Since abortion was nationally legalized nearly 50 years ago, Louisiana has enacted almost 100 anti-abortion restrictions, more than any other state in the country, according to a new study shared exclusively with CBS News.

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If the high court sides with the state, Louisiana would become the first state not to have a legal abortion provider. [Guttmacher Institute’s Elizabeth] Nash said that's by design.

“The history of Louisiana's abortion restrictions are in fact a history of attempts to ban abortion, it's not about giving care to patients," Nash said. “What we're trying to say is that the legislature's intent has been to regulate abortion out of existence. That's been the pattern."

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Though politicians deny that Louisiana's admitting privilege law is about getting rid of abortion, the state has passed five bans on the procedure, four of which are not currently implemented, according to Guttmacher's report. Louisiana currently has one of the country's strictest abortion bans in effect, a 22-week ban on the procedure.

The state has also passed legislation banning the procedure at any point in pregnancy with limited exceptions, a six-week ban, a 15-week ban, and a so-called "trigger ban," which would immediately prohibit abortion if Roe v Wade were overturned. All four have been blocked by courts, according to Guttmacher.

Clinics have been closing across the South and Midwest for a decade now, and for many people in the region, Hope is the best option — even if it’s a three-hour drive. The majority of patients at Hope live at or below the poverty line, and many don’t own cars. So they wait until they can borrow a car or get a ride.

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If Hope closes, patients who would ordinarily come to this clinic in the northwest corner of Louisiana would likely have to travel to New Orleans, more than 300 miles away in the southernmost part of the state. The other option would be to cross state lines — but if the Court upholds Louisiana’s law, other states in the region are likely to pass more restrictions, and their clinics could shut down, too.

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A visit to Hope is a reminder that in many parts of the country, all that stands between pregnant people and the end of Roe v. Wade is a handful of clinics — most of them small, isolated, and racing to keep up with an increasing number of restrictions that, staff say, have nothing to do with patient care. And with each new requirement from the state, Hope clinic administrator Kathaleen Pittman tells me, “it’s the patients that pay the price.”

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If Hope and other clinics in Louisiana close, some people who want an abortion simply won’t be able to get one and will end up carrying their pregnancies to term. Such a situation can have a severe impact on pregnant people and their families: Research has shown that people who want an abortion but can’t get one are more financially insecure than people who are able to terminate their pregnancies, and may have more difficulty bonding with their children. Being denied an abortion is also associated with short-term health risks, like anxiety, and longer-term ones, like higher rates of chronic headaches and migraines compared with people who are able to get the procedure.

First, I wasted three weeks going back and forth, an hour each way, to what I believed was a health center that could help me get an abortion. It turned out to be an anti-abortion crisis pregnancy center — one of more than 2,500 across the country, multiplying while abortion providers are being regulated out of existence. There, I was asked deeply personal questions, made to sit through two ultrasounds, watch a video of complete lies tying abortion to breast cancer and other health risks, and told multiple times that if I just came back for one more appointment, they could schedule my abortion. At one point, someone told me that I wasn’t “the type to get an abortion.”

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It wasn’t until I went to Planned Parenthood that I finally got the information I needed. I was told where I could get an abortion and what the process would be like. I traveled 250 miles each way to Hope Medical Group in Shreveport, home to one of the three remaining abortion clinics in the state: once for state-mandated counseling, and once for my procedure.

Both times, the doctors and staff at the health center made me feel supported, not judged. I was asked multiple times to confirm that this was what I wanted and that I was not being pressured into ending my pregnancy. They empowered me to make my own decision. Unlike the crisis pregnancy center. Unlike the state government.

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What I know from personal experience is that it’s already very hard to get an abortion in Louisiana. The state has put up a series of hoops women must jump through — including state-mandated counseling designed to convince you not to have an abortion, and a waiting period designed to put you in time out and make you travel back and forth to multiple appointments. I jumped through their hoops and more. I don’t wish my experience on anyone.

