State Abortion Laws in the Wake of Roe v. Wade

Roe v. Wade, the landmark 1973 case that established a constitutional right to an abortion up until the fetus can survive outside of the womb, was the law of the land for nearly 50 years. But over a year ago, the Supreme Court overturned the almost half-century old precedent.

Dobbs v. Jackson Women’s Health Organization was a challenge to a Mississippi law banning abortion after 15 weeks of pregnancy that experts say stands in direct opposition to what the Supreme Court decided in Roe – that states may not ban abortion prior to fetal viability, which is generally understood by experts to mean between 22 and 24 weeks of pregnancy. But in a 6-3 decision in June 2022, the conservative supermajority on the high court sided with Mississippi, upholding its ban in a massive reversal of precedent.

Following the ruling, states have been left to decide their own stances on the controversial issue. While legislators have worked to introduce a number of new restrictions and bans over the last year, questions over the legality of these new laws has meant many are blocked from taking effect while they’re debated in state courts. The new landscape is volatile, and the evolving situation has meant that access to abortion in some states is restricted, in part, by complexity alone.

In January 2023, the U.S. Food and Drug Administration finalized a rule change allowing pharmacies such as CVS and Walgreens to begin offering abortion pills in qualifying states. The move could increase access to the pills at both physical stores and online pharmacies, and has sparked legal questions, particularly in the most restrictive states. An analysis by the Guttmacher Institute, a research group that supports abortion rights, found that medication abortion – often a two-drug combination of mifepristone and misoprostol – accounted for more than half of all facility-based abortions in 2020.

Legal debates over access to abortion medication were elevated to the Supreme Court on April 14, 2023, after two conflicting rulings on separate cases were both issued a week earlier. In one case, a Texas federal judge ruled that the FDA overlooked “legitimate safety concerns” when approving mifepristone, and ruled that access to the drug be suspended. In the other, a Washington state federal judge ruled that the FDA cannot restrict access to the drug in any of the 17 states that sued to expand access. In early May, abortion clinics in Virginia, Montana and Kansas – none of which are included in the 17 states – filed a lawsuit in an attempt to preserve access to the drug in their states as well, but the judge in that case has declined to issue a preliminary injunction, and intends to wait for the outcome of related cases before a decision is reached.

The U.S. Supreme Court intervened quickly to block the Texas ruling in its entirety back in April, meaning access to mifepristone will not be immediately affected or further restricted. The case then went back to the U.S. Court of Appeals for the 5th Circuit, which ruled in August that while the FDA’s approval of mifepristone could remain intact, the drug can no longer be mailed, must be administered in the presence of a physician and will only be legal through the seventh week of pregnancy. The Biden administration is appealing, and no changes, either as a result of the Texas or Washington rulings, will take effect until the Supreme Court weighs in again, possibly during its current term, which lasts till June.

If mifepristone is taken off the market, medication-assisted abortion will remain available through misoprostol-only regimens, which are said to be somewhat less effective than the two-drug combination.

Here’s where things stand in states as of Oct. , 2023, and how state policy is expected to change, according to the Guttmacher Institute:

Jump to State:

Abortion banned, except in cases where “abortion is necessary in order to prevent a serious health risk to the unborn child’s mother.”

While state law specifically exempts patients from prosecution, Republican Attorney General Steve Marshall indicated he will pursue prosecution against providers under the Human Life Protection Act. In August, Marshall stated that people who help others travel out of state to obtain abortions could be prosecuted, a statement which has since prompted several lawsuits against the state with claims such prosecution violates the constitutional right to travel freely between states.

Abortion legal throughout pregnancy.

Abortion is legal up to 15 weeks *

* A law is currently blocked that would ban abortion except to save the life of a pregnant woman. An Arizona court ruled in late December that an 1864 law banning nearly all abortions cannot be used to prosecute licensed providers. However, the state Supreme Court will review that ruling. In June 2023, Democratic Gov. Katie Hobbs signed an executive order that added protections for abortion providers in the state. The order also stated that Hobbs will deny extradition requests from states seeking to prosecute those who “provide, assist with, seek or receive abortion services.” Finally, the order also gives Democratic Attorney General Kris Mayes the power to handle all abortion-related prosecutions in the state.

