REPRODUCTIVE HEALTH DIGEST (10/15/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers where reproductive health access is on the ballot this November, the Food and Drug Administration’s court filing establishing a Spring 2027 timeline to complete its mifepristone safety review, and a novel civil suit in Texas invoking House Bill 7’s medication transport prohibitions against anti-abortion activists who conducted a pill-ordering stunt. We also discuss the accelerating wave of hospital maternity ward closures across the country, new reporting detailing systemic insurer violations of the Affordable Care Act’s contraceptive coverage mandates, a University of Michigan study linking post-Dobbs state abortion bans to higher health insurance premiums for women, and the appointment of White House Press Secretary Katie Zacharia amid scrutiny over her past leadership ties to an anti-abortion organization. As always, please read on to the end for the news that you need to know.  

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Legislation & Litigation:

Overview

• The Food and Drug Administration notified a federal court that its ongoing administrative review of mifepristone safety data will extend into early next year, deferring any potential federal regulatory changes until spring 2027;

• A Texas resident filed a civil lawsuit invoking state abortion pill transport prohibitions against anti-abortion activists who ordered abortion medication online during a public demonstration within state borders; and 

• Abortion is on the ballot in multiple states this November. 

• FDA Formally Establishes Spring 2027 Timeline to Complete Re-evaluation of Mifepristone Safety and Telehealth Rules:

• On October 7th, the DOJ filed an official status report in federal district court stating that the Food and Drug Administration (FDA) review of mifepristone will extend into early next year. In the court-ordered update, the DOJ confirmed the study, which will reportedly evaluate the side effects of mifepristone across roughly 100,000 patients, will conclude in mid-December 2026. A final report is expected in March 2027. The review, commissioned last year by HHS Secretary Robert F. Kennedy Jr. following pressure from conservative groups, utilizes statistical data mining across electronic health records to re-evaluate the agency’s 2021 and 2023 determinations that in-person dispensing of mifepristone is not medically necessary. 

• The update came in a federal lawsuit brought by Louisiana alleging that mail-order distribution of abortion pills undermines its state abortion ban. However, existing Supreme Court orders keep current mail and telehealth access intact nationwide while litigation and agency reviews continue. By establishing a March 2027 completion date, it appears that the agency is unlikely to take any independent action to significantly modify the regulation of mifepristone prior to the spring. 

• Novel Civil Lawsuit Invokes Texas Medication Transport Ban Against Anti-Abortion Activists: 

• A recent lawsuit filed in Harris County District Court targets four activists affiliated with Students  for Life of America under Texas House Bill 7. Known as the Woman and Child Protection Act, House Bill 7 prohibits providing, delivering, or transporting abortion-inducing drugs to or from anyone in Texas. It employs a broad civil enforcement framework that allows any private citizen, regardless of their connection to the alleged violation, to bring a lawsuit seeking statutory damages against defendants. 

• The complaint argues that defendants violated state law when they attempted to order medication abortion online while standing outside Space Center Houston as part of a media demonstration intended to highlight the ease of accessing pills.  The filing references social media posts documenting the incident, alongside reporting by Mother Jones journalists who observed the ordering process. 

• Represented by Amplify Legal, the legal arm of Abortion in America, the plaintiff alleges that state abortion bans forced her to carry two unplanned pregnancies to term at severe financial cost, leaving her unable to complete college or maintain employment. The suit seeks $459,782 in damages – the estimated average cost of raising two children to age 18 in Texas. Under HB 7, the plaintiff would be entitled to receive $10,000 of any recovery herself, and the remaining damages would go to a charity of her choosing. She has indicated that she would donate the funds to Jane's Due Process, a nonprofit dedicated to helping young people access abortion and birth control. 

• Attorneys for the plaintiff argue that while state law exempts pregnant individuals seeking abortion care from civil liability, non-pregnant activists ordering medication inside state borders fall directly within the statutory prohibitions against transporting and facilitating abortion medication. The lawsuit is a novel application of Texas private civil enforcement mechanisms, turning medication abortion restrictions drafted with the support of anti-abortion advocates against anti-abortion activists themselves.

• State Ballot Measures and Federal Litigation Strategy Highlight Pre-Election Landscape: 

• Reproductive health access is on the ballot in four states this November. In Nevada and Virginia, where most abortions are currently legal, proposed constitutional amendments would cement those protections. Nevada’s Question 6 passed with nearly 65% approval in 2024 - it requires a second consecutive passage to take effect. If successful, the ballot question would add a right to pre-viability abortion care to the state constitution. Similarly in Virginia, Question 1, referred by the General Assembly, asks voters to guarantee a constitutional right to comprehensive reproductive healthcare, including contraception, fertility care, and abortion prior to the third trimester. 

• In Idaho, voters will consider Proposition 1, a citizen-initiated state statute designed to create an independent right to reproductive freedom and privacy, establish protections for procedures before fetal viability, and shield healthcare providers from criminal, civil, and professional liability. Importantly, Idaho’s measure would only create statutory protections - it would not amend the state constitution. Conversely, Missouri voters face Amendment 3, a legislatively referred constitutional proposal that seeks to repeal the voter-approved 2024 reproductive freedom amendment and constitutionally enshrine strict gestational limits, parental consent mandates, and restrictions on gender-affirming care for minors. 

Trend and Policy Watch:

• Overview

  • Impending federal Medicaid cuts are driving a wave of hospital maternity ward closures across the country, worsening rural maternal healthcare shortages; 

  • A new report reveals that insurance companies continue to violate Affordable Care Act rules by denying no-cost birth control coverage; 

  • A new study finds that state abortion bans following the 2022 Dobbs decision are associated with a 5.4% increase in out-of-pocket health insurance premiums for women;  and

  • President Trump named former media commentator Katie Zacharia as White House Press Secretary, drawing scrutiny over her recent tenure on the advisory board of an anti-abortion organization. 

• Federal Medicaid Funding Restrictions Accelerate Nationwide Closures of Hospital Maternity Units: 

• A new analysis by healthcare advocacy group Protect Our Care reports that 52 hospital maternity wards have permanently closed since the 2025 passage of HR 1, also known as the One Big Beautiful Bill Act. An additional eight facilities have announced plans to close in the upcoming year. HR 1 has forced healthcare institutions to restructure by reducing federal Medicaid funding, imposing restrictions on state funding, introducing mandatory work requirements, and increasing burdensome eligibility re-certifications. Taken together, these changes place significant financial and logistical strain on safety-net institutions that rely on Medicaid to cover roughly 40% of births nationwide. 

• Facility administrators at impacted regional institutions, including Central Southside Community Hospital in Virginia and St. Mary’s Sacred Heart Hospital in rural Georgia, cited federal policy shifts and projected operating losses as primary drivers behind terminating obstetrical services. Erin Jones, from March of Dimes, highlights that the trend threatens to create expansive maternity care deserts, identifying 31 rural hospitals whose potential closures would leave 96 counties without localized labor and delivery services.

• National Women’s Law Center Report Highlights Ongoing Insurer Noncompliance With Federal Contraceptive Coverage Mandates:

• The National Women’s Law Center released a report examining ongoing implementation failures in the Affordable Care Act’s requirement that health plans provide preventative care without cost-sharing. Drawing from intake data collected through its CoverHer assistance hotline, the analysis found that insurers frequently exclude entire categories of birth control methods, deny coverage for integral clinical services such as office visits or surgical anesthesia, and impose improper medical management protocols like age restrictions or mandatory “try and fail” requirements. The report notes that individuals who experienced unlawful coverage denials incurred an average out-of-pocket cost of $2,097.19 annually between 2022 and 2025, while also highlighting a sharp increase in requests for permanent contraception following the Supreme Court decision overturning federal abortion protections.

• University of Michigan Study Associates Post-Dobbs State Abortion Bans With Increased Insurance Costs for Women: 

• Researchers at the University of Michigan’s Institute for Social Research analyzed data from the Current Population Survey to better understand how abortion bans impact out-of-pocket expenditures for women aged 18 to 44. The study, authored by Joelle Abramowitz and Olga Aristova, looked at data from 2018 to 2024 and found that residing in states with abortion bans is associated with a 5.4% rise in annual out-of-pocket health insurance premium spending for women. This increase appears to be driven by higher birth rates, increased care complications, and elevated maternal risks that prompt insurers to pass costs onto beneficiaries. The economic impact was disproportionately concentrated among communities of color, with annual out-of-pocket premium spending rising by 12.8% for Black women and 13.7% percent for Latine women. The paper notes that while non-premium out-of-pocket costs and men’s insurance spending showed no statistically significant change, women in affected states experienced a 2.6% increase in private health insurance coverage and bore higher proportions of employer-sponsored plan premiums. 

• White House Appoints Press Secretary with Ties to Abortion Abolitionist Movement:

• The President appointed political commentator Katie Zacharia as the 37th White House Press Secretary, following the departure of Karoline Leavitt. Zacharia, who held her inaugural press briefing on October 13th, served until early 2026 on the advisory board of The White Rose Resistance, an extremist anti-abortion organization that advocates for treating abortion as capital murder and prosecuting both providers and patients under criminal homicide statutes. Zacharia has drawn past criticism for public statements comparing medication abortion to chemical agents used in Nazi extermination camps. The appointment underscores growing links between the federal administration and the self-described “abortion abolitionist” movement, which seeks the complete criminalization of abortion and full implementation of fetal personhood principles. 

REPRODUCTIVE HEALTH DIGEST (10/01/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest opens with the breaking news that a group of anti-abortion Attorneys General have asked the Supreme Court to strike down state shield laws in a move with major Constitutional implications. We break down a trial in California around so-called ‘abortion pill reversal,’ Tennessee’s investigations into reproductive healthcare providers and advocacy groups, a Sixth Circuit decision partially blocking Tennessee’s abortion trafficking law, a new Oklahoma lawsuit challenging the state’s abortion ban, and a federal court’s dismissal of a challenge to changes in Title X funding. We then discuss global trends in medication abortion access, state and federal politics around abortion, and Illinois’ newly-launched Reproductive Healthcare Hub. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

🚨Action Alert🚨

The Reproductive Health Coalition, a project of the American Medical Women’s Association (AMWA) and Doctors for America (DFA), is proud to offer a series of free, interactive trainings designed to help clinicians, advocates, and community members communicate more effectively about reproductive healthcare. Gain practical skills, build confidence, and learn how to have respectful, values-based conversations that make a difference.  Click here to register!

Legislation & Litigation:

• Overview

• Three Republican states have filed a lawsuit asking the Supreme Court to strike down shield laws protecting reproductive healthcare; 

• Trial has ended in a California lawsuit over anti-abortion groups’ promotion of so-called abortion pill reversal; 

• Tennessee Attorney General Jonathan Skrmetti is reportedly investigating reproductive healthcare providers and advocacy groups, issuing sweeping requests for patient, provider, and donor information; 

• The Sixth Circuit Court of Appeals has upheld a partial block on Tennessee’s abortion trafficking ban; 

• Two Oklahoma women filed a lawsuit challenging the state’s abortion ban after being denied care for devastating fetal diagnoses; and 

• A federal court has dismissed a case challenging harmful changes to Title X funding. 

• Republican States Ask Supreme Court to Strike Shield Laws:

  • In a move that reproductive rights advocates have long anticipated, a group of anti-abortion states have filed a lawsuit at the U.S. Supreme Court, asking justices to strike state shield laws on sovereignty grounds. Louisiana, Arkansas, and Alabama have asked the Court to take the extraordinary step of exercising original jurisdiction over the case, skipping over fact-finding and legal analysis normally performed by the lower federal trial and appellate courts. In the complaint, the states argue that California, Massachusetts and New York’s shield laws have resulted in “one of the most dramatic and sweeping interstate conflicts in modern history.” They argue that their sovereign interests are infringed upon by blue state shield laws and compare the mailing of medication abortion to the mailing of fentanyl or anthrax, asserting that the harm from loss of life is the same because the plaintiff states “protect unborn babies from the moment of conception.” The states also invoke Dobbs to support their claim that shield states’ laws “brazenly seek[] to subordinate pro-life states’ laws” in contempt of the Supreme Court’s ruling purporting to return the abortion issue to individual states. 

  • Simultaneous with filing their complaint before the Supreme Court, the plaintiff states have also filed a lawsuit in the Western District of Louisiana against a host of reproductive healthcare providers and organizations. This complaint argues that the defendants have violated a host of consumer protection laws by, among other things, making the evidence-based claim that medication abortion is safe and effective and endorsing the FDA-approved view that in-person dispensing is not medically necessary. The states characterize their restrictive laws as protective of “the lives and health of unborn babies and their mothers,” ignoring the well-documented deaths and devastating health outcomes that have resulted directly from abortion bans. 

  • Telehealth abortion has served as a lifeline for individuals in red states who need care - particularly those for whom traveling out of state is an impossibility. The stakes in this case are incredibly high for access to healthcare, bodily autonomy and the rule of law. 

• Trial Concludes in California Lawsuit About “Abortion Pill Reversal” Advertising:

• Closing arguments concluded in California’s false advertising lawsuit against anti-abortion groups Heartbeat International and RealOptions Obria. The trial spanned six weeks of arguments about the promotion of high-dose progesterone treatments marketed to counteract and reverse medication abortions. State prosecutors argue that the organizations take advantage of individuals in emotional turmoil by touting the procedure as safe and effective without credible scientific backing or adequate warnings about potential side effects. The state is seeking $20 million in penalties and an injunction under California’s False Advertising and Unfair Competition laws.  Alameda County Superior Court Judge Patrick McKinney is expected to issue a decision within three months, delivering a ruling that could define state authority over crisis pregnancy center communications. 

• Tennessee Investigating Reproductive Healthcare Providers  and Advocacy Groups:

• Tennessee Attorney General Jonathan Skrmetti is reportedly investigating reproductive healthcare providers and advocacy groups in the state. On September 23rd, Planned Parenthood affiliate Planned Parenthood of Tennessee and North Mississippi (PPTNM) filed a petition asking a  Tennessee court to block the state’s request for patient records and donor and physician information. The state’s investigation also seeks information related to gender-affirming care for minors, a service that the Planned Parenthood affiliate states it does not currently and has never provided. Although Tennessee is enforcing a total abortion ban, Skrmetti alleges that the state believes that PPTNM has committed multiple violations of state law, including consumer protection laws and laws prohibiting gender-affirming care for minors and in-state telehealth abortion. 

• Abortion Care Tennessee (ACT), an abortion fund that helps individuals to access lawful out-of-state abortion care, is facing a similar investigation. As TN Repro News reports, the abortion fund received a request for information including “internal information, communications, and processes related to self-managed abortion and abortion pills by mail,” and a requirement for “all ACT staff, volunteers, and board members to fill out an affidavit about any verbal conversations they’ve had with anyone about abortion pills by mail or self-managed abortion,” including the details of those conversations and whether they believe it led to the person purchasing medication. This sweeping request raises alarming patient privacy and first amendment concerns. ACT has filed a petition to stay AG Skrmetti’s requests. 

• Taken together, these investigations appear to be an attempt by the state to intimidate patients and providers and chill the free flow of abortion-related speech. They also come on the heels of a Sixth Circuit decision upholding a partial block of Tennessee’s abortion trafficking law, as discussed in greater detail below. ACT’s petition argues explicitly that the state’s escalation was motivated in part by developments in the 6th Circuit case.

• Federal Appeals Court Strikes Tennessee’s Abortion “Recruitment” Provision:

• The U.S. Court of Appeals for the Sixth Circuit affirmed a lower court ruling blocking the “recruitment” provision of Tennessee’s 2024 “Underage Abortion Trafficking Act.” The law sought to impose criminal penalties on adults who “recruit” unemancipated minors to obtain abortions without parental consent, including lawful out-of-state care. State Representative Aftyn Behn and attorney Rachel Welty challenged the provision, arguing that it improperly criminalized speech about healthcare.   In its decision, the appellate panel held that the prohibition constitutes unconstitutional viewpoint discrimination and is facially overbroad under the First Amendment. By upholding the permanent injunction, the court ensured that individuals and advocates in Tennessee may continue providing information and counsel regarding legal abortion options without facing prosecution.  

• Patients and Providers Harmed by Oklahoma’s Abortion Ban File Suit:

• A group of Oklahoma patients and healthcare providers have filed a lawsuit challenging the state’s total abortion bans, which only permit abortion to save the patient’s life. In the complaint, two women detail how, faced with devastating fetal diagnoses, they were forced to flee the state to access care. Following fertility treatment, Magon Hoffman was “thrilled” to discover that she was pregnant in September 2022; however, several months into her pregnancy she learned that her daughter had anencephaly. She was reportedly told that her two options were to either leave the state or continue the pregnancy and likely watch her daughter die after birth. At great personal and financial cost, she chose to travel to New Mexico for care. Another plaintiff in the case, Sheena Hamlin, learned at her 21-week anatomy scan that her child had a number of lethal conditions - she was told that, if she continued the pregnancy, the baby would “suffocate almost as soon as the umbilical cord was cut.” She chose to travel to Illinois. The case also names the two women’s physicians, who are suing on behalf of both themselves and their patients. The complaint alleges a host of constitutional violations, including equal protection, substantive due process, and the fundamental right to life and liberty.

• Federal Court Dismisses Lawsuit Challenging Political Restrictions on Title X Family Planning Grants:

• U.S. District Judge Jennifer P. Wilson dismissed a lawsuit brought by the National Family Planning and Reproductive Health Association (NFPRHA) and the Family Health Council of Central Pennsylvania, holding that the healthcare providers faced insufficient concrete harm to establish a justiciable controversy. The plaintiffs, represented by the ACLU, challenged an HHS notice of funding opportunity for fiscal year 2027. They argued that the new process imposes politicized criteria, requiring grant applicants to align with administration priorities such as ending diversity initiatives and gender-affirming care, while shifting focus away from effective contraception toward menstrual cycle tracking. Although federal officials removed a threshold provision that allowed immediate rejection based on political alignment, the court’s procedural dismissal leaves the remaining grant requirements in place. Advocates warn that the new criteria threaten to displace long-standing, experienced Title X administrators in favor of new ideologically-motivated applicants, such as religious organizations and crisis pregnancy centers. 

Trend and Policy Watch:

• Mifepristone to be Legalized in South Korea:

  • Although we rarely use this Digest to discuss international developments in reproductive health, it is worth comparing how progress in other countries maps onto recent U.S. regressions. While the U.S. is facing relentless attacks on access to mifepristone, South Korea has announced plans to approve and introduce medication abortion. The first phase will reportedly begin in early 2027, and will likely comprise a combination of mifepristone and misoprostol for use during the first 9 weeks of pregnancy. Although South Korea has a fraught history of severely restricting abortion, its Constitutional Court ruled in 2019 that a near-total abortion ban was unconstitutional. The recent announcement has been met with mixed responses. Advocacy groups have applauded the move as a step forward but cautioned against instituting medically unnecessary barriers to accessing the medications, while conservative groups have voiced their objections and insisted that the government should focus its efforts on supporting mothers. 

• Utah Supreme Court Justice Recuses Himself from Challenges to New Judicial Panels:

• Utah Supreme Court Justice John Nielson recused himself from hearing challenges to the state legislature’s newly created three-judge panels, reversing his previous stance in a lawsuit brought by Planned Parenthood Association of Utah. Planned Parenthood requested Nielson’s disqualification because he had previously represented Pro-Life Utah while in private practice. Nielson also voluntarily disqualified himself from a separate challenge to the judicial panels arising from a  redistricting lawsuit due to his prior legal consultations with lawmakers. A lower court judge will be selected to fill Nielsen’s seat for the upcoming October 5th oral arguments, which will determine whether the Legislature had the authority to create the special panels to hear constitutional challenges. 

• Nominee for FDA Commissioner Faces Questions about Abortion:

• During her Senate confirmation hearing, Trump’s nominee for FDA Commissioner, Dr. Heidi Overton, faced questions about her record on public health. Dr. Overton was tapped for the role following Dr. Marty Makary’s departure earlier this year - she is currently the deputy director of the White House Domestic Policy Council, and has seemingly been active in the administration’s anti-vax agenda. In the past, she has also been critical of medication abortion, raising concerns about her fitness to impartially run the agency in charge of its regulation. During her hearing, she was pressed on whether and how she would regulate medication abortion if confirmed. In response, she stated that “[a]ccording to FDA standards, the drug is safe and effective as labeled today,” avoiding taking a more direct stance. At one point, Senator Patty Murray, D-Wa., asked Dr. Overton if she believes that  intrauterine devices (IUDs), a common form of contraception, are ‘abortifacients,’ or substances intended to cause an abortion. Dr. Overton did not answer directly and instead stated that she would make decisions according to standards of safety and efficacy. The anti-abortion right has recently gained substantial ground in arguing that certain forms of contraception are abortifacients and should be regulated as such. Following the hearing, over 2,500 physicians signed onto a letter opposing Dr. Overton’s confirmation, stating that “a vote to confirm [her]is an attack on abortion access, vaccine access, and public health.”

• Illinois Launches Online Hub to Expand Access to Reproductive Healthcare Resources:

• The State of Illinois launched a new resource - the Reproductive HealthCare Hub - to assist residents and out-of-state patients in navigating their options, including abortion services, contraception, and maternal care. The online portal offers a centralized platform to evaluate care pathways, locate low-cost or free treatment options, and understand state legal protections under the Illinois Reproductive Health Act and the Illinois Human Rights Act. With one in four out-of-state patients traveling to Illinois for abortion care, state officials created the hub to counteract misinformation and streamline access to services. To protect user confidentiality, the site incorporates enhanced privacy controls, including a quick exit feature that aligns with state medical privacy protections established under the Reproductive Health Records Privacy Act.  

