ST. LOUIS (AP) — The fate of Missouri’s only abortion clinic is at stake in a hearing scheduled for Wednesday in St. Louis.

Circuit Judge Michael Stelzer will hear testimony in a hearing on Planned Parenthood’s request for a preliminary injunction that would keep open its abortion clinic in St. Louis.

Missouri’s health department last week declined to renew the clinic’s license to perform abortion procedures, citing concerns about patient safety, including allegations of “failed abortions” and legal violations. Clinic leaders say the allegations are part of an effort by an anti-abortion administration to eliminate the procedure in the state.

Stelzer on Friday issued a temporary restraining order to allow the clinic to continue to perform abortions, at least until a decision is made on the injunction request.

Stelzer ruled Tuesday that four former doctors in training who worked briefly at the clinic are not required to testify at the hearing.

Lawmakers in Missouri and many other conservative states have recently passed new restrictions taking aim at the U.S. Supreme Court’s 1973 Roe v. Wade ruling that legalized the procedure nationwide. Abortion opponents, emboldened by new conservative justices on the Supreme Court, hope federal courts will uphold laws that prohibit abortions before a fetus is viable outside the womb, the dividing line the high court set in Roe.

If the St. Louis clinic closes, Missouri would become the first state since 1974 without a single functioning abortion clinic.

The number of abortions performed in Missouri has declined every year for the past decade, reaching a low of 2,910 last year. Of those, an estimated 1,210 occurred at eight weeks or less of pregnancy, according to preliminary statistics from the state health department.

Missouri women also seek abortions in other states. In Kansas, about 3,300 of the 7,000 abortions performed in 2018 were for Missouri residents, according to the state’s health department. Illinois does not track the home states of women seeking abortions.

If the St. Louis clinic closes, women seeking abortion services wouldn’t have much farther to travel. An abortion clinic is just across the Mississippi River in Granite City, Illinois, less than 10 miles (16 kilometers) from the St. Louis clinic. Planned Parenthood’s abortion clinic in the Kansas City area is in Overland Park, Kansas, just 2 miles (3 kilometers) from the state line. State figures show a handful of Missouri hospitals also perform abortions, but those are relatively rare.

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