Voters passed a state constitutional amendment that says “the state shall not deny or interfere with an individual’s reproductive freedom in their most intimate decisions.” This enshrines the right to abortion and contraception, but it is unclear whether this will override current restrictions. The state has also launched a hotline that will provide callers with legal help surrounding abortion access. In September, California’s attorney general announced he is suing several crisis pregnancy centers in the state for advertising progesterone as an “abortion pill reversal,” something that is explicitly banned in Colorado.

Abortion legal throughout pregnancy.

On April 14, Democratic Gov. Jared Polis signed a series of bills into law that aim to make the state a “safe haven” for those seeking abortion, gender-affirming surgery and puberty-blocking medications without fear of prosecution. The legislation means Colorado joins Illinois as “a progressive peninsula offering reproductive rights to residents of conservative states on three sides,” according to the Associated Press. Additionally, the state became the first to ban the prescription of progesterone as a “reversal” of medication abortion. It is illegal to approach anyone within 100 feet of a Colorado health care facility, including abortion clinics, due to a state “bubble law,” but that law is being challenged in a federal lawsuit. In November, voters may have the chance to decide to enshrine abortion rights into the state constitution, and to lift a 40-year-old ban on abortions funded by state dollars.

Abortion legal up to fetal viability.

Abortion legal up to 15 weeks of pregnancy.

In Florida, those seeking abortion pills must see a physician in-person 24 hours before the procedure and must take some of the medication in their physician’s presence, meaning that the state will not allow pharmacists alone to remotely fill prescriptions for abortion pills, despite the January Food and Drug Administration ruling. In September the Florida Supreme Court heard legal challenges to a state law banning abortions after 15 weeks. The ban will remain in effect until a decision is reached. However, if the state Supreme Court upholds the 15-week ban, a six-week ban will take effect 30 days later because of a bill signed into law by Republican Gov. Ron DeSantis in April 2023. Right now, the language in the six-week ban states that “any person who willfully performs or actively participates in a termination of pregnancy” could face felony charges. On the presidential campaign trail, DeSantis has stated that only providers could face felony charges, not patients, and some lawmakers are moving to solidify that interpretation. Meanwhile, efforts to put an abortion rights amendment on the 2024 ballot have reached enough signatures for it to be reviewed by the state Supreme Court..

Abortion legal up to detection of a fetal heartbeat, as early as six weeks of pregnancy.

The Georgia Supreme Court reinstated a ban just days after a lower court ruling had made abortions legal up to 22 weeks of pregnancy. However, in early April, the state Supreme Court heard arguments that the ban was void because it invalidated precedent when it was passed.

Abortion legal up to fetal viability.

Democratic Gov. Josh Green signed a bill into law which expands abortion access by a number of measures. The new law removes the requirement that abortions must take place in a hospital or clinic, expanding access to medication-assisted abortions which often take place at home. It is now legal for medical providers such as physician assistants to perform the procedure, when only doctors or registered nurses were licensed to do so previously. Additional protections for providers treating out-of-state patients are also included in the law.

Abortion banned except in cases of rape or incest reported to law enforcement or when the procedure is “necessary to prevent the death of the pregnant woman.”

In April, Republican Gov. Brad Little signed a bill that makes it illegal for an adult to help a minor get an abortion without parental consent, even if the abortion happens out of state. Opponents have mounted a legal challenge to the law, which is the first of its kind in the U.S., arguing it violates freedom of speech, right to travel and right to freely associate. Arguments in the lawsuit were heard in early September, with a ruling expected in a few weeks.