REPRODUCTIVE HEALTH DIGEST (09/17/26) (Copy)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes through litigation developments involving religious freedom and abortion access, the reinstatement of Idaho’s total abortion ban,  a new Wisconsin lawsuit challenging medically unnecessary abortion restrictions, oral arguments in the Fifth Circuit in a key case on medication abortion, and a Texas lawsuit alleging multiple state and federal violations of law in connection with the 2024 death of Tierra Walker. We also discuss changes to federal public health funding, a spike in ectopic pregnancy-related deaths, polling on Missouri’s anti-abortion ballot measure, and the EPA’s newly-announced plan to study drinking water for evidence of certain chemicals, including medication abortion,  contraceptives, and other hormones. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

🚨Action Alert🚨

The Reproductive Health Coalition, a project of the American Medical Women’s Association (AMWA) and Doctors for America (DFA), is proud to offer a series of free, interactive trainings designed to help clinicians, advocates, and community members communicate more effectively about reproductive healthcare. Gain practical skills, build confidence, and learn how to have respectful, values-based conversations that make a difference.  Click here to register!

Legislation & Litigation:

• Overview:

• The Ninth Circuit has upheld a Washington law requiring insurance plans to cover abortions;

• The Indiana Supreme Court heard oral arguments in a case challenging the state’s abortion ban on religious freedom grounds; 

• Idaho’s total abortion ban is once again in full effect; 

• The Fifth Circuit heard oral arguments last week in Louisiana v. FDA, a case seeking to reinstate in-person dispensing requirement for mifepristone; 

• Planned Parenthood of Wisconsin has filed a new lawsuit challenging the state’s 24-hour waiting period and physician-only requirement for abortions; and 

• A new lawsuit has been filed alleging multiple state and federal claims related to the 2024 death of Tierra Walker. 

• Ninth Circuit Upholds Washington Law Requiring Insurance Plans to Cover Abortion Services:

• In a 2-1 decision, a Ninth Circuit panel rejected a First Amendment  challenge brought by a local church against Washington’s 2018 Reproductive Parity Act. The Reproductive Parity Act mandates that health plans offering maternal care also cover abortion services. The majority held that the Parity Act is a neutral law of general applicability that rationally advances Washington’s compelling interest in ensuring equitable access to reproductive healthcare. Dismissing claims of religious hostility, the panel noted that the statutory framework explicitly shields objecting organizations from being forced to directly purchase or pay for abortion coverage. While the dissenting judge argued that the regulations unconstitutionally burden religious exercise, the majority affirmed that the state did not coerce religious compliance or violate church autonomy. 

• Indiana Supreme Court Hears Arguments on Whether Abortion Ban Violates Religious Freedom: 

  • Last week, the Indiana Supreme Court heard oral arguments in a case challenging the state’s abortion ban on religious freedom grounds. The plaintiffs, Hoosier Jews for Choice and other anonymous individuals, filed the lawsuit in 2022, arguing that Indiana’s abortion ban interferes with the  exercise of their sincerely held religious beliefs by prohibiting abortion in circumstances where their faith would counsel in favor of such care. The plaintiffs ground their arguments in the idea that, although some faith traditions believe that life begins at conception, others do not and may require the prioritization of the pregnant person’s health and life over that of the fetus. Previously, a lower court ruled in their favor, issuing an injunction blocking the abortion ban's application to plaintiffs in circumstances where it conflicts with their religious beliefs. The state appealed. 

  • During last week’s arguments, Solicitor General James Barta disputed the idea that the abortion ban burdens religious exercise, arguing that the “nation’s long tradition of respect for religious exercise has never been understood to encompass a right to intentionally destroy human life.” He also questioned whether the plaintiffs had shown sufficient injury to bring the case given that none of them have been pregnant and required an abortion during the duration of the litigation. The ACLU, arguing for the plaintiffs, pointed to the fact that the plaintiffs have received abortions in the past for religious reasons and have been forced to change their behavior under the ban “to avoid pregnancies they would not be able to terminate even when religiously required.” The ACLU also argued that Indiana has undercut its own asserted compelling interest in protecting fetal life by permitting exceptions for non-religious reasons, such as instances involving rape or incest. During arguments, the judges heavily questioned both sides, probing how the state could craft a law that both protected its interest and allowed for religious exercise, and whether this case is similar to those that have found that religious entities do not have to cover contraception for their employees. How the court rules in this case will create important precedent on the question of whether religious freedom arguments can be wielded only to limit reproductive rights, but not to vindicate them. 

• Indiana Supreme Court Hears Arguments on Whether Abortion Ban Violates Religious Freedom: 

  • Last week, the Indiana Supreme Court heard oral arguments in a case challenging the state’s abortion ban on religious freedom grounds. The plaintiffs, Hoosier Jews for Choice and other anonymous individuals, filed the lawsuit in 2022, arguing that Indiana’s abortion ban interferes with the  exercise of their sincerely held religious beliefs by prohibiting abortion in circumstances where their faith would counsel in favor of such care. The plaintiffs ground their arguments in the idea that, although some faith traditions believe that life begins at conception, others do not and may require the prioritization of the pregnant person’s health and life over that of the fetus. Previously, a lower court ruled in their favor, issuing an injunction blocking the abortion ban's application to plaintiffs in circumstances where it conflicts with their religious beliefs. The state appealed. 

  • During last week’s arguments, Solicitor General James Barta disputed the idea that the abortion ban burdens religious exercise, arguing that the “nation’s long tradition of respect for religious exercise has never been understood to encompass a right to intentionally destroy human life.” He also questioned whether the plaintiffs had shown sufficient injury to bring the case given that none of them have been pregnant and required an abortion during the duration of the litigation. The ACLU, arguing for the plaintiffs, pointed to the fact that the plaintiffs have received abortions in the past for religious reasons and have been forced to change their behavior under the ban “to avoid pregnancies they would not be able to terminate even when religiously required.” The ACLU also argued that Indiana has undercut its own asserted compelling interest in protecting fetal life by permitting exceptions for non-religious reasons, such as instances involving rape or incest. During arguments, the judges heavily questioned both sides, probing how the state could craft a law that both protected its interest and allowed for religious exercise, and whether this case is similar to those that have found that religious entities do not have to cover contraception for their employees. How the court rules in this case will create important precedent on the question of whether religious freedom arguments can be wielded only to limit reproductive rights, but not to vindicate them. 

• Ninth Circuit Temporarily Reinstates Idaho’s Full Abortion Ban Pending Appeal 

• Earlier this month, the Ninth Circuit Court of Appeals granted an emergency administrative stay reinstating Idaho’s ban and blocking a lower court ruling that had allowed a maternal-fetal medicine specialist to perform certain health-preserving abortions without fear of criminal prosecution. U.S. District Judge B. Lynn Winmill had previously enjoined the state from enforcing its near-total ban against Dr. Stacy Seyb in cases where a pregnancy threatens a patient’s physical health or poses a severe risk of self-harm. Following an appeal by Idaho Attorney General Raúl Labrador, the Ninth Circuit panel temporarily reinstated the state’s criminal penalties pending its consideration of emergency motions. While the panel emphasized that this administrative pause does not reflect its view on the ultimate legal merits, the decision leaves Idaho’s ban fully in effect with no protections for health-preserving care as appellate arguments approach.

• Fifth Circuit Hears Oral Arguments in Louisiana v. FDA:

  • Last week, the Fifth Circuit Court of Appeals heard oral arguments in Louisiana v. FDA, one of several cases seeking to restrict access to medication abortion. Relying on disinformation about the alleged dangers of medication abortion and arguments about state sovereignty, Louisiana asked the 3-judge panel to force FDA to reinstate in-person dispensing requirements for mifepristone. Interestingly, Louisiana is not asking the court to broadly rescind telehealth prescribing of medication abortion, but merely to require the pills to be dispensed in person. Functionally, this would create a procedure whereby a patient could undergo medical screening and receive a prescription through telemedicine services but would then be required to travel in person to a healthcare facility just to pick up their medication. Earlier in the case, a different panel of Fifth Circuit judges issued an order briefly reinstating in-person dispensing requirements; however, the U.S. Supreme Court paused that order while litigation plays out. 

  • The case is now back before the Fifth Circuit, and this time Louisiana faced a considerably more liberal panel, comprising judges appointed by Presidents Obama, Biden, and George W. Bush. The judges appeared skeptical of Louisiana’s theory of standing, which hinges on the idea that abortions facilitated by telehealth are taking place in the state despite its abortion ban. At multiple points, the judges questioned how this purported harm was caused by FDA rather than by the long chain of intervening actions and decisions of providers and patients. The judges also pressed counsel for FDA on the agency’s position on mifepristone’s safety and its process for modifying regulations for a particular drug.  However, counsel repeatedly declined to provide any substantive answers, insisting on only addressing the standing question and arguing that the case should be put on hold until the agency concludes its own review. 

• Wisconsin Planned Parenthood Challenges Abortion Restrictions:

• Last week, Planned Parenthood of Wisconsin filed a new lawsuit challenging the state’s mandatory 24-hour waiting period and requirement that only physicians perform abortions. Post-Dobbs, anti-abortion lawmakers and state officials in Wisconsin pushed to enforce a long-dormant 1849 abortion ban; however, last year, the Wisconsin Supreme Court sided with the state’s Democratic Attorney General and struck the ban as unconstitutional.  Currently, abortion is legal in Wisconsin until 20 weeks gestational age, with certain exceptions. 

• Advocates are now seeking to undo remaining medically unnecessary restrictions on care, and the recent election of liberal justices to the state’s highest court has created a favorable judicial environment in which to do so. The newly-filed complaint alleges a host of constitutional deficiencies, including violations of the rights to privacy, bodily autonomy, and equal protection for both patients and providers. If successful, the case will be a substantial step towards establishing a fundamental right to abortion in the state. 

• Lawsuit Filed Over the Death of Tierra Walker, a Woman Denied Lifesaving Abortion Care:

  • Amplify Legal, the litigation arm of Abortion in America, has filed a new lawsuit in Texas alleging violations of state and federal law in connection with the preventable death of thirty-seven year old Tierra Walker in 2024. The lawsuit names as Defendants Texas Attorney General Ken Paxton and various health systems and individual doctors involved in Walker’s care. 

  • When Walker found out she was pregnant, she was suffering from multiple chronic conditions, including asthma, hypertension and diabetes. She was repeatedly hospitalized during the first few months of her pregnancy and requested termination at multiple points as her health deteriorated. She died as a result of medically predictable cardiovascular complications and was reportedly found by her teenage son on his fifteenth birthday. The lawsuit argues that the defendants actions and inactions violated state and federal constitutional protections, EMTALA, and multiple state laws governing the practice of medicine. Walker is among a growing list of women who have lost their lives in Texas and elsewhere as a direct result of abortion bans that severely restrict the practice and provision of reproductive medicine.

Trend and Policy Watch:

• HHS Cancels $38 Million in Grants for Infant Mortality, Postpartum Research, and Maternal and Infant Health:

• In late August, the U.S. Department of Health and Human Services terminated $38 million in federal grants administered through HHS’s office of  Minority Health. The cancelled grants funded work addressing urgent and well-documented healthcare disparities experienced by minority groups in areas including infant mortality, postpartum care, mental health, and maternal and infant health.

• Impacted programs include organizations that engage in suicide prevention efforts, send nurses to visit and support postpartum parents and newborns, and provide healthy food to those in need. Reportedly, letters to the grantees stated that future awards would be focused on “reducing overmedicalization in health care by addressing the root causes of infertility,” including “hormonal imbalances, endometriosis, uterine fibroids, low sperm count, low testosterone levels and erectile dysfunction.”

• New Polling Shows Missouri Voters Sharply Divided Over Amendment to Reinstate Abortion Ban:

  According to the latest SLU/YouGov poll, Missouri voters are evenly divided on Amendment 3, the November ballot measure asking Missourians to reinstate a total abortion ban. Recent polling found that 44% of respondents oppose the measure and 43% are in support, well within the survey’s margin of error. The measure was placed on the ballot by state lawmakers to dismantle the constitutional right to reproductive freedom approved by voters in 2024 and enshrine restrictions on gender-affirming care for minors. Earlier polling showed voters favoring the legislative proposal by double digits, and the significantly narrowed gap underscores the need for sustained advocacy and voter education, particularly among undecided voters. 

• Reporting from ProPublica Shows that Ectopic Pregnancy Related-Deaths Have Skyrocketed Post-Dobbs:

  • New reporting from ProPublica shows that ectopic pregnancy-related deaths doubled from 2020-2025 as compared to the prior six years. Ectopic pregnancies occur when a fertilized egg implants outside of the uterus - most commonly in a fallopian tube - creating imminent risk of rupture, severe bleeding, and possible death. Although extremely dangerous, ectopic pregnancies are also treatable if diagnosed and addressed promptly. 

  • ProPublica’s reporting analyzed the increased mortality rates and found that, although the initial spike may have been partially caused by disruptions to the healthcare system during the Covid-19 pandemic, the numbers have continued to rise. Unsurprisingly, mortality rates are significantly higher in states with abortion bans, where providers are forced to practice reproductive medicine under threat of severe criminal, civil, and professional penalties. Experts that ProPublica spoke to indicated that, although more research is required to fully understand the root of the problem, it is likely attributable to a combination of abortion bans, reduced Medicaid coverage, and a lack of research, investment, and reliable data. 

• EPA Yields to Political Pressure to Screen Drinking Water for Mifepristone, Contraceptives, and Gender-Affirming Hormones:

• The Environmental Protection Agency announced it will conduct non-targeted screening of the national drinking water supply for a “broad array” of trace compounds, explicitly incorporating mifepristone, alongside contraceptives and gender-affirming hormone therapies. The inclusion of medication abortion follows sustained lobbying by anti-abortion groups seeking to classify reproductive healthcare pharmaceuticals as environmental pollutants. By framing medication abortion as a water contaminant, conservative lawmakers and anti-abortion organizations are actively working to weaponize environmental regulations to restrict access to healthcare. As Guttmacher Institute Principal Federal Policy Advisor Anna Bernstein pointed out, “singling out medication abortion while ignoring the agricultural and industrial pollutants that are proven threats to our health makes clear that these efforts are about restricting access to abortion, not protecting our water.”

REPRODUCTIVE HEALTH DIGEST (09/03/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest walks through developments in federal litigation around access to mifepristone, the ongoing legal battle over the scope of Idaho’s abortion ban, Idaho advocates fighting to pass a reproductive rights ballot measure in November, and a new lawsuit filed by a coalition of 23 states challenging cuts to Title X funding. We also discuss the rise of abortion abolitionism, Missouri’s attempts to weaponize anti-trans sentiment to ban abortion, and how abortion bans are forcing patients to obtain abortion care later in pregnancy. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

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🚨Action Alert🚨

The Reproductive Health Coalition, a project of the American Medical Women’s Association (AMWA) and Doctors for America (DFA), is proud to offer a series of free, interactive trainings designed to help clinicians, advocates, and community members communicate more effectively about reproductive healthcare. Gain practical skills, build confidence, and learn how to have respectful, values-based conversations that make a difference.  Click here to register!

Legislation & Litigation:

• Overview:

• A federal court has paused Texas and Florida’s lawsuit challenging FDA’s approval of mifepristone, postponing proceedings until the earlier of December 1, or the FDA’s conclusion of its ‘review’ of mifepristone’s safety record; 

• A federal judge has narrowed his ruling finding a constitutional right to life and health preserving abortions in Idaho, applying it only to the physician who brought the lawsuit; 

• The Seventh Circuit Court of Appeals has struck Indiana’s prohibition on clinicians providing minors with information about out-of-state abortions without parental consent, finding that it violates the First Amendment;  

• In the run-up to November’s elections, Idaho advocates have filed a lawsuit challenging biased ballot language on a proposed reproductive rights measure; and 

• A coalition of 23 states have filed a federal lawsuit challenging the Trump Administration’s cuts to Title X funding. 

• Mifepristone Lawsuit Paused Until December:

  • Federal Judge Reed O’Connor has paused Texas and Florida’s lawsuit challenging the FDA’s approval of mifepristone. The case, Florida v. FDA is one of several concurrently asking federal courts to restrict access to medication abortion, and it seeks the broadest relief. The states are asking the court to find that FDA acted erroneously and unlawfully in initially approving mifepristone for medication abortions in 2000 and in subsequently relaxing regulations for its use. A ruling granting the states the full relief sought would render mifepristone unavailable in all U.S. states, including those that affirmatively protect abortion access. 

  • Judge O’Connor’s most recent ruling denied Intervenor Defendants Genbio Pro and Danco Laboratories motion to dismiss and granted the government’s request to pause the case until the sooner of December 1st or the conclusion of the FDA’s politically charged ‘review’ of mifepristone’s safety record. Throughout the opinion, Judge O’Connor employed openly anti-abortion and non-medical language and talking points, including finding that the Plaintiff States have shown that “chemical abortions claim the lives of thousands of preborn children in Florida and Texas each year” and crediting inaccurate information about the rates of patients who are harmed by mifepristone. The government’s request to stay the case is likely spurred, at least in part, by the intense scrutiny that the administration is currently facing on the issue of abortion. Anti-abortion groups are frustrated with what they perceive as the Trump administration’s failure to act aggressively to curb access to care, while others see restricting abortion as a political liability for Republicans in the upcoming midterm elections. 

  • Oral arguments in Louisiana v. FDA, the related case seeking to reinstate in-person dispensing requirements for mifepristone, are scheduled for next Wednesday, September 9th. 

• Idaho District Court Narrows Scope of Health-Preserving Abortion Injunction:

• In the last Digest, we covered Idaho District Court Judge B. Lynn Winmill’s groundbreaking ruling finding a Fourteenth Amendment right to life and health-preserving abortion care. Following that ruling, Judge Winmill issued a modified order narrowing the original preliminary injunction. Responding to motions filed by Idaho Attorney General Raúl Labrador, Judge Winmill limited the direct protections of the order to the physician plaintiff and covered care providers rather than maintaining a broad, statewide injunction while the case moves through appellate review. Despite aggressive state attempts to dissolve the decision, Judge Winmill stood firmly by his original finding that Idaho’s ban unconstitutionally forces pregnant patients to endure severe physical and mental health risks. As state officials appeal to the Ninth Circuit, legal scholars emphasize that by directly testing the unresolved boundaries of post-Dobbs health exceptions, this landmark lawsuit may ultimately force the U.S. Supreme Court to decide whether states can outlaw health-preserving emergency care nationwide.

• Federal Court Strikes Indiana Ban on Informing Minors About Out-of-State Options: 

• In late August, the Seventh Circuit Court of Appeals issued a decision striking an Indiana law limiting what kinds of abortion information could be shared with minors. The law was first challenged prior to the overturn of Roe and Indiana’s subsequent enactment of a total abortion ban. It states that providers “may not knowingly or intentionally aid or assist an unemancipated pregnant minor in obtaining an abortion” without parental consent. Although the law was previously blocked and never went into effect, its language would have barred clinicians from providing pregnant minors with comprehensive counseling about their potential options, including traveling out-of-state for lawful care. The Seventh Circuit’s ruling found that abortion-related speech and referrals are protected by the First Amendment. Judge David Hamilton, writing for the court, also found that the speech is not viewpoint-neutral, because it “allows conversations on the subject of abortion but forbids a certain point of view.” He noted that this kind of viewpoint discrimination is a “particularly egregious form of content discrimination,” because it allows some perspectives while restricting others. The case is a victory for abortion-related speech at a time when providers are grappling with the chilling effect that abortion bans have on their ability to freely treat and communicate with their patients.  

• Advocates Challenge Skewed Ballot Language for Idaho Reproductive Freedom Initiative:

• Idahoans United for Women and Families, a leading Idaho-based reproductive rights coalition, filed a lawsuit challenging the biased ballot and voter guide summaries drafted by Idaho officials for Proposition 1,  the citizen initiative to restore legal abortion access until viability. The complaint asserts that Attorney General Raúl Labrador and Secretary of State Phil McGrane violated statutory requirements for neutral messaging by authoring “yes” and “no” statements that obscure Idaho’s harsh criminal felony penalties and misrepresent fetal viability standards. This latest action is not the campaign’s first challenge against state officials for weaponizing administrative ballot titles. Last year, a unanimous Idaho Supreme Court ruling ordered the state to rewrite prejudicial ballot summaries. The campaign is now urging the court to make a decision before state voter guide printing deadlines to ensure that Idahoans receive clear, accurate information on the impact of their vote.

• Coalition of 23 States Sue Trump Administration Over Ideological Title X Grant Restrictions:

  • A coalition of 23 states filed a federal lawsuit in Maryland challenging new ideological funding conditions imposed by HHS on the federal Title X family planning program. The complaint asserts that the administration’s fiscal year 2027 grant rules violate the Administrative Procedure Act by arbitrarily withholding healthcare funds from states that fail to comply with political priorities, such as opposing diversity, equity, and inclusion initiatives, refusing to discourage contraception, or refusing to provide gender-affirming care to transgender people. By conditioning critical safety-net funding on these non-statutory mandates, federal officials are attempting to force state healthcare systems to dismantle essential family planning services, cancer screenings, and STI testing for low-income patients. State attorneys general are urging the court to declare the political conditions unlawful and enjoin federal regulators from penalizing state programs that continue providing comprehensive, evidence-based reproductive care.

Trend and Policy Watch:

• Abortion Abolitionists in Kansas Look to Enshrine Fetal Personhood:

  • Abortion abolitionists - radical anti-abortion activists who oppose abortion at all gestational ages without exceptions, and advocate for penalizing abortion patients - have been gaining momentum in the mainstream anti-abortion right. This year, lawmakers introduced bills in states across the country that would enshrine fetal personhood, redefine life as beginning at conception, and allow for the prosecution of pregnant people. Most recently, a Kansas anti-abortion organization - misleadingly named the Kansas Equal Rights Amendment Committee - has put pressure on the Kansas Legislature to hold a special session to place an amendment on November’s ballot defining life as beginning at conception. Reportedly, the group’s leader was spurred to action by Kansans’ rejection of a constitutional amendment that would have changed the selection process for state supreme court justices from appointment to election. The failed amendment was intended to give conservatives a majority on the court and pave the way for the rollback of certain rights, including abortion rights. In 2022, Kansans similarly rejected a constitutional amendment that would have stated that abortion is not protected by the state’s constitution. Although a spokesperson for Kansas Senate President Ty Masterson has stated that he is not associated with or familiar with the Kansas Equal Rights Amendment Committee’s efforts, anti-abortion extremism will continue to attempt to edge its way into the mainstream in Kansas and elsewhere, and advocates should be prepared to respond. 

