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Protesters outside of an abortion clinic. Sarah McCammon/NPR hide caption

Even without the U.S. Supreme Court weighing in - and with Roe v. Wade still officially the law of the land - Republican lawmakers managed to shut down abortions in Kentucky for more than a week. That was until abortion rights advocates won a court order on Thursday allowing them to resume the procedure.

"This is where patients would come after their procedure," Tamarra Wieder, Kentucky state director for Planned Parenthood Advocates of Indiana and Kentucky, said on Wednesday as she stood behind an empty nurses' station in her Louisville health center. "Generally all of the beds would be full on a procedure day. There is nobody in here, and it has been empty since last week."

A 'temporary reprieve'

Abortion providers in Kentucky say they're now resuming abortion services after a federal judge issued the order temporarily blocking a new state law known as House Bill 3, which had halted abortions there since the middle of last week.

But they acknowledge it may be a fleeting victory and a preview of what's likely coming next, if the Supreme Court overturns Roe and other precedents guaranteeing abortion rights, as many observers expect.

"We know it's a temporary reprieve and it's heartbreaking to see how this is going to play out. You begin to feel the dominoes cascade," Wieder said. "It's not going to last long."

Tamarra Wieder testifies during a hearing on a bill that would ban abortion after 15 weeks at the Capitol Annex in Frankfort, Kentucky, on March 10, 2022. Sam Upshaw Jr./Courier Journal/USA Today Network via Reuters hide caption

'Impossible' to comply

HB 3 includes a ban on abortion after 15 weeks, modeled after a Mississippi law that is currently before the Supreme Court, and includes layers of new regulations which clinics say are impossible to comply with on short notice. It took effect immediately under an emergency provision after Republican lawmakers voted to override Democratic Gov. Andy Beshear's veto on April 13.

Both of the two health centers that offer abortions in Kentucky said they had no choice but to shut down abortion services after the regulations took effect. Those regulations include rules for abortion pills and providers, requirements for collecting patient information, and regulations around the handling of fetal remains.

Heather Gatnarek is an attorney with the American Civil Liberties Union of Kentucky, which represents the EMW Women's Surgical Center, also in Louisville. She said state health officials haven't had time to develop the necessary forms and other protocols for compliance.

"At this point, it's impossible for the clinic to comply or to take steps for compliance because we need things from the state of Kentucky that they haven't created yet," Gatnarek said.

Beshear called the new law an "unfunded mandate" because of the heavy role the state will need to play in complying with the regulations. But he said Kentucky health officials will comply if the courts ultimately uphold the law.

On Thursday afternoon, a federal judge issued an order temporarily blocking HB 3, after both the ACLU and Planned Parenthood filed federal lawsuits challenging it.

In a response filed earlier in the week, Kentucky Attorney General Daniel Cameron, a Republican, had argued that clinics are not required to "comply with forms and regulations that do not yet exist." But abortion providers disagreed with that interpretation, saying they can't take the risk of facing heavy fines, or jail time for violating some parts of it.

Kentucky Attorney General Daniel Cameron speaks during a news conference in Frankfort, Ky. Timothy D. Easley/AP hide caption

Stopping abortion through bans or through rules

Republican state Rep. Nancy Tate, who opposes abortion rights, sponsored the proposal.

"People accuse me of trying to stop abortions, and personally, they're absolutely right," she said in an interview with NPR. "I would dearly love to stop abortions in the Commonwealth of Kentucky as well as everywhere else."

But until then, Tate argued the law would make patients safer. Abortion rights groups say the procedure already is heavily regulated, and that the law would only make it inaccessible.

The past week has been almost a trial run of what's likely ahead for many states with Republican-dominated legislatures, if the Supreme Court allows them to ban most or all abortions.

Abortion-rights opponents have employed a multi-pronged strategy designed to ban abortion as quickly and completely as the courts will allow, and to prepare for the anticipated Supreme Court ruling. This year, Republican lawmakers in states including Arizona, Florida, Idaho, and Oklahoma, have passed a wave of new abortion restrictions many modeled after those in Texas or Mississippi.

Since September, Texas Republicans have succeeded in blocking most abortions after about six weeks of pregnancy, under a new state law that relies on private citizens to enforce it through lawsuits.

Abortion-rights supporters chant their objections at the Kentucky Capitol on April 13, 2022 in Frankfort, Ky., as Kentucky lawmakers debate overriding the governor's veto of an abortion measure. Bruce Schreiner/AP hide caption

Abortion-rights supporters chant their objections at the Kentucky Capitol on April 13, 2022 in Frankfort, Ky., as Kentucky lawmakers debate overriding the governor's veto of an abortion measure.

The 'long game'

For patients in Louisville who were unable to obtain abortions in Kentucky in recent days, the nearest alternative was more than two hours away in Indiana. Planned Parenthood staff said appointments there were filling up fast in the days after HB 3 took effect.

Erin Smith is executive director of the Kentucky Health Justice Network, which spent more than $100,000 dollars last year helping low-income people pay for abortions, and travel. Smith said they're on pace to exceed those numbers this year, and thinking about new strategies for responding to an increasingly restrictive legal landscape around abortion.

"We are going to have to just restructure. We're going to have to think long game," Smith said. "We're going to have to make plans, like, hey, maybe we should charter a bus. Maybe it takes that."

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How Kentucky Republicans blocked all abortions for more than a week - NPR