The Idaho Supreme Court ruled earlier this year that access to abortion is not a fundamental right in the state Constitution. The state’s “Defense of Life Act,” a trigger ban that took place 30 days after Roe v. Wade was overturned, says that abortions are legal to prevent the death of a pregnant woman, but not explicitly to prevent serious jeopardy to her health. President Joe Biden’s administration sued the state last year, arguing that the ban interfered with a federal law on emergency care. A U.S. district court judge temporarily blocked the ban from taking effect, writing that abortions should be legal not only to prevent death, but also to avoid “serious jeopardy” for the patient and to avoid risking “serious impairment to bodily functions.” However, a recent ruling put that block on hold, meaning abortions are currently only legal to prevent death, while the court considers an appeal. Meanwhile, the “Defense of Life Act” also states that if a health care professional in the state “assists in performing or attempting to perform an abortion,” their license will be suspended or revoked. According to the state attorney general’s interpretation, referring patients to out-of-state abortion services would count as assisting an abortion, but a federal judge ruled that interpretation would violate free speech for providers.

Abortion legal up to fetal viability.

In January, state lawmakers approved additional protections for the procedure, ensuring providers and out-of-state patients will not be prosecuted across state lines.

Abortion banned with very limited exceptions.

*In September 2022, an Indiana judge blocked enforcement of a law that would ban abortion with very limited exceptions in the state due to arguments the ban violated a constitutional right to privacy. The case was elevated to the state Supreme Court, which ruled in late June that the ban was not in violation of the constitution and therefore could be upheld. The state American Civil Liberties Union filed a petition the next day, requesting a rehearing, but the request was denied, and the law took effect Aug. 21. With the new ban in effect, all abortion clinics in the state have lost their license, and abortions are illegal with limited exceptions for rape, incest, the health of the mother and for cases of lethal fetal anomalies. A second lawsuit, challenging the law on the grounds of religious freedom, is currently being considered by the state’s appeals court, which is scheduled to hear arguments in September. The state’s attorney general is suing Indiana’s largest hospital system for violating patient privacy laws after a doctor shared her story after treating a 10-year-old rape victim who travelled from Ohio for the procedure.

Abortion legal up to 22 weeks of pregnancy.

A law passed in July that would make abortion illegal after a fetal heartbeat is detected, typically at about six weeks, has been temporarily blocked from taking effect. Gov. Reynolds called a special legislative session this summer to pass the fetal heartbeat bill with exclusive Republican support. A similar ban was initially blocked by a permanent injunction in 2019, and in June 2023 the state Supreme Court ruled that the ban would remain blocked in-part because the justices wanted to avoid “legislating from the bench.” Therefore, the new ban is already meeting similar legal challenges, and Gov. Reynolds has moved to appeal the temporary block, wanting the law to take effect even while its constitutionality is debated in court.

Abortion legal up to 22 weeks of pregnancy.

In an August 2022 statewide referendum, Kansans voted to uphold the right to an abortion. The following November, a state judge blocked the state from enforcing a ban on telemedicine for abortion care, which is now available in the state. Earlier this year, state lawmakers passed several bills, including House Bill 2313, a “born-alive infants protection” law that could prosecute providers for not giving enough care to infants born alive during abortion procedures, and House Bill 2264, a bill that will require providers of medication-assisted abortion to inform patients that the procedure can be reversed after it is started, despite evidence that may not be true. Democratic Gov. Laura Kelly originally vetoed both, but lawmakers had the power to override her vetoes. House Bill 2264, which was supposed to take effect July 1, is not being enforced for the time being, in part due to an active lawsuit against it by Planned Parenthood.

Abortion banned, except when necessary “to prevent the death or substantial risk of death due to a physical condition, or to prevent the serious, permanent impairment of a life-sustaining organ of a pregnant woman.”

In November 2022, voters rejected a ballot proposal that would amend the state constitution to explicitly state that there is no right to abortion in Kentucky, but the statewide ban remains in effect after the Kentucky Supreme Court sent a case challenging the ban back to a lower court. In December, a federal appeals court ruled that the enforcement of a buffer zone around health care centers per a city ordinance in Louisville infringes on protesters’ First Amendment rights. In November, voters will decide whether to support incumbent Democratic Gov. Andy Beshear or Daniel Cameron – the Republican gubernatorial nominee and current state Attorney General. Abortion has been highlighted as a central issue to the race, with Cameron a staunch anti-abortion activist and Beshear’s views more moderate.