• Anti-Abortion Lawmakers in Missouri Hope to Weaponize Anti-Trans Sentiment to Ban Abortion:

• Although we have written about this previously, with November fast-approaching, it bears reiterating. In Missouri, anti-abortion lawmakers are attempting to undo a previously-passed abortion rights amendment, and they are using the deeply cynical tactic of leaning on anti-trans sentiment to do so. In 2024, Missouri became the first state to overturn a total abortion ban via citizen-led ballot initiative, and the state has been fighting to stop Missourians’ reproductive rights from being realized ever since. In addition to fighting in court to retain statutory abortion restrictions, Republican lawmakers placed a measure on the November ballot that asks voters to effectively restore a total abortion ban and to ban gender-affirming care for minors. This move to logroll the two issues into one initiative tracks polling showing that banning care for transgender people polls far more favorably than banning abortion. Despite the fact that gender-affirming care for minors is considered safe and effective and is already statutorily prohibited in Missouri, lawmakers hope to weaponize anti-trans sentiment to convince voters to once again ban abortion and restrict bodily autonomy in the state.

• State Restrictions and Coverage Losses Force Patients to Seek Care Later in Pregnancy:

• Recent reporting highlights how state-level abortion bans and shrinking health insurance coverage are driving a nationwide surge in patients seeking care later in pregnancy. With 41 states enforcing total bans or gestational restrictions, pregnant individuals face a patchwork of legal barriers, frequently traveling across multiple state lines and navigating different gestational limits in an attempt to access care. These delays are exacerbated by rising healthcare costs and mass Medicaid disenrollments, forcing low-income patients in healthcare deserts into a situation where they arrive at specialized clinics sicker and facing funding gaps. Describing the compounding crises, Partners in Abortion Care co-founder Diane Horvath observed that patients are showing up “later and sicker” for care. While all-trimester providers and regional funds work tirelessly to absorb these administrative barriers, this reality illustrates how political mandates inherently delay necessary medical care and directly undermine patient autonomy.

REPRODUCTIVE HEALTH DIGEST (8/20/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes through a federal judge’s ruling that a constitutional right to abortion exists in cases involving the health of the patient, an order pausing the Trump Administration’s attempted overhaul of the Teen Pregnancy Prevention Program, an Oklahoma law criminalizing possession of medication abortion, and Massachusetts’ new law expanding abortion rights. We also discuss Trump’s pick for FDA Commissioner, a multi-state legal battle over a surrogate who fled to Texas, a new 50-state telehealth provider, Texas’s failure to report on key maternal mortality indicators, and new anti-abortion tactics to block access to care. As always, please read on to the end for the news that you need to know. 

Legislation & Litigation:

• Overview:

• Three Republican states have filed a lawsuit asking the Supreme Court to strike down shield laws protecting reproductive healthcare; 

• Trial has ended in a California lawsuit over anti-abortion groups’ promotion of so-called abortion pill reversal; 

• Tennessee Attorney General Jonathan Skrmetti is reportedly investigating reproductive healthcare providers and advocacy groups, issuing sweeping requests for patient, provider, and donor information; 

• The Sixth Circuit Court of Appeals has upheld a partial block on Tennessee’s abortion trafficking ban; 

• Two Oklahoma women filed a lawsuit challenging the state’s abortion ban after being denied care for devastating fetal diagnoses; and 

• A federal court has dismissed a case challenging harmful changes to Title X funding.

• A  Federal Judge Ruled that There is a Constitutional Right to Abortion in Order to Preserve a Patient’s Health:

  • In a groundbreaking ruling, U.S. District Court Judge B. Lynn Winmill struck down key provisions of Idaho’s near-total abortion ban, ruling that  the Fourteenth Amendment’s due process and equal protection clauses guarantee a fundamental right to abortion when pregnancy poses a serious threat to a patient’s physical health or risk of self-harm. In an 81-page decision stemming from a lawsuit brought by a maternal-fetal medicine specialist represented by the Lawyering Project and Legal Voice, the court enjoined state prosecutors from criminally prosecuting Idaho physicians who provide necessary abortion care to preserve a patient’s health. Rejecting state arguments that bodily autonomy yields to government mandate, Judge Winmill wrote that a pregnant person’s health is not a state resource to be allocated at the legislature’s whim. Judge Winmill’s ruling does not relitigate Dobbs, nor does it rely on the privacy-based constitutional grounds that led to Roe’s determination that abortion was a fundamental right. Instead, the court found that the right to health-preserving abortion is separately protected under the Constitution’s guarantees of liberty. While the ruling represents a critical federal constitutional precedent affirming health-preserving care, state officials have already vowed to appeal, and civil enforcement mechanisms under state law remain an ongoing threat to providers.

• A Federal Court has Halted the Trump Administration’s Abrupt Changes to the Teen Pregnancy Prevention Program:

  • In late June, the Trump Administration abruptly cancelled nearly $70 billion in federal grants under HHS’s Teen Pregnancy Prevention Program. The grants were cancelled two years prior to their expiration and grantees were reportedly told that their programs “normalize[] or promote[]  sexual activity for minors” and did not align with the administration’s priorities. New notices of grant opportunities indicated that future applicants must demonstrate that their program aligns with the administration’s priorities - which seem to include abstinence-only and “fertility awareness” education, rather than a robust and evidence-based sex-ed curriculum. Following the grant cancellations, several impacted organizations sued, alleging various constitutional and Administrative Procedure Act violations. On August 19th, U.S. District Judge Christopher Cooper issued an order halting the administration’s actions - though he stopped short of ordering reinstatement of the grant money. HHS is all but certain to appeal Judge Cooper’s decision up to the D.C. Circuit. 

• Oklahoma Law Criminalizing Possession of Abortion Pills Is In Effect:

  • Last week, an Oklahoma law creating a felony trafficking charge for possession or delivery of abortion pills took effect. The bill subjects alleged violators to up to 10 years in prison, a $100,000 fine or both. It carves out immunity for the pregnant person. Although Oklahoma already enforces a total abortion ban, the law is a clear attempt to crack down on access to telehealth abortion, which has allowed pregnant people in all 50 states to continue to access care. Oklahoma Rep. Denise Crosswhite Hader, the author of the bill, framed it as protecting “vulnerable women who have too often been coerced or deceived into taking [medication abortion] pills with no medical care or support.” Despite anti-abortion activists’ frequent use of talking points around coercion, the danger of medication abortion, and protecting women, research has consistently shown that medication abortion is highly safe and effective and that abusers are far more likely to coerce their partners into remaining pregnant or to sabotage birth control than they are to force an abortion.

• Massachusetts Governor Signs Legislation to End Abortion Limitations After 24 Weeks:

  • Last week, Massachusetts Governor Maura Healey signed the Prioritizing Patient Access to Care Act into law, eliminating the state’s 24-week gestational limit and placing healthcare decisions firmly back in the hands of patients and their trusted medical providers. This legislation directly addresses systemic barriers that previously forced patients facing severe pregnancy complications and heartbreaking fetal diagnoses to travel hundreds of miles and pay out of pocket for essential care. By removing the government from reproductive healthcare decisions and placing authority in the hands of physicians and patients, the new law establishes Massachusetts as a vital sanctuary for comprehensive reproductive freedom.

Trend and Policy Watch:

• President Trump Taps White House Aide Dr. Heidi Overton to Lead FDA:

  • President Trump has reportedly tapped Dr. Heidi Overton to be the new Commissioner of the FDA, following the departure of Dr. Marty Makary earlier this year. Dr. Overton is the deputy director of the White House Domestic Policy Council. She has seemingly been active in the Trump Administration’s anti-vax policies, appearing beside him when he announced a new policy to split the measles, mumps, and rubella (MMR) vaccinations into three separate vaccines and repeated the long-debunked talking point that vaccines cause autism. Dr. Overton has been critical of medication abortion and called for its regulation. If confirmed as head of the FDA, she will be in a key position to guide the administration’s actions with respect to access to medication abortion, including ongoing litigation seeking to limit availability to care. 

• A Surrogate Has Ignited a Multi-State Legal Battle After Fleeing to Texas Following a Severe Fetal Diagnosis:

• Anti-abortion groups and Texas Attorney General Ken Paxton injected state power into a complex, tragic, medical dispute involving a surrogate who fled to Texas after refusing to honor a surrogacy contract following a severe fetal heart diagnosis. Earlier this year, a California couple expecting a child via surrogate received a devastating fetal diagnosis at 20 weeks. The surrogate, supported by anti-abortion group Live Action and represented by the far-right legal group Alliance Defending Freedom, relocated to Texas in an apparent bid to avoid termination and force delivery under the state’s abortion ban. She then asked a Dallas court to grant her parental rights, and Paxton intervened, demanding court-ordered medical intervention while falsely accusing the biological parents of refusing care. A judge subsequently issued a temporary restraining order stripping the surrogate of medical decision-making authority, prohibiting her from holding herself out as the parent, and mandating that the child receive necessary medical care. The child’s parents are now with him as he receives care in Texas. The case is an extreme example of anti-abortion groups weaponizing abortion bans, twisting narratives, and politicizing highly personal circumstances in order to further their agenda.

• A North Carolina Teen Has Been Arrested After Allegedly Self-Managing An Abortion:

• In Durham, North Carolina, an 18-year-old faces multiple felony charges, including assault inflicting serious bodily injury on an unborn child and assault with a deadly weapon with intent to kill, after allegedly taking FDA-approved medication to self-manage an abortion late in pregnancy. Emergency services were dispatched to her residence after she gave birth, escalating an already traumatic medical emergency into a criminal investigation. Legal advocates and civil rights organizations, including If/When/How and Pregnancy Justice, have vehemently condemned the arrest, noting that North Carolina law does not recognize fetal personhood and explicitly excludes pregnant individuals from criminal liability regarding outcomes of their own pregnancies. This arrest underscores the need for pregnant people to be met with accessible resources and information - not stigma, investigation, and criminalization.

• A New 50-State Telehealth Provider Has Opened its Virtual Doors:

• A new telehealth provider, At Home Abortion (AHA), opened its virtual doors on August 11th with the mission of ensuring continued access to medication abortion regardless of restrictions that the administration may put into place. According to its website, AHA’s staff is made up of providers with over 100 years of experience in abortion and reproductive health care. They are based in Europe and operate out of shield states in the U.S., which block out-of-state investigations and extraditions. They charge $150 for their services, but also operate a sliding scale model supported by donors and abortion funds that allows them to ship medication for free if that is what the patient needs. Groups like At Home Abortion are a critical safety net for pregnant patients in need of care and will create a safe harbor in the event that the Trump administration takes action to prohibit or limit medication abortion nationwide. 

• Upcoming Texas Maternal Mortality and Morbidity Review Committee Report Will Exclude the First Full Years of the State’s Abortion Ban:

• Texas’s forthcoming report on maternal mortality and morbidity will exclude the years immediately following the state’s 6-week and then total abortion bans taking effect. The Texas Maternal Mortality and Morbidity Review Committee, which studies pregnancy-related deaths in the state and makes recommendations for improving outcomes, is expected to publish its latest report on September 1. In 2024, Dr. Carla Ortique, who chairs the MMRC, defended the decision to skip over 2022 and 2023, claiming that there was no political motivation or interference involved and that the committee merely intended to focus on recent cases. Regardless, the MMRC faced accusations of attempting to obfuscate the immediate impacts of the state’s abortion bans. Since the state banned abortion, many people have gone public with their stories of how they have been denied lifesaving care and faced severe physical harm and trauma. Several women, including Porsha Ngumezi, Tierra Walker, Josseli Barnica, and Nevaeh Crain, lost their lives to the bans. These women deserve better than a state that is willing to sweep their suffering and their stories under the rug in the name of political expediency. 

• Anti-Abortion Groups Seeks to Use Interpol to Crack Down on Abortion Pills:

• According to reporting  by The 19th, a prominent anti-abortion group plans to ask the Department of Justice to involve Interpol in stopping the flow of medication abortion into the U.S. In a late July webinar, SBA Pro-Life America’s research arm, the Charlotte Lozier Institute, reported on upcoming research on how the DOJ could use an “annual global law enforcement campaign known as Operation Pangea to disrupt the domestic distribution of mifepristone.” Interpol, an international law enforcement entity, conducts Operation Pangea as an effort to “disrupt the online sale of counterfeit and illicit health products,” and raise awareness of the dangers of buying from unregulated sellers. Commonly seized products under the campaign include fake erectile dysfunction medications, anti-depressants, anabolic steroids, and diabetes and cancer medications. Experts have reportedly indicated that it is unlikely that Operation Pangea could be successfully utilized to block access to mifepristone; however, the new strategy is indicative of the anti-abortion right’s growing frustration with the Trump Administration’s perceived inaction on abortion.

• Pregnancy Justice Released its 2025-2026 Report on Criminalization and the Rights of Pregnant People:

• Pregnancy Justice, an organization dedicated to fighting the criminalization of pregnancy and pregnant people, released its 2025-2026 Report titled “Trends in Criminalization and the Legal Rights of Pregnant People.” In it, Pregnancy Justice analyzed over 730 harmful and protective bills from across the country to identify trends in legislation and policy. Among the notable negative trends are: 1) increased momentum in the abortion-abolitionist movement - the movement that seeks to criminalize abortion as murder; 2) extreme fetal personhood bills, including those that would impact access to IVF and contraception; and 3) harmful legislation masked in seemingly unrelated parts of state law. Positive trends included 1) states repealing fetal personhood laws; 2)  increased understanding about substance use during pregnancy as a mental and maternal health issue; 3) protections against the criminalization of pregnant and postpartum people, and 4) some improvements in conditions for incarcerated pregnant people. For a detailed look at where legislation involving pregnancy criminalization, fetal personhood, and the rights of pregnant people stands over 4 years post-Dobbs, we highly recommend reading the full report. 

REPRODUCTIVE HEALTH DIGEST (7/10/26)

Developments in Abortion, Autonomy, and Access:

This week’s Repro Health Digest walks through the expiration of the one-year “defunding” of Planned Parenthood, new Illinois legislation protecting abortion data privacy, and new laws restricting medication abortion in Iowa and Mississippi. We also discuss the Texas GOP’s anti-IVF platform, the story of another Texas woman who nearly lost her life to the state’s abortion ban, the shifting availability of Planned Parenthood clinics, ballot measure developments, and the Trump Administration’s rescission of teen pregnancy prevention funding. As always, please read on to the end for the news that you need to know. 

🚨Action Alert🚨

L4GG is calling on our attorney community to oppose Todd Blanche for Attorney General. Under Blanche’s leadership, DOJ has already staked out anti-abortion positions, including accusing the Biden Administration of ‘weaponizing’ the Freedom of Access to Clinics (FACE) Act against violent anti-abortion protestors and firing several DOJ attorneys involved in FACE Act prosecutions. He is also facing intense pressure from the anti-abortion right to settle lawsuits challenging the FDA’s relaxation of restrictions on mifepristone. If confirmed or allowed to continue in an acting capacity, Blanche is in a position to lead the DOJ’s legal strategy in a direction that could devastate access to reproductive healthcare. We are asking our community to stand up and call on their senators to demand a just and independent DOJ. 

L4GG is delivering our Block Blanche letter to the Senate this week → Sign the open letter

Legislation & Litigation:

• Overview:

• Overview:

• The one-year “defunding” of Planned Parenthood has expired, allowing federal Medicaid reimbursements to resume; 

• Illinois Governor JB Pritzker has signed legislation strengthening privacy protections for reproductive health information; 

• Iowa's telemedicine abortion ban has taken effect, making access to medication abortion more difficult in the state; and 

• A Mississippi law treating mifepristone and misoprostol under the state’s drug trafficking laws has gone into effect. 

• The One-Year Defunding of Planned Parenthood Expired in Early July:

  • The one-year ‘defunding’ of Planned Parenthood and other large abortion providers expired in early July, allowing federal Medicaid reimbursements for essential services to resume. Reportedly, around 30 health centers, which provided contraceptive care to over 40,000 patients, were forced to close since last July. Additionally, according to data compiled by Planned Parenthood, in the past year, 25% less birth control pills were dispensed; long-activing reversible contraception like IUDs dropped by 26%; 20% less breast exam visits occurred; and, STI testing dropped by 10%. The Hyde Amendment has long prohibited federal funding from paying for abortion, so the defund provision succeeded only in hindering low-cost access to basic preventative and reproductive healthcare. 

  • Although many Planned Parenthood clinics will now be able to bill Medicaid once again, some states have enacted prohibitions on state funding for abortion care, following the Supreme Court’s 2025 decision in Medina v. Planned Parenthood South Atlantic, which essentially allows states to exclude Planned Parenthood from their covered providers. Meanwhile, as KFF points out, the expiration will provide needed relief to the 11 states who stepped up to use state funding to fill the gap created by the defund provision. Although the long-term future of Planned Parenthood and reproductive healthcare funding remains uncertain, the end of the defund provision will allow clinics to see more patients and patients to access care more easily within their communities. While abortion rights advocates have celebrated the news, Anti-abortion activists have reacted in frustration and continued disappointment with the Trump Administration for failing to take more aggressive action on abortion. 

• New Iowa Law Eliminates Telehealth Option for Medication Abortions:

• In Iowa, a strict new law targeting abortion-inducing medications mifepristone and misoprostol has officially gone into effect, heavily restricting how patients access early-term reproductive care. Under House File 2563, signed by Governor Kim Reynolds and effective as of  July 1st, Iowans seeking medication abortions must now obtain prescriptions through in-person appointments at a physical medical center. The legislation effectively eliminates telehealth and mail-order options for these prescriptions within the state, requiring an Iowa provider to see the patient in person, perform an ultrasound, provide mandatory counseling, and obtain written consent. While the in-person requirement only applies to Iowa healthcare providers, this law creates additional challenges for those who cannot afford to travel to a physical health center in-state or are unable to access care from a neighboring shield law state, like Minnesota or Illinois. Opponents of this law and medical advocates sharply criticize the measure, warning that forcing multiple medically unnecessary in-person visits, when combined with the state’s mandatory 24-hour waiting period, creates immense logistical hurdles for rural residents and delays time-sensitive care.

• Illinois Strengthens Data Privacy Laws for Reproductive Healthcare:

• On July 1st, the Reproductive Health Privacy Act went into effect in Illinois. Signed by Governor JB Pritzker in late June, the new law shores up privacy protections for healthcare data by requiring separation of certain records around abortion and gender-affirming care from a patient’s general digital medical records and prohibiting sharing with out-of-state entities except for certain limited purposes. Signed on the anniversary of the Dobbs decision, Governor Pritzker praised the bill as being “yet more progress in rejecting the invasion on privacy rights being perpetrated by states across the country.” According to Guttmacher, in 2025, Illinois absorbed nearly a quarter of abortion patients traveling from their home state for care, making it one of the most critical safety net states for reproductive healthcare. The new law bolsters Illinois’ preexisting protections for reproductive health, including a robust shield law, public and private coverage for abortion care, contraception and medication abortion on college campuses, and strict regulations on misinformation spread by crisis pregnancy centers. 

• Mississippi Law Tightening Restrictions on Abortion Medications Goes Into Effect:

• A new Mississippi law criminalizing medication abortion drugs mifepristone and misoprostol under the state’s drug trafficking laws has taken effect. Under HB 1613, passed in April, it is a crime for anyone to – among other things – transfer, manufacture, distribute, dispense, or possess an “abortion-inducing drug,” unless the drugs are prescribed for a lawful purpose under the state’s strict abortion ban. Alleged violators can face up to 10 years in prison. The crackdown on medication abortion is intended to make it more difficult for people in Mississippi to access telehealth abortion care through shield providers or other third-parties. However, opponents have criticized the potential for heightened criminalization and negative effects on patient care. Democratic Representative Zakiya Summers explained her opposition to the bill, saying that “I think we’re going to end up trapping a lot of people into the criminal justice system simply because they want to have autonomy over their own bodies.” Dr. Bhavik Kumar, a family medicine physician, expressed concern that the law would create confusion for patients and providers and that “healthcare providers are suddenly having to think about laws and rules that have nothing to do with patient safety.”

Trend and Policy Watch:

• Texas GOP Adopts Anti-IVF Platform:

  • The Texas GOP has adopted anti-IVF and anti-surrogacy policies in its official platform, asking lawmakers to “protect fetal life from destructive practices, such as IVF and commercial surrogacy,” prevent “embryo discarding,” and prohibit public funding for procedures that destroy embryonic life.” Although the party’s platform is a non-binding statement of its positions and priorities and cannot mandate legislative action, it is a powerful expression of the political will of some of the state's most far-right factions. Current Texas Attorney General Ken Paxton has broken with the party’s position, affirming that he continues to support IVF. However, his position may be informed, at least in part, by the electability politics involved in his current race for state senator against Democrat James Talarico. Polling from Pew Research Center shows that Americans overwhelmingly support access to assisted reproductive technologies, with only 8% stating that access to IVF is a bad thing. Despite this, the anti-abortion movement’s growing focus on fetal personhood has led to rising anti-IVF sentiment. Their opposition is rooted in the belief that life fully begins at fertilization, so procedures like IVF that require the destruction of embryos are necessarily akin to destroying human life.

