Abortions in Iowa down, Iowans traveling to other states up on 1-year anniversary of new restrictions

DES MOINES — The frequency of abortions in Iowa plunged, but the number of Iowans seeking abortions in neighboring states spiked under a new state law that banned most abortions and went into effect one year ago today.

A new state law that — after multiple rounds of litigation — went into effect on July 29, 2024, restricts most abortions in Iowa once an embryo’s cardiac activity can be detected, which typically happens around the sixth week of pregnancy, often before the individual is aware of the pregnancy.

The law contains limited exceptions that allow for an abortion when the pregnancy involves some cases of rape, incest, the life or health of the mother, or a fetal abnormality judged by a doctor to be incompatible with life.

Prior to the state law change, abortion had been legal in Iowa up to 20 weeks of pregnancy with the requirement that the abortion could not be performed until 24 hours after an initial consultation with a doctor.

Since the new state law went into effect one year ago, the rate of abortions in Iowa has declined by more than half, while the number of Iowa women traveling to neighboring states to seek abortions has in some cases as much as doubled.

“They (laws restricting abortions) just make them (abortions) harder to access, and push them out farther … in the gestational timeline, and then just end up making them more inaccessible and more costly for the people who need them the most,” Iowa Abortion Action Fund board chair Lyz Lenz said. Lenz is a former Gazette columnist.

The new restrictions, in the form of House File 732, were passed by statehouse Republicans during a special session of the Iowa Legislature in July of 2023. Opponents challenged the law in the state’s courts, and the Iowa Supreme Court by a 4-3 decision in late June of 2024 deemed the law constitutional.

After final legal procedures in the case, the law went into effect on July 29, 2024.

Abortions in Iowa dropping

There were 2,771 induced, terminated pregnancies in Iowa in 2023, the last full year under the previous state law, and 1,196 in the first six months of 2024, before the law change, according to figures from the Iowa Department of Health and Human Services.

There were just 596 abortions in the final six months of 2024 — including the first five-plus months under the new state restrictions — according to preliminary HHS data.

And in the first five months of 2025, there have been just 378 abortions in Iowa, according to preliminary state figures.

Those numbers average out to roughly 200 abortions per month in the first six months of 2024, 100 per month in the final six months of the year — including the first five months under the new law — and roughly 75 per month this year.

Iowans traveling to other states for abortions

The law also appears to be driving Iowans to seek abortions in neighboring states.

Planned Parenthood, which provides women’s reproductive health care services, including abortions, said it has seen a 182 percent increase in Iowa women seeking abortions at its clinics in Nebraska and Minnesota.

According to data from Nebraska’s Department of Health and Human Services, 358 Iowans had an abortion in the western neighbor state in 2024 — an increase over the 149 Iowans who had an abortion there in 2022 and the 222 in 2023.

The Chicago Abortion Fund, in partnership with the Iowa Abortion Access Fund, saw a 200% increase in Iowans who obtained abortions in Illinois since the new law went into effect. In that time period, the fund connected with 870 Iowans overall, 360 of whom traveled to Illinois for abortions.

In Illinois, abortion is legal until fetal viability, which is roughly around 24 weeks of pregnancy.

In Nebraska, abortions are legal until 12 weeks after gestation with exceptions for rape, incest and life of the mother.

Minnesota state law was changed in 2023 to effectively remove all restrictions on abortions.

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In the first six weeks after the new law went into effect, Lenz said the Iowa Abortion Access Fund saw a significant drop-off in Iowans seeking help with abortions, going from receiving a couple of hundred calls every month to none.

“There was just absolute silence, and that was very concerning. And Chicago was seeing the same thing,” Lenz said. “I think that speaks to a culture of fear. And that also, I think, reveals that there were a lot of people not getting the abortions that they needed.”

Since then, the IAAF has seen a 9 to 10% increase in Iowans reaching out to the organization for help.

The number of Iowans going out of state for abortions has also spiked, which Lenz says is making the procedure more expensive for Iowans with the addition of wraparound care, or the cost of travel, lodging, taking time off work, and in some cases, finding child care.

Iowa’s tightened window around abortion complicates things for those who don’t know they are pregnant until after the ban’s 6-week time period and have to push their out-of-state abortions back further to save for travel costs, Lenz said. IAAF saw one Iowan whose travel expenses to receive an abortion in Washington, D.C., cost roughly $20,000. Lenz said this was a rare circumstance, but added the organization is seeing more of them.

The Chicago Abortion Fund has seen a 100% increase in wraparound care costs it covers for Iowans traveling to the state for abortions, growing from $40,000 in the year before the ban to over $80,000 in the year since the ban, according to the executive director Megan Jeyifo.

“The number is staggering,” Jeyifo said. “You think about, each one of those people has a really unique story and needed an abortion for their reasons that only they might know, and many of them having had to travel for that care, I think is devastating.”

Medication abortions likely next policy debate in Iowa

Since the new law went into effect, Lenz said Iowa Abortion Access Fund has seen an increase in the number of Iowans accessing medication pills by mail. This includes mifepristone, a medication that blocks a hormone called progesterone that is needed for a pregnancy to continue.

Lenz said the IAAF has partnered with the Abortion Freedom Fund to help cover the costs and make the pills more affordable.

