AMES, Iowa (AP) — Iowa’s state law banning most abortions after six weeks of pregnancy takes effect Monday, a drastic change that infuriates but doesn’t surprise Sarah Traxler.
When Traxler, a Minnesota-based obstetrician-gynecologist and chief medical officer of Planned Parenthood North Central States, was in high school in a conservative Louisiana town in the 1990s, she saw abortion rights losing ground — decades before the U.S. Supreme Court and the Iowa Supreme Court declared there was no constitutional right to abortion.
“Roe’s protections have been slowly eroded over time,” she told the Associated Press.
At 8 a.m. Monday, Iowa will join more than a dozen other states that have drastically restricted access to abortion in the roughly two years since the Supreme Court overturned Roe v. Wade.
It’s an outcome that Iowa abortion providers have fought against but have prepared for nonetheless, strengthening abortion access in neighboring states and drawing on experience from cases where bans went into effect more quickly.
States with restrictive laws are “a glimpse into our future,” Traxler said. Even if they can prepare for it, she told reporters Friday, “this transition is devastating and tragic for the people of Iowa.”
Iowa’s Republican-dominated legislature passed the law last year, but shortly after it went into effect, a judge blocked its implementation following a lawsuit filed by the American Civil Liberties Union of Iowa, Planned Parenthood and the Emma Goldman Clinic in Iowa City.
The Iowa Supreme Court affirmed in June that there is no constitutional right to abortion in the state and ordered the ban to be lifted. The district judge’s July 22 orders set July 29 as the first day of enforcement.
The law prohibits abortions when cardiac activity can be detected, which is around the sixth week of pregnancy and before many people know they are pregnant. There are narrow exceptions in cases of rape, incest, fetal abnormalities or when the mother’s life is in danger. Previously, abortion was legal in Iowa up to the 20th week of pregnancy.
The U.S. Centers for Disease Control and Prevention found that 44% of the 3,761 abortions performed in Iowa in 2021 occurred at six weeks or earlier. Only six abortions occurred at 21 weeks or later.
Alex Sharp, senior health manager at Planned Parenthood’s abortion clinic near Des Moines, said staff overbooked this week, moving up appointments for women seeking abortions who would likely be past their legal deadline on Monday.
That wasn’t an option for everyone, though. Nearly a third of the people Sharp spoke to said they couldn’t get time off from work or find daycare before next week. Those patients could work with staff to find out-of-state appointments, she said.
Since the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, the status of abortion has been in constant flux across the country: laws taking immediate effect, states passing recent restrictions or expanding access, and court cases putting them on hold.
In states with restrictions, the main options for obtaining an abortion are obtaining the pill via telemedicine, underground networks, or traveling, which dramatically increases demand in states with better access.
The Guttmacher Institute, which advocates for abortion rights, predicted last month that about 20,000 abortions would be performed in Kansas in 2023, up 152 percent from 2020. Near Iowa, Illinois saw a 71 percent enhance and Minnesota a 49 percent enhance, with providers there expecting another influx after Monday.
When the first restrictive laws came into effect, such as in Texas, providers essentially had to “figure everything out as we go,” says Amy Hagstrom Miller, founder of Whole Woman’s Health. And while providers across the country have learned to work within the restrictions, “I don’t want this to ever seem normal to us.”
Hagstrom Miller has talked with leaders of the independent Emma Goldman Clinic about accepting referrals to the Whole Woman’s Health clinic in Minnesota, where 20% of abortion appointments are given to out-of-state travelers, she said. That percentage is expected to rise under the recent Iowa law.
Planned Parenthood’s regional affiliate has also been making investments for over a year to prepare for Monday. A location opened 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 the number of exam rooms and hiring additional staff.
Maggie DeWitte, who has campaigned against abortion in Iowa for decades, said that after the Dobbs case, it is to be expected that while some states will work to regulate or even abolish abortion, others will be less restrictive.
“We certainly hope that the women don’t migrate to other states, but we know that will happen,” she said. “So we just have to continue our educational efforts with these women to let them know that there are other options.”
Many people don’t know the law has been passed or is taking effect, making these conversations even more exquisite. Staff have had to tell patients they are too far along and it’s too slow unless they travel and miss even more work, said Planned Parenthood’s Sharp.
It was tough, she said, even though the clinics were well prepared for Monday.
“We are operationally prepared for this,” Sharp said, “but emotionally or mentally not at all.”
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Mark Vancleave in Bloomington, Minnesota, and Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.
