The Iowa Supreme Court will allow the state’s “fetal heartbeat bill” to go into effect in a decision handed down on Friday, placing a near-total ban on abortion in Iowa.

The decision is the result of years of legal battles and legislative action to restrict abortion access in the state after the federal right to an abortion was overturned in 2022. 

The seven-person Iowa Supreme Court decided 4-3 to uphold the 2023 law, commonly referred to as the “heartbeat bill,” that held that abortion is not a fundamental right under the Iowa Constitution.

The court found that since abortion is not a fundamental right under the state’s constitution it cannot apply the same level of constitutional scrutiny applied in previous cases blocking state abortion laws. 

The court found there was no textual or historical basis for a woman’s right to an abortion in the Iowa constitution; thus, it is not a fundamental right. 

However, the majority opinion found that there was historical context to support anti-abortion laws in Iowa’s history. For most of the state’s history abortion had been illegal until Roe v. Wade in 1973. 

The court reversed the district court’s injunction on the law and remanded it to the Polk County District Court for further proceedings to decide if the state’s law withstands constitutional scrutiny. 

For now, abortion remains legal up to 20 weeks of pregnancy, but the law will go into effect in the coming weeks once it has been received at the district court and the injunction is dissolved under the Iowa Rules of Appellate Procedure.

What does the law do 

The law, House File 732, will prohibit abortions — with exceptions for rape, incest, or the life of the mother — after a heartbeat is detected in the fetus. 

Heartbeats can be detected as early as six weeks into pregnancy when most people don’t know they are pregnant but can also be as late as eight to 10 weeks into the pregnancy. 

Under the law, a rape must be reported within 45 days and acts of incest within 140 days to qualify for the exception. The report can be made to the doctor performing the abortion and does not need to be made to law enforcement. 

Doctors would need to perform diagnostic tests to determine if a pregnancy is “incompatible with life” to qualify for a medical exemption, and an abortion can be performed if the pregnant woman faces major physical health risks.

How we got here 

Iowa Gov. Kim Reynolds signed a wider Republican-led law in July 2023 during a special session of the Iowa Legislature after an initial 2018 heartbeat bill and after the Iowa Supreme Court declined to set a new standard for which to review constitutional challenges to abortion statutes. 

The court evenly split on whether to strike down the law in 2023 with Justice Dana Oxley withdrawing from the case because of conflicts of interests with one of the parties in the case. With no majority opinion, the “undue burden” test — that requires laws to not place an undue burden on a person’s rights to remain constitutional — remained in effect, blocking the original 2018 heartbeat bill from going into effect. 

The 2023 case before the court was brought after the U.S. Supreme Court overturned Roe v. Wade — the landmark case that protected a woman’s right to abortion— in a 2022 decision in Dobbs v. Jackson, leaving abortion decisions up to the state. 

Reynolds and the state asked the court to reconsider the injunction on the 2018 law. In April, before the Iowa Supreme Court, abortion advocates argued that the court should keep the “undue burden” standard and find the law unconstitutional or set up another intermediate scrutiny to examine the law. 

The state argued that the court should use a “rational basis” standard of review on the law, meaning the law should be allowed to go into effect if the state has a rational basis for depriving a right. Rational basis is the standard of review in place at the federal level after Roe v. Wade was overturned in 2022.

Christensen’s scathing dissent 

Chief Justice Susan Christensen wrote the dissenting opinion for the court and was joined by justices Thomas Waterman and Edward Mansfield. 

Christensen, who was appointed by Iowa Republican Gov. Kim Reynolds to the court, wrote a scathing dissent stating the ruling undermined women’s rights. 

“Today, our court’s majority strips Iowa women of their bodily autonomy by holding that there is no fundamental right to terminate a pregnancy under our state constitution,” Christensen wrote in her dissenting opinion. “I cannot stand by this decision.” 

Christensen argued that the majority’s opinion written by Justice Matthew McDermott ignored the progress in women’s rights since the state’s founding and that “it is a bold assumption to think that the drafters of our state constitution intended for their interpretation to stand still while we move forward as a society.” 

