Tennessee's near-absolute ban on abortion takes effect on Thursday, two months after the Supreme Court's landmark Dobbs v. Jackson Women's Health Organization overturned federal protection for this type of reproductive health care.
The state's abortion law — commonly referred to as the "trigger ban" — is one of the most strict in the nation.
Here's a breakdown of the law, its history and what it may mean for women and their medical providers:
Previous coverage:Lee says abortion law protects doctors in severe cases. Critics say it's not so clear.
What is the 'trigger ban?'
The so-called trigger ban is the Tennessee ban on nearly all abortions that was triggered by the Supreme Court ruling this summer that effectively overturned Roe v. Wade.
The 2019 state law, designed for that eventuality, makes performing an abortion a felony. The law provides no exceptions for cases of incest or rape.
Doctors performing abortions on women in order to save their lives could, in theory, be subject to arrest and criminal charges. Though the state law allows them to use that reason as a defense in any such case against them.
Women who seek illegal abortions would not be subject to criminal prosecution under the law.
Inside the ban:Here's what Tennessee's new, near-total abortion law actually says as it goes into effect
We answered:What questions do you have about abortion access in Tennessee following the reversal of Roe?
Immediately following the Supreme Court ruling, the state's so-called "heartbeat bill" that banned abortions after six weeks took effect. That law will now be moot with the near-total ban.
Are there any exceptions?
Not really.
Again, the law taking effect makes providing an abortion or attempting to perform an abortion a Class C felony, for any reason. Rape and incest exceptions are not included.
Though the law allows doctors to use as an "affirmative defense" in a criminal case the fact that the abortion "was necessary to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman."
Ashley Coffield, CEO of Planned Parenthood of Tennessee and North Mississippi, told reporters on Wednesday that this language effectively places the burden of proof on medical providers, rather than the state.
"The law will make the doctor second guess their medical training and expertise when choosing a treatment plan or risk a felony criminal conviction," Coffield said. "Now, hospitals and lawyers will be weighing in on life and death scenarios."
The Tennessee law also states that this life-of-the-mother defense is not valid in cases in which doctors worry that the abortion is needed to protect a woman's mental health or out of concerns the woman "will engage in conduct that would result in her death or substantial and irreversible impairment of a major bodily function."
Are other medical procedures affected?
An abortion technique known as a dilation and curettage procedure (D&C) to remove tissue from inside a uterus is sometimes used in miscarriages and other medical emergencies.
The law does not address such situations specifically, but some doctors worry that the law will lead some doctors to hesitate even in these non-abortion cases.
Medical practitioners commonly use the example of ectopic pregnancies, cases in which fertilized eggs develop outside the uterus. Such pregnancies are always fatal for the fetus, according to the Cleveland Clinic.
Removal of the fetus is necessary to protect the lives of those who are carrying them. But, under Tennessee law, this could be considered an abortion. The law defines abortion as terminating a pregnancy, which is defined as having a "living unborn child within (a woman's) body."
Read this:Tennessee judge issues restraining order against anti-abortion group after armed activist arrest
Will contraception and morning-after pills be affected?
The state's trigger ban does not explicitly mention contraception, though confusion surrounding it did lead many to worry that emergency birth control like "Plan B" would be outlawed.
Plan B and other "morning after" contraceptions are not abortion pills. Rather, they prevent a woman's egg from fully developing and prevent eggs from attaching to the wall of the uterus, according to the Mayo Clinic.
Some have expressed concern that certain long-acting forms of contraception, such as IUDs (intrauterine devices) may be affected by the law. IUDs are T-shaped devices implanted in the uterus to release hormones, or sometimes copper ions, to prevent sperm from fertilizing eggs.
Coffield notes that IUDs do not trigger abortions. Though she added:
"But, it's about the enforcement of this law and how it's interpreted. How it's put into effect in Tennessee is left to be seen."
This story includes reporting and research provided by Tennessean reporters Melissa Brown and Mariah Timms
Frank Gluck is the health care reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at @FrankGluck.
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