Full opinion text
OPINION Myron H. Thompson, United States District Judge Providers of abortion and other reproductive-health services in Alabama challenge two 2016 state statutes that regulate abortions and abortion clinics. The first statute, which the court will call the “school-proximity law,” provides that the Alabama Department of Public Health may not issue or renew licenses to abortion clinics located within 2,000 feet of a K-8 public school. 1975 Ala. Code § 22-21-35. The second statute, which the court will call the “fetal-demise law,” effectively criminalizes the most common method of second-trimester abortion—the dilation and evacuation, or D&E, procedure—unless the physician induces fetal démise before performing the procedure. 1975 Ala. Code § 26-23G-1 et seq. The plaintiffs are West Alabama Women’s Center (an abortion clinic in Tuscaloosa, Alabama) and its medical director and Alabama Women’s Center (an abortion clinic in Huntsville, Alabama) and its medical director. The plaintiffs sue on behalf of themselves and their patients. The defendants are the State Health Officer, the State Attorney General, and the district attorneys for Tuscaloosa and Madison Counties. All defendants are sued in their official capacities. The plaintiffs claim that the school— proximity and fetal—demise laws are unconstitutional restrictions on abortion access in the State of Alabama that violate the Due Process Clause of the Fourteenth Amendment. Jurisdiction is proper under 28 U.S.C. §§ 1331 (federal question) and 1343 (civil rights). This litigation is now before the court on the plaintiffs’ motion for a preliminary injunction. For reasons that follow, and based on the evidence presented at a hearing on October 4-6, 2016, the motion for a preliminary injunction will be granted as to both laws. I. HISTORICAL BACKGOUND Abortion clinics and their physicians have been subject to a number of regulations in Alabama. In just the last five years, Alabama has passed a host of legislation to regulate how and where abortion care can be provided. The court, however, now mentions only some of those laws. In 2011, the State prohibited abortions at 20 or more weeks after fertilization, unless a woman’s condition necessitates, an abortion to avert her death or “serious risk of substantial and irreversible physical impairment of a major bodily function.” 1975 Ala. Code § 26-23B-5. In 2013, the State enacted a law requiring all abortion clinics to meet the same building safety codes applicable to ambulatory surgical centers. 1975 Ala. Code § 26-23E-9. Under that requirement, abortion clinics must meet the standards of the “NFPA 101 Life Safety Code 2000 edition,” id., which include requirements for egress, fire protection, sprinkler systems, alarms, emergency lighting, smoke barriers, and special hazard protection. To comply with that law, abortion clinics in Alabama conducted renovations such as installing a fireproof closet, fire alarm system, and outside lighting. Tr. Vol. I (doc. no. 110) at 162:3-7. In 2013, the State also required all physicians who perform abortions in the State to hold staff privileges at a hospital within the same statistical metropolitan area as the clinic. 1975 Ala. Code § 26-23E-4(c). The court held the staff-privileges requirement to be unconstitutional. Planned Parenthood Se., Inc. v. Strange, 33 F.Supp.3d 1330 (M.D. Ala. 2014) (Thompson, J.); see also Planned Parenthood Se., Inc. v. Strange, 172 F.Supp.3d 1275 (M.D. Ala. 2016) (Thompson, J.). ' Prior to 2014, Alabama law also required physicians to wait at least 24 hours after providing informed consent explanations to patients before conducting the abortion procedure. That year, the legislature extended the informed-consent waiting period from 24 hours to 48 hours, 1975 Ala. Code § 26-23A-4, Two years later, Alabama enacted the two statutes now challenged in this litigation. The number of clinics in Alabama has decreased significantly in the last 15 years: as of 2001, 12 clinics provided abortions in the State. Today, only five clinics continue to operate. The vast majority of abortions performed in Alabama occur in these five clinics. The plaintiffs operate two of the clinics: the Alabama Women’s Center, located in Huntsville, and the West Alabama Women’s Center, in Tuscaloosa. Together, these two clinics provided 72 % of all abortions in Alabama in 2014. Second Johnson Decl. Ex. D (doc. no. 54-2) at 35. The Alabama Women’s Center, which opened in 2001, is the only abortion clinic in Huntsville, in the far northern part of the State, The Huntsville metropolitan area, with a population of 417, 593, is Alabama’s second largest urban area. In addition to abortion services, the Huntsville clinic provides contraceptive counseling and care, testing and treatment for sexually transmitted infections, pap smears, pregnancy testing, and referrals for prenatal care and adoption. In 2014, approximately 14 % of the abortions in Alabama took place at the Huntsville clinic. Second Johnson Decl. Ex. D (doc. no, 54-2) at 35. The West Alabama Women’s Center began operations in 1993 and is the only abortion clinic in Tuscaloosa and all of west Alabama. The Tuscaloosa metropolitan area is Alabama’s fifth largest urban area. The Tuscaloosa clinic provides reproductive health services to women, including abortions, birth control, treatment for sexually transmitted infections, pregnancy counseling, and referrals for prenatal care and adoption. In 2014, approximately 58 % of the abortions in Alabama took place at the Tuscaloosa clinic, far more than at any other clinic. Second Johnson Decl. Ex. D (doc. no. 54-2) at 35. The Tuscaloosa and Huntsville clinics are the only ones in Alabama that perform abortions at or after 15 weeks of pregnancy.. Prior to 15 weeks, most abortions are performed either through the use of medication or the dilation and curettage method, the latter of which uses suction to empty the contents of the uterus. Starting at 15 weeks, it ordinarily is not possible to complete an abortion using suction alone, so patients must go to clinics that offer the D&E procedure. The D&E procedure is a surgical abortion method where a physician uses suction and instruments to remove the fetus and other contents of the uterus. In 2014, the Huntsville and Tuscaloosa clinics provided about 560 abortions starting at 15 weeks, all of which were D&E abortions. Donald Deck Ex. F, Induced Terminations of Pregnancy 2014 Report (doc. no. 81-14) at 19. That said, the vast majority of abortions performed by the Huntsville and Tuscaloosa clinics occur prior to 15 weeks and therefore do not involve D&E. II. LITIGATION BACKGROUND In July 2015, after the retirement of its long-time, sole physician who had hospital staff privileges, the Tuscaloosa clinic, along with its new medical director, initiated this litigation to challenge an Alabama Department of Public Health regulation that required all physicians who perform an abortion procedure to have staff privileges at a local hospital or to have an outside covering physician with such privileges. Ala. Admin. Code r. 420-5-l-.03(6)(b). This court temporarily restrained enforcement of the regulation against the Tuscaloosa clinic. W. Ala. Women’s Ctr. v. Williamson, 120 F.Supp.3d 1296 (M.D. Ala. 2015) (Thompson, J.). The department then granted a temporary waiver to the Tuscaloosa clinic, and, with the agreement of the parties, the court stayed the proceeding