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RALEIGH, N.C. (AP) — New regulations governing how North Carolina’s abortion clinics operate are being quietly implemented more than two years after abortion-rights groups protested loudly against lawmakers and Gov. Pat McCrory for passing legislation directing rules be updated.

The final rules took effect Oct. 1, two weeks after a panel that examines regulations created by state agencies signed off on the changes. Some clinic rules had not been altered since the mid-1990s.

There were no formal objections filed after the Rules Review Commission approved the rules developed by the Division of Health Service Regulation. At least 10 of them would have required the rules to clear another hurdle at the General Assembly next spring. The lack of objections reflects how neither abortion-rights advocates nor anti-abortion groups were too displeased with the final regulations.

Drexdal Pratt, the division chief, said his agency has heard no significant complaints.

“We haven’t quite honestly had any pushback,” Pratt said in a recent interview, adding “it was a long process and we were pleased with the outcome.”

Each clinic now must have a more structured nursing staff and a quality assurance program. Clinics must give patients a phone number that will be answered by a person 24 hours a day should questions or complications arise. And clinics must have a plan in place on how they’ll transfer patients to a nearby hospital.

Hundreds of women rallied at the Legislative Building in July 2013 against abortion legislation that Senate Republicans inserted into an unrelated measure directing that clinic regulations had to meet the same standards as those governing ambulatory surgery centers.

The final bill that McCrory signed into law told the Department of Health and Human Services it was optional for the new clinic rules to meet those of the same-day surgery centers. Still, abortion-rights advocates feared the rules would become cost prohibitive to comply with, forcing clinics to shut down, as had happened in other states, like Texas.

Clinics and physicians and other health professionals provided input before the division issued draft rules in December 2014. Representatives of both sides of the abortion debate spoke out at a public hearing on the draft rules, and many others wrote in before a Jan. 31 deadline. The final version made largely technical changes, Pratt said.

While some abortion-rights groups and allies said changes were unnecessary, they were generally satisfied that the updates were based on science, not politics.

Former DHHS Secretary Dr. Aldona Wos “was fair and reasonable in her approach,” said Paige Johnson, a vice president for Planned Parenthood South Atlantic, which operates five licensed clinics in North Carolina. Without speaking for other clinic operators, Johnson said she didn’t believe the regulations were burdensome to the point that clinics couldn’t operate.

“We are not going to shut our doors,” she said.

Tami Fitzgerald of the conservative North Carolina Values Coalition said while the rules should have been tougher, they are putting more scrutiny upon the state’s 16 clinics and will better protect the health and safety of women.

“I think the rules made a good start,” Fitzgerald said.

Fitzgerald said she’s unhappy with an exception to the rule requiring a clinic to have a written agreement with a hospital to facilitate the transfer of clinic patients in an emergency. A clinic still meets this requirement if an agreement isn’t reached as long as the clinic has documents showing it tried.

“That’s essentially a non-rule,” Fitzgerald said.

Abortion opponents also are pleased a law passed last summer that ensured certain clinic requirements would be in place regardless of the final rules. The law made clear clinics would be inspected annually and results posted online. Previously, state inspections were being completed every three to five years. The law also said no one under 18 could work at a clinic.

The rewrite of clinic rules is among several abortion-related laws approved by the GOP-led General Assembly since 2011. A woman generally now must wait 72 hours before getting an abortion. Starting next month, abortion providers must provide ultrasound images and other data from women who have had an abortion after 16 weeks of pregnancy.