COLUMBIA, S.C. (AP) — When the South Carolina Supreme Court upheld a ban on most abortions this week, the majority wrote that they were leaving “for another day” a decision on when, exactly, the “fetal heartbeat” limit begins during pregnancy. Doctors practicing under the strict law cannot similarly punt on that question.

Physicians say the statute’s unclear guidance is already chilling medical practice at the few abortion clinics that operate in the conservative state. With potential criminal charges hanging in the balance, most abortions are being halted as doctors wrestle with the murky legal definitions.

“These medical definitions they tried to put forward are legislative and put forward by people who don’t practice medicine,” said Dr. Dawn Bingham, chair of the South Carolina section of the American College of Obstetricians and Gynecologists, or AGOC. “This language creates uncertainty among medical providers who may be unsure they’re legally allowed to terminate a pregnancy.”

South Carolina and Georgia are the only two states with such bans on the books. An Ohio court is weighing another one, and a six-week ban is pending in Florida.

In South Carolina, the measure passed by the Republican-dominated General Assembly bans abortion after what it calls a “fetal heartbeat” is identified. The law defines that term as “cardiac activity, or the steady and repetitive rhythmic contraction of the fetal heart, within the gestational sac.” Medical professionals can usually detect cardiac activity around six weeks of pregnancy, which is before most people know they are pregnant.

That language is clinically inaccurate according to medical consensus, which holds that such “cardiac activity” is not a heartbeat and an embryo has not yet become a fetus at that stage. A 2013 University of Leeds study determined that the four clearly defined chambers in the heart that appear from the eighth week of pregnancy remain “a disorganized jumble of tissue” until around the 20th week.

South Carolina’s law requires that providers perform an ultrasound on any patient seeking an abortion, display the images and record a description of any present “fetal heartbeat.” But the justices left legally undecided the question of whether “cardiac activity” and the described “rhythmic contraction of the fetal heart” refer to the same point or two separate points in a pregnancy.

From a medical standpoint, the ACOG says that while electronic impulses signifying “cardiac activity” can be recognized early on, an actual heart is not detectable by ultrasound until roughly 17 to 20 weeks of gestational age.

Charleston-based OB-GYN Jessica Tarleton said the presence of the word “or” between the terms in the law’s language creates two different definitions and is “vague.” It always takes lawyers some time to put together advice following any restrictions on abortion, she added.

“Defining a structure as a heart would put the definition later in pregnancy than earlier when you would see rhythmic contractions of some kind of cardiac structure,” she said.

In his dissent, South Carolina Supreme Court Chief Justice Donald Beatty questioned how doctors and their lawyers could comply with the law without “a determination of this key point.”

State Senate Majority Leader Shane Massey, a Republican, dismissed the idea that the definitions lack precise guidelines for medical professionals. He said the state has long required that doctors perform ultrasounds to provide an opportunity for patients to see the images before having an abortion.

“Now it just says if there is cardiac activity that is present on that ultrasound — if you can hear the heart beating — then you can’t perform that abortion,” Massey told reporters Wednesday.

On Thursday, abortion providers filed a petition for a rehearing based on what they called the ambiguity arising from the definition of “fetal heartbeat.” While some South Carolinians will remain eligible for abortions under the law, Planned Parenthood attorney Catherine Humphreville predicts widespread confusion resulting from the ruling.

In the meantime, doctors have been cancelling abortion appointments.

A handful of the 30 or so people scheduled for abortions Wednesday had been served at a Planned Parenthood location in Columbia when the ruling was delivered. The remaining appointments got put on hold, according to Dr. Katherine Farris, chief medical officer of Planned Parenthood South Atlantic.

The Center for Reproductive Rights reported similar postponements at another clinic upstate, and Farris heard the same from colleagues in hospitals.

Abortion providers who violate the law could face felony charges carrying up to two years in prison and the loss of professional licenses. That threat has them interpreting these types of laws very conservatively, according to Tarleton, meaning many abortions have stopped altogether.

“In the setting of very high penalties,” Farris said, “the only option for providers is to pause as we try to figure this out.”

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CHEYENNE, Wyo. (AP) — Abortion bans set to take effect this week in Wyoming and North Dakota have been temporarily blocked by judges in those states amid lawsuits arguing that the bans violate their state constitutions.

A judge in Wyoming on Wednesday sided with a firebombed women’s health clinic and others who argued the ban would harm health care workers and their patients, while a North Dakota judge sided with the state’s only abortion clinic, Red River Women’s Clinic in Fargo.

The Wyoming law was set to take effect Wednesday. The North Dakota law was set to take effect Thursday.

Meanwhile, West Virginia lawmakers moved ahead with a ban amid protests and dozens speaking against the measure.

During hours of debate leading up to the 69-23 vote in the Republican-dominated House of Delegates in West Virginia, the sound of screams and chants from protesters standing outside the chamber rang through the room.

“Face us,” the crowd yelled.

The latest court action in North Dakota and Wyoming put them among several states including Kentucky, Louisiana and Utah where judges have temporarily blocked implementation of “trigger laws” while lawsuits play out.

