DES MOINES, Iowa (AP) — The Iowa Supreme Court said Friday the state's strict abortion law is legal, telling a lower court to dissolve a temporary block on the law and allowing Iowa to ban most abortions after about six weeks of pregnancy — before many women know they are pregnant.
The 4-3 ruling is a win for Republican lawmakers, and Iowa joins more than a dozen other states with restrictive abortion laws following the U.S. Supreme Court's overturning of Roe v. Wade in 2022.
The instructions to the lower court will be formally sent in 21 days and, for now, abortion remains legal in Iowa up to 20 weeks of pregnancy. It is unclear how long the district court would take to act after that point.
Currently, 14 states have near-total bans at all stages of pregnancy and three ban abortions at about six weeks.
The Iowa Supreme Court's majority reiterated on Friday that there is no constitutional right to abortion. As the state requested, they instructed courts to assess whether the government has a legitimate interest in restricting the procedure, rather than whether there is too heavy a burden for people seeking abortion access.
In writing the majority's opinion, Justice Matthew McDermott wrote that a right to an abortion is "not rooted at all in our state's history and tradition." In fact, the majority determined it was the opposite.
"The state's interest in protecting the unborn can be traced to Iowa's earliest days," he wrote.
But Chief Justice Susan Christensen emphatically delivered a dissent, writing that the majority opinion "strips Iowa women of their bodily autonomy."
Christensen countered McDermott, saying the majority's "rigid approach relies heavily on the male-dominated history and traditions of the 1800s" and said the Iowa Constitution was not written to reflect the full and equal rights of women.
The ruling previews the ending of a yearslong legal battle over abortion restrictions in Iowa that escalated in 2022 when the Iowa Supreme Court and then the U.S. Supreme Court both overturned decisions establishing a constitutional right to abortion.
In the Iowa State Capitol rotunda, Maggie DeWitte, executive director of Pulse Life Advocates, said she's been working for 25 years to reach this moment.
"Today is celebration for life for moms, for babies and for the entire state," she said. "To think now that we will finally have protection for children is really hard to put into words."
Republican Gov. Kim Reynolds immediately released a celebratory statement Friday morning.
"I'm glad that the Iowa Supreme Court has upheld the will of the people of Iowa," she said.
The Iowa law passed with exclusively Republican support in an one-day special session last July. A legal challenge was filed the next day by the American Civil Liberties Union of Iowa, Planned Parenthood North Central States and the Emma Goldman Clinic.
The law was in effect for a few days before a district court judge put it on pause, a decision that Reynolds appealed.
At the time, Planned Parenthood North Central States said it stayed open late and made hundreds of phone calls to prepare patients amid the uncertainty, rescheduling abortion appointments in other states for those who wanted. Court filings showed Iowa clinics had several hundred abortion appointments scheduled over two weeks last July, with most past the six-week mark in their pregnancies.
Since then, Planned Parenthood has ceased abortion services in two Iowa cities, including one in Des Moines. The other Des Moines location doesn't currently have the capacity to serve patients seeking an abortion, so abortion medication and the procedure are being offered about 36 miles (59 kilometers) north in Ames.
Before Friday, Planned Parenthood providers had again been communicating with people seeking upcoming appointments about the potential outcomes of the high court's decision, Masie Stilwell, the director of public affairs, told The Associated Press in early June. That included the possibility that abortion would no longer be legal for their circumstance and they would need to work with staff to reschedule in other states.
Planned Parenthood North Central States called the decision Friday a "devastating blow" after years of fighting Iowa lawmakers' efforts to restrict abortion access.
"Today's dangerous and reprehensible ruling will impact Iowans for generations to come," said Ruth Richardson, president and CEO.
Abortion access stands to be a major issue in the 2024 election across the country, though it remains to be seen whether Friday's decision will turn the tide in an increasingly red Iowa.
There are limited circumstances under the Iowa law that would allow for abortion after six weeks of pregnancy: rape, if reported to law enforcement or a health provider within 45 days; incest, if reported within 145 days; if the fetus has a fetal abnormality "incompatible with life"; or if the pregnancy is endangering the life of the patient. The state's medical board recently defined rules for how doctors should adhere to the law.
Still, details from the board on enforcement were more limited. The rules do not outline how the board would determine noncompliance or what the appropriate disciplinary action might be.
Also missing was additional guidance on just how imminent risks to the pregnant women must be before doctors can intervene, a question vexing physicians across the country, especially after the Texas Supreme Court denied a pregnant woman with life-threatening complications access to abortion. While the U.S. Supreme Court on Thursday cleared the way for emergency abortions in Idaho, the court stopped short of issuing broader rulings.
Emily Boevers, an obstetrician gynecologist practicing in rural Iowa who advocates for abortion access, questioned how far women will suffer before they are provided life-saving care.
"I hope that our governor will be available by telephone to take the calls wondering if we pass that line where patients are deadly ill and we can perform life-saving care for her," she said Friday. "Our patients will suffer."