Category Archives: Health

America’s Abortion Rate Hits All-Time Low | Gleanings |

America's Abortion Rate Hits All-Time LowGuttmacher Institute

The abortion rate in the United States declined to an all-time low, while the number of lethal procedures dropped below a million for the first time since 1975, according to a new report.

The Guttmacher Institute reported Tuesday (Jan. 17) the rate fell to 14.6 abortions per 1,000 women 15 to 44 years old in 2014, which is a decline of 14 percent since its most recent survey in 2011.

In its census of all known abortion providers in the country, Guttmacher found abortions totaled 958,700 in 2013 and 926,190 in 2014.

The abortion rate reached its zenith at 29.3 in 1980 and 1981, and the total number of abortions peaked at more than 1.6 million in 1990, according to Guttmacher.

Guttmacher Institute

Pro-life advocates welcomed the report, and pointed to the work of pro-life citizens and legislators as a reason for the dramatic decline in abortions and their rate.

“The falling abortion number is due to the ceaseless advocacy and ministry of the pro-life community in neighborhoods all around this country,” said Russell Moore, president of the Southern Baptist Ethics & Religious Liberty Commission (ERLC). “The pro-life movement advances by calling out to consciences with the truth of what unborn human life is and matching that call with real ministry to women in crisis.

“While a lower rate is undoubtedly good news, the violent taking of the life of even one unborn child ought to cause us to weep and redouble our efforts to protect every human life and contend against the predatory abortion industry,” Moore told Baptist Press in written comments.

Americans United for Life (AUL), the country’s leader in helping state legislators pass pro-life laws, cited such policies, as well as technology, in explaining the trend.

“Research has shown that life-affirming laws do have an impact on lowering the number of abortions, and with all the life-affirming laws passed since 2010, we have a reason to celebrate the number of lives saved and women protected as legislators worked to defend them from a predatory and rarely accountable abortion industry,” AUL Acting President Clark Forsythe said in a written statement.

“But another factor in lower[ing] the number of abortions is the power of beautiful pictures of life inside the womb, through ultrasound,” he said. “Such pictures are worth more than a thousand words when it comes to helping people understand whose lives are on the line.”

In 2016, 43 states considered more than 360 abortion-related measures, according to AUL’s annual report released Jan 10. The bills introduced included such measures as bans on government funding of abortion, restrictions on late-term abortions, ultrasound requirements, and prohibitions on abortions based on sex, race, or genetic abnormality.

The Guttmacher Institute, which is affiliated with the abortion rights movement, suggested the improved use of contraceptives attributed to the falling rate and total. But it also acknowledged state regulations and the declining number of abortion clinics may have contributed.

“Abortion restrictions and clinic closures mean that patients may need to travel greater distances to access services,” said Rachel Jones, lead author of the study, in a written release. “The majority of abortion patients—75%—are poor or low-income, and nearly two-thirds are already parents. It can be very difficult for them to arrange for time off from work, transportation and child care. While many find ways to access care despite these obstacles, some of the abortion rate decline is likely attributable to women who were prevented from accessing needed services.”

The good news for pro-lifers came only five days before the anniversary of Roe v. Wade—the Supreme Court’s Jan. 22, 1973, decision that legalized abortion nationwide—and the observance of Sanctity of Human Life Sunday on the Southern Baptist Convention calendar.

It also arrived shortly before the second annual Evangelicals for Life conference Jan 26-28 in Washington, D.C. The conference—cohosted by the ERLC and Focus on the Family—features more than 50 speakers addressing not only abortion but such issues as adoption, end-of-life care, ministry to those with special needs, human trafficking, service to immigrants and refugees, and the development of a pro-life worldview. Conference attendees will be able to participate in the Jan. 27 March for Life.

The Guttmacher report also included the following information:

  • Nearly half—45 percent—of all abortions in the first nine weeks of gestation were performed using pills, and the percentage of such nonhospital abortions increased from 24 percent in 2011 to 31 percent in 2014.
  • The abortion rate declined between 2011 and 2014 in all but six states and the District of Columbia.
  • Ninety percent of all U.S. counties in 2014 contained no abortion clinic.
  • Five states—Mississippi, Missouri, North Dakota, South Dakota, and Wyoming—had only one abortion clinic apiece in 2014.
  • The number of abortion clinics fell by 17 percent from 2011 to 2014.
  • Abortion clinics made up 16 percent of all abortion facilities in 2014 but provided 59 percent of all abortions.