Attorneys arguing before Teton County District Judge Melissa Owens, in Jackson, Wyoming, disagreed over whether the state constitution provided a right to abortion that would nullify the state’s abortion “trigger” law that took effect Wednesday.

Owens proved most sympathetic, though, with arguments that the ban left pregnant patients with dangerous complications and their doctors in a difficult position as they balanced serious medical risks against the possibility of prosecution.

“That is a possible irreparable injury to the plaintiffs. They are left with no guidance,” Owens said.

Several states including Wyoming recently passed abortion “trigger” bans should the U.S. Supreme Court overturn Roe v. Wade, which happened June 24. The U.S. Supreme Court formally issued its judgment Tuesday.

After a more than three-week review, Gov. Mark Gordon, a Republican, last week gave the go-ahead for the Wyoming abortion ban he signed into law in March to take effect Wednesday but it is instead on hold after the ruling.

The Wyoming law would outlaw abortions except in cases of rape or incest or to protect the mother’s life or health, not including psychological conditions. Doctors and others who provide illegal abortions under Wyoming’s new law could get up to 14 years in prison.

The four Wyoming women and two nonprofits that sued Monday to contest the new law claim it violates several rights guaranteed by the state constitution. Wyoming Special Assistant Attorney General Jay Jerde was skeptical, saying the state constitution neither explicitly nor implicitly allowed abortion.

“No such right exists. You can’t infringe what isn’t there,” Jerde told Owens.

The lawsuit claims the abortion ban will harm the women — two obstetricians, a pregnant nurse and a University of Wyoming law student — by outlawing potentially life-saving treatment options for their patients or themselves.

Those suing include a nonprofit opening a Casper women’s and LGBTQ health clinic, Wellspring Health Access, that would have offered abortions. A May arson attack has set back the clinic’s opening from mid-June until at least the end of this year.

In North Dakota, Burleigh County District Judge Bruce Romanick sided with the state’s only abortion clinic that the state had moved fast to let the law take effect. The clinic had argued that a 30-day clock should not have started until the U.S. Supreme Court issued its certified judgment on Tuesday.

The ruling will give the Red River clinic more time to relocate a few miles away to Moorhead, Minnesota, where abortion remains legal. North Dakota’s law would make abortion illegal in the state except in cases of rape, incest and the life of the mother.

Meetra Mehdizadeh, attorney for the Center for Reproductive Rights, which is helping the clinic with the suit, said the plaintiffs “will do everything in our power to fight this ban and keep abortion accessible in North Dakota for as long as possible.”

In West Virginia, meanwhile, lawmakers on Wednesday debated a sweeping abortion ban bill on the House floor that would make providing the procedure a felony punishable by up to 10 years in prison. The bill makes exceptions for rape or incest up to 14 weeks of gestation and for certain medical complications.

“What’s ringing in my ears is not the noise of the people here,” said one of the bill’s supporters, Republican Del. Brandon Steele of Raleigh County. “It’s the cries of the unborn, tens of thousands of unborn children that are dead today.”

The bill now heads to the Senate for consideration.

After the Supreme Court overturned Roe v. Wade, West Virginia Attorney General Patrick Morrisey said a 19th century law banned abortion in the state. Last week, a state judge barred the state from enforcing that ban, saying it was superseded by conflicting, newer laws.

Hundreds of people descended on the state Capitol for the debate. Many stood outside the House chamber and Speaker Roger Hanshaw’s office chanting and holding signs reading “we will not go quietly” and “stop stealing our health care.” Security officers escorted some from the House chambers.

Dozens spoke against the bill on the House floor including Katie Quiñonez, executive director of the Women’s Health Center of West Virginia, who was cut off and asked to step down as she started to talk about the abortion she got when she was 17.

“I chose life,” she said, raising her voice to speak over the interruption. “I chose my life, because my life is sacred.”

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MOUNTAIN VIEW, Calif. (AP) — Google will automatically purge information about users who visit abortion clinics or other places that could trigger legal problems now that the U.S. Supreme Court has opened the door for states to ban the termination of pregnancies.

The company behind the internet’s dominant internet search engine and the Android software that powers most of the world’s smartphones outlined the new privacy protections in a Friday blog post.

Besides automatically deleting visits to abortion clinics, Google also cited counseling centers, fertility centers, addiction treatment facilities, weight loss clinics, and cosmetic surgery clinics as other destinations that will be erased from users’ location histories. Users have always had the option edit their location histories on their own, but Google will proactively do it for them as an added level of protection.

“We’re committed to delivering robust privacy protections for people who use our products, and we will continue to look for new ways to strengthen and improve these protections,” Jen Fitzpatrick, a Google senior vice president, wrote in the blog post.

The pledge comes amid escalating pressure on Google and other Big Tech companies to do more to shield the troves of sensitive personal information through their digital services and products from government authorities and other outsiders.

The calls for more stringent privacy controls were triggered by the U.S. Supreme Court’s recent decision overturning the 1973 Roe v. Wade ruling that legalized abortion. That reversal could make abortion illegal in more than a dozen states, raising the specter that records about people’s location, texts, searches and emails could be used in prosecutions against abortion procedures or even for medical care sought in a miscarriage.

