NASHVILLE, Tennessee (AP) – Four more Republican-led states will ban nearly all abortions this week as yet another series of laws severely limiting the procedure take effect following the U.S. Supreme Court’s decision to overturn Roe v. Wade.
To date, 13 states have passed so-called trigger laws that are designed to ban most abortions if the higher court rejects the constitutional right to terminate a pregnancy. Most of these states began enforcing their bans shortly after the June 24 ruling, but Idaho, Tennessee and Texas had to wait 30 days beyond the time the judges formally entered the trial, which was several weeks after the ruling was announced. decision.
That period ends on Thursday. Meanwhile, North Dakota’s trigger law is scheduled to take effect on Friday.
The change will not be dramatic. All of these states except North Dakota already had anti-abortion laws in place that largely barred patients from accessing the procedure. And most clinics that offered abortions in those areas either stopped offering these services or moved to other states where abortion remains legal.
Texas, the country’s second-largest state, banned most abortions as soon as fetal heart activity was detected, which can occur as early as six weeks into pregnancy, before many women know they are pregnant. The ban has been in place for nearly a year, since courts refused to stop the law last September.
Although the clinics were severely limited in the services they could provide during this time, they officially stopped offering abortions on the day of the Supreme Court’s decision. Republican Attorney General Ken Paxton argued that state laws that prohibited abortion before Roe v. Wade could be applied prior to the implementation of the trigger law.
Like the current abortion ban in Texas, the upcoming trigger law does not include exceptions for rape or incest. Instead, there is a loophole if a woman’s life or health is in danger.
But the state challenged a legal interpretation put forward by the federal government that aimed to require Texas hospitals to provide abortion services if the mother’s life was at risk. On Wednesday, a federal judge temporarily blocked the government from applying that interpretation.
Texas argued that federal guidance would require hospitals to perform abortions before the mother’s life was clearly at risk, which would violate the state’s trigger law.
A similar situation occurred in Idaho, but there a federal judge ruled Wednesday that the state’s abortion ban violated federal law. US District Judge B. Lynn Winmill said the state could not impose a ban on abortion in cases where a pregnant woman was experiencing a medical emergency that seriously threatened her life or health. Idaho’s abortion ban makes all abortions a crime but allows doctors to defend themselves in court by arguing that the procedure was necessary to save the mother’s life or done in cases of rape or incest.
In all, more than 40 states limit some abortions after a certain point in pregnancy, according to the Guttmacher Institute, a research group that supports abortion rights. These state laws generally require a doctor to determine the gestational age before performing an abortion.
In Tennessee, only two of the six clinics that offer abortions have continued to offer the service since Roe was taken down. They are doing this even as Tennessee enacted a “heartbeat law” similar to the one passed in Texas. Doctors who break the law risk criminal convictions and up to 15 years in prison.
Continuing to operate after the superior court’s abortion decision has sometimes been a “painful” experience, said Melissa Grant, director of operations at carafem, which has had a clinic in Nashville since 2019. The legal environment has required difficult conversations between staff and patients. who may not know how early in pregnancy cardiac activity can be detected.
Since Tennessee requires patients to wait 48 hours before having an abortion, Grant says his team has seen some patients qualify for the procedure during an initial visit only to be turned away two days later because an ultrasound detected fetal heart activity. .
“When we find that we have to reject someone, whether on the first or second visit, conversations can be very emotional. Mostly anger, fear, sadness, sometimes disbelief, and it’s hard on the team,” she said.
The situation is similar in Memphis, where abortion providers at the region’s only operating clinic say they turned away nearly 100 patients who did not qualify for an abortion during their second visit, said Jennifer Pepper, executive director of CHOICES: Memphis Center for Reproductive Health. .
This stress continues to build in the days leading up to the trigger law deadline. As the last consultations took place, the team had to assess each patient’s situation against their likelihood of qualifying under Tennessee’s already severe restrictions and their ability to travel out of state.
“These decisions are very difficult,” Grant said. “You can only see a finite number of people before you have to stop.”
CHOICES was the first abortion clinic to open in Memphis in 1974, and Thursday will be the last. The clinic is preparing for change by increasing its midwifery resources, expanding the birth center and offering gender-affirming care. A second location is also opening in Carbondale, Illinois, a three-hour drive north.
The team planned to meet on Friday to “celebrate how we serve thousands of our patients. We’re starting a new chapter, but it’s not our last chapter,” said Pepper.
In Idaho, 20 states and Washington, D.C., have since filed a court order for the federal government, arguing that Medicaid-funded hospitals must provide “stabilizing treatment” to patients experiencing medical emergencies despite their law. trigger. .
Separately, 16 states allied with Idaho’s Republican leaders in support of the law.
Much of Idaho’s law is yet to go into effect on Thursday, but US District Judge B. Lynn Winmill ruled Wednesday that the state cannot prosecute anyone who is performing an abortion in an emergency medical situation.
Most abortions in Idaho were effectively banned on August 12, when the Idaho Supreme Court allowed a different law to take effect allowing potential relatives of an embryo or fetus to sue abortion providers.
North Dakota is also waiting to see if its trigger law will be implemented. Lawyers for the state’s only abortion clinic, which recently moved a few miles to Minnesota, have asked for a stay as they pursue a lawsuit challenging the ban. A judge has promised to make a decision on the request by the end of this week.