A ruling from the U.S. Supreme Court Thursday will allow for abortions in emergency situations in Idaho - for now.
The justices said they were dismissing an appeal, reestablishing a lower court decision allowing hospitals to perform abortions in emergency cases, despite the state's restrictive abortion laws.
Molly Meegan, chief legal officer for the American College of Obstetricians and Gynecologists, said the organization is glad to see temporary relief in this case but added it is far from a complete solution.
"The way these laws are set up in Idaho and elsewhere are that there are limits on what care can be provided," Meegan explained. "Those limits are not clearly defined, and they're not committed to the discretion, the judgment, the expertise and the training of the physician that's facing a particular patient."
The protection for emergency abortions stems from a federal law known as the Emergency Medical Treatment and Labor Act. The law requires Medicare-funded hospitals to perform abortions in emergency situations. The three dissenting justices in Thursday's case called the Act's ability to preempt Idaho's restrictive abortion laws "plainly unsound."
Dr. Stella Dentas, president of the American College of Obstetricians and Gynecologists, said there is still a lack of clarity around the law in Idaho and OB/GYNs are leaving the state as a result. She noted when doctors face the prospect of jail over restrictive laws like Idaho's, it makes their job more difficult in emergency situations.
"It's already hard enough to make these critical decisions in the moment," Dentas emphasized. "If you're stuck on, 'OK, I can go down path A, but I'm not allowed to go down path B,' that is very confusing for both clinicians and the patients and the shared decision-making that we do."
Meegan added legislators should not be determining what care is available to patients.
"These questions need to be decided by science, by evidence, by the individual case in front of you," Meegan contended. "The idea that you can have black and white worlds being created by people without the expertise, training or experiencing the emergencies is really fundamentally dangerous."
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A majority of South Dakotans have voted to maintain a strict abortion ban but other factors are shifting the landscape for reproductive care in the state.
Of the 10 states voting on abortion during the 2024 election, South Dakota was one of three to keep a ban in place.
Kim Floren, director of the Justice through Empowerment Network, which provides financial assistance to people seeking abortions, said the state's view on the issue is not new but concern is growing over how the federal government may affect reproductive rights.
"I'm feeling the panic from people who are in areas that maybe haven't experienced what we've experienced as far as barriers go," Floren noted. "The reality is that we as a community can figure out how to take care of one another."
The Justice through Empowerment Network provides assistance with travel and transportation, child care, lodging, interpreters, birth control and medical procedure funding. Floren pointed out the organization supports 30 to 40 people per month. The final tally for Amendment G, which would have established a right to abortion in the state's constitution, was 41% for and 59% against.
South Dakotans voted in 2006 and 2008 against near-total abortion bans but Floren stressed since then, President-elect Donald Trump's first term made people feel "emboldened to be more vocal." Still, she acknowledged his second term will begin in a different context than his first.
"Before Dobbs, we did not have all of these reliable, safe websites where you can order abortion pills from and have them sent to your house for extremely cheap," Floren observed. "In some ways, access here has gotten better."
Floren added Gov. Tim Walz of Minnesota will return to his post after running for vice president on the Democratic ticket. Walz in 2023 signed a bill protecting patients who travel to Minnesota for abortion care and their providers from legal penalties in other states.
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It is now up to Wisconsin Supreme Court justices to decide the fate of an abortion law from the mid-1800s.
A circuit court determined last year an 1849 law does not apply to "medically consented" abortions in Wisconsin. The high court heard arguments Monday about whether a 1985 state law overrides the older one, allowing abortions before the point at which a fetus could survive outside the womb.
Jenny Higgins, professor of obstetrics and gynecology at the University of Wisconsin-Madison, said while the impact of this case is critically important, even if the 1849 law is determined to be unenforceable, returning to the status quo would mean a dire landscape for abortion access.
"Even though abortion is technically available at clinics in Wisconsin right now, it's heavily restricted," Higgins explained. "Because of insurance and Medicaid prohibitions, people have to pay out-of-pocket for a service that should be covered by insurance."
The 1849 law, which was brought to light after Roe v. Wade was overturned by the U.S. Supreme Court, prompted a statewide freeze on abortion services for more than a year. Higgins noted if Wisconsin's high court rules the law still applies today, the state would be looking at another abortion freeze.
Abortion access disproportionately affects those who are already the most marginalized, Higgins pointed out. She noted while people from all walks of life may find themselves needing abortion care, factors like poverty and racism make it much harder for some to achieve reproductive autonomy, compared to those with more economic and social resources.
"Those effects make it much harder for folks to be able to access contraceptive care, be in relationships that are stable and healthy and communicative, to be able to see past the end of the day into one's future if you are, again, mostly focused on your own economic scarcity or figuring out how to feed your kids, or figuring out how not to get evicted," Higgins outlined.
The 1976 Hyde Amendment, established three years after Roe v. Wade, prohibits the use of federal funds for abortion. Higgins hopes federal lawmakers will focus more on this amendment when considering the barriers to abortion care.
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Strong reactions are pouring in from both sides as Missouri voters made history by adding abortion rights to the state constitution.
The decision to pass Amendment 3, the "Right to Reproductive Freedom Initiative," makes Missouri the first state to overturn a near-total statewide abortion ban. Advocates and opponents are now gearing up for future battles.
Jamie Morris, executive director and general counsel of the Missouri Catholic Conference in Jefferson City, said he is disappointed with the passage of the amendment but emphasized his organization's pride in the conference's efforts, despite limited resources, and vowed the fight is not over.
"From the church's perspective, win or lose, we were going to continue to advocate for policy to help address the needs of women to help them choose life to begin with," Morris explained. "So that not only you're dealing with, necessarily, the supply of abortion, but also the demand."
In addition to abortion rights, Amendment 3 protects access to contraception and reproductive health services.
Meanwhile, pro-choice advocates in Missouri including Planned Parenthood and the ACLU are celebrating the passage of the amendment, while filing a lawsuit to block some restrictions, including parental consent for minors and continued regulatory oversight of abortion services.
Maggie Olivia, senior policy manager for the advocacy group Abortion Action Missouri, applauded the vote.
"I could not be more proud of the first steps that we are taking together as Missourians to dismantle the decades of political infringements on our access to abortion and, frankly, all reproductive care," Olivia stressed.
Missouri was among nine states with abortion rights measures on the 2024 general election ballot. Amendment 3 takes effect Dec. 5.
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