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Abortion in Iowa will remain available until 22 weeks of pregnancy as a lawsuit against the newly enacted six-week ban proceeds, a state judge ruled Monday.

The Iowa state legislature convened last week for a single day with the express purpose of passing a new six-week ban. The law, which Republican Gov. Kim Reynolds signed last Friday, includes exceptions for people pregnant because of rape and incest, but requires those cases to be reported to a “law enforcement agency or to a public or private health agency” within 45 or 145 days, respectively. That represents a significant hurdle, since most cases of rape and incest are never reported. The ban also includes narrow exceptions for “medical emergencies” or if the fetus was found to be “incompatible with life.”

“We are deeply relieved that the court granted this relief so essential health care in Iowa can continue. We are also acutely aware that the relief is only pending further litigation and the future of abortion in Iowa remains tenuous and threatened,” said Dr. Abbey Hardy-Fairbanks, medical director of the Emma Goldman Clinic, one of six abortion clinics in the state.

The ban blocked Monday — which was in effect for just over 72 hours — represents a second attempt by state Republicans to ban abortion early in pregnancy. It is almost identical to a law passed in 2018, which state courts had blocked from taking effect, citing federal abortion rights protected by Roe v. Wade. 

After Roe’s overturn in June 2022, Reynolds asked the courts to reconsider their decision. A district court held that the law still violated Iowa’s constitution. The governor appealed that decision to the state Supreme Court, which on June 16 deadlocked 3-3 over whether to let the ban be enforced, meaning that the lower court’s decision blocking the 2018 ban remained in effect.

“The court believes it must follow current Iowa Supreme Court precedent and preserve the status quo ante while this litigation and adversarial presentation which our Supreme Court has invited moves forward,” Judge Joseph Seidlin wrote.

The state is expected to appeal the new block on the six-week ban. And it is possible that as the case moves forward, the state’s Supreme Court could ultimately decide to uphold a six-week ban.

The decision will keep Iowa, for now, on a shrinking list of states in the Midwest to allow abortion for most of pregnancy. Nebraska recently passed a 12-week ban set to take effect October 1. Indiana’s near-total ban will be enforced starting August 1. And courts in Ohio are still weighing whether to let the state’s six-week ban take effect once again.

If Iowa’s ban were to take effect, residents would likely have to travel to Kansas, Illinois, Minnesota and Ohio for abortions. It’s unlikely the clinics in those states will have the bandwidth to care for everyone. Kansas and Illinois have experienced some of the country’s largest increases in abortion patients since Roe v. Wade was overturned, and clinics in both states have already reported significant increases in waiting times for appointments.