Many patients seeking abortion care in Iowa over the past few weeks were unaware that the state has been banning most abortions since Monday, Planned Parenthood staff said.
More than six years after the bill was first passed in the Legislature, abortion became illegal in Iowa, with few exceptions, at 8 a.m. Monday.
Kristina Remus, a patient care worker at Planned Parenthood, said Friday that many people she works with are unaware of the change in Iowa’s abortion law.
“To say the last few weeks have been difficult is an understatement,” Remus said. “People are confused and looking for answers. And many patients don’t realise there’s a law banning abortions at around six weeks, before many people know they’re pregnant, that’s due to come into effect on Monday. We’re having some incredibly difficult conversations with patients in my department.”
Iowa law prohibits abortion once fetal heart activity is detected, which can occur as early as six weeks into pregnancy. There are some exceptions to the ban, including rape, incest and saving the life of the mother.
The so-called “fetal heartbeat” law was blocked from enforcement shortly after it was enacted in July 2023. It was signed into law by Gov. Kim Reynolds in a special session after the Iowa Supreme Court ruled to uphold a court order challenging a similar 2018 law. But in June of this year, The state’s highest court ruled that a district court judge should vacate the 2023 order and set a lower legal standard for reviewing the constitutionality of Iowa’s abortion laws.
Dr. Sarah Traxler, medical director of Planned Parenthood North Central States, said the bill would have a major negative impact on health care in Iowa — especially maternal and child care and reproductive care, areas of care where the state already struggles with staffing shortages.
“We now live in a reality where politicians have control over the bodies and the futures of Iowans,” Traxler said. “His impact will be broad and generational. Of course, we are tired, but we are not defeated. Instead, we stand strong with the people of Iowa in this moment.”
Shapiro administration tells Pennsylvania court it won’t defend state’s ban on Medicaid-funded abortions
Following District Judge’s announcement law that takes effect Monday, Reynolds said in a statement that “our work will continue to strengthen the culture of life in Iowa” by supporting expectant parents, encouraging adoption and ensuring legal access to in vitro fertilization treatments. She also celebrated that a ban on abortions at six weeks of pregnancy became enforceable after years on the books.
“Today is a victory for life,” Reynolds said. “There is nothing more sacred and no cause more worthy than protecting innocent, unborn lives.”
Remus said that in the week before the law took effect, Planned Parenthood facilities in Iowa were “overbooking” themselves trying to ensure patients had access to legal abortion care.
“But I would say 30% of the people I talked to on the phone told me, ‘Well, I can’t take time off this week, you know, I already have a job scheduled this week and I can’t find daycare, I can’t take time off — I have it for next week,’” she said. “So unfortunately, those people, I was able to get through to the navigator, and they’re going to have to go out of state because they’re past the (gestational age of) six weeks. So I would say we were able to get maybe 50% of the people that were scheduled for next week, but the rest of them, the fact is, it was too late to change their schedules and be able to come in earlier.”
Here’s what you need to know about the law and how abortion providers plan to aid Iowans seeking the medical procedure starting Monday.
What changes will be made to Iowa’s abortion law?
Before Monday, abortions were legal up to 20 weeks of pregnancy in Iowa. After the order is lifted, abortions will be illegal once fetal heart activity can be detected. Heart activity could become detectable as early as six weeks of pregnancy.
There are many exceptions to this rule:
In cases of rape resulting in pregnancy, if the fact is reported within 45 days to law enforcement, public health or a physician. In cases of incest, if the fact is reported within 140 days to law enforcement, public health or a physician. When an abortion is necessary to save the life of the pregnant woman.
Planned Parenthood advocates say the standards for medical providers to determine when an abortion is necessary to prevent a patient’s death are unclear. Lawsuits against other states that ban abortion, including similar exceptions to save the mother’s life, have sought clarification on the exception. Five women filed a lawsuit in Texas in 2023, alleging they were denied abortions despite medical problems that threatened their lives during the pregnancy. Texas Supreme Court dismissed the lawsuit in May.
