BISMARCK, N.D. (AP) -- North Dakota's lone abortion clinic is on pace to end the year with the fewest number of pregnancy-ending procedures recorded in more than a decade, a drop the facility's director attributes in part to new legislation she says has confused some women into thinking abortion in the state is now outlawed.
Tammi Kromenaker, director of the Red River Women's Clinic in downtown Fargo, said the clinic is expected to end the year having conducted about 1,125 abortions — around a 15 percent drop from the 1,330 in 2012.
A doctor who works at the Fargo clinic and others in South Dakota and Minnesota has heard from some North Dakota women who sought abortions elsewhere, assuming that they are now banned in the state, Kromenaker said.
"We're definitely hearing from women that they thought we were closed and that abortion is illegal," she said. "Abortion is still legal in the state of North Dakota and we're still here."
But state Rep. Bette Grande, an ardent opponent of abortion, said the decline in the number of abortions in the state is a positive thing. She suspects it happened because more women have become educated on the issue.
"Women are changing their hearts and minds," said Grande, a Fargo Republican who supported legislation this year aimed at limiting abortions, including a measure that bans them when a fetal heartbeat is detected — as early as six weeks into pregnancy.
Abortion rights advocates call the heartbeat law the most restrictive in the country and an attempt to shutter the clinic. Supporters of the measure have said it's a challenge to the U.S. Supreme Court's 1973 ruling that legalized abortion up until a fetus is considered viable, usually at 22 to 24 weeks. U.S. District Judge Daniel Hovland in Bismarck granted a temporary injunction in July that temporarily blocks enactment of the law, calling it "clearly invalid and unconstitutional."
The measure is among four Republican Gov. Jack Dalrymple signed into law this year with overwhelming support by the state's Republican-led Legislature.
Grande said she has received numerous emails in recent months from women who decided against abortion because of the debate in North Dakota over the issue.
"They are saying, 'This has affected my thinking,'" she said. "More women have thought through the process and said, "This is not what I want to do."
The Fargo clinic does not perform abortions after 16 weeks and officials there did not challenge a new North Dakota law that bans abortions after 20 weeks of pregnancy, based on the disputed premise that a fetus can feel pain by then.
The clinic has performed an average of about 1,300 abortions annually over the past decade, according to state Health Department data.
The clinic opened in 1998, bringing to two the number of abortion providers in the state. Combined, the clinics performed 1,242 abortions that year. The Red River Women's Clinic became the state's sole abortion provider in 2001, and recorded 1,216 abortions, the fewest number since then.
According to the Centers for Disease Control and Prevention, the number of U.S. abortions has been dropping slightly over much of the past decade, and fell 3 percent in 2010, the most recent year for which statistics are available.
Abortions in North Dakota have remained steady over the past decade and increased from 1,290 in 2009 to 1,291 in 2010, state data show.
"I don't think women's circumstances and the reason they come to us have changed," Kromenaker said.
Planned Parenthood of Minnesota, North Dakota and South Dakota operates an abortion clinic in St. Paul, Minn. and the only one in South Dakota. Spokeswoman Connie Lewis said the clinics don't have statistics yet on how many women may have crossed state lines from North Dakota seeking an abortion either South Dakota or Minnesota.
"But I absolutely believe that it's happening," she said.
Lewis said anti-abortion legislation in South Dakota in 2006 and 2008 — though ultimately defeated — created confusion for women in that state over whether abortion remained legal.
"It certainly mirrors the experience we had in South Dakota," she said. "It was a significant drop off and we did hear from people who said they weren't sure we were open. It has leveled off some now."
Lewis said abortion numbers in Minnesota and South Dakota have been dropping slightly over the past few years, following the national trend.
Austin, Texas-based Whole Woman's Health, which operates an abortion clinic in Minneapolis, said in a statement that about 3 percent of its patients come from North Dakota, a percentage that has remained the same for the past two years.
"Most of the women traveling to us are over the gestational limit offered at Red River Women's Clinic and come to us for care beyond 16 weeks," the statement said.
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