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Nationally, there has been an uptick in medication abortions following the Supreme Court's Dobbs decision in 2022, overturning Roe v. Wade. The rate of medication abortions made up 63% of all abortions in the country 2023 compared to 53% in 2020, according to the Guttmacher Institute, a nonprofit that supports abortion rights.

Pulse Life Advocates and other anti-abortion organizations are teeing up a piece of legislation for next session called the “Black Market Abortion Pill Bill,” which Pulse Life Advocates Executive Director Maggie DeWitte said would put safeguards around the medication, adding it is advocates’ “next logical step.”

“What we're looking at as our biggest threat right now is the abortion pills, and particularly the online abortion,” DeWitte told the Lee-Gazette Des Moines Bureau at the Iowa March for Life in June. “It (the bill) would really showcase what we know to be true is that these drugs are dangerous and that these women need to have information.”

DeWitte said 1 in 10 women experience adverse effects after taking the abortion pill, citing a recently published study from the right-leaning Ethics and Public Policy Center. The study has not been peer-reviewed or published in a medical journal and reproductive rights advocates have criticized it, arguing it's not supported by science.

During the 2025 legislative session, Republican state lawmakers attempted to restrict the medication. House Study Bill 186, would’ve required health care providers in Iowa to tell patients that it may be possible to reverse the effects of a medication abortion. Reproductive rights advocates said the bill would mislead people into thinking medication abortions are unsafe and reversible. The bill made it out of committee but failed to make it to the House floor.

The FDA has found that performing abortions using mifepristone followed by misoprostol is safe and effective.

How Iowa’s abortion restrictions are impacting providers

The state restrictions have led to changes at providers like Planned Parenthood. The organization in May announced its plan to close clinics in Cedar Rapids, Ames, Sioux City and Urbandale — leaving only clinics in Des Moines and Iowa City.

Planned Parenthood continues to perform abortions in compliance with the new state restrictions, said Dr. Sarah Traxler, the Chief Medical Officer of Planned Parenthood North Central States.

Meantime, Planned Parenthood has been expanding its facilities and services in neighboring states — in part to accommodate the increase in Iowans traveling to seek abortion services.

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“Because we realize people need to travel across state lines, we have been making long-term regional investments to ensure that patients who are facing bans like the one in Iowa have some regional options,” Traxler said.

Traxler said, for example, Planned Parenthood increased the number of exam rooms at its clinics in Mankato, Minn., and Omaha, Neb. — right across the Missouri River from Council Bluffs — including tripling its patient capacity in Omaha.

The Emma Goldman Clinic in Iowa City says it continues to offer surgical and procedural abortions.

Even before the new restrictions were passed into law, Iowa had the nation’s worst ratio of obstetrics and gynecologist specialists per population. According to a 2017 report from the American College of Obstetrics and Gynecologists, Iowa had 3.3 OBGYNs per 10,000 women of reproductive age — the worst ratio in the U.S. and well below the national average of 4.5 OBGYNs per capita.

When the law was passed, critics argued it would make the situation in Iowa even worse by making it less attractive for OBGYN doctors to work or attend medical school here. Some Iowa physicians also expressed concern that the law’s language was too vague and did not make clear how doctors were expected to consider women eligible for an abortion under the law’s exceptions.

There has been no discipline related to abortion since Iowa’s new law went into effect, a spokeswoman for the Iowa Department of Inspections, Appeals and Licensing said.

The most recent state data on OBGYN doctors and residents in Iowa does not include the time period after the new state restrictions went into effect in 2024.

The number of OBGYNs in Iowa decreased by 4.1 percent from 2019 to 2023, according to an Iowa Department of Health and Human Services report published early this year.

And the University of Iowa had 23 OBGYN residents in the 2023-2024 state budget year, according to the Iowa HHS report.

Both figures show the state of Iowa OBGYNs and residents before the new state restrictions went into effect in July of 2024 and thus do not reflect any potential impact of the new state law.

What abortion opponents are saying

A year after the 6-week abortion ban went into effect, anti-abortion advocates are still celebrating its enactment.

During this year’s Family Leadership Summit in Des Moines, Susan B. Anthony Pro Life America President Marjorie Dannenfelser commended the new law and the decrease in abortions across the state.

“These laws save lives,” Dannenfelser said in her remarks. “We used to always say that, and now it's turning out to be true. We will know. We will meet the children.”

Jennie Bradley Lichter, the president of the March for Life Education and Defense Fund, told a crowd gathered in the Iowa State Capitol Rotunda in June for the annual March for Life that despite the closure of Planned Parenthood clinics and the state’s abortion restrictions, Iowans should continue working toward limiting abortions.

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“Our political and our cultural leaders take notice of events like this one, which are unmatched opportunities to show in the flesh the persistence and the doggedness and the power of the pro-life movement here in Iowa,” Bradley Lichter said. “Even here in Iowa, there's still a lot of work left to do, and today we have some specific policy goals to rally around … all of us here know that women deserve real, compassionate health care and genuine pregnancy support, not dangerous pills that are misleadingly pushed on women as a quick fix.”

Comments: (515) 355-1300, erin.murphy@thegazette.com

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