Opinion ID: 4433771
Heading Depth: 1
Heading Rank: 5

Heading: Applying the Preliminary Injunction Standard

Text: To obtain a preliminary injunction, a plaintiﬀ must show a reasonable likelihood of success on the merits, the absence of an adequate remedy at law, and a threat of irreparable harm without the injunction. E.g., Planned Parenthood of Indiana, Inc. v. Commissioner, 699 F.3d 962, 972 (7th Cir. 2012). If the plaintiﬀ makes this showing, the court weighs two additional factors: the balance of harms—harm to the plaintiﬀ if the injunction is erroneously denied versus harm to the defendant if the injunction is erroneously granted—and the effect of the injunction on the public interest. Id.; accord, Winter, 555 U.S. at 24; Abbott Laboratories v. Mead Johnson & Co., 971 F.2d 6, 11–12 (7th Cir. 1992). The higher the likelihood of success on the merits, the less decisively the balance of harms needs to tilt in the moving party’s favor. In reviewing a district court’s grant of a preliminary injunction, we review factual findings for clear error, legal conclusions de novo, and balancing of the equitable factors for abuse of discretion. The abuse of discretion standard means that the district court’s weighing of evidence and balancing of the equitable factors receive “substantial deference.” Whitaker v. Kenosha Unified School Dist. No. 1 Bd. of Educ., 858 F.3d 1034, 1044 (7th Cir. 2017). That deference is appropriate given the nature of preliminary injunction decisions, which must be based on incomplete information and are subject to further consideration and revision after discovery, more evidence, and a trial. 14 No. 17-2428 Motions for preliminary injunctions call upon courts to make judgments despite uncertainties. Uncertainty about a law’s application does not necessarily preclude an injunction. We have read Casey as calling for consideration of a law’s “likely eﬀect.” E.g., Karlin, 188 F.3d at 481 (emphasis added). Casey itself spoke in terms of possibilities in striking down a spousal notice law before it took eﬀect. See, e.g., 505 U.S. at 893 (“may fear,” “likely to prevent,” “will impose”), 895 (“will operate”) (opinion of the Court) (emphases added). Our decision in A Woman’s Choice is not inconsistent with this focus. In A Woman’s Choice, the state had not appealed the preliminary injunction that preserved the status quo while the parties developed a more complete record. See 305 F.3d at 684. The preliminary injunction had been issued despite the district court’s inability “to draw definitive conclusions.” A Woman’s Choice-East Side Women’s Clinic v. Newman, 904 F. Supp. 1434, 1462 (S.D. Ind. 1995) (emphasis in original). And when we decided the appeal from the permanent injunction in that case, we distinguished the record before us from the record in Casey on spousal notice, a record showing a rule “facilitating domestic violence or even inviting domestic intimidation.” A Woman’s Choice, 305 F.3d at 692.4
We consider first Planned Parenthood’s likelihood of success on the merits, and then turn to the other equitable factors 4 As noted above, our opinion in A Woman’s Choice criticized the unappealed preliminary injunction in that case, see 305 F.3d at 692–93, but on grounds tied to the pre-enforcement challenge issue discussed above, for which Whole Woman’s Health provides more recent and authoritative guidance from the Supreme Court. No. 17-2428 15 for preliminary injunctive relief. The district court concluded that Planned Parenthood demonstrated a likelihood of success on the merits because the parental notification requirement appeared highly likely to impose an undue burden for the minors whom it will aﬀect. We agree with the district court’s analysis, except that we do not need to decide whether the Supreme Court’s requirements for parental consent statutes also apply in full to parental notice statutes. Planned Parenthood demonstrated a likelihood of success on the merits because Indiana’s notice law creates a substantial risk of a practical veto over a mature yet unemancipated minor’s right to an abortion. This practical veto appears likely to impose an undue burden for the unemancipated minors who seek to obtain an abortion without parental involvement via the judicial bypass. The burden appears to be undue because the State has made no eﬀort to support with evidence its claimed justifications or to undermine with evidence Planned Parenthood’s showing about the likely eﬀects of the law. In Whole Woman’s Health, the Supreme Court applied the Casey plurality’s undue burden standard. 136 S. Ct. at 2309– 10. The undue burden standard “is a shorthand for the conclusion that a state regulation has the purpose or eﬀect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.” Casey, 505 U.S. at 877 (plurality opinion). In both cases, the Court took a common-sense approach in considering the practical eﬀects of the state regulations. Whole Woman’s Health, 136 S. Ct. at 2317 (“Courts are free to base their findings on commonsense inferences drawn from the evidence.”); Casey, 505 U.S. at 892 (opinion of the Court) (noting that district court’s findings regarding eﬀect of 16 No. 17-2428 spousal notice statute and potential for domestic abuse “reinforce what common sense would suggest”).
