While we approach three years post the reversal of Roe v. Wade, domains can be expected to keep proposing and reviewing bills that either enhance or limit access to services related to reproductive health and abortion, as legislative sessions commence once more. Numerous states that strongly advocate for reproductive rights are proposing new legislations seeking to protect individuals partaking in these procedures and their treating physicians. On the opposite end of the spectrum, states that pose more stringent regulations are contemplating the initiation of fetal personhood prohibitions, penalties for usage of abortion pills, and other similar sanctions. Most legislative bodies are due to assemble in the second week of January or later and their sessions usually wind up around the middle of the year.
Throughout his presidential campaign, Donald Trump vocally opposed a federal abortion prohibition and went as far as criticizing a few strict state legislations. However, now the destiny of numerous policies related to federal abortion and associated lawsuits is in the hands of Trump and his chosen committee. Multiple groups opposed to abortion on a national level are lobbying the impending Trump administration to execute a comprehensive range of regulatory actions. These include withdrawing a regulation that mandates emergency healthcare staff to stabilize expecting patients, even if it involves proceeding with an abortion.
Different healthcare organizations contend that measures aimed at limiting abortions through medication, which the U.S. Food and Drug Administration debatably disputes, might inadvertently compromise women’s health. As the new year approaches, multiple bills have been proposed by Democrats in California to protect medication abortion and effectively enforce the state’s affirmative Reproductive Privacy Act. This Act serves to safeguard the right of every individual to autonomously make decisions concerning their reproductive healthcare, free from interference by the government.
There are several bills currently being considered. Assembly Bill 40 is aimed at including emergency abortion and reproductive health services in the ’emergency services and care’ definition; Assembly Bill 45 endeavors to prevent providers from sharing abortion-related medical data of patients with other states, and Assembly Bill 54 aims to indemnify manufacturers and distributors of abortion-pills, as well as healthcare professionals from legal and professional liabilities.
In 2021, Texas implemented a strict ban on abortion, leading to Republican lawmakers and legal authorities signaling a clampdown on abortion drugs common in states having so-called shield laws. These drugs are usually transported via mail to states with robust abortion prohibitions from states providing protection. In November, Pat Curry, an incoming Republican representative from Texas, proposed House Bill 1339. This bill holds similarities to a law executed in Louisiana the previous year, aiming to classify mifepristone and misoprostol as regulated items, despite the FDA affirming the safety of these drugs.
Healthcare service providers have initiated lawsuits in response to the law from Louisiana, citing that the law necessitates stricter storage and documentation protocols leading to potential delays in the procurement of care for patients in critical conditions. Groups opposing abortion keep crafting narratives suggesting that state legislation ought to target abortion medications more stringently as a means to prevent forced or unwanted abortions. An expectation exists that, in 2025, states with bans on abortion will try to incorporate explicit rights for fetuses into the existing law.
In Oklahoma, House Bill 1008, aims to establish protections for unborn children and declaring abortion as a felony crime for healthcare professionals who facilitate the procedure. Meanwhile, in Tennessee, House Bill 26 pronounces that ‘life commences at the moment of fertilization’ and entails that an unborn child is entitled to full and equal protection from violence, similar to any other individual. In addition, House Joint Resolution 7 supports equal protection rights for ‘each human being from fertilization until natural death’.
Opinions on abortion rights in America, as per shared inputs from ballot initiative organizers are not simply divided based on political affiliations. The 2024 presidential election substantiated this fact when Trump-supporting voters also overwhelmingly championed the protection of abortion rights. On the November ballot, ten states had associated policy questions about abortion, out of which seven states voted affirmatively.
The measures concerning abortion were unsuccessful in Florida, Nebraska, and South Dakota—states where Trump’s electoral favor was secured. On the other hand, states such as Colorado, Maryland, and New York, with pre-existing broad abortion access, approved measures to extend these rights further. For instance, Colorado made it mandatory for insurers to cover treatments, Maryland enshrined the right to abortion in its state constitution, and New York banned discrimination rooted in pregnancy.
In a bid to secure a position for an abortion-related ballot question during the midterms in 2026, at least one state is making efforts. North Dakota, currently in a state of uncertainty following a ruling from a district judge in September, had its abortion ban declared as unconstitutional. The state’s Supreme Court is in the course of hearing arguments to decide on the legality of abortions while the appeal is still under deliberation.
In the midst of this legal turmoil, Professor of Medicine and Republican state representative, Eric Murphy, proposed a bill asserting to provide a science-based middle ground concerning abortion access within the state. While certain states persist in their focus on restrictions related to abortion, others are shifting their attention towards enhancing maternal healthcare provisions. This includes particularly focusing on people of color and those residing in rural areas, as well as reinforcing protections for individuals within states having access to abortion services.
In Michigan’s Senate, a bundle of eight bills named ‘Momnibus’ made progress. These are geared towards improving healthcare outcomes for expectant mothers and reducing racial disparities in health outcomes during pregnancy. One of these, Senate Bill 819, calls for obligatory reporting of incidents of obstetric violence or racism by a government body. The legislative assembly is also working towards passing a bill safeguarding data related to reproductive health care.
Lawmakers in Virginia are getting ready to review bills related to maternal health care, which propose remote monitoring services for high-risk patients in rural areas, along with a growth in Medicaid. Kentucky is witnessing efforts to establish specific insurance coverage periods extending to two years after childbirth, employing more people of color in medical teams, recruiting additional doula workers for care teams, and more.
Furthermore, Texas legislators may deliberate on a suite of suggestions aimed at addressing maternal health care in rural regions. A staggering nearly half of all counties in Texas currently do not provide any maternity care services. A bill has been released in New Jersey that would permit employees to take leave ranging between seven to twenty-one days for a child’s death, miscarriage, stillbirth or other associated reproductive losses. This bill will face one more round of review in the state senate.