The Virginia Board of Health on Thursday voted to amend some of the state’s strict anti-abortion regulations that subject clinics to the same architectural standards as hospitals. The regulatory process set in motion by the 13-2 vote can take up to two years to complete, but could result in the effective reversal of the law, which threatens to close the state’s 18 abortion clinics.

The targeted regulation of abortion providers (TRAP) law has been mired in controversy from the beginning. In 2013, Republican Gov. Bob McDonnell signed the law, which mandated clinics that perform five or more first-trimester abortions per month conform to the same architectural standards as hospitals.

The law applied to every abortion clinic (though not any other outpatient surgical clinic), meaning facilities already built would have to undergo building renovations to operate lawfully.

The architectural requirements included the presence of five-foot wide hallways, treatment rooms of a certain size and type, covered front entrances, public telephones and drinking fountains in waiting rooms, and specific new ventilation systems.

The health board, which must approve regulations to the state health code, had originally amended the rules to grandfather in already-existing clinics. After significant pressure from the McDonnell administration, including a letter from the ultra conservative then Attorney General Ken Cuccinelli threatening to deny the board funding for legal counsel for lawsuits that he assured would follow, the board approved the regulations without that amendment.

The board of health’s commissioner at the time, Karen Remley, left her position after receiving the letter, citing the abortion restrictions in her resignation.

After being elected to the governor’s mansion last year, Democrat Terry McAuliffe in May asked the state Department of Health to review the law.

“The regulations enacted last year placed unprecedented construction requirements on these facilities,” McAuliffe said in the executive order requesting the review, “and I am concerned that these new restrictions may negatively impact women’s access to necessary health services.”

The department of health’s commissioner in October published recommendations to amend the law. The Virginia Board of Health’s Thursday vote approves the commissioner’s recommendations, allowing the state to craft and move forward with an amendment.

“These laws were designed with one purpose in mind: to shut down women’s health centers and prevent patients from accessing safe and legal abortion along with the comprehensive preventive health-care services that women’s health-care centers provide,” Katherine Greenier, the director of the ACLU’s Reproductive Freedom Project, told Rewire in October.

Three abortion clinics closed in Virginia as a result of the law.

“We are absolutely thrilled with the Board’s vote to move forward with amendments to medically-inappropriate restrictions on women’s health centers,” Tarina Keene, executive director of NARAL Pro-Choice Virginia, said in a statement after the vote on Thursday. “The Board’s decision today is a first, crucial step towards ensuring that these politically-motivated restrictions are revised, and that our safe, trusted women’s health care centers can remain open and accessible for Virginia’s women and families.”