Abortion is banned except in the case of medical emergency or if the pregnancy is “medically futile.”

In May, lawmakers rejected legislation which would have added exemptions for cases of rape or incest to the state’s ban.

Abortion legal up to fetal viability.

Currently, the state law has an exception that allows abortions after fetal liability, typically at 24 weeks, in cases where it is necessary to preserve the life or health of the mother. However, a bill that would expand this exception to include cases where a physician believes it is necessary, such as when a fetus is determined to have a deadly condition, was signed into law by Democratic Gov. Janet Mills in July, and is scheduled to take effect in late October. It will mean Maine has one of the least restrictive abortion policies in the country.

Abortion legal up to fetal viability.

A constitutional amendment that would enshrine the right to an abortion in the state constitution passed the Maryland House and Senate, meaning it will go before voters in November 2024. Democratic Gov. Wes Moore signed a series of additional protections into law in May, including legal protections for patients and providers, a data privacy bill and another bill that ensures access to contraception and abortion for students attending public colleges or universities in the state.

Abortion legal up to fetal viability*

On election day, voters enshrined the right to an abortion via an amendment to the state constitution, rendering a pre-Roe abortion ban unconstitutional. A bill which would make it illegal for companies to discriminate against employees who have received abortions was signed by Democratic Gov. Gretchen Whitmer in May, and will take effect next year.

Abortion is not restricted based on gestational age.

Just one month into the state’s new legislative session, after quick action by the state’s Democratic lawmakers, Democratic Gov. Tim Walz signed a bill into law that establishes that “every individual has a fundamental right to make autonomous decisions about the individual’s own reproductive health” in the state. In late April, Walz signed additional legal protections into law for patients from out-of-state and for providers. While abortion was previously legal up to fetal viability in the state, with some exceptions, the latest legislative session amended that law to make abortion legal at any point of pregnancy. Abortions performed beyond likely viability are legal if they are performed in a hospital or if a physician says it is necessary for the life or health of the mother.

Abortion banned except when “necessary for the preservation of the mother’s life or where the pregnancy was caused by rape” that was reported to law enforcement.

Republican Gov. Tate Reeves signed into law a measure that guarantees access to Medicaid to mothers for a full year after giving birth, a move increasingly common in red states. Additional bills signed by the governor also seek to improve foster care, the adoption process and care for pregnant women, which he says will “build a culture of life” in the state.

A ruling in late 2022 determined that the state cannot restrict public funds from going to Planned Parenthood, a decision that will now go before the state Supreme Court after the state attorney general filed an appeal in early September. In 2024, Missouri voters could decide whether to enshrine abortion rights and access to birth control in the state constitution if the associated proposals gather enough signatures. However, the process has been severely delayed by debates over what those amendments would cost the taxpayer, and by disagreements over the wording voters would see. Meanwhile, the pro-abortion rights campaign has lost more than 100 days they could have spent gathering signatures in support of the ballot proposal while the disagreements are ongoing.

Abortion is legal up to 15 weeks of pregnancy.

Montana’s Republican Gov. Greg Gianforte recently signed five bills related to abortion access into law, listed below for clarity. The situation is volatile, with Planned Parenthood challenging several of the laws and several others temporarily blocked as their legality is debated in court.

  • House Bill 721: This bill took effect immediately on May 16 after it was signed by the governor, banning the most common abortion method, which uses dilation and evacuation procedures, after 15 weeks of gestation. However, a judge has temporarily blocked the bill from taking effect. Because medication abortion is typically not recommended after 10 weeks of pregnancy, this bill may severely restrict abortions after 15 weeks, overwriting the state’s previous law at fetal viability, typically around 24 weeks.  
  • Senate Bill 154: The bill states that the right to privacy protected by the state constitution does not include the right to an abortion. 
  • House Bill 575: The bill requires providers to define how they calculate gestational age and “viability,” and patients to get an ultrasound before the procedure. 
  • House Bill 625: The bill states that life-saving care must be provided to newborns after attempted abortions. This bill is similar to one voters rejected on the November ballot, but has rolled back penalties for providers and clarifies that care is not mandated for infants with serious health conditions for whom death is inevitable.
  • House Bill 544: The bill requires patients to get prior authorization if they want Medicaid insurance to cover abortion. This law would also only allow physicians to perform the procedure, despite a 1999 ruling by the state Supreme Court which also allowed physician assistants to provide abortion care. The state Supreme Court recently ruled that qualified nurses and midwives can also be providers.