If a statute “will operate as a substantial obstacle” “in a large fraction of the cases in which [it] is relevant,” the statute “is an undue burden and therefore invalid.” Casey, 505 U.S. at 895 (opinion of the Court); accord, Whole Woman’s Health, 136 S. Ct. at 2320. The analysis starts with those “upon whom the statute operates”—i.e., “the group for whom the law is a restriction, not the group for whom the law is irrelevant.” Casey, 505 U.S. at 894 (opinion of the Court). For the spousal notice law struck down in Casey, that was less than one percent of women seeking abortions. This group serves as the denominator for the relevant fraction Casey described. Under Casey, a statute that will have the practical eﬀect of giving someone else a veto over a woman’s abortion decision is an undue burden. See 505 U.S. at 897 (spousal notice requirement would give husbands of spousal abuse victims “an eﬀective veto” that “will often be tantamount to the veto found unconstitutional in Danforth”) (emphasis added). Casey qualified its holding on spousal notice by saying it was “in no way inconsistent” with the Court’s parental notice and consent requirements for minors. 505 U.S. at 895. But here, as in Casey, evidence matters. See id. at 887–94 (discussing district court’s findings and studies of domestic violence). Planned Parenthood’s evidence—which the State did not rebut with its own—raises concerns about minors similar to those the Casey Court had about the practical veto imposed on some women by spousal notice. Casey shows that a practical veto can be an undue burden, whether that practical veto is held by a partner or a parent of a mature minor. No. 17-2428 17 The Casey analysis focuses on proportions, not total numbers. See Van Hollen, 738 F.3d at 798 (“It is not a matter of the number of women likely to be aﬀected.”). Although the record does not indicate the exact number of unemancipated minors who will be aﬀected as they go through the judicial bypass, the number appears to be small. In fiscal year 2015, 96 percent of minors who had abortions at Planned Parenthood facilities in Indiana had their parent or guardian’s consent. Beeley Decl. ¶ 9. Just four percent did not have consent. Between October 2011 and September 2017, about 60 young women contacted the bypass coordinator, and only some of them obtained an abortion. Smith Decl. ¶ 9. On average, that is about 10 minors per year.5 In the district court, Planned Parenthood argued that the denominator for the Casey fraction is unemancipated minors seeking bypasses. These are the young women for whom the law’s restriction is relevant. Cf. Casey, 505 U.S. at 895 (opinion of the Court) (defining denominator as “married women seeking abortions who do not wish to notify their husbands of their intentions and who do not qualify for one of the statutory exceptions to the notice requirement”). The district court found that the bypasses granted to Planned Parenthood patients “have generally been based on the juvenile court’s finding that the minor was suﬃciently mature.” Planned Parenthood, 258 F. Supp. 3d at 936, citing Beeley Decl. ¶ 26. Accordingly, Planned Parenthood argues that the burdensome eﬀects of the new parental notice requirement produce a large 5In calendar year 2017, 236 minors obtained abortions in Indiana. Indiana State Department of Health, Terminated Pregnancy Report 2017, at 7, available at https://www.in.gov/isdh/files/2017%20Indiana%20Terminated%20Pregnancy%20Report.pdf. 18 No. 17-2428 Casey fraction because most bypasses have been granted on maturity grounds, which is not a basis for excusing parental notice under the challenged Indiana law. We agree. On this record, though, the correct numerator and denominator may both actually be even larger. Both numbers include not only young women who could be deemed mature in a judicial bypass of the consent requirement, but also young women who are likely to be deterred from even attempting judicial bypass because of the possibility of parental notice. Indiana has aimed this requirement at the tiny group of minors who could show maturity but could not show that parental notice would not be in their best interests. The evidence in the preliminary injunction record indicates that the statute’s eﬀect will be broader because it will prevent some minors from even seeking bypass in the first place. The fear these minors feel at the prospect of the “chance that their parents will have to be informed that they are seeking an abortion … would be a deal breaker.” Smith Decl. ¶ 20.