to allow the department time to modify the regulation. In May 2016, while the stay was pending, the department amended the regulation to provide that an abortion clinic could operate without a physician with staff privileges or a covering physician as long as the clinic provided to all women undergoing an abortion before they left the clinic, a copy of their medical records. See Ala. Admin. Code r. 420-5-l-.03(6)(c)(4). That same month the school-proximity law and the fetal-demise law were signed into law. After obtaining leave of the court, the Tuscaloosa clinic and its medical director further amended their complaint to challenge the amended regulation and the two new laws, which impacted both the Tuscaloosa and Huntsville clinics. W. Ala. Women’s Ctr. v. Miller, _ F.R.D. _, No. 2:15-cv-497-MHT, 2016 WL 3621273 (M.D. Ala. July 5, 2016) (Thompson, J.). The Huntsville clinic and its medical director were added as plaintiffs, and the State Attorney General and two district attorneys were added as defendants. On July 13, 2016, the parties agreed to an order temporarily restraining enforcement of the two laws until three weeks after the end of a hearing on the plaintiffs’ preliminary-injunction motion. The parties later agreed to settle the challenge to the amended regulation, and the court entered a judgment dismissing that claim. From October 4 through October 6, 2016, the court held a preliminary-injunction hearing, during which the court heard evidence and oral argument. The order temporarily restraining enforcement of the school-proximity and fetal-demise laws expires today, October 27, 2016. III. LEGAL STANDARDS To show that a preliminary injunction is appropriate, a plaintiff must show that “(1) there is a substantial likelihood that he ultimately will prevail on the merits of the claim; (2) he will suffer irreparable injury unless the injunction issues; (3) the threatened injury to the movant outweighs whatever damage the proposed injunction may cause the opposing party; and (4) the public interest will not be harmed if the injunction should issue.” Cate v. Oldham, 707 F.2d 1176, 1185 (11th Cir. 1983). The plaintiff bears the burden of persuasion as to each of the four required showings. McDonald’s Corp. v. Robertson, 147 F.3d 1301, 1306 (11th Cir. 1998). To satisfy the first prong of preliminary-injunction requirements, likelihood of success on the merits, the plaintiffs in this case must show that the statute is likely to violate the “substantive due process rights of the women who seek abortions from the plaintiff clinics.” Planned Parenthood Se., Inc. v. Strange, 9 F.Supp.3d 1272, 1279 (M.D. Ala. 2014) (Thompson, J.). The governing standard for finding a violation of substantive due process rights in this context is the “undue burden” standard developed in Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833, 876-79, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992) (plurality opinion) and Whole Woman’s Health v. Hellerstedt, _ U.S. _, 136 S.Ct. 2292, 2309-11, 195 L.Ed.2d 665 (2016). In Casey, a plurality of the Court concluded that, if a government regulation has “the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus,” the regulation is an undue burden on a woman’s right to have an abortion and is unconstitutional. 505 U.S. at 877, 112 S.Ct. 2791. Casey recognized that a woman’s right of privacy extends to freedom “from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.” Id. at 896, 112 S.Ct. 2791 (majority opinion) (quoting Eisenstadt v. Baird, 405 U.S. 438, 453, 92 S.Ct. 1029, 31 L.Ed.2d 349 (1972)). The Supreme Court recently reiterated the undue burden standard, that “a statute which, while furthering [a] valid state interest, has the effect of placing a substantial obstacle in the path of a woman’s choice cannot be considered a permissible means of serving its legitimate ends.” Whole Woman’s Health, 136 S.Ct. at 2309 (quoting Casey, 505 U.S. at 877, 112 S.Ct. 2791 (plurality opinion)). The undue-burden analysis requires a court to “consider the burdens a law imposes on abortion access together with the benefits those laws confer.” Whole Woman’s Health, 186 S.Ct. at 2309. The court must “weight ] the asserted benefits against the burdens.” Id. at 2310. As this court has stated: “[T]he heart of this test is the relationship between the severity of the obstacle and the weight of the justification the State must offer to warrant that obstacle.... [T]he more severe the obstacle a regulation creates, the more robust the government’s justification must be, both in terms of how much benefit the regulation provides towards achieving the State’s interests and in terms of how realistic it is the regulation will actually achieve that benefit.” Planned Parenthood Se., Inc. v. Strange, 9 F.Supp.3d 1272, 1287 (M.D. Ala. 2014) (Thompson, J.); see also Planned Parenthood of Wis. v. Van Hollen, 738 F.3d 786, 798 (7th Cir. 2013) (Posner, J.) (“The feebler the [state interest], the likelier the burden, even if slight, to be ‘undue’ in the sense of disproportionate or gratuitous.”). IV. SCHOOL-PROXIMITY LAW The school-proximity law provides that the Alabama Department of Public Health “may not issue or renew a health center license to an abortion clinic or reproductive health center that performs abortions and is located within 2,000 feet of a K-8 public school.” 1975 Ala. Code §-22-21-35(b). The parties agree that both the Tuscaloosa and Huntsville clinics are located within 2,000 feet of at least one K-8 public school. Order on Pretrial Hearing (doc. no. 93), Stip. 3(b) at 13. Each clinic is licensed by the department, and their existing licenses will expire December 31, 2016. Accordingly, if the school-proximity law were to take effect, the parties agree the department would not renew either clinic’s license to continue operations at its existing location. No legislative findings accompany the school-proximity law, so the court does not have an explanation from the legislature of the purpose for the law. The plaintiffs have submitted newspaper articles, to which the State has not objected, that report that Reverend James Henderson, a leader of anti-abortion protestors outside the Huntsville clinic, drafted the bill that ultimately became the school-proximity law, with the purpose of shutting down the Huntsville clinic. Newspaper Article, Second Johnson Decl. Ex. H (doc. no. 54-2) at 56. Another article reported that Governor Robert Bentley’s staff offered Henderson assistance in seeking sponsors for the bill. Id. Ex. I at 61. Nevertheless, the State has asserted that the school-proximity law furthers two interests: minimizing disturbance in the educational environment and supporting a parent’s right to control their children’s exposure to the subject of abortion. With regard to these interests, the State acknowledges two things. First, the State’s interests are threatened by demonstrations outside the clinics, but not by the clinics themselves. Tr. of Final Pre-Trial Status Conf. (doc. no. 99) at 35:1-11. Thus, the school-proximity law attempts to serve the State’s interests through an expressed means (the 2000-foot prohibition on clinics) to an unexpressed end (the relocation of the demonstrations away from public K-8 schools). Second, demonstrators have no effect on the educational environment inside any school; the state interest concerns only disruption outside and around schools. Id. at 37:9-21. In the absence of legislative findings, the court must now, based on the “judicial record,” make findings as to the State’s two asserted interests. See Whole Woman’s Health, 136 S.Ct. at 2310 (“[T]he relevant statute here does not set forth any legislative findings. Rather, one is left to infer that the legislature sought to further a constitutionally acceptable objective.... For a district court to give significant weight to evidence in the judicial record in these circumstances is consistent with this Court’s case law.”). A. Likelihood of Success The court is persuaded that the plaintiffs are likely to succeed in their argument that the school-proximity law would impose a substantial obstacle on a woman’s right to obtain a pre-viability abortion, in violation of her substantive due-process rights. As discussed below, the judicial record reflects that the State’s asserted interests are only minimally, if at all, furthered by the law, while the burden imposed on a woman’s right to obtain an abortion is substantial. 