A federal appeals court upheld key parts of Texas's strict anti-abortion law on Tuesday, a decision that could leave as few as seven abortion clinics in the nation's second largest state.
The decision by the 5th US Circuit Court of Appeals upholds requirements that abortion clinics meet hospital-level operating standards, which owners of small clinics say demand millions of dollars in upgrades they can't afford and will leave many women far from an abortion provider.
But the court said the clinics failed to prove that the restrictions would unduly burden a "large fraction" of women.
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Republican Gov Greg Abbott and other conservatives say the standards protect women's health. But abortion-rights supporters say the law is a thinly veiled attempt to block access to abortions in Texas, and they promised to immediately appeal to the US Supreme Court, which temporarily sidelined the law last year.
"Not since before Roe v Wade has a law or court decision had the potential to devastate access to reproductive health care on such a sweeping scale," said Nancy Northrop, president and CEO of the Center for Reproductive Rights, referring to the landmark 1973 Supreme Court decision that made abortion legal.
"We now look to the Justices to stop the sham laws that are shutting clinics down and placing countless women at risk of serious harm."
The ruling, made by a three-judge panel, is the 5th Circuit's latest decision in a lawsuit challenging some of the toughest abortion restrictions in the country.
The New Orleans-based court, considered one of the most conservative in the nation, allowed Texas to enforce the restrictions when abortion providers first sued in 2013, but the Supreme Court put the law on hold last year and ordered the 5th Circuit to reconsider.