The broad scope and vague language of a South Dakota bill that would restrict abortion services in the state by targeting a procedure used in surgical abortions could, according to reproductive health-care experts, effectively ban abortions past seven weeks’ gestation in the state. The bill could have broad constitutional implications as well.

Introduced last week, HB 1241 would make it illegal to perform an abortion if a “living” fetus is “dismembered” during an abortion, an apparent reference to dilation and evacuation (D and E) procedures. This is despite the fact that no D and E procedures are performed in South Dakota. Planned Parenthood Sioux Falls, the only clinic that provides abortions in South Dakota, provides medication abortions up to nine weeks and surgical abortions up to 13 weeks. However, the clinic does not provide surgical abortions in which a D and E is required. The clinic told Rewire that all patients who need D and E services are referred to clinics in other states. Technically, hospitals can perform such procedures in the state, but none of the hospitals in the state do.

A violation of the proposed law could carry a prison sentence of up to 25 years under one provision, and a maximum life sentence under a second provision.

The bill, sponsored by state Rep. Isaac Latterell (R-Tea), has been referred to the House Health and Human Services Committee and is scheduled for a hearing on Thursday.

Reproductive rights advocates in the state have characterized the bill as a backdoor attempt to ban later abortions. But according to a physician who provides abortions, who spoke with Rewire on condition of anonymity, the vagueness of the law could allow for interpretations that ban abortion procedures much earlier in pregnancy. “As soon as there are visible parts, the embryo or fetus is rarely removed intact,” said the physician. “This bill could ban any abortion past seven weeks.”

The embryonic stage of pregnancy lasts from the second week to the tenth week; the fetal stage developmentally begins at eleventh week. During the procedure used to remove a fetus prior to 13 weeks’ gestation, commonly referred to as suction aspiration, the fetus is often not removed fully intact. According to the physician, depending on how the bill’s language is interpreted, it could ban that procedure or prevent abortion providers from performing the procedure out of fear of prosecution.

Tammi Kromenaker, director of the Red River Women’s Clinic (RRWC) in neighboring North Dakota, told Rewire that legislation targeting specific medical procedures is always problematic. “The legislature should not be dictating medicine,” said Kromenaker. “When legislators who are not physicians attempt to use medical terms when drafting bills there are unforeseen consequences.”

The bill “puts a physician or a clinic in a position where they have to defend themselves from inflammatory language. It is meant to be inflammatory. It is meant to have a chilling effect,” she said.

Anne Davis, consulting medical director for Physicians for Reproductive Health and an abortion provider herself, told Rewire that legislation like this is designed not to ban abortion outright, but to make it so difficult to access that abortion is effectively banned. “It doesn’t address any medical need for patients, and it doesn’t address any need in medicine,” she said.

HB 1241 does not “use language to help providers understand what’s what,” she said. “That creates an environment of fear and confusion, and people are not going to risk being jailed,” so providers could instead stop providing abortions.

What’s more, legislation that imposes criminal penalties on individuals for failing to comply, but does not clearly spell out how to comply with the law, raises significant constitutional concerns. Lawmakers who write bills that are too vague violate due process protections; South Dakota’s proposed restriction appears to do just that.

While there is some precedent for banning specific abortion procedures from the campaign against “partial-birth abortion” and the Supreme Court’s decision that upheld the federal ban against such procedures, the Supreme Court has said repeatedly that states cannot ban abortions outright prior to viability. If the effect of this law was to ban abortions as early as seven weeks, that would raise serious constitutional problems as well. So while a lot depends on the specific language of whatever law may ultimately be passed, it’s clear that anti-choice lawmakers are searching for legislative language that would have the effect of re-criminalizing abortion care, since the Supreme Court has forbidden states from re-criminalizing abortion directly.

“If there was real dialog about making care safer, that would be different,” said Anne Davis. “None of this is about making it safer. This is about making abortion unobtainable for women.”

