For six years, my lawyers have been fighting a law that would have shut down the abortion clinic I run in Shreveport, Louisiana — Hope Medical Group for Women. On Monday, we won in the U.S. Supreme Court, which struck down the law, meaning we can stay open for our patients. I am relieved that the court saw through Louisiana’s deceitful attempts to shut us down, but I’m still deeply worried.

I wish the relentless attempts by politicians to shut down our clinic would finally stop. I know they won’t.

Our win was critical because it saves the few clinics remaining in Louisiana. When I started working at Hope Medical Group 28 years ago, we were one of 11 abortion clinics in Louisiana. Over the years, I’ve watched the other clinics disappear, wondering whether we will be next. Today, there are only three left to serve the roughly 1 million women of reproductive age in Louisiana. This is because of the seemingly endless laws designed to shut down clinics. Louisiana has more abortion restrictions than any other state in the country, 89 to be exact.

It should come as no surprise that these abortion restrictions disproportionately impact Black women and other marginalized communities. Women of color make up 70% of abortion patients in Louisiana, according to 2015 data, and they already face obstacles to accessing health care, as we’ve seen during the COVID-19 pandemic. Privileged people with resources will always be able to access abortion. Largely, it’s vulnerable communities who are being denied the ability to determine their futures and make decisions about their own bodies and families.

Vulnerable women face high obstacles

Many of the women we see each day have traveled hundreds of miles to reach us because there are so few clinics left. By law, our patients must wait 24 hours after their initial visit to the clinic before they can return to have an abortion. Th means many must pay for a hotel room or sleep in their car if they have one; take more time off work and lose wages; and pay for childcare if, like most of our patients, they have children. Given that 75% of abortion patients nationwide are poor or low-income, these are often insurmountable obstacles.

Abortion safety, not politics: I wrote Louisiana’s pro-life law. The Supreme Court ruled against women’s health.

And if that wasn’t enough, in 2016 the Louisiana Legislature passed a law that increased the waiting period to 72 hours, which would triple the height of this hurdle for patients. We are now challenging that law in court as well.

Try explaining these laws to the woman crying on the phone because she has bills due, children to care for and no means to get to a clinic once, let alone twice. The same woman who is afraid to take a few days off her low-paying job because she is one lost paycheck from total despair. Or the woman desperately trying to escape an abusive relationship. These women fuel me to keep fighting.

Our patients frequently ask why they must go to a clinic, often hours away from their home, to have an abortion. Why can’t they get an abortion at a doctor’s office or their OB-GYN? That would seem to make sense, especially because nearly 40% of abortions today are simply done by taking two pills.

Kathaleen Pittman in Washington, D.C., in March 2020. Center for Reproductive Rights

But Louisiana — and many other states — have made commonsense abortion policies illegal. The state forces physicians who provide five or more abortions a year to be licensed as an abortion clinic, meaning they must comply with a mountain of laws and requirements. It is a clever tactic: Prevent people from having an abortion anywhere but an abortion clinic, then pass every law imaginable to shutter those clinics.

Restrictions not about safety

The laws we must comply with are intentionally tedious, dictating even the size of our procedure rooms. The Louisiana Department of Health regularly shows up unannounced to conduct unwarranted, multiday inspections of our clinic, and they can revoke our license for any deficiency, no matter how insignificant. These kinds of exhaustive regulations do not exist for any other medical facilities or doctors’ offices. They only target abortion clinics, and they have nothing to do with improving care for our patients.

Research and evidence: Science prevails in Supreme Court ruling on abortion law that provided no medical benefit

Abortion is one of the safest outpatient medical procedures in the United States, according to a five-year study by Advancing New Standards in Reproductive Health. It should be treated no differently than other medical services, but in reality, being an abortion provider in the South means we must be more than just health care workers. We’re forced to fight every day just so we can do our jobs, whether that means fighting anti-abortion laws in court so our clinic can stay open, or consoling our patients after they’ve been harassed by protesters outside. Our physicians have even had protesters show up at their homes and private offices.

All too frequently, there are new anti-abortion laws passed that we must learn to comply with somehow. I have our lawyers at the Center for Reproductive Rights on speed dial and often call them multiple times a week to make sure the state has no excuse to shut us down.

Lawmakers claim that these restrictions are meant to protect women, that they care about their health and safety. That was the state’s argument in the case we won Monday. This is a laughable claim considering Louisiana has the highest maternal mortality rate in the country — and lawmakers have failed to act to reduce this rate. Maternal mortality has actually increased an alarming 28% in the past four years. The mortality rate for Black women is even more dire.

States have passed more than 450 anti-abortion laws since 2011, and the law struck down by the Supreme Court Monday was just one of them. This week we won the battle, and that means we can stay open to fight another day. But after working at an abortion clinic in the South for nearly three decades, I’m still just as frightened for the future.

If these laws keep piling up, it is not a matter of whether we will be forced to close, but when.

Kathaleen Pittman is the clinic administrator at Hope Medical Group for Women — an abortion clinic in Louisiana and the lead plaintiff in June Medical Services v. Russo.