Mike Groll | Associated Press

Historic NY abortion vote

New York lawmakers Tuesday passed the most significant changes in 49 years to the state's landmark law that legalized abortion in 1970.

Gov. Andrew Cuomo says the sweeping legislation is a rare opportunity to update a state law that failed to match protections guaranteed under federal law by the Supreme Court's 1973 ruling in Roe v. Wade.

The state's Reproductive Health Act had been blocked by Senate Republicans for the better part of a decade.

Now with the Assembly and Senate under Democratic control, Cuomo kept a campaign promise to pass the bill and sign it into law in the first 30 days of the legislative session. The governor also wants to include the changes as an amendment to the New York Constitution.

What do the changes mean? What follows is a quick glimpse of how abortion rights will change in New York.

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Hans Pennink | AP

Why now?

The federal law guaranteeing abortion rights has always superseded New York's law. But Cuomo fears that all or part of Roe v. Wade could be overturned by the U.S. Supreme Court's new conservative majority, leaving it to each state to regulate abortion with their own laws.

The Democratic-controlled Assembly has passed the Reproductive Health Act in each session for most of the past decade. But each time, the bill was blocked by the Republican majority in the Senate.

In November, Democrats won a majority in the Senate for only the second time in decades. With Democrats holding 39 seats in the 63-member chamber, new Senate Majority Leader Andrea Stewart-Cousins, pictured above, promised to make the bill a top priority.

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Hans Pennink | AP file photo

A bipartisan history

New York's 1970 law that legalized abortion in the state was a bipartisan effort. The law was co-authored by Assemblywoman Constance Cook, a Republican from Ithaca, and state Sen. Franz Leichter, a Manhattan Democrat.

"I didn't really have a sense at that time that we had done something momentous, though it was long overdue," Cook told The New York Times in April 2000. "Looking back now, it seems like a bigger deal."

The bill passed the Senate on March 18, 1970 by a vote of 31-26.

The Assembly struggled to pass the bill and added an amendment to allow unrestricted abortions up to 24 weeks in a pregnancy. After 24 weeks, abortions were permitted only to save the life of the woman. The bill eventually passed in the Assembly, 76-73.

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Delcia Lopez | File photo

Historic declines in the number of abortions

The effort to update abortion rights in New York comes as abortion rates have declined to historic lows in the state and nation.

New government statistics released in November reported 638,169 abortions nationwide in 2015, the most recent year for which data is available, about half the number recorded in 1980.

The U.S. abortion rate was 11.8 abortions per 1,000 women of child-bearing age in 2015, compared with 15.9 in 2006.

New York reported 119,940 abortions in 2014, the most recent year with available data. That represented a 13 percent decline from 2011, according to the Guttmacher Institute.

Despite the declining numbers, New York's abortion rate of 23.1 per thousand was still twice the national average. About 25 to 27 percent of pregnancies in the state end in abortion. New York ranks among the top three states for the highest rate of unintended pregnancies.

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Kathy Willens | AP

What would change under the new law

Under the rights guaranteed by Roe v. Wade and New York law, all women have the right to an abortion at any time in their first 24 weeks of pregnancy.

After 24 weeks, exceptions can be made under federal law when a woman's life or health is at risk. But the 1970 New York law made exceptions only when a woman's life is at risk.

The Reproductive Health Act changes New York's law to permit abortions after 24 weeks in case where a woman's life or health would be threatened by continuing the pregnancy.

The updated New York law leaves it to doctors to decide when a woman's health is at risk. Opponents argued that the law should have defined what constitutes a threat to a pregnant woman's health.

Republican lawmakers say the change gives too much discretion to doctors, and could open the door to late-term abortions that are not medically necessary.

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Allowing abortions when a fetus is not viable

New York's 1970 law gave women the right to an abortion if a fetus is not viable during the first 24 weeks of a pregnancy.

Under the Reproductive Health Act, a woman will have the right to abortion at any time, including the third trimester, if the fetus is not viable and cannot survive outside the womb.

The change matches the right on fetal viability already guaranteed under Roe v. Wade and subsequent Supreme Court rulings.

