At first look, 6232 Vance Road is nothing more than a one-story brick building tucked away on a side road off Lee Highway.

But this place has a history.

For almost two decades women came here from across the region, pregnant and often desperate, hoping to make a problem disappear. And for much of that time, crowds gathered here to try to stop them from going in.

From the minute the city’s lone, free-standing abortion clinic opened in 1975, people prayed that its doors would close. The faithful protested with their Bibles, imploring women to change their minds. Walking past the protesters were women, some of them teenagers who felt like they were far too young to have a child, some of them mothers who could not afford another baby.

In the waiting room, the staff handed the women colored cards, and they were called back by color instead of name, to protect their privacy. Outside the building, protesters chained themselves to the door. Others encircled the clinic and sang hymns, refusing to move until police carried them away on stretchers. Protesters were arrested by the dozens. People were determined to end what happened inside.

The fight over 6232 Vance Road, nearly forgotten now, resulted in dramatic battles in court and vitriol in the newspapers and left a permanent mark on the city. And with the vote on Amendment 1 quickly approaching, abortion is again in the spotlight.

Voter approval of the proposed constitutional amendment would give the General Assembly the authority to pass laws governing abortion.

Supporters say the amendment would lead to measures that will allow women to better understand the impacts of abortion and that it will help assure that abortion facilities are safe.

Opponents say the measure represents government interference with a personal decision.

The anti-abortion and pro-choice camps are using new kinds of language — there’s little talk now of killing babies and women’s rights — but at its core, the question of abortion is the same as it’s always been: Should a woman be able to choose to end a pregnancy?

It’s a question that Chattanooga has tried to answer before.

In 1973, the landmark U.S. Supreme Court ruling in Roe v. Wade extended the constitutional right to privacy to include a woman’s right to decide whether to have an abortion.

Prior to the ruling, 44 states, including Tennessee, Alabama, and Georgia, outlawed abortions in most cases, unless the mother’s life or health was at risk. After Roe v. Wade, states still could regulate aspects of abortion, especially after the first trimester of pregnancy. But in the 41 years since Roe v. Wade, all states’ abortion laws have been shaped by one major principle: First-trimester elective abortion is legal.

The Chattanooga Women’s Clinic opened on Vance Road two years after the Roe v. Wade ruling. Any woman still in her first trimester could end her pregnancy for $150. At the time, there were also doctors at Erlanger who would terminate pregnancies, but they eventually shut down their services.

The clinic was the city’s first — and only — free-standing abortion clinic.

From the start, the clinic had enemies. It was a daily struggle to keep the doors open. Protesters, lawsuits and vandalism threatened its existence.

One protester, Charlie Wysong, was a fixture outside the clinic for almost 10 years. He even bought a house close by so that he could be there in five minutes.

Wysong and others who opposed abortion searched for women who had had bad experiences at the clinic and helped them find attorneys to file lawsuits. The clinic was sued again and again, on claims of negligence and malpractice.

Usually, there were just two protesters — Wysong and Dan Martino — but sometimes dozens or even hundreds gathered. They held signs with pictures of fetuses and reminded the young women going inside of the biblical commandment, “Thou shalt not kill.” Once, vandals smashed windows and spray-painted “killer” on the building.

But the Chattanooga Women’s Clinic wouldn’t bend. Instead, the owners fought, because they believed that women should have access to safe abortions. One of the co-owners, Sue Crawley, told The Chattanooga Times in 1990 that she founded the clinic because she had an illegal abortion when she was younger, and she didn’t want other women to have to go through that.

“I don’t want a woman going to back alleys. I want her to have medical treatment the way it should be done,” she told the Times.

Abortion supporters organized in Chattanooga, too, occasionally. Their demonstrations were small but targeted. Activists visited the homes of legislators, signed petitions of support for a woman’s right to choose and abortion, and sent representatives from Chattanooga to a national rally in Washington, D.C.

Selma Cash Paty, a Chattanooga attorney who represented the clinic for many years, helped get an injunction that kept the protesters across the street, away from the clinic doors. Protesters were arrested for disorderly conduct, criminal trespassing and assault. The clinic sued protesters for damaging their reputation and interfering with the performance of a legal medical procedure.

But eventually, the clinic’s defenses began to wear down.

Both of the clinic’s owners, Crawley and Mary Frances Muzzacco, died of cancer by 1993, a fact celebrated by their detractors.

“We prayed to God to change Sue Crawley’s heart and mind, but that if she did not, to bring her judgment upon her,” a clinic protester told The Chattanooga Times in 1995.

