Iowa Abortion Laws

Abortion is legal in Iowa until medical professionals can detect a fetal heartbeat, which typically happens at a fetal gestational age of six weeks. After that, abortion is legal only in limited cases. These include medical emergencies, cases of rape or incest reported within specific time frames, and certain cases of a fetal abnormality incompatible with life.

Iowa Abortion Law After Dobbs

Since the U.S. Supreme Court decided Dobbs v. Jackson Women's Health Organization in 2022, states are free to construct their abortion laws in different ways. They can regulate or limit access to abortion and require waiting periods, notice, and consent for the procedure. They can even prohibit abortion entirely.

The Dobbs decision overturned the 1973 Supreme Court holding in Roe v. Wade that recognized a woman's constitutional right to terminate a pregnancy. The 6-3 court majority in Dobbs concluded that Roe was wrongly decided. It upended decades of case precedent and reliance upon the right to abortion.

Iowa lawmakers enacted several abortion restrictions and amended them over the years. Many of these laws remain on the books.

On July 14, 2023, Gov. Kim Reynolds signed into law a six-week abortion ban known as the Iowa fetal heartbeat law. The law came about during a special session that Reynolds called. It passed with only Republican support in the Iowa legislature.

Within days, the law faced a legal challenge from the ACLU of Iowa, Planned Parenthood North Central States, and the Emma Goldman Clinic. A lower court judge blocked the new law based on claims that the Iowa Constitution still protected the right to abortion.

In June 2024, the Iowa Supreme Court reversed its prior ruling and found that the state constitution does not protect abortion as a fundamental right. It directed the district court judge to remove the injunction. As a result, the six-week abortion ban took effect on July 29, 2024.

The Iowa Fetal Heartbeat Law

Iowa first passed a fetal heartbeat abortion ban in 2018. At that time, Roe was still the law of the land and protected access to abortion until fetal viability. The law did not survive a legal challenge. The state supreme court found that it placed an undue burden on the right to abortion. By 2022, Iowa abortion law allowed a legal abortion up to 20 weeks of a pregnancy.

In 2023, after the Dobbs decision, Reynolds convened a special legislature session to pass a new fetal heartbeat law. Although the law was also challenged, the courts upheld it. As a result, Iowans' access to abortion care was greatly reduced.

Under Iowa's fetal heartbeat law, abortion means the "termination of a human pregnancy with the intent other than to produce a live birth or to remove a dead fetus." The law requires a treating physician to test a pregnant patient to determine if they can detect a fetal heartbeat. If so, the physician must inform the patient of the finding and notify them that an abortion will be illegal.

The law defines a fetal heartbeat as "cardiac activity, the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac." Yet many question the identification of this cardiac activity as a heartbeat. Around six weeks of pregnancy, doctors may detect an electrical pulse from the embryo. In time, this will develop as part of the fetal heart.

The new law's definition is controversial as experts say the structure of a fetal heart does not form until 10 weeks into a pregnancy. To those who support these laws, the cardiac activity is a heartbeat. To those who oppose these laws and many medical experts, there is no fetal heart at six weeks. Of course, many people don't know they are pregnant at the six-week mark.

Iowa law does allow exceptions to the abortion ban in limited circumstances. These include:

• Cases of medical emergency, where the abortion is necessary to preserve a patient's life when endangered by a physical condition or where the continuation of the pregnancy will create a serious risk of substantial and irreversible impairment of a major bodily function
• When the abortion procedure will preserve the life of an unborn child
• When the pregnancy resulted from a rape, and the patient reported the incident to law enforcement or a health care provider within 45 days (about 6 and 1/2 weeks)
• When the pregnancy resulted from incest, and the patient reported the incident to law enforcement or a health care provider within 140 days (20 weeks)
• Cases of spontaneous abortion (miscarriage) when not all products of conception have been expelled
• Cases that present a fetal abnormality that is incompatible with life

Once a physician determines that a patient's pregnancy is at 20 or more weeks, then the only exceptions that apply are to preserve the patient's life or to preserve the life of an unborn child.