Whole Woman’s Health reiterated that Casey “requires that courts consider the burdens a law imposes on abortion access together with the benefits those laws confer,” and courts must balance these interests. 136 S. Ct. at 2309. Whole Woman’s Health shows that courts must consider actual evidence regarding both claimed benefits and claimed burdens of abortion regulations. Id. at 2309–10. In that case, for example, Texas argued that its admitting-privileges requirement was intended to provide health benefits in cases with complications. The evidence showed, however, that “there was no significant health-related problem that the new law helped to cure.” Id. at 2311. No. 17-2428 19 In this case, the State has not yet come forward with evidence showing that there is a problem for the new parentalnotice requirement to solve, let alone that the law would reasonably be expected to solve it. See id. The State has several substantial interests that can be relevant in this context, if there is reason to think they will be advanced by the new law. E.g., Casey, 505 U.S. at 871 (plurality opinion) (“protecting the potentiality of human life,” quoting Roe v. Wade, 410 U.S. 113, 162 (1973)); Casey, 505 U.S. at 872 (plurality opinion) (“expressing a preference for normal childbirth,” quoting Webster v. Reproductive Health Svcs., 492 U.S. 490, 511 (1989)); Planned Parenthood, 258 F. Supp. 3d at 941 (“protecting children and adolescents, preserving family integrity, and encouraging parental authority”). Against these potential State interests, minors also have constitutional rights that require protection. Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 74 (1976) (“Constitutional rights do not mature and come into being magically only when one attains the state-defined age of majority. Minors, as well as adults, are protected by the Constitution and possess constitutional rights.”). In the face of evidence of burdensome eﬀects, it is not enough for the State merely to recite its interests and to claim the new law will serve those interests or to say it is only experimenting. The State’s arguments assume that, in raising their children, parents will fulfill the role the Supreme Court has said is constitutional for them to fulfill. We can all hope that that is the reality for the vast majority of young women who face an unexpected pregnancy and that they will turn to their parents for guidance. But the evidence before the district court here illustrates a diﬀerent and “stark social reality,” Ohio v. Akron Center for Reproductive Health, 497 U.S. at 537 (Blackmun, J., dissenting), “that there is ‘another world out there,’” id. at 541, 20 No. 17-2428 quoting Beal v. Doe, 432 U.S. 438, 463 (1977) (internal quotation marks omitted). For those pregnant minors aﬀected by this Indiana law, the record indicates that in a substantial fraction of cases, the parental notice requirement will likely have the practical eﬀect of giving parents a veto over the abortion decision. That practical eﬀect is an undue burden because it weighs more heavily in the balance than the State’s interests. We agree with the district court that the burden of this law on a young woman considering a judicial bypass is greater than the eﬀect of judicial bypass on her parents’ authority. Planned Parenthood, 258 F. Supp. 3d at 948. Indiana argues that parents need notice because they need to know about the abortion to be able to care for their daughter’s health: “abortion is a facet of medical history that could have implications for future treatment.” State’s Br. at 22. While that rationale sounds reasonable at first, it is not supported by logic or evidence. As a matter of logic, if we assume this knowledge would help parents care for their daughters later, the State’s proposed benefit would not depend on giving parents prior notice of an abortion, as the statute requires. Planned Parenthood’s evidence shows a serious risk that prior notice, instead of giving parents an opportunity to oﬀer wise counsel, will actually give parents an opportunity to exercise a practical veto, preventing the pregnant minor from actually exercising the constitutional right the juvenile court has allowed her to exercise. In fact, the State has oﬀered no evidence that any actual benefit is likely or that there is a real problem that the notice requirement would reasonably be expected to solve. Whole Woman’s Health shows that myths, speculation, and conventional wisdom are not enough to justify restrictions on the No. 17-2428 21 right to abortion. 136 S. Ct. at 2311 (“there was no significant health-related problem that the new law helped to cure”). In applying the undue burden standard, actual evidence is key in weighing both the extent of burdens and the extent of benefits a State oﬀers to justify them. 136 S. Ct. at 2310, citing Casey, 505 U.S. at 888–94 (discussing evidence showing spousal notice requirement imposed undue burden on right to terminate pregnancy). In this case, the State oﬀered no evidence to support these proposed benefits, such as how, why, and how often a minor’s past abortion is likely to aﬀect her mental health or her future health-care.6 6 Without relevant evidence in the record, our dissenting colleague cites studies cited in an amicus brief on appeal and in the concurring opinion in McCorvey v. Hill, 385 F.3d 846, 850–51 & n.3 (5th Cir. 2004) (Jones, J., concurring), to assert