In April, the state health department announced a rule similar to House Bill 544, mandating prior authorization, but the rule has since been temporarily blocked. Some argue that preauthorization mandates are unnecessary and adversely affect low-income women. The legality of the health department rule, and of the recently signed laws, were discussed at a hearing in May, resulting in a number of temporary blocks, until courts decide which, if any, of the laws are constitutional.

Yet another bill, House Bill 937, was set to take effect Oct. 1, but has been partially blocked by a temporary restraining order. The law would mandate that all state abortion clinics get licenses from the Montana Department of Public Health and Human Services, and in order to obtain the license, they must follow specific rules about staffing, equipment and architecture. Because the state has not yet decided on these rules, however, two clinics sued over the law and are seeking a preliminary injunction.

Abortion legal up to 12 weeks of pregnancy.

Nebraska lawmakers passed a bill in May that bans abortion at 12 weeks. The same bill also prohibits gender-affirming care for minors in the state. The new abortion ban took effect immediately, and though the ACLU sued to block the law, a district judge sided with the state, upholding it.

Abortion legal up to 24 weeks of pregnancy.

A bill that will strengthen protections for out-of-state abortion patients and for the providers that treat them was signed into law by Republican Gov. Joe Lombardo in May. A separate bill that would put protections for abortion into the state constitution was advanced by lawmakers in the same month, and if lawmakers pass it again in 2025, voters must support the measure on the 2026 ballot before it can be added to the state constitution. Per Nevada law, if the constitutional amendment is passed, the governor will not be able to veto it.

The New Hampshire Senate recently rejected a bill that would have codified the right to an abortion into state law, a right some argued was already protected by the existing law. Legislators in the House tabled a bill that would have repealed the ban at 24 weeks of pregnancy, following a 192-192 tie vote, and rejected a series of bills that would have implemented additional restrictions on abortion access, in a win for abortion rights advocates.

New Jersey
Abortion legal throughout pregnancy. In January the state announced that it will award $15 million to health care facilities with abortion services, in the form of zero-interest loans and grants, for facility improvements and updated security. Starting in September, the state also mandated all employers of 50 or more in the state to include coverage for abortions in employer-provided health plans.

In March, Democratic Gov. Michelle Lujan Grisham signed a bill that overrides local ordinances in which lawmakers have attempted to limit access to abortion. The state Supreme Court blocked local ordinances from taking effect in March, with plans to hear arguments about their legality in December. Outside of legislation surrounding local ordinances, the governor also signed a bill that provides legal protection to abortion providers treating patients from out-of-state, and set up a telephone hotline as a resource for women with questions about abortion, transportation and other maternal health queries.

New York
Abortion legal up to fetal viability.

In mid-January, New York City became the first U.S. city to offer free abortion pills at a city-run health clinic in an effort to reduce barriers to care in low-income communities. In June, Democratic Gov. Kathy Hochul signed a law that protects doctors prescribing abortion pills to out-of-state patients from prosecution. In 2024, voters will decide whether to ratify a state constitutional amendment that could add protections for reproductive rights. Anti-abortion activists are challenging a state “buffer zone” law that prohibits anti-abortion activists from approaching people outside abortion clinics, and it may be brought to the Supreme Court after an appeals court rejected the lawsuit. Meanwhile, the state Attorney General has sued anti-abortion groups for violating this law and prohibiting access to clinics across the state.

