Most abortions will soon be illegal in Iowa after six weeks of pregnancy following the Iowa Supreme Court’s decision Friday to overturn a lower court’s block on the 2023 abortion law.

The 4-3 decision allows enforcement of the law that was previously blocked by a temporary injunction in a case challenging Iowa’s law restricting most abortions after six weeks of pregnancy.

Abortion remains legal in Iowa for now, until the case returns to the district court for further proceedings, according to American Civil Liberties Union of Iowa. That will take at least 21 days under Iowa court rules, according to ACLU of Iowa, and abortion will remain legal during that time.

The law bans abortions after cardiac activity can be detected in an embryo, with exceptions in cases of rape, incest, and when the medical procedure is necessary to save the life of the mother. To qualify for an exception to the law, people must report the rape resulting in pregnancy within 45 days to law enforcement or a public health agency or doctor, and within 140 for cases of incest.

Embryonic cardiac activity can typically be detected as early as six weeks of gestation. Reproductive health care advocates have argued that many women do not know they are pregnant at six weeks, and that the law would effectively make most abortions illegal in Iowa. Abortions were previously legal in Iowa up to 20 weeks of pregnancy.

The lawsuit was brought forward by Planned Parenthood of the Heartland, the Emma Goldman Clinic — both health care providers that perform abortions — as well as Dr. Sarah Traxler and ACLU of Iowa.

The ruling states that the Iowa law is serving a legitimate state interest, and thus can be upheld legally.

“Every ground the State identifies is a legitimate interest for the legislature to pursue, and the restrictions on abortion in the fetal heartbeat statute are rationally related to advancing them,†Justice Matthew McDermott wrote in the majority opinion. “As a result, Planned Parenthood’s substantive due process challenge fails. The district court thus erred in granting the temporary injunction.â€

Gov. Kim Reynolds, a supporter of the measure, alongside Senate Majority Leader Jack Whitver and House Speaker Pat Grassley, praised the court decision in a news release Friday.

“There is no right more sacred than life, and nothing more worthy of our strongest defense than the innocent unborn,†Reynolds said in a statement. “Iowa voters have spoken clearly through their elected representatives, both in 2018 when the original heartbeat bill was passed and signed into law, and again in 2023 when it passed by an even larger margin. I’m glad that the Iowa Supreme Court has upheld the will of the people of Iowa.â€

Iowa Democratic Party Chair Rita Hart wrote in a statement that the decision strips Iowa women of “reproductive rights that they have maintained for more than 50 years.â€

“It’s obvious Kim Reynolds and Iowa Republicans do not trust women to make their own decisions regarding their own medical care or for doctors to use their best judgment while treating their patients,†Hart said in a statement. “Republicans went too far with this abortion ban, and Iowa voters will hold them accountable this November.â€

Reynolds signed the six-week abortion ban into law after convening the Legislature for a special session in July 2023. That session followed a state Supreme Court decision in June of the same year to uphold the injunction on the 2018 so-called “fetal heartbeat†law, a similar measure.

Justices were split in a 3-3 decision on the case, upholding a lower court’s decision to enjoin the law. The 2018 abortion law was previously ruled unconstitutional, but Reynolds challenged the decision following major changes to abortion law at both the state and federal levels. In June 2022, the U.S. Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization that there was no constitutional right to an abortion, overturning the 1973 Roe v. Wade precedent and allowing states to enact abortion restrictions.

Since the U.S. constitutional protections for abortion lifted, multiple states have enacted restrictions or total bans on abortion. Most states surrounding Iowa have enacted laws limiting the procedure since 2022, according to information compiled by the Guttmacher Institute. South Dakota and Missouri have near total abortion bans with limited exceptions. Nebraska has restricted abortion at 12 weeks of gestation, and in Kansas and Wisconsin, abortions are currently legal up to 22 weeks of pregnancy.

Minnesota and Illinois have the fewest restrictions, allowing abortions to be performed until “fetal viability†— when a fetus is able to survive outside the uterus, typically around 25 weeks of pregnancy. Exceptions are granted for this limit in cases where the procedure is necessary to save the life of the woman, or if their health is at risk.