Reproductive Rights

The Supreme Court overturned Roe v. Wade on June 24, 2022. Since then, 13 states have imposed near-total abortion bans. Four more ban abortion at six weeks, before most people know they are pregnant. Idaho has lost 35% of its OB-GYNs. Alabama ruled frozen embryos are legally children. The Gender Equity Policy Institute found mothers in ban states nearly twice as likely to die during pregnancy.

When voters get a direct say, abortion rights usually win. From 2022 through 2024, abortion-rights measures won in 11 of 14 states, including Kansas, Kentucky, and Montana.

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Abortion Access by State

Thirteen states enforce near-total bans, and four more ban abortion at about six weeks. Thirteen allow it with a gestational limit, and twenty states plus D.C. protect access. Missouri moved from a ban to protected access after voters amended its constitution in 2024.

State-by-state abortion access after Dobbs. Sources: Center for Reproductive Rights, KFF

Approximately 155,000 people traveled out of state for abortion care in 2024, more than double the number in 2019. Average travel time for residents of ban states increased from 2.8 hours to 11.3 hours. More than 28,000 Texas residents left the state for care.

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Abortion Ballot Measures Since Dobbs

Abortion-rights measures have won in 11 of the 14 states that voted on one from 2022 through 2024. All three losses came in November 2024. Florida’s measure drew 57% but fell short of the state’s 60% threshold, and Nebraska and South Dakota rejected protections.

Abortion-related ballot measures since Dobbs

Three more measures are confirmed for November 2026: Virginia (protect access), Nevada (second required vote), and Missouri (legislature trying to repeal the 2024 voter-approved protections). In Idaho, supporters submitted signatures for a statutory initiative; the Idaho page tracks whether it qualifies.

Several states have also moved to make citizen ballot initiatives harder to pass, including Missouri, South Dakota and North Dakota.

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Court Rulings on Abortion Since Dobbs

Courts are where bans get challenged, upheld, or rewritten. Since Dobbs, many of the rulings that changed access have come from state courts.

In the Planned Parenthood case, the Supreme Court held that individual Medicaid patients cannot sue to enforce their right to choose a provider. Five states have already excluded Planned Parenthood from Medicaid. The 2025 federal reconciliation law blocked Medicaid payments to abortion providers for one year, through July 4, 2026. KFF warned the cutoff could close about 200 Planned Parenthood centers, most in states where abortion is legal. These centers provide cancer screenings, STI testing, and contraception, not just abortion.

Title X, the only federal program dedicated to family planning, also faced a funding freeze in 2025: 879 clinics across 23 states had funding frozen, serving roughly 834,000 patients.

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OB-GYN and Maternity Care Losses

Idaho lost 35% of its OB-GYN workforce (94 of 268 doctors) in the two years after its ban took effect. Six of nine maternal-fetal medicine specialists left. Only 23 OB-GYNs serve 37 rural counties with nearly a quarter of the state’s population. Three maternity wards have closed.

Nationally, OB-GYN residency applications declined 10.5% in states with total bans, while states with legal abortion saw a 0.4% increase. Since 2018, approximately 300 maternity wards have closed nationwide, and two million people now live in maternity care deserts.

The Gender Equity Policy Institute found mothers in ban states nearly twice as likely to die during pregnancy, childbirth, or postpartum compared to states that protect access. Maternal mortality fell 21% in protective states after Dobbs. In Texas, maternal mortality rose 56% in the first full year of the ban. Black mothers in ban states are 3.3 times as likely to die as white mothers.

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IVF and Fetal Personhood Laws

In February 2024, the Alabama Supreme Court ruled that frozen embryos are legally children under the state’s Wrongful Death of a Minor Act. IVF treatments halted across the state. Nineteen days later, the legislature passed emergency immunity for providers, but it did not change the underlying legal status of embryos. That immunity has been described as “tenuous at best.”

Seventeen states have established fetal personhood by law or judicial decision, Scientific American reported. At least 38 personhood bills were introduced across 24 states in a recent session, and 9 of them were broad enough to threaten IVF.

At the federal level, Senate Republicans blocked a 2024 bill establishing a federal right to IVF care.

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Medication Abortion and the Comstock Act

63% of all abortions in the United States are now medication-based, using mifepristone plus misoprostol. More than 25% are managed via telehealth. The FDA approved mifepristone in 2000, and Guttmacher reports a serious complication rate below 0.4%.

KFF Health News reported that medication abortion has become a main focus for anti-abortion groups. South Dakota’s governor signed HB 1274 on March 20, 2026, making dispensing or advertising abortion pills a felony. Multiple ban states have enacted specific prohibitions on medication abortion by mail.

The federal threat: the Comstock Act of 1873 prohibits mailing anything “intended for producing abortion.” KFF notes that a broad Justice Department reading could block the mailing of pills and instruments nationwide, including in states that protect access. The DOJ has not enforced Comstock against abortion medication, but anti-abortion groups delivered nearly 13,000 petitions demanding enforcement.

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What You Can Do About Reproductive Rights

1. Know your state’s law. The Center for Reproductive Rights maintains the definitive state-by-state map. Laws change fast. Check before you need to.

2. Find a provider. The National Abortion Federation Hotline at 1-800-772-9100 connects patients with verified providers. INeedAnA.com helps locate the nearest clinic and estimates costs and travel.

3. Know your rights if you travel for care. You cannot be prosecuted in a state where abortion is legal for obtaining care there. But digital evidence (search history, texts, location data) has been used in investigations. The Digital Defense Fund has security guides.

4. Contact your state legislators. If your state is considering a personhood bill, a medication abortion ban, or a ballot initiative restriction, your call matters. Use our letter on personhood laws and IVF, or the letter on abortion bans in your state.

5. Support the ballot initiative in your state. If you are in Idaho, Virginia, Nevada, or any state with a pending reproductive rights measure, volunteer with the campaign. Abortion-rights measures have won in 11 of the 14 states that have voted since Dobbs.

6. Talk to people who don’t think this affects them. IVF patients, people with high-risk pregnancies, and rural residents who depend on local maternity wards are all affected by abortion bans, whether or not they would seek an abortion.