Planned Parenthood asked the nation's highest court on Thursday to stop a 2015 Arkansas law restricting pill-induced abortions from going into effect.
The organization wants the U.S. Supreme Court to reinstate a federal judge's injunction that stopped the law from going into effect last year. The U.S. 8th Circuit Court of Appeals later lifted the injunction, but stayed its ruling pending consideration by the high court.
At issue is a section of Act 577 that requires providers of medication-induced abortions to contract with a physician who has admitting privileges at one of several designated hospitals. Lawmakers who backed the law say it protects women's safety in case of emergencies, while reproductive-rights advocates argue that instead of preserving Arkansas women's health, the law will dramatically reduce their access to the procedure.
Act 577 was set to take effect on Jan. 1, 2016, but Planned Parenthood Great Plains filed a lawsuit in U.S. District Court to block it.
Dr. Stephanie Ho, a physician in Northwest Arkansas, is also a plaintiff.
In March 2016, a federal district judge issued a preliminary injunction, blocking Act 577 from being enforced.
In July, the 8th Circuit lifted that injunction, but later issued a stay on its ruling so Planned Parenthood could petition the U.S. Supreme Court.
On Thursday, attorneys for Planned Parenthood filed the petition with the high court, asking the nine justices to reverse the 8th Circuit's decision and reinstate the injunction.
Act 577 will remain inactive until the U.S. Supreme Court either takes up the case and issues a ruling, or declines to hear the case.
Abortions are carried out through surgical procedures or medication. For a medication-induced abortion, a combination of two pills -- mifepristone and misoprostol -- are ingested.
Under Planned Parenthood protocol, the first pill is taken in the presence of a physician. Women ingest the remaining pills at home and can call a 24-hour hotline if there are problems.
The procedure is generally an option within the first nine weeks of a pregnancy.
Three clinics in Arkansas administer abortions of any kind.
The two existing Planned Parenthood clinics, one in Little Rock and one in Fayetteville, offer the medication, and the Little Rock Family Planning Services conducts both types of procedures.
In 2016, 3,207 abortions were performed in Arkansas, 556 of which were medication-induced, according to the state Department of Health.
That number will "drastically reduce" if Act 577 is allowed to take effect, Planned Parenthood argues in its lawsuit.
Attorneys for the organization dispute the science and the stated reasoning behind the law.
Act 577 says that abortion-inducing drugs are associated with "an increased risk of complications relative to surgical abortion." Risks include "abdominal pain, cramping ... headache, fatigue" and a host of other conditions, the law states.
Because of those complications, an abortion provider must contract with a physician with admitting privileges at a hospital that can handle "any emergencies associated...with abortion-inducing drugs," the law says.
When asked about the contract-provision, the law's sponsor, Rep. Charlene Fite, R-Van Buren, said she thought it was "common sense."
"I see that as something I would expect from a responsible facility," Fite said, mentioning media reports of women suffering extreme bleeding during the procedure.
Planned Parenthood rejects the law's scientific reasoning. Medication abortion is safe, and major complications from the pills "are extremely rare," according to the complaint.
Rather, legislators created Act 577 under the guise of safety concerns, the lawsuit claims. The real purpose, according to Planned Parenthood, is to put abortion providers out of business and greatly reduce the number of procedures performed.
This reduction will happen, Planned Parenthood says, because no physician with hospital admitting privileges is willing to contract with the organization. Doctors fear stigma and harassment, the lawsuit says.
Ho, the doctor named in the lawsuit, said Thursday that she hasn't been able to find another doctor willing to work with her.
"If the Supreme Court does not step in, I will be forced to stop providing abortions altogether," Ho said.
Anyone who violates the law faces criminal penalties.
Without medication abortions, women will have to travel to Little Rock for the surgical procedure, the lawsuit says.
They'll make the trek multiple times, as there's a state-mandated 48-hour waiting period between a doctor consultation and a procedure.
Those trips would cost time and money for many women who have neither, Planned Parenthood argues.
U.S. District Judge Kristine Baker wrote in her 2016 order that an inability to travel "will lead some women to take desperate measures, such as attempting to self-abort or seeking care from unsafe providers."
Baker wrote that the contract-physician requirement would provide negligible medical benefits over Planned Parenthood's existing care.
The burden imposed by the law "would be undue, and therefore, unconstitutional," Baker wrote.
However, the 8th Circuit disagreed.
On July 28, a three-judge panel decided that the lower court "did not define or estimate the number of women who would be unduly burdened by the contract-physician requirement."
Because that number of women was not defined, the panel vacated the preliminary injunction and remanded the case.
Another state's law that is similar to Act 577, Planned Parenthood says, was declared unconstitutional by the U.S. Supreme Court last year.
In 2013, the Texas Legislature passed a law that, in part, required a physician performing an abortion to have admitting privileges at a hospital within 30 miles of where the procedure was performed.
On June 27, 2016, in a 5-3 ruling in the case of Whole Woman's Health v. Hellderstedt, the justices ruled the Texas law placed an undue burden on a woman's constitutional right to an abortion.
In previous filings defending Act 577, attorneys for the state criticized Baker's finding that the law would cause women to postpone abortions or forgo the operation.
Those attorneys have also said, in court filings, that Planned Parenthood has misconstrued how the Hellderstedt ruling applies to Act 577.
In a statement, Arkansas Attorney General Leslie Rutledge said she was pleased the state prevailed at the 8th Circuit, and she's reviewing Planned Parenthood's petition.
Information for this article was contributed by Linda Satter of the Arkansas Democrat-Gazette.
Metro on 12/22/2017