The sun has just begun to rise, but outside an abortion clinic known as the EMW Women’s Surgical Center in Louisville, KY, protesters have already begun to assemble. Signs in hand, they boast pictures of fetuses and slogans preaching Biblical messages:

“You’re going to hell!”

“Babies are murdered here!”

As harsh as these messages are, they are not an uncommon sight. EMW is the last remaining abortion clinic in the state of Kentucky and a point of focus for the fierce pro-life advocacy movement in the area.

An abortion clinic is defined as a facility in which more than half of patient visits are for abortion services. Since abortion was legalized nationwide by Roe v. Wade in 1973, hundreds of clinics opened their doors to women seeking help.

However, in recent years, the number of facilities has declined: in 1996, 452 clinics were open in the United States. Nine years later, in 2005, surveys revealed that the number had dropped to 381. Fast forward to 2014 and only 272 remained throughout the country.

Faced with increased legal regulations, clinics have often been forced to shut down. Legislation, commonly referred to as TRAP laws (Targeted Regulation of Abortion Providers), correlates directly with the decrease in clinics. The Center for Reproductive Rights explained that “some TRAP laws require that abortions be performed in far more complicated and expensive facilities than are necessary to ensure the provision of safe procedures.”

Simply put, the clinics cannot keep up with the costs of the ever-increasing standards. Not to mention, according to Rachel K. Jones, principal research scientist at the Guttmacher Institute, doctors willing to provide such services are becoming harder and harder to find.

In the past two decades, the National Abortion Federation states that 11 doctors have fallen victim to anti-abortion extremists with another 26 targeted. More facilities, 39 to be exact, have been destroyed by arson and explosives.

Women entering these clinics, for a range of reasons, have to be escorted from the moment they leave their cars to when they set foot within the sanctuary of the clinic—but that doesn’t stop the vicious verbal onslaughts from protesters.

The women entering these clinics are already making an incredibly difficult decision, only to be jeered at and belittled by members of the pro-life movement. They are labeled as murderers, despite the fact that some of them are victims of incest, rape, or cannot support a child financially or emotionally.

It is not a choice made lightly.

Anna Collins, a 32-year-old woman from Kentucky, learned she was pregnant at 20, and took days to make the decision. She was just a young adult working a minimum-wage job, struggling to make ends meet on her own. The responsibility of raising a child was incomprehensible. Today, she is a successful business owner and philanthropist; neither of which would have been possible had she chosen to proceed with the pregnancy.

The freedom of choice is an important one, something America has prided itself on since day one. The landmark Supreme Court case of Roe v. Wade in 1971 clearly states that this freedom included a woman’s right to her personal medical decisions sans interference from politicians.

The close of EMW is a dark cloud on the horizon—one that would render hundreds of women helpless and without a choice. Programs founded in order to shuttle patients to states lacking the airtight regulations of Kentucky, such as the Kentucky Health Justice Network, are already stretched for funding—not for lack of business.

There is little stopping other states from following suit; Roe v. Wade need not even be overturned to deem abortions illegal. Planned Parenthood statistics show that prior to legalization in 1965, illegal abortions made up one-sixth of all pregnancy and childbirth related deaths.

A ban on abortions would undoubtedly be a step backwards. This would place women in a revived era of dangerous back-alley procedures.

“All it [would take] is more state restrictions,” says Dona Wells, co-founder of EMW. Meanwhile, Collins, and many others, fear that the freedom they possessed may be coming to an end, leaving hundreds of women without a choice.