• Another Texas Woman Almost Died As a Result of the State’s Abortion Ban:

• Another Texas woman has filed a federal complaint after nearly losing her life to the state’s abortion ban. According to her Complaint, Lynn Callaway learned that she was pregnant last September; however, despite initial excitement, approximately 7 weeks into her pregnancy, she began to experience bleeding and severe abdominal pain. Following a visit to her ob-gyn, which resulted in instructions to monitor her symptoms at home, Ms. Callaway went to an emergency room. There, it was confirmed for her that she was almost certainly in the process of an active miscarriage, but despite this diagnosis and her worsening symptoms, she was again told to go home and wait it out. After several more days, during which she suffered agonizing pain, increased bleeding and chills, she returned to a second emergency room. This time she was told that she was miscarrying and that she had developed an infection, but she was sent home with only pain medication and antibiotics - she was still not offered standard care to terminate the doomed pregnancy that was making her sick. Ultimately, after days of unnecessary suffering, Ms. Callaway was given medication abortion pills by her ob-gyn. When she asked why she had not been helped earlier, her doctor expressed that she would “have to be damned sure that it’s an actual miscarriage to be offering the pill,” seeming to confirm that the reason Ms. Callaway’s care was delayed because of uncertainty about when during a miscarriage a physician can intervene. Months later, Ms. Callaway had to be treated for retained products from the miscarriage, and she has since been diagnosed with PTSD. 

• Ms. Callaway’s story is far from the only one involving pregnant patients failing to receive standard care for obstetrical emergencies and pregnancy loss. In Texas alone, over 20 women sued the state to expand exceptions for the life and health of the pregnant person after being denied needed abortions. And, several women have needlessly lost their lives to the ban. Despite mounting evidence of the devastating harm caused by abortion bans, anti-choice lawmakers have shown no indication of an intent to amend or eliminate the laws. 

• A Planned Parenthood Opens in Louisiana and Shutters in Iowa:

• Access to Planned Parenthood remains in flux  across the U.S. This month, Planned Parenthood Great Plains announced its plans to begin providing care in Louisiana once again. Later this summer, it will offer telehealth services throughout the state, and an in-person clinic will open in New Orleans in the fall. Although abortion is banned at all gestational ages in Louisiana, Planned Parenthood will be able to offer critical health services including STI testing and treatment, contraception, pregnancy testing, and cancer screenings. These services are urgent in Louisiana, which ranks among the worst states in the country for health indicators like STI rates and maternal mortality. 

• As Louisiana welcomes a new Planned Parenthood, Iowa is losing one of its only remaining clinics. On July 31st, Planned Parenthood’s Iowa City clinic will close its doors - leaving only one clinic left in the state. Last year, four other Planned Parenthood clinics in the state were forced to close. Abortion is extremely restricted in Iowa, with patients only able to access care until about 6-weeks gestational age. Reportedly, the state’s restrictions combined with severe losses in federal funding have forced the organization into restructuring. According to Planned Parenthood’s website, it will continue to offer telehealth services to Iowans. However, with Iowa’s recent passage of a law requiring patients to make an in-person clinic visit for medication abortion, patients’ in-state telehealth options are extremely limited. 

• Idaho Coalition Submits Signatures for Reproductive Rights Ballot Measure:

  • In Idaho, a monumental grassroots effort has positioned a reproductive rights initiative on the horizon for the upcoming November election. Idahoans United for Women and Families, a strictly volunteer-led coalition, announced that they have successfully submitted over 110,000 signatures to the Secretary of State’s office to place the Reproductive Freedom and Privacy Act on the ballot. The total comfortably clears the state’s requirement of roughly 70,000 valid signatures. The proposed constitutional amendment seeks to restore the standard applicable prior to the overturning of Roe v. Wade, protecting access to abortion up to fetal viability, alongside explicit safeguards for contraception, miscarriage care, and IVF. The massive mobilization effort follows growing pressure from Idaho medical professionals, who have repeatedly warned that the state’s near-total abortion ban’s vague and narrow exceptions place patients at a severe risk and has forced a devastating exodus of OB-GYNs from the state. The state has also been engaged in years-long litigation over whether its abortion ban violates the Emergency Medical Treatment and Active Labor Act (EMTALA) by failing to adequately permit care in obstetric emergencies. 

• Trump Administration Abruptly Terminates Teen Pregnancy Prevention Grants:

• The Department of Health and Human Services (HHS) under the Trump administration has abruptly canceled the vast majority of federal grants dedicated to the Teen Pregnancy Prevention (TPP) Program. The sweeping directive slashes 53 of the 67 existing grants, worth approximately $68 million and impacting funding mid-project for state health departments, universities, community groups, and Planned Parenthood affiliates across more than two dozen states. Federal officials defended the decision by arguing that the targeted programs promoted age-inappropriate, “sexually explicit” curricula that normalized adolescent sexual activity and conflicted with the agency’s current mission. Conversely, health advocates and a coalition of Democratic lawmakers have fiercely condemned the mid-cycle terminations, calling them an ideological rejection of evidence-based medicine that actively undermines a program responsible for decades of declining teen birth rates. According to the CDC, teen pregnancy rates have fallen by around 72% in the past 20 years, a decline at least in part attributable to increased access to education and contraception. The cuts to Teen Pregnancy Prevention funding come as some voices on the right have lamented the fall in teen pregnancy rates, framing it as a crisis and a problem to be solved. 

REPRODUCTIVE HEALTH DIGEST (6/25/26)

Developments in Abortion, Autonomy, and Access:

This week’s Repro Health Digest discusses a new lawsuit challenging in-person requirements for medication abortion in Alaska, two state court decisions striking down abortion restrictions, a new lawsuit targeting transgender healthcare, and the Supreme Court’s decision not to hear a case involving anti-abortion speech at the high school level. We also examine how abortion bans are impacting the economy, the Trump Administration’s quiet nod to the fetal personhood movement, state-level attacks on mifepristone, and a Texas mural honoring women who lost their lives to the state’s abortion ban. As always, please read on to the end for the news that you need to know. 

Legislation & Litigation:

• Overview:

  • Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky has filed a new lawsuit challenging Alaska’s ban on telemedicine abortion; 

  • The Federal Trade Commission and states have filed a lawsuit against the World Professional Association for Transgender Health alleging deceptive claims; 

  • A Missouri Court has struck down a series of anti-abortion restrictions, opening the door for patients to access medication abortion for the first time in years; 

  • The U.S. Supreme Court has declined to hear a case brought by a former high school student challenging her school’s prohibition on flyers with anti-abortion political messaging; and 

  • A Wyoming court has struck down three medically unnecessary abortion restrictions. 

• Planned Parenthood Sues Alaska Over In-Person Requirements for Medication Abortion:

  • Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky has filed a lawsuit challenging Alaska's ban on telemedicine abortion. Under current law, abortion is legal in Alaska, but individuals seeking to use medication must have an in-person clinic visit. The newly-filed lawsuit argues that this requirement violates the Alaska Constitution’s guarantee of privacy, which has been interpreted to include a right to abortion. Dr. Colleen McNicholas, the chief medical officer at the Planned Parenthood affiliate, notes that medication abortion is only available to patients under 12 weeks, but in Alaska traveling to access a clinic presents unique challenges that can take patients outside of that window. As explained by The Hill, “more than 60,000 Alaskans live off the road system and can only travel by plane to reach Anchorage or Fairbanks,” where the two in-state Planned Parenthood clinics are located, and “even if someone does live on the road system, they are being forced to drive hundreds of miles round-trip to reach a health center.” 

• Federal Trade Commission and States Sue the World Professional Association for Transgender Health Over Alleged Deceptive Claims:

  • Note: this story was originally published in our Trans Rights Digest. 

  • On June 17th, the Federal Trade Commission (FTC), along with Alaska, Iowa, Nebraska, and Texas, filed suit against the World Professional Association for Transgender Health (WPATH) in the U.S. District Court of the Northern District of Texas. The complaint focuses heavily on the ‘market’ for transition services that they allege is created and expanded by WPATH through the self-publication and distribution of its Standards of Care (SOC), which are evidence and consensus based clinical guidelines for medical transition services. The FTC feigns concern for youth by arguing that the latest version of the SOC provides either misleading at best or fraudulent at worst recommendations for medical transition services by omitting age limitations for mastectomies or penectomies. The Nebraskan, Iowan, and Alaskan Attorney Generals all echoed a similar sentiment: that WPATH is not a medical body, but instead advances profit-driven ideology unsupported by science and makes recommendations based on politics rather than science. 

  • Although WPATH has not yet filed its response, on June 17th, it published an organizational statement referencing prior federal court wins against the FTC and a federal court finding that the FTC “is acting out of pure retaliation as a part of the federal government’s relentless and targeted campaign to undermining gender-affirming care.” 

  • The lawsuit will likely prompt statements from organizations and advocates across the nonprofit sphere. The Consumer Federation of America wrote that the FTC could be a “powerful fighter against high prices”, but instead they have chosen to fight a “baseless culture war,” and that American consumers should “question whether this is the best use of public time and resources.”

• Missouri Court Strikes Down Anti-Abortion Restrictions:

  • In Missouri, a state court has struck down a series of abortion restrictions, siding with Planned Parenthood and increasing access to care. Over a year ago, Missourians voted to overturn the state’s total abortion ban and restore pre-viability abortion rights; however, a series of state restrictions have made access difficult. Although procedural abortion has been available since last year, the state’s medically unnecessary requirement of “complication plans” has functionally blocked medication abortions. However, on June 18th, Judge Jerri Zhang issued a ruling finding that a host of abortion restrictions were unconstitutional in light of the amended constitution’s protections for reproductive health. Among the struck laws are reporting requirements, a telemedicine ban, onerous licensing requirements, and the requirement for a state-approved “complication plan” for medication abortions. Planned Parenthood will begin prescribing abortion pills within the week. Missouri Attorney General Catherine Hanaway called the ruling a “radical decision” and vowed to appeal it as soon as possible. Additionally, the state is asking voters to repeal the abortion rights constitutional amendment in November’s election. 

• Supreme Court Rejects Student Anti-Abortion Speech Case:

  • The U.S. Supreme Court has declined to hear a case brought by a former student arguing that her Indiana high school violated her constitutional rights by prohibiting the use of a flyer with political speech on it. The case involves a former student - identified as E.D. - who formed a local chapter of Students for Life of America at her school. Although the school permitted her to start the club and advertise it at an activity fair using the slogan “I am the pro-life generation,” she was prohibited from hanging flyers that included political speech such as “Defund Planned Parenthood.” The trial court sided with the school, finding that their policy prohibiting political content on flyers posted on school walls did not violate the student’s rights; the 7th Circuit Court of Appeals later affirmed. The case turns on a 1988 case called Hazelwood School District v. Kuhlmeier, in which the Supreme Court found that schools have some authority to reasonably restrict the content of student speech, particularly where it does not appear in a public forum. Notably, Justice Alito dissented from the Court’s decision not to hear the case, arguing that the court should revisit its precedent in Hazelwood.

• Wyoming Court Strikes Down Abortion Restrictions:

  • A Wyoming state court has struck three abortion restrictions, finding that they violate the state’s constitution. Although Wyoming has tried several times to ban or severely restrict abortion, the state’s supreme court has upheld the right to abortion under the Wyoming constitution’s guarantee of autonomy in medical decisionmaking, which was ironically passed in response to the Affordable Care Act. Currently, abortion is legal in the state until viability. The most recent court order found that laws 1) requiring patients to get an ultrasound 48 hours prior to an abortion; 2) mandating that abortion clinics meet the standards of ambulatory surgical centers; and 3) prohibiting the use of abortion pills for off-label uses were unconstitutional. The laws were already temporarily blocked by court order, but the court’s decision cements that ruling. The State may now decide to appeal to the Wyoming Supreme Court.

Trend and Policy Watch:

• States Push EPA to Classify Mifepristone as an Environmental Contaminant:

  • A cohort of 14 state attorneys general and 19 congresspeople are urging the U.S. Environmental Protection Agency (EPA) to include mifepristone in its Contaminant Candidate list on the grounds that its entrance into wastewater could create environmental and health risks. The states and congresspeople sent concurrent letters to the Agency in which they purport to be concerned with environmental safety; however, the letters use highly inflammatory anti-abortion language, including referring to mifepristone as “baby poison” and describing it as “barbarically starv[ing] the unborn baby.” Students for Life of America has also been pushing the narrative that mifepristone is an environmental threat, with their head of policy famously claiming that we are “drinking other people’s abortions.” However, there is no credible evidence that the medication poses any risks to waterways or drinking water. Mifepristone is now used in over 2/3 of abortions in the U.S., - a fact that anti-abortion activists have responded to by attempting to eliminate access through any available means. 

• Abortion Bans Take an Enormous Toll on the Economy:

  • New reporting from the Institute for Women’s Policy Research shows that abortion bans and restrictions have resulted in over $140 billion in lost earnings annually. This is in large part because bans can limit pregnant people’s ability to get an education, enter and stay in the workforce, and advance their careers. IWPR’s research shows that states with total or 6-week abortion bans in place account for approximately $68 billion of that economic cost. The total number is up $7 million from last year’s analysis - a number that IWPR notes could fund SNAP benefits for a million Americans for a year. As Melissa Holly Mahoney, the report’s co-author told Rewire, “abortion bans are a drag on the economy by impacting women’s choices about their careers,” and “when women are unable to make choices about when, or if, to start a family, they are less willing to change jobs, to take time out from employment for education or skills training, which could then lead to higher-paying jobs,” or they may end up “leaving the labor force altogether.” 

  • This reporting comes at the same time as new data showing that ACA enrollment fell by more than 5 million people this year, in large part due to the expiration of ACA subsidies and provisions in the “big, beautiful bill.” Experts have indicated that, although some people may be “switching to job-based insurance, [] the scale of the decline suggests many people likely lost their health coverage.” As abortion bans force more people out of the workforce, the numbers of uninsured Americans will only rise, increasing strain on the economy and worsening quality of life for those impacted. 

• Alabama Attorney General Sends Cease and Desist Letters to Companies Associated with Medication Abortion:

  • Alabama Attorney General Steve Marshall issued cease-and-desist letters threatening legal action against six companies involved in the provision of medication abortion. The letters were sent to Plan C, Southern Woven, ybycmeds, Abortion Pills in Private, Red State Access, and Cambridge Reproductive Health Consultants. The letters state that abortion is illegal in the state and the companies are breaking the law by providing pills. It also accuses them of misleading Alabamians about the safety of the drugs and trying to “exploit Alabamians for profit” and threatens to prosecute the companies “to the fullest extent permitted by law.” As Robin Marty, executive director of West Alabama Women’s Center explains, by naming the companies, the press release ironically “has now improved the ability for people to find out where they can access abortion in a way that [providers] were never able to actually let people know before.” 

• Trump Administration Takes Step Toward Enshrining Fetal Personhood:

  • The Trump Administration has quietly taken a step towards enshrining fetal personhood at the federal level. In a new notice of funding opportunity for the Embryo Adoption Awareness and Services program, which was created in 2002 by President George W. Bush and is administered by HHS, the administration has changed language to refer to embryos as children and refer to unused embryos as “children who already exist and are in need of a family.” As Mother Jones reports, embryo adoption “was the Christian right’s response to the rise in popularity of [IVF] in the early aughts,” and because “the fertility treatment involves generating far more embryos than any prospective parent is likely to use” many IVF patients are left with frozen embryos that will never be used. Recently, opposition to IVF has become more mainstream within the anti-abortion movement, with activists seeking to define and legislate life as beginning at the moment of conception and characterize frozen embryos as unborn children. Several states have used such language in legislation, opening the door to increased restrictions on abortion, the conduct of pregnant people, access to certain kinds of contraception, and access to assisted fertility.

• San Antonio Mural Honors Texas Woman Who Died As a Result of the State’s Abortion Ban:

  • In San Antonio, Texas, artist Ana Hernandez has created a mural honoring the lives of four women lost to Texas’s abortion ban. The women, Josseli Barnica (28), Nevaeh Crain (18), Porsha Ngumezi (35), and Tierra Walker (37) each lost their lives as a direct result of being unable to access the life-saving care that they needed under Texas’s abortion bans. Families of the deceased were present and spoke at the unveiling, sharing their loved ones’ stories and speaking out against the injustices of their deaths. The mural is located in the Southtown Arts District on the side wall of the Mercury Building. May we continue to remember the names and stories of everyone lost to abortion bans as we continue to fight for reproductive freedom for all. 

REPRODUCTIVE HEALTH DIGEST (5/28/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers the latest decision from the Supreme Court on access to medication abortion, litigation developments out of Arkansas and Indiana, a new lawsuit challenging the VA’s abortion ban, Texas’s continued legal pursuit of a New York shield provider, Iowa’s new law restricting medication abortion access, and ongoing policy developments impacting reproductive health and bodily autonomy. As always, please read on to the end for the news that you need to know. 

Legislation & Litigation:

• Overview:

• The Supreme Court issued a ruling allowing mifepristone to continue to be available by mail while litigation challenging the removal of in-person dispensing requirements plays out in the lower courts; 

• A previously-dismissed challenge to Arkansas’ total abortion ban has been revived; 

• A veterans rights advocacy group is suing the Trump Administration over the VA’s rescission of abortion coverage; 

• Indiana’s total abortion ban will remain in place, following a state supreme court order; 

• Iowa Governor Kim Reynolds has signed a law restricting access to medication abortion; 

• Texas is continuing its lawsuit against New York shield provider Dr. Maggie Carpenter; it has appealed an October ruling by a New York court that affirmed protections under the state’s shield law. 

• Supreme Court Issues Order Allowing Mifepristone by Mail to Continue for Now:

• Shortly after publication of our last Digest, the Supreme Court issued an Order allowing mifepristone to continue to be prescribed and dispensed through telehealth. As a reminder, Louisiana initiated this litigation against the FDA in order to challenge the 2023 removal of in-person dispensing requirements for the commonly used medication abortion drug. On May 1, 2026, a panel of Republican-appointed Judges from the 5th Circuit Court of Appeals granted Louisiana’s request to reinstate in-person dispensing requirements during the pendency of litigation. Danco and GenBioPro, the manufacturers of the medication, appealed the 5th Circuit’s decision to the Supreme Court. After a brief extension, Justice Alito, who oversees emergency appeals out of the Fifth Circuit, issued an Order preserving the status quo and allowing mifepristone to continue to be sent by mail while the litigation makes its way through the lower courts. Notably, Justice Thomas penned a dissent in which he called out the Comstock Act - an 1873 anti-vice law - as a legitimate basis for ruling in Louisiana’s favor on the merits of the case. Despite courts being clear that Comstock is dead law in the context of lawful abortion, anti-abortion activists have responded to the growing availability of telehealth abortion care by calling for its enforcement - a move that could lead to a de-facto nationwide abortion ban. Some legal experts have speculated that the Trump administration has made a strategic decision not to take a strong stance on the question of mifepristone until after the midterm elections.

• Lawsuit Challenging Arkansas’ Abortion Ban Revived After Previous Dismissal:

• As we have previously reported, a group of Arkansas women who were denied abortion care in their home and an Arkansas ob-gyn are suing to overturn the state’s total abortion ban on constitutional grounds. The ban only permits abortion in circumstances where the patient's life is at risk. On April 30th, Pulaski County Circuit Judge Cara Conners issued a decision dismissing the case pursuant to a recently-passed Arkansas law requiring certain constitutional challenges to go before the Arkansas Court of Appeals. However, shortly before Judge Conners issued her decision, the Arkansas Supreme Court found that the law that she had based her ruling on is unconstitutional. Upon the plaintiffs’ motion, Judge Conners agreed that the case should be revived in her court. 

• As reported by the Arkansas Advocate, five of the six women involved in the lawsuit were forced to travel to Kansas or Illinois to obtain care; of those women, three had nonviable pregnancies, one had been the victim of sexual assault, and one did not want children - the final plaintiff had to carry her pregnancy for nearly two months after learning it was nonviable as a result of the state’s abortion ban. The case is being litigated by Molly Duane of Amplify Legal, the litigation arm of Abortion in America. 

• Veterans Advocacy Organization Sues Trump Administration Over Rescission of Abortion Coverage:

• A veterans advocacy group - Minority Veterans of America - has filed a lawsuit against the Trump Administration challenging its policy rescinding abortion coverage and counseling for service members. The memo announcing the change in policy was issued late last year and authored by anti-abortion Deputy Attorney General Joshua Craddock. It asserted that the Biden-era policy of coverage for veterans was invalid. Under the new policy, abortion coverage is only permitted when the life of the pregnant person is endangered. Reportedly, many of Minority Veterans of America’s members live in states with abortion bans, leaving them to rely on the VA for access to care. The Organization’s lawsuit argues that the VA violated the Administrative Procedure Act by enacting restrictions on abortion coverage in cases where the patient’s health is in danger or where the pregnancy resulted from rape or incest.

• Indiana’s Abortion Ban Remains in Place After State Supreme Court Upholds Lower Court Decisions:

• Indiana’s near-total abortion ban will remain in place following an Indiana Supreme Court Order declining to review lower court rulings. The ban prohibits abortion at all gestational ages and includes exceptions only for the life or health of the patient, and for cases involving rape or incest or fatal fetal anomalies within a certain gestational age. Following its passage, Planned Parenthood and others filed suit arguing that it violated Indiana constitutional protections. In August of last year, the Indiana Court of Appeals found that there were no circumstances identified wherein the “limited” constitutional right to an abortion to save a patient’s life or preserve their health would be implicated and the state’s abortion ban would prohibit care. The ACLU acknowledged that the Indiana Supreme Court’s decision ends the legal challenge and lamented the impact that the ban’s continued enforcement will have on patient safety. This case does not impact a separate case challenging the state’s abortion ban on religious freedom grounds. 

• Iowa Passes Restrictions on Medication Abortion:

• On May 19th, Iowa Governor Kim Reynolds signed House File 2788, a bill restricting access to medication abortions through telehealth and mail-order prescription services. The bill also creates a new civil cause of action against any person who dispenses medication abortion in violation of the law. Effectively, the law reinstates in-person dispensing requirements and incentivizes lawsuits against individuals who provide or facilitate access through other methods. The law will not take effect until July 1, but it comes during a time of national conversation and scrutiny about access to medication abortion and intense pressure from anti-abortion activists to curtail telehealth abortion care. 

