Anti-abortion politicians are more brazen than ever under Trump: They recently even tried to sneak language into the GOP tax bill that would define life as beginning at conception. And that was just the latest salvo. In the last month, the Trump administration has tried to block a young woman in Texas from getting an abortion and proposed a plan for the Department of Health and Human Services that swaps public health language for the loaded rhetoric of the religious right.

These policies have a real impact on whether someone who needs an abortion can get that care. Across the country, women who seek abortion care at different points in pregnancy often struggle to find a provider or find themselves blocked by restrictive state laws. I’m proud to provide abortion to women as pregnancy progresses, and because of that, I was heartbroken when the clinic in Germantown, Maryland, was forced to close.

In August of this year, my staff and I learned we would no longer be providing abortion care at Germantown Reproductive Health Services in Maryland, where I served as the medical director and a practicing physician since 2010. The closure of that clinic meant that hundreds of women who needed our services every month may not have been able to exercise their human and constitutional right to abortion.

The abortion rate is declining in the United States, and I am an enthusiastic supporter of the things that allow people to plan, create and raise the families they dream of — including comprehensive sex education; access to effective, affordable contraception; and the opportunity to raise children safely in thriving communities.

I’m heartened to know that more women than ever are able to prevent unwanted pregnancy. But not every woman has equitable access to effective contraception, sexual health information, health insurance or providers. And birth control isn’t perfect. Whatever her circumstance, I plan to be there for the woman who finds herself pregnant, and knows that it just isn’t the right time for her.

It’s not always possible for a woman to get an abortion as soon as she’s made her decision. Many things can stand in her way, from delays in finding out she is pregnant, not being able to afford care, a lack of physicians who provide abortion near her or barriers put in place by politicians, such as bans on insurance covering abortion or — in Jane Doe’s case — oppressive policies that deny women their human rights. Laws that restrict access to abortion at different points in pregnancy — while upholding policies that simultaneously push care out of reach — are inhumane and are attempts to play politics with women’s lives.

In the last five years alone, nearly 30 percent of all independent abortion clinics have been forced to shut their doors, and of those that closed over the last two years, over 80 percent provided care after the first trimester. As independent clinics close, access to care at different points in pregnancy becomes increasingly inaccessible, and travel distances, out-of-pocket costs and wait times increase.

Independent abortion care providers like me are struggling to keep our clinic doors open in the face of many challenges, including — as in the case of the Germantown clinic — anti-abortion extremism. And as the number of clinics dwindles, so does a woman’s ability to access care.

I am no stranger to the harassment, threats and violence that many abortion care providers experience. My family and my colleagues have experienced losses that could compel anyone to walk away — including the assassination of my associate and friend, George Tiller, who was killed by an anti-abortion extremist while at church. But every day, my commitment to women’s health and decision-making outweighs any fear, and I — and others around the country–continue to serve the women who need us.

Those of us committed to reproductive freedom cannot rest while anti-abortion extremists work overtime to rob women of their health, lives and autonomy. This is why I count my colleagues among the most compassionate and courageous people I know, and this is why in October, I opened a new reproductive health clinic in Bethesda, Maryland. I believe it is my moral obligation to ensure that women can get the care they need without shame, burdens or delays.

To achieve any sort of justice, every woman needs to be able to determine when, whether and how to create her family. This conviction is what inspires doctors, nurses, counselors and front-line staff throughout the United States to provide abortion care, and it’s why we will not back down in the face of extremism.

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