Respect Accessibility

South Dakota restricts abortion pills, but remains entangled in litigation

South Dakota Gov. Kristi Noem speaks during the Family Leadership Summit, Friday, July 16, 2021, in Des Moines, Iowa.  Charlie Neibergall/ AP

Story at a glance

  • South Dakota Gov. Kristi Noem signed a bill that will require women in her state to make three separate trips to a doctor to receive the two pills necessary for a medication abortion.
  • The law hinges on an earlier preliminary injunction that blocked Noem’s attempt to restrict abortion pills via executive order.
  • Noem appealed that injunction and in the meantime, South Dakota’s new abortion pill law remains uncertain.

South Dakota Gov. Kristi Noem (R) signed a bill into law this week that makes getting abortion pills harder, though core pieces of the legislation can’t be enacted because the state remains embroiled in a court battle over access to abortion.  

Noem signed House Bill 1318 Wednesday which will require women in South Dakota to make three separate trips to a doctor to receive the two pills necessary for a medication abortion starting in July. The bill also outlaws medical abortions through telemedicine and increases the penalty for the unlicensed practice of medicine when performing a medical abortion.  

Noem also signed a separate bill, HB 1113, which makes it a felony to coerce a woman into getting an abortion. 

Nationally, medication abortion accounted for 54 percent of U.S. abortions in 2020, according to the Guttmacher Institute. Abortion pills are becoming a growing resource for women in the U.S., accounting for only 6 percent of abortions in 2001 and jumping to 24 percent by 2011.   

The pills became available to women in the U.S. in 2000 and come in a two-drug combination, known as mifepristone and misoprostol. The drugs are approved for use up to 10 weeks of pregnancy, with additional research showing provision beyond 10 weeks is safe and effective. 


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Noem has made abortion a key pillar of her administration, attempting to restrict abortion pill access through executive action last year. That executive order would have forced women seeking abortion pills to take both doses of the two-dose regimen at a doctor’s office — but it was blocked by a federal judge.  

That decision was brought after Planned Parenthood and the American Civil Liberties Union (ACLU) of South Dakota filed a joint complaint against Noem and South Dakota’s Department of Health.  

U.S. District Judge Karen Schreier sided with Planned Parenthood — the only abortion provider in South Dakota — writing in her opinion, “the rule likely imposes an undue burden on Planned Parenthood and its patients’ right to seek an abortion.” 

Though Noem was able to pass a similar version of her executive order legislatively, that preliminary injunction is still preventing newly signed HB 1318 from taking full effect.  

The bill text indicated core sections of the act would direct women to make three separate trips to a doctor’s office to receive abortion medication, “are effective on the date there is no longer an injunction preventing enforcement of the procedures detailed in sections 2 and 3, provided no further appeal is pending or can be made.” 

Noem has appealed Schreier’s decision and is riding on the prospective ruling that may come out of Supreme Court case Dobbs v. Jackson Women’s Health Organization. That case will directly challenge the historic 1973 ruling on Roe v. Wade by calling into question a Mississippi law that bans abortions after 15 weeks. 

“I look forward to the day when all life (born and unborn) is protected by law. This litigation will help,” said Noem in a Tweet. 

Currently, women in South Dakota must make two separate visits to a doctor’s office, waiting 72 hours in between appointments, before they can receive an abortion, including abortion pills. 

There are many states around the country similarly attempting to restrict abortions, like the state of Texas which passed S.B. 8, known as the fetal heartbeat law, which bans all abortions after fetal cardiac activity is detected. That usually happens around six weeks of pregnancy and before most women know they are pregnant.    

Florida is attempting to pass similar legislation that would ban abortions after 15 weeks of pregnancy, as is Arizona.


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