The fetal heartbeat law does not specify criminal penalties for physicians who violate it. Instead, it authorizes the Iowa Board of Medicine to administer the law. This has raised issues of what rules physicians will follow in medical emergencies and other situations.

Iowa also has several crimes related to those who cause the death of a fetus, including feticide and "partial-birth" abortion. Any doctor performing an abortion under an exception to the heartbeat law or non-physician questioning whether they can perform an abortion would need to be aware of these crimes.

Iowa Abortion Restrictions

Iowa law contains several other abortion regulations that go beyond standard consent for a medical procedure. The state's informed consent law on abortion requires that abortion providers take the following actions before the procedure, except in cases of medical emergency:

• Get at least 24 hours before the abortion procedure or treatment the patient's written certification that the provider has complied with the consent law
• Conduct an ultrasound exam and offer the patient the opportunity to view any image, hear a description of the fetus' age and development, and hear any detectable fetal cardiac activity
• Provide information based on state-produced materials to the patient on options of carrying the pregnancy to term, retaining parental rights, placing a child for adoption, and terminating the pregnancy
• Discuss risk factors related to abortion in light of the patient's health history

Iowa also requires parental notification in cases where a minor (person under 18 and not married) seeks an abortion. The law requires that the physician notify one parent or legal guardian of the minor at least 48 hours before the procedure or treatment. If a minor objects to such notice, then they can seek a waiver before a juvenile court judge.

The notice law does not apply in cases where the minor's parent authorizes the procedure or in cases of medical emergency. Another exception permits a grandparent to step in and accept the notice at the minor's request. Finally, notice will not apply in certain cases of reported child abuse or in reported sexual assault cases.

Iowa Abortion Laws At A Glance

State abortion laws vary after Dobbs. The chart below lists the details of Iowa's abortion statutes.

FindLaw also provides more general information on reproductive rights, including a state-by-state guide on abortion laws.

Note: State laws may change at any time through various avenues, including newly enacted laws, decisions from higher courts (including federal courts), constitutional amendments, and other means. Contact an Iowa attorney or conduct your own legal research to verify the status of any state law(s) you are reviewing.

How Iowa Compares to Other States

With the enactment of the heartbeat law that bans most abortions at around 6 weeks into pregnancy, Iowa falls in line with some 16 other states, including Missouri, that currently ban most abortions. Although all restrictive states offer an exception for abortion if necessary to preserve a patient's life, several do not offer exceptions in cases of rape or incest like Iowa.

As Gov. Reynolds and the majority of lawmakers in the Iowa House and Senate all belong to the GOP, legislative efforts to protect abortion rights or modify the new ban are not likely to succeed.

The majority of states protect abortion access through at least fetal viability. After Dobbs, these states now rely on state constitutional provisions or state laws instead of the U.S. Constitution. Iowa has several neighboring states that provide greater access to abortion services, including Minnesota, Wisconsin, and Illinois. In Nebraska, abortion is available through the first 12 weeks of pregnancy.

A Note About Medication Abortion

According to a recent study, medication abortion accounts for some 63% of all abortions in the U.S. In many states today, a patient can access abortion pills via telehealth services in the first 10 weeks of pregnancy.

Although the U.S. Food and Drug Administration approved the use of the abortion medication mifepristone in 2000, abortion opponents filed a legal challenge to the drug's approval in 2022.

The federal court case made it to the U.S. Supreme Court. In 2024, the Supreme Court ruled that the medical providers who filed the case, physicians who do not perform abortions or prescribe abortion pills, did not have legal standing to bring the case.

As a result, it appears that telehealth services for medication abortion will remain legal for now. It is expected that a new challenge in the future may seek to block providers in states where abortion remains legal from sending medication to patients in states with abortion bans.

Iowa Abortion Laws: Related Resources

• Iowa Legal Research
• Official State Codes
• Abortion
• Birth Control
• Iowa Health and Human Services - Family Planning Program

Have More Questions? Talk To An Attorney

Deciding whether or not to get an abortion can be complicated, both emotionally and legally. Often, you need accurate information on the law and support and services in your community.

In these situations, you may want to seek legal advice to understand your state's laws and the options available to you. You can contact an Iowa health care attorney to get answers to your questions today.