* Appeals court upholds law by 7-4 vote
* Reverses decision by three-judge appeals panel
* Planned Parenthood 'extremely disappointed'
(Adds reaction from Planned Parenthood executive and state
By David Bailey
July 24 A federal appeals court on Tuesday
upheld a South Dakota law requiring doctors to advise women
seeking abortions that they face an increased risk of suicide
after the procedure.
The 7-4 ruling by the full 8th Circuit Court of Appeals
reversed a decision by a three-judge appellate panel in
September 2011 that had ruled unconstitutional the suicide
advisory provision in South Dakota's 2005 law.
The panel, which had upheld much of the law that set out
what a pregnant woman should be told 24 hours before undergoing
an abortion, had said a link between abortion and suicide was
unproven and may not exist. South Dakota's governor and attorney
general and two crisis pregnancy centers appealed.
The appeals court ruled on Tuesday that conclusive proof of
a causation was not required and the suicide advisory was not
misleading and was relevant to the patient's decision.
"Today's decision supports the Legislature's goal of
encouraging women seeking an abortion to make informed and
voluntary decisions," South Dakota Attorney General Marty
Jackley said in a statement.
Planned Parenthood, the only abortion provider in South
Dakota, was "extremely disappointed" by Tuesday's ruling, said
Sarah Stoesz, president of Planned Parenthood Minnesota, North
Dakota, South Dakota.
"This ruling by the 8th Circuit Court represents the
greatest intrusion by the government into the patient-doctor
relationship to date," Stoesz said in a statement.
Judge Raymond Gruender wrote in a 27-page opinion that a
multitude of studies published in peer-reviewed medical journals
have found an increased risk of suicide for women who had
received abortions compared to women who gave birth, miscarried
or never became pregnant.
"Various studies found this correlation to hold, even when
controlling for the effects of other potential causal factors
for suicide, including pre-existing depression, anxiety, suicide
ideation, childhood sexual abuse, physical abuse, child
neuroticism, and low self-esteem," Gruender wrote.
Four judges dissented from the decision on Tuesday, finding
that the suicide advisory violates the patient's due process
rights and violates a doctor's right against compelled speech.
"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," Judge Diana Murphy wrote.
South Dakota has been at the center of some of the most
bitter recent fights over abortion, which was legalized in 1973
by the U.S. Supreme Court in Roe v. Wade.
South Dakota was the first state to have what is sometimes
called an informed consent law and has the most expansive law
that has been imitated in part in other states including North
Dakota, Missouri, Kansas and Indiana, according to the
Guttmacher Institute, which studies reproductive health issues.
Jackley said Tuesday's ruling would provide guidance for
challenges to South Dakota laws approved in 2011 and 2012.
South Dakota last year mandated the longest waiting period
in the nation at 72 hours and a meeting at an anti-abortion
counseling center before a woman could undergo the procedure,
both challenged by Planned Parenthood.
Planned Parenthood had contended the suicide advisory
imposes an undue burden on abortion rights and violates the free
speech rights of the physician.
"That requirement really flies in the face of the science,"
Elizabeth Nash, public policy associate at the Guttmacher
Institute, said on Tuesday of the suicide advisory.
Nash said extensive reviews, particularly by the American
Psychological Association, have found no link between negative
mental health outcomes and a single abortion for the average
(Reporting by David Bailey in Minneapolis; Editing by Cynthia
Osterman and Stacey Joyce)