In what women’s health advocates are hailing as a victory, the U.S. Supreme Court has decided not to weigh in on a lower court decision that prevented Indiana from stripping funding from the state’s Planned Parenthood clinics. By declining to hear the case on Tuesday, the nation’s highest court has ensured that Indiana will remain unable to defund the national women’s health organization.

Indiana was the first state to target Planned Parenthood by banning it from receiving state-level Medicaid funds, a tactic that anti-abortion politicians have increasingly used in their ongoing crusade against the organization. In 2011, Gov. Mitch Daniels (R-IN) signed a law to cut off the Medicaid dollars that finance Planned Parenthood’s general health screenings for thousands of low-income women in Indiana.

But the courts have consistently held that discriminating against qualified Medicaid providers simply based on their position on abortion rights is unconstitutional. Even though Indiana’s 2011 law inspired a rash of similar legislation in states like Arizona, North Carolina, Kansas, and Tennessee, all of those efforts to defund Planned Parenthood have been blocked in court. A notable exception is Texas, where anti-choice officials opted to forfeit all of the federal funding for their Medicaid program in order to kick Planned Parenthood out of the program.

Cecile Richards, the president of Planned Parenthood Action Fund, noted that the most recent court decision regarding Indiana should send a clear message to anti-choice lawmakers. “Politicians in all 50 states should take note: blocking Planned Parenthood from funding to provide preventive health care is both unlawful, and deeply unpopular,” Richards pointed out in a press release. “Over and over again, courts have said that states cannot block people from getting preventive health care at Planned Parenthood, and the vast majority of the American public agrees.”

Planned Parenthood estimates that one out of every five women in the United States has visited one of the organization’s health clinics at some point in her life. Indeed, recent research from the Guttmacher Institute has demonstrated that women rely on publicly-funded family planning clinics as their primary care provider — and many of those women say they don’t seek out health care anywhere else because Planned Parenthood better provides for their reproductive needs.

The current situation in Texas provides a stark illustration of what happens to those women when they can no longer use their Medicaid insurance to visit Planned Parenthood: they’re forced to look for new doctors, and many of them simply forgo family planning services altogether. Nonetheless, lawmakers hostile to abortion rights continue to push to defund the organization. Just last week, in the aftermath of the devastating damage from two tornadoes, Oklahoma legislators voted to strip funding from Planned Parenthood.

On Monday, illegal abortion provider Kermit Gosnell was convicted of first-degree murder for the barbaric crimes he committed in his unsanitary Philadelphia-area clinic. Throughout his high-profile murder trial, anti-choice activists claimed that Gosnell’s case proved that abortion is always an inherently dangerous procedure — attempting to conflate incredibly late-term abortion services with first-trimester medication abortions. Even though their claims often fly in the face of scientific fact, abortion opponents have been largely successful at obscuring the medical realities of different types of abortion procedures.

That’s partly why restrictions on the abortion pill, which is medically known as mifepristone, are advancing across the country. Despite the fact that mifepristone is perfectly safe for women to take outside of the doctor’s office — an option that many women prefer, since it allows them the added privacy of taking the medication in their own home — anti-choice Republicans claim that more restrictions are necessary to protect women’s health. But these kind of restrictive state laws actually drive up the cost of the abortion pill, and don’t do anything to improve reproductive health care.

Here are five states where anti-abortion lawmakers are advancing medically unnecessary restrictions on the abortion pill, ultimately inserting themselves between a woman and her doctor:

1. MISSOURI: On Monday, Missouri lawmakers gave final legislative approval to HB 400, a measure that requires doctors to be physically present to administer the first dose of mifepristone and schedule an in-person follow-up appointment two weeks later. Critics of the legislation say it will interfere with women’s relationships with their doctors, as well as impose a serious burden on the women who must travel from different parts of the state to terminate a pregnancy. According to Paula Gianino, the CEO of Planned Parenthood for the St. Louis region and southwest Missouri, about 1 in 5 patients seeking an abortion at her clinic travel at least 100 miles.

2. NORTH CAROLINA: Anti-choice Republicans in North Carolina are currently pushing a package of anti-abortion bills intended to limit reproductive rights from several different angles. The most far-reaching measure is SB 308, which would require the clinics that administer medication abortions to adhere to the same standards as surgical facilities, including making costly updates to the building and requiring physicians to obtain admitting privileges from local hospitals. That’s a common method of attacking abortion clinics, and it often forces them to either stop providing the abortion pill or shut down altogether.

3. INDIANA: Earlier this month, Indiana lawmakers successfully pushed through SEA 371, a measure that is solely intended to prevent a Planned Parenthood clinic in the state from providing the abortion pill to its patients. Just like North Carolina’s proposed bill, the new law in Indiana requires clinic that administer medication abortions to make costly and unnecessary updates to their facilities under the guide of “protecting women’s safety.” When Gov. Mike Pence (R) signed the bill into law at the beginning of May, he repeated the popular anti-choice myth that the abortion pill is “dangerous” — despite all scientific evidence to the contrary.

