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WASHINGTON — The U.S. Supreme Court will listen to arguments over a 2014 Louisiana abortion law Wednesday morning while thousands of abortion rights supporters and anti-abortion advocates rally outside the high court's chambers.

Louisiana's Act 620, which would require abortion providers to have admitting privileges at a nearby hospital in the state, is seen as the first major test for the landmark 1973 Roe v. Wade decision under a more conservative majority on the court.

While mostly technical in nature — arguments involve potential health complications for women seeking abortions, procedures doctors have to go through to obtain admitting privileges and questions over who has the right to challenge such restrictions — both sides see the law as an opening to begin scaling back abortion access in the country.

The Louisiana Legislature passed the law on an overwhelming bipartisan majority.

“In Louisiana, we’ve come to a point where it doesn’t matter if you are black or white, Democrat or Republican, male or female, we’re going to stand together in many areas — one of those areas is women’s health," said state Sen. Katrina Jackson, a Monroe Democrat who authored the bill as a state House member. "Who’s pushing this bill? Women.”

The law is being challenged by the Center for Reproductive Rights on behalf of the clinics that say the law is a threat to their very existence. 

“Our lawmakers claim they are doing this in the interest of women’s health. We know this isn’t true,” said Kathaleen Pittman, administrator at Hope Medical Group for Women, a clinic in Shreveport. “Our lawmakers have never prioritized women’s health.”

“We’ve been a part of the Shreveport community for 40 years; hopefully we will be around for many more," she added.

There are three abortion clinics in Louisiana — the one in Shreveport and one each in New Orleans and Baton Rouge. There were fewer than 10,000 abortions in the state in 2017, according to the most recent figures available through the Guttmacher Institute, a research and policy outfit that supports abortion rights and tracks statistics. The number has been relatively stable since 2014, when there were 10,150.

Although the state is well below the Southern regional average rate of abortions for women of child-bearing age, it has drawn significant interest in restrictions on the procedure. 

Louisiana currently bans abortion after 20 weeks and requires two doctors visits, 24 hours apart, before the procedure can be performed. The Legislature has since handily passed additional restrictions that hinge on favorable court rulings, including legislation that would limit abortion to about six weeks or would require a 72-hour waiting period.

The Supreme Court struck down a Texas law in 2016 that was nearly identical to Act 620, ruling it would create a “substantial obstacle in the path of a woman’s choice.”

But the court's make-up has significantly changed, and the state's legal team, under Attorney General Jeff Landry's leadership, argues there are enough differences from the Texas law that should allow Louisiana's to pass muster.

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Landry and others, who generally oppose abortion in most cases, have argued that the procedure can be dangerous if a doctor isn't allowed to follow the patient to a local hospital when complications occur.

"Women seeking abortions deserve better than that; they should have the same assurance of prompt and proper care in the event of complications," Landry, a Republican, said in a statement Tuesday. He didn't appear at a news conference with his supporters in Washington on the eve of the court hearing, citing the need to study the case.

Justices Neil Gorsuch and Brett Kavanaugh, both Trump appointees who have taken conservative positions in recent rulings, were not on the bench for the court's 5-3 Texas decision.

Just hours before the Louisiana law was set to take effect in February, the court narrowly voted for a temporary delay in its implementation. Gorsuch and Kavanaugh both sided with allowing it to go into effect, while Chief Justice John Roberts sided with the more liberal wing of the court — Justices Stephen Breyer, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan — on agreeing to the delay.

The court is unlikely to act for several months on a final decision.

Several other states, including Arkansas, Alabama and Indiana, are keeping a close watch to determine whether similar restrictions could survive a court test, creating a potential ripple effect if the court agrees to let the Louisiana law to stand.

“For me, this becomes about ensuring every woman has quality care," said state Sen. Regina Barrow, a Baton Rouge Democrat who also backed the 2014 law. “It makes sense that a physician should have admitting privileges.”

Abortion rights groups argue that admitting privileges, for which qualifications vary from hospital-to-hospital, can be onerous to obtain, particularly in areas where such a move could be politically polarizing. 

Julie Rikelman, the lead attorney for the Center for Reproductive Rights, said such restrictions are medically unnecessary because doctors and clinics already can work with local hospitals without meeting such restrictions, which in some cases include patient quotas and higher credentials.

“All of Louisiana’s arguments are completely contrary to precedent,” she said.

As a side to the central issue of whether abortion providers should be required to have admitting privileges, the law's supporters also argue that clinics shouldn't have a say in the law because it's aim is at women's health.

“The abortion industry should not be able to challenge this," said U.S. Rep. Mike Johnson, a Benton Republican and attorney who defended the law in district court before his political career. "They have a financial interest in making sure those practices are sub-standard.”

Email Elizabeth Crisp at ecrisp@theadvocate.com and follow on Twitter, @elizabethcrisp.