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A Helena judge denied the motion to block House Bill 721 from taking effect, saying it was premature.
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After Roe v. Wade was struck down, abortion remains legal in Montana. But providers are defending against threats from lawmakers and possibly violent extremists.
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The ruling upholds a district court ruling from October in the case filed by Planned Parenthood of Montana.
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Planned Parenthood of Montana has reversed course on its decision to stop offering medication abortions to patients living in states that have banned abortion.
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Montana Republicans are zeroed in on the races for two state Supreme Court seats this election cycle that could decide the future of access to abortion in Montana.
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Just hours after President Joe Biden issued an executive order aiming to protect access to abortion nationwide, a longtime Montana state lawmaker participated in a roundtable discussion on abortion access with Vice President Kamala Harris.
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Montana is an island of legal abortion, but three of the state's five clinics now restrict abortion pills from people in states with trigger bans to shield themselves and patients from legal attacks.
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The decision is "based on protecting our providers and patients," according to Planned Parenthood of Montana President Martha Fuller.
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Abortion politics have created a power struggle over the administration of federal family planning dollars in conservative-leaning states.
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The leak of a draft U.S. Supreme Court opinion that calls for overturning federal protections for abortion drew swift reaction.