Iowa now bans most abortions after about 6 weeks, before many women know they are pregnant

“There is no right more sacred than life,” Republican Gov. Kim Reynolds said in June. “I am pleased that the Iowa Supreme Court has upheld the will of the people of Iowa.”

Currently, four states in the US ban abortions after about six weeks of pregnancy, and 14 states have a near-total ban at all stages of pregnancy.

The Iowa law and other restrictions across the country will be a focus of the 2024 election, with Republicans celebrating their successes and Democrats criticizing them as an attack on women’s rights. Vice President Kamala Harris, the Democratic nominee for president, has said reproductive rights are at stake in November.

Harris’ campaign released a video Monday to draw attention to the issue as the law takes effect in Iowa.

“What we need to do is vote,” she said. “When I am president of the United States, I will sign protections for reproductive freedom into law.”

Iowa abortion clinics are opposing the new law, but they are preparing for it. They are improving abortion access in neighboring states and learning from the situation where bans went into effect more quickly.

They have said they will continue to operate in Iowa in accordance with the new law, but Sarah Traxler, chief medical officer of Planned Parenthood North Central States, called it a “devastating and dark” moment in the state’s history.

The Iowa law passed the Republican-controlled Legislature in a special session last year, but the American Civil Liberties Union of Iowa, Planned Parenthood North Central States and the Emma Goldman Clinic immediately filed a legal challenge. The law was in effect for only a few days before a district judge temporarily blocked it, a decision that Gov. Kim Reynolds challenged in the state Supreme Court.

The Iowa Supreme Court’s 4-3 ruling in June reiterated that there is no constitutional right to abortion in the state and ordered the blockade lifted. A district judge said last week that the blockade would be lifted Monday morning.

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called it a “historic day for Iowa.”

The law prohibits abortions after cardiac activity can be detected, which is about six weeks. 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 state medical board earlier this year established standards for compliance with the law. However, the rules do not outline disciplinary action or how the board would determine noncompliance.

According to Planned Parenthood representatives and Emma Goldman, three abortion clinics in two Iowa cities are offering in-person abortion procedures and will continue to do so until cardiac activity is detected.

A law based on heart activity is “tricky,” said Traxler of Planned Parenthood. Because six weeks is approximate, “we don’t necessarily have plans to cut people off at a certain gestational age,” she said.

For more than a year, Planned Parenthood has been investing in the region, both inside and outside Iowa, to prepare for the restrictions. As in other regions, it has dedicated staff to answer the phone, help people find appointments, connect with other providers, arrange travel plans or financial assistance.

Also, the center in Omaha, Nebraska, just across the state line, is being renovated and now offers medication abortions in Mankato, Minnesota, about an hour’s drive from Iowa.

However, health care providers fear the dramatic change in access will widen health disparities for Iowa women of color and residents from low-income families.

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.