1. State’s Interests First of all, the State’s interests are furthered by neither the law’s means (the 2000-foot prohibition on clinics) nor its end (the relocation of the demonstrations). In Tuscaloosa, a middle school sits just within 2,000 feet of the clinic, but a vast wooded area separates the school and the clinic. Map, Second Gray Deck Ex. E (doc. no. 54-1) at 77 (showing Tuscaloosa clinic at 1,986 feet away from middle school); PI. Ex. 27 (satellite view showing wooded area separating clinic and school); Tr. Yol. II (doc. no. Ill) at 106:4-9. Up to five protestors (but usually fewer than that) stand outside the clinic on weekdays, but they are neither visible nor audible to children entering, exiting, or inside the school. Second Gray Decl. (doc. no. 54-1) at ¶ 35; Tr. Vol. II (doc. no. Ill) at 104:15-20, 108:24-25 - 109:1-5. Indeed, on the record currently before the court, there is absolutely no evidence that the children (or their parents) at the Tuscaloosa school are even aware that an abortion clinic is located nearby. Thus, because the record does not reflect that any K-8 public school children within 2,000 feet of the Tuscaloosa clinic are even aware of the clinic or the demonstrations at the clinic, the school-proximity law does not serve either of the State’s asserted purposes of minimizing disruption or supporting a parent’s right to control their children’s exposure to the subject of abortion. The Tuscaloosa clinic (A) and its protestors (B) are separated from the nearest school (C) by a large wooded area. PI. Ex. 27 (excerpt). The State does not dispute that, while the law covers the Tuscaloosa clinic, it was targeted to the “perceived problem” at the Huntsville clinic. Tr. Vol. Ill (doc. no. 112) at 14:12-16. Indeed, the State relies on newspaper articles that describe parental complaints about demonstrations outside the Huntsville clinic. In Huntsville, from 2 to 15 protestors stand outside the clinic on weekdays. Tr. Vol. I (doc. no. 110) at 168:5-12 (medical director of Huntsville clinic estimates 2 to 5 protestors on a regular basis and up to 10 protestors on weekdays); Second Johnson Decl. (dóc. no. 54-2) ¶ 31 (owner of Huntsville clinic estimates 5 to 15 protestors). Occasionally larger crowds of protestors congregate on weekends, when school is not in session. Tr. Vol. I (doc. no. 110) at 169:5-10; Johnson Dep., Def. Ex. 20 (doc. no. 81-20) at 3:13-18 (describing large rallies with up to 150 protestors). Demonstrators may yell at patients as they enter or exit the clinic. Tr. Vol. I (doc. no. 110) at 216:9-11. Two public schools that include some or all of grades K-8—Highlands Elementary School and the Academy for Academics and Arts—are located within 2,000 feet of the Huntsville clinic. The entrances to Highlands and the clinic are on different streets, and they are approximately three blocks apart. Id. at 176:18-19, 177:5-6. It is not necessary to drive past the clinic to access the school. Id. at 176:20-23. The record contains absolutely no evidence of concerns expressed by the school’s students or their parents about the Huntsville clinic or the demonstrations near it. As to Highlands, the State’s two interests (minimizing disruption and supporting a parent’s right to control their children’s exposure to the subject of abortion) would not in any way be furthered by the closing or relocation of the Huntsville clinic. The Huntsville clinic (A) and the two schools, the Academy for Academics and Arts (B) and Highlands Elementary School (C). PI. Ex. 31 (excerpt). The Academy for Academics and Arts sits diagonally across a five-lane street from, and to the east of, the Huntsville clinic. Published newspaper articles report that some parents have complained about the presence of protestors near the clinic. But the record reflects no disturbance to the educational environment: no evidence suggests that protests are visible or audible from inside the school; no evidence suggests the classroom setting has been in any way disturbed by the protests; and no evidence suggests that children are hindered or disturbed while entering or exiting the school. In fact, although demonstrators sometimes stand across the street from the abortion clinic and close to an Academy driveway, that driveway is not used by parents who are dropping children off; it is used by parents to access an attached parking lot if they need to enter the school for business or opt to personally walk their child into the school. Tr. Vol. II (doc. no. Ill) at 26:21-25-27:1-3. The entrance used by parents during drop-off and pick-up is accessed from another street on the opposite side of the school, while the driveway used by buses bringing children to and from the school is on the same street as the clinic, but further up the road. Id. at 27:21-25 - 28:1-8; Tr. Vol. I (doc. no. 110) at 174:16-23; PI. Ex. 33 (depicting traffic flow at the Academy). As to the Academy, the State’s interest in minimizing disruption would be feebly, if at all, advanced by the closing or relocation of the Huntsville clinic. Traffic pattern at Huntsville's Academy for Academics and Arts. PI. Ex. 33. Also with regard to the Academy, the State’s interest in supporting a parent’s right to control their children’s exposure to the subject of abortion would be very weakly furthered by the closing or relocation of the Huntsville clinic. The record reflects only that one mother was forced to respond to questions from her son, an Academy student, about the subject of abortion after he witnessed the protests. Newspaper Article, Def. Ex. 16 (doc. no. 81-16). Moreover, because the school-proximity law does not define all the locations where an abortion clinic may not operate, reality dictates that it is highly likely, if not inevitable, that regardless of whether an abortion clinic is located within or without 2,000 feet of a K-8 public school in Huntsville, K-8 public school students are, at one time or another in their travels throughout the city, going to witness demonstrations at that clinic regardless of a parent’s best efforts to prevent it. In addition, the State’s statutory means (the closing or relocation of the Huntsville clinic) will not lead to the State’s intended end (the relocation of demonstrations away from the Academy). The evidence reflects, and the court so finds, that protests will continue at the Huntsville clinic’s current location even if the school-proximity law were to