New Iowa abortion restrictions quickly draw legal challenge

DES MOINES — New restrictions on abortion in Iowa will not be signed into law until Friday, but challengers are not waiting.

The Republican-led Iowa Legislature during a special session passed a new version of a bill late Tuesday that bans abortions once cardiac activity can be detected, usually around six weeks of pregnancy.

House File 732 passed in the House 56-34, with 10 representatives absent. Republican Reps. Mark Cisneros of Muscatine and Zach Dieken of Granville joined Democrats in voting no. Dieken and Cisneros previously sponsored a bill that would ban abortions from the moment of conception. Neither spoke during floor debate.

In the Senate, the bill passed mostly along party lines, 32-17. Republican Sen. Mike Klimesh of Spillville joined Democrats in voting no, and Republican Sen. Kevin Alons of Salix was absent.

Republican Iowa Gov. Kim Reynolds said she will sign the bill into law at a political event hosted Friday by the Christian conservative group The Family Leader. She is scheduled to deliver remarks and sign the bill at 2:15 p.m. Friday.

Planned Parenthood of the Heartland, the Emma Goldman Clinic and the ACLU of Iowa announced Wednesday they already challenged the pending new law in district court. A hearing is scheduled for 1:30 p.m. Friday in Polk County District Court on their petition to temporarily block the law from taking effect.

The legislation would go into effect upon Reynolds’ signature unless the court grants a temporary injunction that would prevent enforcement of the law.

Rita Bettis Austen, legal director of the ACLU of Iowa, said there is precedent. She noted the organization did the same in 2017 when it successfully challenged a law overturned by the Iowa Supreme Court that required women to wait 72 hours before getting an abortion, which also had an immediate effective date.

The three organizations that filed the challenge are the same ones that also challenged a similar law passed in 2018 and stopped by the courts, including a deadlocked Iowa Supreme Court last month. The new, similar bill was passed with the hopes by supporters it will be approved by the courts after 2022 rulings by the Iowa Supreme Court and U.S. Supreme Court effectively removed constitutional protections for abortion access at both the state and federal levels.

Currently, abortion is legal in Iowa until the 20th week of pregnancy. That would change if the new bill is signed into law and implemented.

Iowa Senate Majority Leader Jack Whitver, a Republican from Grimes, said the legislation was passed with the expectation that it will again run through the Iowa courts, and this time the Iowa Supreme Court will be asked to judge the constitutionality of the law — not rule on a procedure like it did in June.

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“I would expect they will go back through the (Iowa) Supreme Court and we’ll get a final answer for Iowans on where the Supreme Court stands,” Whitver told reporters Tuesday after the bill passed the Senate. “You don’t know what’s going to happen with the Supreme Court until they rule on that. So that will be a process that obviously we’ll follow close and adjust from there.”

Advocates for abortion rights say the pending new law would end 98 percent of abortions that are currently legal in Iowa.

“If this abortion ban goes into effect, it will place an unacceptable burden on patients’ ability to access essential abortion care, especially those who already face systemic inequities,” Ruth Richardson, president and chief executive officer of Planned Parenthood North Central States, said in a statement. “Hundreds of Iowans will be impacted in mere weeks. We refuse to stand idly by and will fight every step of the way to block this abortion ban and restore Iowans’ rights.”

Planned Parenthood representatives did not say if abortion providers are canceling appointments in the event the law takes effect. A total of 200 Iowa patients had abortions scheduled with Planned Parenthood and the Emma Goldman Clinic this week and next, said Peter Im, a staff attorney at Planned Parenthood Federation of America.

“We are fully hoping for relief from the court, and we’re hoping that we won’t have any interruption in providing care,” Im said. “But, certainly, we acknowledge that it’s a possibility.”

What does the bill do?

HF 732 prohibits abortions once a “fetal heartbeat” — defined as “cardiac activity, the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac” — is detected. Doctors would be required to perform an abdominal ultrasound to detect embryonic or fetal cardiac activity. Iowa OB-GYNs said a doctor's ability to detect embryonic cardiac activity varies between pregnancies, but can occur as early as six to eight weeks of pregnancy — before many women know they are pregnant.

