An Iowa law banning most abortions in the state will take effect Monday, roughly one year after Gov. Kim Reynolds signed it. 

The law prohibits physicians from administering an abortion after a fetal heartbeat is detected — around six weeks into pregnancy, before most women even know they’re pregnant. It briefly took effect in July 2023, but a lower court temporarily blocked the ban just days later in response to a legal challenge brought by abortion providers and the American Civil Liberties Union. 

The Iowa Supreme Court reversed that ruling last month, declaring the policy constitutional and clearing the way for it to go into effect.

A district court judge for Polk County said the law can be fully enforced starting July 29 at 8 a.m. CT, to allow time for medical providers to receive notice of the change.

The ACLU of Iowa tried earlier this month to petition the Iowa Supreme Court to rehear the case, but the court denied that request Monday.

Iowa’s new abortion law includes exceptions for rape, incest, fetal abnormalities that are “incompatible with life” and medical emergencies that endanger the life of a pregnant woman.

Previously, Iowa allowed abortions up to 20 weeks, meaning the vast majority of those seeking to terminate a pregnancy were able to do so. The new law puts Iowa among three other states that similarly ban abortion after around six weeks: Florida, Georgia and South Carolina. Fourteen states have full abortion bans, and 22 (including Iowa) have some kind of abortion restriction.

Just two abortion clinics in Iowa offer in-person care: the Emma Goldman Clinic and a Planned Parenthood facility in Ames. Planned Parenthood of the Heartland — which represents its Iowa clinics — and the Emma Goldman Clinic were both plaintiffs in the lawsuit challenging the law.

Both organizations have said they’ll continue to provide abortions within the limits of state law, but most Iowa residents seeking abortions will have to go to other states. The closest options for Iowans would most likely be Illinois, Minnesota or Nebraska, though Nebraska restricts abortions after 12 weeks. 

Ruth Richardson, president of Planned Parenthood North Central States, said the organization has been expanding abortion access in the region in anticipation of Iowa’s policy change. For example, she said, the clinic in Mankato, Minnesota, added medication abortion services; the St. Paul, Minnesota, clinic opened up more appointments; and the Omaha, Nebraska, location is extending its physical footprint to triple the number of patients it can accommodate.

“We are standing by ready to help patients receive access to care, even if that means traveling out of state,” Richardson said in a call with reporters last week.

The Emma Goldman Clinic said in a statement last month that it would also help those who can’t get abortions in Iowa seek care in other states.

According to an analysis from the Guttmacher Institute, a research organization that supports abortion access, the number of people who crossed state lines to obtain abortions has roughly doubled since 2020. The analysis largely attributes the trend to restrictions enacted after the Supreme Court overturned Roe v. Wade in 2022.

Republican lawmakers in Iowa attempted in 2018 to enact legislation restricting abortions after six weeks of pregnancy, but a lower court permanently blocked that law in 2019, and the Iowa Supreme Court upheld the lower court’s ruling last year.

In a statement last month about the new law, Reynolds, a Republican, said Iowa voters had “spoken clearly through their elected representatives” and that the Iowa Supreme Court’s decision had “upheld the will of the people.”

Around 63% of respondents in a national Pew Research Center poll earlier this year said they thought abortion should be legal in all or most cases.