Kentucky's last abortion clinic fights to stay in state

Escorts stand outside of EMW Women's Surgical Center in Louisville, Ky., the last abortion clinic in the state. The center is embroiled in a legal battle with the state over requirements to stay open. (Reuters/Chris Kenning)

Kentucky’s lone abortion clinic is fighting to survive.

The EMW Women’s Surgical Center is Kentucky’s last remaining abortion clinic – and if it doesn’t win its legal battle, Kentucky could be the first state in the nation without an abortion clinic in the modern era.

The entire legal battle, which began in U.S. District Court Wednesday, is centered on a state law that requires the abortion clinic to have agreements with a hospital and ambulance service in the event of an emergency with one of its patients. EMW Women’s Surgical Center has said that it had such agreements.

But Kentucky state regulators noted technical deficiencies in the agreement which they called “important safeguards” that protect women’s health. They've threatened to revoke the clinic’s license.

The licensing fight began in March when Gov. Matt Bevin’s administration said the clinic lacked proper transfer agreements and took steps to shut it down. The clinic countered with a federal lawsuit to prevent the state from revoking its license.

A temporary restraining order was issued in March to keep the clinic open until a judgment is decided in the case, according to the American Civil Liberties Union (ACLU), which is part of EMW Women’s Surgical Center’s legal team.

“The stakes in this case couldn’t be higher: the very right to access legal abortion in the state of Kentucky is on the line,” Dr. Ernest Marshall, founder of the clinic, said in a statement provided to Fox News. “Will we build on the momentum of last year’s Supreme Court decision upholding abortion rights? Or will Kentucky be the harbinger of a future where the right to abortion only exists if you live in the right zip code?”

In this Monday, July 17, 2017, photo, Dr. Ernest Marshall, owner of the EMW Women's Surgical Center, poses for a photo at the door of the clinic in Louisville, Ky. The clinic is the last in Kentucky offering abortion procedures and is facing a legal challenge from state officials and a major protest from a national anti-abortion group that wants it shut down. (AP Photo/Dylan Lovan) (AP)

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A spokesperson for Bevin told Fox News that the requirements in question were enacted in 1998 and were not questioned before now.

“Essentially all healthcare facilities in Kentucky are required to have such agreements, and it is telling that the abortion industry believes that it alone should be exempt from these important safety measures,” Amanda Stamper, Bevin’s communications director, said, adding that EMW Women’s Surgical Center’s sister location in Lexington, Ky., was shut down in 2016 because “it was filthy and didn’t even have a license.”

The Kentucky National Organization for Women on its Facebook page said the Lexington clinic was a "permanent casualty" of Bevin's administration.

The state’s legal team has said that simply being able to dial 911 isn’t enough for the clinic as “that does not provide the protection for women deemed necessary by the Kentucky General Assembly and does not satisfy the law of Kentucky.”

Bevin, Kentucky’s Republican governor, is staunchly anti-abortion and billed himself as “pro-life, pro-family and pro-2nd amendment” on his campaign website. And the ACLU has pointed to his anti-abortion stance as proof that the fight with the clinic is “an attempt to ban abortion in Kentucky.”

"It is telling that the abortion industry believes that it alone should be exempt from these important safety measures."

— Amanda Stamper, communications director for Gov. Matt Bevin

“The state’s bureaucratic sleight of hand is fooling no one,” Brigitte Amiri, a senior staff attorney with the ACLU’s Reproductive Freedom Project, said in a statement in March. “This is an attempt to ban abortion in Kentucky, plain and simple. We are fighting to keep this from happening.”

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The clinic maintained in its lawsuit that the state’s “about face” on its compliance with requirements came “out of the blue.” It argued that there is no medical need for the state’s requirements and claimed the requirements infringe on constitutional protections.

Marshall, too, accused the Kentucky legislature and Bevin for being “relentless in trying to stop us from providing abortion care.”

“The patients that walk through our doors have already dealt with so many obstacles: many have traveled long distances to get their abortion, they’ve had to take time away from work, usually unpaid, find childcare and transportation, and figure out how to pay out-of-pocket for care that isn’t covered by their insurance,” he said.

Planned Parenthood of Indiana and Kentucky was also allowed to join the lawsuit on behalf of EMW Women’s Surgical Center, the Courier-Journal reported in June.

"It is very troubling that Planned Parenthood has shown so little concern for women’s safety," Stamper told Fox News.

Republian state Rep. Addia Wuchner defended the state’s transfer agreements for medical facilities as “pro-woman.”

“There is nothing more pro-woman than ensuring all women that very same quality and standard of healthcare, and it would be irresponsible and immoral to do otherwise,” Wuchner, who sits on the House’s Health and Family Services Committee, told Fox News.

"The transfers agreements required by Kentucky law are not barriers to care but are standards of care, in place to ensure any patient receiving care in an ambulatory surgery center, healthcare clinic or an abortion clinic [have] appropriate emergency care and expedient transfer to a healthcare facility capable of responding to a life threatening emergency,” she said.

This lawsuit is one of two the abortion clinic has against the state. Another suit – detailed by the ACLU – is challenging a Kentucky law that requires doctors to provide ultrasounds to women before having an abortion.

The case is expected to last a couple of days.

The Associated Press contributed to this report.