4. MISSISSIPPI: At the end of April, Gov. Phil Bryant (R) approved SB 2795, which will require women to take the abortion pill in the presence of a physician as well as come in for a follow-up physical examination two weeks later. The measure takes effect on July 1 of this year — and it could represent a significant burden for women in the state. There’s only one abortion clinic left in all of Mississippi, and it’s fighting to remain open as anti-choice Republicans keep trying to shut it down.

5. LOUISIANA: Last month, the Louisiana Senate approved SB 90, a measure that would require a doctor who has completed a residency in obstetrics or gynecology to be physically present when administering medication abortions. If the bill becomes law, doctors who violate the new rule could be fined $1,000, imprisoned for two years, or both.

Requiring doctors to be physically present to administer the pill, even though most clinics don’t currently use that protocol, is a thinly-veiled attempt to ban abortion procedures conducted with the help of internet technology. Allowing doctors to prescribe mifepristone over a video conference helps improve low-income and rural women’s access to abortion services, since they may not be able to make a long trip to the nearest abortion clinic. Studies have shown that this type of abortion procedure is safe and effective. Nonetheless, anti-choice lawmakers continue to launch attacks at so-called “webcam abortions.”

On Wednesday, Indiana Governor Mike Pence (R) signed a measure that is solely intended to shut down abortion clinics, and will almost certainly force one of the state’s Planned Parenthood health centers to stop providing abortion care. And as the governor added his signature to the legislation, he justified his support for the new clinic restrictions by repeating a scientifically inaccurate talking point about early abortion services.

Indiana’s new law is part of a broad national trend to indirectly limit women’s reproductive access by attacking abortion providers, imposing unnecessary restrictions on abortion clinics under the guide of “protecting women’s safety.” So it’s no surprise that Pence justified his decision to sign the anti-choice bill into law by relying on this type of logic.

But the governor went a step further, asserting that the tightened clinic rules are necessary because the mifepristone abortion pill — a method that allows women to safely terminate an early pregnancy without undergoing a surgical procedure — is actually a “dangerous” medical practice. “Abortion-inducing drugs can be very dangerous, and must be prescribed under conditions that ensure proper medical care,” Pence said in a statement. “This new law helps accomplish that goal. I applaud both chambers of the General Assembly for passing this legislation.”

That assertion is not actually based in scientific fact. The abortion pill is an FDA-approved medication that has been used safely around the world since 1981. The American College of Obstetricians and Gynecologists recommends mifepristone as a “highly effective” method of terminating a pregnancy within the first 9 weeks. Several studies have found that the rate of complications for this type of early abortion service is less than two tenths of a percent.

And medical experts agree that unnecessary abortion clinic regulations, like Indiana’s new law, don’t actually accomplish the goal of keeping women safer — in fact, they actually do just the opposite. “Anyone who talks about the dangers of abortion is just blowing smoke,” Dr. David Grimes, the former chief of abortion surveillance at the CDC, recently told Bloomberg Businessweek. “These kinds of regulations do nothing to advance women’s health. All they do is drive up the cost of care and cause women to delay, which drives up the risks.”

Nevertheless, abortion opponents have worked hard to obscure the scientific realities of abortion by conflating illegal, incredibly late-term surgical procedures with first-trimester medication services. Anti-choice activists often attempt to play to Americans’ emotions by making the case that every single abortion procedure is a violent, invasive act — even though that’s not actually rooted in fact, since nearly 90 percent of all abortions occur in the first trimester.

On Wednesday morning, Indiana Gov. Mike Pence (R) approved Senate Enrolled Act 371, a measure that imposes unnecessary restrictions on non-surgical abortion clinics with the specific goal of forcing a Planned Parenthood location to end its abortion care. Planned Parenthood of Indiana, in conjunction with the ACLU, has vowed to fight the new law and will very likely challenge it in court.

Since the fight to pass SEA 371 is a prime example of the way that anti-choice lawmakers strategically advance this type of legislation — known as the Targeted Regulation of Abortion Providers, or TRAP — it’s worth looking back at the history of the bill to track its successful course through the state legislature.

The legislation was always intended to limit access to medication abortions, which allow women to safely terminate an early pregnancy by taking the RU-486 abortion pill rather than having a surgical procedure. But when it was first introduced in February, it was even more stringent. In its original form, SEA 371 would have required women to undergo two invasive, medically unnecessary transvaginal ultrasound procedures, both before and after taking the RU-486 pill. Predictably, that provision erupted into controversy. Ever since Virginia garnered national attention for its own forced transvaginal ultrasound bill at the height of last year’s outcry over the GOP’s “War on Women,” that type of vaginal probe has become somewhat of a symbol of anti-choice politicians’ overreach into women’s personal medical decisions.