The American Civil Liberties Union (ACLU) and Planned Parenthood joined forces again on Thursday to challenge an anti-choice law that the organizations say will prove burdensome for reproductive clinics and their patients alike in Indiana.

The two parties filed a lawsuit on behalf of Planned Parenthood of Indiana and Kentucky in the U.S. District Court for the Southern District of Indiana to challenge a provision of the omnibus HEA 1337, which requires an ultrasound at least 18 hours before an abortion procedure.

The official digest language for the law says that pregnant patients considering an abortion “must be given the opportunity to view the fetal ultrasound imaging and hear the auscultation of the fetal heart tone” at least 18 hours before an abortion. At the same time, the clinic must obtain the state-required “informed consent.”

The provision went into effect July 1. Prior to its enactment, Indiana law required an ultrasound but did not mandate the time at which the imaging had to be provided. As such, clinics typically performed ultrasounds right before the procedure.

The plaintiffs claim the new law would require many patients to make two lengthy trips to obtain an abortion or pay for an overnight stay in order to receive care. This, Planned Parenthood officials said, would also burden its majority low-income clientele by causing them to lose at least a day of wages and by potentially requiring them to arrange special child care.

The law, the plaintiffs argue, would also cause clinics to become more crowded, delaying abortions to the point where some patients may not be able to receive care within Indiana’s legal limits. Indiana bans abortions after 20 weeks except when the pregnant person’s life is in danger.

Betty Cockrum, president and chief executive of Planned Parenthood of Indiana and Kentucky, told the Indiana News Service the Supreme Court’s recent ruling against Texas’s omnibus anti-abortion bill, HB 2, opened the door for the organization to seek further review of Indiana’s laws.

In an official statement, Cockrum said the 18-hour ultrasound requirement was “unduly burdensome” and added no value to the state’s already restrictive abortion policies.

The 10-page lawsuit, which argues that there is no medical justification for an ultrasound 18 hours before an abortion, lists Indiana State Department of Health Commissioner Dr. Jerome Adams and the prosecutors of Marion, Lake, Monroe, and Tippecanoe Counties as defendants.

As commissioner, Adams is the “duly appointed official” in charge of the agency responsible for licensing abortion clinics pursuant to Indiana law, the suit explains.

Similarly, the prosecutors of the four counties listed in the lawsuit, help enforce the laws that the four Planned Parenthood clinics that provide abortion care in Indiana must adhere to.

While Planned Parenthood has 23 health centers throughout the state, it only provides abortions in Bloomington, Merrillville, Indianapolis, and Lafayette.

Thursday’s lawsuit is the second legal action Planned Parenthood has taken against Indiana officials in recent weeks to challenge laws the health-care provider says could make securing abortion care cumbersome or impossible for state residents.

On June 30, a federal judge granted a preliminary injunction to block several provisions in HEA 1337 that would have kept a pregnant person from terminating a pregnancy when an abnormality, such as a life-threatening disability, is present in the fetus.

The lawsuit filed Thursday asks for the law to be blocked during the trial and until the court makes a decision, a declaration that the ultrasound provision is unconstitutional, and an monetary award for the plaintiff’s attorney fees.

Last week’s decision in Whole Woman’s Health v. Hellerstedt was remarkable not just for what it did say—that two provisions in Texas’s omnibus anti-abortion law were unconstitutional—but for what it didn’t say, and who didn’t say it.

In the lead-up to the decision, many court watchers were deeply concerned that Justice Anthony Kennedy would side with the conservative wing of the court, and that his word about targeted restrictions of abortion providers would signal the death knell of reproductive rights. Although Kennedy came down on the winning side, his notable silence on the “dignity” of those affected by the law still speaks volumes about his apparent feelings on women’s autonomy. That’s because Kennedy’s obsession with human dignity, and where along the fault line of that human dignity various rights fall, has become a hallmark of his jurisprudence—except where reproductive rights are concerned.