As of July 1, most abortions are banned after 12 weeks, as opposed to 20, as was previously the case. Democratic Gov. Roy Cooper attempted to veto the bill, but lawmakers were able to override the veto. Notably, state Rep. Tricia Cotham switched her party registration from Democrat to Republican in April, swinging the House into a Republican supermajority and enabling lawmakers to override the governor’s veto. The new law includes exceptions for when the life of the pregnant woman is in danger, exceptions for rape or incest through 20 weeks of pregnancy and exceptions for “life-limiting” fetal anomalies through 24 weeks.

In late September, two provisions in the current law were blocked from taking effect due to an ongoing lawsuit by Planned Parenthood. The first provision would require surgical abortions after 12 weeks to be performed in a hospital, rather than in a clinic. The second provision would require doctors to document the existence of a pregnancy in the uterus before they prescribe medication abortion, which some say was aimed at ensuring the pregnancy was not ectopic. Because ultrasounds cannot locate an embryo in the earliest stages of pregnancy, however, that law would effectively prohibit all medication abortions in early pregnancies. The second provision was originally blocked in June, but the block has been extended as a part of the current preliminary injunction.

Republican Gov. Doug Burgum signed legislation in April that bans abortion throughout pregnancy, with exceptions for rape, incest or medical emergency only applicable in the first six weeks. A similar ban was blocked by the North Dakota Supreme Court in March after a lawsuit questioned its constitutionality. The new law bans abortion except “to terminate a pregnancy that resulted from gross sexual imposition, sexual imposition, sexual abuse of a ward, or incest” or “to prevent the death of the pregnant female.” The state’s only clinic moved across the border to Minnesota last year, and is part of a lawsuit challenging the state’s restrictions. Gov. Burgum is a Republican presidential candidate, and has said “the best decisions are made locally” and that he would not sign a federal abortion ban despite his backing of a ban at the state level.

Abortion legal up to 22 weeks of pregnancy*

*A law that would ban abortion after about six weeks of pregnancy is currently blocked by a preliminary injunction. Reproductive rights advocates and abortion providers, including the ACLU of Ohio and Planned Parenthood, filed a lawsuit in 2022 that called the ban unconstitutional, and the state Supreme Court heard arguments in the case in September of 2023. However, before ruling on the constitutionality of the ban, the court will first decide whether doctors and clinics can even legally sue on behalf of patients.

In November, voters will decide whether to pass a state constitutional amendment which would enshrine an individual’s right to make decisions about reproductive health care, such as abortion. After backers of the measure collected signatures in support of the amendment, the Republican-controlled Ohio Ballot Board made changes, such as replacing the word “fetus” with “unborn child.” Advocates sued over the language of the ballot description, calling it misleading, and the court ruled in mid-September that the majority of word choices would stand. Voting ahead of the Nov. 7 election began in September, with the amendment on the ballot. Opponents of the ballot measure have released ads claiming its approval would affect parental rights, legalize infanticide and protect abusers, making arguments that many call misleading.

Abortion banned except when necessary to preserve the life of the woman or if “the pregnancy is the result of rape, sexual assault, or incest that has been reported to law enforcement.”

However, there has been legal debate over when an abortion should be considered “necessary,” and who is allowed to make that call. In late March, 2023, the state Supreme Court determined that abortion is legal if a physician says there is a “reasonable” chance that continuing the pregnancy will endanger the woman’s life, striking previous wording that required physicians to have “absolute certainty.” In March, the court also ruled that the state constitution protects the “inherent right of a pregnant woman to terminate a pregnancy when necessary to preserve her life.” In May, two different bans on abortion, which required a “medical emergency” for doctors to perform the procedure, were deemed unconstitutional by the state Supreme Court, as they conflicted with the language supported by the court in March .

Abortion legal throughout pregnancy.

In June, lawmakers passed updated requirements outlining when parents must be notified if their child is seeking abortion care. The legislation was amended and passed less than a week before the end of the legislative session, after Republican senators staged a six-week walkout, the longest in the state’s history. Language in the bill that would have required student health centers at public universities to provide medication abortions and emergency contraception was dropped.