The Guttmacher Institute acknowledged its report has limitations. For instance, it reported only 58 percent of facilities it believes provided abortions in 2014 responded to the survey. Guttmacher used state health department information for 20 percent of facilities and made estimates on another 17 percent.

While the Guttmacher report is based partly on estimates, it covers all 50 states. The federal Centers for Disease Control and Prevention (CDC), which also reported a decline in abortions in its December announcement, does not require states to provide information on abortions. Three states—California, Maryland and New Hampshire—did not provide data to the CDC.

Forsythe said the country needs “a more complete picture of the impact of abortion on women, through verifiable tracking.”

In its annual report, AUL named these as the 10 best states for protecting life in 2016: (1) Oklahoma; (2) Kansas; (3) Louisiana; (4) Arkansas; (5) Arizona; (6) South Dakota; (7) Mississippi; (8) Georgia; (9) Michigan; (10) Pennsylvania.

The 10 least protective states were: (1) Washington, for the eighth straight year; (2) California; (3) Vermont; (4) New Jersey; (5) Oregon; (6) Nevada; (7) New York; (8) Connecticut; (9) Massachusetts; (10) Hawaii.

The ERLC has offered six pro-life priorities for action by President-elect Trump and Congress in 2017, including the nomination and confirmation of a pro-life successor to the late Supreme Court justice Antonin Scalia, a permanent ban on all federal funding of abortion and the defunding of Planned Parenthood, the country’s No. 1 abortion provider.

Source: America’s Abortion Rate Hits All-Time Low | Gleanings |

No Confusion: Alcohol Causes Seven Cancers

There is “strong evidence” that alcohol causes seven cancers, and other evidence indicates that it “probably” causes more, according to a new literature review published online July 21 in Addiction.

Epidemiologic evidence supports a causal association of alcohol consumption and cancers of the oropharynx, larynx, esophagus, liver, colon, rectum, and female breast, says Jennie Connor, MB, ChB, MPH, from the Department of Preventive and Social Medicine, University of Otago, in Dunegin, New Zealand.

In short, alcohol causes cancer.

This is not news, says Dr Connor. The International Agency for Research on Cancer (IARC) and other agencies have long identified alcohol consumption as being causally associated with these seven cancers.

So why did Dr Connor, who is an epidemiologist and physician, write a new review? Because she wants to “clarify the strength of the evidence” in an “accessible way.”

There is “confusion” about the statement, “Alcohol causes cancer,” explains Dr Connor.

Public and scientific discussion about alcohol and cancer has muted the truth about causality, she suggests.

“In the public and the media, statements made by the world’s experts are often given the same weight as messages from alcohol companies and their scientists. Overall messages become unclear. For these reasons, the journal [Addiction] has tagged this piece [her review] as ‘For Debate,’ ” she told Medscape Medical News.

The use of causal language in scientific and public discussions is “patchy,” she writes.

For example, articles and newspaper stories often use expressions such as “alcohol-related cancer” and “alcohol-attributable cancer”; they refer to a “link” between alcohol and cancer and to the effect of alcohol on “the risk of cancer.”

These wordings “incorporate an implicit causal association, but are easily interpreted as something less than cancer being caused by drinking,” observes Dr Connor.

“Stop drinking alcohol” is a catch phrase that could be ― but is not ― akin to “stop smoking,” she also suggests.

“Currently, alcohol’s causal role is perceived to be more complex than tobacco’s, and the solution suggested by the smoking analogy — that we should all reduce and eventually give up drinking alcohol — is widely unacceptable,” writes Dr Connor.

The newly published review “reinforces the need for the public to be made aware of the causal link between alcohol and cancer,” said Colin Shevills, from the Alcohol Health Alliance UK, in a press statement.

“Research shows that only around 1 in 10 people [in the UK] are currently aware of the alcohol-cancer link,” he said.

