the decision could leave women across the vast expanse of Texas with access to just a handful of clinics, forcing them to travel more than 100 miles to seek an abortion.

“Not since before Roe v Wade [in 1973] has a law or court decision had the potential to devastate access to reproductive healthcare on such a sweeping scale,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, which challenged the law.

The Center for Reproductive Rights, along with the Texas women’s healthcare providers, said they plan to appeal the case to the nation’s highest court, arguing that the regulations may force all but seven clinics in Texas to close.

“Once again, women across the state of Texas face the near total elimination of safe and legal options for ending a pregnancy, and the denial of their constitutional rights,” Northup said.

In a small victory for providers, the panel ruled in favor of Whole Women’s Health in McAllen, Texas, and granted an exemption to the admitting privileges requirements – a doctor’s right to admit patients to a hospital. Without the McAllen clinic, women seeking an abortion in the Rio Grande Valley would have to travel more than 200 miles to get the procedure, which the panel agreed was too far.



The exemption for the McAllen clinic lasts only until another licensed abortion facility opens in a location closer to the Rio Grande Valley than San Antonio.

The court did not expand the exemption to a clinic in El Paso, ruling that Texas women seeking an abortion could travel to New Mexico, where clinics are not required to meet these ambulatory requirements.

Most of the remaining clinics, though, were immediately thrown into a state of limbo, with many abortion providers expected to close – if they weren’t in the process of closing already.

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Texas’s omnibus law – known as HB2 – is part of a legislative trend to limit access to abortions by regulating facilities, providers and doctors. The added red tape forces clinics that cannot afford to make the upgrades to close. Moreover, hospitals often require doctors to admit a minimum number of patients before they’re granted admitting privileges.

The law was enacted by a Republican-led legislature in 2013. One month prior to its approval, there were 41 clinics in Texas that provided abortions, according to a study by the Texas Policy Evaluation Project at the University of Texas. By May 2014, there were only 22 clinics where women could legally end their pregnancies.



Last August, a US district judge Lee Yeakel in Austin ruled that a key provision of the law requiring hospitals to meet surgical center standards placed an unconstitutional burden on women seeking abortions. Yeakel argued that the impact of the law burdened women’s constitutional right to the procedure “just as drastically as a complete ban on abortion”.

Tuesday’s ruling arrived after the US supreme court intervened in October to allow a handful of abortion clinics to remain open while the appeals process played out in New Orleans.