that a mature minor who has an abortion faces substantial risks to her mental and physical health and would benefit from her parents’ support. Post at 45. Because these studies on this controversial subject are not in the record and have not been subject to adversarial testing in litigation, we do not address them in detail. As a general rule, however, data on physical health indicate that “complications from an abortion are both rare and rarely dangerous.” Planned Parenthood of Wisconsin, Inc. v. Schimel, 806 F.3d 908, 912 (7th Cir. 2015); id. at 913 (noting studies finding “that the rate of complications is below 1 percent”); see also Whole Woman’s Health, 136 S. Ct. at 2311–12 (finding no legitimate state interest in requiring facilities that perform abortions also have hospital admitting privileges because weight of the evidence revealed extremely low rate of abortion-related complications). Regarding mental health issues, the American Psychological Association undertook a comprehensive review of mental health studies of women who had abortions and found serious methodological problems in many published studies finding serious mental health risks. The APA task force found, among other things, that the “best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.” American Psychological Association, Task 22 No. 17-2428
There is of course a formal legal diﬀerence between a notice requirement and a consent requirement. The Supreme Court has drawn that distinction on the basis that notice statutes “do not give anyone a veto power over a minor’s abortion decision.” Ohio v. Akron Center, 497 U.S. at 511, citing H. L. v. Matheson, 450 U.S. 398, 411 n.17 (1981). Although a notice requirement is not the formal or legal equivalent of a consent requirement, it is equally clear that a notice requirement can operate as the practical equivalent of a consent requirement. Casey recognized just that possibility. That was the basis for striking down the spousal notice requirement. 505 U.S. at 833, 897 (“spousal notice requirement enables the husband to wield an eﬀective veto over his wife’s decision”); see also Planned Parenthood v. Miller, 63 F.3d 1452, 1459 (8th Cir. 1995) (distinguishing between notice providing an “opportunity” and consent providing a “tool” to obstruct abortion).7 Force on Mental Health and Abortion at 4 (2008), available at http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf. Nothing we decide today prevents the State from presenting further evidence on such matters to the district court, where both the State’s and Planned Parenthood’s evidence can be tested and challenged without the urgent time pressure of a preliminary injunction proceeding. As the Supreme Court outlined in Whole Woman’s Health, the district court, in “determining the constitutionality of laws regulating abortion procedures,” will “place[] considerable weight upon evidence and argument presented in judicial proceedings,” rather than deferring to a legislative resolution of “questions of medical uncertainty.” 136 S. Ct. at 2310. The district court will then apply “the standard … laid out in Casey, which asks courts to consider whether any burden imposed on abortion access is ‘undue.’” Id. 7 This reading of Justice Kennedy’s opinion for the Court in Ohio v. Akron Center is consistent with Justice Kennedy’s language in another No. 17-2428 23 The preliminary injunction record here shows the serious potential for the kind of harms identified in Casey. For a significant fraction of the small number of unemancipated minors seeking an abortion via judicial bypass, Indiana’s notice requirement will likely operate as an undue burden by giving parents a practical veto over the abortion decision. The district court credited the unchallenged testimony of the bypass coordinator and a bypass attorney indicating that young women have chosen not to inform their parents of their pregnancy out of fear of abuse. Planned Parenthood, 258 F. Supp. 3d at 946–47, citing Smith Decl. ¶¶ 16–17 and Flood Decl. ¶ 9. The district court also credited unchallenged testimony that pregnancy is a “flashpoint” for abuse. Id. at 946, citing Pinto Decl. ¶¶ 14– 15. This evidence parallels the evidence the Supreme Court accepted in Casey. 505 U.S. at 889 (opinion of the Court), quoting district court’s finding of pregnancy as a “flashpoint for battering and violence within the family,” and at 893 (crediting fear of “threats of future violence”). The district court found here that fear of abuse may “prompt pregnant minors to engage in hazardous self-help measures such as attempting to physically and/or chemically induce miscarriage or to entertain thoughts of suicide.” Planned Parenthood, 258 F. Supp. 3d at 947, citing Pinto Decl. ¶ 16 (one patient attempted to induce miscarriage by convincing boyfriend to stomp on her opinion issued the same day. See Hodgson v. Minnesota, 497 U.S. 417, 496 (1990) (Kennedy, J., dissenting in part) (“Unlike parental consent laws, a law requiring parental notice does not give any third party the legal right to make the minor’s decision for her, or to prevent her from obtaining an abortion should she choose to have one performed.”) (emphasis added). 24 No. 17-2428 stomach and push her down stairs; another patient attempted to induce miscarriage by drinking poison). The district court also found that notice to parents could result in actual obstruction of the abortion itself, in addition to indirect obstruction via withdrawal of financial support. 