The impact stands to be felt most along the Texas-Mexico border and in the western half of the state, where access to a legal abortion is especially limited. The only abortion clinic in McAllen, which reopened after the lower court's ruling, now stands to close again. That would leave women in the Rio Grande Valley facing a 300-mile drive to the next-nearest abortion facility.
But the court wrote that "women from McAllen have been travelling outside their city for nearly a year and Plaintiffs made no showing that clinics in San Antonio (or any other city) have been deluged."
U.S. District Judge Lee Yeakel of Austin ruled in August that the Texas law would require abortion clinics to spend millions of dollars on hospital-level upgrades and that it was less about safety than making access to abortion difficult.
Abortion-rights groups bristled Thursday over having that victory taken away.
"Today's ruling has gutted Texas women's constitutional rights and access to critical reproductive health care and stands to make safe, legal abortion essentially disappear overnight," said Nancy Northup, president and CEO of the Center for Reproductive Rights.
Under the entire scope of the law, only seven abortion facilities in Texas meet the requirements. All those facilities are concentrated around the major cities of Houston, Austin, San Antonio, Dallas and Fort Worth.
Attorneys for the state have denied that women would be burdened by fewer abortion facilities, saying nearly 9 in 10 Texas women would still live within 150 miles of a provider. The law's opponents, however, note that still leaves nearly a million Texas women embarking on drives longer than three hours to get an abortion
Republican Attorney General Greg Abbott, who is the favorite to be elected Texas' next governor in November, is defending the law in court.
"This decision is a vindication of the careful deliberation by the Texas Legislature to craft a law to protect the health and safety of Texas women," Abbott spokeswoman Lauren Bean said.
Democrat Wendy Davis, who's running against Abbott, launched her campaign for governor behind the celebrity she achieved through a nearly 13-hour filibuster last summer that temporarily blocked the law in the state Senate.
The lawsuit in Texas is the latest battle over tough new abortion restrictions sweeping across the U.S. Earlier Thursday, an Oklahoma doctor who performs nearly half the state's abortions filed a lawsuit to block that state's admitting-privileges law.