Last Wednesday, a federal judge in Alabama extended a temporary restraining order that prevents the state from enforcing the portion of a state law that requires every physician who performs abortions in the state to have admitting privileges at a nearby hospital.

U.S. District Judge Myron Thompson extended the order until April 2, as the court considers how to proceed next in the case.

Three clinics in the state sued to block the admitting privileges requirement, arguing that it is medically unnecessary and unconstitutional. The law also makes it a felony for a nurse, nurse practitioner, or anyone who is not a doctor to administer an abortion-inducing drug and requires abortion clinics to meet the same architectural standards as ambulatory clinics. Those provisions have not yet been challenged.

Those clinics claim the law will force them to close, while attorneys representing the state told the court there is no way to know the impact of the hospital admitting privileges requirement until the law takes effect.

Doctors and leading medical groups, such as the American Congress of Obstetricians and Gynecologists, oppose hospital admitting requirements like Alabama’s because they are unnecessary for the provision of safe, high-quality health care. Alabama law does not require doctors providing surgery at other health centers to have admitting privileges even for more complicated procedures, a fact challengers of the law argue shows that, despite what attorneys for the state claim, the admitting privileges requirement serves no legitimate medical purpose.

Attorneys for the state and the clinics challenging the law have asked the court to rule on the merits of their claims without a trial, but at a hearing last month, the court noted that avoiding a trial may be difficult since the parties had significant differences on the key facts of the case.

According to the clinics challenging the law, if the law is allowed to take effect it would force three of the state’s five abortion clinics to stop providing abortions since doctors at these clinics are unable to obtain hospital staff privileges  for a number of reasons, including that some hospitals are opposed to abortion or require that physicians admit a minimum number of patients. That would leave abortion clinics open in only Huntsville and Tuscaloosa, with none left in the state’s three most populous cities: Birmingham, Mobile, and Montgomery.