While ordinarily, plaintiffs in court cases lack standing to argue for the rights of those who are not parties to the case, the Supreme Court has permitted doctors to argue on behalf of women’s right to abortion ever since the immediate aftermath of Roe v. Wade. Doctors were involved in the early contraception and abortion cases as well, but back then they were in part arguing for their own freedom from prosecution. Once abortion became legal, the theory supporting what is known as third-party standing for doctors and clinics in post-Roe abortion cases is that there are too many obstacles of timing, resources and privacy for women to get to court to assert their own right to an abortion free of the regulatory obstacles that stand in their way. Take away doctors’ right to advocate in court on their patients’ behalf and most legal attacks on state-created obstacles to abortion conveniently disappear.

Doctors’ standing is so much an accepted part of abortion litigation that Louisiana didn’t even question it in defending its law in the lower courts, and the lower courts naturally didn’t address it. Ordinarily, the Supreme Court refuses to address issues that were not raised at an earlier stage. On its face, then, the state’s cross-petition is frivolous. I sensed potential trouble when I stumbled upon it by chance over the summer, but the idea that the justices would actually grant it seemed so far-fetched that I put it out of my mind.

It turns out that the idea of eliminating doctors’ third-party standing has been in the anti-abortion movement’s water supply ever since Justice Thomas raised it in his dissenting opinion in Whole Woman’s Health three years ago. I suppose Louisiana’s cross-petition is an example of “when all else fails, change the subject,” but I have to give the state credit for coming up with a superficially clever argument. The state is arguing that the realities of clinic-based abortion practice belie the assumption behind the third-party standing doctrine, which is that the interests of both parties are aligned. Instead, the state notes that there was no evidence in this case “that any particular Louisiana woman who has obtained or is considering an abortion would personally (1) prefer to obtain an abortion from a doctor without admitting privileges, (2) prefer to forgo the protections Act 620 was intended to provide, or (3) consider her decision to obtain an abortion to be burdened by Act 620.”

Of course, there’s so much wrong with that argument that the question is where to begin. It assumes the counterfactual: that the law was intended to protect women and that it actually protects them, or that women have any reason to prefer a doctor who has admitting privileges. The clinic points out in its own brief that only four out of thousands of abortion patients it has treated over the past 23 years required hospital treatment and that the District Court found that all had received appropriate hospital care “regardless,” in the words of the district judge, “of whether the physician had admitting privileges.”

In order to assert the rights of others, a plaintiff must personally face injury from the regulation at issue and have a relationship with the third party. There also needs to be some obstacle to the third party raising its own rights. The courts have long held — including in Whole Woman’s Health — that abortion providers satisfy these three conditions when challenging state abortion restrictions.

But now, in briefs filed with the Supreme Court, Louisiana is arguing that the courts have granted standing to abortion providers based on “unexamined assumptions” that should be “abandoned.” They argue that abortion providers don’t have a sufficiently close relationship with their patients — as the state sees it, they don’t spend enough one-on-one time with them — and that there is no good reason that a woman couldn’t assert her own rights in court. They shrug off the notion that a woman might fear stigma or other harm in bringing a suit herself. “The notion that women considering abortion are unable to assert their own rights is a legal fiction,” lawyers for the Louisiana Department of Justice write in their petition, which notes that Roe v. Wade and its related cases were brought by individual women. Of course, in those cases the women filed suit using pseudonyms like “Jane Roe” precisely to protect their identities.

Louisiana also argues that when a health and safety regulation such as the admitting privileges law is at stake, there is an inherent conflict of interest between providers and patients that should preclude the providers from filing suit — after all, the law is meant to protect women from allegedly unfit doctors, they argue. “There is no basis to simply assume that women … get ‘what they want’ when the court allows a doctor to use women’s rights to challenge health and safety standards designed to protect women from those very doctors.”