Democratic Gov. Josh Shapiro has announced plans to cut the state’s contract with “abortion alternative” organization Real Alternatives by the end of the year. For nearly 30 years, under both Republican and Democratic governors in the state, the organization has received millions in taxpayer dollars that it has then distributed to not only abortion counseling centers, but also to maternity homes and Catholic charities that provide food, shelter and clothing to pregnant women. While some argue that the move will prevent the spread of medical disinformation, others fear it will result in fewer resources for pregnant women. In November, voters will elect the next member of the state Supreme Court, and abortion rights look like they will be a central issue in the election. Pennsylvanians will choose between abortion rights candidate Democrat Dan McCaffery and Republican Carolyn Carluccio, who has a history of being anti-abortion. However the election won’t swing control of the court, which is currently at a 4-2 Democratic majority.

Democratic Gov. Dan McKee signed a bill into law in May that will allow state funding to support health insurance, which covers abortions, for state workers and Medicaid recipients.

South Carolina
Abortion legal up to detection of a fetal heartbeat, as early as six weeks of pregnancy.

In late May, Republican Gov. Henry Dargan McMaster signed into law a bill that bans most abortions at the detection of a fetal heartbeat, typically at six weeks of pregnancy. The state Supreme Court voted in August to uphold the ban, despite striking down a similar law in January because it violated the right to privacy. The court has said that the decision to uphold the ban will not be reconsidered despite pleas to do so from Planned Parenthood.

However, Planned Parenthood launched a second lawsuit in September after the court’s decision acknowledged that the law is unclear about the definition of a “fetal heartbeat” and about the number of weeks after which abortion should be restricted. Language in the law defines a fetal heartbeat as “cardiac activity, or the steady and repetitive rhythmic contraction of the fetal heart.” Cardiac activity can be detected as early as 6 weeks into pregnancy, but the fetal heart does not completely form until closer to 9 weeks, so depending on how “or” and the “fetal heartbeat” definition are interpreted, Planned Parenthood is arguing the window for legal abortions should be extended from 6 to 9 weeks. The court said they would leave a decision about interpretation “for another day” but in the meantime, practitioners are likely to opt for the more conservative 6-week interpretation for fear of prosecution.

Meanwhile, the state’s attempt to defund Planned Parenthood is being debated by the 4th U.S. Circuit Court of Appeals, which was asked by the U.S. Supreme Court to reconsider an earlier decision in light of a new federal ruling in a related case.

South Dakota
Abortion banned except when “necessary to preserve the life of the pregnant female.”

Republican Gov. Kristi Noem and the state attorney general have both said they intend to prosecute pharmacists who provide abortion pills to patients.

Abortion banned except when “necessary to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function.”

In April, Republican Gov. Bill Lee signed a bill that would allow doctors to use “reasonable medical judgment” to determine the medical necessity of an abortion to save the mother’s life. Previous versions of the legislation allowed broader exemptions and protections for providers, but were walked back after an anti-abortion lobbying group voiced opposition. State budget writers have said that $20 million of taxpayer dollars will go toward support of crisis pregnancy centers, sometimes called anti-abortion centers, significantly less than the $100 million the governor originally proposed.

Abortion banned with limited exceptions.

In September 2021, the state passed a bill stating that private citizens could sue abortion providers, even when they had no connection to specific cases or patients. However, a December lawsuit testing the policy was tossed, setting the precedent that members of the public, unaffiliated with specific cases, cannot sue providers for violating state restrictions. Meanwhile, lawmakers passed multiple bills in the last legislative session, the first since the Dobbs ruling, that will provide support for college students in the state who have children. The state is also suing Planned Parenthood for fraud.

A lawsuit against the state brought by the Center for Reproductive Freedom argues that, given uncertainty around the current legal landscape, “physicians are over-complying with the laws to the detriment of their patients’ lives and health.” A bill clarifying the instances in which life-saving care to save the mother is legal was passed in June. The bill, which legalized abortions in specific cases such as ectopic pregnancy or when the fetus cannot survive, took effect Sept. 1.