Abortion opponents in Indiana didn’t want to drop their measure altogether, but they did want to assuage the public outrage. So the Indiana Senate removed the bill’s second ultrasound requirement, amending the provision to require just one probe, to ensure its passage. A month later, a House committee removed the other requirement as well, dropping the forced transvaginal provision altogether. At the time, the Associated Press reported that the head of the state’s major anti-choice group, Indiana Right to Life, explained that they agreed with the decision to drop the ultrasound requirement from SEA 371 because “debate over it in the state Senate had taken focus away from its goal of tightening regulations on clinics that provide abortions.”

That’s a common tactic for the anti-choice lawmakers who are pushing through an ever-increasing number of stringent abortion restrictions on the state level. By proposing far-right legislation and then agreeing to soften it, legislators are able to position their anti-abortion bills as more reasonable and moderate. This dynamic played out in Arkansas earlier this year, when the legislature began considering an extreme “fetal heartbeat” bill that would have banned abortions after just six weeks of pregnancy. After amending the bill to push the cut-off back to 12 weeks — which is still a blatantly unconstitutional attack on reproductive rights — it seemed as though lawmakers has compromised. The bill passed.

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Last month, Indiana Republicans proposed a measure intended to shut down a Planned Parenthood clinic in the state. The original SB 371 legislation also contained a clause that would have required women taking the RU-486 abortion pill to undergo two invasive transvaginal probes — one before taking the pill, and one after. But ever since the transvaginal ultrasound provision first erupted into controversy, the state’s GOP has been working to scale it back, hoping to assuage public outrage and quietly shepard the rest of the anti-choice legislation’s passage into law.

At first, the Indiana Senate removed the bill’s second ultrasound requirement to ensure its passage. And now, a House committee has removed the first ultrasound requirement too, dropping that aspect of the legislation altogether. According to an Associated Press report, “Indiana Right to Life president Mike Fichter says the group agreed with the decision to drop the ultrasound requirement because debate over it in the state Senate had taken focus away from its goal of tightening regulations on clinics that provide abortions.”

Now that abortion opponents have conceded to public pressure on the invasive forced ultrasound measures, the rest of SB 371 could seem moderate in comparison. But the anti-choice legislation would still have far-reaching consequences for women’s reproductive rights in the state.

Indiana lawmakers are pursuing a popular right-wing strategy for limiting abortion access: Indirectly restricting abortion by imposing costly, unnecessary requirements on abortion clinics with the intention of forcing them to close their doors. SB 371 would force health clinics that prescribe the abortion pill to adhere to the same standards as surgical clinics, even though medication abortions are not actually surgical procedures. It’s a direct attack on a Planned Parenthood clinic that provides the RU-486 to patients seeking to terminate a pregnancy during the first trimester, since that clinic would likely not be able to comply with the new restrictions.

Women’s health advocates consider these type of abortion restrictions to be some of the most dangerous assaults to women’s health — because they can take effect fairly quickly, they effectively limit women’s abortion access, and they often fly under the radar without inspiring the same kind of outrage that other laws, like transvaginal ultrasound requirements, do. That’s exactly why Indiana Republicans are willing to sacrifice mandatory ultrasounds to focus on their real “goal.”

The Indiana senate advanced a measure on Tuesday to require all women to undergo an unnecessary, and potentially invasive, ultrasound procedure before taking the RU-486 abortion pill.

The original version of the bill actually mandated two tranvaginal ultrasounds — before and after women took the pill. Yesterday, before the Senate vote, GOP lawmakers agreed to remove the second ultrasound requirement to ensure the legislation’s passage. Their efforts were successful. Despite bipartisan opposition as four Republican state senators broke from the rest of their party to oppose SB 371, the measure will now advance to the GOP-controlled House:

The bill passed on a 33-16 vote despite a chorus of complaints from opponents who said it’s a step too far into doctors’’offices without improving their patients’ health.

“This bill is not about patient safety. It’s about patient harassment,” said Sen. Vaneta Becker of Evansville, who was one of only four of the Senate’s 37 Republicans to join the 12 Democrats who opposed the bill.

Now, Senate Bill 371 heads to the House, where Republican Speaker Brian Bosma of Indianapolis said he expects it to win passage as well — perhaps after some changes.

And this legislation has another anti-choice provision tucked into it, too. SB 371 also seeks to over-regulate abortion providers — requiring health clinics that prescribe the abortion pill to adhere to all of the same standards as surgical clinics, even though medication abortions are not surgical procedures — which threatens to shut down a Planned Parenthood clinic in the state.

“This bill is directly targeted to Planned Parenthood in Lafayette,” state Sen. Becker (R) pointed out in the debate on the floor. “When you do this, you’re not doing anything that will improve the health and safety of low-income women in the state of Indiana. All you’re doing is forcing them to go other ways — in particular, to the Internet — to get this same particular drug that you’re talking about regulating.”