North Dakota on Monday adopted one of the strictest anti-abortion laws in the country as Republican Gov. Doug Burgum signed legislation banning the procedure throughout pregnancy, with slim exceptions up to six weeks’ gestation.

In those early weeks, abortions would only be allowed in cases of rape or incest, or in medical emergencies. After six weeks, rape and incest victims cannot get abortions. Abortions to treat some medical emergencies, such as ectopic pregnancies, are allowed at any stage of pregnancy.

“This bill clarifies and refines existing state law … and reaffirms North Dakota as a pro-life state,” Burgum said in a statement.

Last year’s U.S. Supreme Court ruling overturning the 1973 Roe vs. Wade decision that legalized abortion nationwide has triggered multiple state laws banning or restricting the procedure. Many were met with legal challenges. Currently, bans on abortion at all stages of pregnancy are in place in at least 13 states and on hold in others because of court injunctions.

On the other side, Democratic governors in at least 20 states this year launched a network intended to strengthen abortion access in the wake of the U.S. Supreme Court decision that eliminated women’s constitutional right to end a pregnancy and shifted regulatory powers over the procedure to state governments.

The North Dakota law is designed to take effect immediately, but last month the state Supreme Court ruled a previous ban is to remain blocked while a lawsuit over its constitutionality proceeds. Last week, lawmakers said they intended to pass the latest bill as a message to the state’s high court signaling that the people of North Dakota want to restrict abortion.

Supporters have said the measure signed Monday protects all human life, while opponents contend it will have dire consequences for women and girls.

North Dakota no longer has any abortion clinics. Last summer, the state’s only facility, the Red River Women’s Clinic, shut its doors in Fargo and moved operations a short distance across the border to Moorhead, Minnesota, where abortion remains legal. The clinic’s owner is still pursuing a lawsuit challenging the constitutionality of North Dakota’s previous abortion ban.

It’s expected that this new ban will also be the subject of legal challenges.

Republican Sen. Janne Myrdal, of Edinburg, sponsored the latest state legislation.

“North Dakota has always been pro-life and believed in valuing the moms and children both,” Myrdal said in an interview. “We’re pretty happy and grateful that the governor stands with that value.”

Democratic Rep. Liz Conmy voted against the bill and said she had hoped Burgum would not sign it.

“I don’t think women in North Dakota are going to accept this, and there will be action in the future to get our rights back,” Conmy said. “Our Legislature is overwhelmingly pro-pregnancy, but I think women in the state would like to make their own decisions.”

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This story was first published April 24, 2023. It was updated April 25, 2023 to make clear that abortion to treat some medical emergencies, including an ectopic pregnancy, is allowed at any stage of pregnancy, not just up to six weeks’ gestation under the state’s new law.

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Trisha Ahmed is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Trisha Ahmed on Twitter: @TrishaAhmed15