Abortions can still be legally performed in Iowa before heart activity becomes detectable. Planned Parenthood officials said they plan to continue performing abortions in Iowa legally.
What Abortion Care Will Look Like in Iowa as of Monday
If a pregnant Iowan goes to a health care facility for an abortion, she must have two visits — with a 24-hour waiting period before the abortion is performed — in addition to an ultrasound. The health care provider must also assess whether fetal heart activity can be detected.
If no cardiac activity is observed, the patient can legally obtain an abortion in Iowa.
If cardiac activity is detected, an abortion cannot be performed in Iowa — except for exceptions under the law for rape, incest if reported within certain time frames, and when the abortion is necessary to save the patient’s life.
Alex Sharp, senior health care manager for Planned Parenthood North Central States, said that if someone seeking an abortion goes to one of the organization’s clinics in Iowa and has heart activity, “they will have a conversation with the patient” about the restrictions on the procedure in Iowa and connect them with a patient coordinator who can aid them find care in other states where abortion may be legal.
Remus, of Planned Parenthood’s patient services team, said navigators will then aid the person make an appointment in a neighboring state where abortion is legal.
Navigators will also aid patients see if they have access to financial assistance—through programs like the Planned Parenthood Justice Fund or outside sources like Iowa Abortion Access Fund — to see if they qualify for funding to cover the cost of the procedure, as well as associated expenses such as transport and accommodation.
In recent months, Planned Parenthood has increased the number of patients at its health centers in Omaha, Nebraska, and Mankato, Minnesota, as the organization has prepared to change Iowa’s abortion law.
Will there be future legal challenges to Iowa’s abortion law?
Peter Im, an attorney for Planned Parenthood Federation of America, said earlier in July that reproductive health care advocates are “considering all of our options right now” to challenge the Iowa law restricting abortion. That includes a potential challenge to the Iowa Board of Medicine’s rulemaking on the law, Im said.
However The Iowa Supreme Court’s decision was a 4-3 majority sets a high standard for declaring state abortion laws unconstitutional. A majority of the Supreme Court justices ruled that the “rational basis” test will be used to assess the constitutionality of Iowa’s abortion laws. That means if a state has a legitimate reason to pass a law restricting abortion, the measure can stand.
“Applying this test to this case, we conclude that the Fetal Heartbeat Act is rationally related to the state’s legitimate interest in protecting unborn life,” wrote Justice Matthew McDermott in June majority opinion.
Sally Frank, professor of law at Drake University, he said in June There could be “applicable challenges” to the law, similar to the Texas lawsuit, in the future. Those challenges could be brought by women whose lives are at risk and families of people who have died under the law, because medical personnel may be reluctant to perform abortions when necessary because of a lack of clarity about what qualifies as a “medical emergency” that would make the procedure legal, she said.
Will Iowa enact further abortion restrictions?
Iowa Democrats and reproductive health care advocates have said Iowa Republicans — who control both houses of the legislature and also hold the governor’s office — could seek further abortion restrictions in future legislative sessions following the state Supreme Court ruling. Frank said she expects Iowa to pass measures restricting travel or assistance with out-of-state abortions similar to those passed by conservatives in other states, such as Idaho state law which made it a crime to assist a minor in having an abortion in another state.
While top Iowa Republican Party leaders have not commented on future abortion legislation, other conservative figures have said they are pushing for more restrictions. Chuck Hurley, vice president of the conservative Christian organization Family Leader and a lobbyist for the Iowa Legislature, he told the crowd at the Family Leadership Summit in early July that we “weren’t done” with the abortion issue in Iowa.
“Fourteen states currently protect children from the moment of conception, and Iowa should be the 15th,” Hurley said.
Iowa Capital Dispatch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) charitable organization. The Iowa Capital Dispatch maintains editorial independence. For questions, contact editor Kathie Obradovich: [email protected]. Follow Iowa Capital Dispatch on Facebook AND X.
