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"I look forward to a new future in North Dakota and hope our lawmakers will finally give up on their crusade to force pregnancy on people against their will," said one advocate.
Two days after Republican presidential candidate Donald Trump claimed that "every Democrat, every Republican, liberal, conservative" wanted the federal right to abortion care to be overturned by the U.S. Supreme Court, a North Dakota judge became the latest on Thursday to strike down a state-level abortion ban, saying it violated residents' constitutional rights.
"The North Dakota Constitution guarantees each individual, including women, the fundamental right to make medical judgments affecting his or her bodily integrity, health, and autonomy, in consultation with a chosen healthcare provider free from government interference," wrote Judge Bruce Romanick, a District Court judge. "This section necessarily and more specifically protects a woman's right to procreative autonomy—including to seek and obtain a previability abortion."
The near-total ban on abortion care will be officially blocked in the coming days, in a move that the Center for Reproductive Rights (CRR) said could ultimately help restore access for people across the Midwest, as abortion care is currently banned in South Dakota and heavily restricted in nearby states including Nebraska and Iowa.
Meetra Mehdizadeh, a staff attorney at CRR, which filed a lawsuit against North Dakota's ban in 2023, said the ruling "is a win for reproductive freedom, and means it is now much safer to be pregnant in North Dakota," but warned that Republican lawmakers who passed the law have already done damage to pregnant people in the state that will take time to reverse.
"The damage that North Dakota's extreme abortion bans have done cannot be repaired overnight," said Mehdizadeh. "There are no abortion clinics left in North Dakota. That means most people seeking an abortion still won't be able to get one, even though it is legal. Clinics are medical facilities that need to acquire doctors, staff, equipment—they can take years to open, like most healthcare centers. The destructive impacts of abortion bans are felt long after they are struck down."
CRR argued in the case that the ban was too vague for medical providers to determine when an exception would be allowed for a pregnant patient whose life or health was at risk.
"This left physicians who provided abortions with the threat of having to defend their decision in court if someone were to question the provider's judgment," said the group. "Violating the ban was considered a class C felony, punishable by a maximum of five years of imprisonment, a fine of $10,000, or both."
Among the plaintiffs represented by CRR was Red River Women's Clinic, which was North Dakota's sole abortion care provider until a prior ban forced it to relocate from Fargo to Moorhead, Minnesota, where abortion has remained legal following the U.S. Supreme Court's overturning of Roe v. Wade.
"Today's decision gives me hope. I feel like the court heard us when we raised our voices against a law that not only ran counter to our state constitution, but was too vague for physicians to interpret and which prevented them from providing the high quality care that our communities are entitled to," said Tammi Kromenaker, director of the clinic. "Abortion is lifesaving healthcare; it should not be a crime. I look forward to a new future in North Dakota and hope our lawmakers will finally give up on their crusade to force pregnancy on people against their will."
Since Roe was overturned in 2022, numerous women have shared stories of being denied abortion care after suffering complications—including some that were life-threatening.
Judges in states including Wyoming, Utah, and Montana have blocked abortion bans in recent years, and voters have rejected anti-abortion ballot measures and approved ones that support the right to abortion in states including Kentucky, Kansas, Ohio, and Michigan.
"I ended up losing half of my fertility and if I was made to wait any longer, it's very likely I would have died," said one Texas patient.
Monday reporting from The Associated Press and newly filed federal complaints highlight how abortion restrictions enacted in U.S. states since the 2022 reversal of Roe v. Wade endanger the health and lives of pregnant people nationwide.
Building on a report published earlier this year ahead of oral arguments in a relevant U.S. Supreme Court case, the AP's Amanda Seitz revealed that "more than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022," according to an analysis of federal hospital investigations.
Legal experts and medical providers argue that "nursing and doctor shortages that have plagued hospitals since the onset of Covid-19, trouble staffing ultrasounds around-the-clock, and new abortion laws are making the emergency room a dangerous place for pregnant women," Seitz reported. Even when laws make exceptions intended for cases of rape, incest, and emergencies, some doctors and facilities decline to provide care out of fear of state restrictions.
