A judge in Iowa has ruled that the hotly debated six-week ban on abortions will take effect officially on July 29. This is just over a month after Republican Governor. Kim Reynolds signed the law.

State law’s “fetal-heartbeat” bans abortions after ultrasound detects fetal activity, usually around six weeks into pregnancy. There are exceptions for rape or incest and fatal fetal anomalies, as well as to protect the life of the mother. The law was passed during a special session in 2023 after the Supreme Court, divided on its decision to block a previous version. However, a district court judge enjoined it last year so that it would not take effect.

A divided Iowa Supreme Court, on June 28, ruled the law constitutional. It set a lower bar for future restrictions on abortion. The court ordered the district courts to lift their injunctions and allow the law to take effect. After several delays in the procedural process, the district judge formally gained jurisdiction on the case on July 22.

In an online order published on Tuesday, Judge Jeffrey Farrell stated that the injunction would end at 8 am on July 29, 2018.

The attorneys for Planned Parenthood who sued to challenge the ban had requested that the order be built in advance to ensure that no medical procedures would be disrupted. Farrell wrote, “plaintiffs’ proposal is reasonable for everyone to have fair notice of when enforcement may begin.”

Reynolds, who worked for six weeks ban on smoking since 2018, described the decision as “a victory of life.”

Reynolds stated that “as the fetal-heartbeat law takes effect, we will continue our work to strengthen a life culture in Iowa.” “I am committed to helping women plan for motherhood and promoting fatherhood. I also want to elevate adoption and protect in vitro fertilisation (IVF). Families are at the core of our society and policies that promote strong families will keep our state and nation strong for future generations.

Iowa will soon join a group of more than a dozen states with a near-complete ban on abortions, with some exceptions. In 2022, after the U.S. Supreme Court ruled against Roe v. Wade, Republican legislators across the country introduced and passed a sweeping set of abortion restrictions.

According to The Guttmacher Institute which tracks abortion statistics, fourteen states have bans that are nearly complete, while seven ban abortions before or after 18 weeks gestation. Three other states have similar abortion bans, including Florida Georgia and South Carolina.

According to KFF, “nearly all these bans have exceptions. These fall into four general categories: To prevent the death or the pregnant woman, When there is a risk to her health, When the pregnancy is due to rape, incest or when there’s a fatal fetal abnormality.”

What is Iowa’s “fetal heartbeat” law?

The new law, once it is in effect will replace Iowa’s existing ban on abortions after 20 weeks of gestation.

The “fetal-heartbeat ban” prevents abortions once cardiac activity is detected during pregnancy. This can happen as early as 6 weeks into pregnancy, or two weeks after your first missed period.

The term “heartbeat” has been criticized by doctors as a misnomer. The embryo develops a cluster at six weeks of gestation that produces sporadic electric impulses. These cells will form the different heart structures, but this organ does not develop until later in pregnancy.

Abortion is allowed in the case of rape or incest and when a fetus’s abnormality makes it “incompatible with its life”.

This ban includes exceptions to miscarriage treatment and “medical emergencies” in order to “preserve the life of the woman pregnant” when her life is threatened by “a physical disorder, physical illness or physical injury including a condition that could be life-threatening caused or arising out of pregnancy” or by “continuing the pregnancy would create a significant and irreversible impairment” of major bodily functions.

How many patients will be affected by this ban?

Ruth Richardson, CEO and president of Planned Parenthood North Central States, said recently that her organization estimated 97%-98% of abortions in Iowa would be prohibited once the law is implemented.

Guttmacher Institute projects that Iowa will have 4,200 abortions in 2023. Researchers said that the vast majority of these patients were Iowans.

Iowa’s most recent data indicates that the vast majority (93%) of abortions performed in 2022 occurred between zero and 13 weeks gestation. Ninety-three percent of the 4,062 abortions performed in 2022 took place between zero to 13 weeks gestation.

According to the Centers for Disease Control and Prevention’s data for 2021, most abortions in the United States occur after six weeks gestation. 49 percent of abortions occurred between seven and 13 weeks gestation, while 7% happened at 14 weeks. In contrast, 45% of the results were achieved at six weeks’ gestation or earlier.

How will this law enforced?

Iowa Board of Medicine is the agency that enforces the six-week ban. It is the top medical board in the state and it licenses and regulates all physicians who practice there.

It’s not clear what penalties doctors may face under the law. The board hasn’t provided any additional information on the punishments it will issue for those who violate the laws. However, administrative rules allow the Iowa Board of Medicine, among other things, to put a doctor on probation or issue civil fines or to suspend or revoke their license.

The board approved administrative rules earlier this year that include guidelines to help physicians comply with the law. One of these is the requirement for doctors to perform ultrasounds on patients who are seeking abortions. A doctor cannot perform an abortion if cardiac activity is detected unless one of the narrow exceptions to the law applies.

The rules specify the steps that doctors must follow to ensure they comply with exceptions such as rape, fetal abnormality and incest. These rules, however, do not provide any guidance on how to act in an emergency medical situation. According to the law, an abortion may be performed in order to save the life of the pregnant mother.

Doctors have criticised the administrative rules of the board, saying that they lack clarity about when a provider can intervene if a patient is in danger. Some critics speculate that the threat of losing a medical license may increase a provider’s reluctance to act. Some critics worry that doctors will delay abortions, putting patients’ lives at further risk.

Planned Parenthood Clinic and Emma Goldman Clinic