Nearly a third of all independent abortion providers have either closed or stopped providing the procedure in the past five years, according to a report from the Abortion Care Network. New state regulations are one reason: Many providers say they can't keep up with the cost of complying with them.

"Anti-abortion politicians have long used onerous restrictions to try and shut down independent abortion providers," said Nikki Madsen, executive director of the Abortion Care Network, a professional organization for independent clinics, or providers not affiliated with Planned Parenthood. "Since 2010, anti-abortion politicians have passed more than 400 laws that attempt to make it too expensive or logistically impossible for abortion clinics to operate."

Independent abortion clinics represent about a quarter of all abortion providers in the United States but serve three out of every five people seeking the procedure, according to the report. Planned Parenthood provided about 37% of abortions in the country; private physicians' offices accounted for 3% and hospitals 1%, the report says.

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For abortions that occur later in pregnancy, independent clinics are particularly important. These facilities performed 94% of abortions occurring at or after the 22nd week of pregnancy, according to the Abortion Care Network. Just under 90% of all abortions are performed in the first trimester.

Since 2014, 136 independent abortion clinics have closed, bringing the nation-wide number down to 344 as of November 2019, according to the Abortion Care Network's 2019 "Communities Need Clinics" report published Wednesday morning. In the same time period, there have only been a "handful" of clinic openings.

Often independent clinics will serve areas where abortion access is limited. Of the six states with one provider, four are served by independent clinics: Kentucky, Mississippi, North Dakota and West Virginia. In four states — Arkansas, Nevada, Oklahoma and Georgia — independent providers are the only options for people seeking abortion after 10 or 11 weeks of pregnancy. In Louisiana, where an upcoming Supreme Court case could entirely eliminate abortion access, all three remaining providers are independent.

"Independent abortion providers are the only clinics in some of the states most hostile to abortion, including states like Mississippi and Kentucky, making them more vulnerable to targeted attacks by anti-abortion politicians and extremists," said Madsen. "Without these providers, meaningful access to abortion throughout pregnancy is merely a right in name alone."