A ballot initiative coming before Colorado’s voters to ban most abortions after the 22nd week of pregnancy could have nationwide implications, according to advocates who say the proposed law will hinder doctor-patient relationships and complicate difficult medical decisions.

“The women who come to me are in extremely difficult circumstances; this is the most painful and difficult decision of their lives,” Dr. Warren Hern, a Boulder clinic founder who specializes in later abortion, told NPR.

Most states restrict later abortions and few doctors are willing or not able to perform the procedures. Hern said about 85% of his patients come from outside Colorado, but most of the procedures performed at his clinic would be banned under Colorado’s Proposition 115, which prohibits abortions after 22 weeks unless a woman’s life is in danger. If the law passes, doctors violating it could be fined and lose their medical licenses.

The proposition needs a simple majority vote to pass. However, Colorado voters have rejected ballot initiatives limiting abortion three times over the past 12 years, and there are currently no laws in the state limiting abortions at any stage. This has left Colorado as one of only 7 states that allow late-term abortions.

Hern said most of his patients are either facing a medical crisis or have been victims of rape and incest, leaving them with delays in getting an abortion, and he thinks “these are very private decisions.”

According to the pro-choice Guttmacher Institute, just over 1% of abortions nationwide happen after the 21-week mark. The 22-week cutoff is the earliest point doctors say a fetus can be delivered, but with medical intervention.

Several groups such as the American College of Obstetricians & Gynecologists oppose Proposition 115, but others say they hope the legislation will shut down Hern’s clinic and pave the way for further restrictions.

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