A reproductive health clinic in South Bend, Indiana, was forced to cease abortion care on Friday after allegedly violating anti-choice measures passed by the GOP-controlled legislature in 2014.

The Women’s Pavilion is the last of Dr. Ulrich Klopfer’s clinics; his others in Gary and Fort Wayne have both been shuttered over the past two years.

Klopfer, who was unavailable for comment, was scheduled to attend hearings on his appeal last Wednesday in Indianapolis, but agreed to drop his appeal after reaching a settlement with the Indiana State Department of Health (ISDH). There are now six abortion providers practicing in Indiana and none in the northern part of the state, according to ISDH.

As part of the settlement, the state agreed to dismiss proceedings against Klopfer for his alleged legal violations, including failure to maintain proper records, if he gave up his abortion clinic license. He cannot re-apply for a license for 90 days.

One of the primary issues with the clinic was an alleged failure to comply with Indiana’s informed consent law and its forced waiting period, which requires patients seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins.

The Life Center, an anti-choice group, has offices next to the Women’s Pavilion, and its volunteers stand outside the clinic trying to coerce women against entering. Shawn Sullivan, an attorney for the Life Center, told Rewire that the forced waiting period and required in-person counseling make it easier for anti-choice volunteers to approach patients seeking abortions before their procedures, but that Klopfer was not following those rules.

“What we have at the Life Center is a group of people we call TLC Advocates, they do the sidewalk counseling. They reach out to the mothers knowing they are going in for counseling and that they will have the opportunity to think about the alternatives that we offer at he Life Center,” Sullivan told Rewire. “What ended up being the violations that would finally close the abortion clinic were the informed consent violations …. That’s how we got started with the complaint letters to the ISDH.”

Sullivan said the Life Center sent many complaint letters to ISDH, as the group believed Klopfer wasn’t complying with Indiana’s restrictive abortion laws. Though Life Center members claim responsibility for the closing, they are unhappy with the settlement, believing that Klopfer’s license should be permanently revoked.

Waiting periods aren’t the only obstacle to abortion access in Indiana. Gov. Mike Pence (R) last month announced a $3.5 million contract with the anti-abortion organization Real Alternatives, a Pennsylvania-based group whose stated purpose is to “actively promote childbirth instead of abortion.” Pence has been outspoken in his opposition to abortion rights during his time as governor.

In a statement regarding the termination of services at the Women’s Pavilion, Patti Stauffer, vice president for public policy at Planned Parenthood of Indiana and Kentucky (PPINK), said that four of Indiana’s 92 counties now have an abortion provider. Neighboring Michigan has a 24-hour forced waiting period, but no face-to-face requirement, so patients can print out the materials with a time stamp 24 hours in advance of their procedures. 

The Women’s Pavilion is remaining open for referrals and other services, but the nearest Indiana abortion clinic is 70 miles away in Merrillville. 

“Indiana’s regulatory environment is becoming increasingly anti-abortion,” Stauffer said in her statement. “Unfortunately this presents great barriers to access, particularly for low-income women who struggle with the burden and cost of longer travel distances and their responsibilities on the home front. Patient safety is paramount. Every new barrier increases risk to the patient.”