Like other technology companies, Google each year receives thousands of government demands for users’ digital records as part of misconduct investigations. Google says it pushes back against search warrants and other demands that are overly broad or appear to be baseless.

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DES MOINES, Iowa (AP) — With a staunch anti-abortion Republican governor and large GOP legislative majorities, Iowa would seem poised to ban abortion if the U.S. Supreme Court overturns Roe v. Wade.

There’s just one catch: a 2018 Iowa Supreme Court ruling that established the right to abortion under the state constitution.

“I don’t know if the people of Iowa know that things aren’t going to change immediately if Roe. v. Wade is overturned,” said state Rep. Sandy Salmon, a Republican and farm manager from northeast Iowa who has made abortion restrictions a cornerstone of her five legislative terms.

Supreme courts in a handful of states, including others controlled by Republicans, have recognized the right to abortion. But in no state is the issue more immediate than Iowa, where Republicans are calling for a state high court with new, conservative justices to reverse a decision made just four years ago.

The Iowa court’s decision, due within weeks, is an example of the complexities that loom in states should the U.S. Supreme Court overturn its 1973 decision that legalized abortion nationwide. Specifically, it highlights the inevitable confrontation between new abortion bans being prepared in anticipation of Roe’s reversal and state constitutions.

“There are states where this is to some extent unknown and an issue that state courts will likely have to confront,” said Helene Krasnoff, vice president of public policy, litigation and law for abortion rights advocates Planned Parenthood Federation of America. “But this is an issue that’s present in Iowa in this very moment.”

The Iowa Supreme Court decision that’s under consideration struck down a 2017 law signed by then-Gov. Terry Branstad requiring a woman to wait 72 hours before receiving an abortion. The court ruled 5-2 that an abortion is a fundamental right protected by the state constitution’s guarantee of liberty.

“Autonomy and dominion over one’s body go to the very heart of what it means to be free,” wrote then-Chief Justice Mark Cady, who died in 2019. “Implicit in the concept of ordered liberty is the ability to decide whether to continue or terminate a pregnancy.”

Since that decision, Branstad’s successor, Republican Gov. Kim Reynolds, has signed other restrictions, including outlawing abortion once cardiac activity is detected in the embryo and requiring a 24-hour waiting period. Both measures were struck down in state district court. Reynolds appealed the waiting-period decision to the Iowa Supreme Court last year.

In the years since Cady’s opinion, Reynolds has appointed four of the court’s seven members. The Republican-controlled Legislature also gave her more control over the process of selecting the panel that recommends potential nominees.

Drake University Law School professor Sally Frank said if the court were to overturn a right established only four years ago, it “would give an even more political look to a decision here than the U.S. Supreme Court.”

Yet abortion opponents argued that court rulings in a half-dozen states, including Iowa, are examples of laws inappropriately established by judges rather than elected officials.

“This case presents the opportunity for the Iowa Supreme Court to return the issue back to the people to decide through their elected representatives in the Legislature,” said Mallory Carroll, a spokeswoman for the anti-abortion Susan B. Anthony List.

Polls indicate support for keeping abortion legal. The Des Moines Register Iowa Poll found in September that 57% supported keeping abortion legal in most or all cases, compared with 38% who said it should be illegal in most or all cases. According to AP VoteCast, a 2020 survey of the electorate, 65% of Iowa voters said the U.S. Supreme Court should leave Roe v. Wade as it is, while a third said it should be overturned.

Reynolds has said she is “proud of the legislation she signed in 2018,” including the ban on abortions once cardiac activity is detected, as early as six weeks and before many women know they are pregnant. While the measure included exceptions to protect the life of the mother and for pregnancies that are the result of incest or rape, Reynolds recently declined to endorse any exceptions.

“I’m not going to set any parameters,” she told reporters last week. “We have a ruling before the Iowa Supreme Court and we’re going to wait and see what they do, and that actually will affect what our next steps are moving forward.”

Supreme courts in Alaska, Florida, Kansas, Montana and Minnesota have ruled that their constitutions protect the right to abortion. Among them, Republicans hold legislative majorities and the governorships in Florida and Montana.

In Montana, a challenge to abortion restrictions is before the state supreme courts.

Majority Republicans in the Kansas Legislature are seeking to invalidate a 2019 state Supreme Court decision that declared access to abortion a “fundamental right” with a referendum on the August primary ballot to amend the state constitution.

Iowa Republicans also are pursuing a constitutional amendment that specifies the state constitution does not recognize, grant, or secure a right to abortion. The amendment could not stop the Legislature from enacting a statutory right to abortion, but would present an obstacle to any court weighing what the state would be required to enforce.

The measure needs a second approval in the Legislature and will likely come up next year, Salmon, the GOP state lawmaker, said. If approved it would go before voters, probably in 2024.

It’s the removal of the abortion guarantee in the 2018 court ruling that would clear the way for lawmakers to ban the procedure, Salmon’s ultimate goal.

“That means that abortion would not be a service offered in this state,” Salmon said.

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