Most abortions now banned in Iowa after Gov. Kim Reynolds signs 'fetal heartbeat' law

Sitting onstage in front of a crowd of 2,000 evangelical Christians, Gov. Kim Reynolds signed a law Friday immediately banning the vast majority of abortions in Iowa.

The law, which took effect immediately, prohibits nearly all abortions after doctors detect cardiac activity in the embryo, which can occur about six weeks into a pregnancy. There are narrowly defined exceptions for rape, incest, fatal fetal abnormalities, and cases of medical emergency.

Reynolds, a Republican, signed the law at the Family Leadership Summit, a gathering of conservative Christians that featured remarks by a half-dozen Republican presidential candidates.

The Iowa Legislature passed the law in a marathon daylong special legislative session on Tuesday, which drew massive protests and heckling as lawmakers voted around 11 p.m.

Although a few Republican lawmakers voted against the measure, the GOP was largely united in supporting the law, while Democrats were universally opposed.

The new law takes effect more than five years after Reynolds signed a nearly identical law in 2018 that was permanently blocked by the courts.

Reynolds tried unsuccessfully to revive it after state and federal court decisions last year rolled back protections for abortion, but last month, the Iowa Supreme Court deadlocked 3-3, leaving the law blocked.

Following the court defeat, Reynolds quickly called the special session and urged lawmakers to act again to restrict abortion.

The new law is already facing a lawsuit from abortion providers and could see a protracted legal battle. A Polk County district court judge heard arguments Friday afternoon about whether the law should be temporarily blocked while the challenge plays out.

Republicans hope the courts will rule that abortion does not merit special constitutional protections and allow the law to take effect.

More: Iowa lawmakers pass 6-week 'fetal heartbeat' abortion ban; Reynolds to sign bill Friday

What does Iowa's new abortion law do?

The law bans nearly all abortions after a "fetal heartbeat" is detected. It defines fetal heartbeat as cardiac activity, or "the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac."

Doctors can detect that rhythmic contraction at around six weeks of gestation. Abortions may not be performed after cardiac activity is detected, with some rare exceptions.

Medical professionals told the Des Moines Register, part of the USA TODAY Network, that it's misleading to call those pulses a fetal heartbeat, as the embryo is not yet a fetus, and the heart is only beginning to form.

More: What is a 'fetal heartbeat?' What you should know about Iowa's new 6-week abortion bill

Doctors noted that each pregnancy is different — cardiac activity may be detected later than six weeks, depending on the patient's body and the ultrasound machine.

The law requires doctors to perform an abdominal ultrasound on a patient seeking an abortion. If a fetal heartbeat is detected, the abortion cannot be performed unless one of the law's exceptions applies.

What are the exceptions to Iowa's abortion law?

The law creates some exceptions for pregnancies resulting from rape or incest, and for medical emergencies that endanger the life of the mother. The law also allows abortion in cases of severe fetal abnormalities.

Here are the cases where abortion may be performed after six weeks gestation:

• For rape, if the rape is reported to law enforcement or to a public health agency or doctor within 45 days.

• If the pregnancy is the result of incest, if the incest is reported to law enforcement or a public health agency or doctor within 140 days.

• If "the attending physician certifies that the fetus has a fetal abnormality that in the physician's reasonable medical judgment is incompatible with life."

• For a miscarriage "if not all of the products of conception are expelled."

• For a "medical emergency," which is defined as "a situation in which an abortion is performed to preserve the life of the pregnant woman whose life is endangered by a physical disorder, physical illness or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy" or when continuing the pregnancy "will create a serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman."

The medical emergency exception does not include psychological, emotional or familial conditions or the woman's age.

When does Iowa's abortion law take effect?

The new abortion restrictions took effect immediately when Reynolds signed the bill.

Doctors and opponents of the law have raised alarms about the quick change in the law, saying there are still questions about how women can prove they qualify for the ban's exceptions, and whether doctors will be disciplined if they perform abortions in violation of the law.

More: Doctors want clarity on Iowa's new 6-week abortion ban. But no rules have been written yet.

Polling shows a majority of Iowans say abortion should be legal

A Des Moines Register/Mediacom Iowa Poll from March found 61% of Iowans say abortion should be legal in all or most cases, while 35% say it should be illegal in all or most cases.

A previous Iowa Poll from October found 49% of Iowans disagreed that abortion should be illegal "once a so-called fetal heartbeat is detected, about six weeks after conception." Forty-five percent of Iowans said they agreed abortion should be illegal after that point.

The October Iowa Poll also found 89% of Iowans say abortion should be legal if the pregnant person's life is in danger and 85% say abortion should be legal in cases of rape or incest.

Stephen Gruber-Miller can be reached by email at sgrubermil@registermedia.com or on Twitter at @sgrubermiller. Katie Akin can be reached atkakin@registermedia.com or on Twitter at @katie_akin.

This article originally appeared on USA TODAY NETWORK: Iowa Gov. Kim Reynolds signs 'fetal heartbeat' abortion ban