Abortion rights advocates noted that New York women sometimes had to travel to other states for an abortion after learning late in their pregnancy that the fetus was no longer viable.

Such late-term abortions are rare. About 1 percent of abortions nationwide are performed after 21 weeks, according to the Guttmacher Institute.

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Hans Pennink | AP file photo

Abortion will be regulated under public health law

Since New York passed its abortion rights law in 1970, it has regulated abortion under criminal law, treating abortion in the third trimester as a felony punishable by up to seven years in prison.

The Reproductive Health Act regulates abortion under public health law, consistent with most states.

Abortion rights supporters say the existing law had a chilling effect on doctors in New York who were reluctant to provide abortions after 24 weeks when the mother's life was in danger or the fetus was no longer viable.

In a widely reported case, one New York woman had to travel to Colorado to terminate her pregnancy when she found out after 31 weeks that the baby she was carrying would not survive outside the womb.

New York Senate Republicans say the new law will limit prosecutors from applying criminal charges in case of domestic violence when a woman loses a child during pregnancy.

The GOP senators introduced "The Liv Act" named after Livia Abreu, an army veteran from the Bronx who was 26 weeks pregnant when her ex-boyfriend stabbed her six times in May 2018. The fetus did not survive.

The Republican bill would treat an assault on a pregnant woman as a felony, even if it does not involve the loss of her pregnancy. Democrats say existing criminal laws do the same thing.

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Dennis Nett | dnett@syracuse.com

Improving access to abortions

The Reproductive Health Act allows licensed nurse practitioners, physician assistants and licensed midwives to provide abortions, in addition to physicians.

The bill's authors say the change is essential for rural parts of the state where women have limited access to doctors and it could take weeks before they can see a doctor.

Opponents say the change extends beyond the scope of Roe v. Wade and will ultimately result in an increase in the number of abortions in the state.

Senate Republicans argued that by allowing non-physicians to perform abortions, it will endanger the health of more women. The bill's sponsors noted that most abortions today occur when a doctor administers a pill to a patient early in a pregnancy.

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Kathy Willens | AP

What happens next

Cuomo promised to sign the Reproductive Health Act into law within the first 30 days of the new legislative session.

The governor, fearing that Roe v. Wade could be overturned by the U.S. Supreme Court's new conservative majority, also wants to make sure it won't be easy to repeal New York's updated law.

Cuomo supports adding the new law as an amendment to New York's constitution. The amendment would have to passed by a separate vote the Legislature, and by a second vote of the Legislature that takes office in 2021.

If that happens, New York voters would be asked to approve the amendment before it could become part of the constitution.

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Doug Mills | File photo

What opponents say

New York's Catholic bishops, including Syracuse Bishop Robert Cunningham, wrote an open letter last week opposing the legislation, claiming it goes beyond protections guaranteed by Roe v. Wade.

"Words are insufficient to describe the profound sadness we feel at the contemplated passage of New York state's new proposed abortion policy," the bishops wrote.

"With an abortion rate that is already double the national average, New York law is moving in the wrong direction," the letter said.

Albany Bishop Edward B. Scharfenberger called the abortion bill a Death Star that would increase the number of abortions in New York.

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Kevin Rivoli | File photo

Expanding other reproductive rights in NY

The focus of New York lawmakers extends beyond abortion. In addition to the Reproductive Health Act, the Assembly and Senate plan to pass a separate bill to expand birth-control coverage.

The Comprehensive Contraceptive Coverage Act "requires health insurance policies to include coverage of all FDA-approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures, contraceptive education and counseling, and related follow up services."

The bill prohibits health insurance companies from imposing cost-sharing requirements for contraception.

Advocates for the bill say it's necessary because about 55 percent of pregnancies in New York are unintended, ranking the state among the top three in the nation for the most unintended pregnancies, according to 2010 statistics.

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Mike Groll | AP

More about abortion rights in NY

New York lawmakers set to pass historic abortion rights law

Cuomo calls for NY constitutional amendment protecting abortion rights

Democrats push to save Roe v. Wade abortion rights in NY

What New Yorkers don't know about Roe

As Supreme Court shifts under Trump, Cuomo vows to expand abortion rights

Abortion rate in U.S. reaches record low