Iowa has implemented one of the strictest abortion bans in the US

Abortion rights activists march to the US Supreme Court on June 24, 2023 in Washington, DC.  | Sha Hanting/China News Service/VCG via Getty Images

A new six-week ban puts further pressure on abortion providers in the Midwest.

Iowa has enacted a ban on abortions after six weeks of pregnancy, before most women know they are pregnant.

Signed by Republican Gov. Kim Reynolds on Friday, the ban has exceptions for cases where the life or health of the pregnant person is in danger and for survivors of rape and incest, miscarriages, and certain fetal diagnoses.

Abortion providers challenged the ban in state court Wednesday on the basis that it violates Iowans’ constitutional rights to abortion and substantive due process, as well as the state constitution’s inalienable rights clause, which they argue guarantees those rights to women specifically and grants them equal protection under the law. They are asking the court to temporarily block the law, but it remains in effect for now.

Before Reynolds signed the bill, Ruth Richardson, president and CEO of Planned Parenthood North Central States, said in a statement that the ban places an “unacceptable burden on patients’ ability to access essential abortion care, especially those who already face systemic inequities. Hundreds of Iowans will be impacted in mere weeks,”

The law is practically identical to one passed in 2018 that was permanently blocked by a state court in a decision upheld by the Iowa Supreme Court last month. In response, Reynolds called a special session Tuesday with the singular purpose of passing the new law, which she maintains is reflective of Iowans’ values.

“Iowans have elected representatives willing to stand up for the rights of the unborn and, in doing so, they have voted strongly in support of pro-life principles and against the arbitrary destruction of innocent, defenseless lives,” Reynolds said in a statement announcing the special session.

However, polling suggests that Iowans feel differently. A Des Moines Register-Mediacom Iowa poll conducted earlier this year found that 61 percent of Iowa adults supported legal abortion in all or most cases, and only 35 percent said it should be illegal in all or most cases.

Still, openly anti-abortion Republicans continue to win elections in Iowa, which has taken a hard-right turn in recent election cycles. And Republican lawmakers are taking that as a carte blanche to advance their ultra-conservative agenda, including an abortion ban among the most restrictive in the country.

What the ban means for Iowans — and the region

The exceptions to the ban are limited, and Republican lawmakers rejected amendments proposed by Democrats that would have expanded them. The organizations challenging the law, including Planned Parenthood North Central States, the Emma Goldman Clinic, and the ACLU of Iowa, said in a joint statement that people who do meet the criteria for an exception will face “barriers to care” and that “the reality is that abortion will be largely unavailable for most vulnerable Iowans that might try to rely upon these exceptions.”

We’ve already seen massive reductions in care in other states that have enacted abortion bans. In Texas, for example, doctors are put in the position of having to determine whether the life or health of the pregnant person is endangered. That’s led to delays in performing abortions, putting patients at further risk for complications.

If Iowans can’t access abortion in-state, only those with the necessary financial resources may be able to do so elsewhere, and even then, they could face hurdles. Abortion access in the Midwest has severely contracted since the US Supreme Court overturned Roe v. Wade last summer. Now, Wisconsin, Missouri, and the Dakotas have implemented bans on almost all abortions. Indiana will also implement its own ban starting in August.

Now that Iowa has joined those states in severely curtailing abortion access, other states in the region will likely be under further pressure to provide abortions to out-of-state patients. That includes Michigan, where voters resoundingly approved a ballot measure last fall to codify abortion rights in the state constitution.

The state has already seen a significant increase in out-of-state patients in the last year, with Michigan doctors performing 2,761 abortions on such patients in 2022 compared to 1,665 in 2021, according to state data obtained by Bridge Michigan. Planned Parenthood, which operates 14 clinics in the state, has seen its out-of-state patient load nearly triple since the end of Roe.

The question is whether they can continue to expand their capacity to meet increasing demand from out-of-state patients. Many blue states have increased government funding for family planning service providers like Planned Parenthood, and the organization itself is redirecting resources toward clinics that are seeing higher demand, but staffing shortages and rising costs remain a concern.

Update, July 14, 5:50 pm ET: This story was originally published July 12 and has been updated with news that Gov. Kim Reynolds has signed the ban into law.