• Texas Appeals in Case Challenging New York’s Shield Law:

• Texas is continuing to pursue a judgment against New York shield provider Dr. Maggie Carpenter for allegedly prescribing medication abortion into Texas. Last October, a New York judge dismissed a claim against Ulster County Clerk Taylor Bruck for refusing to file the Texas state court judgment. The court found that Bruck’s conduct was proper in light of New York’s shield law for providers and patients involved in reproductive healthcare. Earlier this month, Texas appealed the October ruling, seeking to enforce its six-figure judgment against Dr. Carpenter, alleging that she acted in violation of the state’s total abortion ban. Bruck is standing by his actions, stating that “in rejecting the Texas filing, I was simply following the law of this State,” and that “the issues in this case . . . are legal in nature; I trust the courts to decide them.” This case is one of multiple pitting state abortion bans against protective shield laws. 

Trend and Policy Watch:

• Texas Attorney General Requires Texas Children’s Hospital to Open a “Detransition Clinic” as Part of Settlement:

• Texas Attorney General Ken Paxton and the Department of Justice have entered into a settlement agreement with Texas Children’s Hospital (TCH) that requires TCH to pay the state $10 million, terminate and revoke medical privileges for five clinicians, and establish the nation’s first “detransition clinic.” This settlement agreement followed a three-year investigation, initiated by AG Paxton’s office, into allegations related to gender-affirming care for minors. During this time, TCH was forced to turn over millions of documents. It is not yet clear what services will be provided at the so-called “detransition clinic.” As the Texas Tribune reports, experts point out that - for the small percentage of individuals who choose to detransition - the resources already exist, and it is unlikely that a clinic created out of a legal battle initiated by a viciously anti-trans politician will have the best intentions of the transgender community at heart. TCH maintains that “all reviews and investigations continue to support” that it has “been compliant with all laws;” the hospital clarified that it is “settling to protect [its] resources from endless and costly litigation,” and that it remains committed to putting its “purpose over politics.”

• Research from the National Abortion Federation Shows that Violence Against Providers and Clinics is On the Rise:

• Research published in the National Abortion Federation’s 2025 Violence and Disruption Report found that violence and threats against abortion clinics and providers significantly increased between 2024 and 2025. The Trump Administration has severely curtailed enforcement of the FACE act,  the federal law seeking to prohibit interference with access to reproductive health clinics. The current DOJ has indicated that it won’t enforce the FACE act, except in extraordinary circumstances, and it has disparaged previous FACE Act enforcement as political weaponization. Trump has also pardoned 23 individuals convicted of FACE Act violations. The administration’s clear message that it does not take threats of anti-abortion violence seriously has clear consequences. As reported by NAF, death threats and stalking incidents against abortion providers more than doubled between 2024 and 2025, and clinic blockades rose from 1 in 2024 to 6 in 2025. Assault and battery, arson, vandalism, and theft also increased. 

• NAF has joined other organizations in a lawsuit challenging the Trump Administration's recently created $1.776 billion  “Anti-Weaponization Fund” on the grounds that it incentivizes and facilitates continued violence against NAF members and their affiliates.

• Missouri Aims to Make Citizen-Led Ballot Initiatives More Difficult to Pass:

• Missouri lawmakers are attempting to make it more difficult for voters to successfully utilize the ballot initiative process. In recent years, Missourians have successfully used the process to legalize marijuana, raise the minimum wage, and reinstate abortion rights. Frustrated by these victories, Governor Mike Kehoe has placed an amendment aimed at making direct democracy more difficult on the August ballot. If passed, Amendment 4 would raise the threshold for passing a citizen-led ballot measure from a simple statewide majority to a majority in every congressional district, allowing a single district veto power. The placement of Amendment 4 on the August ballot, rather than the November ballot has also raised questions. The August ballot draws a traditionally more conservative electorate, and the top races on this August ballot are for competitive Republican primaries. Notably, Amendment 4 would only apply its more stringent passage standard to citizen-initiated measures - it would require constitutional amendments proposed by lawmakers to only receive a simple majority.

• Planned Parenthood Great Northwest to Begin Providing ‘Just in Case’ Abortion Pills to Patients in Hawaii and Washington State:

• Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky (PPGNHAIK) has announced that it will start offering advance provision of abortion pills to people over the age of 18 in Hawaii and Washington. The new service - called Just In Case Abortion Pills - will allow people to obtain pills before they become pregnant, giving them increased options and access. Although other organizations and providers follow a similar model and allow for advance orders of medication abortion, having a provider as established as Planned Parenthood choose to do so sends an important message about the safety of self-managing abortion and the importance of being prepared for a future where medication abortion access may be limited. According to Planned Parenthood, “medications come with clear instructions, and PPGNHAIK clinicians are available by phone every day to answer questions before and after use.

REPRODUCTIVE HEALTH DIGEST (5/14/26)

Developments in Abortion, Autonomy, and Access:

We thank you for your patience while we switched up the Digest schedule to accommodate the needs of our staff in the past several weeks, and we hope that you enjoyed last week’s joint edition of the repro digest and the trans rights digest. We are excited to now be back on our regular schedule, delivering critical repro news directly to your inbox every two weeks. This week’s Digest walks through developments in access to mifepristone, legislation restricting or criminalizing care, the overturn of Michigan’s pregnancy exclusion law for end of life care, and updates in the Tennessee case challenging the state’s abortion ban. We also discuss developments in abortion politics, the future of Planned Parenthood funding, and the Trump Administration’s latest moves with respect to reproductive health. As always, please read on to the end for the news that you need to know. 

Reproductive Rights and Health Equity News

This Week’s Must-Read: 

This week’s must-read tells the story of Tiffany McElroy, an Alabama woman who went into early labor shortly after being booked in an Alabama jail and was forced to give birth on the prison floor while guards reportedly watched and ignored her pleas for help. Other detained women helped her to give birth and revived the baby, who was not breathing when she was born. Pregnancy Justice has filed a federal civil rights lawsuit on Ms. McElroy’s behalf, seeking justice for her and her baby. 

Legislation & Litigation:

• Overview:

  • In-person dispensing requirements for mifepristone remain on hold until 5:00 EDT on Thursday, May 14th, while the Supreme Court continues to consider the matter; 

  • Tennessee is using a newly enacted procedural law to delay trial and testimony  in a case challenging the state’s abortion ban; 

  • South Carolina lawmakers and advocates continue to battle over a proposed total abortion ban that would see providers, patients, and helpers penalized; 

  • Oklahoma Governor Kevin Stitt has signed a law criminalizing medication abortion; 

  • A Michigan court struck down the state’s pregnancy exclusion for end of life directives; and 

  • A bill strengthening so-called ‘conscience protections’ for healthcare providers, institutions, and entities awaits Iowa Governor Kim Reynolds’ signature.

• Medication Abortion Still Available In the Mail Until At Least Thursday, May 14th:

• As reported in our last Digest, on May 1, 2026, a panel of Republican-appointed judges from the 5th Circuit Court of Appeals granted Louisiana’s request to pause a 2023 FDA policy removing in-person dispensing requirements for mifepristone during the pendency of litigation. Danco and GenBioPro, the manufacturers of the medication, appealed the 5th Circuit’s grant to the Supreme Court, and the Supreme Court issued a temporary stay, requiring the parties to submit briefing by Thursday, May 7th. You can read a detailed analysis of this procedural history in this piece published by L4GG legal fellow Zane McNeill. 

• On Monday, May 11th, Justice Alito extended the pause until Thursday, May 14th. Louisiana submitted its brief last week, arguing that in-person dispensing requirements should be reinstated nationwide while the case makes its way through the lower courts. Notably, the Department of Justice, which represents FDA, the actual defendants in this matter, did not file a brief. Both sides reportedly took the administration’s silence as approval of the Fifth Circuit’s decision to re-impose restrictions on access.

• Tennessee Delays Trial in Case Challenging the State’s  Abortion Ban:

• Tennessee has taken procedural action to delay progress in the trial challenging the state’s total abortion ban. The case was originally filed in 2023 by women who had  been denied care in the face of severe medical complications. The law was temporarily paused for circumstances involving medical emergencies, but attorneys  in the case argue that it remains insufficiently clear and that patients will continue to suffer as a result. Trial in the case was set to begin last month; however, the state used a recently passed law allowing for automatic appeals in certain cases to halt the trial at the last minute. This move delays the  plaintiffs’ opportunity to be heard and to tell their stories in a court of law. Notably, the plaintiffs in the case are merely asking for the state to clarify that a patient’s health is sufficient grounds for medical intervention, and that the patient need not be facing an imminent threat to their life - they are not asking the court to overturn the ban altogether. Regardless, the state has attempted to have the case dismissed four times.

• South Carolina Legislature Battles Over Total Abortion Ban:

• South Carolina lawmakers are continuing consideration of a total abortion ban with an exception only for the life of the patient. Currently, South Carolina is enforcing a ban on abortion after detection of fetal cardiac activity - around 6 weeks gestational age - with exceptions for the life of the patient, fatal fetal anomalies, and certain cases of rape or incest. If passed, Senate Bill 1095 would not only make South Carolina a total ban state, but would also take the first-of-its kind step of allowing punishment of the patient themselves. The bill makes it a felony for someone to perform an abortion or provide medication to terminate a pregnancy and a misdemeanor for a person to have an abortion. It would also further limit the rights of minors to obtain abortions, both in and out of state. At this time, the bill still faces a long road and substantial opposition, but the Senate Medical Affairs Committee recently voted to give a favorable report on the bill, advancing it one step closer to passage. 

• Oklahoma Passes Law Restricting Abortion Medications:

• On May 5th, Oklahoma Governor Kevin Stitt signed a new law criminalizing medication abortion, despite the state already enforcing a total abortion ban. House Bill 1168 creates a felony charge for knowingly providing abortion-inducing medication to a pregnant person to terminate their pregnancy, with narrow exceptions for ectopic pregnancies and miscarriage management. Penalties include prison time and up to $100,000 in fines - even for friends or family members who assist someone in obtaining care. According to Senate Minority Leader Julia Kirt, the bill was intended as a political talking point for Republicans on the campaign trail. Regardless, its impact will be to intimidate patients out of seeking care (including lawful care), increase obstacles to clinicians providing care, and interfere with the doctor-patient relationship. The measure will go into effect 90 days after the end of Oklahoma’s legislative session.

• Michigan Court Strikes Down Pregnancy Exclusion for End of Life Directives:

• A Michigan court has struck down provisions of state law that restricted end of life directives for incapacitated pregnant people. Judge Sima Patel wrote that the laws - known as the “pregnancy exclusion” - “infringe on the fundamental right to reproductive freedom as was enshrined in the Michigan Constitution in 2022.” The lawsuit was filed by Michigan women, physicians and patient advocates challenging the state’s denial of incapacitated pregnant people’s right to have their end of life wishes honored. Under the law, patient advocates could not refuse life-sustaining treatment for pregnant people. According to a report by Pregnancy Justice, 29 states have laws invalidating advance directives for pregnant people.

• Iowa Considers Increased ‘Conscience Protections’ as the State’s Abortion Ban Harms Patients:

• A bill to strengthen so-called ‘conscience protections’ for healthcare providers awaits Iowa Governor Kim Reynolds signature. House Bill 571 would empower medical providers and institutions to decline to provide care that they allege conflicts with their moral or religious beliefs - oftentimes, this involves care related to abortion, contraception, or the LGBTQ+ community. Conscience laws generally allow healthcare providers to opt out of caring for a patient when the care required in some way conflicts with their belief system. Proponents of these laws say that they are crucial for protecting religious and individual liberties, but critics say that they conflict with clinicians' ethical obligations to care for all patients equally and threaten to worsen already dire physician shortages. Federal conscience protections already exist for healthcare providers, but many states have passed their own provisions. Iowa’s proposed law would strengthen providers and payors’ rights to refuse to participate in certain care, create additional ‘anti-discrimination’ regulations for objectors, and implement whistleblower and first amendment ‘protections.’ 

Trend and Policy Watch:

• Idahoans Gather Enough Signatures to Put Abortion on the Ballot:

  • Idahoans have officially gathered enough signatures to qualify for the November ballot. The Reproductive Freedom and Privacy Act, championed by Idahoans United for Women and Families, would functionally restore Idaho’s abortion laws to their pre-Dobbs status. Idahoans have suffered under one of the most draconian abortion bans in the country in the years since the Supreme Court overturned Roe, and despite repeated calls for change and clarification, the state has failed to take any action to relieve the healthcare crisis unfolding in the state. As Executive Director of Idahoans United stated, the “hope is that this is one significant step back towards stabilizing  [Idaho’s] healthcare system in asserting that people deserve dignity and privacy as it relates to their medical care.”

• Advocates and Politicians on Both Sides Look to Whether Planned Parenthood will Remain “Defunded”:

• Last year, President Trump effectively defunded Planned Parenthood as a part of the “One Big Beautiful Bill Act.” The defund provision was set to last a year, and as that deadline approaches, politicians on both sides of the aisle are looking to shape the future of reproductive healthcare funding. During reconciliation bill talks, rifts have emerged between Republicans who want to focus solely on funding for immigration enforcement, and those who want to ensure that Planned Parenthood remains defunded. Senator Josh Hawley (R-Mo.) unsuccessfully attempted to pass an amendment to extend the defund provision, and other lawmakers like Texas Senator John Cornyn have called for the permanent defunding of Planned Parenthood through a third reconciliation bill. As Republicans weigh their current legislative priorities, they are grappling with the very real possibility that they may lose the House in the November midterms and, with it, the political power to pass certain hardline conservative policies. 

• Trump Administration Meets with Anti-Abortion Officials:

• The Trump Administration reportedly met with anti-abortion officials last Friday, at a time when prominent anti-abortion groups have vocally criticized Trump’s handling of abortion policy. The Administration has found itself in a difficult position with respect to abortion rights in a midterm year – while taking bolder action to oppose abortion may appease the religious right, it has proven to be a politically challenging or damaging stance with broad swaths of the electorate. The administration’s recent meeting came days before FDA Commissioner Marty Makary resigned from the role, reportedly over moral opposition to the administration’s handling of flavored e-cigarettes. Makary was in charge of the FDA’s “review” of mifepristone’s safety record and had faced calls for his removal from anti-abortion groups that viewed him as not taking sufficiently aggressive action to curb access to medication abortion. 

• Trump Administration Launches Moms.gov, a Government Website Riddled with Anti-Abortion ‘Resources’:

• On Mothers Day, the Trump Administration launched “Moms.gov,” a website that purports to address “the needs of mothers and fathers who face difficult or unexpected pregnancies” and ensure “the wellbeing of mothers and the health of American families.” The website conspicuously features a link to Option Line’s crisis pregnancy center finder - notably, Option Line is a project of Heartbeat International and is touted as a helpline for “Rescuing Lives from Abortion.” The new moms.gov website features no information about abortion or hormonal contraception, and instead highlights “fertility awareness based methods.” During the press conference about this new “resource”, Dr. Mehmet Oz stated that “one in three Americans are ‘under-babied’”, and Trump - not for the first time - confusingly referred to himself as the father of fertility.  The launch comes after a year that saw devastating cuts to healthcare for Americans across the country and widespread defunding of reproductive health clinics and resources.

SPECIAL EDITION: Repro Health x Trans Rights Digest

Written by: Allison Chapman & Alyssa Morrison

Developments in Transgender & Reproductive Rights:

Welcome to this special omnibus edition of the Transgender Rights Digest & Reproductive Health Digest. Last week, we celebrated Law Day of Action with 75 coordinated events taking place across 65 cities in 25 states with 3,000+ participants representing state and local bar associations, national legal advocacy organizations, law schools, and affinity bar groups. We are back at our desks, packing two intense weeks of bodily autonomy news and legal updates into one special issue. We hope you get tremendous benefit from it – please let us know what you think! 

Want access to a detailed analysis of the transgender rights law in every U.S. state and territory? Please view our free Policy Resource Hub for Transgender Rights, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Top Line News Stories

• Trump Administration Has Major Impact on Transgender Mental Health:

• New reports from the Trevor Project and Williams Institute reveal the deep psychological harm caused by the Trump administration's policies targeting the transgender community.

• The Trevor Project report showed the devastating results of anti-LGBTQ+ policies on the lives of young people within the United States – especially those who are transgender and nonbinary. The Trevor Project found that 40% of transgender and nonbinary people have seriously considered attempting suicide in the past year. Young people who lack access to gender-affirming hormones are twice as likely to attempt suicide as those with such access.

• The Williams Institute’s April report included findings that 66% of transgender or nonbinary parents reported that their children had become more fearful under the Trump administration, and 73% of transgender or nonbinary parents reported that they were pursuing or considering pursuing self-defense classes to better protect themselves and their families.

• Read more analysis of these reports on our website.
  
  

• 2023 FDA Policy On Mifepristone Back In Effect After SCOTUS Pauses 5th Circuit Ruling:

• On May 1, 2026, a panel of Republican-appointed judges on the 5th Circuit Court of Appeals granted Louisiana’s request to pause a 2023 Food and Drug Administration (FDA) policy allowing the abortion medication mifepristone to be prescribed online and sent by mail. This created widespread confusion about what care was still legally permissible. 

• Intervenor pharmaceutical companies that produce mifepristone quickly appealed the 5th Circuit’s grant, and on May 4, 2026, the Supreme Court issued a temporary stay, allowing the telehealth provision of mifepristone until at least May 11, 2026. The briefing in the case was due on Thursday, May 7th.

• Read more analysis from L4GG legal fellow Zane McNeill on our website.

Legislation & Litigation Developments

• Federal Agencies Continue To Target Transgender Rights:

• The animus against transgender people continues to spread across all governmental agencies. The Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are the latest federal agencies to target transgender people, signaling their willingness to fall in line with r the president’s agenda.

• Over the past few months, the FTC has begun targeting transgender healthcare under the guise of consumer protections. In February, the organization sent civil investigative demands (CIDs) to the American Academy of Pediatrics, World Professional Association for Transgender Health, and the Endocrine Society. A former FTC employee has flagged multiple unusual happenings within the department, from the targeting of nonprofit organizations to hiring lawyers specifically for investigating gender affirming healthcare. 

• The FCC has requested public comment on the current TV rating system and whether  programs should be rated differently or contain descriptions flagging transgender or gender nonconforming content. The request for comments states that the FCC believes that the lack of warnings undermin[e] the ability of parents to make informed choices for their families.” If changes are implemented, it could result in LGBTQ+ people being censored in the media.
  

• Pennsylvania Court Strikes Down Ban on Medicaid Coverage of Abortion:

• In late April, a Pennsylvania court struck the state’s ban on using state Medicaid funds for abortion coverage and found that the Pennsylvania Constitution includes a right to abortion. The case, Allegheny Reproductive Health Center v. Pennsylvania Dep’t. of Human Services was first filed in 2019 and has gone through a winding procedural history centering on the question of whether and to what extent equal protection considerations require state coverage of reproductive healthcare. In 2024, the Pennsylvania Supreme Court overturned state precedent holding that the Medicaid ban did not violate the constitution and instead found that it constituted a form of sex-based discrimination by allowing healthcare coverage for men’s reproductive healthcare without covering women’s. The court further found that the ban should be subject to strict scrutiny - the most rigorous test for a state to pass in examining the constitutionality of a statute. The ruling is a huge victory for reproductive health in Pennsylvania and provides a vital reprieve as healthcare faces massive defunding at the federal level.  It also places Pennsylvania among the ranks of states whose courts, legislature, or voters have determined that their state constitution protects abortion rights. The state may appeal the ruling.

• Wyoming Court Blocks State’s Fetal Heartbeat Ban:

• On April 27th, a Wyoming court blocked the state’s recently passed ban on abortion after detection of fetal cardiac activity, which occurs around 6 weeks of gestational age. The so-called “heartbeat ban” was rushed through the state legislature after the Wyoming Supreme Court ruled in January that the state constitution protects a right to choose abortion and struck down a previously passed total abortion ban. The Supreme Court based its ruling on a 2012 amendment to the state constitution that was passed in response to the Affordable Care Act and guarantees Wyoming citizens the right to make their own healthcare decisions. In the April 27th order, the judge found that the plaintiffs challenging the new 6-week ban had shown a likelihood of success and demonstrated irreparable harm if the ban stays in place during the pendency of litigation. The state will continue to fight to enforce the ban. In the meantime, Governor Mark Gordon has signed an alternate provision banning abortion after viability.

• Indiana Case Challenging Abortion Ban On Religious Grounds Will Go Directly to the State Supreme Court: 

• As we reported on in the Repro Health Digest in March, an Indiana court recently blocked the state’s abortion ban for cases in which it conflicts with a person’s sincerely held religious beliefs. Although Indiana is currently enforcing a total abortion ban, the plaintiffs argued in their complaint that Jewish beliefs around when life begins, and Jewish laws’ requirement of prioritizing the mother’s physical and mental health prior to birth, mean that their faith would, in certain circumstances, dictate pregnancy termination as the proper course of action. A Marion County Court agreed, but the state appealed. Now, the case will go directly to the Indiana Supreme Court, bypassing the state’s court of appeals. Oral arguments will be held on September 10th.
  

• Six Transgender Iowians Challenge State Bathroom Ban:

• On April 29, 2026, six transgender Iowa residents filed a class action lawsuit in federal court challenging the restroom provision of H.B. 752. The lawsuit argues that the law violates the plaintiffs’ constitutional rights to due process, equal protection, and informational privacy.  
  

• Ninth Circuit Stays Removal of Surgery Prerequisite For Arizona Gender Marker Changes

• On April 28, 2026, the Ninth Circuit issued a stay pending appeal of a preliminary injunction in Roe v. Johnston that would have required Arizona to remove its surgery prerequisite for gender marker changes on birth certificates beginning on April 30, 2026.

Trend and Policy Watch

• Gun Control: But Only If You Are Transgender:

• Experts have warned that a new rule from the U.S. Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) could deter trans people from buying guns due to a mandatory requirement to report their sex assigned at birth when purchasing a firearm. 

