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Last week, Gov. Kristi Noem's telemedicine ban on medical abortions cleared its last hurdle in becoming South Dakota law.
Lawmakers at a six-member legislative rules review committee finalized the ban with a 4-2 vote, "troubled" the bill skirted a more thorough debate in the legislature.
"I truly am troubled," said Republican Sen. Timothy Johns at the review committee meeting. "I'm highly reluctant to ever intervene when it comes to decisions between patients and doctors, and I think we're getting too close."
The new rule makes it harder for pregnant people to access abortion pills, mandating patients take two prescribed medications for a medical abortion in-person at a licensed abortion provider, namely Planned Parenthood's clinic in Sioux Falls.
Pregnant people also have to wait an additional two weeks following the administration of the abortion medications for a follow-up appointment with Planned Parenthood.
That's on top of the mandated "informed consent visit" with a pregnancy help center and a 72-hour waiting period before the medical abortion procedure.
The rule represents South Dakota's strictest abortion law yet, and one of the strictest bans on abortions in the country.
"I look forward to the day when the life of every unborn child is protected in South Dakota," Noem stated in a press release on the rule change.
Until then, Noem says South Dakotans know pregnant people "will not get those pills from a stranger over the internet."
What will change for abortion in South Dakota?
Before Noem issued the executive ban on telemedicine abortions, South Dakota law mandated a 72-hour waiting period between an "informed consent visit" at a pregnancy help center and an abortion procedure at the state's only licensed abortion facility, Planned Parenthood in Sioux Falls.
After completing the informed consent visit and the waiting period, a pregnant person seeking a medical abortion typically would take the first dose of the abortion pill, mifepristone, at the first visit with Planned Parenthood. The second dose is given to the patient within that visit to take at home within three days.
The new rule, however, forces pregnant people to come back to the clinic, within 24 to 72 hours of taking the first pill, to take the second pill in-person. Two weeks after the abortion medications are taken, a pregnant person has to return for a fourth visit "to confirm that the fetus, placenta, and membranes have been fully expelled."
Staff at abortion facilities are also expected to monitor patients for complications following the administration of the abortion medications and report "(1) Any complication that requires medical follow-up; (2) The medical follow-up that was required resulting from any complication; (3) The facility where the medical follow-up was performed; and (4) If the pregnant woman was sex trafficked" to the Department of Health.
The ban is set to go into effect on Jan. 27. The DOH expects abortion facilities to familiarize themselves with the new rule and comply with it, as written.
"We want all South Dakotans to be healthy and strong, including pregnant women," said DOH spokesman Daniel Bucheli in an email to the Argus Leader. "Gov. Noem has never wavered in her promise to protect life at all stages, and the DOH will implement the new rule."
The DOH also intends to work with the legislature to enforce the telemedicine ban and communicate with abortion facilities on the new reporting requirements.
Planned Parenthood: "We'll do our best and comply"
Abortion-rights advocates, like Dr. Sarah Traxler, Chief Medical Officer of Planned Parenthood North Central States, decried the rule during last week's rules review committee meeting as one more "medically unjustified restriction" designed to prevent pregnant people seeking abortions from safely and easily accessing the care they need.
"It's important to keep in mind that most abortion patients or parents, most have low incomes, many work inflexible minimum wage jobs and about 10% are suffering intimate partner violence," said Traxler in her public testimony to the committee. "For patients who spend hours driving to return to our clinic, the extra trip is going to be an insurmountable barrier to care."
Kristin Hayward, Manager of Advocacy and Development for Planned Parenthood Minnesota, North Dakota, South Dakota Action Fund, echoed Traxler's concerns. Hayward said the abortion rule is "ludicrous" and adds an extra stressor for pregnant people in South Dakota.
"We'll do our best and comply with the new law," she said.
What's next? Noem plans to adopt Texas' abortion law
Noem is already eyeing her next target in eliminating abortions in South Dakota: banning abortions after six weeks.
"Science tells us that an unborn child’s heartbeat starts six weeks after conception," Noem told lawmakers at Tuesday’s State of the State address for the first day of this year’s legislative session. "And any abortion after that point stops that heartbeat — stops that life — stops that gift from God."
The first-term governor announced her intentions to adopt Texas' Heartbeat Act in September, shortly after the U.S. Supreme Court allowed the law to stand. A week later, Noem issued an executive ban on telemedicine abortions, restricting prescription drugs used to terminate pregnancies from being delivered by mail and other means.
“Today, I am asking all of you to protect the heartbeats of these unborn children,” Noem said in her State of the State address. “I am bringing legislation to ban all abortions once a heartbeat can be detected.”
Email human rights reporter Nicole Ki at email@example.com or follow on Twitter at @_nicoleki.
This article originally appeared on Sioux Falls Argus Leader: South Dakota Gov. Noem's abortion pill law: What changes after Jan. 27