Kentucky's "unapologetically pro-life" governor and the state's last abortion clinic will square off on Wednesday in a federal courtroom in a case that could make it the first U.S. state without an abortion provider.
In a three-day trial, the state will argue before a U.S. District judge in Louisville that EMW Women's Surgical Center does not have proper state-required agreements with a hospital and an ambulance service in case of medical emergencies.
The clinic, which earlier this year filed suit to stop the state from revoking its license, wants to overturn the regulations it says are unnecessary and create an unconstitutional barrier to abortion.
"In 37 years providing abortion, I've seen more than a dozen clinics close down in our state, and now ours is the last clinic standing in the entire state," Ernest Marshall, a doctor and EMW clinic founder, said in a statement.
"The very right to access legal abortion in the state of Kentucky is on the line," he added.
The case could test court interpretations of last year's U.S. Supreme Court ruling that struck down parts of a Texas law that required clinics to meet hospital-like standards and for clinic doctors to have admitting privileges at nearby hospitals.
Despite that ruling, conservative legislatures and Republican governors such as Kentucky's Matt Bevin have continued to tighten new regulations on abortion clinics.
U.S. state legislatures enacted 41 new abortion restrictions in the first half of 2017, according to the Guttmacher Institute, a reproductive health think tank that supports abortion rights.
Abortion rights groups say that has reduced access to abortion, particularly in rural areas of the South and Midwest. Kentucky is among seven U.S. states with just one clinic left.
Bevin, whose administration waged a licensing battle in 2016 that led to the shutdown of a Lexington clinic, argued the transfer agreements in question were meant to protect women.
"It is telling that the abortion industry believes that it alone should be exempt from these important safety measures," said Bevin spokeswoman Amanda Stamper.
EMW, which is the site of almost daily protests, argues that hospitals are already legally bound to accept any patient in an emergency and local EMS will transport patients without such agreements.
Planned Parenthood of Indiana and Kentucky joined the suit because it said the same transfer agreements were used to block a license for a facility in Louisville. The American Civil Liberties Union is providing legal help to the clinic.
(Reporting by Chris Kenning; Editing by Andrew Hay)