As the AP detailed:
A pregnant patient at a Bakersfield, California, emergency room was quickly triaged, but staff failed to realize the urgency of her condition, a uterine rupture. The delay, an investigator concluded, may have contributed to the baby’s death.
Doctors at emergency rooms in California, Nebraska, Arkansas, and South Carolina failed to check for fetal heartbeats or discharged patients who were in active labor, leaving them to deliver at home or in ambulances, according to the documents.
Seitz also shared stories from Florida, Idaho, Texas, and Washington. Two women from Texas—Kelsie Norris-De La Cruz and Kyleigh Thurman—had the Center for Reproductive Rights (CRR) file complaints on their behalf with the U.S. Department of Health and Human Services last week. They both had ectopic pregnancies and lost a fallopian tube.
"Despite the fact that my life was clearly in danger, the hospital told me that they could not help me. I ended up losing half of my fertility and if I was made to wait any longer, it's very likely I would have died," Norris-De La Cruz said Monday in a CRR statement.
"The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare," she continued. "So, I'm filing this complaint because women like me deserve justice and accountability from those that hurt us. Texas state officials can't keep ignoring us. We can't let them."
Thurman said that "I never imagined I would find myself in the crosshairs of my home state's extreme abortion bans. For weeks, I was in and out of emergency rooms trying to get the abortion that I needed to save my future fertility and life. This should have been an open-and-shut case. Yet, I was left completely in the dark without any information or options for the care I deserved."
"Pregnancy is not straightforward, and I now have to live with the consequences of these extreme laws every day," she added. "None of this should have happened to me, and I want to make sure this doesn't happen to anyone else."
Beth Brinkmann, CRR's senior director of U.S. litigation, asked: "How many more people will nearly die before we see change? These women are proof that exceptions do not make abortion bans less dangerous, even when they are exceedingly clear."
"Texas law clearly allows for abortions to treat ectopic pregnancies, and federal law requires it," Brinkmann explained. "Yet, Kelsie and Kyleigh were denied absolutely urgent care. As long as these bans are in place, doctors will be terrified to provide abortions of any kind."
"It's impossible to have the best interest of your patient in mind when you're staring down a life sentence," she asserted. "Texas officials have put doctors in an impossible situation. It is clear that these exceptions are a farce, and that these laws are putting countless lives in jeopardy."
The relevant Supreme Court case focuses on Idaho's strict abortion ban and the Emergency Medical Treatment and Labor Act (EMTALA), a federal law requiring emergency departments that accept Medicare to provide patients with "necessary stabilizing treatment," which the Biden administration argues includes abortion care.
Two years after reversing Roe with the Dobbs v. Jackson Women's Health Organization ruling, the high court in June dismissed the Idaho case without ruling on its merits and sent it back to the lower courts. The decision temporarily restored emergency abortions in Idaho but, as CRR said at the time, "still leaves millions of people in states with abortion bans vulnerable."
In response to the "horrifying" AP reporting and CRR complaints, reproductive rights advocates, including some doctors, called out the Supreme Court's right-wing supermajority—led by Chief Justice John Roberts—and politicians who installed them and are trying to outlaw abortion care.
"In addition to these individual incidents is the horrifying recognition that they are not one-off consequences of some short-term disaster. They represent a reality created by the Supreme Court that will take a generation at minimum to undo. This is now our status quo," said Gillian Branstetter, a communications strategist at the ACLU, on her personal social media.
Denver Post opinion editor Megan Schrader declared that "pregnant women are suffering because of the twisted and corrupted jurisprudence of Justices Neil Gorsuch, Samuel Alito, Amy Coney Barrett, Brett Kavanaugh, and Clarence Thomas."
Dr. Michelle Au, an anesthesiologist and Democratic member of the Georgia House of Representatives for the 50th District, stressed that "standards of care haven't changed. EMTALA hasn't changed. What has changed are state laws inhibiting doctors from caring for patients."
Au took aim at former President Donald Trump, the Republican nominee for the November election, declaring that "Trump did this."
American Bridge 21st Century, a super political action committee and research group that supports Democrats, similarly said Monday that "Trump overturned Roe and American women are paying the price."
