On Friday, the North Dakota Supreme Court reinstated a near-total abortion ban, reversing a previous ruling by a lower court. Under this new ruling, it is now classified as a felony for medical professionals to perform abortions, with exceptions only to protect the life or health of the pregnant individual, or in cases of rape or incest within the first six weeks of pregnancy. While patients are not subject to prosecution, medical providers who violate this ban could face penalties of up to five years in prison and a $10,000 fine.

This decision aligns North Dakota with twelve other states in the U.S. that have enacted similar or more restrictive abortion laws. Medical professionals in North Dakota have expressed concerns that this ruling will heighten existing fears surrounding the provision and receipt of medically necessary abortions, particularly in a state where access to such services is already limited.

Dr. Ana Tobiasz, a maternal-fetal medicine specialist in Bismarck and a plaintiff in the case, noted that many healthcare providers in the state have been apprehensive about potential repercussions, even during the period when the abortion ban was temporarily halted in 2024. She anticipates that the reinstatement of the ban will further complicate medical care, as it creates ambiguity regarding when exceptions to the ban are applicable. "It is extremely confusing," she stated, highlighting concerns that individuals may revert to fearing whether their circumstances will qualify for the legal exceptions.

In a closely contested ruling, three justices acknowledged that the abortion ban was unconstitutionally vague concerning medical exceptions. However, North Dakota law stipulates that a minimum of four out of five justices must concur for a law to be deemed unconstitutional.