“People have the right to know about the impact of alcohol on their health, including its link with cancer, so that they can make informed choices about how much they drink,” added Shevills.

The lack of clarity about alcohol causing cancer, Dr Connor believes, is related to alcohol industry propaganda as well as the fact that the “epidemiological basis for causal inference is an iterative process that is never completed fully.”

What the Epidemiology Says

Dr Connor writes that the strength of the association of alcohol as a cause of cancer varies by bodily site. The evidence is “particularly strong” for cancer of the mouth, pharynx, and esophagus (relative risk, ~4-7 for ≥50 g/day of alcohol compared with no drinking) but is less so for colorectal cancer and liver and breast cancer (relative risk, ~1.5 for ≥50 g/day).

“For cancers of the mouth, pharynx, larynx and oesophagus there is a well-recognized interaction of alcohol with smoking, resulting a multiplicative effect on risk,” adds Dr Connor.

Other cancers are also likely caused by alcohol. Dr Connor writes that there is “accumulating research” supporting a causal contribution of alcohol to cancer of the pancreas, prostate, and skin (melanoma).

The exact mechanisms as to how alcohol, either alone or in combination with smoking, cause cancer “are not fully understood,” although there is some supporting “biological evidence,” she says.

One British expert had an opinion about alcohol’s carcinogenicity.

In a statement about the new review, Prof Dorothy Bennett, director of the Molecular and Clinical Sciences Research Institute at St. George’s, University of London, said: “Alcohol enters cells very easily, and is then converted into acetaldehyde, which can damage DNA and is a known carcinogen.”

In the new review, Dr Connor describes various hallmarks of causality that have been found in epidemiologic studies of alcohol and these seven cancers, such as a dose-response relationship and the fact that the risk for some of these cancers (esophageal, head and neck, and liver) attenuates when drinking ceases.

Current estimates suggest that alcohol-attributable cancers at the seven cancer sites make up 5.8% of all cancer deaths worldwide, she states.

The alcohol industry has a lot at stake, she says, which in turn leads to “misinformation” that “undermines research findings and contradicts evidence-based public health messages.”

A recent example comes from New Zealand, where a symposium on alcohol and cancer was covered by national media. An opinion piece by an industry-funded scientist in the capital’s daily newspaper disputed the evidence reported from the conference. That essay was entitled: “To Say Moderate Alcohol Use Causes Cancer Is Wrong.”

The essay included the statement: “While chronic abusive alcohol consumption is associated with a plethora of health problems including cancer, attributing cancer to social moderate drinking is simply incorrect and is not supported by the body of scientific literature.”

But there is no safe level of drinking with respect to cancer, says Dr Connor, citing research about low to moderate levels of alcohol, which has been covered by Medscape Medical News.

This was also the conclusion of the 2014 World Cancer Report, issued by the World Health Organization’s IARC.

The promotion of health benefits from drinking at moderate levels is “seen increasingly as disingenuous or irrelevant in comparison to the increase in risk of a range of cancers,” writes Dr Connor.

Public health campaigns “with clear messages” are needed to spread the word about alcohol’s carcinogenicity, she told Medscape Medical News.

“I think that the UK is leading the way. Alcohol consumption as a public health issue has had high exposure in the UK over quite a number of years,” said Dr Connor, who provided links to two awareness campaigns, the Balance campaign, and the Balance Northeast campaign.

Earlier this year, the United Kingdom issued new guidelines on alcohol drinking, recommending that men drink no more than women and warning that any amount of alcohol increases the risk of developing a range of cancers.

Organizations in New Zealand are also taking action. The New Zealand Medical Association, the Cancer Society of New Zealand, and the National Heart Foundation have all adopted evidence-based position statements that “debunk” cardiovascular benefits as a motivation to drink and that highlight cancer risks, Dr Connor said.

Dr Connor has disclosed no relevant financial relationships.

Addiction. Published online July 21, 2016. Full text
Medscape Medical News © 2016 WebMD, LLC
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Cite this article: No Confusion: Alcohol Causes Seven Cancers. Medscape. Jul 27, 2016.

Exercise Cuts the Risk for 13 Cancers

Higher levels of leisure-time physical activity are associated with a significantly lower risk of developing a number of cancers, the results of a pooled analysis of data from more than a million Europeans and Americans reveal.

