The US Court of Appeals for the Eighth Circuit on Wednesday allowed Arkansas to ban most surgical abortions during the COVID-19 pandemic.

On April 3—in response to COVID-19—the Arkansas Department of Health (ADH) began to require that all non-medically necessary surgeries be postponed. On April 9 inspectors from the ADH discovered that Little Rock Family Planning Services (LRFP) facility, which is a provider of surgical abortions in Arkansas, was still providing surgical abortions. The following day the ADH sent LRFP a cease-and-desist letter stating that LRFP was violating the ADH directive, arguing that surgical abortions that were not immediately necessary were prohibited under the ADH directive.

On April 13 LRFP challenged the ADH directive in federal district court. LRFP alleged that the directive from the ADH is “the latest effort in the State’s long-running campaign to eliminate women’s access to constitutionally guaranteed health care.” On April 14 the district court entered a temporary restraining order (TRO) enjoining the state from enforcing the directive against surgical-abortion providers. However, this ruling was reversed by the Eighth Circuit.

Restrictions in Alabama, Iowa, Louisiana, Ohio, Oklahoma and Tennessee have also taken similar measures to restrict access to surgical abortion procedures during the pandemic. However, courts in Alabama, Ohio, Oklahoma and Tennessee have ruled that any attempt to bar abortion care access is unconstitutional.

“This decision contradicts everything leading medical experts have told us about abortion—that it is essential, time-sensitive health care, and it need not and must not be restricted during the COVID-19 crisis,” said Ruth Harlow, senior staff attorney for the American Civil Liberties Union Reproductive Freedom Project.