• This could give the ATF the ability to create a list of transgender gun owners. In a statement to The Independent, Patrick G. Eddington, a senior fellow in homeland security and civil liberties at the Cato Institute and ex-CIA analyst said that "it's pretty clear that [Trump's team] want to try to collect data on individuals who don't fit the regime's idea of who is male and female... [creating] a de facto registry of people by gender identity."

• Last fall, the Department of Justice reportedly weighed options to ban transgender people from obtaining firearms in response to the assassination of right-wing activist Charlie Kirk. For years, right-wing figures have repeatedly fearmongered that transgender people are likely to carry out acts of mass violence. Despite the accusations, transgender shooters are statistically inconsequential with the majority of attacks being carried out by cisgender men. 

• Texas Is Still Texas:

• Texas is oftentimes a testing ground for right-wing policies and strategies. Lawmakers nationwide take note of what works and fails to then implement similar theories and policies at both the state and federal levels. In a prescient article by Legal Fellow Zane McNeill in The New Republic on December 9, 2024, Project Fellow, Allison Chapman was quoted, warning about potential FTC investigations into gender affirming care after Texas utilized a similar strategy. “The ultimate goal of these attacks is to have transgender people disappear from public life. Attacking the basic right to privacy would help create those conditions. So I think it’s absolutely possible this will be a continual issue and we’ll continue to see regulations and legislation to make this happen.”
  

• Next Texas Attorney General May Take Aim at Marriage Equality: 

• In November, Texans will vote for a new attorney general (AG), ending Ken Paxton’s 10+ year tenure in the role. Right-wing groups are hopeful that the next AG will be even more aggressive than Paxton in advancing a regressive agenda that would seek to overturn key Supreme Court precedents and roll back civil rights. 

• U.S. Rep. Chip Roy (R) has signaled that overturning a Supreme Court case that prohibited Texas from excluding undocumented students from public school is one of his “foremost priorities in running for attorney general.” He has also expressed his desire to see marriage equality overturned, referring to it as “a war raging against our souls as Texans.” 

• has taken similar positions. 

• Attorneys general have not always acted as agents of public policy change at a national level. However, since the 1990s that has gradually changed, and state authorities have increasingly viewed themselves as key players in shaping (and fighting) federal law and policy. Georgetown Law professor and constitutional scholar Steve Vladeck explains, [t]he notion that the attorney general of any one state, even Texas, should be leading the charge in defining what the Constitution means on a nationwide basis, is, to me, the epitome of hubris.”
  

• Texas Therapists Unsure About How to Proceed with Counseling LGBTQ+ Minors: 

• Last month, the Supreme Court issued an 8-1 ruling finding that Colorado’s ban on conversion therapy violated Christian counselor Kaley Chiles’ First Amendment rights by censoring the kinds of speech that she could engage in with her patients. Although many have rightly criticized the ruling for prohibiting states from banning a demonstrably harmful, discredited, and clinically unsupported form of ‘therapy,’ others have also pointed out that the ruling could make it more difficult for states to prohibit gender-affirming talk therapy. This is at odds with an opinion issued by AG Ken Paxton that purported to apply Texas’s ban on gender-affirming care for minors to mental health providers and prohibit them from  “transitioning” youth. Although the Supreme Court’s reasoning in Chiles should apply to protect affirming therapy, experts have expressed concern that courts will adhere to it and apply it equally in the context of transgender healthcare.
  

• Texas Medical Board Sanctions Physicians in Connection with Pregnant Patients Deaths: 

• Three Texas doctors who had been previously investigated by ProPublica following their patients’ deaths after improper or delayed care under the state’s total abortion ban have been disciplined by the Texas Medical Board.

• Two of the doctors were found to have failed to provide proper medical care to a teenager who was suffering from a life-threatening pregnancy complication. The teen ultimately died after seeking emergency medical care on three separate occasions within 12 hours.

• The third doctor was disciplined due to failing to administer a D&E to a patient with severe bleeding after a miscarriage. The doctor gave the patient misoprostol as an alternative, which should have been contraindicated due to excessive bleeding. The patient ultimately bled to death.

• Texas’s abortion ban prohibits abortion at all gestational ages, with only a narrow exception for the life of the patient. And, physicians face a potential life sentence if they are found to have violated the law. When physicians are forced to make emergency decisions under threat of severe legal penalty, patient care suffers.
  

• Texas’s Total Abortion Ban Falls Heavily on the Shoulders of Immigrant Communities:

• In the Rio Grande Valley (RGV) in southern Texas, Texas’s total abortion ban has had devastating effects. The geographic isolation of the RGV makes it extremely difficult to access care. “People in my community are having to travel more than 12 hours to drive out of state,” said Zaena Zamora, executive director of Frontera Fund. “If they’re taking a bus, that’s a 24-hour bus ride. If they’re taking a flight, it’s a two- or three-hour flight to get their care.”

• Immigration crackdowns have only exacerbated this problem. Immigration checkpoints are located approximately 100 miles from the border, requiring those seeking an abortion to be interrogated about their citizenship status and subjecting them to warrantless searches. These restrictions can leave people in impossible and sometimes life-threatening situations.

Take Action!

• Tell HUD: Protect LGBTQ Housing

• On April 28, the Trump administration announced a proposal to rescind the Equal Access Rule (EAR), which guarantees equal access to programs and services funded by the U.S. Department of Housing and Urban Development (HUD) regardless of sexual orientation, gender identity, or marital status.

• The Equal Access Rule benefits all people seeking access to housing and homeless services, but its impact is vital for transgender and nonbinary people seeking the services of homeless shelters.  HUD officials are proposing to eliminate the EAR and replace it with a new rule that would force recipients of federal funding to discriminate against the trans community.  

• Please submit your comment with our partners at A4TE, and if you need support drafting a substantive comment, stay tuned for an L4GG comment training!

REPRODUCTIVE HEALTH DIGEST (4/16/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest details two lawsuits against strict anti-abortion and anti-midwifery regulations in Georgia and Arkansas (states with some of the highest maternal mortality rates); Mississippi Governor Tate Reeves  signing a bill criminalizing medication abortion;  the Kansas legislature overriding the Governor Laura Kelly’s veto of two abortion regulation bills; a federal judge dismissing state officials from a Texas woman’s lawsuit alleging false arrest and malicious prosecution after she was wrongfully arrested for self-administering abortion medication; the Trump administration shifting Title X from a contraception program into a tool to push pro-natalism; and a federal judge pausing Louisiana’s legal challenge to the FDA’s regulation of abortion medication until the agency finalizes a review of the medication that abortion advocates are saying is based on “junk science.” As always - please read on to the end for the news that you need to know. 

🎥 Zurawski v. Texas, Documentary Screening: Join L4GG tonight for a virtual screening of Zurawski v. Texas — a documentary about the Texas women who sued their state after being denied critical reproductive healthcare — The film screening will be followed by a live conversation with two of the plaintiffs, Amanda Zurawski and Dr. Austin Dennard. The film runs 98 minutes. It will be available starting at 5pm ET; we recommend watching at 6pm so the discussion is fresh. Click "Pre-register for Free" to reserve your spot.

✍️ Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: 

Earlier this month, our legal fellow Zane McNeill published an article exploring the intersections between reproductive justice and transgender liberation. He explains that both movements are grounded in the principles of bodily autonomy, self-determination, and freedom from discrimination and state violence. Today, these principles are under attack by the far-right, which seeks to control our bodies and undermine our safety and dignity. Because of these shared threats—and the strong overlap between these movements—he argues that it is imperative that we do not operate in siloes and work together to protect our communities and our democracy.

Legislation & Litigation:

• Overview:

  • Three midwives are challenging Georgia’s laws that criminalize the practice of direct-entry midwifery and strictly regulate certified nurse-midwives;

  • A federal judge ruled that state officials are protected by qualified immunity in a case brought by a Texas woman who was wrongfully arrested in 2022 after taking abortion medication; 

  • Mississippi’s governor signed a bill into law that will make it illegal to manufacture, distribute, dispense, or prescribe abortion medication;

  • The Department of Health and Human Services posted a guidance for Title X clinics that only mentions “contraception” once and pushes pro-natalist “natural family planning methods;”

  • A federal court  has granted the FDA’s request to pause Louisiana’s legal challenge to the agency's abortion medication regulations until after the FDA finishes its “junk science” review of the medication.

  • The Kansas legislature overrode the governor’s veto of abortion regulation bills, which will now go into effect July 1; 

  • Two more women have joined a lawsuit challenging Arkansas’ abortion ban after they were unable to access abortion care in the state; and 

  • The Virginia Governor signed the ‘Right to Contraception Act’ into law, barring  state and local governments from restricting or banning the sale, provision, or use of contraceptives, including birth control, emergency contraception, and intrauterine devices (IUDs).

• Georgia Midwives File Lawsuit Challenging Strict Midwifery Regulations:

• Three midwives, represented by the Center for Reproductive Rights, have brought a legal challenge to Georgia’s restrictive laws governing midwifery. The laws criminalize the practice of direct-entry midwives (midwives trained outside of the nursing profession who specialize in out-of-hospital births) and impose significant burdens on certified nurse-midwives (who are advanced practice nurses also trained in midwifery). 

• The complaint alleges that these restrictions lack a demonstrated connection to health and safety and, in fact, endanger patient welfare. The complaint notes that this is particularly concerning given Georgia’s ongoing maternal health crisis and research showing that maternal and infant outcomes improve when midwives are allowed to practice to the full extent of their training. In states like Georgia with  significant rural counties, birth workers like midwives and doulas fill critical gaps. 

• The plaintiffs are asserting multiple legal claims, including violations of due process and equal protection, as well as claims based on nondelegation, ultra vires actions, the anti-competition clause, and vagueness. They are seeking a permanent injunction to prevent the state from enforcing the challenged midwifery restrictions while the lawsuit advances.

• Federal Judge Dismisses Texas Prosecutors, Sheriff From Lawsuit Brought By Woman Who Was Arrested After Taking Abortion Medication in 2022:

• A federal judge has dismissed Texas prosecutors and law enforcement officials from a lawsuit filed by Texas woman Lizelle Gonzalez, who was arrested and briefly jailed in 2022 when she sought hospital care after taking medication to induce an abortion. Following her visit, hospital staff contacted the district attorney’s office, which, along with the sheriff’s office, secured a grand jury indictment. Although Texas bans the performance of non-emergency abortions, Texas law did not, and still does not, permit charges against a pregnant person for seeking or obtaining an abortion.

• Gonzalez sued Starr County District Attorney Gocha Allen Ramirez, Assistant District Attorney Alexandria Lynn Barrera, and Starr County itself in 2024 under Section 1983, alleging false arrest, malicious prosecution, and conspiracy. Ramirez was disciplined by the Texas State Bar and briefly suspended from practicing law in 2024 over the prosecution. Gonzalez later also added Starr County Sheriff Rene Fuentes as a defendant.

• On April 1, 2026, U.S. District Judge Drew B. Tipton, a Trump appointee, ruled that the Starr County officials were protected by qualified immunity—granting their motions for summary judgment and dismissing them from the case. The lawsuit will proceed against Starr County as the sole remaining defendant.

• Mississippi Governor Signs Bill Criminalizing Medication Abortion:

• On April 8, Mississippi Governor Tate Reeves (R) signed HB 1613 into law. The legislation makes it unlawful to manufacture, distribute, dispense, or prescribe abortion medication. Anyone who violates the law may face civil liability and up to 10 years in prison. The law is set to take effect on July 1, 2026.

• This law could make it more difficult for doctors to provide appropriate care—especially in emergency situations—and may worsen Mississippi’s maternal mortality rate, which is already among the highest in the country. Research shows that a similar law enacted in Louisiana in 2024 disrupted pregnancy and fertility care, as well as other treatments relying on mifepristone and misoprostol.

• The American Civil Liberties Union (ACLU) has noted that while called “abortion medication,” mifepristone and misoprostol are both used to treat a wide range of conditions, both related and unrelated to pregnancy termination. These include postpartum hemorrhage, miscarriage management, Cushing’s syndrome, uterine fibroids, ovarian cancer, and gastric ulcers.

• HHS Title X Guidance Instructs Clinics to End DEI and “Protect Parent’s Rights:” 

• The Department of Health and Human Services (HHS) posted new Title X guidance for reproductive healthcare clinics that critics say reimagines the Title X program, shifting it from “a contraception program into a pronatalist machine.” The HHS guidance was posted just hours after the White House released its 2027 budget proposing the wholesome elimination of the program. 

• The HHS guidance mentions “contraception” only once and only to say that fewer people are using hormonal birth control because of “side effects.” Instead of focusing on contraception, the guidance instead touts practices like “fertility-awareness based methods,” “natural family planning methods,” and “preconception health services.” 

• The guidance also instructs clinics to “[e]nd diversity, equity, and inclusion (DEI) policies,” “ensure that federal resources are not used to facilitate or incentivize illegal immigration” “[p]rotect parental rights to direct the religious upbringing of their children,” and “[e]nforce the Hyde Amendment,” a prohibition on the use of federal funds for abortion.

• The guidance seems to have been drafted by Trump appointees to placate anti-abortion groups who have recently criticized the administration for not cracking down on medication abortion access or going far enough in targeting Title X funding to Planned Parenthood clinics. 

• Anti-abortion groups have increasingly strategized on how to help crisis pregnancy centers (CPCs), or facilities that pretend to be reproductive health clinics but whose true purpose is to dissuade patients from accessing abortion care, access Title X funding. Abortion rights advocates believe this guidance is part of this attempt to “reroute” Title X funding to CPCs.

• Federal Judge Grants Government’s Motion to Stay in Louisiana v. FDA:

• On April 7, 2026, a federal court granted a request by the Food and Drug Administration (FDA) to pause Louisiana’s legal challenge to the agency’s 2023 decision to remove the in-person dispensing requirement for the abortion medication mifepristone. The pause will remain in effect while the FDA completes its ongoing review of the medication– a review that has been widely criticized for being politically motivated and inconsistent with the mifepristone’s well-established safety record

• While the ruling allows telehealth prescribing of mifepristone to continue for now, abortion rights organizations cautioned that it is not an absolute victory. The judge, David C. Joseph, a Trump appointee, appeared sympathetic to Louisiana’s arguments. He urged the FDA to complete its review promptly and ordered the agency to provide a status update to the court within six months.

• Mifepristone currently accounts for 63 percent of abortions and roughly one in four abortions are provided via telehealth. The availability of telehealth abortion medication has become a lifeline for people who live in states that ban abortion care.

• Kansas Legislature Overrides Governor’s Veto of  Abortion Regulation Bills:  

• On April 9, 2026, the Kansas legislature overrode Gov. Laura Kelly’s (D) vetoes of two abortion regulation bills. HB 2729 requires the Kansas Department of Health and Environment to produce a standardized informed consent form for people seeking abortion care in accordance with the state’s biased counseling requirements. HB 2727 allows people who file lawsuits alleging violations of the state’s informed consent requirements to bypass medical malpractice screening panels if they agree to limit damages to $5,000.

• Kelly has said that HB 2729 “requires the state to put false medical information out that has no scientific basis and only serves to mislead women,” and HB 2727 “is another attempt by politicians to involve themselves in these private decisions, this time by trying to intimidate health care providers.”

• These laws will take effect July 1.

• Two Women Denied Abortion Care in Arkansas JoinLawsuit Challenging Ban:

• Two additional women have joined a lawsuit challenging Arkansas’ near-total abortion ban after they were unable to access abortion care in the state. Arkansas’ abortion ban makes the provision of abortion a felony punishable by up to a $100,000 fine and a 10-year prison sentence. The plaintiffs—who now include 6 patients and one physician—are arguing that the state's abortion ban should be struck down in its entirety based on various constitutional grounds. In March, the defendants filed a motion to dismiss the complaint, asserting that the state has sovereign immunity from the suit.

• Virginia Governor Signs Right to  Contraception Act:

• On April 8, 2026 Virginia Governor Abigail Spanberger (D) signed the Right to Contraception Act into law. The law bars state and local governments from restricting or banning the sale, provision, or use of contraceptives, including birth control, emergency contraception, and intrauterine devices (IUDs).

• Abortion rights advocates have praised the measure, arguing that protections for contraception are increasingly important amid ongoing Republican efforts to undermine reproductive healthcare. Officials in the Trump administration have repeatedly (incorrectly) called birth control like the Pill and IUDs “abortifacients” and Trump himself has said that he wants to be remembered as the “fertilization president.”

Trend and Policy Watch:

• Research Finds that Abortion Medication Is Safe Enough to Be Provided Over-the-Counter:

• A recently published study in JAMA Internal Medicine found that abortion medications such as mifepristone and misoprostol “likely meet the FDA’s criteria for over-the-counter sale.”

• In the study, researchers recruited people seeking abortion medication at five abortion-providing facilities across three states. Participants were shown a prototype package for an over-the-counter abortion medication and asked to determine whether they were good candidates for its use based on the package instructions. Researchers then compared participants’ self-assessments with evaluations made by clinicians. The results showed that 88% of participants reached the same conclusion as their clinician.

• Although over-the-counter abortion medication is not yet available, researchers noted that the path to over-the-counter sale could be similar to that of birth control pills, which also faced a “long road” before the first oral contraceptive received FDA approval for over-the-counter use in 2023.

• Planned Parenthood Takes Aim At Anti-Abortion Republicans:  

• On April 9, 2026 Planned Parenthood Action Fund, the advocacy arm of Planned Parenthood Federation of America, launched a new $1.5 million campaign to fight back against Republicans's efforts to ‘defund’ Planned Parenthood health centers and deprive countless Americans of basic reproductive healthcare.

• The campaign specifically identifies five House Republicans–Juan Ciscomani (AZ), Gabe Evans (CO), Brian Fitzpatrick (PA), Mike Lawler (NY), and Mariannette Miller-Meeks (IA)—as “key targets.” As part of the effort, the Action Fund plans to spend nearly $900,000 on advertisements in these districts, “encouraging their constituents to ask them to oppose any legislation that attempts to ‘defund’ Planned Parenthood.”

• Reproductive Rights Wins Contribute to Republican Crackdown on Direct Democracy: 

• In 2024, voters in seven states approved measures affirming that their state constitutions protected the right to abortion care. In response to the success of these citizen-led ballot initiatives, legislatures in North Dakota, Utah, and South Dakota are advancing measures for the November ballot that would raise the approval threshold for citizen-led amendments from a simple majority to 60 percent. 

• In Missouri, the legislature is trying to make it even more difficult for voters to successfully pass citizen-sponsored amendments by requiring them to win in each of the state’s eight U.S. House districts. Under this rule, a measure could receive 95 percent of the statewide vote and still fail if it loses in just one district.  

• Meanwhile, in Florida, Governor Ron DeSantis signed a bill that increases requirements, fees, and criminal penalties related to collecting petition signatures for ballot initiatives. As a result, all 22 citizen-proposed initiatives this year failed to qualify for the ballot.

REPRODUCTIVE HEALTH DIGEST (4/2/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes discusses the politics and ethical concerns surrounding crisis pregnancy centers, anti-abortion legislation and ballot initiatives out of Mississippi, Ohio, Missouri, and South Dakota, the story of a woman being charged with murder for allegedly taking abortion pills, and new information about how and where people are accessing abortion care. As always - please read on to the end for the news that you need to know. Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: 

This week’s must-read comes from the Dallas Morning News and tells the story of a pregnant Texas woman who underwent emergency surgery for an ectopic pregnancy after a crisis pregnancy center assured her that her ultrasound and pregnancy were normal. Crisis pregnancy centers - anti-abortion centers that often misleadingly present themselves as medical clinics - have been accused for decades of providing substandard care and inaccurate information to the people who walk through their doors. They raise serious questions about the ethics of facilities that purport to offer certain medical and diagnostic services while actually centering a mission of dissuading people from deciding to have an abortion. Although anti-abortion activists view these centers as the “front line” of their movement, experts warn that they provide a woefully inadequate alternative to comprehensive prenatal and reproductive healthcare. 

Legislation & Litigation:

• Overview:

  • Mississippi legislators are advancing legislation that would criminalize “abortion-inducing drugs” under the state’s drug trafficking laws; 

  • Despite Ohioans passing an abortion rights constitutional amendment in 2023, Ohio lawmakers are pressing forward with bills to limit and surveil care; 

  • South Dakota has passed a series of anti-abortion laws, including one which targets ‘advertising’ related to abortion; 

  • The Kansas Legislature overrode the governor’s veto of a bill de-regulating crisis pregnancy centers; and

  • A Georgia woman is facing unprecedented murder charges for allegedly taking abortion pills.

• Mississippi Legislators Aim to Criminalize Medication Abortion:

• Mississippi lawmakers are advancing a bill to criminalize “abortion-inducing drugs” such as mifepristone and misoprostol under state drug trafficking laws. HB 1613 was introduced by Republican Representative Celeste Hurst as an amendment to a pre-existing drug  trafficking bill. It prohibits, among other things, creating, distributing, prescribing or possessing these drugs and subjects alleged violators to up to ten years in prison. Rep. Hurst’s stated purpose is to stop the flow of abortion pills to patients in Mississippi - a state currently enforcing a total abortion ban. Although the amendment includes an exception for circumstances where these drugs are prescribed for purposes other than abortion, experts warn about the confusion and chilling effect that bills like HB 1613 create. 

• HB 1613 is one of many proposed state laws aiming to stop patients in ban states from accessing care. Other states have passed medication abortion bans, reclassified abortion drugs as controlled substances, introduced legislation to create causes of action against abortion pill manufacturers, limited access to telehealth, and moved to enshrine fetal personhood in state law. This crackdown comes as telehealth abortions continue to rise in states enforcing total bans, largely as a result of access to care through shield providers and online distributors in protective states.

