By KRISTI EATON, Associated Press
SIOUX FALLS, S.D. (AP) - Doctors in South Dakota must warn women seeking abortions that they face an increased risk of suicide if they go through with the procedure, a federal appeals court ruled Tuesday.
The 8th Circuit Court of Appeals upheld the portion of the 2005 South Dakota law dealing with the suicide advisory 7-4.
"On its face, the suicide advisory presents neither an undue burden on abortion rights nor a violation of physicians' free speech rights," the court wrote in its majority opinion.
In September, a three-judge panel upheld U.S. District Judge Karen Schreier's decision to overturn the requirement following a lawsuit brought by Planned Parenthood. The decision Tuesday by the full 11-member court grants judgment to the state and vacates the permanent injunction against enforcing the provision.
The ruling ultimately was a battle of medical studies. Statistics show that women who have had abortions have higher rates of suicide compared with women who've given birth, but the sides don't agree that there's a causal link between abortion and suicide.
The four dissenting judges said that multiple studies cited failed to take into account factors such as pre-existing mental health issues, domestic violence and a young age at the time of pregnancy.
"The most reliable evidence in the record shows that abortion does not have a causal relationship to the risk of suicide and that South Dakota's mandated advisory is not truthful, but actually misleading," Circuit Judge Diana Murphy wrote for the dissenting side.
The state, in supporting the law passed seven years ago, disagreed, submitting several studies published in peer-reviewed medical journals to demonstrate a "statistically significant correlation between abortion and suicide."
Planned Parenthood, however, relied on another study to argue its belief that certain underlying factors, such as mental health issues, predispose women to have both unwanted pregnancies and suicidal tendencies.
Attorney General Marty Jackley and representatives of Planned Parenthood were not immediately available for comment.
In December, when it was announced that the full 8th Circuit Court would rehear the case, the president of Planned Parenthood Minnesota, North Dakota, South Dakota said she was confident the panel would uphold the two prior decisions and find that an abortion does not subject a woman to an increased risk of suicide.
"The research is on our side," Sarah Stoesz said.
Leslee Unruh, the founder of the Alpha Center pregnancy counseling center in Sioux Falls, which seeks to persuade women not to seek abortions, applauded Tuesday's decision as one that benefits South Dakota women.
"We are thrilled. This has been a long time working from 2005. It's a long, long haul. We are so excited for the women of South Dakota that they have this victory," she said.
The suicide advisory was part of a larger law requiring South Dakota doctors to provide women with certain information before an abortion can be voluntary.
In September, the appeals court overturned Schreier's ruling that it was unconstitutional to require doctors in South Dakota to tell women they have an existing relationship with a fetus that is protected by law.
Schreier found the wording misleading because she said a relationship, in the eyes of the law, can only exist between people and the Supreme Court has ruled that the unborn are not legally considered people.
The appeals court disagreed with Schreier's reasoning, agreeing with the state's argument that doctors would be providing patients with valid legal advice -- that they can't be compelled to have an abortion -- allowing patients to make more informed decisions.