258 F. Supp. 3d at 946. In Casey, the Supreme Court credited similar fears of women who were afraid of notifying their husbands of a pregnancy. 505 U.S. at 893 (discussing fear of “psychological abuse,” including “verbal harassment, threats of future violence, the destruction of possessions, physical confinement to the home, the withdrawal of financial support, or the disclosure of the abortion to family and friends”). The district court found here that Casey’s concerns are “heightened with regard to unemancipated minors, who typically must rely on their parents … for financial support, housing, and transportation in addition to the many legal incapacities for which the parents must serve as proxy.” 258 F. Supp. 3d at 946. For young women who have these fears, the potential for parental notice is a threat that may deter them from even attempting bypass in the first place. Id. at 947, citing Pinto Decl. ¶ 28; see also Smith Decl., ¶ 20; Glynn Decl., ¶ 17; Flood Decl., ¶ 13. For some, as noted, it is a “deal breaker.” Smith Decl. ¶ 20. We have recognized a similar deterrent eﬀect before. Indiana Planned Parenthood Aﬃliates Ass’n v. Pearson, 716 F.2d 1127, 1141 (7th Cir. 1983) (“It is hardly speculative to imagine that even some mature minors will be deterred from going to court if they know that their parents will be notified if their petitions are denied, because no minor can be certain that the court will rule in her favor.”). This record gives evidentiary weight to the possibilities we identified as concerns about No. 17-2428 25 mandatory notice even before Bellotti was decided. See Wynn v. Carey, 582 F.2d 1375, 1388 n.24 (7th Cir. 1978). We must also recognize that any particular obstacle to exercising the right to choose to end a pregnancy does not exist in a vacuum. See Whole Woman’s Health, 136 S. Ct. at 2313. Cumulative eﬀects are relevant, especially in an environment in which very few clinics and physicians perform abortions in Indiana. The deterrence shown in this record must be understood in the larger context of the logistical puzzle that the Indiana bypass statute already requires minors to solve. A teenager who suspects she is pregnant but who has good reasons to fear telling her parents must figure out where to go to determine whether she is pregnant, how to get there (without missing school or work and without alerting her family), and how to pay for whatever that initial visit costs. If she visits a Planned Parenthood clinic, she might find out about the possibility of a judicial bypass to obtain an abortion. If she wants to pursue that route, she must then find her way to a state court, with or without a lawyer, and persuade a judge either that she is mature enough to have an abortion without her parents’ consent or that doing so would be in her “best interests.” Even if she proves that she is mature enough to have the abortion without her parents’ consent, Indiana’s new law would allow a judge to require parental notice unless she proves that an abortion without parental notice would be in her “best interests.” Planned Parenthood’s unchallenged evidence shows that the existence of that additional requirement is likely to cause a significant fraction of aﬀected young women to be too afraid to even try to seek an abortion. None of the district court’s findings are clearly erroneous. The State’s position that the parental notice requirement does 26 No. 17-2428 not aﬀord parents a legal or practical right to obstruct the abortion stretches too far. Notice is not the legal equivalent of consent, but a notice requirement can have the same practical eﬀect as a consent requirement, as Casey reasoned in striking down a spousal notice requirement. 505 U.S. at 896–98; see also Indiana Planned Parenthood Aﬃliates v. Pearson, 716 F.2d at 1132. The district court credited Planned Parenthood’s evidence showing that Indiana’s law has the serious potential to create that practical eﬀect by triggering parental obstruction, triggering hazardous self-help, and deterring some minors from even attempting bypass. The preliminary injunction here was appropriate because, taken individually or collectively, those possibilities demonstrate serious potential for an undue burden. The undue burden analysis can include cumulative eﬀects. See Whole Woman’s Health, 136 S. Ct. at 2313 (describing increased driving distances as “one additional burden … taken together with others”). In applying the undue burden test, we must also address two other oddities of the notice requirement. First, the State acknowledges that a 48-hour parental notice requirement, like the one the Eighth Circuit addressed in Miller, 63 F.3d at 1458, “raises additional questions about the opportunity for the parents to intercede and to obstruct the abortion.” The only timing requirement in Indiana’s statute is that notice be given “before the abortion is performed.” Ind. Code § 16-34-2-4(d). That is troubling. It leaves the potential for a judge to require notice to be given even longer in advance than in Miller. The two methods the statute identifies for delivering that notice pose similar practical problems. The statute requires that the “attorney representing the unemancipated pregnant minor shall serve the notice required by this subsection by No. 17-2428 27 certified mail or by personal