What Iowa’s new medication abortion law means for patients and providers

Chief Political Reporter

Patients receiving medication abortions from Iowa healthcare providers must now be seen in person before the medication can be prescribed and dispensed. The new law took effect Wednesday.

However, legal experts say the law does not prevent Iowans from obtaining abortion pills by mail through some out-of-state telehealth providers operating in states with laws that protect clinicians who provide abortion medication across state lines.

For patients using an Iowa provider, the process now begins with an in-person appointment. During that visit, providers must perform an ultrasound, provide mandatory counseling, obtain the patient’s written consent and screen for abuse or coercion.

Because Iowa’s existing 24-hour waiting period remains in effect, patients must then return at least a day later before the medication can be prescribed and dispensed.

Supporters of the law say the new requirements are intended to improve patient safety.

“We want you to be safe. We want you to have all the information. We certainly want you to be seen by a doctor in a health care setting,” said Maggie DeWitte, executive director of Pulse Life Advocates.

Legal experts say the law requires the medication to be prescribed and dispensed in person, but it does not necessarily require patients to take the medication at the clinic. Because medication abortions typically involve two doses taken at different times, patients can likely still take the medication at home after receiving it from their provider.

Drake Law professor Sally Frank said the law’s in-person requirement applies only to Iowa healthcare providers.

She said patients may still obtain medication abortions through telehealth appointments with providers in states that have enacted shield laws, including Minnesota, Illinois and New York.

“What women need to know is if they need to get an abortion, they can do telehealth with somebody out of state, especially in states that have shield laws, and then they will get mailed the medication,” Frank said.

Frank also said Iowa law does not criminalize women who have received an abortion procedure or obtained abortion medication.

Opponents of the law argue it adds another hurdle for patients already facing multiple abortion restrictions in Iowa.

Kimya Forouzan, principal state policy advisor at the Guttmacher Institute, said additional requirements can make abortion harder to access.

“It could be something like they just can’t afford the cost of the travel. They can’t afford the cost of the procedure itself,” Forouzan said. “It’s yet another obstacle that may push it completely out of reach.”

Planned Parenthood North Central States said the law comes on top of an abortion landscape that has already become increasingly restrictive.

“This bill does nothing but double down on a ban that was already failing Iowans, but above all else, we need Iowans to know that medication abortion is still available,” Erin Heisler Wagner, the organization’s senior director of strategic communications, said in a statement to KCCI. The organization said it will continue providing medication abortion “under legal guidelines” at its Des Moines health center.

The law also takes effect as Planned Parenthood prepares to close its Iowa City health center at the end of July, consolidating in-person services at its Des Moines clinic. The organization said patient navigators will continue helping Iowans connect with abortion care and other reproductive health services available through its remaining health centers and virtual care.

Wednesday’s law is the latest change to abortion access in Iowa. Since 2024, most abortions have been prohibited once fetal cardiac activity is detected, which doctors say typically occurs around six weeks of pregnancy.