After years of fighting Iowa’s strict abortion law, clinics have also prepared to follow it

“Roe’s protections have slowly but surely eroded over time,” she told The Associated Press.

On Monday at 8 a.m., Iowa will join more than a dozen other states where abortion access has been drastically restricted in the roughly two years since the Supreme Court overturned Roe v. Wade.

It’s an outcome that Iowa abortion clinics have fought against, but one they’re prepared for anyway, expanding abortion access in neighboring states and learning from the days when bans went into effect more quickly.

States with restrictive laws are “a glimpse of our future,” Traxler said. Even with the opportunity to prepare, she told reporters Friday, “this transition is devastating and tragic for the people of Iowa.”

The Republican-controlled Iowa Legislature passed the law last year, but a judge blocked its enforcement shortly after the measure took effect because of a lawsuit from the American Civil Liberties Union of Iowa, Planned Parenthood and the Emma Goldman Clinic in Iowa City.

The Iowa Supreme Court reiterated in June that there is no constitutional right to abortion in the state and ordered the blockade lifted. The district judge’s July 22 orders set July 29 as the first day of enforcement.

The law prohibits abortions after cardiac activity can be detected, which is about six weeks into pregnancy and before many people know they are pregnant. There are limited exceptions in cases of rape, incest, fetal abnormality, or when the mother’s life is in danger. Previously, abortion was legal in Iowa up to 20 weeks of pregnancy.

The U.S. Centers for Disease Control and Prevention found that 44% of the 3,761 total abortions in Iowa in 2021 occurred at or before six weeks. Only six abortions occurred at 21 weeks or later.

Alex Sharp, senior manager at the health center that runs Planned Parenthood’s closest abortion clinic to Des Moines, said staff had busy schedules this week and moved up appointments for people seeking abortions who were likely to exceed Monday’s legal limit.

Still, that wasn’t an option for everyone. Nearly a third of people Sharp spoke with said they couldn’t get off work or find child care for the following week. Those patients were able to work with staff members to find out-of-state appointments, she said.

Across the country, the status of abortion has been in flux since the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization. For example, laws banning abortion have gone into effect immediately, states have enacted new restrictions or expansions on abortion access, and lawsuits have stayed those cases.

In states with restrictions, the main abortion options are obtaining pills through telehealth or underground networks and travel. This creates a huge increase in demand in states with more access.

The Guttmacher Institute, which supports abortion rights, predicted last month that about 20,000 abortions would be performed in Kansas in 2023, up 152% from 2020. Nearby Iowa saw a 71% increase in Illinois and Minnesota jumped 49%. Providers there expect more influx after Monday.

When the first restrictive laws went into effect, like in Texas, providers essentially had to “figure it out on the fly,” says Amy Hagstrom Miller, founder of Whole Woman’s Health. And while providers across the country have learned how to work within the restrictions, “I don’t ever want this to seem normal.”

Hagstrom Miller has spoken with leaders at the independent Emma Goldman Clinic about accepting referrals at its Whole Woman’s Health clinic in Minnesota, where 20 percent of abortion appointments go to out-of-state travelers, she said. That percentage is expected to increase under Iowa’s new law.

Planned Parenthood locations in the region have been investing for more than a year to prepare for Monday. A location added last year in Mankato, Minnesota, just an hour’s drive from Iowa, recently began offering medication abortions. Just across the state line in Omaha, Nebraska, a facility is quadrupling its exam rooms and adding staff.

Maggie DeWitte, who has campaigned against abortion in Iowa for decades, said Dobbs expects some states to move to regulate or even abolish abortion, while other states will be less restrictive.

“We certainly hope that women don’t travel to another state, but we know that’s going to happen,” she said. “So we just have to continue our educational efforts with those women to let them know that there are other options.”

Many people don’t know the law has passed or is about to go into effect, making those conversations even more sensitive. Staff have had to tell patients they’re too far away and it’s too late unless they travel and miss more work, Planned Parenthood’s Sharp said.

It was difficult, she said, even though the clinics are prepared as best they can for Monday.

“We are operationally prepared,” Sharp said, “but not emotionally or mentally prepared at all.”

Mark Vancleave in Bloomington, Minnesota, and Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.