Abortion ban: What impacts Iowans can expect going forward

Iowans are now likely to experience devastating impacts to maternal health care and higher rates of infant and maternal mortality as a result of our new abortion ban.

As of Monday, Iowa now bans abortion at six weeks, before most people know they’re pregnant, and with few exceptions. Only three other states—Florida, Georgia, and South Carolina—ban abortion that early. (Fourteen states have total abortion bans.)

Iowa bans abortion when electrical impulses—falsely called heartbeats—are detected in embryos, which can be as early as six weeks.

South Carolina also bans abortion at this point, and the number of abortions provided in the health system went down from 870 in August 2023 to 250 that September—a 71% decrease, according to the Guttmacher Institute. In Georgia, another state with a similar ban, abortions declined 50%.

Iowa’s ban was made possible because the Iowa Supreme Court in 2023 ruled there was no right to abortion in the state Constitution.

A week later, a 6-3 majority of the US Supreme Court said there isn’t a right to abortion in the US Constitution either, overturning Roe v Wade. Three of those six justices were appointed by convicted felon and former President Donald Trump.

Studies have shown there have been devastating impacts to maternal health care, rates of infant and maternal mortality, and a loss of dignity in states with draconian abortion bans.

Thousands of Iowans will be affected

Already, the Guttmacher Institute, a research and policy group that tracks abortion restrictions across the country, has estimated the impacts Iowans could experience.

According to their research, Iowans have had an estimated 1,370 clinician-provided  abortions between January and April of this year, and an estimated 3,730 clinician-provided abortions in all of 2023. Clinician-provided abortions are surgical and medication abortions that happen in the clinic as well as the medication prescribed through telehealth appointments or virtual providers.

Before Monday, Iowa was also a destination for people unable to get care in their home states. In 2023, an estimated 470 non-Iowans got abortions in Iowa. The majority came from Nebraska, where a 12-week abortion ban is in place.

Now, Iowans will need to rely on other states for abortion care, whether they go to another clinic or order pills through doctors in other states. More than 940 Iowans left the state for abortion care in 2023.

New doctors won’t stay in abortion ban states

In Iowa’s ban, there are exceptions for rape and incest, but both crimes have reporting requirements before a patient can use them. There are also some exceptions for fatal fetal abnormalities and the life of the mother, but there is no guidance for how doctors should navigate those situations. Iowa doctors have said the exceptions won’t help Iowans.

In other states, patients have rarely been able to use the exceptions in abortion bans. When they do, the care has often been delayed to the point that patients are in serious medical conditions. Many women have needed emergency surgeries.

Though rape and incest don’t have to be reported to law enforcement under Iowa’s law, doctors are required to interrogate patients about their attacks if those patients ask for the exception.

Most cases of rape and incest aren’t reported.

OB-GYNs have also left states with abortion bans, leaving them with shortages in doctors who specialize in reproductive health. Graduates from medical schools (not just OB-GYNs) also don’t want to practice in states with bans.

Iowa already has many maternity care deserts, especially in rural areas. If doctors leave, or don’t come here in the first place, that problem will only worsen.

61% of Iowans disagree with ban

A majority of Iowans—61% according to the latest Des Moines Register poll—think abortion should be legal in all or most cases. That majority includes 69% of women and 52% of men.

Yet, Iowa Republicans still frequently say restricting abortion is the will of the people, because they keep getting elected. This is despite Iowa Republicans rarely campaigning on abortion, especially while the 2018 ban was working through the courts.

Iowa Republicans have also stopped pursuing an amendment to the Iowa Constitution which would have explicitly outlawed abortion. The last step to amend the state constitution is to put the language on the ballot.

Iowa Democrats have introduced a bill to amend the constitution to guarantee abortion rights, but Republicans are unlikely to discuss or vote on it.

There is no process in Iowa for voter-driven ballot initiatives, which voters in other states have used to enshrine reproductive rights into law.