His opinion on marriage equality in Obergefell v. Hodges, along with his prior opinions striking down sodomy laws in Lawrence v. Texas and the Defense of Marriage Act in United States v. Windsor, assured us that he recognizes the fundamental human rights and dignity of LGBTQ persons.

On the other hand, as my colleague Jessica Mason Pieklo noted, his concern in Schuette v. Coalition to Defend Affirmative Action about the dignity of the state, specifically the ballot initiative process, assured us that he is willing to sweep aside the dignity of those affected by Michigan’s affirmative action ban in favor of the “‘dignity’ of a ballot process steeped in racism.”

Meanwhile, in his majority opinion in June’s Fisher v. University of Texas, Kennedy upheld the constitutionality of the University of Texas’ affirmative action program, noting that it remained a challenge to this country’s education system “to reconcile the pursuit of diversity with the constitutional promise of equal treatment and dignity.”

It is apparent that where Kennedy is concerned, dignity is the alpha and the omega. But when it came to one of the most important reproductive rights cases in decades, he was silent.

This is not entirely surprising: For Kennedy, the dignity granted to pregnant women, as evidenced by his opinions in Planned Parenthood v. Casey and Gonzales v. Carhart, has been steeped in gender-normative claptrap about abortion being a unique choice that has grave consequences for women, abortion providers’ souls, and the dignity of the fetus. And in Whole Woman’s Health, when Kennedy was given another chance to demonstrate to us that he does recognize the dignity of women as women, he froze.

He didn’t write the majority opinion. He didn’t write a concurring opinion. He permitted Justice Stephen Breyer to base the most important articulation of abortion rights in decades on data. There was not so much as a callback to Kennedy’s flowery articulation of dignity in Casey, where he wrote that “personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education” are matters “involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy.” (While Casey was a plurality opinion, various Court historians have pointed out that Kennedy himself wrote the above-quoted language.)

Of course, that dignity outlined in Casey is grounded in gender paternalism: Abortion, Kennedy continued, “is an act fraught with consequences for others: for the woman who must live with the implications of her decision; for the persons who perform and assist in the procedures for the spouse, family, and society which must confront the knowledge that these procedures exist, procedures some deem nothing short of an act of violence against innocent human life; and, depending on one’s beliefs, for the life or potential life that is aborted.” Later, in Gonzales, Kennedy said that the Partial-Birth Abortion Ban “expresses respect for the dignity of human life,” with nothing about the dignity of the women affected by the ban.

And this time around, Kennedy’s silence in Whole Woman’s Health may have had to do with the facts of the case: Texas claimed that the provisions advanced public health and safety, and Whole Woman’s Health’s attorneys set about proving that claim to be false. Whole Woman’s Health was the sort of data-driven decision that did not strictly need excessive language about personal dignity and autonomy. As Breyer wrote, it was a simple matter of Texas advancing a reason for passing the restrictions without offering any proof: “We have found nothing in Texas’ record evidence that shows that, compared to prior law, the new law advanced Texas’ legitimate interest in protecting women’s health.”

In Justice Ruth Bader Ginsburg’s two-page concurrence, she succinctly put it, “Many medical procedures, including childbirth, are far more dangerous to patients, yet are not subject to ambulatory-surgical-center or hospital admitting-privileges requirements.”

“Targeted Regulation of Abortion Providers laws like H.B. 2 that ‘do little or nothing for health, but rather strew impediments to abortion,’ cannot survive judicial inspection,” she continued, hammering the point home.

So by silently signing on to the majority opinion, Kennedy may simply have been expressing that he wasn’t going to fall for the State of Texas’ efforts to undermine Casey’s undue burden standard through a mixture of half-truths about advancing public health and weak evidence supporting that claim.

Still, Kennedy had a perfect opportunity to complete the circle on his dignity jurisprudence and take it to its logical conclusion: that women, like everyone else, are individuals worthy of their own autonomy and rights. But he didn’t—whether due to his Catholic faith, a deep aversion to abortion in general, or because, as David S. Cohen aptly put it, “[i]n Justice Kennedy’s gendered world, a woman needs … state protection because a true mother—an ideal mother—would not kill her child.”

