As few as seven abortion clinics will be left open in Texas after an appeals court upheld a lower court's ruling that the state may require all facilities performing abortions to meet hospital-like standards. A three-judge panel of the U.S. Fifth Circuit Court of Appeals issued the ruling. The 2013 law requires facilities to meet ambulatory surgical center standards, including minimum room and door sizes and anesthesia pipelines. As few as seven clinics—all in metropolitan areas—meet those standards. There are currently 17 clinics, down from 40 clinics in 2012.