The Alabama Senate approved a measure on Tuesday that would outlaw almost all abortions in the state, setting up a direct challenge to Roe v. Wade, the landmark 1973 U.S. Supreme Court ruling which said a woman has a constitutional right to end a pregnancy until the fetus is developed enough to live outside the uterus.
The legislation, called the Human Life Protection Act, would prohibit abortions at every stage of pregnancy, and it is poised to become the country's most restrictive abortion ban. A doctor could be charged with a felony and face up to 99 years in prison for performing an abortion in most circumstances; doctors would face a 10-year prison sentence for even attempting an abortion.
The bill allows abortions in cases when a pregnant woman's life is at serious risk, although not for cases of rape or incest — a subject of heated debate among lawmakers in recent days. Two physicians would be required to certify an abortion is medically necessary.
The bill passed on Tuesday, 25 to 6. Before the vote, the Republican-controlled state Senate removed an amendment without a roll call vote that would have allowed abortions in cases of rape and incest. The bill passed the state's House of Representatives without those exceptions late last month.
The text of the legislation compares abortion to some of history's greatest tragedies, including the Holocaust, the mass killings in the Soviet Union under Joseph Stalin, China's deadly "Great Leap Forward," Cambodian killing fields and the Rwandan genocide.
"All of these are widely acknowledged to have been crimes against humanity," the bill states, in reference to the atrocities. "By comparison, more than 50 million babies have been aborted in the United States since the Roe decision in 1973 — more than three times the number who were killed in German death camps, Chinese purges, Stalin's gulags, Cambodian killing fields and the Rwandan genocide combined."
The legislation has moved through the deep-red state at a time when opponents of legal access to abortion nationwide have been emboldened by the transformation of the Supreme Court with the confirmation of Justice Brett Kavanaugh, which secured a conservative majority on the nation's highest court for decades to come.
Anti-abortion activists and lawmakers across the country have pursued a range of proposals to limit abortions this year, including so-called "heartbeat bills," which outlaw abortions once a fetal heartbeat can be detected. That can be as early as six weeks, before many women even know they are pregnant.
Gov. Brian Kemp of Georgia, a Republican, signed one such measure last week. Similar bills have been signed into law in Kentucky, Mississippi and Ohio. Lawmakers in Florida, Louisiana, Missouri, South Carolina, Tennessee, Texas and West Virginia are considering their own proposals.
Still, the measure in Alabama appears intended to go farther than the heartbeat bills — and to encourage a legal showdown over Roe's 46-year-old precedent. And it is likely to become law, given it heads to the desk of a conservative governor.
Gov. Kay Ivey, a Republican, has not yet indicated whether she plans to sign the measure into law if it reaches her desk. However, the state's lieutenant governor admitted the bill is a direct attempt to overturn Roe.
"It is important that we pass this statewide abortion ban legislation and begin a long overdue effort to directly challenge Roe v. Wade," Alabama Lt. Gov. Will Ainsworth, a Republican, said last week.
Ainsworth, who presides over the state Senate chamber, applauded President Donald Trump with making the nation's courts more conservative, thus giving anti-abortion activists the chance to overturn Roe.
"Now that President Donald Trump has supercharged the effort to remake the federal court system by appointing conservative jurists who will strictly interpret the Constitution, I feel confident that the U.S. Supreme Court will overturn Roe and finally correct its 46-year-old mistake," he added.
Alabama, a conservative state where Republicans have long dominated politics and there are just three abortion clinics that regularly provide care, has a documented history of attempting to curb abortion access. Last year, voters supported an amendment to the Alabama Constitution declaring that the "public policy of this state is to recognize and support the sanctity of unborn life and the rights of unborn children, including the right to life."
In the past, lawmakers set a 48-hour waiting period for abortions; mandated that women receive state-directed counseling before the procedure; required a woman to undergo an ultrasound before obtaining an abortion (and the provider must offer her the option to view the image); and required minors to receive consent for an abortion from a parent or legal guardian.
State lawmakers have introduced more than 250 abortion restriction bills so far this year, according to a study conducted by Planned Parenthood and the Guttmacher Institute, a reproductive rights research organization.
Opponents of the legislation in Alabama have vowed to sue to block the measure if it becomes law. They intend to argue that a state cannot restrict access to abortion before viability — the point at which a fetus can survive outside the uterus — which is a right that federal courts have repeatedly reaffirmed in decisions since Roe. Any restriction on abortion must contain exceptions to protect the life and health of the woman and cannot create an "undue burden" on a woman seeking an abortion — a standard that was established in Planned Parenthood v. Casey" in 1992 and clarified in Whole Woman's Health v. Hellerstedt in 2016.
"Passing bills that they know will be struck down in federal court are a waste of millions of taxpayer dollars that could be going to address the urgent needs in our communities," the American Civil Liberties Union of Alabama said in a statement. "Ignoring those needs in favor of scoring political points is an irresponsible use of their power and privilege."
Planned Parenthood President Dr. Leana Wen said, "In a state that has some of the worst health outcomes for women in the nation — such as the highest rate of cervical cancer — Alabama is putting women's lives at an even greater risk. Politicians who say they value life should advocate for policies to solve the public health crises that are killing women — not dismantle what little access to health care Alabamians have left."
Tarah Demant, the director of the Gender, Sexuality and Identity Program at Amnesty International USA called Alabama's vote "a gross and dangerous turn back to a dark history where women risked their lives to access their sexual and reproductive rights."
"These bans reinforce violence against women by victimizing survivors of rape and sexual violence twofold by denying their right to access abortion," Demant said.