Milwaukee Journal Sentinel

More abortion ‘trigger laws’ take effect

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NASHVILLE, Tenn. – Four more Republican-led states will ban almost all abortions this week as yet another slate of laws severely limiting the procedure takes effect following the U.S. Supreme Court’s decision to overturn Roe v. Wade.

To date, 13 states have passed socalled trigger laws that were designed to outlaw most abortions if the high court threw out the constituti­onal right to end a pregnancy. The majority of those states began enforcing their bans soon after the June 24 decision, but Idaho, Tennessee and Texas had to wait 30 days beyond when the justices formally entered the judgment, which happened several weeks after the ruling was announced.

That deadline was Thursday. Meanwhile, North Dakota’s trigger law is scheduled to take effect Friday.

The change will not be dramatic. All of these states except North Dakota already had anti-abortion laws in place that largely blocked patients from accessing the procedure. And the majority of the clinics that provided abortions in those areas have either stopped offering those services or moved to other states where abortion remains legal.

Texas, the country’s second-largest state, has banned most abortions once fetal cardiac activity has been detected, which can be six weeks into pregnancy, before many women know they’re pregnant. The ban has been in place for almost a year, since courts refused to stop the law last September.

While clinics were severely limited in the services they could provide during that time, they officially stopped offering abortions on the day of the Supreme Court ruling. Republican Attorney General Ken Paxton argued that state laws that banned abortion before Roe v. Wade could be enforced ahead of the implementa­tion of the trigger law.

Much like Texas’ current abortion ban, the upcoming trigger law does not

Protesters at North Dakota’s lone abortion clinic are flanked by patient escorts in rainbow-colored vests May 11 in Fargo. North Dakota’s abortion trigger law is scheduled to take effect Friday.

include exceptions for rape or incest. Instead it has a loophole if a woman’s life or health is in danger.

But the state challenged a legal interpreta­tion put forth by the federal government that was aimed at requiring Texas hospitals to provide abortion services if the life of the mother is at risk. On Wednesday, a federal judge temporaril­y blocked the government from enforcing that interpreta­tion.

Texas argued that the federal guidance would have required hospitals to provide abortions before the mother’s life is clearly at risk, which would have violated the state’s trigger law.

A similar situation played out in Idaho, but there a federal judge ruled Wednesday that the state’s abortion ban violated federal law. U.S. District Judge B. Lynn Winmill said the state could not enforce its abortion ban in cases where the pregnant person was experienci­ng a medical emergency that seriously threatened their life or health. Idaho’s abortion ban makes all abortions felonies, but allows physicians to defend themselves in court by arguing that the procedure was necessary to save the life of the mother 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. Those state laws generally require a doctor to determine the gestationa­l age before performing an abortion.

In Tennessee, just two of the six clinics that provide abortions have continued to offer the service since Roe was overturned. They are doing so even as Tennessee has enacted a “heartbeat law” similar to the one passed in Texas. Doctors who violate the law risk felony conviction­s and up to 15 years in prison.

Continuing to operate after the high court’s abortion ruling has been at times a “painful” experience, said Melissa Grant, chief operations officer of carafem, which has had a Nashville clinic since 2019. The legal environmen­t has required difficult conversati­ons between staffers and patients who may be unaware how early in pregnancy cardiac activity can be detected.

Because Tennessee requires patients to wait 48 hours before getting an abortion, Grant says her staff has seen some patients qualify for the procedure during an initial visit only to be turned away two days later because an ultrasound picked up fetal cardiac activity.

“When we find that we do ultimately have to turn somebody away, whether it’s the first visit, the second visit, the conversati­ons can be very emotional. Primarily anger, fear, grief, sometimes disbelief, and it’s difficult for the staff,” she said.

The situation is similar in Memphis, where abortion providers at the region’s lone operating clinic say they’ve turned away nearly 100 patients who did not qualify for an abortion during their second visit, said Jennifer Pepper, chief executive officer of CHOICES: Memphis Center for Reproducti­ve Health.

CHOICES was the first abortion clinic to open in Memphis in 1974, and on Thursday it became the last. The clinic is bracing for the change by increasing its midwife resources, expanding the birth center and offering gender-affirming care. It is also opening a second location in Carbondale, Illinois, a three-hour drive to the north.

In Idaho, 20 states and Washington, D.C., have since filed a friend-of-thecourt brief siding with the federal government as it argues that Medicaidfu­nded hospitals must provide “stabilizin­g treatment” to patients experienci­ng medical emergencie­s despite its trigger law.

Separately, 16 states have sided with Idaho’s Republican leaders in support of the law.

Much of Idaho’s law went into effect Thursday, but U.S. District Judge B. Lynn Winmill ruled Wednesday the state cannot prosecute anyone who is performing an abortion in an emergency medical situation.

Most abortions in Idaho were effectively banned Aug. 12, when the Idaho Supreme Court allowed a different law to go into effect 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 delay as they pursue a lawsuit challengin­g the ban. A judge promised to make a decision by the end of this week.

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