The sign out front advertises free pregnancy tests, information about abortion and testing for sexually transmitted diseases. But it is not an abortion clinic — it is home to the Alpha Center, an organization in Sioux Falls, S.D., dedicated to encouraging women to bring their babies to term.
A law signed by Gov. Dennis Daugaard on Tuesday makes the state the first to require women who are seeking abortions to first attend a consultation at such “pregnancy help centers,” to learn what assistance is available “to help the mother keep and care for her child.”
The legislation, which passed easily in a state Legislature where Republicans outnumber Democrats by more than 3 to 1, also establishes the nation’s longest waiting period — three days — after an initial visit with an abortion provider before the procedure can be done. It makes exceptions for medical emergencies, but not for rape or incest.
Many states require counseling from doctors or other clinic staff members before an abortion to cover topics like health risks. What makes the new South Dakota law different is that the mandated counseling will come from people whose central qualification is that they are opposed to abortion.
“I think everyone agrees with the goal of reducing abortion by encouraging consideration of other alternatives,” Mr. Daugaard, a Republican, said in a statement Tuesday.
The law has provoked vehement opposition from supporters of abortion rights, both locally and nationally, who describe the requirements as unconstitutional obstacles for women seeking to have an abortion. Planned Parenthood said it would challenge the law in court; it is scheduled to take effect July 1.
Peggy Gibson, a Democratic state representative who voted against the measure, said the law amounted to “government intrusion into people’s medical decisions.”
“South Dakota women should not need to submit to an in-person lecture from an unqualified, noncertified, faith-based counselor or volunteer at an anti-choice crisis pregnancy center,” Ms. Gibson said.
In statehouses around the country, Republicans have used their success in the midterm elections in November to push bills aimed at reducing abortions.
More than half the states have introduced such legislation, including bills restricting health insurance coverage for abortion, requiring women to receive an ultrasound before an abortion, and banning abortion after 20 weeks, said Elizabeth Nash, who tracks abortion legislation for the Guttmacher Institute, a research organization.
South Dakota’s is the most far-reaching of the bills to become law, Ms. Nash said. Despite an abortion rate that is among the lowest in the nation, the state has become a battleground over the issue in recent years, with the Legislature passing a number of laws aimed at curbing abortions, some of which have been overturned by the courts and by voters in two referendums.
Those laws that remain are already restrictive by national standards. The state, for example, requires a one-day waiting period and some counseling, mandating that women be told that an abortion “will terminate the life of a whole, separate, unique living human being.”
Requiring visits to pregnancy help centers, which have been growing nationwide in recent years, is a significant tactical shift by opponents of abortion.
Such centers — both secular and religiously affiliated — can provide counseling under the law as long as their main mission is to “educate, counsel and otherwise assist women to help them maintain their relationship with their unborn children.”
“There’s greater assurance that a woman considering an abortion is going to be fully informed about all the risks and about all the options,” said Roger Hunt, a Republican legislator who wrote the bill. “That’s not being done at the current time.”
The law appears likely to escalate the tensions between abortion providers and the pregnancy help centers, which often operate in close proximity and are listed alongside each other in the phone book under abortion (the Alpha Center even used to be in a space that was once a Planned Parenthood clinic). Each side regularly accuses the other of manipulating and coercing women.
Leslee Unruh, the founder of the Alpha Center and a leader of anti-abortion efforts, said that counseling sessions at her clinic would be carried out only by medical professionals and would ensure that women were not being pressured by a boyfriend, husband or parents. The center already provides counseling sessions to women who regret the decision to have an abortion.
She was dismissive of any opposition to the law, saying that women remained free to have an abortion if they chose to.
“What are they so afraid of?” Ms. Unruh asked. “That women might change their minds?”
The nearby Planned Parenthood clinic is the sole provider of nonemergency abortions in the state. It has no local doctors willing to perform them, so doctors fly in each week from Minnesota.
Patients often have to drive hours across the state to seek an abortion, so under the new law they would need to make several trips or find a place to stay for the three-day waiting period.
Sarah Stoesz, president of the local Planned Parenthood chapter, said the clinic was careful to ensure that patients were making the decision themselves, sometimes turning away a woman who appeared to be making the decision under pressure.
In contrast, she said, employees at the pregnancy help centers have a record of providing misinformation about the physical and psychological risks associated with the procedure and use tactics like displaying graphic photos or quoting scripture to influence a woman’s decision.
“They’re not licensed, they’re not regulated, they’re not accredited and they’re openly ideological,” Ms. Stoesz said.
She added that the idea that pregnant women were now “legally mandated to be coerced by people who aren’t even medical professionals — not that they should be coerced by anyone — is really beyond the pale.”