As I wrote last year in the wake of Kennedy’s majority opinion in Obergefell, “according to [Kennedy’s] perverse simulacrum of dignity, abortion rights usurp the dignity of motherhood (which is the only dignity that matters when it comes to women) insofar as it prevents women from fulfilling their rightful roles as mothers and caregivers. Women have an innate need to nurture, so the argument goes, and abortion undermines that right.”

This version of dignity fits neatly into Kennedy’s “gendered world.” But falls short when compared to jurists internationally,  who have pointed out that dignity plays a central role in reproductive rights jurisprudence.

In Casey itself, for example, retired Justice John Paul Stevens—who, perhaps not coincidentally, attended the announcement of the Whole Woman’s Health decision at the Supreme Court—wrote that whether or not to terminate a pregnancy is a “matter of conscience,” and that “[t]he authority to make such traumatic and yet empowering decisions is an element of basic human dignity.”

And in a 1988 landmark decision from the Supreme Court of Canada, Justice Bertha Wilson indicated in her concurring opinion that “respect for human dignity” was key to the discussion of access to abortion because “the right to make fundamental personal decision without interference from the state” was central to human dignity and any reading of the Canadian Charter of Rights and Freedoms 1982, which is essentially Canada’s Bill of Rights.

The case was R. v. Morgentaler, in which the Supreme Court of Canada found that a provision in the criminal code that required abortions to be performed only at an accredited hospital with the proper certification of approval from the hospital’s therapeutic abortion committee violated the Canadian Constitution. (Therapeutic abortion committees were almost always comprised of men who would decide whether an abortion fit within the exception to the criminal offense of performing an abortion.)

In other countries, too, “human dignity” has been a key component in discussion about abortion rights. The German Federal Constitutional Court explicitly recognized that access to abortion was required by “the human dignity of the pregnant woman, her… right to life and physical integrity, and her right of personality.” The Supreme Court of Brazil relied on the notion of human dignity to explain that requiring a person to carry an anencephalic fetus to term caused “violence to human dignity.” The Colombian Constitutional Court relied upon concerns about human dignity to strike down abortion prohibition in instances where the pregnancy is the result of rape, involves a nonviable fetus, or a threat to the woman’s life or health.

Certainly, abortion rights are still severely restricted in some of the above-mentioned countries, and elsewhere throughout the world. Nevertheless, there is strong national and international precedent for locating abortion rights in the square of human dignity.

And where else would they be located? If dignity is all about permitting people to make decisions of fundamental personal importance, and it turns out, as it did with Texas, that politicians have thrown “women’s health and safety” smoke pellets to obscure the true purpose of laws like HB 2—to ban abortion entirely—where’s the dignity in that?

Perhaps I’m being too grumpy. Perhaps I should just take the win—and it is an important win that will shape abortion rights for a generation—and shut my trap. But I want more from Kennedy. I want him to demonstrate that he’s not a hopelessly patriarchal figure who has icky feelings when it comes to abortion. I want him to recognize that some women have abortions and it’s not the worst decision they’ve ever made or the worst thing that ever happened to him. I want him to recognize that women are people who deserve dignity irrespective of their choices regarding whether and when to become a mother. And, ultimately, I want him to write about a woman’s right to choose using the same flowery language that he uses to discuss LGBTQ rights and the dignity of LGBTQ people.  He could have done so here.

Forcing the closure of clinics based on empty promises of advancing public health is an affront to the basic dignity of women. Not only do such lies—and they are lies, as evidenced by the myriad anti-choice Texan politicians who have come right out and said that passing HB 2 was about closing clinics and making abortion inaccessible—operate to deprive women of the dignity to choose whether to carry a pregnancy to term, they also presume that the American public is too stupid to truly grasp what’s going on.

And that is quintessentially undignified.