Abortion Law In America: Understanding The Complex Landscape

Abortion law in the United States has been a divisive issue in politics and culture wars. In June 2022, the Supreme Court's decision to overturn Roe v. Wade gave individual states the power to regulate any aspect of abortion not preempted by federal law. Since then, 14 states have made abortion illegal, while four have banned the procedure after roughly six weeks of pregnancy.

The legality of abortion and the various restrictions imposed on the procedure vary significantly depending on the laws of each state or other jurisdiction. Some states prohibit abortion at all stages of pregnancy, with few exceptions, while others permit it up to a certain point in a woman's pregnancy. In states where abortion is legal, several classes of restrictions on the procedure may exist, such as parental consent or notification laws, requirements that patients be shown an ultrasound before obtaining an abortion, mandatory waiting periods, and counseling requirements.

Abortion laws by state

In June 2022, the US Supreme Court overturned Roe v. Wade, which had protected the federal constitutional right to abortion. The decision gave states the power to restrict or prohibit abortion. As a result, abortion laws vary significantly across the US.

States with a right to abortion

As of 2024, the following states have a right to abortion in their state constitutions, either explicitly or as interpreted by the state supreme court: Alaska, California, Illinois, Kansas, Michigan, Minnesota, North Dakota, Ohio, and Vermont. Other states, such as Colorado, Massachusetts, and New York, protect abortion under state law.

States with trigger laws

Thirteen states have trigger laws, which effectively ban abortion, in place. These include Alabama, Arizona, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia.

States with gestational limits

Some states allow abortion up to a certain point in the pregnancy. Arizona bans abortion after 15 weeks, Florida and Iowa after 6 weeks, and Nebraska after 12 weeks.

States with other restrictions

Some states that allow abortion have other restrictions in place, such as parental consent or notification laws, mandatory waiting periods, and counselling requirements.

The overturning of Roe v. Wade

On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, the 1973 landmark decision that had protected abortion rights for nearly 50 years. The ruling in Dobbs v. Jackson Women's Health Organization ended the constitutional right to abortion and allowed individual states to regulate any aspect of abortion not preempted by federal law.

The Impact of Overturning Roe v. Wade

The Future of Abortion Rights

The future of abortion rights in the United States is uncertain, with several states enacting laws or holding ballot referendums to protect abortion access. Ten states are scheduled to hold ballot measures on abortion rights during the November 2024 elections, including key battleground states. The overturning of Roe v. Wade has led to a deeply uneven abortion landscape, with access to abortion clinics cut off across much of the South and Midwest but remaining strong on both coasts.

State-by-state abortion rights

In the United States, abortion laws vary from state to state. As of October 2024, 41 states have abortion bans in effect, with only limited exceptions. 13 states have a total abortion ban, while 28 states have abortion bans based on gestational duration.

States with expanded access

California, Illinois, Kansas, Michigan, Minnesota, North Dakota, Ohio, and Vermont have a right to abortion in their state constitutions, either explicitly or as interpreted by the state supreme court. Other states, such as Colorado and Massachusetts, protect abortion under state law.

States with protected access

The right to abortion is protected by state law in 21 states and the District of Columbia, but there are limitations on access to care.

States where abortion is not protected

In these states, abortion may continue to be accessible, but it is not protected by state or territory law. It is unclear whether the legislature in these states will enact a ban.

States with a hostile stance

These states have expressed a desire to prohibit abortion entirely and are extremely vulnerable to the revival of old abortion bans or the enactment of new ones. None of these states have legal protections for abortion.

States where abortion is illegal

As of June 2022, 14 states have made abortion illegal. These states ban abortion outright, with criminal penalties for performing abortions, regardless of gestational age.

History of abortion laws in the US

Abortion was not an issue of significant controversy in the US from the American Revolution to the mid-19th century. Most people held the traditional Protestant Christian belief that personhood began at quickening, which occurs sometime between 18 and 21 weeks. It was legal prior to quickening in every state under the common law.

In 1821, Connecticut became the first state to regulate abortion, outlawing it after quickening. Many states subsequently passed various abortion laws until the Supreme Court decisions of Roe v. Wade and Doe v. Bolton decriminalized abortion nationwide in 1973. The Roe decision imposed a federally mandated uniform framework for state legislation on the subject and established a minimal period during which abortion is legal, with more or fewer restrictions throughout the pregnancy.

In 2022, Roe and Casey were overturned in Dobbs v. Jackson Women's Health Organization, ending protection of abortion rights by the US Constitution and allowing individual states to regulate any aspect of abortion not preempted by federal law.

Abortion restrictions

Abortion laws in the US vary from state to state, with some prohibiting abortion at all stages of pregnancy, some permitting it up to a certain point, and others allowing abortion throughout a woman's pregnancy.

Parental consent laws

Some states require parental consent or notification for minors seeking an abortion. For example, in Florida, parental consent is required for minors under the age of 18.

Ultrasound requirements

In some states, patients must be shown an ultrasound before obtaining an abortion.

Waiting periods

Mandatory waiting periods are common in many states.

Counselling requirements

Some states require patients to receive counselling before obtaining an abortion.

Gestational limits

Many states have introduced gestational limits on abortion, prohibiting the procedure after a certain number of weeks. For example, abortion is illegal in Florida after 6 weeks, with some exceptions.

Criminalisation of self-managed abortion

Some states criminalise people who self-manage their abortion, i.e. end their pregnancies outside of a healthcare setting.

Bans on specific methods

Some states prohibit specific methods of abortion, such as dilation and extraction procedures.

Bans based on reason

Some states prohibit abortion if sought for a particular reason, such as the sex or race of the foetus. However, there is no evidence that people seek abortion care because of these reasons.

Abortion protections

Statutory Protections for Abortion

Some states have passed laws that protect the right to abortion. For example, in April 2022, Colorado passed the Reproductive Health Equity Act, which protects abortion rights and assures that "every individual has a fundamental right to make decisions about their reproductive health care".

State Constitutional Protection

A declaration from the state's highest court affirming that the state constitution protects the right to abortion, separately and apart from the existence of any federal constitutional right. For example, in November 2022, Michigan voters passed a state constitutional amendment that explicitly added the right to abortion and contraception to the Michigan state constitution.

Public Funding for Abortion Care

States are required to provide public funding through the state Medicaid program for abortion care necessitated by life endangerment, rape, or incest. States can also dedicate state-only funding to cover all or most medically necessary abortion care for Medicaid recipients.

Private Insurance Requirements

States can require private health insurance plans that are regulated by the state to contain specific benefits, including abortion coverage.

Clinic Safety and Access

Laws that prohibit, for example, the physical obstruction of clinics, threats to providers or patients, trespassing, and telephone harassment of the clinic, and/or create a protected zone around the clinic.

Abortion Provider Qualifications

Scope of practice for health-care practitioners is regulated by state legislatures and licensing boards. Generally, state legislation does not outline specific medical care that is within or beyond a practitioner's scope of practice. However, many states have treated abortion differently by restricting the provision of abortion to physicians. Other states have taken proactive measures to expand the types of clinicians who may lawfully provide abortion care by repealing physician-only laws or expressly authorising physician assistants, certified nurse midwives, nurse practitioners, and other qualified medical professionals to provide abortion care.

Frequently asked questions