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

AMES, Iowa– Iowa law banning most abortions after about six weeks of pregnancy takes effect Monday, a drastic change that infuriates — but doesn’t surprise — Sarah Traxler.

When Traxler, a Minnesota-based obstetrician and gynecologist and medical director of Planned Parenthood North Central States, went to high school in a conservative Louisiana town in the 1990s, she saw abortion rights lose ground even then, decades before the US Supreme Court. and the Iowa high court would say there is no constitutional right to abortion.

“The protections of Roe were slowly eroded over time,” she told the Associated Press.

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

It’s an outcome Iowa abortion providers have struggled with but are still prepared for, bolstering abortion access in neighboring states and building on lessons learned where bans took effect more quickly.

States with restrictive laws are “glimpses of our future,” Traxler said. Even with preparedness, 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 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 suspension to be lifted. The district judge’s July 22 orders set July 29 as the first day of execution.

The law prohibits abortion after cardiac activity can be detected, which occurs at approximately six weeks into pregnancy and before many 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 in Iowa was legal up to 20 weeks of pregnancy.

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

Alex Sharp, a senior manager at the health center that runs the Planned Parenthood abortion clinic closest to Des Moines, said staffers were overbooked this week, postponing appointments for people seeking abortions who would likely exceed the legal limit as of of Monday.

Still, this wasn’t an option for everyone. Nearly a third of the people Sharp spoke to said they wouldn’t be able to leave work or find child care until next week. Those patients could work with staff members to find out-of-state appointments, she said.

Across the country, the abortion situation has been constantly changing since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, with triggering laws taking effect immediately, states passing new restrictions or expansions of access, and court battles halting them.

In states with restrictions, the main abortion options are increasingly pills via telehealth or underground networks It is travelingvastly increasing demand in states with more access.

The Guttmacher Institute, which supports abortion rights, designed last month that about 20,000 abortions will be performed in Kansas in 2023, or 152% more than in 2020. Near Iowa, Illinois saw a 71% increase and Minnesota was up 49%. Providers expect to see more flow after Monday.

When the first restrictive laws went into effect, like in Texas, providers essentially had to “figure it out as we went along,” said Amy Hagstrom Miller, founder of Whole Woman’s Health. And while contractors across the country have learned to work within limits, “I never want this to feel normal.”

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

The area’s Planned Parenthood affiliate has also been making investments for more than a year to prepare for Monday. A location added last year in Mankato, Minnesota, is just an hour’s drive from Iowa and recently began providing medication abortions. Just across the state line in Omaha, Nebraska, one facility is quadrupling exam rooms and increasing staffing.

Maggie DeWitte, who has worked for decades to advocate against abortion access in Iowa, said that after Dobbs, it is to be expected that while some states will work to regulate or even eliminate abortion, others will be less restrictive.

“We certainly hope that women don’t travel out of state, but we know that will happen,” she said. “So we just need to continue our educational efforts to let these women know that there are other options out there.”

Many people are unaware that the law has been passed or is coming into force, which makes these conservations even more sensitive. Staff members had to tell patients that they were too far along and that it would be too late unless they traveled and missed more work, Planned Parenthood’s Sharp said.

It’s been difficult, she said, even though clinics are as ready as possible for Monday.

“We’re prepared operationally for it,” Sharp said, “but not emotionally or mentally ready for it.”

___

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