service.” Id. That puts the minor and her lawyer in a diﬃcult position. The lawyer cannot control the timing of delivery of a letter sent by certified mail. To comply with the requirement of actual notice before the abortion is to be performed, the lawyer will have to allow plenty of time for the letter to be delivered and received, and for the proof of receipt to be returned. As a practical matter, that is likely to require a planned delay of at least a week and perhaps longer. Abortions in Indiana require advance scheduling to comply with the State’s informed-consent and cooling-oﬀ rules. See Ind. Code § 16-34-2-1.1(a). The only alternative is personal notice to the parents, by the lawyer. Picture the scene: a stranger knocks at the door and announces to the young woman’s parents that their daughter is pregnant and is seeking an abortion, that a judge has authorized the abortion, and that it will occur soon. The potential for serious trouble is self-evident, for the lawyer and for the pregnant minor and her constitutional rights. And all of this after a judge has already been convinced to bypass pa- rental consent. The district court’s recognition of the likely practical consequences of this law is consistent with Casey. Casey distinguished its holding as to married women from the line of cases addressing parental notice or consent requirements because those cases “are based on the quite reasonable assumption that minors will benefit from consultation with their parents and that children will often not realize that their parents have their best interests at heart.” 505 U.S. at 895 (opinion of the Court). Just as the Casey court did not have to adopt that same assumption for married women, the district court was not required to adopt it in the face of this record with 28 No. 17-2428 unchallenged evidence showing that the same assumption is too optimistic in a substantial fraction of relevant cases. After all, in this case, that assumption was directly refuted by evidence for purposes of the preliminary injunction. The State argues that the notice requirement creates no additional risk for young women who fear parental notice. According to the State, these minors are “in no worse position than if [they] had not attempted bypass” because a young woman who initiates the bypass process but fails to convince a court to waive notice can make notice unnecessary by deciding not to have an abortion. The argument illustrates the potential for irreparable harm. A minor who obtains a bypass of parental consent, only to be forced to choose between parental notice and not having the abortion, will still have to weigh the consequences of notice. As the district court found, minors for whom the potential consequences include, for example, contemplating suicide or self-inducing a miscarriage, Planned Parenthood, 258 F. Supp. 3d at 947, citing Pinto Decl. ¶ 16, would not be in the same position as if they had never attempted bypass. They would be worse oﬀ. Further, the State’s brief acknowledges that at least one purpose of the notice requirement is to inhibit the eﬀectiveness of the judicial bypass process itself. While the State asserts some interests that could be legitimate, at least in theory, one of the interests proﬀered is to “ensure that parents of minor[s] are notified of their abortions and provides safeguards for the parent-child relationship by preventing circumvention of the consent requirement.” State’s Br. at 27 (emphasis added). The very purpose of the constitutionally required judicial bypass is to “circumvent” the consent requirement in appropriate cases. If the State had presented evidence that the judicial No. 17-2428 29 bypass procedure is being abused in some systematic way, we might see this diﬀerently. But without such evidence, the argument acknowledges that the new notice requirement is designed to impose a new burden on a minor exercising her constitutional right to seek a judicial bypass and thus to be able to make her own decision about her own pregnancy. Cf. Casey, 505 U.S. at 877 (plurality opinion) (regulation with “purpose or eﬀect” of creating substantial obstacle to abortion decision is unduly burdensome). Like the district court, we reject the State’s and the dissent’s argument that a bypass court can avoid any undue burden by simply considering the potential for abuse as part of the best-interests determination. The district court found that the trauma of even attempting to prove abuse would deter young women from pursuing bypass. Planned Parenthood, 258 F. Supp. 3d at 947. That finding is well-supported. It is not clearly erroneous. Indeed, the finding parallels the district court’s finding in Casey that the Supreme Court credited. See Casey, 505 U.S. at 890 (opinion of the Court) (abused wives “may be psychologically unable to discuss or report the rape for several years after the incident”). Because we decide this appeal based only on an application of Casey’s undue burden standard, we need not and do not decide whether Bellotti applies to all parental notice requirements. The context of a preliminary injunction enjoining the enforcement of this statute on a limited factual record necessarily narrows our holding. The Supreme Court has announced clear bypass requirements for parental consent requirements. Bellotti v. Baird, 443 U.S. at 643–44 (opinion of Powell, J.) (requiring bypass based either on