The North Dakota Senate voted today to force Red River Clinic, the sole public abortion provider in the state, to require all of its doctors to obtain admitting privileges at a local hospital, a move that the clinic fears could force them to stop providing abortion care. The Senate also voted to move an amendment that would grant legal rights to fertilized eggs to the voters of the state, despite the state as a whole rejecting abortion bans when put up for a vote.

These bills are just two of a handful of restrictions proposed in the state this year, all meant to come at the right to safe abortion care from every angle. With just one clinic left, it’s an onslaught on abortion—and even birth control and infertility treatments—that leaves reproductive rights advocates trying to weather the blows.

“Politicians in North Dakota are wasting taxpayer time advancing what would no doubt become another divisive constitutional amendment with dangerous unintended consequences for North Dakota families,” said Sarah Stoesz, President and CEO of Planned Parenthood Minnesota, North Dakota, South Dakota in a statement, responding to the movement of the “personhood” amendment. “Planned Parenthood will continue to fight these legislative attacks on women’s health in partnership with a broad coalition of doctors, patients, teachers, lawyers and other concerned North Dakotans who do not want to see politicians inserting themselves into the private medical decision-making of women and families in our state.”

Voters may be ready to reject a full out abortion and birth control ban when it comes before them, just as they have done in the past. But should the admitting privileges bill go into effect, it could end abortion in the state just as easily. Tammi Kromenacker, director of Red River Women’s Clinic told the Associated Press that in the last decade of operation, only one patient has been transported to the emergency room due to a complication, a fact that could actually make it more difficult to get hospital privileges.

Admitting privileges can be hard to get. Kromenaker said some hospitals require that doctors admit a certain number of patients to the hospital each year. A physician working at the clinic isn’t likely to reach any threshold, she said.

“Honestly, abortion is so safe, we just don’t admit patients to the hospital,” she said.

There are only two local hospitals to which Red River will be able to apply. Should the clinic be unable to provide abortions, many women in North Dakota would need to either travel to South Dakota or Minnesota, trips that would add at least four hours of travel in each direction on top of potential waiting periods as well.