A panel of judges in North Dakota's state Supreme Court has upheld a law that makes it a felony crime to perform an abortion in the state.
The decision reverses a lower court's ruling temporarily blocking the new law. The ruling on Friday came after three of the court's five justices ruled that the law was invalid, however, it required the support of four justices to strike it down.
Violating the state law comes with a penalty of up to five years in prison and a fine of $10,000 (£7,600).
The US Supreme Court overturned a federal right to abortion in 2022, leaving it up to states to regulate. North Dakota now joins 12 other states that have passed total bans on abortion.
The decision comes after the law was challenged by an abortion clinic in the state. Courts had ruled that the ban could not go into effect while the legal case was ongoing.
The law contains exceptions if the mother's life is threatened, though rape and incest victims are only eligible for an abortion during the first six weeks of pregnancy - which opponents argue is before many women know they are pregnant.
In their ruling, the judges found that the state constitution does not provide a right to an abortion, and that the new law "provides adequate and fair warning to those attempting to comply".
North Dakota's Republican Attorney Drew Wrigley praised the ruling, saying in a statement that the high court "has upheld this important pro-life legislation, enacted by the people's Legislature".
"The Attorney General's office has the solemn responsibility of defending the laws of North Dakota, and today those laws have been upheld."
The Red River Women's Clinic - which was the last abortion provider in North Dakota before moving to Minnesota in 2022 - has not yet reacted to the ruling.