It's been 41 years since Roe v. Wade, and Dr. Brent Blue is the only person in Wyoming left openly performing abortions.
"I feel strongly that women should have access to appropriate health care and as a family physician, part of my practice should provide services for women. I don't mind taking the heat for that," Blue says. "Last time I checked, we don't have anyone out front protesting vasectomies for men."
Emerg-A-Care, his family clinic in Jackson Hole, Wyo., has seen an uptick in both protesters and clientele during the past three years as the anti-abortion movement has increased its pressure on state legislatures across the country. And since his clinic is the only one within a 150 mile radius, he serves clients from every corner of his state, eastern Idaho and western Montana. In Idaho and Montana, he says new abortion restrictions have forced women to drive hundreds of miles, over mountain passes to see him.
"An unwanted pregnancy is a failure of contraception and it is a failure of a lot of things. It is never a good thing, but to continue to force someone to continue a pregnancy is so intrusive," he says.
While half of the pregnancies in the U.S. are still unintended, access to abortion is rapidly eroding not only out West, but across the U.S.
For abortion rights advocates, the anniversary of Roe v. Wade is a time to reevaluate how the movement can gain back ground it has lost.
"There has really been a tidal wave over the last three years. If it is not the worst, it is the worst we have seen in a very long time," says Elizabeth Nash, state issues manager at the Guttmacher Institute, a think tank that advocates to expand access to reproductive health.
Between 2011 and 2013, states have passed 205 abortion restrictions, more than the 189 measures that were enacted in the entire previous decade.
Just last year, Texas passed a sweeping bill that put restrictions on abortions including one that required abortion providers to have admitting privileges at local hospitals. In North Dakota, the governor signed a law which prohibits women from terminating a pregnancy as soon as a baby's heartbeat can be detected, which can occur as early as six weeks after conception. While both pieces of legislation are tied up in court, their mere existence reveals how successful anti-abortion groups have become at lobbying for their cause.
Just as Republicans have made historic gains in state legislatures, anti-abortion groups have made major headway in the halls of their statehouses.
Since 2011, more than 54 abortion clinics have closed their doors, many citing new restrictions on their services.
Conservative lawmakers who campaigned on solving the country's economic woes in 2010, have pivoted from advocating for those bread and butter issues to promoting a broader social agenda.
"As legislatures are elected and new majorities come in, new opportunities present themselves," says Mary Spaulding Balch,director of state legislation for the National Right to Life, an anti-abortion group. "When all those things line up, the pro-life movement is able to have great gains."
In an effort to make the most of the new opportunity, anti-abortion groups like the National Right to Life Committee and Americans United for Life have found success pushing "model legislation," similarly worded bills in multiple state legislatures across the country.
"Our model legislation enables legislators to easily introduce bills without needing to research and write the bills themselves, helping ensure that their efforts will have the desired impact and withstand judicial scrutiny," an excerpt on the Americans United for Life website reads.
The National Right to Life Committee has found immense success with its "Pain-Capable Unborn Child Protection Act," which since 2010 has passed in 10 states from Nebraska to North Dakota, although several state laws are held up in court. A similar bill passed overwhelmingly in the U.S. House of Representatives and has been introduced by Sen. Lindsey Graham, R-S.C., in the Senate. It is not likely, however, to get a vote in the Democratic-controlled Senate.