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Mississippi's only abortion clinic is fighting to remain open. State regulations have tightened around it and today, the fight over that clinic goes to court. A federal appeals court in New Orleans hears arguments in a dispute over a state law. The law requires abortion providers to have hospital admitting privileges. Mississippi is not the first state to try such a rule and also, not the first to see it tested in court.

NPR's Debbie Elliott reports.

DEBBIE ELLIOTT, BYLINE: The Jackson Women's Health Organization has long been a flashpoint in the abortion debate.

THE REV. DAVID LANE: Ma'am, won't you let your baby be born alive today? Give your baby life, ma'am.

ELLIOTT: Pastor David Lane, of Pro Life Mississippi, is peering through a wrought iron fence as patients enter the bright-pink clinic located in an art deco section of Jackson, just minutes from the Mississippi state Capitol. Lane says when he started protesting 30 years ago, there were several abortion clinics. Now, it's down to this last one.

LANE: We're hoping, and we're praying, this thing closes. Well, Mississippi will be first in something that's good, anyway, and that is no free-standing abortion mills. That's what we're after.

ELLIOTT: Anti-abortion groups have been fighting a war of attrition at the state level, with tighter restrictions on how abortion clinics operate.

GOV. PHIL BRYANT: Well, I want to thank the House and Senate leadership on this - another good bill for protecting the unborn in Mississippi...

ELLIOTT: Mississippi's Republican Gov. Phil Bryant last week signed a new law that bans abortions after 20 weeks' gestation. And he's vigorously defending the 2012 law that's before the 5th Circuit Court of Appeals today. It requires doctors who perform abortions in the state to be board-certified OB-GYNs, and to have privileges to admit patients at a local hospital.

BRYANT: We regulate restaurants. We regulate hotels, for health and safety purposes. And certainly, we ought to have the authority - and I believe we certainly do have the authority - to regulate a procedure such as an abortion.

(SOUNDBITE OF BEEPING)

ELLIOTT: Inside Jackson Women's Health Organization, there's growing uncertainly how much longer the doors will be open.

DR. WILLIE PARKER: So I didn't get to introduce myself. I'm Dr. Parker. I'm one of two physicians who comes to Mississippi to provide abortion care. As you know, there's an effort to try to close the clinic, and we're fighting to keep the clinic open.

ELLIOTT: Dr. Willie Parker flies in from Chicago, to perform abortions here. In this counseling session, he advises patients that the outcome of the appeal could change everything.

PARKER: What I don't want to do is gamble with your opportunity to have an abortion. So the safest thing for me to do is to advise you all to schedule for tomorrow.

ELLIOTT: Parker is a plaintiff in the lawsuit challenging Mississippi's law. He's a board-certified OB-GYN but has not been able to get admitting privileges at any of the 13 regional hospitals he applied to.

PARKER: Some, we received no response from but the ones that we did, they made reference to the fact that because the care that we provide is related to abortion, they felt that it might be disruptive to the internal politics as well as the external politics, for the hospital.

ELLIOTT: Parker says it's part of a strategy to gut the Supreme Court's Roe versus Wade decision legalizing abortion.

PARKER: Abusing the regulatory authority of states by making access to abortion so cumbersome as to be impractical, even when it remains legal.

ELLIOTT: BeBe Anderson is with the Center for Reproductive Rights, which is representing Dr. Parker. She says because there's only one clinic in the entire state, Mississippi's law amounts to a de facto ban on abortion.

BEBE ANDERSON: Under the Supreme Court's rulings, this law would definitely constitute what's called an undue burden because it would really block women's access to safe, legal abortion throughout the state of Mississippi. Therefore, it's unconstitutional.

TERRY HERRING: There is no constitutional right to bad medicine.

ELLIOTT: Terri Herring is director of the Pro Life America Network. She helped craft Mississippi's legislation and is hopeful it will withstand legal scrutiny.

HERRING: I think it's going to be hard for the court to decide that because Mississippi has one abortion clinic, that it should be allowed to be unsafe.

ELLIOTT: The 5th Circuit Court of Appeals has already upheld a similar admitting privileges law for abortion providers in Texas. But a federal judge has blocked Alabama's, pending a trial. The issue could ultimately be headed to the U.S. Supreme Court.

Debbie Elliott, NPR News.

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