Although Trump has recently tried to downplay the significance of abortion rights in this cycle and distance himself from some restrictions, recognizing them as politically risky, he has previously backed anti-abortion laws and bragged about appointing half of the justices who overturned Roe. Rights advocates fear what his return to office would mean for reproductive freedom.
Trump and his vice presidential candidate, anti-choice U.S. Sen. JD Vance (R-Ohio), are set to face Democratic Vice President Kamala Harris and her running mate, Minnesota Gov. Tim Walz, on November 5.
"This is an immense victory for the health, safety, and dignity of people in Kansas and the entire Midwestern region, where millions have been cut off from abortion access," said one advocate.
Reproductive rights defenders on Friday cheered a pair of Kansas Supreme Court decisions reaffirming the right to abortion and striking down various restrictions—rulings expected to impact people beyond the Midwestern state, given how many patients must now travel for care.
"The state devoted much of its brief to inviting us to reverse our earlier ruling in this case that the Kansas Constitution protects a right to abortion. We decline the invitation," Justice Eric Rosen wrote in the decision against Senate Bill 95, which outlawed a common abortion procedure for second-trimester pregnancies called dilation and evacuation (D&E).
Rosen was referring to the court's 2019 ruling that "Section 1 of the Kansas Constitution Bill of Rights affords protection of the right of personal autonomy," which "allows a woman to make her own decisions regarding her body, health, family formation, and family life—decisions that can include whether to continue a pregnancy."
The justice wrote Friday that "S.B. 95 does not further patient safety, it compromises patient safety," noting that "as the district court found and the state did not contest, S.B. 95 eliminates a safe and common medical procedure and leaves patients subject to procedures that are rarely used, are untested, and are sometimes more dangerous or impossible."
The court's other new ruling was about what critics call targeted restrictions on abortion providers (TRAP) policies. Both decisions were 5-1—with Justice Stegall Caleb dissenting and Justice K.J. Wall not participating—and followed Kansas voters rejecting a proposed anti-choice amendment to the state constitution in August 2022.
"Now the Kansas Supreme Court has decisively reaffirmed that the state constitution protects abortion as a fundamental right."
"Kansas voters made it loud and clear in 2022: The right to abortion must be protected. Now the Kansas Supreme Court has decisively reaffirmed that the state constitution protects abortion as a fundamental right," said Nancy Northup, president and CEO of the Center for Reproductive Rights, which was involved with both cases.
"This is an immense victory for the health, safety, and dignity of people in Kansas and the entire Midwestern region, where millions have been cut off from abortion access," Northup added. "We will continue our fight to ensure Kansans can access the essential healthcare they need in their home state."
The anti-choice ballot measure's failure two years ago came shortly after the U.S. Supreme Court's right-wing supermajority reversedRoe v. Wade with Dobbs v. Jackson Women's Health Organization—which bolstered GOP efforts to further restrict reproductive rights at the state level, forcing patients to more frequently travel for abortion care.
Kansas allows abortion care up until 22 weeks of pregnancy and has seen an influx of healthcare refugees from states that have imposed bans. The Guttmacher Institute said last month that "in Kansas, clinic numbers increased by 50% (from four to six) between 2020 and 2023, and the number of abortions rose by 152% (an increase of 12,440)."
Despite the fresh wins in court, the broader battle for reproductive freedom continues in Kansas. As KMUWreported Friday:
Several new abortion laws took effect in Kansas earlier this week, but one of them—a law requiring doctors to ask patients getting abortions their reason for doing so—is being challenged in court. A Johnson County judge said Monday that doctors could add the law to a larger lawsuit they brought against a handful of older state abortion restrictions, including a 24-hour waiting period. The judge agreed to temporarily block the older laws while the case proceeds.
The Kansas Department of Health and Environment told providers it will "not, for now" enforce the abortion reasons law, providers said Monday. The health department has not responded to requests seeking to confirm that.
The Center for Reproductive Rights noted Friday that it "is currently representing abortion providers in another ongoing challenge to several onerous restrictions including a law forcing providers to falsely tell their patients that a medication abortion can be 'reversed,' an unproven claim not based on medicine or science."