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Judge Blocks North Dakota's Abortion Ban—But There Are No Clinics Left in the State

The Burleigh County District Court in Bismarck, North Dakota. Photo: Courthouses.ca

On Thursday, a North Dakota court struck down the state’s total abortion ban entirely, after plaintiffs sued in 2023, arguing the ban was unconstitutionally vague in its language about when medical exceptions are allowed. “The North Dakota Constitution guarantees each individual, including women, the fundamental right to make medical judgments affecting his or her bodily integrity, health, and autonomy, in consultation with a chosen health care provider free from government interference,” Judge Bruce Romanick’s opinion states. “This section necessarily and more specifically protects a woman’s right to procreative autonomy—including to seek and obtain a pre-viability abortion.”

Importantly, the law remains active for the time being. On a press call, Meetra Mehdizadeh, staff attorney at the Center for Reproductive Rights, told reporters "there's just an extra procedural step that needs to happen," as Romanick still needs to sign a formal judgment. There's no precise date set for that yet as of Thursday afternoon, but the judge has made clear the law will be struck down.

This legal victory comes as about half of all states impose total or near-total abortion bans. Prior to the ruling, North Dakotans seeking abortion care had to travel to Minnesota and Montana. North Dakota bans telemedicine access to medication abortion, meaning that to access medication abortion, patients would have to obtain it from providers in states with shield laws, which protect providers from prosecution in abortion-banned states.

In a statement, Mehdizadeh called the ruling “a win for reproductive freedom” that will make it “much safer to be pregnant in North Dakota.” But she stressed that “the damage that North Dakota’s extreme abortion bans have done cannot be repaired overnight.”

“There are no abortion clinics left in North Dakota. That means most people seeking an abortion still won’t be able to get one, even though it is legal,” Mehdizadeh said. And because “clinics are medical facilities that need to acquire doctors, staff, equipment,” they “can take years to open, like most healthcare centers. The destructive impacts of abortion bans are felt long after they are struck down.”

The ruling, which unequivocally restores a right to abortion in North Dakota, follows a court ruling from January which stated the ban could be fully enforced even in situations where an abortion is necessary to preserve the pregnant person’s life or health. Since 2023, the extensive legal back-and-forth on abortion in the state has been head-spinning, and emblematic of the pure chaos inflicted by Dobbs v. Jackson Women’s Health for over two years now. 

In March 2023, the North Dakota state Supreme Court blocked the state’s original abortion ban—a trigger law that took effect once the Supreme Court overturned Roe v. Wade in 2022—because the law didn’t provide exceptions to save the pregnant person’s life. A month later, North Dakota Republicans passed a new abortion ban that included a narrow exception for such medical emergencies, which was then signed into law.

Shortly after, CRR sued on behalf of Red River Women’s Clinic, originally in North Dakota, arguing the ban’s exception was unconstitutionally vague. Further, the law threatened physicians with five years in prison, a $10,000 fine, or both, discouraging them from providing life-saving abortion care. CRR is still representing plaintiffs in Tennessee and Idaho who are also challenging the vagueness of medical exceptions in their own state abortion bans. CRR attorney Linda Goldstein told Jezebel in January there’s a throughline connecting all of these cases: “They show exceptions don’t work,” she said. “The language is too vague and too difficult for doctors to be able to apply to save someone’s life—and that’s the entire point.”

This week, a court sided with Red River Women’s Clinic—but, again, the clinic already moved two miles away to Minnesota to continue legally providing abortion care. North Dakota is still without a clinic.

Tammi Kromenaker, director of Red River Women’s Clinic, said in a statement that the ruling “gives me hope.” She added, “I look forward to a new future in North Dakota and hope our lawmakers will finally give up on their crusade to force pregnancy on people against their will.”

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