Abortion legal up to 18 weeks of pregnancy*

*The state’s trigger ban, which would prohibit abortions throughout pregnancy except for in cases related to the health of the mother, rape, incest or severe fetal abnormalities, is temporarily blocked by a preliminary injunction. The state Supreme Court, which currently holds a female justice majority, heard arguments for and against the ban in early August. Pending their decision, the ban could remain blocked or could take effect in a matter of days or weeks. Meanwhile, the state’s legislature passed a joint resolution that may affect whether the preliminary injunction holds. The state has also pursued a ban on abortions indirectly through a law that prevents abortion clinics from obtaining or renewing licenses to practice. The law was blocked one day before it was about to take effect amid legal challenges, but if it does take effect, no clinic will have an active license to operate as of January 2024. Nearly all abortions in the state, 95%, are provided through specialized clinics.

Abortion legal throughout pregnancy.

While the right to abortion has been protected by law in Vermont, voters passed Proposal 5 on election day via a statewide referendum. In December 2022, Republican Gov. Phil Scott signed an amendment protecting the right to “personal reproductive autonomy” into the state constitution. In May the state became the first to explicitly protect access to medication abortion, and two separate bills, Senate Bill 37 and House Bill 89, were signed into law, providing additional protections to both patients and providers.

Abortion legal up to the third trimester.

In January, Democratic lawmakers voted down a series of bills in the state Senate that would have imposed additional restrictions on abortion access, including one which proposed a ban on abortions after 15 weeks.

In April, a Washington federal judge heard arguments in a case brought by 17 state attorneys general to keep mifepristone legal. Shortly after, the judge ruled that access to abortion drugs should not be federally regulated at all in the 17 states participating in the suit, a decision that conflicts with a same-day ruling issued by a Texas federal judge. In the meantime, Washington state officials have stocked up on a three-year supply of mifepristone to ensure access, prompting several other states to stockpile as well.

West Virginia
Abortion banned, with exemptions for rape, incest and when medically necessary to save the life of the mother.

The current ban has exemptions for medical emergencies and for victims of rape or incest, applicable up to eight weeks for adults and up to 14 weeks for those under 18. GenBioPro, the maker of abortion pill mifepristone, attempted to sue the state for restricting access to the drug under this ban. However, in late August, a state judge ruled that the state has the right to restrict sales of abortion pill mifepristone despite the FDA’s approval of mifepristone.

Abortion legal up to 22 weeks of pregnancy

Providers in the state had stopped offering abortion care due to legal uncertainty, but after being closed for more than a year, Planned Parenthood resumed operations in mid September after “confirmation from the Court that there is not an enforceable ban in Wisconsin.”

A law from 1849 took effect when Roe v. Wade was overturned, and banned all abortions except when necessary to save the life of the mother. In July, a county circuit judge ruled that a lawsuit challenging the law could continue, with the judge saying it did not apply to abortions, and two months later, Planned Parenthood resumed operations. The lawsuit, filed by Democratic Attorney General Josh Kaul, is still active in a county court and will likely go before the state Supreme Court, which shifted to a liberal majority for the first time in 15 years in August after a high-turnout April election. Meanwhile, some argue that a 1985 law, which instead criminalizes abortions beyond fetal viability, typically between 22 and 24 weeks of pregnancy, should be in place instead. No matter which law is eventually determined to trump the other, Kaul, who won re-election against an anti-abortion candidate, stated he would not investigate or prosecute anyone for getting an abortion, but local law enforcement can.

Abortion legal up to fetal viability*

*After being temporarily blocked from taking effect in July 2022, the state’s trigger ban took effect for a few days in late March 2023 before a state judge blocked it again amid new legal challenges. The law bans abortion except “when necessary to preserve the woman from a serious risk of death or of substantial and irreversible physical impairment of a major bodily function,” or if the pregnancy is the result of incest or rape. The state became the first to explicitly ban abortion pills through legislation that was scheduled to take effect on July 1, but that law has since been blocked while a related lawsuit is ongoing. There is currently only one in-person clinic operating in the state.

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