South Dakota's abortion ban was supposed to have a medical exception. Then lawmakers passed a new law in March 2026 to make that exception clearer. But doctors in the state say it still isn't working.

Consider what that means in practice. A woman whose water breaks at 18 weeks — too early for the baby to survive — can develop a life-threatening infection within hours. A woman with a heart condition whose risk of dying during pregnancy is 40% may still not clearly qualify for care under the law. A woman with an ectopic pregnancy, where the embryo implants outside the uterus and can cause fatal internal bleeding, may face delays while her doctor consults a lawyer. These are not edge cases. They are obstetric emergencies that happen every day.

Dr. Amy Kelley, an OB-GYN in Sioux Falls, says she still waits longer than she should to end pregnancies for medical reasons — and still sends patients out of state for care. "It's just not helpful," she said of the new law, according to South Dakota Searchlight. She and other physicians warned lawmakers the language was too vague before it passed. They were ignored.

The problem is real: when a doctor isn't sure if treating a dying patient is legal, they wait. That waiting causes harm. Research has linked abortion restrictions to higher rates of maternal death and injury across the country.

The new law still leaves it up to individual physicians to decide whether their judgment will hold up in court — or land them a felony charge. That is not a workable standard for emergency medicine.

We're calling on Governor Larry Rhoden and the South Dakota Legislature to go back to the table — this time with OB-GYNs, not just anti-abortion advocates — and write a medical exception that doctors can actually use and patients can trust.

Patients in South Dakota deserve care that doesn't depend on a doctor's fear of prosecution. Fix this now.