SALT LAKE CITY (AP) — A Utah law that would ban abortion clinics has been challenged in state court by abortion advocates who argue it effectively prohibits abortion in the deeply conservative state.

While abortions remain legal up to 18 weeks of pregnancy in Utah, the Planned Parenthood Association of Utah and the ACLU of Utah said in a Monday news conference that limiting abortions to licensed hospitals would dramatically reduce access to treatments, as roughly 95% of abortions in Utah are provided at clinics.

“Honestly, there are no realistic alternative locations for Utahns to continue to get this really essential health care,” said Sarah Stoesz, the president-CEO of Utah’s Planned Parenthood affiliate. “This law wouldn’t just ‘shift care’ to hospitals — as some politicians are cynically maintaining. In fact, it would functionally eliminate access to abortion in Utah, putting the lives and health of people at risk.”

Planned Parenthood and the ACLU’s legal challenge asks the court to delay the implementation of the law until the courts rule on its legality. It was signed by Republican Gov. Spencer Cox last month after passing through the Republican-led statehouse, where supporters argued Utah wouldn’t need licenses for abortion clinics when courts rule in their favor and limit abortions to only exceptional and emergency circumstances.

Still, the signing of the law last month set off a rush of confusion among clinics, hospitals and prospective patients, who are already navigating a raft of overlapping trigger laws and legal challenges in Utah. It’s set to take effect May 3, at which time abortion clinics will no longer be able to apply to be licensed. It institutes a full ban on Jan. 1, 2024 through stripping all clinics of their licenses.

Though state officials have said clinic licenses will remain until that time, Planned Parenthood attorney Hannah Swanson said “confusing licensing provisions” would force clinics to stop providing abortions on May 3 unless the court intervenes. She said Planned Parenthood was concerned about sections of the 1,446-line bill that they believe make providing abortion a crime on that date.

Republican lawmakers said last month that Planned Parenthood’s claims about the legislation were inaccurate. State health officials, in response to a question about currently licensed clinics, directed The Associated Press to licensing rules that do not require abortion clinics to pursue new licenses for the time being.

Rep. Karianne Lisonbee, the legislation’s Republican sponsor, said the law was a byproduct of working with doctors and hospitals to “strike the best balance of protecting innocent life and protecting women who experience rare and dangerous complications during pregnancy.”

The law has wide-ranging implications while the courts sort through legal challenges to other abortion restrictions passed by Utah lawmakers. Last year’s US Supreme Court ruling overturning Roe v. Wade triggered two pieces of legislation passed years prior designed to go into effect should the court roll back the constitutional right to abortion. In 2019, lawmakers passed a ban on abortion after 18 weeks and in 2020, a ban on abortions regardless of trimester, with several exceptions including for instances where maternal health is at risk, as well as in cases where rape or incest is reported to the police.

Utah’s Planned Parenthood affiliate sued over the 2020 ban, and in July, a state court delayed implementing it until legal challenges could be resolved. The 18-week ban has since been a de facto law, though Stoesz said on Monday that the clinic law would be tantamount to a full ban on abortions should it take effect.

She warned that the state’s hospitals weren’t designed or equipped to accommodate the patients who had sought comparatively affordable care at specialty clinics for decades. The Utah Hospital Association has yet to answer questions on their plans to adapt to the new legal landscape.

Utah’s turmoil mirrors developments in Republican strongholds throughout the United States that have taken shape since the US Supreme Court overturned Roe v. Wade transformed the legal landscape and prompted a raft of lawsuits in at least 21 states.

Planned Parenthood operates three of the state’s four abortion clinics and said they do not plan to discontinue the majority of non-abortion services they provide — including tests and screenings for pregnancy, cancer and sexually transmitted infections.

The new restrictions are most likely to affect those seeking to terminate pregnancies via medication because they account for the majority of abortions in Utah and the United States. Abortion medication is approved up to 10 weeks of pregnancy, mostly prescribed at clinics and, since a pandemic-era FDA rule change, increasingly offered via telemedicine.

Stoesz said the law was an attack on all kinds of abortion. She said that although she didn’t doubt capable providers worked at hospitals, she said that for most who seek it, abortion is a routine part of their medical care and best provided at a specialty clinic, not a high-cost environment like a hospital .

“An abortion is an abortion. And this law isn’t specific to the way that abortion occurs,” she said.

Utah lawmakers have previously noted that the law also clarifies the definition of abortion to address liability concerns about how exceptions are worded in state law — a provision they have called a compromise.

Since the law’s passage, both lawmakers and Utah’s Department of Health and Human Services have said abortion clinics could apply for new licenses as hospitals.

“If an abortion clinic meets the requirements of a hospital then they may apply for a hospital license,” Charla Haley, a state health department spokesperson, said in a statement last month.

However, due to different licensing requirements, doing so could require changes for the state’s four standalone clinics, which primarily provide medication abortion and have relied on clinicians and other practitioners rather than physicians and surgeons to provide abortions.

Sam Metz, The Associated Press