Here's what you need to know about the Iowa Supreme Court's ruling on 6-week abortion ban
Here's what to know about the major abortion decision the Iowa Supreme Court handed down Friday.
What's the decision?
The 4-3 ruling strikes down an injunction by a Polk County court that barred enforcement of a 2023 Iowa law banning abortions after fetal cardiac activity, which the law calls a "fetal heartbeat," can be detected — usually in the sixth week of pregnancy. It also makes it easier for the state to impose other restrictions on abortion.
The ruling came in an appeal by Gov. Kim Reynolds, who signed the law and had called the Iowa Legislature into a special session to pass it. The law replaced a previous one that also had been enjoined by a Polk County court. That injunction also was appealed to the Iowa Supreme Court, which deadlocked 3-3, leaving it in place.
The case the court ruled on Friday was the sixth in the past eight years to be captioned Planned Parenthood of the Heartland v. Kim Reynolds. The reproductive rights organization has repeatedly clashed with Iowa's Republican governor and Legislature over abortion.
Timeline: How Iowa's abortion laws have changed over the decades leading to Friday's ruling
When does the law take effect?
Under court procedures, the law can begin to be enforced in three weeks. Meanwhile, Iowa's limit on abortion remains 20 weeks.
Why did the Supreme Court rule differently in 2024 than it did in 2023?
In the 2023 case, Justice Dana Oxley recused herself. She did not give a reason, but she had previously worked for a law firm that represented an abortion clinic involved in that case. This time, Oxley participated, and joined the majority decision.
What does the latest decision mean in Iowa and who's impacted?
The Iowa Supreme Court's decision means the state can now enforce the abortion ban while the court case continues.
The so-called "fetal heartbeat" law allows exceptions for rape, incest, fetal abnormality or to save the life of the mother. In order to use the rape or incest exception, a doctor must gather facts about the circumstances of the pregnancy and obtain a signed certificate that the information is true, according to administrative rules approved by the Iowa Board of Medicine ahead of the court's latest decision.
The Iowa Board of Medicine offered no insight on how doctors can comply with the provision of the six-week ban that allows abortions to be provided in cases of medical emergency.
What is the penalty for violating the law?
The law does not carry criminal penalties. The Iowa Board of Medicine is the sole authority in charge of enforcement. Guidelines it issued simply say failure to comply with the law or the rules for applying it "may constitute grounds for discipline."
Under existing administrative rules, the board has the authority to revoke or suspend a physician's license or impose civil fines up to $10,000, among other disciplinary actions.
Tell me more about the 'fetal heartbeat' law
The law prohibits nearly all abortions after doctors detect cardiac activity in the embryo, which can occur about six weeks into a pregnancy. Patients often don't yet know they are pregnant at that stage.
The law defines a fetal heartbeat, or cardiac activity, as "the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac."
More: What is a 'fetal heartbeat?' What you should know about Iowa's new 6-week abortion bill
The law requires doctors to perform an abdominal ultrasound on a patient seeking an abortion. If a fetal heartbeat is detected, the abortion cannot be performed unless one of the law's exceptions applies.
Medical professionals told the Des Moines Register in 2023 that it's misleading to call those pulses, usually detectable in the sixth week of pregnancy, a fetal heartbeat, as the embryo is not yet a fetus and the heart is only beginning to form. Doctors noted that each pregnancy is different — cardiac activity may be detected later than six weeks, depending on the patient's body and the ultrasound machine.
Are there any exceptions to Iowa's abortion law?
More: Most abortions now banned in Iowa after Gov. Kim Reynolds signs 'fetal heartbeat' law
Here are the cases where abortion may be performed after six weeks of gestation:
For rape, if the rape is reported to a law enforcement or public health agency or doctor within 45 days of its occurrence.
In a pregnancy that is the result of incest, if the incest is reported to a law enforcement or public health agency or doctor within 140 days.
If "the attending physician certifies that the fetus has a fetal abnormality that in the physician's reasonable medical judgment is incompatible with life."
For a miscarriage "if not all of the products of conception are expelled."
For a "medical emergency," which is defined as "a situation in which an abortion is performed to preserve the life of the pregnant woman whose life is endangered by a physical disorder, physical illness or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy" or when continuing the pregnancy "will create a serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman."
Who is behind the Iowa Supreme Court decision?
Friday's majority decision was written by Justice Matthew McDermott, joined by Oxley and Justices David May and Christopher McDonald.
Chief Justice Susan Christensen and Justice Edward Mansfield both wrote dissents, joined by each other and by Justice Thomas Waterman.
More: Iowa medical board has finalized rules for state's 6-week abortion ban. What they say:
What was the underlying issue in the decision?
The question was what standard the state must meet in order to impose restrictions on abortion. The Iowa Supreme Court in some prior cases used the federal standard at the time. It held that restrictions were unconstitutional if they imposed an "undue burden" on the mother. That high standard of court scrutiny aligns with the Iowa Supreme Court's 2018 decision that found women had a "fundamental right" to have an abortion under the Iowa Constitution.
A more conservative Iowa Supreme Court in 2022 reversed the 2018 finding of a fundamental right to abortion. Under Friday's ruling, the state will have to show only that it had a "rational basis" for imposing abortion restrictions — that basis being to protect the life of the unborn.
This rational basis test will apply to other abortion restrictions going forward.
What do the law's supporters say?
In a statement, Reynolds said: "There is no right more sacred than life, and nothing more worthy of our strongest defense than the innocent unborn. Iowa voters have spoken clearly through their elected representatives, both in 2018 when the original heartbeat bill was passed and signed into law, and again in 2023 when it passed by an even larger margin. I’m glad that the Iowa Supreme Court has upheld the will of the people of Iowa."
Read reactions: What Kim Reynolds, Democrats are saying about the Iowa Supreme Court abortion ruling:
State Sen. Jack Whitver, R-Grimes, said: “Today’s decision marks a step in the right direction for the protection of life. While litigation continues, I appreciate the clarity the Supreme Court has provided on this issue. I am optimistic the common-sense law passed again last year to protect life at the sound of a heartbeat with exceptions for rape, incest, and life of the mother will be found constitutional.”
What do critics have to say?
Critics of the decision included Iowa Democratic Party Chair Rita Hart, who said it stripped Iowa women of reproductive rights they have had for more than 50 years.
"We’ve already seen the effects that these new and extreme abortion bans have on states like Alabama — where IVF is in jeopardy — and in Texas, where women have been forced to miscarry in lobby restrooms because hospitals refused to help them while they’re experiencing medical emergencies," she said.
Leah Vanden Bosch, of the Iowa Access Abortion Fund, an organization that helps Iowans access abortion care that they might otherwise not be able to afford, called the abortion ban an "absolute devastation and violation of human rights."
"We know a ban will not stop the need for abortions," Bosch said in a statement. "Please continue to stay engaged and support people who need abortion care. By working together, we will continue to take care of one another."
Des Moines Register staff writers William Morris, Michaela Ramm and Stephen Gruber-Miller contributed to this article.
Virginia Barreda is the Des Moines city government reporter for the Register. She can be reached at [email protected]. Follow her on Twitter at @vbarreda2.
This article originally appeared on Des Moines Register: What to know about Iowa Supreme Court's ruling on 6-week abortion ban
Solve the daily Crossword