take effect. Anti-abortion protestors have demonstrated not just outside the Huntsville clinic, but also outside the private practice of the clinic’s medical director, Dr. Yashica Robinson White, as well as a hospital where she holds admitting privileges. Robinson White Decl. (doc. no. 54-4) ¶¶ 8-10; Tr. Vol. I (doc. no. 110) at 179:2-16; 180:14-20. Because Robinson White previously used the Huntsville clinic’s current site for her private obstetrics and gynecology practice, and routinely two and as many as ten protestors demonstrated outside the facility on weekdays, protests occurred at the site even before it became an abortion clinic. Robinson White Decl. (doc. no. 54-4) It 10; Tr. Vol. I (doe. no. 110) at 166:22-25-167:1-5. And, because Robinson White has credibly testified that, if the law were to go into effect, she would again use the facility for her private practice, the law will not stop protests at the site. Tr. Vol. I (doc. no. 110) at 181:22-25 - 182:1-12; Robinson White Deck (doc. no. 54-4) ¶ 16. Moreover, because, as the court will explain later, the clinic is likely to close if the law were to go into effect, Robinson White has made clear she will be performing abortions at the facility, all but guaranteeing continued protests at the site. Id. Based on the current judicial record, the court finds that the school-proximity law is likely to provide little to no benefit to‘the State’s asserted interests in minimizing disruption and supporting a parent’s right to control their children’s exposure to the subject of abortion. Because the court has found little to nothing in the record evidence that shows that the new school-proximity law advances the State’s interests, the court accords it little to no weight in the balancing test. 2. Burdens Imposed on Women In addition to examining the State’s asserted interests, the court must also “consider the burdens [the] law imposes on abortion access.” Whole Woman’s Health, 136 S.Ct. at 2309. The parties do not dispute that, if the school-proximity law goes into effect, the State Health Department could not renew the licenses of the Huntsville and Tuscaloosa abortion clinics at their existing locations after December 31, 2016. At that time, the clinics would need to relocate or shut down. The court finds, based on the credible record, that it would not be feasible for the Tuscaloosa clinic and the Huntsville clinic to relocate and that the two clinics would have to shut down if the law were to take effect. Tr. Vol. I (doc. no. 110) at 164:19-25-165:1-18; Second Gray Deck (doc. no. 54-1) ¶ 34; Second Johnson Deck (doc. no. 54-2) ¶ 3. The current evidence credibly shows that, because each clinic incurred significant expenses as a result of the surgical-center requirement imposed on abortion providers by the State in 2013, it would not be financially feasible to relocate now. Because the Huntsville clinic could not bring its old building into compliance with the surgical-center standards, it was forced to relocate, requiring $ 530,000 to purchase a new facility (the place where Robinson White had leased space for her private practice) and more than $ 100,000 for building renovations.' Tr. Vol. I (doc. no. 110) at 160:23-24, 162:1-4. To cover those expenses, Dalton Johnson, the clinic owner, and Robinson White incurred significant personal financial debt. Second Johnson Deck (doc. no. 54-2) ¶ 16 (“In order to purchase the facility, I cashed in all of my retirement savings; borrowed from my life insurance policy; refinanced the mortgage on the Madison Street building and pulled all the equity out of it; took out a $ 100,000 line of credit; and spent money' I had inherited from my father, who had recently passed away. In addition, Dr. Robinson White and I each maxed out every one of our credit cards.”); Tr. Vol. I (doc. no. 110) at 162:11-18 (Robinson White explaining that the clinic owner removed “all of the equity” from his mortgage on the prior clinic facility; and that she and the clinic owner “emptied” their savings accounts, “took all of the cash value” out of their insurance policies, obtained a line of credit through a bank, and “maxed out” all of their credit cards). Johnson remains hundreds of thousands of dollars in debt from these expenses. Second Johnson Decl. (doc. no. 54-2) at ¶ 17 (describing outstanding debt on $ 100,000 line of credit; $ 90,-000 owed to life insurance policy; and hundreds of thousands of dollars remaining on mortgages for both prior and current clinic facilities). The testimony of Robinson White, which the court found highly credible, establishes that she and Johnson have committed significant personal financial sacrifices to continue to operate the Huntsville clinic. The Tuscaloosa clinic spent $ 130,000 to renovate its existing facility to comply with the surgical-center requirements. Second Gray Decl. (doc. no. 54-1) ¶ 32. Purchasing a new facility now would require the Tuscaloosa clinic’s owner to use retirement funds or go into debt, which she would not be able to pay off at this stage of her career. Id. ¶ 34. The Tuscaloosa and Huntsville clinics also could not rely on leasing a new facility. Anti-abortion protestors in Alabama have also targeted the landlords that lease space to facilities used to provide abortions. After demonstrations targeted the former landlord of the Tuscaloosa clinic, the landlord did not renew the clinic’s lease. Id. ¶ 31. Similarly, during an earlier search for a Huntsville facility, Johnson hired real estate agents and engaged in an extensive six-month search, but “each and every time [h]e would meet with the owner or real estate agent of a building [h]e wanted to lease, the moment [h]e informed prospective lessors that we intended to operate an abortion clinic in the space, they would not lease to [him].” Johnson Decl. (doc. no. 54-2) ¶¶ 12, 14. Robinson White explained that, during the Huntsville clinic’s recent relocation, the stigma surrounding abortion made it difficult to find a banker and closing attorney to work with them. Tr. Vol. I. (doc. no. 110) at 165:2-11. These difficulties are consistent with the court’s previous finding that abortion providers in Alabama face a “climate of extreme hostility to the practice of abortion.” Planned Parenthood Se., 33 F.Supp.3d at 1334. Against this backdrop, the plaintiffs have credibly demonstrated that it would not be practicable for them to relocate. The State contends that the burdens analysis should not include the closure of the Huntsville and Tuscaloosa clinics because whether the clinics close depends on “the idiosyncrasies of [the clinics’] specific financial position.” Def. Br. (doc. no. 81) at 9. In other words, the State seems to argue that the court should not consider the actual financial circumstances of the climes. This contention misapprehends the undue-burden case law. As this court previously explained, the undue-burden analysis requires an examination of the “real-world context” of the challenged statute and its actual effects—and not just those circumstances that were directly attributable to the statute. Planned Parenthood Se., 9 F.Supp.3d at 1285-86. In Casey, the Supreme Court’s evaluation of the burdens imposed by a spousal-notification requirement considered that many women live in abusive relationships, meaning that requiring notification to an abusive spouse imposed a potentially insurmountable barrier to obtaining an abortion. See 505 U.S. at 888-898, 112 S.Ct. 2791 (majority opinion). It did not matter that the notification requirement could not be said to cause women to live in abusive relationships or contribute to the existence of such relationships; it was nonetheless dispositive that the notification requirement had the actual effect of imposing a substantial obstacle on women’s access to abortion. Similarly, courts have routinely recognized that imposing substantial costs on abortion providers to comply with a statute places burdens on women’s access to abortion—regardless of the financial circumstances of the climes. In Whole Woman’s Health, the Supreme Court noted that the costs of $ 1 to $ 3 million required to achieve compliance with Texas’s surgical-center requirement were “considerable.” 