"Iowa is set to become the latest state to tightly restrict access to abortion after the state's supreme court upheld a law banning abortions at six weeks of pregnancy.

That will replace the current ban on abortions after 20 weeks of pregnancy. It sets a short timeline for getting the procedure, with many women not aware of their pregnancy for the first several weeks.

It's unclear when the law will take effect, with some saying it won't be for at least three weeks as other court procedures still play out.

Abortions after six weeks of pregnancy will be allowed in cases of rape if the assault is reported to law enforcement within 45 days, in cases of incest reported within 140 days, and if the pregnancy endangers the life of the pregnant person. It allows abortion in the case of life-threatening fetal abnormalities.

In the two years since the U.S. Supreme Court ended a federal right to abortion in the Dobbs case, state lawmakers around the country have been making a new patchwork of reproductive rights. In many states, that's meant setting new restrictions on abortion - though the number of abortions being carried out has increased.

The law had been in effect for a few days after Republican Gov. Kim Reynolds signed it last year but was blocked by a lower court in a lawsuit filed by Planned Parenthood of the Heartland.

Today the court found that there is a "rational basis" to write a law banning abortion based on the detection of a fetal heartbeat, stating, "We conclude that the fetal heartbeat statute is rationally related to the state’s legitimate interest in protecting unborn life."

In a dissenting opinion, Chief Justice Susan Christensen wrote, "The majority’s rigid approach relies heavily on the male-dominated history and traditions of the 1800s, all the while ignoring how far women’s rights have come since the Civil War era."

The ruling will put Iowa among 18 states that either ban nearly all abortion or ban abortions after six weeks of pregnancy. That includes 14 with near total bans and now four with six-week bans, according to the Guttmacher Institute, a research group that backs abortion rights.

The Midwest is still a mixed picture for abortion rights. Neighboring Iowa are Minnesota, Wisconsin, Kansas and Illinois that still allow access to abortion beyond 20 weeks. But Missouri and the Dakotas have near-total bans and Nebraska has a 12-week ban."

- Larry Kaplow, npr