• Ohio Lawmakers Move Forward with Abortion Restrictions, Despite Constitutional Protections:

  • Despite Ohioans passing an abortion rights constitutional amendment in 2023, Ohio lawmakers are continuing to press for restrictions on care and abortion surveillance. The Republican-led Ohio House is pushing forward legislation implementing a mandatory 24-hour waiting period, despite there being no medically indicated reason supporting such delays in care. Although a court previously struck a similar waiting period on the grounds that it violated the amended state constitution, proponents of the new law argue that it does not contravene constitutional protections and instead provides “women with the full protection of informed medical consent when making a stressful, life-altering decision.” Far from improving quality of patient care, waiting periods actually delay and deter care, particularly for patients who are forced to travel long distances and obtain childcare and work coverage - a fact that anti-abortion lawmakers are well aware of. . 

  • In addition to the waiting period bill, Republican lawmakers have also introduced a “Certificate of Life” bill that would require physicians to file a certificate with the state government within 10 days of detection of fetal cardiac activity and to register all fetal deaths, regardless of age or manner of death. In other words, it would effectively create a registry of all pregnant people in the state and all pregnancy terminations and losses. The bill’s sponsor openly stated that its purpose is to "acknowledge the sanctity of life beginning in the womb.” 

• South Dakota Passes Law Targeting Abortion Information:

• In late March, South Dakota Governor Larry Rhoden signed several anti-abortion bills into law. The first - and perhaps most alarming - is HB 1274. Although South Dakota is already enforcing a total abortion ban, HB 1274 creates a new felony for any person who dispenses, distributes, sells, or advertises anything intended to be used to produce an abortion. The law allows the attorney general to pursue monetary penalties for alleged violators. South Dakota’s targeting of abortion advertising comes as Attorney General Marty Jackley is attempting to block Mayday Health - an abortion rights nonprofit - from providing abortion information in the state. Jackley stated that the new law would give prosecutors another tool for blocking out-of-state abortion providers and advertisers. 

• In addition to the anti-advertising law, Governor Rhoden also signed an abortion “clarification” law, which excepts specific treatments from the state’s abortion ban - namely, miscarriage treatment, ectopic pregnancy treatment, removal of a deceased fetus and procedures that are intended to preserve the pregnancy or that unintentionally result in pregnancy loss. These kinds of clarification laws do little to actually inform providers of when they are able to intercede to help their patients and fail to account for even a fraction of the complications and risks inherent to pregnancy. 

• The final abortion-related law targets public school education on human reproduction and requires South Dakota schools to show students a video depicting fetal development from fertilization to birth. By law, the video cannot be provided by an organization affiliated with abortion. Critics are concerned that the video provided to students will be created by anti-abortion groups or biased towards anti-abortion sentiment and will not show a scientifically accurate portrayal of fetal development.

• Kansas Governor Vetoes Legislation De-regulating Crisis Pregnancy Centers:

  • Kansas lawmakers successfully overrode Democratic Governor Laura Kelly’s veto of a law that prohibits regulation of crisis pregnancy centers in order to “protect [their] ability to provide life-affirming care.” Although Governor Kelly explained that Kansans have made clear that they do not want their tax dollars going towards regulating private medical decisionmaking, the House and Senate both easily defeated her veto. The now-passed law aims to block the state from regulating or limiting what kinds of information and resources can be provided by CPCs, despite the anti-abortion centers’ long history of presenting biased,  inaccurate, and medically contradicted information to pregnant people while prioritizing discouraging abortion over patient care. The law also creates a private right of action for individuals to sue and allows the state legislators to join in such cases. Reportedly, the state has given over $7 million to CPCs since 2022, and they outnumber abortion clinics 44 to 7. 

• A Georgia Woman has Been Charged with Murder After Taking Abortion Pills:

• Georgia prosecutors have brought murder charges against 31-year-old Georgia woman Alexia Moore after she allegedly took abortion pills and delivered a premature fetus. Although Georgia bans abortion after detection of fetal cardiac activity (around 6 weeks gestational age), it - along with other abortion ban states - bars the state from prosecuting the pregnant person themselves and instead targets the person performing the abortion. In a bond hearing, both the DA and Moore’s defense attorney pointed out this fact, and the judge agreed. The DA also reportedly stated that the Kingsland Police Department did not seek his office’s support before bringing the murder charge, but he was nonetheless not yet prepared to drop it. Moore’s case represents one of the first times that a person has been charged with a crime like murder for self-managing an abortion, and experts on pregnancy criminalization have spoken out to condemn the charges. At this time, Moore has been released on bond, with the Superior Court Judge setting a symbolic $1 dollar bond for the murder charge and expressing doubt about the state’s ability to succeed in the charges. 

Trend and Policy Watch:

• New Data from Guttmacher Shows how Abortion Rates and Methods Changed in 2025:

  • Guttmacher’s 2025 abortion reporting data demonstrates how, nearly four years after the Dobbs decision, overall abortion numbers remain roughly steady, while the ways in which people are accessing care have shifted. Despite vigorous efforts from anti-abortion advocates and lawmakers, things like shield laws and telehealth have allowed people to continue to obtain abortions - even while living in states that ban such care. Guttmacher’s latest reporting shows that, in states without total bans, abortion numbers “declined slightly from 1,049,000 to 1,036,000,” while in states with total abortion bans in place, telehealth provision increased from 74,000 to 91,000 between 2024 and 2025. Additionally, the number of people crossing state lines to obtain care declined slightly from 154,000 in 2024 to 142,000 in 2025. What this tells us is that people are increasingly turning to telehealth and self managed abortion to obtain care - rather than traveling to other states in person.

• Anti-Abortion Groups in Missouri Aim to Overturn Abortion Rights Constitutional Amendment:

  • This November, anti-abortion groups in Missouri hope to overturn the abortion rights constitutional amendment passed by citizen-led ballot initiative in 2024. Reportedly, they are hoping that increased coordination, funding, and support from Republican lawmakers will help them succeed in 2026 where they failed in 2024. The anti-abortion campaign - misleadingly called “Her Health, Her Future” - aims to reinstate a total abortion ban, with narrow exceptions for rape, incest, or medical emergencies. Although they have the benefit of time and increased public awareness this time around, they are still being outspent by the opposition “Stop the Ban” campaign.  The 2024 win was a somewhat narrow one, with abortion rights supporters garnering only 52% of the vote, and access to abortion in the state has remained in flux as arguments over the constitutionality of remaining abortion restrictions play out in state courts. This election cycle, the anti-abortion amendment also includes a ban on gender-affirming care for minors, which recent polling shows may increase Missourians likelihood of supporting the measure.

• HHS Investigating States for Alleged Violations of “Conscience” Laws:

• The Department of Health and Human Services is reportedly opening investigations into 13 blue states over alleged violations of the Weldon Amendment. The Weldon Amendment, which was first implemented in 2005, is a refusal of care policy that prohibits federally funded healthcare entities from ‘discriminating’ against healthcare institutions, providers and insurers who decline to provide, cover, or refer for abortions. HHS alleges that the targeted states have unlawfully ‘coerced’ healthcare entities into providing care over conscience objections. Notably, officials involved disclosed that the investigations were not prompted by any actual complaints from individuals or entities who allege they were subject to coercion. This investigation reflects a broader move by the current administration to restrict and defund abortion coverage.

REPRODUCTIVE HEALTH DIGEST (3/19/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers Wyoming’s new 6-week abortion ban, an Indiana court’s ruling on abortion and religious freedom, Senator Josh Hawley’s attempts to rescind FDA approval for mifepristone, legislative and policy developments related to fetal personhood, and new research about how abortion bans impact where people choose to live and work. As always, please read on to the end for the news that you need to know. 

🚨If you find the Repro Digest to be a valuable resource, we are so excited to share with you the upcoming launch of a second Digest - the Transgender Rights Digest. The Transgender Rights Digest is a bi-weekly newsletter that distills the most important state and federal developments affecting transgender rights — drawn directly from our continuously updated Policy Resource Hub for Transgender Rights. In addition to the bi-weekly national newsletter, subscribers can opt into state-specific email alerts for developments that directly impact any state they’re monitoring. It will launch on March 31, Trans Day of Visibility! Pre-Register for the Digest here. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from ProPublica and details how pregnant patients have been forced by court order to undergo unwanted c-sections. The practice of court intervention in birthing dates back to the 1980s and is rooted in the idea that the state’s interest in unborn life gives it authority to override a pregnant patient’s medical decisions, even if that means operating on a patient without their consent. As fetal personhood arguments like this gain traction in the mainstream and more and more states pass laws granting fetuses and embryos legal rights, concerns over the erosion of the patient’s rights are growing. 

Legislation & Litigation:

• Overview:

• An Indiana court has issued a ruling blocking the state’s abortion ban for patients whose sincerely held religious beliefs dictate that pregnancy termination is the proper course of action; 

• Wyoming Governor Mark Gordon has signed a new fetal “heartbeat” bill into law, restricting abortion after 6-weeks gestational age; a group of abortion rights advocates have already challenged it in court; 

• Republican Senator Josh Hawley has introduced legislation to rescind FDA approval of mifepristone; and 

• Arizona lawmakers are considering a fetal personhood bill that would define embryos and fetuses as pre-born children and allow child support from the moment a person realizes they are pregnant.

• Indiana Court Partially Blocks Abortion Ban on Religious Freedom Ban:

• In early March, an Indiana judge issued a ruling permanently preventing the state from enforcing its total abortion ban against individuals who say it violates their sincerely held religious beliefs. The state’s abortion laws ban care at all gestational ages, except in cases where the patient’s life or health are at serious risk, and certain cases involving rape, incest, or fetal anomalies. The law does not allow abortions for reasons related to mental health. Over three years ago, Hoosier Jews for Choice and a number of individual plaintiffs sued the state, arguing that the ban violated the state’s Religious Freedom Restoration Act (RFRA). 

  In their complaint, the plaintiffs argue that Jewish beliefs around when life begins and Jewish laws’ requirement of prioritizing the mother’s physical and mental health prior to birth mean that their faith would, in certain circumstances, dictate pregnancy termination as the proper course of action. However, under Indiana law, they would be prohibited from seeking that course of treatment. Indiana’s RFRA prohibits the state from substantially burdening a person’s religious practice, absent a compelling state interest. In issuing a permanent injunction, Judge Christina Klineman sided with the plaintiffs’ religious freedom arguments and wrote that “[p]enalizing providers to avoid the violation of RFRA is an untenable end-run around the conflict in these laws.” Her ruling applies to any person in Indiana whose religious beliefs require them to seek an abortion otherwise banned by state law. The Attorney General has  appealed that ruling. 

• Wyoming Governor Signs Fetal “Heartbeat” Bill into Law:

• In January, the Wyoming Supreme Court struck down the state’s abortion bans on the grounds that they violate the Wyoming Constitution’s guarantee of individuals’ rights to healthcare decisionmaking. In response, the legislature swiftly introduced and passed a “heartbeat” ban, which prohibits abortion at approximately 6-weeks gestational age - a point at which many people do not yet know that they are pregnant. Republican Governor Mark Gordon signed the bill into law on March 9th, despite previously expressed reservations about its lack of exceptions for victims of rape or incest. The day after Governor Gordon signed the bill, a group of abortion rights advocates filed a motion asking the court to block it. In their motion, they requested to add their challenge to the 6-week ban to an ongoing lawsuit challenging other abortion restrictions in the state. Whether the court will find that the law has the same constitutional deficiencies as the previously-struck total ban remains to be seen; however, for the time being, the one remaining abortion clinic in the state has canceled appointments for patients past 6 weeks. 

• Senator Josh Hawley Introduces Legislation to Rescind FDA Approval of Mifepristone:

• Republican Senator Josh Hawley of Missouri has introduced federal legislation to withdraw FDA approval for mifepristone. Medication abortion now accounts for over 60% of abortions performed in the U.S. and access to abortion pills via telehealth has served as a lifeline for patients living in abortion ban states. In recent months, anti-abortion groups and activists have become vocally frustrated with the Trump Administration’s failure to take aggressive action to curtail access. Although mifepristone has been approved for over 25 years and has an excellent safety record, Hawley claims that “the science” shows that “the chemical abortion drug is inherently dangerous to women and prone to abuse.” His bill would not only strip mifepristone of its FDA approval but would also create a private right of action for patients to sue its manufacturers. Thus far, the bill has received little support from fellow Republican lawmakers - many of whom are likely weighing the politics of opposing abortion in a midterm year. President Trump, who has been relatively quiet on the issue of abortion in his second term, is now caught in a bind between dissatisfied anti-abortion groups threatening to withhold support in the midterms and the reality that opposing abortion is deeply politically unpopular. 

• Arizona Considers Fetal Personhood Legislation:

  • While we cannot possibly report on all of the pieces of anti-abortion legislation being introduced around the country, it is important to highlight those that are representative of broader anti-abortion trends and strategies. Arizona HB 2144 falls into that category. The proposed law would allow pregnant people to seek child support from the moment they realize they are pregnant. It would also define “pre-born child” under state law as embryos and fetuses from conception to birth. Although proponents of the bill insist that they are merely trying to provide more support for pregnant people, critics point to its obvious fetal personhood implications. The law’s definition of “pre-born child” and attachment of child support obligations that traditionally do not apply until a child is born create a legal framework for granting embryos and fetuses the same kinds of rights that born persons have. This kind of fetal personhood structure paves the way for abortion opponents to further entrench abortion restrictions and argue that abortion violates state law.

Trend and Policy Watch:

• Texas Attorney General Threatens Mental Health Providers:

• Texas Attorney General Ken Paxton has threatened mental health providers who treat transgender or gender non-conforming minors. Although Texas already bans gender-affirming care for minors, AG Paxton issued an opinion on February 27th, declaring that mental healthcare providers are similarly prohibited from “transitioning” minors - though it is unclear what conduct would fall under this asserted prohibition. In his published statement on the opinion, he stated that “[a]ny radical facilitating the ‘transitioning’ of our kids is committing child abuse,” and that the opinion “should send a clear warning there will be consequences for any medical professional, whether a doctor or therapist, who is illegally ‘transitioning’ Texas kids.” The opinion will inevitably have its intended effect: chilling the speech and therapeutic efforts of mental health professionals treating minors for issues related to gender. 

• Virginia Towns Using Zoning Laws to Restrict Abortion:

• Although abortion is legal in Virginia - making it a singular stronghold of access in the South - certain towns have begun weaponizing zoning laws to enact restrictions. For example, in Lynchburg, the City Council recently enacted a zoning ordinance prohibiting clinics that provide abortion services from operating near certain locations, such as schools, parks and churches. The ordinance renders nearly all of Lynchburg off-limits, highlighting the ways in which laws seemingly unrelated to healthcare can be used to choke off access. Similarly, in Roanoke County, the Board of Supervisors passed a resolution in February instructing the planning commission to examine how it could limit the locations of abortion clinics. Reportedly, the resolution “was included on the board’s consent agenda, usually reserved for routine, procedural items that all parties have previously agreed on.” Individuals in both Lynchburg and Roanoke County have criticized the political maneuvering for lacking transparency.

• Abortion Absent From State of the Union Address:

  • President Trump’s State of the Union Address, delivered on February 24th, conspicuously skirted the issue of abortion, with the word not being mentioned a single time. Although President Trump has previously referred to himself as “the most pro-life president in history” and proudly touted his administration’s anti-abortion agenda, he has been remarkably quiet on the subject in the past several months. Notably, multiple anti-abortion groups and leaders have publicly expressed discontent with the President’s failure to take more aggressive action to ban abortion at the federal level in his second term and called on the administration to restrict access to mifepristone, following medication abortion’s post-Roe rise in popularity. The administration’s silence likely reflects a calculation that aggressively taking on abortion would hurt the President and his allies politically in an already-contentious  midterm year. 

• Surgeon General Candidate Espouses Anti-Birth Control Views:

  • President Trump’s nominee for surgeon general, wellness influencer Dr. Casey Means, faced intense scrutiny during her confirmation hearing before the Senate. Dr. Means, who would act as the top doctor in the country, was asked to answer for her history of anti-vaccine and anti-birth control statements and positions. She was specifically pressed on issues related to whether parents should have their children vaccinated, the efficacy of the flu vaccine, and debunked links between autism and vaccines. She was also questioned about her history of statements criticizing birth control, including referring to birth control pills as disrespectful to human life. At this time, it is unclear whether Means will garner the votes necessary to secure the position.

REPRODUCTIVE HEALTH DIGEST (3/5/26)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest covers escalating attempts to criminalize reproductive healthcare providers, litigation challenging access to medication abortion, proposed legislation restricting abortion in Wyoming and Arizona, a new draconian anti-trans law out of Kansas, and multiple stories around the politics of abortion access in the run-up to the midterm elections. As always, please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Legislation & Litigation:

• Overview:

  • In late February, a Louisiana federal court heard arguments over the question of whether the FDA erred in removing in-person dispensing requirements for medication abortion; 

  • Texas Attorney General Ken Paxton has brought another suit against a California shield provider and a telehealth organization in his ongoing effort to block access to abortion options for Texans; 

  • Last month, a Texas court heard arguments in its case against a midwife for allegedly providing illegal abortions, but the defense argues that the state’s case is exceedingly weak;

  • Wyoming lawmakers are moving forward with legislation to ban abortion after detection of fetal cardiac activity; 

  • Kansas has begun enforcing one of the most draconian anti-trans bills in the country; and 

  • Arizona lawmakers have proposed a slew of abortion restrictions, despite Arizonans voting to constitutionally protect access to care.

• Federal Court Hears Argument About Access to Mifepristone:

• Late last month, the Western District of Louisiana heard arguments in a case seeking to limit access to the common abortion pill mifepristone. The lawsuit, brought by Louisiana Attorney General Liz Murrill, is one of multiple cases challenging the legality of the drug. 

  During the Covid-19 pandemic, in-person dispensing requirements for mifepristone were temporarily lifted. That change was later made permanent based on a finding that allowing telehealth eased access to care and posed no significant safety risks to patients. Louisiana is now asking the court to reinstate in-person dispensing requirements. If successful, this would severely limit telehealth access to care even in states where abortion is legal and protected. 

  During arguments, Louisiana asserted that removal of in-person requirements increases risks of harm to patients and allows for the medication to flow into states that ban abortion, circumventing those states’ laws. When forced to take a position in the case last month, the FDA under the Trump Administration asked for the judge to temporarily halt the case’s progress while the agency undertakes a review of mifepristone’s safety record - a review that has been heavily criticized for being politically motivated and ignoring mifepristone’s sound scientific record. Manufacturers GenBioPro and Danco Laboratories intervened in the case, affirmatively arguing for continued telehealth access to mifepristone. The companies point the court to the drug’s excellent safety record and the lack of evidence that in-person dispensing is medically necessary. They also cautioned against allowing Louisiana to reshape the national regulatory landscape for an FDA-approved drug - a move that could open the doors to increased non-expert scrutiny of other long-approved medications. The court did not indicate when it will make its ruling, but the outcome of the case will significantly impact ongoing fights over medication abortion in and out of the courtroom. 

• Texas Attorney General Sues California Shield Provider and Medication Abortion Organization:

• In our last Digest, we reported on the first lawsuit filed under HB7, Texas’s newly enforced medication abortion ban. In that case, a Texas man amended his prior lawsuit alleging that California shield provider Dr. Remy Coeytaux sent medication abortion pills into the state to add a count under HB7. Texas Attorney General Ken Paxton has now filed an additional lawsuit against Dr, Coeytaux and Aid Access and its founder, alleging violations of HB7 and Texas’s abortion ban. AG Paxton has lodged separate but similar lawsuits against Delaware and New York providers. Texas now asks the court to prohibit Dr. Coeytaux and Aid Access from shipping medication abortion across state lines and into Texas. Lawsuits like this one, Louisiana’s litigation against the FDA, described above, and individual lawsuits against shield providers, are a part of a multi-faceted and coordinated effort to severely restrict or wholly withdraw access to medication abortion - particularly for individuals living in ban states.

• Texas Hears Arguments in Case Charging Midwife with Providing Illegal Abortions:

  • On February 19th, the Fifteenth Court of Appeals in Texas heard arguments in a case accusing a Houston-area midwife of performing abortions in violation of Texas law. Last year, Maria Rojas and several of her associates were indicted on felony charges, in what appears to be the first attempted prosecution of a healthcare provider for allegedly violating a state’s abortion ban post-Roe. The state has brought both a civil and criminal case against Rojas, and she faces a sentence of up to life in prison if she is found guilty. 

    Rojas’s attorneys, however, argue that the state’s case is exceedingly weak. They point to the lack of any credible eyewitness or documentary evidence indicating that illegal abortions were performed at Rojas’s clinics, and explain that a statement by a person identified as “E.G.” who claimed to have been given abortion pills lacks any concrete corroborating evidence and amounts to hearsay. Further, although a bottle of misoprostol was found on the premises, this does not necessarily indicate that abortions were being performed. Misoprostol is routinely used in miscarriage management, and Rojas was legally allowed to prescribe it under supervision of a physician. And, investigators have not put forth any evidence that they found mifepristone, the drug that typically accompanies misoprostol in a medication abortion, or surgical abortion tools. Despite the lack of evidence proving the State’s case, AG Paxton has aggressively smeared Rojas and her affiliates, using inflammatory and racially charged language. Rojas’s clinics are currently closed, and she is out on a $1.4 million bond.

• Wyoming Takes Steps to Ban Abortion After Fetal Cardiac Activity:

  • In January, the Wyoming Supreme Court struck down the state’s abortion bans on the grounds that they violate the Wyoming Constitution’s guarantee of individuals’ rights to healthcare decisionmaking. In response, the legislature is now attempting to pass a “heartbeat” ban, which would prohibit abortion at approximately 6-weeks gestational age - a point at which many people do not even know they are pregnant. HB 126, championed by fetal personhood proponent Chip Neiman, only includes an exception for medical emergencies. It would not allow abortion in cases involving fatal fetal abnormalities or circumstances of rape or incest.