maturity or best interests). The open question is whether those requirements 30 No. 17-2428 also apply to parental notice requirements. The district court decided that the standards for parental consent requirements apply equally to parental notice requirements. Planned Parenthood, 258 F. Supp. 3d at 945–46. The State acknowledges that, if Bellotti applies to notice statutes, then the Indiana law is unconstitutional because it does not allow a bypass of notice based on maturity. Because the Supreme Court has expressly declined to decide whether Bellotti applies to parental notice statutes, we decline to decide this appeal on this ground. Instead, we aﬃrm the preliminary injunction based on Planned Parenthood’s evidence of likely eﬀects, which Indiana did not rebut in the district court with evidence of its own. As the district court noted, we applied Bellotti to parental notice requirements in the 1980s. Zbaraz v. Hartigan, 763 F.2d 1532, 1539 (7th Cir. 1985) (“This standard [i.e., maturity and best interests-based bypass] also governs provisions requiring parental notification.”), citing Bellotti, 443 U.S. at 651 (opinion of Powell, J.), and Indiana Planned Parenthood Aﬃliates Ass’n v. Pearson, 716 F.2d 1127, 1132 (7th Cir. 1983). But since then, the Supreme Court has said that it has not decided whether Bellotti applies to parental notice statutes. E.g., Lambert v. Wicklund, 520 U.S. 292, 295 (1997) (per curiam) (reversing Ninth Circuit’s invalidation of parental notice statute as inconsistent with Bellotti because the Court “declined to decide whether a parental notification statute must include some sort of bypass provision to be constitutional.”), citing Akron Center, 497 U.S. 502, 510 (1990) (expressly leaving question open). We have noted this evolution before. Zbaraz v. Madigan, 572 F.3d at 380 & n.5 (declining to decide No. 17-2428 31 applicability of Bellotti because parental notice statute satisfied Bellotti consent requirements).8 The district court acknowledged that the question whether Bellotti’s requirements for parental consent statutes apply 8 H.L. v. Matheson does not save this Indiana statute. The Court upheld Utah’s parental notice requirement with no bypass at all, but it did so because the plaintiff “made no claim or showing as to her maturity or as to her relations with her parents.” 450 U.S. 406, 407 (1981). The Court said clearly what it was not deciding: “This case does not require us to decide in what circumstances a state must provide alternatives to parental notification.” Id. at 412 n.22. Justice Powell, author of the lead opinion in Bellotti, joined the H.L. majority opinion “on the understanding that it leaves open the question whether [the statute] unconstitutionally burdens the right of a mature minor or a minor whose best interests would not be served by parental notification.” Id. at 414 (Powell, J., concurring), citing id. at 412 n.22. The majority refused to “assume that the statute, when challenged in a proper case, will not be construed also to exempt demonstrably mature minors.” Id. at 406 (opinion of the Court). The same assumption cannot be made here. Indiana’s statute permits bypass of the notice requirement based on best interests but not based on maturity. See Ind. Code § 16-34- 2-4(d), (e). We have to assume that the textual difference was intentional. In other cases, the Court has upheld parental notice statutes based on the rationale that a parental notice statute that contains both a maturityand best-interests-based bypass is necessarily constitutional. In each case, the Court upheld a statute permitting bypass based on either maturity or best interests. Wicklund, 520 U.S. at 294 (Montana statute with notice bypass based on maturity, evidence of abuse, or notice not being in minor’s best interests); Hodgson v. Minnesota, 497 U.S. 417, 497 (1990) (Kennedy, J., concurring in judgment) (upholding Minnesota parental notice requirement with bypass based on maturity or abortion without notice in minor’s best interests); Akron Center, 497 U.S. at 508, 510–11 (upholding Ohio parental notice requirement with bypass based on maturity, abuse, or notice not in best interests). We have taken the same approach. Zbaraz, 572 F.3d at 374, 380 (upholding Illinois parental notice requirement with bypass based on maturity or best interests). 32 No. 17-2428 equally to parental notice statutes “remains unanswered by the Supreme Court and the Seventh Circuit,” but held that Bellotti “must” apply. Planned Parenthood, 258 F. Supp. 3d at 945–46. Although we otherwise agree with the district court’s undue burden analysis, we aﬃrm without deciding this question at this preliminary injunction stage.9 9There is certainly support in the case law for the district court’s conclusion. Five Justices in H.L. signaled that Bellotti should apply to notice bypass statutes. 