The bill includes exceptions for pregnancies that are the result of rape in cases reported within 45 days, and incest in cases reported within 140 days. It also includes exceptions for miscarriages, a fetal abnormality that would result in the infant’s death, and for when the mother’s life is threatened.

Supporters say the presence of a heartbeat indicates life that merits equal protection under the law.

“The voices of Iowans and their democratically elected representatives cannot be ignored any longer, and justice for the unborn should not be delayed,” Reynolds said in a statement. “As a pro-life Gov., I am also committed to continuing policies to support women in planning for motherhood, promote the importance of fatherhood, and encourage strong families. Our state and country will be stronger because of it.”

Physicians and opponents argue the use of the term “fetal heartbeat” is misleading. Some major medical organizations, including the American College of Obstetricians and Gynecologists, note that what is detected at about six weeks is electrical impulses. An actual heartbeat does not occur until roughly 17 to 20 weeks of pregnancy, they say.

"The act bans abortions at a stage at which many people do not yet know they are pregnant, and even those who do know may not have had time to make a decisions about whether to have an abortion, research their options, and schedule appointments at a health center, not to mention overcoming the logistical and financial obstacles required to travel to a health center for an abortion,“ the lawsuit states. ”By banning the vast majority of abortions in Iowa, the act unlawfully violates the right of petitioners, their medical providers and other staff, and their patients under the Iowa Constitution and would severely jeopardize their health, safety, and welfare.“

Planned Parenthood of the Heartland provided more than 3,500 abortions in Iowa in 2021 and more than 3,300 abortions in the state in 2022. The provider performed about 1,200 abortions in the first half of this year, according to the lawsuit.

Emma Goldman Clinic, based in Iowa City, provided 686 abortions from October 2020 through September 2021, and 703 abortions from October 2021 to September 2022.

While the ban contains some exceptions, opponents argue they are too narrow and unworkable. Iowa physicians warned the restrictions do not account for complications that occur during pregnancy, and will hinder their ability to provide medically necessary care and respond to time-sensitive issues.

Rep. Shannon Lundgren, R-Peosta, who managed the bill in the House, pushed back on assertions the bill would restrict pregnancy care.

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“I want to assure Iowans this bill does not in any way stop health care for pregnant women,” she said. “The medical emergency definition has been in place since 2017, and Iowa health care providers will continue to provide medical care in their reasonable medical judgment.”

House and Senate Democrats offered amendments voted down by Republicans that would have removed the time-limited reporting requirements for instances of rape and incest to be eligible for exceptions. Democrats said most rapes and instances of incest are not reported, and the short time frame will require many victims to give birth.

Republicans also voted down amendments to create exceptions for any pregnant children 12 years old or younger, and another that would create an exception for people under 16. Republicans said children would be protected under exceptions for rape, incest and medical emergency.

What options will Iowans have for getting an abortion?

Im, the Planned Parenthood staff attorney, said options for Iowans seeking an abortion depends on what the court does now.

The bill focuses on regulating physicians who provide abortions in Iowa. It does not provide penalties directly, but leaves enforcement up to the Iowa Board of Medicine, and directs the board to adopt rules to administer the bill.

Woman who receive an abortion would not face civil or criminal liability. They could still travel out of state for the procedure, and could self-manage their abortion via medication. Access to the medication, however, would be limited if the law takes effect.

A vast majority of abortions performed in Iowa are medically induced.

Individuals in Iowa who are more than six to eight weeks pregnant would need to consult with a physician in a state without abortion restrictions and schedule a telehealth appointment to have medications prescribed and shipped by mail.

Richardson said Planned will continue providing abortion care in Iowa within the legal guidelines, and are prepared to advise people who are beyond six weeks of pregnancy to refer them to abortion providers in other states that allow the procedure.

She said the organization has expanded its abortion patient navigator program that helps make appointments for patients to receive care across the region and country, and cover the cost of transportation, hotel stays and child care for patients traveling more than 100 miles to a health center.

The Minnesota Department of Health reported a 211 percent increase last year in Iowans traveling to the state to receive an abortion. In 2022, 174 Iowans traveled to Minnesota for the medical procedure, compared to 56 in 2021.

Richardson said 160 Iowans traveled to Nebraska in 2021 to receive an abortion, and 146 traveled in 2022 to that state for the medical procedure.

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