Planned Parenthood says it will continue providing abortions in Iowa but only in the very limited circumstances allowed by the state’s six-week abortion ban, which goes into effect at 8 a.m. Monday after a year of legal wrangling.

The law restricts the procedure after six weeks of pregnancy, the point when fetal cardiac activity can be detected, with the only exceptions being cases of rape, incest, a fetal abnormality “incompatible with life” or if the life of the mother is in danger. Iowa had previously permitted abortions until 22 weeks of pregnancy.

Reproductive care groups in neighboring states where the procedure remains legal are already seeing an influx of patients from Iowa. The Chicago Abortion Fund received more than 60 support requests from Iowa residents during the first three weeks of July, a 165 percent increase over previous months.

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“It’s staggering even to me,” executive director Megan Jeyifo said Wednesday.

The Iowa Supreme Court’s sweeping decision on June 28 left abortion rights with the lowest level of constitutional protection, a ruling that reversed an injunction on the 2023 statute and paved the way for the near-total ban to take effect. The court on Monday declined a request for a rehearing from Planned Parenthood, the state’s largest abortion provider and one of the plaintiffs in the case. The following day, a district court judge lifted the injunction.

“Our hearts are heavy as Iowans have lost the ability to make personal, private medical decisions,” said Ruth Richardson, president of Planned Parenthood North Central States. “We will continue to fight to restore their bodily autonomy.”

Republican Gov. Kim Reynolds, who had pushed the GOP-led legislature to pass the measure, this week called the court ruling “a victory for life.”

“There is nothing more sacred and no cause more worthy than protecting innocent unborn lives,” Reynolds said in a statement. She said she remained “deeply committed” to supporting women planning for motherhood by “elevating adoption” and “protecting in vitro fertilization.”

Richardson estimates that the number of abortions performed in Iowa will drop by at least 97 percent starting Monday morning. More than 4,000 procedures were done in the state in 2023, according to the Guttmacher Institute, a policy and research organization that supports abortion rights.

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Eighteen states will now ban all or most abortions, a Washington Post analysis shows, with reproductive rights expected to be a key issue in the fall presidential campaign. Constitutional amendments to enshrine abortion rights already are on the ballot in five states.

Since the U.S. Supreme Court ended federal protection for abortion in 2022, the Chicago Abortion Fund has helped 465 Iowans seeking the procedure and now anticipates even greater need. Jeyifo said Florida’s abortion ban, which took effect May 1, prompted a huge increase in pregnant patients coming to Illinois from there and throughout the South.

The Iowa Abortion Access Fund has seen a 27 percent jump in requests for help since 2021, officials said, and requests to date this year are up 7 percent over 2023.

Groups in Iowa have been planning for the ban’s eventuality for months, according to advocates. Planned Parenthood North Central States, which also covers Nebraska, Minnesota and the Dakotas, has expanded elsewhere. During a call Friday with reporters, chief medical officer Sarah Traxler said the organization increased its health center capacity in Minneapolis and moved to a larger site in Mankato, Minn. Its Omaha facility is growing from four to 16 exam rooms.

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“This abortion ban will further widen already gaping health inequities [in Iowa] affecting the working class, Black people, people living in rural areas and young people,” Traxler said. She and other staff on the call described several challenging days and “extremely difficult conversations” as women set for abortions next week tried to change their procedures to this week. Only about half could be accommodated even with overbooking appointments, they said.

The impact of the law, Traxler stressed, “will be widespread and generational.”

Abortion measures are set for the November ballot in Florida, Nevada, Colorado, South Dakota and Maryland, with activists awaiting confirmation in Arizona, Missouri and Montana that they gathered enough signatures to also put measures on the ballot in their states. Voters have overwhelmingly supported abortion rights in ballot questions since 2022, including in red states such as Kansas and Ohio.

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Iowa’s process toward a constitutional amendment is complex and could take years. In 2021, conservative lawmakers there launched a measure asking voters to decide that there is no right to an abortion in the state, but it has not moved forward.

The new law will limit the procedure to a time frame in which many people don’t yet know they are pregnant. The nonmedical exceptions will only apply if a sexual assault is reported to law enforcement or a health provider within 45 days for rape and 145 days for incest.

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