Then, in 1993, the Women’s Clinic suffered its final blow. It had been renting its office for nearly two decades when the building’s owner went bankrupt and the building went to auction. A bidding war between the clinic’s abortion doctor, Ed Perry, and abortion opponents ensued. The opponents won, raising nearly a quarter-million dollars in less than a week. The Women’s Clinic was kicked out and never reopened.

It had survived for 18 years, and when it closed, women from Chattanooga left town for abortion services.

Today, more than 20 years after the abortion clinic closed, Chattanooga remains without an abortion clinic, though there are seven of them statewide.

Those who oppose abortion have heralded Chattanooga as a leader in their movement. In 2013, Life News, a news source that opposes abortion, called Chattanooga “an abortion-free city done right” and listed it as one of the biggest cities in the country where there is no access to elective abortion.

Today, the old building on Vance Road is filled with some of the last things that would have been found there when it was an abortion clinic: a rocking chair, tiny shoes, diapers.

Now people come here, to the Choices Pregnancy Resource Center, not to end a pregnancy, but to prepare to have a baby.

On the inside, the Choices Pregnancy Resource Center is a modern and welcoming place where women can talk about alternatives to abortion. The pregnancy center opened in 1985 across the street from the Chattanooga’s Women Clinic, but moved into the same building in 1993 when the clinic closed.

Women, mostly between 19 and 24, come here for free pregnancy tests, counseling, and parenting classes. Volunteers and staff members talk to pregnant women about their options, including a discussion of the trauma and regret that choosing abortion can cause.

Baldwin said that Choices, formerly called AAA Women’s Services, has always been “pro-baby” and “pro-woman,” but that it is trying to include the entire family now.

“We’re launching a men’s ministry, to really be pro-family,” she said.

Behind the building stands a reminder of the old abortion clinic. The National Memorial for the Unborn, built in 1994, honors lives lost to abortion or miscarriage, as well as babies who were stillborn or died in early infancy. People visit the garden and indoor sanctuary to pray and leave notes for the children they never knew. A wall is filled with plaques with inscriptions such as, “Baby, we loved you too late.”

Last month a woman who had an abortion in 1985, when she was 17, was visiting her baby’s plaque. She recently held a memorial service for the unborn baby and had a plaque put in the sanctuary in honor of it.

“At that time, I knew about God, but I didn’t realize that there was a life inside of me,” the woman said.

From 2011 to 2013, states passed more laws to restrict abortion than in the prior three decades, according to the Guttmacher Institute, a nonprofit that researches reproductive health, loosely affiliated with Planned Parenthood. Some states, such as Texas and Mississippi, have all but banned abortion in recent years, passing laws that require ultrasounds and waiting periods. Texas enacted a law a year ago that required the state’s 40 licensed abortion providers to have admitting privileges at hospitals. Now, only eight providers remain. In Mississippi, only one clinic is left.

Currently, Tennessee has a few laws governing abortion — minors must have parental consent, the “abortion pill” must be prescribed to a woman in-person, and physicians who perform abortions must have admitting privileges to hospitals. Also, public funding for abortion is highly restrictive.

Tennessee could follow the same course as Texas, Louisiana, Alabama, and Mississippi, all of which are quickly losing abortion providers. Amendment 1, which will be on the state’s Tuesday ballot, asks Tennesseans whether they agree that there is nothing in the state constitution that guarantees a woman’s right to an abortion.

If the “yes” votes win, the General Assembly will be free to enact legislation that regulates abortion, including new standards for abortion facilities and laws that make no exceptions for victims of rape, incest, or the health or life of the mother.

The abortion rate in Hamilton County has been on a steady decline for the past 10 years. As a whole, women from Tennessee had abortions twice as frequently as women from Hamilton County, according to 2012 data from Tennessee’s Department of Health. The U.S. abortion rate was three times as high as the rate in Hamilton County in 2010, according to the newest available data from the Centers for Disease Control and Prevention.

At current rates in the U.S., about one in three women will have had an abortion by the time she is 45, according to the Guttmacher Institute. But in Chattanooga, the rate is low and dropping. For every 1,000 women aged 15 to 44 from Hamilton County, 3.8 received abortions in 2012, the most recent data show. The rate for Tennessee that year was 8.1. It’s the lowest rate for both Tennessee and Hamilton County, since the state began keeping records in 1997.

Protesting against the procedure in Chattanooga today is all but irrelevant.

But the debate over whether there should be an abortion provider in Chattanooga may soon bubble up again.

A new pro-choice group, Choice Chattanooga, has been working since January to reassert a woman’s right to her own body and to an abortion. Organizers have spent the last several months campaigning for people to vote against Amendment 1, but they have bigger dreams. They want to bring abortion services back to Chattanooga.

“We want to get a Planned Parenthood here, and if an amendment like this were to pass, that would be one more obstacle,” said Lauren Kramer, one of the organization’s founders.