6-week abortion ban can take effect, Iowa Supreme Court rules, ending injunction

A divided Iowa Supreme Court decided 4-3 Friday to remove an injunction blocking enforcement of Iowa's so-called "fetal heartbeat" abortion law and to remove legal barriers for future abortion restrictions.

The ruling is the latest in a string of legal disputes over the status of abortion in Iowa. It comes after the court in 2022 held there is no "fundamental right" to abortion, and a 2023 case in which the court split 3-3 on what the correct legal standard should be for judging the constitutionality of abortion laws.

The law the court is allowing to take effect bans most abortions after fetal cardiac activity can be detected — about the sixth week of pregnancy, before many women know they're pregnant — with exceptions for rape, incest, unsurvivable fetal abnormalities or to save the life of the mother.

More: Here's what you need to know about the Iowa Supreme Court's ruling on 6-week abortion ban

The decision means the injunction blocking the law will be lifted and the case will be sent back to the district court in Polk County, where Justice Matthew McDermott writes that Planned Parenthood of the Heartland, the lead plaintiff, "cannot show a likelihood of success on the merits" of its challenge to the law under the new legal standard.

The injunction will remain in place until the district court formally receives the case, a process that will take at least three weeks, according to Attorney General Brenna Bird's office. In the meantime, an Iowa law predating the fetal heartbeat statute, allowing abortions until the 20th week of pregnancy, will continue to apply.

Timeline: How Iowa's abortion laws have changed over the decades in advance of Friday's ruling

McDermott wrote Friday's majority decision, which was joined by Justices Dana Oxley, David May and Christopher McDonald. It held that laws restricting abortion are unconstitutional only if the state cannot show a "rational basis" for the law.

What is the legal standard for abortion laws?

In a 2015 case, the court had held that abortion restrictions were unconstitutional if they imposed an "undue burden" on the rights of the mother, a high bar for restrictions to clear. Federal courts at the time defined an undue burden as a "substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability."

In 2018, the Iowa Supreme Court went a step further, finding there was a fundamental right to abortion. But in 2022, the court, with by then a more conservative makeup, reversed that decision.

That opened the door for what the court's majority on Friday agreed is rational basis as the appropriate standard for laws limiting abortions. It allows the state to impose a restriction if it has a rational basis for doing so — in this case, protecting the life of the unborn — and does not deny a fundamental right.

"Stated simply, we can find no principled basis under our due process precedents to apply the heightened scrutiny of an undue burden test to abortion," McDermott wrote, adding that "every ground the state identifies is a legitimate interest for the legislature to pursue, and the restrictions on abortion in the fetal heartbeat statute are rationally related to advancing them."

Dissents argue ruling undermines women's rights

Chief Justice Susan Christensen and Justice Edward Mansfield both wrote dissents, joined by each other and by Justice Thomas Waterman.

Christensen, in her dissent, wrote that the majority decision "strips Iowa women of their bodily autonomy," and that Iowa should have kept its prior legal standard banning abortion restrictions that impose an undue burden on pregnant woman.

More: What Kim Reynolds, Democrats are saying about the Iowa Supreme Court abortion ruling:

She focused in particular on the law's exceptions, including permitting abortions for a woman "whose life is endangered" but explicitly forbidding abortions "when continuation of the pregnancy will create a serious risk ofsubstantial and irreversible impairment of a major bodily function."

"In my opinion, the only female lives that this statute treats with any meaningful regard and dignity are the unborn lives of female fetuses," she wrote. "After that, this statute forces pregnant women (and young girls) to endure and suffer through life-altering health complications that range from severe sepsis requiring limb amputation to a hysterectomy so long as those women are not at death’s door."

Mansfield's dissent likewise suggested that the standard imposed by the majority "gives no weight to a woman's autonomy over her body" and said the Iowa Constitution protects the right not to have children just as much as it protects the rights of parents.

"We need to ask whether a woman has a fundamental right of personal autonomy over her body as part of the 'life' and 'liberty' protected by (the Iowa Constitution)," Mansfield wrote. "I think that answer is clearly yes. We then should ask whether a law practically banning abortion is an improper invasion of that right — notwithstanding the State’s undeniable interest in promoting and preserving human life."

Mansfield wrote that the appropriate balance is to keep the "undue burden" standard in place through the 15th week of pregnancy. Christensen in her dissent concurred that the Iowa Constitution provides that much protection for abortion rights "at the very least."

Plaintiffs call ruling 'devastating blow' to abortion rights

In statements, leaders of Planned Parenthood and Iowa City's Emma Goldman Clinic warned that Friday's ruling will have long-lasting and harmful repercussions for Iowa women.

Ruth Richardson, president and CEO of Planned Parenthood North Central States, said abortion is "essential, time-sensitive health care."

"Every person deserves to have the full range of sexual and reproductive health care they need, including abortion, no matter their ZIP code," she said. "Each patient is the expert on their own life, and we trust patients to make decisions about their health, families, and futures."

More: Planned Parenthood will continue providing abortion care in Iowa after law takes effect

Emma Goldman Executive Director Francine Thomas said in a news conference that her organization would continue scheduling and offering abortions up to July 19, the estimated date for the injunction to be lifted. After that point, she said, the clinic will continue providing abortions prior to the law's cutoff when possible, while also referring women to other providers outside Iowa.

"For so many of our staff, this is not just a job. Providing reproductive health care for women in our state is a passion, and it's a career for many of them," Thomas said. "We're going to work as hard as we possibly can to help folks get the care that they need between now and when the ban takes effect."

Political leaders react to abortion ruling

Gov. Kim Reynolds and Bird were among Republicans who quickly issued statements praising the decision.

“There is no right more sacred than life, and nothing more worthy of our strongest defense than the innocent unborn," Reynolds said. "... Families are the cornerstone of society, and it’s what will keep the foundation of our state and country strong for generations to come.”

Democratic leaders condemned the ruling. Iowa Democratic Party Chair Rita Hart said in a statement that the decision stripped Iowa women "of reproductive rights they have maintained for more than 50 years."

"It's obvious Kim Reynolds and Iowa Republicans do not trust women to make their own decisions regarding their own medical care or for doctors to use their best judgment while treating their patients," Hart said. "Republicans went too far with this abortion ban, and Iowa voters will hold them accountable this November."

Future litigation? ACLU won't say

Although the Supreme Court directed the district court to lift its injunction blocking the law, that won't necessarily end the lawsuit. Planned Parenthood raised several arguments before the district court that were not part of the original injunction ruling and were not addressed on appeal. The plaintiffs could renew their request to have the law blocked under alternative constitutional theories, such as the "inalienable rights" guaranteed to all men and women for "obtaining safety and happiness."

Christensen, in her dissent, also suggested other possible legal avenues of attack. While the majority rejected the argument that the law is unconstitutional "on its face," it could still be vulnerable to "as applied" challenges from individual women harmed by the law, she said.

In addition, she pointed to the state's recent "religious freedom" law, which imposes higher standards for laws that infringe on religious beliefs. An Indiana court recently ruled against an abortion restriction in that state under a similar religious freedom law, Christensen noted, because it ran afoul of Jewish religious teachings permitting women to obtain abortions.

ACLU of Iowa legal director Rita Bettis Austen repeatedly refused to comment on possible next steps in this lawsuit or future litigation, saying the organization will closely review Friday's decision but cannot forecast any litigation strategy.

Staff writer Chris Higgins contributed to this article.

William Morris covers courts for the Des Moines Register. He can be contacted at [email protected] or 715-573-8166.

This article originally appeared on Des Moines Register: Six-week abortion ban can take effect, Iowa Supreme Court says