Four federal appellate courts in recent months have delayed acting on abortion-related challenges as they anticipate a major ruling by the U.S. Supreme Court in a Mississippi abortion case that could overturn landmark abortion rights precedents.

On Wednesday, the full U.S. Court of Appeals for the Sixth Circuit, in an 11-6, order, allowed Tennessee’s ban on abortions because of sex, race or Down syndrome to take effect after being blocked by a district court and affirmed by a panel of the appellate court.