An abortion provider in Cincinnati, Ohio, is suing the state Department of Health (ODH), alleging that the department’s move to close the clinic was unreasonable and politically motivated.

The writ of mandamus, filed by the Lebanon Road Surgical Center on Tuesday, focuses on the reasoning behind the clinic’s impending closure: According to the lawsuit, the ODH arbitrarily revoked the clinic’s variance permit, which it needed by law, and then revoked the clinic’s license to operate because it no longer had a variance.

The writ is just the latest move in a battle that began in 2012 to keep the clinic open.

Ohio law requires that ambulatory abortion providers have agreements with local hospitals to transfer patients in the case of an emergency. Alternatively, the law also allows the clinic to operate with a variance permit, if the clinic can show it meets the standards of the law in another way.

The Lebanon Road clinic had been operating with a variance and in October 2012 submitted a request to renew both the variance and its license to operate. Later that month, the state Department of Health issued proposals both refusing to renew and revoking the clinic’s license. The clinic was allowed to stay open pending a hearing and final decision by the department director, the former of which was held in September 2013.

The following January, the ODH director denied the clinic’s request for a variance, and in a separate order denied its license renewal “based on its failure to obtain a written transfer agreement or variance.” The director’s decision has been in the appeal process since January, and a Hamilton County judge is scheduled to hear oral arguments this Friday.

The Lebanon Road clinic says that the director faced significant political pressure to close the clinic, thus preventing him from acting based on his own discretion as a medical professional. According to the lawsuit, the ODH received 240 emails from anti-choice advocates asking that the clinic’s license be revoked. The results of an open records request revealed that the Ohio Department of Health “cleared its response” to the emails “with the Governor’s office and reveal ongoing communications among [the Department], the administration, and Ohio Right to Life about LRSC’s license.”

The lawsuit also says that political pressure and the culture of hostility toward abortion in the state makes finding a transfer agreement with a local hospital increasingly difficult for abortion providers. In a letter submitted as evidence in the case, the CEO of the Christ Hospital, located in Cincinnati, illustrates this point in explaining why the hospital won’t come into a transfer agreement. The letter reads:

We are not able to execute formal transfer agreement with the Lebanon Road Surgery Center given the significant negative messages we have received from the community and the public’s access to those agreements under the Ohio Open Records Act. It is unfortunate that Ohio is now requiring a separate transfer agreement.

An investigation by the Cincinnati Enquirer in February found that “from the start, top officials in the health department were involved in the license review process, directing [ODH staff] not to follow normal practices.” A retired ODH regulator, Roy Croy, told the Enquirer that the department was “looking for anything” to close the clinic, and that “I was pretty sure that when it came time for renewal of the license that it was going to be very unlikely that it would be renewed.”

The struggle to remain open in the face of coordinated political attacks is one that has already plagued clinics across the state. The Ohio Department of Health recently revoked the license of a Toledo-based provider because the clinic did not hold an agreement with a nearby hospital. The Toledo clinic has since appealed the decision.