Christensen said that justices instead should interpret the Constitution from a modern lens. 

Christensen said that women did not have a hand in drafting state laws, or the state constitution, explaining why anti-abortion laws are “deeply rooted” in the state’s history. 

“So is it any wonder why Iowa is not flush with legal history demonstrating that a medical procedure specific to women is a deeply rooted in part of our state’s tradition?” she questioned.

Christensen argued that a woman’s fundamental right to choose to move forward with pregnancy should receive strict scrutiny and that it was a woman’s liberty at stake. 

“It is painfully apparent to me that the majority misapprehends the nature of the liberty at issue here,” Christensen wrote. “It is not whether abortion, with the polarizing reactions it evokes, is a fundamental right but rather whether individuals have the fundamental right to make medical decisions affecting their health and bodily integrity in partnership with their healthcare provider free from government interference.” 

Iowa AG Brenna Bird: “There is work left to be done” 

Following the verdict this morning, Iowa Attorney General Brenna Bird said much is still needed to be done to “support Iowa families, parents, and the unborn as the fight for life continues.” 

“Today’s … decision to uphold Iowa’s heartbeat law sends a loud and clear message: Iowa stands for life,” Bird said in a statement Friday. “While today’s decision is a landmark victory, we know that there is work left to be done.” 

Reynolds said that Iowa Republicans are “deeply committed to supporting women” in family planning and parenting. Reynolds said Republicans will continue developing policies that encourage “strong families” such as promoting adoption and protecting in-vitro fertilization. 

“There is no right more sacred than life and nothing more worthy of our strongest defense than the innocent unborn,” Reynolds said in a statement Friday. “Families are the cornerstone of society, and it’s what will keep the foundation of our state and country strong for generations to come.”

Republican leaders in the Iowa House and Senate echoed Reynolds’ statement on Friday. 

Senate Majority Leader Jack Whitver said the decision “marks a step in the right direction for the protection of life.” 

House Speaker Pat Grassley said the ruling today is a victory and that “for too long, the courts have stood in the way of Iowans having their voices heard on this matter.”

Konfrst: “Now is the time for Iowans to hold their elected officials accountable”

Democrats from statehouse elections to the presidency have made access to abortion a defining issue for November. 

Iowa House Democrats leader Jennifer Konfrst said that the ruling is “truly devastating, really beyond measure.” 

“Let’s remember today that women will die and women will leave the state because of what happened today and what Republicans have been pushing for a long time,” Konfrst said in a call with reporters on Friday. 

But the issue is popular with the majority of Iowans, who said they believe abortion should be legal in most cases in a March 2023 Des Moines Register/Mediacom Iowa Poll. 

Iowa Democratic Party Chair Rita Hart said the issue will be a “game-changer” for many Iowans who weren’t persuaded by the threat of a possible abortion ban. 

“This is actual reality,” Hart said in a call with reporters on Friday. “This is going to slap people in the face and tell them, ‘Wake up.’”

Abortion providers are committed to ensuring access 

Iowa reproductive healthcare providers like Planned Parenthood and the Emma Goldman Clinic in Iowa City said they remain committed to continue providing access to abortions for Iowans. 

In fact, the groups said they remain committed to providing abortion care up to 20 weeks in a pregnancy until the decision goes into effect and up to the detection of a fetal heartbeat after the law goes into effect. 

The groups said they will continue to offer services under the exceptions built into the law as well. 

“I want to make it clear Planned Parenthood isn’t going anywhere,” Ruth Richardson, president and CEO of Planned Parenthood North Central State, said in a call with reporters on Friday. “We will continue to provide abortion care in accordance with the law, and when the ban goes into effect, we will provide access to abortion care in Iowa if no cardiac activity is detected.” 

Planned Parenthood will also help women who need abortions outside the bounds of Iowa’s law find care in other states like Minnesota and Illinois that don’t have restrictions on abortion and states with less restrictive laws like Nebraska where abortion is legal until 12 weeks.