NASHVILLE, Tenn. (Reuters) - A Tennessee woman accused of using a coat hanger to try to abort her 24-week-old fetus pleaded not guilty to a charge of attempted first-degree murder in a Nashville-area court on Tuesday, a sheriff’s official said.

Anna Yocca, 31, was indicted earlier this month for attempting to abort the fetus in a bathtub filled with water in September. She began bleeding heavily, and her boyfriend took her to a Nashville hospital.

The infant, named Leo Kluge, weighed 1.5 pounds at birth. Though he survived, his quality of life was harmed, and he will need extensive medical care, according to a complaint by Murfreesboro Police Detective Tommy Roberts. His lungs, eyes and heart were injured as a result of the hanger, Roberts said.

The charge for the attempted abortion led to complaints by pro-abortion activists, some of whom appeared at the courthouse on Tuesday wearing T-shirts and carrying signs in support of Yocca, according to Twitter posts. The shirts read “Abortion on Demand & Without Apology.”

Yocca appeared by video monitor from the Rutherford County Jail in Murfreesboro, about 35 miles southeast of Nashville, said Lisa Marchesoni, spokeswoman for the Rutherford County Sheriff’s Office. Yocca told Circuit Judge Royce Taylor that she needed an attorney, and a public defender was appointed.

The name of the defense attorney was not immediately available.

Under Tennessee law, an abortion must be performed by a licensed physician and is restricted by viability, according to the New York-based Guttmacher Institute, which studies reproductive health policies. Tennessee has a total of 14 abortion providers, none of which provides abortions after 16 weeks, according to the Tennesseean newspaper.

A 48-hour waiting period is required for all abortions, Guttmacher reported.

The state’s largest anti-abortion organization, Tennessee Right to Life, expressed “profound sadness” over the incident.

“Tennessee Right to Life is grieved by any woman’s decision to choose abortion as a supposed solution to an unexpected pregnancy and we continue to work for the promotion of alternatives and the protection of innocent human life,” said the group’s spokeswoman, Karen Brukardt.

Yocca, who is being held on a $200,000 bond, will return to court on Jan. 5.