Iowa law banning abortions after about six weeks of pregnancy is now in effect

Iowa’s law banning most abortions after about six weeks of pregnancy took effect Monday morning at 8 a.m. following an Iowa Supreme Court decision in June that found the law to be constitutional.

It’s a major change in a state where abortions were legal up to about 20 weeks of pregnancy for the past several years.

Iowa joins a wave of states limiting abortion after the U.S. Supreme Court overturned federal abortion rights two years ago. It’s the fourth state with a six-week ban. There are 14 other states with bans on nearly all abortions, according to the Guttmacher Institute, which supports abortion rights.

Planned Parenthood estimates the new law will block most abortions in the state .

The law not only affects Iowans, but those seeking abortion care in some surrounding states that have also severely restricted the procedure, such as Missouri, according to Planned Parenthood North Central States Chief Medical Officer Sarah Traxler.

"This is going to have pretty resounding impacts on the region itself, especially the Midwest in the South," she said. "I imagine we will be seeing people from Missouri in Omaha and Minnesota."

Planned Parenthood is expanding abortion care in clinics in Minnesota and Nebraska and will have patient navigators to help Iowans who are past the state’s new cutoff get appointments in other states, Traxler said.

Anti-abortion rights advocates like Maggie DeWitte, executive director of Pulse Life Advocates, are celebrating the law going into effect.

During the years of legal battles over abortion, DeWitte said she wasn’t sure if the law would ever be enforced in Iowa.

“It’s just a range of emotions to now finally get to this day where the legal process in the state of Iowa is finally going to protect babies from the moment the heartbeat can be detected,” she said. “And that’s a day for celebration.”

She said she will keep advocating for Iowa lawmakers to ban abortion from the moment of conception.

How the law banning abortions after cardiac activity is detected works

The law bans abortions — with some exceptions — after cardiac activity is detected with an abdominal ultrasound. According to medical providers, that can be as early as six weeks of pregnancy, or it can be a bit later.

The text of the law uses the phrase “fetal heartbeat” to describe this cardiac activity, but medical professionals have criticized that language. They say before 10 weeks the pregnancy is still considered an embryo, not a fetus, and the heart is not fully formed.

Administrative rules approved by the Iowa Board of Medicine detail how medical providers are supposed to implement the law. But some physicians say it’s still not clear how they should handle certain medical complications that can arise during pregnancy.

What are the exceptions to the ban?

• Rape: A pregnancy that is the result of a sexual assault that is reported to law enforcement or a health care provider within 45 days.

• Incest: A pregnancy resulting from a sex act between “closely related persons” that is reported to law enforcement or a health care provider within 140 days.

• Medical emergency: An abortion can be performed to save the life of a person whose life is endangered by a physical condition, but not by a psychological condition. According to the definition of medical emergency in Iowa law , an abortion can also be performed “when continuation of the pregnancy will create a serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.”

• Fetal abnormalities incompatible with life: A physician provides written certification that a fetus has an abnormality that is incompatible with life.

Where are abortions provided in Iowa?

Two clinics provide in-person abortions — a Planned Parenthood clinic in Ames, and the Emma Goldman Clinic in Iowa City.

Carafem, an organization that provided telehealth medication abortions in Iowa, stopped providing abortions in the state on July 19, according to its website .

What are the other requirements for getting an abortion?

Iowa law also mandates a 24-hour waiting period and an additional appointment to get an abortion.

People seeking an abortion in Iowa must see a health care provider to get an ultrasound and receive counseling at least 24 hours before going to a second appointment to receive abortion pills or an abortion procedure.

What happens if someone violates the law?

Doctors who violate the law could face licensing discipline or civil fines. Specific penalties for violating the abortion ban are not spelled out in the law or administrative rules.

Iowa’s law does not contain penalties for people who get an abortion.

Where are Iowans expected to travel for abortions?

Iowans are likely to travel to Minnesota, Nebraska and Illinois — all states where Planned Parenthood has expanded services — to obtain abortions. Read more about the regional impact of Iowa’s abortion ban here .

The Chicago Abortion Fund says it is partnering with the Iowa Abortion Access Fund to help people pay for their abortion and related travel costs.

IPR Health Reporter Natalie Krebs contributed to this story.