The US Court of Appeals for the Sixth Circuit on Tuesday affirmed a district court’s ruling striking down Kentucky HB 454, which prevented the dilation and evacuation (D&E) abortion procedure after 13 weeks.

The case was brought by EMW Women’s Surgical Center, which is the sole abortion provider in Kentucky. They contend that preventing D&E abortions after 13 weeks except in cases of medical emergency is a violation of constitutional rights. They argued that because D&E is the most common abortion method in the second trimester, not allowing D&E abortions would be a violation of the Fourteenth Amendment.

On the other hand, the state of Kentucky contends that HB 454 does not ban D&E abortions but rather requires that people seeking D&E abortions first undergo a procedure to induce fetal demise. They presented three methods that they believed were acceptable under the law, but, after expert testimony on both sides, the court ruled in favor of the plaintiffs.

The Sixth Circuit court upheld the decision after de novo review of the evidence. They cited the Supreme Court’s decision in Whole Woman’s Health v. Hellerstedt to show the undue burden the law places on women seeking abortions. They also cited the 10 states where similar laws have been struck down because of the undue burden they place on women.

Judge Bush wrote in the dissent that he believes the plaintiffs lacked standing to bring the case.