A State-by-State Look at Abortion Restrictions in the US

Tara Haelle and Marcia Frellick

May 29, 2018

Abortion laws are changing in the United States, prompting hard questions about the current situation across the country.

Healthcare providers and patients tracking changes to abortion laws in the United States are witnessing a rapidly shifting landscape.

One-third of the 1193 state abortion restrictions passed after the landmark Roe v. Wade decision in 1973 were enacted in the past 7 years, according to Talcott Camp, JD, a lawyer with the Reproductive Freedom Project at the American Civil Liberties Union (ACLU).

Specifically, 33 states have enacted 416 abortion restrictions since January 2011, said Elizabeth Nash, senior state issues manager at the Guttmacher Institute in Washington, DC, where she tracks abortion legislation.

But despite the headlines, most are not challenged, Nash explained.

One reason for this is that there are too many regulations to challenge them all, and organizations fighting them must focus their limited resources on cases they are most likely to win or that will have the biggest impact. And these organizations must find someone with legal standing to bring a case. If a state bans abortions beyond 20 weeks but no providers offer the procedure and no pregnant women are seeking an abortion, there's no one to challenge the law, she pointed out.

Ins and Outs of Abortion Rules

States have the legal right to ban abortion after viability of the fetus, but not before. However, viability — defined as a "reasonable likelihood of sustained survival, with or without artificial support" — is not a set point during pregnancy; it is determined by a physician, Camp said.

Still, many states have enacted restrictions, such as prohibiting abortion after a certain gestational age, not including exceptions for the mother's life or health, and requiring the involvement of a second physician.

States passing abortion restrictions typically require counseling and ultrasound provisions to influence a patient's decision. They can also apply waiting periods, in-person counseling, and multiple visits to delay the procedure.

In addition, they can implement funding restrictions, place limitations on certain methods of abortion or on gestational age, and enact Targeted Regulation of Abortion Providers laws

However, with elections in November, the slew of restrictions might be slowing down, especially in states where so many regulations have already been enacted or proposed that there are few left to pursue, Nash said.

But those still in the works tend to be more extreme than previous regulations, such as the 6-week abortion ban in Iowa and the 15-week ban in Mississippi. These are primarily aimed at getting a case in the pipeline to the US Supreme Court that could overturn Roe v. Wade, she explained.

Abortion Regulations by State
Alabama

Partial-birth abortion is permanently enjoined. Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Public funding is limited to life endangerment, rape, and incest.

Alaska

Partial-birth abortion is permanently enjoined. Public funding can be used for all or most medically necessary abortions.

Arizona

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding can be used for all or most medically necessary abortions. Private insurance coverage is limited.

Arkansas

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment, rape, or incest. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

California

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

Colorado

Public funding is limited to cases of life endangerment, rape, and incest.

Connecticut   

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

Delaware

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment or fetal abnormality. Public funding is limited to cases of life endangerment, rape, and incest.

Washington, DC

Public funding is limited to cases of life endangerment, rape, and incest.

Florida

Abortion is prohibited starting at 24 weeks, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest.

Georgia

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned after a fetus is viable. Public funding is limited to cases of life endangerment, rape, and incest.

Hawaii

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

Idaho

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited. Partial-birth abortion is permanently enjoined.

Illinois

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding can be used for all or most medically necessary abortions.

Indiana

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, incest, and threat to a woman's physical health. Private insurance coverage is limited.

Iowa

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest.

Kansas

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Kentucky

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Louisiana

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

Maine

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding is limited to cases of life endangerment, rape, and incest.

Maryland

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment or fetal abnormality. Public funding can be used for all or most medically necessary abortions.

Massachusetts

Abortion is prohibited starting at 24 weeks, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

Michigan

Abortion is prohibited, except when a woman's life is endangered. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Minnesota

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

Mississippi

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. A court has temporarily blocked enforcement of a law that would have banned abortion 15 weeks after a woman's last menstrual period. Public funding is limited to cases of life endangerment, rape, incest, and fetal abnormality.

Missouri

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Montana

Abortion is prohibited if the fetus is viable, except in cases of life or health endangerment. Partial-birth abortion is banned after viability. Public funding can be used for all or most medically necessary abortions.

Nebraska

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Nevada

Abortion is prohibited starting at 24 weeks. Public funding can be used for all or most medically necessary abortions.

New Hampshire

Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

New Jersey

Partial-birth abortion is permanently enjoined. Public funding can be used for all or most medically necessary abortions.

New Mexico

Partial-birth abortion is banned after viability. Public funding can be used for all or most medically necessary abortions.

New York

Abortion is prohibited starting at 24 weeks, except when a woman's life is in danger. Public funding can be used for all or most medically necessary abortions.

North Carolina

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Public funding is limited to cases of life endangerment, rape, and incest.

North Dakota

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Ohio

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

Oklahoma

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest. Private insurance coverage is limited.

Oregon

Public funding can be used for all or most medically necessary abortions.

Pennsylvania

Abortion is prohibited starting at 24 weeks, except when a woman's life is in danger. Public funding is limited to cases of life endangerment, rape, and incest.

Rhode Island

Abortion is prohibited starting at 24 weeks, except when a woman's life is in danger. Partial-birth abortion is permanently enjoined. Public funding is limited to cases of life endangerment, rape, and incest. Ruling on whether private insurance is limited is permanently enjoined.

South Carolina

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

South Dakota

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is permitted only when a woman's life is in danger.

Tennessee

Abortion is prohibited when a fetus is viable, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

Texas

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, and incest.

Utah

Abortion is prohibited when a fetus is viable, except in cases of life or health endangerment, rape, incest, and fetal abnormality. Partial-birth abortion is banned. Public funding is limited to cases that involve threats to a woman's physical health, life endangerment, rape, and incest. Private insurance coverage is limited.

Vermont

Public funding can be used for all or most medically necessary abortions.

Virginia

Abortion is prohibited starting in the third trimester, except in cases of life or health endangerment. Partial-birth abortion is banned. Public funding is limited to cases of life endangerment, rape, incest, and fetal abnormality.

Washington

Abortion is prohibited when a fetus is viable, except in cases of life or health endangerment. Public funding can be used for all or most medically necessary abortions.

West Virginia

Abortion is prohibited when a fetus is viable, except in cases of life or health endangerment, rape, and incest. Partial-birth abortion is permanently enjoined. Public funding can be used for all or most medically necessary abortions.

Wisconsin

Abortion is prohibited starting at 20 weeks, except in cases of life or health endangerment. Partial-birth abortion is permanently enjoined. Public funding is limited to cases that involve threats to a woman's physical health, life endangerment, rape, and incest.

Wyoming

Abortion is prohibited when a fetus is viable, except in cases of life or health endangerment. Public funding is limited to cases of life endangerment, rape, and incest.

Source: Guttmacher Institute

Camp and Nash have disclosed no relevant financial relationships.

Follow Medscape OBGYN on Twitter @MedscapeObGyn, Tara Haelle @TaraHaelle, and Marcia Frellick @mfrellick

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