450 U.S. at 420 (Powell, J., joined by Stewart, J., concurring) (“In sum, a State may not validly require notice to parents in all cases, without providing an independent decisionmaker to whom a pregnant minor can have recourse if she believes that she is mature enough to make the abortion decision independently or that notification otherwise would not be in her best interests.”); id. at 428 n.3 (Marshall, J., joined by Brennan and Blackmun, JJ., dissenting) (exception to parental notice required for emancipated minors, mature minors, and minors for whom notice would not be in minor’s best interests). And the Akron majority observed that notice of a bypass proceeding without any exception for a mature or emancipated minor would be unconstitutional. City of Akron v. Akron Center for Reproductive Health, Inc., 462 U.S. 416, 441 n.31 (1983). The Sixth Circuit had upheld the ordinance’s notice requirement, though, and the petitioners did not challenge that ruling. Id. at 439 n.29. At least two other circuits have applied Bellotti to parental notice requirements. See Causeway Medical Suite v. Ieyoub, 109 F.3d 1096, 1112 (5th Cir. 1997) (declining to read the Supreme Court’s silence as a holding that Bellotti does not apply to parental notice statutes), overruled on other grounds, Okpalobi v. Foster, 244 F.3d 405, 427 n.35 (5th Cir. 2001); Planned Parenthood v. Miller, 63 F.3d 1452, 1460 (8th Cir. 1995) (“In short, parentalnotice provisions, like parental-consent provisions, are unconstitutional without a Bellotti-type bypass.”). At least one other circuit has gone the other way. Planned Parenthood of the Blue Ridge v. Camblos, 155 F.3d 352, 373 (4th Cir. 1998) (“[W]e hold that a notice statute that [includes at least the Hodgson ‘best interest’ exception] need not include, in addition, a bypass for the mature minor in order to pass constitutional muster”). No. 17-2428 33
Planned Parenthood showed a suﬃcient likelihood of succeeding on the merits to support the district court’s injunction. The district court also did not abuse its discretion in concluding that Planned Parenthood satisfied the other requirements for a preliminary injunction. First, Planned Parenthood demonstrated a likelihood of irreparable harm. In applying the undue burden standard to a restriction on abortion, it is hard to separate the merits from irreparable harm. As discussed above, the record supports the conclusion that young women would suﬀer irreparable harm if injunctive relief were denied. See Doe v. Mundy, 514 F.2d 1179, 1183 (7th Cir. 1975) (enforcement of hospital policy would violate right to privacy and cause irreparable harm); see also Christian Legal Society v. Walker, 453 F.3d 853, 867 (7th Cir. 2006) (presumption of irreparable harm applies to First Amendment violations); 11A Charles Alan Wright & Arthur R. Miller, Federal Practice and Procedure § 2948.1 (3d ed.) (“When an alleged deprivation of a constitutional right is involved, such as the right to free speech or freedom of religion, most courts hold that no further showing of irreparable injury is necessary.”). Planned Parenthood also does not have an adequate legal remedy. The State has not argued otherwise. Instead, it argues that a pregnant minor seeking a judicial bypass could challenge an adverse notification ruling by raising a constitutional challenge in an expedited appeal after the bypass proceeding. Given the time pressures at work in such cases, we reject that alternative as an insuﬃcient answer to the burdens here. See Fleet Wholesale Supply Co. v. Remington Arms Co., 846 F.2d 1095, 1098 (7th Cir. 1988) (irreparable injury implies inadequacy of 34 No. 17-2428 legal remedies); see also 11A Wright & Miller § 2944 (“Probably the most common method of demonstrating that there is no adequate legal remedy is by showing that plaintiﬀ will suffer irreparable harm if the court does not intervene and prevent the impending injury.”). Because Planned Parenthood satisfied these threshold showings, the district court also balanced the equities and considered whether an injunction would be in the public interest. Planned Parenthood, 258 F. Supp. 3d at 955. The district court’s conclusions on these points were well within the bounds of its discretion. The district court did not err on the balance of harms. The more likely it is that a plaintiﬀ will win on the merits, the less the balance of harms needs to weigh in the plaintiﬀ’s favor. Planned Parenthood v. Van Hollen, 738 F.3d 786, 795 (7th Cir. 2013); Planned Parenthood of Indiana, Inc. v. Commissioner, 699 F.3d 962, 972 (7th Cir. 2012); Abbott Laboratories v. Mead Johnson & Co., 971 F.2d 6, 11–12 (7th Cir. 1992). On this record, Planned Parenthood’s likelihood of success on the merits is substantial. A final judgment in Planned Parenthood’s favor would not undo the irreparable harm to which its patients would have been subjected in the meantime, absent the injunction. It was within the district court’s sound discretion to weigh those consequences more heavily than any irreparable harm the State faces by delay in implementing its statute. The district court also did not err on the public interest analysis. 258 F. Supp. 3d at 955, citing Planned Parenthood of Indiana & Kentucky, Inc. v. Commissioner, 984 F. Supp. 2d 912, 931 (S.D. Ind. 2013). Because Planned Parenthood has shown that it is likely to succeed on the merits and that the balance of harms favors the injunction, those showings weigh more No. 17-2428 35 heavily in the balance than the State’s interest in enforcing a law that Planned Parenthood has shown is likely unconstitutional. See, e.g., Preston v. Thompson, 589 F.2d 300, 306 n.3 (7th Cir. 1978) (injunction in public interest where continuing constitutional violation is proof of irreparable harm). For all of these reasons, the district court’s preliminary injunction barring enforcement of the new parental notice requirement in Ind. Code § 16-34-2-4(d) and (e) is AFFIRMED. 36 No. 17-2428