W. Ala. Women's Ctr. v. Miller, 299 F. Supp. 3d 1244

Background

Two Alabama statutes challenged: (1) a "school-proximity" law barring issuance/renewal of state health licenses for abortion clinics located within 2,000 feet of a K–8 public school; (2) a "fetal-demise" law criminalizing "dismemberment" abortions unless physicians first induce fetal demise.
Plaintiffs: two Alabama outpatient clinics (West Alabama Women's Center in Tuscaloosa and Alabama Women's Center in Huntsville) and their medical directors, suing on behalf of themselves and patients; defendants are state officials sued in official capacities.
The Tuscaloosa and Huntsville clinics together perform ~72% of Alabama abortions and are the only clinics providing abortions beginning at 15 weeks (standard D & E). If forced to relocate they likely could not due to prior surgical-center compliance costs, landlord/finance issues, and a hostile environment toward providers.
The fetal-demise law would effectively ban the common second‑trimester method (standard D & E) unless one of three methods (umbilical‑cord transection, potassium‑chloride injection, digoxin injection) is used first. The court found those alternatives unsafe, experimental, or infeasible in plaintiffs’ outpatient-clinic setting.
Court applied the Casey undue‑burden test as refined in Whole Woman's Health: evaluate real‑world burdens on access against the law’s benefits and medical evidence in the judicial record.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
School‑proximity law: does it impose an undue burden?	Law would force closure of Huntsville and Tuscaloosa clinics, eliminating most late‑term services and imposing severe travel, delay, and access burdens.	Law protects schoolchildren and parental control over exposure to protests; analogous to routine zoning/regulation near schools.	Held unconstitutional (facially and as‑applied): benefits minimal; closures would impose substantial/insurmountable burdens on access.
Fetal‑demise law: does required fetal‑demise create an undue burden?	Mandating fetal demise before D & E would force patients to undergo risky, experimental, or impractical procedures or lose access to abortions at/after 15 weeks.	State says safe alternatives exist (cord transection, KCl, digoxin) so D & E remains available only after inducing demise.	Held unconstitutional as‑applied: alternatives are unsafe, experimental, or infeasible in clinics, so law would effectively deny abortion access at ≥15 weeks (imposes undue burden).
Scope of relief: facial vs as‑applied relief appropriate?	Plaintiffs sought both; argued large fraction of relevant women would be affected.	State urged narrower relief or waiting until enforcement.	School‑proximity: facial and as‑applied injunction granted. Fetal‑demise: court grants as‑applied injunction for the plaintiffs (did not extend to private‑civil enforcement).
Reliance on Gonzales v. Carhart: does it compel upholding fetal‑demise law?	Plaintiffs: Gonzales is distinguishable; here ban reaches the commonly used method and record shows alternatives are not safe/available.	State: Gonzales permits upholding abortion‑method bans when medical uncertainty exists.	Held: Gonzales not controlling; Whole Woman's Health requires weighing record evidence and Gonzales addressed a rare method while here the statute would bar the common method—court must independently assess effects.

Key Cases Cited

Gonzales v. Carhart, 550 U.S. 124 (2007) (upheld federal ban on intact D & E where common alternatives remained available; courts still review factual record).
Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992) (articulated undue‑burden standard for pre‑viability abortion regulations).
Whole Woman's Health v. Hellerstedt, 136 S. Ct. 2292 (2016) (courts must weigh real‑world burdens against benefits using judicial record; reject undue deference on medical uncertainty).
Stenberg v. Carhart, 530 U.S. 914 (2000) (struck down ban that reached common D & E method because ban imposed undue burden).