136 S.Ct. at 2318. Evidence of those costs, the Court reasoned, “supports the conclusion that more surgical centers will not soon fill the gap when licensed facilities are forced to close.” Id.; see also Casey, 505 U.S. at 901, 112 S.Ct. 2791 (plurality opinion) (finding that record-keeping requirements, which “[a]t most ... increase the cost of some abortions by a slight amount” do not impose an undue burden, but acknowledging that “at some point increased cost could become a substantial obstacle”); Tucson Woman’s Clinic v. Eden, 379 F.3d 531, 542 (9th Cir. 2004) (concluding that application of new licensing and regulatory scheme to abortion facilities, which would have required abortion providers to expend “[t]ens of thousands of dollars,” contributed to undue burden finding). The likely closure of two of Alabama’s five abortion clinics would leave only three abortion clinics operating in the State— one each in Birmingham, Montgomery and Mobile—while the rest of the State, including the highly populated metropolitan areas of Huntsville and Tuscaloosa, would have no licensed abortion providers at all. The resulting burdens on women would be substantial. First, women would lose the right to obtain an abortion in Alabama when they reached 15 weeks of pregnancy altogether, because the Tuscaloosa and Huntsville clinics are the only providers of abortions beginning at 15 weeks of pregnancy. Second, while abortions before 15 weeks would remain available in Alabama, women who would currently rely on the Huntsville or Tuscaloosa clinics would need to travel significantly greater distances. This burden would become particularly devastating for low-income women who represent half of all abortion recipients and a significant majority of women seeking abortions in Alabama. Second Henshaw Decl. (doc. no. 54-3) ¶ 9; Katz Decl. (doc. no. 54-11) ¶ 15. If the Huntsville clinic closed, a woman in Huntsville would need to travel at least 200 miles round-trip to Birmingham for the next-closest abortion provider. Without a clinic in Tuscaloosa, a woman there would need to travel at least 110 miles round-trip to Birmingham. Multiple studies have concluded that longer travel distances to access an abortion provider correlate with lower abortion rates. Second Henshaw Deck (doc. no. 54-3) ¶¶ 4-8, 19. The court has previously discussed the seiious impact of the “first 50 miles” of travel on women seeking abortions, and that “when a clinic closes, the largest effects are actually felt by women who, prior to the closure, needed to travel only short distances, less than 50 miles.” Planned Parenthood Se., 33 F.Supp.3d at 1358-60. The Supreme Court has also recognized that increased driving distances, when taken together with other burdens, increases the burdens on women seeking an abortion. Whole Woman’s Health, 136 S.Ct. at 2313 (citing evidence that, after regulation took effect, the number of women living more than 150 and 200 miles from an abortion provider skyrocketed). Here, without the school-proximity law, women in Huntsville and Tuscaloosa could obtain an abortion with a short trip within the city. If the law were to take effect, women in those cities would be required to arrange lengthy out-of-town trips, including obtaining access to transportation, time off from work, childcare, and lodging. But not all women have the means to do so, which would either prevent such women from obtaining an abortion altogether or delay their ability to obtain one. Second Hen-shaw Deck (doc. no. 54-3) ¶¶ 14, 24 (noting that half of women who experience unwanted delay in obtaining abortions attributed the delay to arrangements such as raising funds, transportation, locating an abortion provider, and organizing childcare). Beyond the increased difficulties women would face in accessing an abortion clinic, the three remaining abortion clinics in Alabama would lack sufficient capacity to meet the new demand. As a result, not all women who would want to obtain an abortion could do so. The Huntsville and Tuscaloosa clinics have performed the majority of abortions in Alabama in recent years: combined, they performed 72 % of all abortions in Alabama in 2014, 60 % of all abortions in 2013, and 55 % of all abortions in 2012. Second Johnson Deck Ex. D (doc. no. 54-2) at 35-37. The three remaining clinics could not shoulder the plaintiff clinics’ substantial caseload. Together, the Huntsville and Tuscaloosa clinics performed 5,833 abortions in 2014, compared to 2,218 abortions provided by the three remaining clinics. Id. at 35. The total maximum capacity for Alabama’s three remaining clinics is 4,500— but that number depends on a significant expansion in staffing and services which seems unrealistic in light of the climate surrounding abortion in Alabama. For example, the Montgomery clinic performed less than 900 abortions in 2014; stretched its resources to perform 1,200 abortions because of the temporary closure of the Tuscaloosa clinic in 2015; and estimates that it could perform a maximum of 1,800 abortions per year at the outermost limit— an estimate dependent on recruiting additional physicians and support staff that it has previously struggled to hire because of the stigma surrounding abortion. Ayers Deck (doc. no. 54-7) ¶¶ 6-8. The Mobile and Birmingham clinics, which provided a combined total of 1,342 abortions in 2014, estimate that, with an expansion of capacity to provide abortions four days per month, they could perform 2,700 abortions per year—but they too are currently struggling to expand capacity because of staffing troubles. Fox Decl. (doc. no. 54-8), ¶ 5; Donald Decl. Ex. F, Induced Terminations of Pregnancy 2014 Report (doc. no. 81-14) at 19. In addition, none of the remaining clinics have plans to expand their services to provide abortions at or after 15 weeks. Beyond the statistical reality that the remaining abortion clinics could not meet the demands of women in Alabama if the school-proximity law were to take effect, evidence in the record suggests that the dramatically expanded services that would need to be provided by the remaining clinics would be accompanied by costly side effects. To assume otherwise flies in the face of “common sense,” which “suggests that, more often than not, a physical facility that satisfies a certain physical demand will not be able to meet five times that demand without expanding or otherwise incurring significant costs.” Whole Woman’s Health, 136 S.Ct. at 2317. Also, capacity constraints, especially when combined with the increased travel times required for women to obtain an abortion, would introduce delays in women’s abilities to obtain an appointment and ultimately an