The findings, published online May 16 in JAMA Internal Medicine, indicate that higher levels of physical activity reduced the risk of developing cancer in 13 of the 26 cancers reviewed.

For that group of 13 cancers, the risk reduction ranged from 10% to 42%.

The affected cancers were esophageal adenocarcinoma (hazard ratio [HR], 0.58), liver cancer (HR, 0.73), lung cancer (HR, 0.74), kidney cancer (HR, 0.77), gastric cardia cancer (HR, 0.78), endometrial cancer (HR, 0.79), myeloid leukemia (HR, 0.80), myeloma (HR, 0.83), colon cancer (HR, 0.84), head and neck cancer (HR, 0.85), rectal cancer (HR, 0.87), bladder cancer (HR, 0.87), and breast cancer (HR, 0.90).

The cancers with risk not positively affected by physical activity included those of the prostate and melanoma.

“These findings support promoting activity as a key component of population-wide cancer prevention and control efforts,” say the researchers.

In an accompanying editorial, Marilie D. Gammon, PhD, Gillings School of Public Health, University of North Carolina at Chapel Hill, described the findings as “exciting,” because they “underscore the importance of leisure-time physical activity as a potential risk-reduction strategy to decrease the cancer burden in the United States and abroad.”

She emphasizes the need for further research into the underlying mechanisms for the association between physical activity and cancer and into the critical timing of exposure to exercise, as well as the types and amounts of activity that have the most impact.

Lead researcher Steven C. Moore, PhD, MPH, National Cancer Institute, Bethesda, Maryland, told Medscape Medical News that three mechanisms have been proposed to relate physical activity to lower cancer risk.

The first, he explained, is via sex hormones. Previous studies have shown, for example, that estrogens occur in lower levels in physically active women. “The second hypothesis is related to insulin, which is that active people have lower levels of insulin, and insulin itself maybe a cancer risk factor,” he said.

The third is connected to inflammation, with studies indicating that exercise is linked to lower levels of inflammatory markers, and that inflammation “is a general cancer risk factor.”

Although it appears from the current findings that the relationship between physical activity and cancer risk is strongest for gastroesophageal and hematologic cancers, it was not possible to determine which of the hypotheses most lends itself to explaining the association.

Dr Moore said: “It’s hard to pin it down exactly, because in the ideal study, you would want to have physical activity as well as those inflammatory factors measured and the cancer outcome, and nobody’s done that study.”

The findings nevertheless strengthen recommendations on minimum activity levels, because the message that exercise reduces cancer risk can be added to that for cardiovascular disease.

Dr Moore noted: “In terms of getting people to be active, it depends on the number of communities and the number of constituencies that are invested in pushing it as a public health message.”

For him, the study “at least in part aligns the evidence for cancer with the evidence for heart disease.”

Dr Moore said: “In other words, there’s enough evidence now to suggest that physical activity may be an important part of cancer prevention and control messages, so that it can be pushed within that research community, and not just within that research community but perhaps also that advocacy community.”

For the analysis, the researchers pooled data from 12 prospective cohorts from Europe and the United States that included self-reported physical activity, yielding a total of 1.44 million individuals (median age, 59 years).

Because different measures of physical activity were used across the studies, the team converted activity to metabolic equivalents (METs), with exercise of moderate intensity defined as 3 or more METs. The median activity level was the equivalent of 150 minutes of moderate-intensity activity per week, or 75 minutes of vigorous intensity, or the equivalent combination.

Higher activity levels of leisure-time physical activity were associated with younger age, more education, lower body mass index (BMI), and lower likelihood of being a current smoker.

During a median follow-up of 11 years, there were 186,932 incident cases of cancer.

The researchers found that higher levels of physical activity were associated with an increased risk for prostate cancer (hazard ratio [HR], 1.05) and malignant melanoma (HR, 1.27). Further analysis showed that the latter was statistically significant only in US regions where there are higher levels of solar ultraviolet radiation (HR, 1.26).

There were suggestions of associations between increased physical activity and reduced risk for gallbladder cancer, small intestine cancer, and non-Hodgkin lymphoma.

