Fight for Abortion Rights Has Turned to States in Years Since Landmark Reproductive Rights Ruling

Fight for Abortion Rights Has Turned to States in Years Since Landmark Reproductive Rights Ruling Since the Supreme Court overturned Roe v. Wade four years ago in the Dobbs v. Jackson case that ended the federal right to abortion, people across the country have felt the fallout, especially in the South and Midwest. Many have had to travel long distances to obtain abortion care in other states. Some have been denied urgently needed care at hospitals. Others have even lost their lives because of abortion bans. Reproductive Freedom Dobbs v. Jackson Women’s Health Organization Reproductive Freedom Dobbs v. Jackson Women’s Health Organization Understandably, people continue to be outraged by this reality and are pushing back. As anti-abortion lawmakers advance increasingly restrictive legislation, their constituents are rallying to stop these dangerous bills. In states that protect abortion, advocates and lawmakers are finding new and creative ways to safeguard abortion access, not just for their own state residents, but for people traveling to their states for care. Voters in states where politicians have restricted abortion rights have gone to the ballot to protect their ability to get the care they need. Attacks on Abortion in the States are Not Slowing Down This legislative session, lawmakers in states with abortion bans doubled down on their attempts to restrict our reproductive freedom. This is no surprise: Overturning Roe v. Wade was never the anti-abortion movement’s end goal. It was merely a major milestone on the path to banning abortion entirely throughout the nation. To continue this work, anti-abortion lawmakers are taking increasingly extreme approaches, pushing restrictions that would not only make it even harder to get abortion care but criminalize the people who need it. Medication abortion continues to be their number one target. This safe, effective method accounts for nearly two-thirds of abortions today, with 1 in 4 patients getting the medication after a telehealth visit. The availability of medication abortion via telehealth has bolstered abortion access in the post-Dobbs era, and that’s exactly why abortion opponents are doing everything they can to try to stop it. Most attacks specifically target mifepristone, a medication used in combination with misoprostol as the most common medication abortion regimen. Abortion opponents are going after it with debunked disinformation, bogus federal lawsuits, and state-level restrictions. It’s all part of a larger, concerted campaign to cut off all abortion access not only in their states but nationwide. Abortion Abortion During the 2026 legislative session, elected officials introduced more than 80 bills undermining access to medication abortion. Many of these bills attempt to reclassify mifepristone and misoprostol as highly controlled substances, which would put these essential medications under strict control, even in emergency rooms and labor and delivery units. Not only do such measures further stigmatize abortion, they could delay care for miscarriage management and life-threatening postpartum complications. But abortion opponents didn’t stop there. Attempts to establish “fetal personhood” and criminalize abortion seekers are on the rise. The concept of fetal or embryonic “personhood” under the law is not new. For more than 40 years, anti-abortion extremists have pushed the notion that a fertilized egg should have independent legal rights that, in practice, supersede the rights of the pregnant person. However, since the Dobbs decision, these attacks have dramatically increased. This year alone, anti-abortion lawmakers in 15 states introduced more than 30 “prenatal equal protection” or “abolish abortion” bills. These bills would empower the state to criminalize people for their pregnancy outcomes, like miscarriage, stillbirth, or abortion, by codifying fetal personhood into state law. In South Carolina, where abortion is already restricted after six weeks of pregnancy, lawmakers introduced a bill that would have banned abortion entirely except for a narrow life exception, eliminated the state’s already limited exceptions for rape, incest and fetal anomalies, and criminalized people who have an abortion in violation of the ban. Anti-abortion lawmakers are also pursuing more nefarious means to surveil and criminalize pregnancy outcomes. An Ohio bill effectively creates a state fetal registry by requiring providers to file a “certificate of life” upon detecting a fetal heartbeat. They would also have to note whether the pregnancy ended due to abortion, miscarriage, or stillbirth. These extreme measures show the lengths to which anti-abortion lawmakers are willing to go to push abortion care out of reach and criminalize pregnant people even after the fall of Roe. How Abortion Rights Advocates Are Fighting Back The path to restoring and protecting abortion rights has run through the states in recent years, and advocates are using every tool they have to make reproductive freedom a reality. Our strategies include pushing bills that make abortion more accessible to passing ballot measures to ensure that reproductive rights are protected by state law. Protecting abortion patients and providers remains crucial to bolstering access. In the post-Dobbs patchwork landscape, with abortion severely restricted or banned in 20 states, people often must travel across state lines for care or order medication online. However, overzealous anti-abortion prosecutors, who seek to enforce their abortion bans beyond their own state borders, could weaponize sensitive information, such as electronic health records, to identify and prosecute both patients and providers. Lawmakers in states supportive of abortion rights are responding in kind by strengthening patient privacy protections. For example, some states are enacting or strengthening “shield laws,” which are designed to protect people from being punished by out-of-state officials for seeking abortion or gender-affirming care or providing such care in accordance with shield states’ laws. This session, Oregon enacted the Strengthening Patient and Provider Privacy Act, which expanded the state’s shield provisions to cover midwives and strengthen data privacy safeguards for patients and providers. Other states have also prioritized patient privacy legislation. Both New York and Illinois have considered electronic health record segmentation bills. Illinois enacted the law earlier this month. These bills seek to prevent the automatic sharing of a patient's health information related to abortion without their consent to other healthcare providers who may potentially be in hostile states. Voters Can Protect Abortions Rights Through Ballot Measures this November Since 2022, voters in 10 states — Arizona, California Colorado, Maryland, Michigan, Missouri, Montana, Nevada, New York, and Ohio — have approved abortion-rights amendments. The ACLU played a key role in those campaigns, but the work didn’t stop of election day. The ACLU and partners have notched critical litigation victories in overturning abortion bans and numerous other restrictions in Arizona, Missouri, and Ohio. These victories are the direct result of successful ballot measure campaigns to restore, protect and expand abortion rights with state constitutional amendments. We consistently see that when we put the power in voters’ hands, they will cast their ballot to protect abortion access. Now, voters will head to the polls again to vote on two crucial abortion measures this November. In Missouri, abortion opponents are attempting to repeal the state’s 2024 reproductive freedom amendment that protected abortion rights. This hostile measure threatens to not only re-impose a total ban on abortion with extremely limited exceptions. It would also permanently ban gender-affirming care for minors. Advocates in the state, including the ACLU of Missouri, are organizing a robust campaign to stop the ban and protect the 2024 victory. Virginians, on the other hand, have the opportunity to enshrine abortion rights in their constitutions. Virginians will vote on the Reproductive Freedom Amendment, which would protect the freedom to make personal decisions about birth control, fertility care, pregnancy care, abortion, and childbirth. While this state work is critical, our rights and access to essential care shouldn’t depend on our zip code or the whims of politicians. Tell Congress to protect the right to abortion and guarantee meaningful abortion access for everyone, regardless of who they are, where they live, or how much money they have. Paid for by American Civil Liberties Union, Inc., Anthony Romero Executive Director, 125 Broad St. New York, New York 10004, in coordination with Virginians for Reproductive Freedom and authorized by Stop the Ban.