NASHVILLE, Tenn. (AP) — Four more Republican-led states will ban nearly all abortions this week as another set of laws severely restricting the procedure takes effect after the U.S. Supreme Court overturned Roe vs. Wade.
To date, 13 states have passed so-called trigger laws designed to ban most abortions if the high court rejected the constitutional right to end a pregnancy. The majority of those states began enforcing their bans immediately after the June 24 ruling, but Idaho, Tennessee and Texas had to wait 30 days after the justices formally entered the ruling, which happened several weeks after the announcement. of the decision.
That deadline ends on Thursday. Meanwhile, North Dakota’s enabling law is scheduled to take effect Friday.
The change will not be dramatic. All of these states except North Dakota already had anti-abortion laws in place that largely prevented patients from accessing the procedure. And the majority of clinics that provided abortions in those areas have either stopped offering those services or moved to other states where abortion remains legal.
Texas, the nation’s second-largest state, has banned most abortions once fetal heart activity is detected, which can be up to six weeks into pregnancy, before many women know they are pregnant. The ban has been in place for almost a year, after the courts refused to stop the law last September.
While clinics were severely limited in the services they could provide during this time, they officially stopped offering abortions on the day of the Supreme Court ruling. Republican Attorney General Ken Paxton argued that state laws that banned abortion before Roe v. Wade could be enforced before the enabling law.
Like the current abortion ban in Texas, the upcoming enabling law does not include exemptions for rape or incest. Instead, it has a loophole if a woman’s life or health is in danger.
But the state challenged a legal interpretation proposed by the federal government that aimed to require Texas hospitals to provide abortion services if the mother’s life is in danger. On Wednesday, a federal judge temporarily blocked the government from applying that interpretation.
Texas argued that federal guidance would require hospitals to provide abortions before the mother’s life is clearly at risk, which would violate the state’s enabling law.
A similar situation occurred in Idaho, but there a federal judge ruled Wednesday that the state’s abortion ban violated federal law. U.S. District Judge B. Lynn Winmill said the state could not enforce the abortion ban in cases where the pregnant woman was facing a medical emergency that seriously threatened her life or health. Idaho’s abortion ban makes all abortions a felony, but allows doctors to defend themselves in court by arguing that the procedure was necessary to save the mother’s life or was done in cases of rape or incest.
In all, more than 40 states restrict certain abortions after a certain point in pregnancy, according to the Guttmacher Institute, a research group that supports abortion rights. These state laws generally require a doctor to determine the gestational age before performing an abortion.
In Tennessee, only two of six abortion clinics have continued to offer the service since Roe was overturned. They do so even as Tennessee has enacted a “heartbeat law” similar to the one passed in Texas. Doctors who violate the law face a felony conviction and up to 15 years in prison.
Continuing to operate after the Supreme Court’s abortion ruling has been a “painful” experience at times, said Melissa Grant, chief operating officer of carafem, which has had a Nashville clinic since 2019. The legal environment requires difficult conversations between of staff and patients who may be unaware of how early in pregnancy cardiac activity can be detected.
Because Tennessee requires patients to wait 48 hours before getting an abortion, Grant says her staff has seen some patients qualify for the procedure during an initial visit only to be turned away two days later because an ultrasound detected heart failure. fetal activity.
“When we find that we eventually have to turn someone away, whether it’s the first visit or the second visit, the conversations can be very emotional. Mostly anger, fear, sadness, sometimes disbelief and it’s difficult for the staff,” he said.
The situation is similar in Memphis, where abortion providers at the area’s only functioning clinic say they turned away nearly 100 patients who didn’t qualify for an abortion on their second visit, said Jennifer Pepper, executive director of CHOICES: Memphis Center for Reproductive Medicine. Health.
That anxiety continues to compound in the days leading up to the activation law deadline. As the final appointments were made, staff had to weigh each patient’s condition against their likelihood of qualifying for Tennessee’s already strict restrictions and their ability to travel out of state.
“These decisions are very difficult,” Grant said. “You can only see a finite number of people before you have to stop.”
CHOICES was the first abortion clinic to open in Memphis in 1974, and Thursday will become the last. The clinic is preparing for the change by increasing midwifery resources, expanding the birthing center and offering gender-affirming care. It’s also opening a second location in Carbondale, Illinois, a three-hour drive north.
Staff planned to gather on Friday to “celebrate how we have served thousands of our patients. We’re starting a new chapter, but it’s not our last chapter,” Pepper said.
In Idaho, 20 states and Washington, D.C., have since filed a brief with the federal government arguing that Medicaid-funded hospitals must provide “stabilization therapy” to patients who experience medical emergencies despite the law’s activation.
Separately, 16 states sided with Idaho Republican leaders in support of the law.
Much of Idaho’s law will still go into effect Thursday, but U.S. District Judge B. Lynn Winmill ruled Wednesday that the state cannot prosecute anyone who performs an abortion in a medical emergency.
Most abortions in Idaho were effectively banned on Aug. 12 when the Idaho Supreme Court allowed a different law to go into effect that allows potential relatives of an embryo or fetus to sue abortion providers.
North Dakota is also waiting to see if its enabling law will be implemented. Attorneys for the state’s only abortion clinic, which recently moved a few miles to Minnesota, have asked for a delay as they continue a lawsuit challenging the ban. A judge has promised to rule on the request by the end of this week.