“We are providing a private clinical sanctuary where an expert can look them in the eye and ask, ‘Are you safe?’ That opportunity for intervention is lost the moment that we move this process to a computer screen, a phone or a mailbox,” Iowa state Rep. Devon Wood, R-New Market, said during debate on the bill May 14.

Maggie DeWitte, director of anti-abortion advocacy group Pulse Life Advocates, said the legislation will restore prior “safeguards.” 

“This bill is a step in the right direction to protect Iowa women from this dangerous drug,” DeWitte said in a statement.

Decades of studies have shown that less than 1% of medication abortions result in serious complications such as severe bleeding or infection.

Reproductive rights advocates have criticized the legislation, contending it will limit access to the medication, which they say many Iowans have acquired through means including telehealth since Iowa implemented laws restricting abortion in recent years. 

“All this bill does is it takes away power from the people, the people who are knowledgeable about giving care to those people who need it,” state Rep. Megan Srinivas, a physician and Des Moines Democrat, said during floor debate. “This doesn’t touch the problem of black-market abortions. It creates a problem of creating a void in care for so many Iowans.” 

Medication abortion has increased since Iowa Republicans passed a law restricting abortions at roughly six weeks after conception. They comprised 63% of all abortions in the country in 2023, compared with 53% in 2020, according to the Guttmacher Institute, a nonprofit that supports abortion rights.

Planned Parenthood North Central States President and CEO Ruth Richardson said abortion pills will continue to be available at the organization’s Iowa health centers “within legal guidelines.”

“Medication abortion has been trusted by providers and patients for more than 25 years. It is safe and effective care. Make no mistake: both nationwide and state attacks on abortion care do nothing to protect patients,” Richardson said in a statement. “There’s no medically necessary reason to restrict how Iowans can access this common, trusted, and safe method of abortion care.”

The Iowa legislation also clarifies the definition of “abortion” to specify that miscarriages and treatment of ectopic pregnancies do not qualify as abortions under the law. which will go into effect July 1. 

Federal lawsuits could limit law’s scope 

Out-of-state providers who dispense abortion pills in Iowa without following the legislation’s requirements will face civil liability. Licensed physicians and pharmacists in Iowa would be immune from that penalty and could only be subject to licensing discipline. 

But lawsuits at the federal level could either expand or stymie Republican lawmakers’ efforts to restrict abortion medication, as shield laws remain in place protecting health care workers in other states who prescribe mifepristone to out-of-state patients.

Rapid Response Politics Reporter Maya Marchel Hoff can be reached at mmarchelHoff@usatodayco.com. You can find her on X (formerly Twitter) at @mmarchelhoff.