It was estimated that physical activity was associated with an overall 7% reduction in the risk of developing cancer (HR, 0.93).

Although BMI reduced the association for several cancers, 10 of the inverse associations remained significant after adjustment. Smoking modified the association only for lung cancer.

Editorialist Dr Gammon told Medscape Medical News that the pooled analysis has strengthened the evidence for an association between physical activity and some of the rarer cancers. “It’s really nice to be able to put it all together, because each of the individual studies were underpowered,” she said.

She believes that the intensity and duration of physical activity needed to lower cancer risk is likely to be tumor specific. “For instance, it was so much easier for us to figure out that physical activity was related to colon cancer, but it was much, much harder to do it with breast, and I’m thinking it’s possible that it could be related to dose and intensity.”

She added: “I think we’re going to need to do more individual type studies to try to really nail that down better, but right now, I would say the best evidence is what the CDC is recommending.”

Dr Gammon concluded that it is “really hopeful” to have the possibility of “such a good strategy to be able to reduce the risk of developing cancers, because some of the cancers on that list are very rare and very deadly.”

The study was supported by the Intramural Research Program of the National Institutes of Health. The work reflected in the editorial was supported in part by grants from the National Institutes of Health. The authorsand editorialists have disclosed no relevant financial relationships.

JAMA Intern Med. Published online May 16, 2016.

Memory as Ministry in the Age of Alzheimer’s

Biblical ministry is not limited to the ordained ministry. Based on the “priesthood of believers,” all Christians are called to minister.

Marketplace ministry, social justice and charitable work are examples of such ministries. But have you heard of a ministry called “memory?”

It appears that there is a legitimate ministry that can be called “remembering.” In this age of great concern about the increasing number of people being afflicted with Alzheimer’s disease, which profoundly affects memory, I consider this a sobering revelation.

The Bible speaks much about God and man in relation to memory and remembrance. God remembers His covenant (Ex. 6:5). He does not remember our forgiven sins (Is. 43:25), but remembers righteous individuals—both men and women. Noah, Abraham and Hannah are examples.

We are told not to forget God’s dealings with us, but to remember them, and to pass on the memory to a new generation (Deut. 11:19). Israel was instructed not to forget that they were slaves in Egypt (Deut. 16: 12), and to remember the Sabbath (Ex. 20:8). The psalmist instructs us not to forget “all His benefits” (Ps. 34:2).

Memory is at the heart of Christian theology. The undisputed instruction of Jesus on the night in which He was betrayed was to “do this in remembrance of me.” The ordinances of the most independent faith groups are built on remembrance! Noticeably, theologian Henri Nouwen defined ministry as being a living reminder of Jesus.

Memory is a matter of great interest and special concern to Saint Paul. He tells us to remember Jesus (2 Tim. 2: 8). He instructs further: Remember the poor (Gal. 2:10); “Remember my chains,” (Col. 4:18). The author of Hebrews adds: “Continue to remember those in prison as if you were together with them in prison, and those who are mistreated as if you yourselves were suffering” (Heb. 13:3). “Remember your leaders, who spoke the word of God to you” (Heb. 13:7).

In Paul’s writings, the ministry of memory is strongly related to prayer. “We remember before our God and Father your work produced by faith” (1 Thess. 1:3). “I constantly remember you in my prayers” (2 Tim. 1:3). “I thank my God every time I remember you” (Phil. 1:3). “I have not stopped giving thanks for you, remembering you in my prayers” (Eph. 1:16). “I always thank my God as I remember you in my prayers” (Philem. 1:4).

What a powerful ministry! Anyone with the ability to remember can do this ministry. There are no geographical limitations! Words may not even be needed for this ministry. Believers of all nations, tribes and tongues can engage in this ministry of memory and remembrance, a ministry in which we connect our memory of each other to God.

The ministry of memory is not only about those who are living. Certainly, the leaders we are expected to remember according to Hebrews 13:7 are not all alive. Some have finished their course and have gone to be with the Lord. They don’t need our prayers, only our grateful memory.

