Last month the parking lot at Toledo's Center for Choice was busy with cars; inside, women talked and waited their turn with the doctor.
When we visited a couple weeks ago the parking lot was empty. Inside, Sue Postal, the Center's former director, took a break from cleaning equipment and packing records.
"We have had and met the most wonderful people here. Men women, mom's dad's, aunts uncles. I would say that I feel like I have a whole new group of friends out there somewhere. They may not think of me all the time but I think there's a place in their brain that I sit," Postal says.
This clinic performed nearly 1,500 abortions last year, according to state records. Now, access to abortion in Toledo will be much more limited.
"It's a blatant attempt to make abortion inaccessible and not one piece of this legislation doesn't necessarily make it safer for women," Postal says.
Ohio is the first state to pass a law that specifically bans publicly supported hospitals from having formal contracts with abortion clinics. Clinics in Ohio and 8 other states are required to have these contracts, or "transfer agreements," in case of emergencies. They enable ready transfer of an abortion patient to a hospital should the need arise…although it very rarely does, according to abortion rights groups.
The new law created a kind of "catch 22" Toledo's Center for Choice. It has to have a transfer agreement but could no longer do so with the University of Toledo Medical Center because it gets some state aid.
The two other local, private hospitals - one of which is Catholic - aren't interested in contracts with abortion clinics.
"We have laws in the state of Ohio that indicate our state tax dollars cannot pay for abortion. And what we saw through an investigation in public record's request that the University of Toledo is their hospital had a transfer agreement with an abortion agreement up in the Toledo area," says Mike Gonidakis, president of Ohio Right to Life. "As pro-life taxpayers we believe our conscious rights were being trampled on because it was an indirect way of paying for abortion."
Gonidakis helped Ohio lawmakers write the unique anti-abortion nuance that got in the state budget.
Gonidakis says his group's strategy on this new law and past ones is working - and saving lives.
"We are at the lowest level of abortions in our state's history because we take this incremental approach," Gonidakis says.
In the past decade, the number of abortions performed in Ohio has dropped 34 percent from 37,041 to 24,7614, according to the most recent state report. There are several reasons for the decline, including more access to birth control and education, as well as more restrictions.
The Guttmacher Institute, which studies reproductive rights nationally, says states are getting more "creative" and prolific with 43 new anti-abortion laws enacted in the first six months of this year. Policy analyst Elizabeth Nash, predicts more states will follow Ohio's lead.
"We are seeing this onslaught of over regulation and with that these hospital relationships, transfer agreements or privilege bills moving at a very quick clip and probably a lot of that will stand up in court," Nash says.
Gonidakis for Ohio's Right to Life also believes the law will stand up in court an says he is crafting legislation that can be an example for other states: "We are ground zero for the pro-life abortion debate nationwide...most other states look to Ohio to see what can be accomplished."
Gonidakis says he's been "exchanging notes" with Texas lately.
Texas State Senator Wendy Davis won national attention last month with her - ultimately unsuccessful - filibuster to block a law that would require all abortion clinics to be ambulatory surgical centers. And that would require clinics to meet routine inspection standards and revamp their facilities.
Ohio adopted that in 1995. Abortion clinics complain that the extra cost has also made it harder for them to stay in business.
Back in Toledo, with the Center for Choice shut down, the remaining abortion clinic's transfer contract with the university hospital expires at the end of this month. If it ends up closing, the closest clinic for Toledo residents will be in Detroit about 60 miles away.
"Do I think what was in the budget will ultimately affect a woman somewhere in this city, county, state - Yes. And I don't know what the outcome will be for those people individually," Postal says.
For the mostly low-income women who often lack their own transportation, Postal says the closing of both clinics in Toledo could mean not getting an abortion or obtaining an illegal one.