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ABORTIONS DROP IN IOWA IN THE MONTHS FOLLOWING 'HEARTBEAT' LAW GOING INTO EFFECT

Iowa Public Radio | By Natalie Krebs
Published November 21, 2024 at 6:30 AM CST
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Listen • 4:27
Madeleine Charis King
/
Iowa Public Radio
In a special legislative session that lasted around 15 hours, Republican
lawmakers passed a "fetal heartbeat" bill that effectively bans abortion after
six weeks on July 11, 2023. Hundreds of Iowans rallied at the Capitol in protest
and support of the legislation, clashing often in the building's rotunda.

Abortions dropped in Iowa after a controversial new law went into effect in late
July, according to new data obtained by IPR.

Iowa's so-called 'fetal heartbeat' law bans abortion when cardiac activity is
detected, which can be as early as six weeks of pregnancy. State lawmakers
passed the law during a special session last year, but it faced legal challenges
and didn't go into effect until July 29, 2024, following an Iowa Supreme Court
ruling in June.

The Guttmacher Institute, a nonprofit that supports abortion rights, estimated
for the first half of the year — when abortion was still legal up to 20 weeks of
pregnancy — that there was an average of about 400 clinician-provided abortions
in Iowa per month.

That number dropped to an estimated 260 clinician-provided abortions in August,
the first full month after Iowa’s new law went into effect, a 35% decrease as
compared to the monthly average for the first part of 2024, according to new
data from the organization.

A Flourish chart

Isaac Maddow-Zimet, a data scientist at Guttmacher Institute, said the data
includes abortions performed by providers in Iowa and those by patients who
obtained abortion pills by mail from out-of-state providers. It doesn't include
Iowans who traveled out of state for care.

"It's important to keep in mind that doesn't mean that those Iowans who would
have otherwise gotten care in the state aren't accessing abortion," he said.
"What it does mean is that they have a lot less choice in how they can access
it, particularly if they want or need to access in-person care at a clinic."


MORE IOWANS ARE CROSSING STATE LINES FOR CARE AND GETTING ABORTION PILLS BY MAIL



Planned Parenthood North Central States, Iowa's largest abortion provider, is
also reporting a significant decrease in abortions.

Ruth Richardson, the CEO of Planned Parenthood North Central States, told IPR
the number of abortions they performed in Iowa dropped 64% when comparing the
number of procedures performed in the two months before the law went into effect
— June and July — to the number performed in the two months after — August and
September.

The organization started preparing months before the Iowa Supreme Court decision
came out for the possibility of the law going into effect, Richardson said.

This included expanding abortion access at Planned Parenthood clinics in Omaha
and southern Minnesota in anticipation of more Iowans traveling across state
lines for care, she said.

"We wanted to be prepared, no matter what the outcome was, just recognizing with
this ever shifting landscape that we find ourselves in, in terms of thinking
about access to abortion care," Richardson said. "We really wanted to ensure
that a number of our border communities would be prepared for what we knew would
be an increase in the number of people traveling outside of the state for care."

In the two months following the law's enactment, the number of Iowans who
traveled out of state across the region for care at Planned Parenthood clinics
increased 159% as compared to the two months prior, she said.

> > With an increased number of people traveling, we're seeing an increase in
> > the amount of charitable care that is being provided.
> 
> Planned Parenthood of North Central States CEO Ruth Richardson

More than 5,400 people across the country, including many Iowans, have been
aided by Planned Parenthood's patient navigator program, which helps those
seeking an abortion get appointments in another state and find the resources to
get there, Richardson said.

"Over 80% of those individuals are people who wouldn't have been able to get to
that appointment, [that] financial support ...is really creating a connection
for them," she said.

However, Richardson said increase in demand for abortion support resources has
added pressure to the organization, which is already dealing with provider
shortages in some areas and a tighter budget due to inflation and low insurance
reimbursement rates.

"With an increased number of people traveling, we're seeing an increase in the
amount of charitable care that is being provided, and we're also providing
services," she said. "So I just think that there are a lot of pressures right
within the nonprofit health care system that we as Planned Parenthood are
seeing."

Abortion rights supporters also expect an increasing number of Iowans to obtain
abortion pills by mail from providers in states with shield laws, which protect
those providers from legal action.

Previously enacted abortion restrictions like a 24-hour required waiting period
meant Iowans were already finding alternative ways to access abortion even
before the most recent law went into effect, Maddow-Zimet of the Guttmacher
Institute said.

"We know that even pre-six-week ban, many people were accessing abortion in Iowa
through shield law provision, so clinicians based in states with shield laws
prescribing abortion medication and sending abortion medication through the mail
to Iowa residents," he said.


