Iowa regulators moved forward and approved a rule by the Iowa Board of Medicine this week that will effectively ban telemedicine abortion in the state.

Prior to the rule, Planned Parenthood of the Heartland offered abortion-inducing drugs at 15 rural clinics where there are no doctors on staff to meet with patients in person. Instead, the organization used an Internet video system that allowed a doctor, usually in Des Moines, to meet with the patients via video conference before giving them pills to end a pregnancy, with one dose to be taken at the office and the other by the patient at home. The new rule now requires doctors to be physically present with a patient when the drug is provided and requires a follow-up visit by the doctor. Supporters of the measure acknowledge it would effectively end the use of telemedicine abortion in many parts of the state.

The move comes as more and more states look to ban the use of telemedicine abortion. According to the Guttmacher Institute, 16 states have passed laws banning telemedicine abortion since 2011, though many of these laws have been blocked by the courts, the Associated Press reported. Iowa’s telemedicine program, passed in 2008, is believed to be the first in the nation and has been a target of anti-choice activists in the state for some time, so much so that Republican Iowa Gov. Terry Branstad made filling vacancies on the Iowa Board of Medicine with anti-choice supporters a priority of his administration.

The move also comes as the issue of states regulating the use of medicine-inducing drugs is likely to land before the U.S. Supreme Court. The Court is considering taking up Cline v. Oklahoma Coalition for Reproductive Justice, a challenge to an Oklahoma law that requires abortion-inducing drugs to be issued following Food and Drug Administration protocol and not off-label use. While the ban at issue in Cline is not a telemed abortion ban, it touches on many of the same issues at play in the fight in Iowa, including just how far states may go under the guise of “safety” and “patent protection” in regulating specific abortion-related procedures.

The rule, which is set to go into effect November 6, is also the subject of ongoing litigation. Planned Parenthood of the Heartland filed a lawsuit last week asking a Polk County, Iowa, district judge to block the rule change. According to the lawsuit, the rule change is a violation of both federal and state constitutional due process and equal protection rights.