Why is the Louisiana abortion case in the Supreme Court so important?

The Supreme Court has now heard arguments in a case that will decide whether a highly controversial Louisiana law regulating abortion providers can come into effect.

It is the first abortion-related case to come before the court since Donald Trump’s two appointees, Neil Gorsuch and Brett Kavanaugh, took up their seats – and it may prove to be a watershed moment in the future of abortion rights across the US.

What is the law in question?

Louisiana’s Unsafe Abortion Protection Act was signed into law in 2014 by governor Bobby Jindal. Among its various provisions, it requires that doctors who provide abortions have admitting privileges at a hospital within 30 miles.

At the signing ceremony, Jindal said: "Women who resort to the traumatic experience of abortion are entitled to have these procedures performed in a safe environment.

“"The Unsafe Abortion Protection Act ensures that surgical abortion facilities are held to the same safety standards of other outpatient surgical facilities in Louisiana, and this initiative will build on our past work to protect life in our state."

Reproductive health organisation Planned Parenthood says the law is part of “a dangerous national trend”, and that “if this law takes effect, it will pose a serious risk to women across Louisiana”.

What case is the Supreme court hearing?

The law is being challenged by doctors who provide abortions and an abortion clinic. They argue that the case is similar to another that the court heard in 2016, namely Whole Woman's Health v Hellerstedt. That case revolved around provisions in a law in Texas that also required abortion providers to have similar admitting privileges.

In a 5-3 vote, the court ruled against the law. In his majority opinion, Justice Steven Breyer wrote that “each of the provisions places a substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access, and each violates the Federal Constitution.”

The Louisiana law, the challengers say, is unconstitutional for the same reasons. The team defending the law, by contrast, argue that the law benefits abortion patients by making abortion safer, even though the court found that the Texas law offered no such benefit.

What are the justices likely to do?

The oral arguments in the court on 4 March seemed to indicate that the usual ideological split among the justices remains clear – but that doesn’t mean the decision is a foregone conclusion.

The outcome is expected to hinge on chief justice John Roberts. While he is a conservative as a matter of course, he also joined the four liberal justices in voting to stay a lower court’s ruling on the Louisiana law, thus allowing its challengers to file their Supreme Court challenge.

Roberts is also known to value the public trust on which the court depends, and which he feels could be endangered if the court pays little heed to its previous decisions.

The lawyer for the challengers, Julie Rikelman, has appealed directly to this concern, arguing to the justices that because the Louisiana law was “expressly modelled on” the Texas law, the Louisiana case is about “respect for the court’s precedent”.

A decision is expected by the end of June.

Could it overturn Roe v Wade?

This case is not a direct challenge to Roe v Wade – but if the court allows the law to stand, it will be allowing yet another in a long series of measures that have made abortion harder to access.

Roe v Wade has been under heavy pressure from such measures for a number of years. If the law is upheld, it will become a template for other states to pass “admitting privileges” laws that could radically reduce the number of doctors who are permitted to provide abortions at all. And it could also provide precedents for anti-abortion groups and activists to draw on in future cases.

Both pro-choice and pro-life factions have latched onto the case as potentially decisive. A controversy arose on the day of the oral arguments when Democratic Senator Chuck Schumer, speaking at a pro-choice rally outside the court, warned conservative justices that they would be held to account.

"I want to tell you Gorsuch. I want to tell you Kavanaugh. You have released the whirlwind and you will pay the price,” he said. “You won't know what hit you if you go forward with these awful decisions."

What does Trump have to say?

Donald Trump has made his views on abortion clear. Since his 2016 presidential campaign, he has promised to see Roe v Wade overturned, pledging to appoint justices who would “automatically” overturn the ruling were it to come back to the court.

With Trump’s first two appointees in place, the court is expected to tilt relatively conservative for some time – especially if Trump is president and Republicans hold the Senate when the next liberal-held seat becomes vacant.