abortion. Later-term abortions, if delayed past the 14th week of the pregnancy, carry greater medical risks and also increase the cost of the procedure; if the delay extends to the 20th week of pregnancy, it would become illegal for a woman to obtain an abortion in Alabama, with certain exceptions for the life and health of the mother. Planned Parenthood Se., 33 F.Supp.3d at 1356. For women in abusive relationships, delays could make the difference between obtaining or not obtaining an abortion at all: where a battered woman attempts to conceal her pregnancy from her abuser through a medication abortion, she must do so in the first ten weeks of pregnancy or risk having her abuser learn of her abortion. Walker Decl. (doc. no. 54-9) ¶¶ 15-16. Furthermore, the abortions that the remaining clinics could provide likely would not equal in quality the care provided prior to the law taking effect: In the crowded clinics that would surely result, women are “less likely to get the kind of individualized attention, serious conversation, and emotional support that doctors at less taxed facilities may have offered.” Whole Woman’s Health, 136 S.Ct. at 2318. These factors, too, would impose a burden on women seeking an abortion. Each of these factors—the unavailability of abortions beginning at 15 weeks, the increased travel times, and the reduced capacity and increased wait times at Alabama’s three remaining clinics—establishes that women will face significantly increased, and even insurmountable, barriers to obtaining an abortion. Where these types of barriers exist, it is likely that some women will pursue risky alternatives. Cf. Whole Woman’s Health, 136 S.Ct. at 2321 (Ginsburg, J., concurring) (‘When a State severely limits access to safe and legal procedures, women in desperate circumstances may resort to unlicensed rogue practitioners, faute de mieux, at great risk to their health and safety.”); Planned Parenthood Se., 33 F.Supp.3d at 1362-63 (describing greater risk that women would attempt to obtain an abortion illegally where travel-related obstacles and capacity constraints are imposed). The Tuscaloosa clinic has had firsthand experience with attempts to self-abort, including when the clinic was temporarily closed in 2015. During that time, women would nonetheless show up to the clinic seeking an abortion—including one woman who threatened to stab herself in the stomach. Second Gray Decl. (doc. no. 54-1) ¶ 47. During the same time period, the Huntsville clinic experienced an increased number of calls from far away women, some of whom said “outright that they would try to self-induce an abortion because they could not reach a provider.” Second Johnson Decl. (doc. no. 54-2) ¶ 49. Recently, Tuscaloosa’s medical director has treated multiple women who attempted to self-abort, such as a woman who consumed turpentine after consulting the Internet and learning about its use as a folk remedy. Tr. Vol. II (doc. no. Ill) 69:1-9. So too can Alabama expect an increased level of self-abortions if the school-proximity law were to take effect. In summary, because the Tuscaloosa and Huntsville clinics provide more than 70 % of abortions in Alabama and are the only providers of abortions beginning at 15 weeks of pregnancy, and because the two clinics would have to cease operations if the school-proximity law went into effect, the availability of abortions in Alabama would be significantly reduced, and abortions beginning at 15 weeks would become almost wholly unavailable. Thus, Alabama women attempting to obtain a pre-viability abortion would likely experience substantial, and even insurmountable, burdens if the school-proximity law were to take effect. 3. Balancing' Because, as stated above, the undue-burden analysis involves a balancing test, the weight given to the State’s interests impacts the weight of the burdens necessary to conclude that a statute unconstitutionally restricts abortion access. In other words, “the more severe the obstacle a regulation creates, the more robust the government’s justification must be, both in terms of how much benefit the regulation provides towards achieving the State’s interests and in terms of how realistic it is the regulation will actually achieve that benefit.” Planned Parenthood Se., 9 F.Supp.3d at 1287. Here, because, as the current judicial record reflects, the State’s interests are so attenuated and thus should be given little to no weight, and because, as the current judicial record further reflects, the school-proximity law would place substantial, and even insurmountable, burdens on Alabama women seeking pre-viability abortions, the court preliminarily concludes that the law does not “confer! ] benefits sufficient to justify the burdens upon access that [it] imposes.” Whole Woman’s Health, 136 S.Ct. at 2299. The court thus preliminarily holds that the school-proximity law “constitutes an undue burden on abortion access” and is unconstitutional. Id. 4. The State’s Other Arguments In its attempt to justify its regulatory approach, the State argues that governments routinely regulate the types of businesses that may operate near schools, relying principally on First Amendment challenges to zoning decisions. See, e.g., Def. Br. (doc. no. 81) at 44 (“ ‘[TJhere can be little doubt about the power of a state to regulate the environment in the vicinity of schools ... by exercise of reasonable zoning laws.’”) (quoting Larkin v. Grendel’s Den, Inc., 459 U.S. 116, 121, 103 S.Ct. 505, 74 L.Ed.2d 297 (1982)). That argument misapprehends the nature of the undue-burden analysis. As the Supreme Court reaffirmed in Whole Woman’s Health, the undue-burden analysis requires the court to consider, based on the judicial record, “the burdens a law imposes on abortion access together with the benefits those laws confer.” 136 S.Ct. at 2809. That analysis must have bite: It would be erroneous to “equate the judicial review applicable to the regulation of a constitutionally protected liberty with the less strict review applicable where, for example, economic legislation is at issue.” Id. In zoning cases, by contrast, the government’s authority is “undoubtedly broad,” and “the standard of review is determined by the nature of the right assertedly threatened or violated rather than by the power being exercised or the specific limitation imposed.” Schad v. Borough of Mount Ephraim, 452 U.S. 61, 68, 101 S.Ct. 2176, 68 L.Ed.2d 671 (1981). Thus, in government regulation of liquor establishments in the vicinity of schools, “judicial deference is the watchword.” Davidson v. City of Clinton, Miss., 826 F.2d 1430, 1433 (5th Cir. 1987) (approving restriction on sale of alcohol within 500 feet of a school, as applied to a nightclub). Where constitutionally protected interests are threatened, by contrast, the State’s cited examples for government regulation of the areas around schools do not withstand scrutiny. See, e.g., Larkin, 459 U.S. at 117, 103 S.Ct. 505 (invalidating, on Establishment Clause ground, statute that delegated authority to schools and churches to veto liquor licenses within 500 feet of their premises). Similarly, the State’s reliance on the First Amendment ‘secondary effects’ doctrine of City of Renton v. Playtime Theatres, Inc., 475 U.S. 41, 106 S.Ct. 925, 89 L.Ed.2d 29 (1986), is mistaken. In that case, the Supreme Court upheld a city ordinance prohibiting adult movie theatres from operating within 1,000 feet of a school because the ordinance advanced the State’s interests in eliminating the “undesirable secondary effects” of the theatres, such as crime, hurting retail trade, and depressing property values. 