ANTI-ABORTION GROUPS RESPOND



For Iowa's anti-abortion advocates, the state's drop in abortions is a positive
shift.

"We're hopeful that the abortion numbers continue to go down. We're hopeful we
get to a point where we don't have any abortion facilities here in Iowa that are
performing abortions," said Maggie DeWitte, the executive director of Pulse Life
Advocates.

She said her goal is focusing on creating a "culture of life" in the state and
discouraging Iowans from obtaining abortions by traveling out-of-state or
getting pills by mail.

"We want them to realize the vast resources that we have available in Iowa for
them should they decide to parent or place for adoption, and that's what we're
going to continue to focus on is our own state — our own backyard — and try and
help these Iowa women understand that abortion is not the answer for them," she
said.

DeWitte said she' would like to see the procedure outlawed entirely with some
exceptions, such as for the life of the pregnant person.

"We will, and will always, continue to push the gold standard, which for us is
life at conception," she said.

> > We're hopeful we get to a point where we don't have any abortion facilities
> > here in Iowa that are performing abortions.
> 
> Pulse Life Advocates Executive Director Maggie DeWitte




REPUBLICAN STRONGHOLD



Iowa Republicans retained their supermajority in the legislature and even added
a few seats during the election earlier this month, making it more likely the
Legislature could pass further abortion restrictions, like a total ban.

But whether this is something Iowa Republicans will pursue this session is yet
to be seen.

Data and some recent election results suggest severe abortion restrictions, like
Iowa's current cutoff, aren’t popular with the general public. This includes
some Republicans.

A Midwest Newsroom poll in October found 55.7% of Iowans found the law "too
strict," while an Iowa Poll in September found 59% "disapprove" of the law.

At the same time, Democrats campaigned hard on the issue of abortion rights this
election cycle, but it appeared to have little effect on Republicans, as they
had sweeping victories across the country.

As Republicans also prepare to take control of the federal government, there is
support by some for additional abortion restrictions, such as using the Comstock
Act to prohibit sending abortion pills by mail.

But many Republicans have backed away from a national abortion ban, and
President-elect Donald Trump has said he doesn’t support one and would leave it
up to the states to decide.

Anti-abortion policymakers are likely still going to push for more restrictions,
Candace Gibson, the director of state policy at the Guttmacher Institute, said.
At the same time, ten states had citizen-led constitutional amendment measures
supporting abortion rights on their ballots this election, even in
Republican-majority states. Seven of those passed.

"You're seeing these ballot initiatives go on in states where folks didn't think
there was a chance, for example, in Nebraska, Missouri [and] Florida," she said.
"So people know that the public supports abortion access, and so I think that's
still something that policymakers actually need to keep in mind here."


CHANGING ACCESS IN IOWA'S NEIGHBORING STATES



Three of Iowa's neighbors — Missouri, Nebraska and South Dakota — voted on such
measures this election.

Nebraska voters passed a measure backed by anti-abortion advocates limiting the
procedure to 12 weeks of pregnancy, which is the current law, while rejecting a
competing initiative by abortion rights supporters that would have restored
access to the procedure until fetal viability.

South Dakota voters also rejected an amendment that would have restored abortion
access to fetal viability, leaving its near total abortion ban in place.

On the other hand, Missouri voters voted to overturn a near total abortion ban,
only allowing exceptions for life-threatening situations enacted by state
Republicans in 2022 shortly after the U.S. Supreme Court's Dobbs v. Jackson
Women's Health Organization decision, which ended the constitutional right to
abortion.

The amendment enshrines abortion rights in the Missouri state constitution,
restoring access to abortion up to fetal viability, which is about 24 weeks of
pregnancy.

Madeleine Charis King
/
Iowa Public Radio
Abortion-rights supporters in Des Moines.

The Iowa Constitution doesn't allow for citizen-led amendments to go on the
ballot, meaning the state's abortion law couldn't face a similar challenge.

The restoration of abortion access in Missouri could affect where Iowans choose
to seek abortion care, but abortion providers say it could take awhile for the
state to get the point where they can meet the demand for abortion care for both
Missourians and those coming from out-of-state.

"When restrictions are repealed or they're overturned, there is this sort of
process that now has to take place in order to rebuild the infrastructure
because it doesn't happen overnight," Richardson of Planned Parenthood North
Central States said.

Tags
Health Abortion2024 Electionmaternal health
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Natalie Krebs
Natalie Krebs is IPR's Health Reporter and collaborator with Side Effects Public
Media. Krebs has expertise covering health news and issues, including maternal
health and rural health care access. She's covered abortion access and women's
health care in Iowa and the Midwest, news from Iowa's state health agencies, and
medical care and health concerns for elders. Krebs is a graduate of the
University of Texas at Austin.
See stories by Natalie Krebs


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