As a person raised in a pastor’s home in South India, I remember people outside my family who have touched my life in profound ways. Some of them are alive, others have finished their race. A Hindu woman was forced to give up her eyes to follow Jesus. A retired teacher found time to teach me English hymns. Church members shared their modest means with their pastor’s kid. Preachers let me carry their Bibles. Classmates left an imprint on my life. The list is long.

A young cancer patient I visited three decades ago is also on my list. I was a chaplain at the City of Faith Hospital in Tulsa, Oklahoma, then. The patient was a born-again Christian who had no family members to visit her. Her mother and grandmother had died from the same disease, her father was dead, and she had no siblings. She lived alone and kept her sickness a secret as long as she could, due to fear. According to the doctors, the prognosis was not good because by the time she came to the hospital, the disease had progressed significantly.

One day she asked me during a pastoral visit, “I have no family left. I don’t know how long I will live. Can I ask you for a favor?” Thinking that she would ask for some practical help, I said, “Of course, what can I do for you?” She asked, “Would you remember me once I am gone?” Moved by her unexpected request, I said, “Certainly. I will remember you.” She thanked me.

I have seen many answers to prayers. I have witnessed both instant and gradual healings, but this was not the case with the young cancer patient. She passed away the following night.

There are times when all you can give others is your prayers and your memory! Sometimes God answers the prayers immediately. Other times, the answers come slowly. In some cases, the answer is not what one expects. In any case, we must pray, and we must remember.

The threat of Alzheimer’s disease reminds us that memory is a gift. How wonderful it would be if all of us could use this gift as a means of ministry!

Thomson K. Mathew, D.Min., Ed.D., is professor of pastoral care and dean of the College of Theology and Ministry at Oral Roberts University, Tulsa, Oklahoma.


How Reading Can Transform Your Health


“As weird as it sounds, reading “War and Peace” put me back in control of my life—and that’s why it’s my favourite book.”

In How Changing Your Reading Habits Can Transform Your Health, Michael Grothaus says, “Reading doesn’t just improve your knowledge, it can help fight depression, make you more confident, empathetic and a better decision-maker.”

Grothaus’ life was in a rut … until he read War and Peace. Its 1,500 pages took him two months to conquer and immediately became his favourite book because of how it changed him. “It’s almost impossible to explain why,” he says “but after reading it I felt more confident in myself, less uncertain about my future. … As weird as it sounds, reading War and Peace put me back in control of my life—and that’s why it’s my favourite book.”

But Grothaus’ further research into reading revealed that such a transformation through reading wasn’t weird but ‘the norm for people who read a lot—and one of the main benefits of reading that most people don’t know about.” What else did he discover?

  • Reading for pleasure can help prevent conditions such as stress, depression and dementia.
  • Reading can offer richer, broader and more complex models of experience, which enable people to view their own lives from a refreshed perspective and with renewed understanding.
  • Reading about other characters and situations helps you to look at life’s challenges from a renewed perspective.
  • People who read find it easier to make decisions, plan and prioritise, because they are more able to recognise that difficulty and setback are unavoidable aspects of human life.
  • People who read for pleasure regularly report fewer feelings of stress and depression than non-readers.
  • Being more engaged with reading, along with other hobbies, is associated with a lower subsequent risk of incidents of dementia.
  • People who read books regularly are on average more satisfied with life, happier and more likely to feel that the things they do in life are worthwhile.
  • Despite reading being a solitary experience, research shows that reading improves empathy and increases social support.
  • A recent survey of 1,500 adult readers found that 76 percent of them said that reading improves their life and helps to make them feel good.

Grothaus goes on to give four tips on how to overcome obstacles to reading in our distracted and over-committed lives (see here).

But if reading secular books can have such life-transforming benefit, how much more will a wide range of good spiritual books transform our lives and even our eternity.

“From childhood you have known the Holy Scriptures, which are able to make you wise for salvation through faith which is in Christ Jesus” (2 Timothy 3:15).

