The US Supreme Court has refused to block a new law in Texas that bans abortions for most women.
The so-called Heartbeat Act bans terminations after the detection of what anti-abortion campaigners call a foetal heartbeat – a point when many women do not know they are pregnant.
The law gives any individual the right to sue doctors who perform an abortion past the six-week point.
Rights groups had asked for an injunction to prevent its enforcement.
But in a late night vote, the Supreme Court justices ruled 5-4 against granting this.
The court’s majority said their decision was not based on any conclusion about whether the Texas law was constitutional or not, and that the door remained open for legal challenges.
All three of former President Donald Trump’s Supreme Court appointees voted against blocking the ban.
One of the court’s six conservatives, Chief Justice John Roberts, joined the three liberal justices in dissent.
Liberal Justice Sonia Sotomayor called the court’s order “stunning”.
“Presented with an application to enjoin a flagrantly unconstitutional law engineered to prohibit women from exercising their constitutional rights and evade judicial scrutiny, a majority of justices have opted to bury their heads in the sand,” she said.
President Joe Biden has condemned the law, which came into effect on Wednesday. He called it “extreme” and warned that it would “significantly impair” women’s access to healthcare.
In a statement, President Biden said his administration would “protect and defend” the constitutional rights established under Roe v Wade and “upheld as a precedent for nearly half a century”.
He was referring to the 1973 case in which the Supreme Court ruled US women have the right to an abortion until a foetus is viable – that is, able to survive outside the womb. This is usually between 22 and 24 weeks into a pregnancy.
White House spokeswoman Jen Psaki told reporters that the president had long wanted to see the “codification” of Roe v Wade – which would mean Congress voting to make the precedent federal law – “and [the Texas law] highlights even further the need to move forward on that effort”.
Other Democrats also expressed their outrage. House Speaker Nancy Pelosi said the Supreme Court had “delivered catastrophe to women in Texas” while New York Mayor Bill de Blasio said it was a “direct assault on the rights of women” across the country and would need a “national mobilisation” to fight it.
Rights groups including Planned Parenthood and the American Civil Liberties Union (ACLU), who had requested that the Supreme Court block the legislation, say they will not give up the fight.
Texas’ Republican Governor Greg Abbott, who signed the Heartbeat Act into law, said the state would “always defend the right to life”.
“No freedom is more precious than life itself,” he tweeted.
By Angélica Casas, BBC News, San Antonio, Texas
Dr Ghazaleh Moayedi, who carries out abortions in her OB/GYN practice in north Texas, said she feels targeted. In the 15 years that she has worked in abortion care, she has seen greater restrictions in the state, but never anything as aggressive as this law.
“Providing abortion care, and accessing abortion care is actually the very heart of being Texan,” Moayedi told the BBC.
“Texans don’t believe that the government should interfere in our personal lives. We believe that the community takes care of each other. It doesn’t make sense that our legislators here in the state continue to go after folks for their personal lives, because that’s really not what we’re about here.”
She said that the bill will immediately stop access to care for 90% of the people that see her for abortions and that those patients will likely be forced to consider going out of state or to continue unwanted pregnancies.
Her biggest fear is for women who will seek dangerous alternatives to a medical abortion with the help of a doctor – but she also fears for herself.
“I’m afraid for my personal future and the future of my career as a result of this.”
How does this law differ from other restrictions?
Most abortion restrictions that have been proposed before have relied on criminal penalties or some form of regulatory punishment.
The Texas law, which was signed into law by Governor Greg Abbott in May, instead authorizes “a private civil right of action”, which allows people to sue to enforce the law even if they themselves have not been harmed.
An ordinary American, from Texas or elsewhere, may now be able to seek up to $10,000 (£7,200) in damages in a civil court against abortion providers and doctors – and possibly anyone at all involved in the process. That means people like clinic staff, family members, or clergy who encourage or support the procedure could, in theory, be sued.
The legislation makes an exception in the case of medical emergency, which requires written proof from a doctor, but not for pregnancies resulting from rape or incest.
Turning over enforcement of the Heartbeat Act to private citizens instead of government officials likely means that – in the absence of Supreme Court intervention – the law cannot be challenged until a private citizen seeks damages.
Kim Schwartz of the Texas Right to Life organisation, which supports the measure, told the BBC most anti-abortion laws were “held up in the court system for years” and this “thwarts the will of the people”. She argued that courts would require “a credible claim that an illegal abortion occurred” and would still undergo fact-finding processes.
But the ACLU and other critics have suggested the Texas law will champion “a bounty hunting scheme” of costly “vigilante lawsuits” designed to harass women seeking an abortion. The ACLU noted tip lines had already been set up by anti-abortion groups.