First day of trial to challenge Indiana's abortion law focuses on 'health or life' exception

A group of abortion care providers is suing Indiana in a challenge against the state’s abortion law.

Abortion providers said a critical exception in Indiana’s near-total abortion ban is vague and unclear — which puts patient lives at risk. The first day of testimony in the latest legal challenge to the law largely focused on concerns around the “health or life exception.”

The ban only allows an abortion if the pregnant person’s serious health or life is at risk; if there’s a lethal fetal anomaly up to 20 weeks post-fertilization; and in cases of rape or incest, but only up to 10 weeks.

The amended lawsuit from a group of abortion providers seeks to “broaden and clarify” when an abortion is considered legal in Indiana. The plaintiffs want clarity around one of the three exceptions to the near-total ban that says an abortion is allowed if there is a “serious health risk” to the pregnant person.

One of the plaintiffs, Dr. Amy Caldwell, is one of just two physicians in the state still providing procedural abortions. During testimony, she said the near-total ban legislates medical decisions using non-medical language, making it confusing and difficult for providers to navigate.
 

Caldwell said she is not confident “at all” that patients with a serious medical risk have access to abortion care when they qualify under the exception in the state.

Because there is a “significant” penalty for physicians who provide an abortion outside of the exceptions, medical experts said doctors may be more likely to wait until the threat to life is much more obvious, which can delay essential care.

Those who testified Wednesday also criticized the law’s explicit exclusion of mental health under “serious health risk,” and the requirement for all abortions in Indiana to be performed in a hospital.

In addition to providing care in a hospital setting, Caldwell also has an active contract to provide abortion care with Planned Parenthood. She said she is no longer able to fulfill the contract due to the hospital requirement.

Caldwell also raised concerns around the cost and accessibility of care with the requirement. A procedural abortion in a hospital can cost around $8,000, while one at a clinic is around $500 — and the care is still safe outside of a hospital setting.

READ MORE: Indiana’s abortion ban has few exceptions. But navigating them can be difficult for providers
 

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Court documents filed by the providers said more than 8,400 abortions were performed in Indiana in 2021. More than 98 percent were performed at abortion clinics — the rest were in hospitals.

It also said the near-total ban’s prohibition on abortion clinics makes it harder to receive legal care in Indiana. Court documents said “on information and belief, no hospital outside of Indianapolis is currently providing abortion care.” Many pregnant people in Indiana, who have legal access to abortion care, would have to seek it out-of-state.

The Indiana Supreme Court’s 2023 ruling on the near-total ban said it did not violate the state’s constitution. But, the court left the door open to challenges on the specifics – including this lawsuit.

Planned Parenthood Great Northwest, Hawai‘i, Alaska, Indiana, Kentucky; All-Options; and an Indianapolis-based OB-GYN brought the lawsuit.

Testimony continues Thursday and the trial is set to conclude on Friday.

Abigail is our health reporter. Contact them at aruhman@wboi.org.