‘Chaos and Confusion’ in States Where Abortion Is On Again, Off Again

After the Supreme Court overturned Roe v. Wade in June, the law on abortion in Utah changed three times in five days. On Friday, the day of the court’s decision, a so-called trigger law banning the procedure took effect. The following Monday, a judge blocked the ban and abortions resumed. The next day, state legislators revived an old law limiting abortions to 18 weeks of pregnancy.

“It changed day by day and hour by hour,” said Dr. David Turok, an OB-GYN and the director of surgical services at the Planned Parenthood Association of Utah. “There were days where we had people show up and wait in the waiting room, and we weren’t sure if we were going to be able to see them.”

The legal back and forth on abortion since the court’s decision in Dobbs has not been confined to Utah. More than a dozen states moved quickly to ban the procedure, enacting trigger laws designed to take effect in the event Roe was overturned or reinstating old laws that were previously unenforceable.

But lawsuits against the abortion bans just as quickly followed. Plaintiffs have argued that the bans run afoul of state constitutions, or are too vague or out of date to enforce. And judges in several states have agreed: Bans have been temporarily blocked, reinstated, and in some cases blocked again, as the cases have wound their way through the courts.

For abortion providers and patients, this has meant navigating a situation in which abortion may be allowed one day and banned the next. Providers have canceled procedures midday or told patients to wait on standby in the event that abortion becomes temporarily legal again.

The legal back and forth has also frustrated opponents of abortion who saw the Dobbs decision as having settled the question of whether states can prohibit the procedure. In Kentucky, the trigger ban took effect but was blocked by a circuit court judge less than a week later, angering Daniel Cameron, the state’s attorney general, a Republican.

“In the wake of an historic victory for life at the nation’s highest court, today, one judge in Kentucky has, without basis in the Kentucky Constitution, allowed two clinics to resume abortions,” Mr. Cameron said in a statement after the ruling. A ban on abortion after six weeks of pregnancy was also blocked by the judge’s order.

Two weeks later, a federal judge allowed a separate ban on abortions after 15 weeks of pregnancy to take effect, though the trigger ban, which would have stopped all abortions, remained blocked. EMW Women’s Surgical Center, one of two abortion providers in Kentucky, saw 232 patients during this time, according to Brigitte Amiri, a lawyer for the American Civil Liberties Union who is representing the clinic.

Then, last week, a Kentucky court of appeals judge allowed the trigger ban to take effect while the case against it proceeds.

“All of this has been so chaotic and so confusing for patients and providers,” said Ms. Amiri.

The situation in Louisiana has been even more in flux. The state’s trigger ban has been blocked and reinstated three times in the course of six weeks.

“I think a lot of people were very discouraged,” said Sarah Zagorski, a spokeswoman for Louisiana Right to Life, an anti-abortion group that worked with legislators in writing the state’s trigger law, known as the Human Life Protection Act. “We went through a great deal of work to ensure that the Human Life Protection Act wasn’t confusing or vague and that any issues of concern would be addressed.”

Kathaleen Pittman, the director of Hope Medical Group for Women, one of three abortion providers in Louisiana and a plaintiff in the lawsuit against the trigger ban, said that when the ban first took effect she began referring patients to clinics in New Mexico and southern Illinois. Before Dobbs, the clinic typically saw 15 to 45 patients a day.

But many people who called could not travel or preferred to wait to see what happened in Louisiana. Ms. Pittman said the clinic continued to schedule patients for an initial consultation, so that in the event the ban were blocked, they could schedule their procedures.

A few days later, on June 27, a judge blocked enforcement of the ban. “We immediately started calling people and saying, ‘We’re back on — can you come right now?’” Ms. Pittman said.

The trigger bans in North Dakota and Wyoming were blocked before they could take effect. But even though abortion remained legal in those states, providers said that patients and medical professionals did not always know what was going on.

“People have called to ask me if the IUD is legal, if Plan B is legal,” said Dr. Giovannina Anthony, an OB-GYN at Women’s Health and Family Care, a family practice that is also Wyoming’s only abortion provider. “I’ve had patients referred to me by other doctors who don’t even know if abortion is still legal in Wyoming. It illustrates what a lot of these laws are doing, which is just causing chaos and confusion.”

The Dobbs decision prompted the Red River Women’s Clinic in Fargo, N.D., to prepare to move its facility across the river to Moorhead, Minn., where abortion remains legal.

When news that a judge had blocked North Dakota’s ban came late in the day on July 27, temporarily allowing abortions to continue, staffers began scheduling patients for the following week in Fargo instead, said Tammi Kromenaker, the clinic’s director.

“We’ve started telling patients, ‘We can provide an abortion to you, but it might be in North Dakota, or it might be in Minnesota, and we will let you know,’” she said.

In some states, the enforcers of the abortion bans have asked for clarity in the laws. In West Virginia, the state’s attorney general said in a memo that an 1849 law banning abortion was “on the books and enforceable” after Dobbs, but he also asked state legislators to reconcile many of the conflicting abortion statues that had been written in the decades since.

A few weeks later, a West Virginia judge blocked the ban, and the state’s only abortion provider began seeing patients again. West Virginia legislators scrambled to pass a new ban on abortion, but the bill has not been finalized.

And in Arizona, there is still no consensus on whether abortion is legal. The state’s attorney general said abortion was banned, pointing to a 1901 law criminalizing the procedure. But abortion rights advocates say the old law cannot take effect until an injunction from 1973 is lifted. The uncertainty surrounding the possibility of criminal prosecution has meant that nearly all providers in the state have stopped offering abortions.

“You have actual abortion bans and then you have confusion that causes a ban,” said Dr. Gabrielle Goodrick, the medical director and owner of Camelback Family Planning in Phoenix, which continues to provide abortions. “Which is essentially a ban.”