Oregon's first new independent abortion clinic in at least 20 years quietly opened its doors in downtown Portland this week. 

The Lilith Clinic’s opening comes just six weeks after the Lovejoy Surgicenter shutdown in Northwest Portland, a landmark both for generations of women who sought safe, later-term abortions, also for protesters who regularly picketed out front. 

Even as access to abortion has been curtailed across much of the country, Oregon has largely “held the line,” says Grayson Dempsey, a long-time abortion rights advocate who has been consulting with the founders of the Lilith Clinic, which is currently accepting appointments and will start providing services on March 19. 

The state is virtually alone in the country in placing no additional legislative restrictions on abortion—parental and spousal consent is not required, for example. There are no waiting periods, nor limits on publicly funded abortions. That has led women from around the region—Alaska, Idaho, Northern California—to come to Oregon for abortions in the fifth month or so of pregnancy. 

Planned Parenthood, which has expanded its footprint in the state, will provide abortions through the 18-week mark, Dempsey says. But like Lovejoy Surgicenter, the Lilith Clinic will do so through 22 weeks, filling a critical gap. (Abortions after that mark are very rare, and generally performed only when there are medical considerations at stake.) 

“What is happening around a lot of the country is that the first generation of clinic owners and providers are getting older and retiring,” Dempsey says. Clinics still close because of states tightening up abortion rules, she adds, but “a big part is making sure we are training the next generation of providers and supporting the next generation of clinic owners. We can be as pro-choice as we want to be, but if there are no clinics to provide access, our policies and our laws are empty.” 

The new clinic will train medical residents in abortion care, Dempsey adds, an effort to build a new generation of doctors who are trained to perform the procedure. Its location in a multi-use downtown office building could also help deter protesters; the Lovejoy SurgiCenter was located on a highly visible corner in Northwest Portland. 

Since Judge Amy Coney Barrett’s elevation to the U.S. Supreme Court at the end of the Trump presidency, abortion rights advocates are bracing for the high court’s conservative majority to overturn Roe v. Wade. That means conservative-leaning states might ban the procedure entirely, making access in Oregon and other left-leaning states even more crucial for abortion rights advocates.