475 U.S. at 48-49, 106 S.Ct. 925. The State asserts that it too has an interest in regulating “the undesirable secondary effects” of abortion clinics, implicitly because of demonstrations and the impact on children who witness them, Def. Br. (doe. no. 81) at 47. But the secondary-effects doctrine justifies State actions that would otherwise constitute an impermissible content-based infringement of First Amendment rights; that is, it is an argument specific to a First Amendment claim, but such a claim is not currently before the court. Further, the Supreme Court has squarely rejected the doctrine’s applicability to speech viewed as disturbing or offensive, specifically con-eluding that “[¡listeners’ reactions to speech are not the type of ‘secondary effects’ we referred to in Renton.” Boos v. Barry, 485 U.S. 312, 321, 108 S.Ct. 1157, 99 L.Ed.2d 333 (1988); accord Reno v. Am. Civil Liberties Union, 521 U.S. 844, 867-68, 117 S.Ct. 2329, 138 L.Ed.2d 874 (1997) (rejecting application of Renton’s secondary-effects doctrine to statute intended to protect children from offensive speech). Thus, even under Renton, the State could not force abortion clinics to relocate based on parents’ reactions to protestor speech. Moreover, if the State seeks to regulate the areas around schools, other approaches could effectively advance its asserted interests. For example, the State could have enacted a “time, place, and manner” restriction on demonstrations outside facilities “where abortions are offered or performed.” McCullen v. Coakley, _ U.S. _, 134 S.Ct. 2518, 2530-32, 189 L.Ed.2d 502 (2014) (approving such a buffer zone because it advanced public safety objectives in light of evidence of crowding, obstruction, and violence). It is undoubtedly the province of the legislature, and not this court, to prescribe the most appropriate regulatory approach. Nevertheless, the availability of alternative means more likely to achieve the State’s asserted interests confirms the court’s conclusion that little weight should be placed on an approach that does not substantially further the State’s interests and, in addition, imposes a substantial obstacle on a woman’s right to obtain an abortion. ■ The court’s preliminary holding that the school-proximity law is unconstitutional still obtains. B. Irreparable Harm The court now turns to whether the plaintiffs have established irreparable harm. Effective January 1, 2017, if the school-proximity law were to go into effect, the Tuscaloosa and Huntsville clinics would have to lay off staff and close their businesses. Second Gray Decl. (doc. no. 54-1) ¶ 5; Johnson Decl. (doc. no. 54-2) ¶ 3. Indeed, the Tuscaloosa clinic would stop providing abortions and begin to wind down operations in November 2016. Second Gray Decl. (doc. no. 54-1) ¶¶ 5, 37-38. Business closure clearly qualifies as irreparable harm. ABC Charters, Inc. v. Bronson, 591 F.Supp.2d 1272, 1307 (S.D. Fla. 2008) (Gold, J.) (finding irreparable harm where evidence showed that plaintiffs would have to close their businesses as a result of the law). Moreover, Alabama women seeking pre-viability abortions would suffer immediate and irreparable harm as described above. Without injunctive relief, they could no longer obtain an abortion beginning.at 15 weeks anywhere in Alabama. Before 15 weeks, women in Alabama’s second largest metropolitan area would need to travel at least 200 miles round-trip to obtain an abortion in Alabama, while women in Alabama’s fifth largest metropolitan area would need to travel at least 110 miles to do so; and the resulting burdens on Alabama’s three remaining clinics would introduce significant delays to obtaining an abortion, translating into reduced quality of care, increased risk of medical complications, and for some women, no access to an abortion until, for reasons of health or law, it is too late. See Harris v. Bd. of Supervisors, L.A. Cty., 366 F.3d 754, 766 (9th Cir. 2004) (concluding that medical complications due to delayed treatment will cause irreparable harm in absence of an injunction). Even if, against all record evidence, one of the clinics should reopen or a new clinic opens to fill the gap, the likelihood of at least a temporary gap of “unknown duration” in which abortions would be unavailable supports a finding of irreparable harm. Planned Parenthood of Wis., 738 F.3d at 795. Finally, by interfering in women’s right to an abortion, the school-proximity law threatens their constitutionally protected privacy rights. “[T]he right of privacy must be carefully guarded for once an infringement has occurred it cannot be undone by monetary relief.” Deerfield Med. Ctr. v. City of Deerfield Beach, 661 F.2d 328, 338 (5th Cir. Unit B 1981). And, where an ongoing threat to the right of privacy exists, irreparable harm is presumed. Ne. Fla. Chapter of Association Gen. Contractors v. City of Jacksonville, 896 F.2d 1283, 1285 (11th Cir. 1990). Thus, in Deerfield Medical Center, a denial of a license to open an abortion facility in a manner that was likely to be unconstitutional mandated a finding of irreparable injury. 661 F.2d at 338. For all these reasons, the plaintiffs have met their burden of showing that a preliminary injunction is necessary to avoid irreparable injury. C. Balance of the Hardships The court turns next to whether the threatened harm to the plaintiffs outweighs whatever damage or harm a proposed injunction may cause the State. The State has not asserted it will suffer any hardships if the school-proximity law were preliminarily enjoined. Nevertheless and presumably, the hardship it would suffer is that a law passed by legislators will not go into effect. This harm is minor given the temporary nature of a preliminary injunction. Planned Parenthood Se., Inc. v. Bentley, 951 F.Supp.2d 1280, 1290 (M.D. Ala. 2013) (Thompson, J.). Further, because the State has not currently demonstrated that its interests are meaningfully threatened or that the law will substantially further those interests, a delay in implementation will not impose a serious hardship to the State. In contrast, as stated, if the law were to go into effect, the- plaintiffs would have to stop providing abortions before January -1, 2017, and, based on the current, record, would close their doors. Women seeking an abortion will face substantial new obstacles following the closure, including the denial of abortions beginning at 15 weeks and accompanying health risks associated with reduced and delayed access to abortion care. Because the plaintiffs have shown concrete and serious harms, while the State faces only speculative harms and has not demonstrated the law will help it achieve its asserted State interests, the balance of hardships weighs heavily in the plaintiffs’ favor. D. Public Interest Finally, the court addresses whether a preliminary injunction is in the public interest. Without question, it is in the public interest to preserve the status quo and give the court an opportunity to evaluate fully the lawfulness of the school-proximity law without subjecting the plaintiffs, their patients, or the public at large to any of its potential harms. Further, the public has no interest in the enforcement of a statute likely to be unconstitutional. Odebrecht