This week marks one year since a state law went into effect banning abortion when cardiac activity is detected. This can be as early as six weeks of pregnancy. The law includes exceptions for rape, incest, life of the pregnant person and fetal abnormalities, but it has still had drastic effects on abortion care in the state.
What supporters call the 'heartbeat law' changed Iowa’s abortion cutoff period from 20 weeks of pregnancy to about six weeks last July. How has this affected abortion in the state?
Data shows that abortions in Iowa have dropped a lot in the past year after this law went into effect.
Preliminary state data shows that there were 1,792 abortions last year, which is down from 2,771 abortions in 2023 and 4,061 abortions in 2022.
The Guttmacher Institute, a nonprofit that supports abortion rights, estimates that before the law went into effect, there were about 400 abortions per month in Iowa. After, it dropped to about 260 abortions per month.
Guttmacher's numbers are higher than state figures because they include Iowans who receive abortions through telehealth appointments with out-of-state providers, according to Isaac Maddow-Zimet, a data scientist at the Guttmacher Institute.
"The number of Iowans getting abortions hasn't changed. What has changed is where they are having to go."Megan Jeyifo, executive director of the Chicago Abortion Fund
"There were many people accessing abortion through shield law provisions — so through telehealth from providers out-of-state — even pre-ban. That continues to be the case post six week ban," Maddow-Zimet said.
More Iowans are now traveling out of state for care to places like Illinois, Minnesota and Nebraska. According to Guttmacher data, 1,080 Iowans left the state to get an abortion in 2023 — that increased to 1,530 in 2024.
The Chicago Abortion Fund, which assists people with getting abortions, reported a 200% increase in helping Iowans travel to Illinois for care since the law went into effect. It connected with 870 Iowans overall with 75% traveling out of state for care.
"The number of Iowans getting abortions hasn't changed. What has changed is where they are having to go," said Megan Jeyifo, the executive director of the Chicago Abortion Fund. "So the most striking thing about this to me is that these abortion bans don't stop abortions. They just make it a lot harder for people to access them."
What are Iowa's abortion providers saying?
Planned Parenthood North Central States said their abortions in Iowa dropped 74% after the new law went into effect, and Iowans traveling to their Minnesota and Nebraska clinics increased 182%.
"There continues to be so much what we just call 'manufactured confusion' for people in terms of what care is available? Where can you get care?" Ruth Richardson, the president of Planned Parenthood North Central States, said.
This past year, Planned Parenthood underwent a number of changes. It expanded access to abortion care in clinics in Des Moines, Iowa City, Omaha and Mankato, Minnesota.
At the same time, Planned Parenthood recently closed four clinics in Iowa, including the one in Ames, which had been its only clinic performing abortions in the state in the past year. It now operates just two clinics in Iowa City and Des Moines.
Planned Parenthood said that decision was due in part to a loss of some of their federal funding under the Trump administration. The organization stands to lose about $11 million in Medicaid funding through a provision in the administration's tax reform legislation that passed last month, which is now tied up in courts, according to Richardson.
Francine Thompson, the executive director of the Emma Goldman Clinic, said the independent abortion clinic in Iowa City continues to get calls from Iowans who are unaware of the law or are confused about what it means.
The law has created a lot of confusion about how and where Iowans can get abortion care, she said.
"Not just for the people seeking those services, but also for clinic staff to be able to adapt and to change and to stay current, as in some of the surrounding states, the laws were changing weekly," Thompson said.
In the past year, Thompson said the clinic has started doing intensive education campaigns to let people know what their options are and even that abortion care is still possible in Iowa.
What has been the reaction from abortion rights opponents and the lawmakers who supported this law?
Republican lawmakers and abortion rights opponents have celebrated the state's drop in abortions and the closure of Planned Parenthood clinics.
But they say there’s more work to be done, and they’re concerned about neighboring states, like Illinois and Minnesota, which have enacted protections for abortion, and the Iowans who are crossing state borders for care or receiving abortion pills in the mail from out-of-state doctors.
Earlier this month, Gov. Kim Reynolds spoke at the Family Leader Summit and said abortion rights opponents need to "change the hearts and minds in other states that aren't moving in the direction that Iowa has moved."
"That involves more than just supporting a miracle of life. It also involves promoting policies that surround every person involved in a pregnancy with protection, love and support." Reynolds said.
Maggie DeWitte, the executive director of Pulse Life Advocates, which opposes abortion rights, echoed Reynolds' sentiment. She said she would like to see more funding go to crisis pregnancy centers.
"The perception is that Planned Parenthood and the abortion industry is the only place women can go if they find themselves in an unplanned pregnancy, and that's not the case," she said.
What might we see when it comes to abortion for the next state legislative session?
It’s unclear at this point if Iowa’s Republican-dominated Legislature will pursue additional restrictions on abortion next session.
Abortion rights opponents said they would like to further restrict abortion in the state, and one main area of focus for them has been trying to limit access to medication abortion, which accounts for the vast majority of abortions in Iowa.
Planned Parenthood said 82% of its abortions since Iowa's law was enacted have been through medication.
"Over the last two years, we've really seen very specific attacks on medication abortion," Kimya Forouzan, principal state policy advisor at the Guttmacher Institute, said. "And I think that's because we know that medication abortion has become such an access point for so many people."
Planned Parenthood said 82% of its abortions since Iowa's law was enacted have been through medication.
DeWitte said abortion rights opponents are pushing for laws next session that put restrictions on telehealth options by requiring abortion pills are administered by a doctor in person.
"We need to look at how we are going to help women in our state, and we're going to do that by putting some safeguards around those pills," she said.
