In a controversial ruling Tuesday, nearly all Texas abortion clinics will now be required to meet hospital-like standards.
The 5th U.S. Circuit Court of Appeals does not believe this imposes an undue burden to most woman.
It will leave as few as eight abortion clinics in the state.
What's a victory for some, means a continuous battle for others.
"Where we go from here, is absolutely the U.S. Supreme Court," says Ana DeFrates, National Latina Institute for Reproductive Health.
When it comes to requirements of abortion clinics in Texas, controversy remains.
A federal appeals court upheld a key part of the abortion law, which requires all clinics to employ hospital-level operating standards.
"The legislature is allowed to ensure that those abortions are not done in a manner that puts the health and safety at risk," says Joe Pojman, Texas Alliance for Life.
Something that Texas Alliance for Life says has been long overdue.
"An ambulatory surgical center has an operating room, which is sterile, so that the surgery is done in a manner that prevents infections. That's very important for abortion, which is an invasive procedure," says Pojman.
Other requirements will include minimum sizes for rooms and doorways, as well as pipelines for anesthesia.
Opponents argue that these upgrades would cost millions of dollars that most clinics can't afford.
"This was never about quality of care, this was never about health and safety. Abortion is one of the safest procedures we have in this country. What this bill is actually about, is putting abortion care, safe and effective abortion care, out of reach for Texas women," says DeFrates.
Texas has about 17 abortion providers right now, down from 40 in 2012.
With Tuesday's ruling, NARAL Pro-Choice says only eight clinics would be left in Texas, most of them being in major cities.
This is raising concerns.
"Abortion will be less safe, less accessible and less effective. That's the real safety question for us," says DeFrates.
As well as trouble with accessing reproductive health care services, including cervical cancer screenings or family planning.
One exception to the hospital-like standards would be McAllen because of access.
The nearest abortion clinic for them is in San Antonio, more than 200 miles away.
"I'm very concerned about why the abortion industry would be willing to offer the people in the valley a lower standard of health care," says Carol Everett, The Heidi Group.
It's an issue that hits close to home for Carol Everett, who had an abortion when she was younger.
Something she regrets to this day.
"It destroyed me. I couldn't reconcile the fact that I killed my child but I found a way to justify abortion on a daily basis by selling abortions to other women," says Everett.
After seeing one death and 19 women needing major life-changing surgery because of an abortion, she fights for the protection of women.
"I work all day, every day to protect the health of women who choose abortion and to provide them opprotunities to choose life. You know, life is a choice after all," says Everett.
The Center for Reproductive Rights says Texas will be able to start enforcing the restrictions in about three weeks unless the U.S. Supreme Court agrees to halt the decision.