Const., Inc. v. Sec’y, Fla. Dep’t of Transp., 715 F.3d 1268, 1290 (11th Cir. 2013). Finally, as stated, the State has not demonstrated that the school-proximity law meaningfully furthers interests in avoiding disturbance in educational environments or protecting children from the subject of abortion. In fact, it is ironic that the State would assert that one of the purposes behind the school-proximity law is to minimize disruption in the educational environment, for the current record reflects that the effect of the law has been the opposite, the encouragement of disruption. The law has essentially rewarded the protesters with the intended goal of their disruption: the harassing, and even closing, of the clinics. The message of the law is arguably that the greater the disruption, the greater the likelihood that the State will react with laws to curb that disruption by placing additional restrictions on the clinics. V. THE FETAL-DEMISE LAW The court now turns to whether it should preliminarily enjoin enforcement of the fetal-demise law. The- Alabama Unborn Child Protection from Dismemberment Abortion Act, which the court calls the fetal-demise law, imposes a criminal penalty on physicians who purposely perform ‘dismemberment abortions,’ defined as “dismembering] a living unborn child and extracting] him or her one piece at a time from the uterus through use of clamps, grasping forceps, tongs, scissors, or similar instruments.” 1975 Ala. Code § 26-23G-2(3). A health exception applies if the physician in reasonable medical judgment decides that “the child’s mother has a condition that so complicates her medical condition that it necessitates the abortion of her pregnancy to avert her death or to avert serious risk of substantial and irreversible physical impairment' of a major bodily function, not including psychological or emotional conditions.” 1975 Ala. Code. § 26-23G-2(6). A physician found to be in violation of this law may face a civil suit or a criminal penalty, consisting of a fíne up to $ 10,000, imprisonment for up to two years, or both. While not mentioned explicitly in the language of the law, the parties agree’ that it would ban the standard D&E method, if used without first inducing fetal demise. Standard D&E is a surgical abortion method in which a woman’s cervix is dilated only enough to allow passage of surgical instruments, after which the physician uses forceps to grasp the fetus and remove it, and uses suction to remove remaining contents of the uterus. It is important to open the cervix gently, and then only a small amount, for safety reasons and to preserve it for future pregnancies. Tr. Vol. I (doc. no. 110) at 16:5-12. Because the opening of the cervix is too small for the entire fetus to pass, separation of fetal tissues occurs during the process of removing the fetus. Id. at 17:6-14. Due to this separation of tissues, standard D&E falls under the category of ‘dismemberment abortions,’ as defined in the fetal-demise law. Physicians start using the standard D&E procedure around 15 weeks of pregnancy, before which they can remove the fetus using only suction. The procedure takes between 10 to 15 minutes. Id. at 17:15-16. Standard D&E is considered an extremely safe abortion method, with a less than 1 % chance of major complications. Id. at 17:17-18. Due to its low risk of complications, relative simplicity, and short duration, it is the most common method of second-trimester abortions in Alabama; in fact, it is the only method that the Tuscaloosa and the Huntsville clinics use to perform abortions at or after 15 weeks of pregnancy. Parker Decl. (doc. no. 54-6) ¶ 14; Robinson White Decl. (doc. no. 54-4) ¶¶ 20, 22-25. D&E is the only second-trimester abortion method that can be used in an outpatient setting. Tr. Vol. I (doc. no. 110) at 189:8-11. Nationally, about 95 % of second-trimester abortions are performed through standard D&E. Davis Decl. (doc. no. 54-5) ¶ 7. In Alabama, the Tuscaloosa and Huntsville clinics are the only ones providing abortions starting at 15 weeks of pregnancy. A. Likelihood of Success on the Merits The court must first determine whether there is a likelihood that the plaintiffs will succeed on their challenge to the fetal-demise law. The Casey undue-burden standard, described previously, governs. Put succinctly, “[a] statute which, while furthering [a] valid state interest, has the effect of placing a substantial obstacle in the path of a woman’s choice cannot be considered a permissible means of serving its legitimate ends.” Whole Woman’s Health, 136 S.Ct. at 2309 (quoting Casey, 505 U.S. at 877, 112 S.Ct. 2791 (plurality opinion)). Thus, abortion regulations that “have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.” Id. (quoting Casey, 505 U.S. at 878, 112 S.Ct. 2791 (plurality opinion)). For the reasons discussed below, the court holds that the plaintiffs are likely to succeed on the merits of their challenge to the fetal-demise law. 1. State’s Interests Because no legislative findings accompany the fetal-demise law, the court does not have an explanation from the legislature of the purpose for the law. Nevertheless, the State argues that the law advances these interests: advancing respect for human life; promoting integrity and ethics of the medical profession; and promoting respect for life, compassion, and humanity in society at large. The court assumes the legitimacy of these interests. Whole Woman’s Health, 136 S.Ct. at 2310 (assuming that the State had legitimate state interests where the statute did not contain any legislative findings). 2. Burdens Imposed on Women The plaintiffs assert that the fetal-demise law would force Alabama women seeking pre-viability abortions to go through medically unnecessary procedures and subject them to heightened health risks. Furthermore, they state that, if the law were, to go into effect they would stop performing D&E abortions altogether due to ethical concerns, thereby rendering abortions essentially unavailable in the State of Alabama starting at 15 weeks. The State responds that fetal demise can be safely achieved before standard D&E with one of these three procedures: umbilical-cord transection, digoxin injection, and potassium-chloride injection. As discussed earlier, the fetal-demise law criminalizes standard D&E unless fetal demise occurs before the procedure; accordingly, the court’s determination whether the law imposes substantial obstacles to abortion access turns on the feasibility of the proposed fetal-demise methods. As with the State’s asserted interests, there are no legislative findings that these procedures are safe and effective. In any event, this court must now, based on the “judicial record,” make its own findings in that regard. See Whole Woman’s Health, 136 S.Ct. at 2310 (“[T]he relevant statute here does not set forth any legislative findings. Rather, one is left to infer that the legislature sought to further a constitutionally acceptable objective For a district court to give significant weight to evidence in the judicial record in these circumstances is consistent with this Court’s case law.”). The court concludes that, on the current record, the proposed fetal-demise methods are not feasible for use in the Tuscaloosa and Huntsville clinics, a. Umbilical-Cord Transection To perform umbilical cord tran-section incident to standard D&E, the physician must first dilate the woman’s cervix enough to allow the passage of instru