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US abortion fight in high gear

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The signs outside the Red River Woman's Clinic in downtown Fargo suggest a place under siege: "It is a federal crime to block the entrance to this building," says one. "No Trespassing," says another.

They are aimed at the protesters who gather each day outside a clinic that performs abortions, warning not to intrude on women's federally protected right to the procedure.

Today, however, the signs outside the clinic - the only abortion provider in conservative North Dakota - seem directed as much at the state's plan to impose the nation's strictest limits on abortion through two new laws that will go into effect in August.

One law is aimed at sharply reducing the number of women who may obtain an abortion, and the other imposes new standards on doctors who perform the procedure.

Unless pending legal challenges lead the courts to intervene, clinic officials say the Fargo clinic will be forced to close next month, leaving a more than 800-mile swath of the upper Plains without an abortion provider.

"If I hadn't been in that position, maybe I wouldn't care as much about the new limits, said Shanna Labrensz-Smith, a mother of two. "As a former patient, this is very upsetting. They are taking our rights away."

The Supreme Court's 1973 Roe v. Wade ruling established the right to abortion and allowed the procedure until a fetus is viable outside the womb - usually after about 24 weeks of pregnancy. But the court has left the states free to place various restrictions on abortion.

Going after doctor privileges

The North Dakota laws are part of an unprecedented wave of abortion restrictions passed in Republican-controlled states since the party made big gains in the 2010 elections.

In 2011, 92 abortion restrictions were approved in 24 states. The most approved in any previous year was 36. In 2012, 43 more were approved in 19 states. This year, as of July, 45 passed in 17 states, according to the Guttmacher Institute, which researches and tracks abortion laws.

State restrictions typically have ranged from limits on insurance coverage for abortions to requirements that women considering an abortion undergo an ultrasound test, during which technicians typically are required to point out a fetus' visible organs. Some states now have extended waiting periods for those who seek an abortion. The legislation before Texas lawmakers would ban abortions after 20 weeks of pregnancy.

North Dakota, which has just one abortion clinic like Wyoming, South Dakota and Mississippi, has gone further.

One of the new laws bans abortions at the first detection of a fetal heartbeat, about six weeks into pregnancy - the nation's strictest standard. Another requires doctors who perform abortions to get admitting privileges at a local hospital.

If either law withstands legal challenges, the Red River clinic - now in its 15th year in a two-story storefront - would have to close, said director Tammi Kromenaker.

The ban on abortions after six weeks would eliminate 89% of her patients, she said. And none of the three out-of-state doctors who travel to North Dakota to perform abortions there could get admitting privileges at any of the three hospitals in Fargo.

"They are putting up barriers that sound reasonable, that sound like they care about women who are having abortions. But in fact they are just trying to put up a wall of regulations and requirements that are impossible to meet," Kromenaker said.

Bette Grande, a state representative who backed both of the new laws, cast the restrictions on doctors as a safety measure, designed to make sure that only qualified physicians perform abortions.

The Center for Reproductive Rights, based in Washington, D.C., has gone to court to challenge both laws. Opponents of the laws hope to win temporary injunctions to keep them from taking effect while the courts weigh their legality.

'The abortion lady'

If the Fargo clinic closes, it would leave no abortion providers between central Montana and Minneapolis.

The number of abortion providers nationwide dropped from a high of 2908 in 1982, to 1793 in 2008, the last year the Guttmacher Institute counted them. Analysts believe the number has fallen further since then.

Kromenaker has seen a groundswell of both support for and threats against the clinic since the North Dakota laws were passed in March. She said she feels pressure from the attention.

"There is stigma to being the 'abortion lady' in Fargo," said Kromenaker.

Former patients of the clinic have rallied to its defense, and Kromenaker has decorated the walls of the clinic's break room with cards and emails of support from across the country.

"I am 89 years old and can't believe these laws ... Don't give up," reads one. "I live down a dirt road in Maine, but my state supports women. I salute and support you," reads another.

On the sidewalk outside the clinic, a small band of protesters lingers on Wednesdays, when abortions are performed. They urge arriving patients to reconsider their decision, and they provide what they call "sidewalk counseling."

Both sides are gearing up to take advantage of the renewed interest in abortion in the 2014 and 2016 elections. Kromenaker said she believes that a "very large silent majority" who back abortion rights will punish lawmakers who backed the new laws.

"Come 2014 and 2016," she said, "we're going to make sure people remember what these legislators did."

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