David Murray

Dr. David Murray is Professor of Old Testament and Practical Theology at Puritan Reformed Seminary. He is also Pastor of Grand Rapids Free Reformed Church. David is the author of Christians get depressed too, How Sermons Work, and Jesus on Every Page. You can read his blog at or follow him on Twitter @davidpmurray. David is married to Shona and they have five children ranging from 4 months to 17 years old, and they love camping, fishing, boating, and skiing in the Lake Michigan area.More from David Murray or visit David at


Supreme Court Weighs Why Abortion Clinics Are Closing at Record Rates

Supreme Court Weighs Why Abortion Clinics Are Closing at Record RatesDelcia Lopez / AP/The Monitor

The first abortion case to reach the US Supreme Court in nearly a decade stands to impact the fate of most clinics in Texas—and possibly clinics in states with similar restrictions that have led to years of record closures.

Opening arguments begin Wednesday for Whole Woman’s Health v. Hellerstedt, a challenge to a 2013 Texas law requiring clinics to adhere to stricter medical standards. It passed the same year as Dr. Kermit Gosnell’s life sentence for grisly practices uncovered at his Philadelphia office.

“The central purpose of the law in Texas and other states is to protect the health of women, and pro-lifers should see that as critical,” said Clarke Forsythe, senior counsel at Americans United for Life.

The case reflects recent shifts in pro-life activism, including a greater emphasis onwomen’s voices, leadership, and wellbeing. While abortion opponents remain concerned with the life of the unborn baby, they also highlight the physical and emotional risks posed to its mother. The women rising in the pro-life movement since the ‘90s “actually believed pretty deeply that abortion hurts women,” law professor Mary Ziegler told The Washington Post for its examination of how the nation’s highest court will test this new strategy.

Texas’s law insists that doctors performing abortions have patient-admitting privileges for nearby hospitals in case of emergencies, as well as that the facilities meet the same building codes as other outpatient surgical clinics. These requirements proved too costly or logistically impossible for all but 8 of the Lone Star State’s 40 clinics, about half of which have closed already, Reuters reports.

In the past five years, more than 150 US abortion providers shut down; America’s abortion rate dropped to its lowest since Roe v. Wade, and in both the most pro-choice and most pro-life states; and states passed more than 300 new restrictions on abortions. Bloomberg notes that five states have just one abortion clinic left. This dramatic pro-life wave followed the Supreme Court’s decision to uphold a partial-birth abortion ban in 2007, the last time it ruled on the issue.

That Gonzales v. Carhart ruling paved the way for states to propose abortion restrictions of their own without much concern that they would be struck down by the court, said Forsythe. A decision in favor of Texas would send a similar message; clinics in Louisiana are pushing to wait to see what the justices say before their state enacts its own version of the Texas law. Across the country, 8 other states have introduced similar restrictions, and 23 states signed a brief sent to the Supreme Court in support of the regulations.

This case will be one of the first high-profile issues to be heard following the death of Justice Antonin Scalia last month, which leaves an even number on the court. The most likely outcome—a 4–4 tie—would defer to the lower court’s ruling in favor of Texas, “but it would not send a nationwide signal” about abortion policy, Forsythe said.

Justice Anthony Kennedy is left as the deciding vote. The New York Times reportsthat the case has amassed hundreds of personal abortion testimonies filed within supporting briefs, including personal stories from lawyers who say their abortions changed the course of their lives for the better, and a statement signed by thousands of women who say they suffered decades of “trauma and emotional injury” as a result.

Pro-choice activists, along with medical professionals including the American Medical Association and the American College of Obstetricians and Gynecologists, have sided against the Texas law. They state that abortion is consistently a safe and complication-free procedure; therefore, state regulations are really efforts to force these providers to close—placing an “undue burden” on women seeking abortions.

“We shouldn’t be surprised that the abortion rights lobby fights legislation that creates accountability for surgeons and clinics. The abortion industry has always operated at the expense of women and families,” said Russell Moore, president of the Southern Baptist Convention’s Ethics and Religious Liberty Commission. “My prayer is that the Supreme Court will act in defense of the lives of women and the unborn in empowering states to cut through the political armor of the abortion industry.”

Presidential candidates Ted Cruz and Marco Rubio signed onto the congressional brief filed on behalf of the Texas law, and both have released statements in support.

CT previously noted the record clinic closures, and examined why 50 may be the best the pro-life movement can hope for. CT also noted how January’s March for Life was the most “catholic” one yet.