    The bill has passed through the legislature with relative ease and now only requires one more vote in the House. It will then go before Republican Governor Mark Gordon. Although the law would almost certainly be subject to swift legal challenge, it is unclear how the state’s courts would rule on a 6-week gestational ban, as opposed to the previously struck total abortion ban.

• Kansas Begins Enforcing Draconian Anti-Trans Law:

  • Last month, Kansas passed one of the most draconian anti-trans laws in the country. SB 244, passed over the veto of Governor Laura Kelly, bars trans people from using restrooms consistent with their gender identity, and implements a bounty hunter-style provision allowing individuals who believe they have encountered a trans person in a public restroom to bring a lawsuit for monetary damages. Additionally, the law prohibits changing gender markers on a person’s driver’s license and invalidates driver’s licenses that have already been updated to reflect a person’s gender identity, effective immediately. 

    Kansans who had legally changed the gender markers on their licenses have received letters informing them of this change in the law and stating that “the Legislature did not include a grace period for updating credentials. That means that once the law is officially enacted, your current credentials will be invalid immediately, and you may be subject to additional penalties if you are operating a vehicle without a valid credential.” In other words, Kansas is restricting the ability of transgender Kansans to drive, without providing any justification or explanation of how the state is harmed by individuals using validly issued licenses with accurate gender markers. The law was swiftly challenged  by the ACLU on multiple constitutional grounds.

• Arizona Republicans Move Forward with Abortion Restrictions, Despite Recent Court Ruling:

  • In early February, an Arizona court issued a ruling striking down a number of medically unnecessary restrictions on abortion. These included 1) a law requiring patients to make two separate trips to their healthcare provider and wait at least 24 hours before receiving care; 2) laws banning abortions sought as a result of certain fetal diagnoses; and 3) a ban on the use of telemedicine for abortion services. The court found that the struck provisions were unconstitutional in light of the constitutional amendment protecting reproductive rights that Arizonans passed in November 2024. 

    The clear expression of the people’s will, and the court’s recent ruling have not deterred anti-abortion lawmakers in the state, however. Republican legislators have filed a notice of appeal challenging the February ruling and introduced a wave of abortion-restrictive legislation. The Arizona Center for Investigative Reporting found “16 [proposed bills] in play this session, including proposals seeking to advance fetal personhood and impose new limits on medication abortion, among other restrictions affecting public universities, schools and state health programs.” This move by lawmakers to restrict the efficacy and scope of the 2024 reproductive rights amendment is a strategy mirrored in states across the country. For example, despite having passed an abortion-rights measure in 2023, Ohioans are still battling in court over restrictions on care. And, in Missouri, anti-abortion lawmakers are asking voters to repeal an abortion rights amendment that they passed in 2024.

Trend and Policy Watch:

• Texas Attorney General Threatens Mental Health Providers:

• Texas Attorney General Ken Paxton has threatened mental health providers who treat transgender or gender non-conforming minors. Although Texas already bans gender-affirming care for minors, AG Paxton issued an opinion on February 27th, declaring that mental healthcare providers are similarly prohibited from “transitioning” minors - though it is unclear what conduct would fall under this asserted prohibition. In his published statement on the opinion, he stated that “[a]ny radical facilitating the ‘transitioning’ of our kids is committing child abuse,” and that the opinion “should send a clear warning there will be consequences for any medical professional, whether a doctor or therapist, who is illegally ‘transitioning’ Texas kids.” The opinion will inevitably have its intended effect: chilling the speech and therapeutic efforts of mental health professionals treating minors for issues related to gender. 

• Virginia Towns Using Zoning Laws to Restrict Abortion:

• Although abortion is legal in Virginia - making it a singular stronghold of access in the South - certain towns have begun weaponizing zoning laws to enact restrictions. For example, in Lynchburg, the City Council recently enacted a zoning ordinance prohibiting clinics that provide abortion services from operating near certain locations, such as schools, parks and churches. The ordinance renders nearly all of Lynchburg off-limits, highlighting the ways in which laws seemingly unrelated to healthcare can be used to choke off access. Similarly, in Roanoke County, the Board of Supervisors passed a resolution in February instructing the planning commission to examine how it could limit the locations of abortion clinics. Reportedly, the resolution “was included on the board’s consent agenda, usually reserved for routine, procedural items that all parties have previously agreed on.” Individuals in both Lynchburg and Roanoke County have criticized the political maneuvering for lacking transparency.

• Abortion Absent From State of the Union Address:

  • President Trump’s State of the Union Address, delivered on February 24th, conspicuously skirted the issue of abortion, with the word not being mentioned a single time. Although President Trump has previously referred to himself as “the most pro-life president in history” and proudly touted his administration’s anti-abortion agenda, he has been remarkably quiet on the subject in the past several months. Notably, multiple anti-abortion groups and leaders have publicly expressed discontent with the President’s failure to take more aggressive action to ban abortion at the federal level in his second term and called on the administration to restrict access to mifepristone, following medication abortion’s post-Roe rise in popularity. The administration’s silence likely reflects a calculation that aggressively taking on abortion would hurt the President and his allies politically in an already-contentious  midterm year. 

• Surgeon General Candidate Espouses Anti-Birth Control Views:

  • President Trump’s nominee for surgeon general, wellness influencer Dr. Casey Means, faced intense scrutiny during her confirmation hearing before the Senate. Dr. Means, who would act as the top doctor in the country, was asked to answer for her history of anti-vaccine and anti-birth control statements and positions. She was specifically pressed on issues related to whether parents should have their children vaccinated, the efficacy of the flu vaccine, and debunked links between autism and vaccines. She was also questioned about her history of statements criticizing birth control, including referring to birth control pills as disrespectful to human life. At this time, it is unclear whether Means will garner the votes necessary to secure the position.

REPRODUCTIVE HEALTH DIGEST (2/12/26)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest walks through litigation developments in a Texas case challenging medication abortion access, a ruling striking down Arizona restrictions on abortion, key examples of anti-abortion legislation being introduced at the state level, and continued legal battles over the right to gender-affirming care. We also discuss policy developments around veterans’ coverage for abortion, the FDA’s study of mifepristone’s safety record, and the Texas Medical Board’s new course for physicians about the state’s abortion laws. As always, please read on to the end for the news that you need to know.  

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Legislation & Litigation:

• Overview:

  • A Texas man who is suing California Dr. Remy Coeytaux for mailing abortion pills to his ex-partner has amended his lawsuit to add the first claims brought under Texas’s new medication abortion ban; 

  • An Arizona court has struck down several medically unnecessary abortion restrictions, including a ban on telehealth, as unconstitutional in light of the state’s abortion rights amendment; 

  • Iowa lawmakers have introduced a slate of anti-abortion legislation, including two total abortion bans; and 

  • California has filed a lawsuit against a hospital for its decision to cease providing gender-affirming care services to patients under 19.

• Texan Man Files First Lawsuit Under New Texas Medication Abortion Ban:

  • In December of last year, Texas’ medication abortion ban, HB7, went into effect. The law uses a ‘bounty hunter’ mechanism that financially incentivizes private citizens to sue anyone who provides abortion pills to Texans without a valid prescription. Texas is already enforcing a total abortion ban; however, abortion pills prescribed via telehealth have acted as a lifeline for individuals in need of care - HB 7 was passed as an attempt to block that route to access. 

  • Last year, Texas man Jerry Rodriguez filed a lawsuit against Californa Dr. Remy Coeytaux for allegedly sending Rodriguez’s former partner abortion pills, and earlier this month, he amended that lawsuit to add a claim under HB7. This appears to be the first lawsuit brought pursuant to the new law.  Rodriguez is seeking both financial damages and an order blocking Dr. Coeytaux from continuing to mail medication abortion into Texas. Dr. Coeytaux is operating under protection of California’s shield law, and California has thus far refused to comply with the lawsuit, with Governor Newsom stating that California “will not allow extremist politicians from other states to reach into California and try to punish doctors based on allegations that they provided reproductive health care services. Not today. Not ever.” Battles over the enforceability of shield laws are playing out in multiple legal forums, and whether these protective laws can ultimately withstand judicial scrutiny will play a fundamental role in the abortion access landscape moving forward.

• Arizona Strikes Down Abortion Restrictions:

• Earlier this month, Arizona Judge Gregory Como issued a ruling permanently striking down several medically unnecessary abortion restrictions in the state. In November 2024, Arizonans voted to amend their constitution to add protections for the right to pre-viability abortion care. However, the constitutional amendment did not automatically undo the many restrictive abortion laws that remained on the books and functionally blocked patients from accessing care.  Like other states that have passed constitutional amendments, Arizonans have had to fight in court to see their rights fully realized. The restrictions struck by Judge Como this month include 1) a law requiring patients to make two separate trips to their health care provider and wait at least 24 hours before receiving care; 2) laws banning abortions sought as a result of certain fetal diagnoses; and 3) a ban on the use of telemedicine for abortion services. The rescission of the 24-hour waiting period and the prohibition on telehealth in particular remove significant barriers to accessing care – particularly for patients who live in rural areas, or do not have the resources to travel and take time away from work, family, and other obligations. A spokesperson for the Arizona Senate President stated that they would appeal the ruling.

• Iowa Lawmakers Introduce Anti-Abortion Legislation:

• Less than a month into Iowa’s legislative session, lawmakers have introduced a number of bills that would significantly roll back access to abortion in the state. Iowa is currently enforcing a so-called ‘heartbeat ban’ that prohibits abortion after approximately 6 weeks gestational age. Although it is not yet clear how much traction each of the measures has in the general assembly, it is important to note that both houses of Iowa’s legislature are Republican controlled, and the state is run by a Republican governor adamantly opposed to abortion. 

• The first bill, HF 2332, would enact a total abortion ban and define the intentional ending of a pregnancy as “feticide”, punishable as a class A felony. A second proposed total abortion ban, HF 2316, goes even further and would punish abortion at all gestational ages as homicide and apply all of Iowa’s criminal and civil laws to a fetus from the time of fertilization. In other words, it would be a full realization of fetal personhood in state law. A third bill, SSB 3115 would tighten up on access to medication abortion by requiring an in-person visit prior to prescription. It would also add new informed consent requirements to Iowa law, including requiring prescribing physicians to screen for abuse or coercion. A similar proposed screening requirement was recently shot down by the Nebraska legislature on the grounds that it would place an additional burden on providers and was unnecessary in light of existing state protections against trafficking and abuse.

• California Brings Suit Against Hospital for Ceasing Providing Gender-Affirming Care:

  • On January 30th, Attorney General Rob Bonta filed a lawsuit against Rady Children’s Health after the hospital announced that it would cease providing gender-affirming care for patients under the age of 19. Rady is only the latest in a large number of healthcare systems and hospitals ceasing care in light of the Trump Administration’s attacks on trans health. AG Bonta’s lawsuit alleged that Rady violated a binding merger agreement that required it to continue to provide all existing levels of healthcare, including gender-affirming care, until 2034. On Wednesday, a judge issued a ruling temporarily requiring Rady to continue providing care. Although many Californians have lauded the lawsuit as an important step taken by the state to protect care, others have questioned why - in a state that protects gender-affirming care and has strong anti-discrimination laws - the suit was brought on narrow contract-based grounds, rather than resting on California civil rights law. 

Trend and Policy Watch:

• Texas Medical Board Rolls Out Training on When Doctors Can Provide Abortions:

  • As ProPublica reports, the Texas Medical Board has started training its doctors on when they can legally provide care under the state’s multiple abortion bans. For years, providers and medical groups in the state have requested meaningful guidance on how to navigate the law - and for years, the Texas Medical Board has failed or declined to provide it. Last year, Texas passed SB 31, the ‘Life of the Mother Act,’ which sought to clarify the state’s exception for the life of the pregnant person. SB 31 also put in place requirements for the Texas Medical Board to create an educational course for providers around what state law prohibits and permits. That course is now available to physicians in the state. SB 31 was passed, in large part, in response to outcry from the medical community about the exceedingly dangerous uncertainty created by Texas’s vague and highly punitive bans.  Since the implementation of its abortion bans, Texas has faced soaring sepsis rates and multiple cases of patients dying after failing to receive abortion care.

• Democrats Are Fighting Back on Abortion Access for Veterans:

• Last year, the Trump Administration rescinded abortion access for veterans and their dependents - including for cases involving threats to the patients health or instances of rape and incest. The new policy, which was implemented immediately by the VA, rolled back Biden-era guidance permitting abortion coverage in limited cases where the pregnant person’s life or health was threatened or where the pregnancy was a result of sexual assault. This coverage was particularly important in light of the disproportionate rates of sexual assault faced by servicemembers. Democratic lawmakers are now using the Congressional Review Act to push back on the new policy. As Planned Parenthood reports, “Sen. Blumenthal introduced the CRA resolution in the Senate along with Sen. Patty Murray (D-WA) and Senate Democratic Leader Chuck Schumer (D-NY), and Rep. Julia Brownley (D-CA) and Rep. Mark Takano (D-CA) are leading the charge in the House.” Other lawmakers have since joined the effort.

• California Passes Legislation Giving $90 Million to Reproductive Health Clinics:

  • California Governor Gavin Newsom has signed a measure giving $90 million in emergency grant funding to Planned Parenthood and other reproductive health clinics. The funding was passed in response to the Trump Administration’s slashes to Medicaid and rescission of federal funding for Planned Parenthood and other clinics. The defunding of Planned Parenthood is currently being challenged in court, and multiple states have stepped up in similar ways as California to fill the gaps, but the loss of funding has already devastated access to affordable reproductive healthcare.

• Republican Lawmaker Reportedly ‘Fuming’ at FDA’s Failure to Expedite its Review of Mifepristone’s Safety:

• As we have reported on previously, the FDA, under the leadership of Commissioner Dr. Marty Makary, has committed to taking steps to review the safety of common abortion drug mifepristone. Mifepristone has been the subject of an onslaught of anti-abortion attacks because of its role in the continued availability of abortion post-Roe.  Recently, anti-abortion lawmakers and groups have expressed frustration and anger at the Trump Administration for not taking more aggressive action to curb abortion access nationwide. Now, Sen. Josh Hawley is reportedly “fuming” after a meeting with Dr. Makary that left him with the impression that Dr. Makary is “not serious” about the review and that it may take the FDA years to complete it. Major policy changes to restrict access to abortion have proven to be extremely politically unpopular, and the Trump Administration is likely factoring the impact of such a move on the midterm elections into its calculus on the question.
  

REPRODUCTIVE HEALTH DIGEST (1/15/26)

Developments in Abortion, Autonomy, and Access:

Happy New Year and welcome back to the Reproductive Health Digest. We appreciate your patience while our staff was on break for the holidays. 2026 has started with no shortage of reproductive health news, and in this Digest we discuss the Wyoming Supreme Court’s decision overturning the state’s abortion ban, attempts to criminalize abortion providers and patients, continued attacks on the LGBTQ+ community, abortion restrictions on trial in Missouri, and developments in reproductive health policy. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• The Wyoming Supreme Court has struck down the state’s total abortion ban, affirming a constitutional right to make healthcare decisions;  

• Louisiana is seeking to extradite and criminally charge a California doctor for allegedly providing medication abortion across state lines; 

• A group of federal employees have filed suit against the federal government over the cessation of gender-affirming care coverage; 

• A Kentucky woman is facing criminal charges over an alleged abortion; 

• Abortion laws in Missouri are on trial this week, as advocates seek to vindicate MIssourians ability to access care; and 

• The Supreme Court heard oral arguments this week over the rights of transgender people to participate in sports. 

• Wyoming Supreme Court Strikes Total Abortion Ban and Affirms a  Constitutional Right to Abortion:

• On January 6th, the Wyoming Supreme Court issued a decision affirming that abortion is a constitutionally protected right in the state. Following the overturn of Roe, Wyoming passed the “Life is a Human Right Act,” a total abortion ban, as well as a medication abortion ban and a series of other restrictions on care. A group of Wyoming citizens and medical providers brought suit, arguing that the abortion ban violates Wyoming’s constitutional guarantee that every adult has the right to “make his or her own health care decisions.” 

• The constitutional amendment enshrining that right was ironically passed in 2012 in response to concerns about the passage of the Affordable Care Act and its impact on individual healthcare decisionmaking. Last week, following a years long legal battle, the Wyoming Supreme Court affirmed that, although the state has an “interest in protecting the life than an abortion would end,” it failed to “meet its burden of justifying the abortion statutes’ restrictions on a woman’s right to make her own health care decisions, as expressly protected by the Wyoming Constitution.” The decision is the first in the nation to uphold abortion rights on the basis of a constitutional right to autonomy in healthcare. 

• Louisiana Seeks to Extradite and Charge California Abortion Provider:

• Louisiana is seeking to extradite and criminally charge California Doctor Remy Coeytaux  over allegations that he provided abortion medication into the state. This is the second doctor that Louisiana has targeted - the first being New York Doctor Maggie Carpenter. Both New  York and California have robust shield laws in place that protect physicians who prescribe abortion medication across state lines. These laws have allowed pregnant people in ban states and maternity care deserts to access medication abortion safely and securely. Louisiana’s efforts set up a legal stress test over the as-yet unanswered question of how courts will weigh one state’s shield law against another’s abortion ban. How that question is answered will significantly shape the nation’s abortion rights landscape and define the future of access to telehealth abortion care. Dr. Coeytaux and Dr. Carpenter are both facing separate lawsuits out of Texas, and thus far California and New York have stood behind their shield laws and refused to extradite their providers. 

• Federal Employees Sue the Government Over Cessation of Gender-Affirming Care Coverage:

• The Trump Administration has announced a new policy that eliminates coverage for gender-affirming care for federal employees, continuing its  onslaught of attacks on the LGBTQ+ community and our nation’s civil rights structures. Human Rights Campaign has filed a class action challenging the policy and arguing that it unjustifiably discriminates on the basis of sex. This attempt to strip coverage from federal employees comes at the same time that CMS has proposed new rules that would bar Medicaid and CHIP coverage from entities that provide gender-affirming care to minors. If implemented, these rules would force countless providers to choose between losing funding and having to close their doors or discontinuing evidence-based care for trans youth. This kind of governmental intrusion into the healthcare decisions of transgender people and their families furthers the same ideological agenda of control and conformity that underlies abortion bans and restrictions. 

• Kentucky Woman Facing Criminal Charges Over Alleged Abortion:

• A Kentucky woman is facing criminal charges following an alleged medication abortion. Law enforcement arrested Melinda Spencer at her home on New Year’s Day after a healthcare provider contacted them to report her for inducing an abortion. She was initially charged with fetal homicide, abuse of a corpse, and tampering with physical evidence, despite the fact that Kentucky’s laws explicitly prohibit charging a pregnant person with homicide for an abortion or miscarriage.  The fetal homicide charge was subsequently dropped after the prosecuting attorney acknowledged that the charge could not be supported; however, Spencer still faces the remaining charges. We will continue to report on this story as it develops. 

• Research from Pregnancy Justice shows that there have been over 400 post-Dobbs prosecutions for pregnancy-related conduct. In many instances, healthcare providers were responsible for involving law enforcement, even where no law was broken. States across the country have investigated or prosecuted women for their handling of miscarriages, decisions to have abortions, conduct while pregnant, and other pregnancy-related outcomes. 

• Abortion Laws in Missouri Go to Trial:

• As we have reported on extensively in this Digest, Missouri passed an abortion rights constitutional amendment and overturned a total abortion ban in the 2024 elections. However, since that vote, the state has successfully done everything in its power to block Missourians from actually accessing care. This week, the state went to trial to defend a host of abortion restrictions and regulations, commonly referred to as Targeted Restrictions on Abortion Providers, or “TRAP”, laws. Although the state argues that these laws are medically necessary and ensure patient safety, abortion rights advocates argue that they violate the Missouri Constitution and are merely a way for the state to maintain a tight grip on individuals' reproductive choices. 

• The regulations at issue in trial include, among other things: a near-total abortion ban that remains on the books, a 72-hour waiting period, burdensome informed consent requirements, a telehealth ban, strict facility licensing requirements, and state-approved complication plans. If these TRAP laws are overturned, Missourians will be able to actually access their constitutionally protected right to care in their state. 

• Supreme Court Hears Arguments in Cases About the Rights of Trans People to Participate in Sports:

• This Tuesday, the U.S. Supreme Court heard oral arguments in Little v. Hecox and West Virginia v. B.P.J., two cases challenging state bans on transgender girls and women participating in sports that align with their gender identity. The rights of trans people to participate in sports has become a hot button issue as the Trump Administration and state-level Republicans work relentlessly to rollback the rights of trans people in all aspects of public life. 

• Lawyers in the case argued that Idaho and West Virginia’s sports bans violate both the equal protection clause and Title IX. But, depending on the breadth of the Court’s ruling, it could have implications for individual rights far beyond participation in sports. Specifically, the question of what burden of proof the government must carry in order to discriminate on the basis of a person’s transgender status is on the line – a question that the Court has skirted in previous trans rights cases. If the court rules that the states only have to meet the lowest burden of proof (known as rational basis review), it will open the floodgates for states to pass and enforce openly discriminatory legislation with little accountability or recourse for the impacted individuals. During arguments, the conservative majority appeared sympathetic to the states’ arguments that their bans could pass constitutional muster. Justice Alito specifically (and unsurprisingly) honed in on the questions of what it means to be a “boy or girl” and whether trans participation in sports threatened the rights of women and girls. Meanwhile, the liberal justices inquired about how they could craft a narrow ruling that respects conflicting laws in red and blue states. Throughout the arguments, multiple justices wrestled with questions about the multitude of contexts and competition levels involved in youth sports and how individual abilities line up with sweeping bans. The Court will likely not issue a decision for several months, and we will report closely on the ruling once it is published. 

Trend and Policy Watch:

• Veterans Lose Access to Abortion Coverage:

• The Trump Administration has issued a legal opinion rescinding nearly all abortion coverage for veterans. Previously, the VA provided abortion counseling and care in cases where there was a threat to the life or health of the pregnant person or in cases of rape or incest. Now,  veterans will only be able to access coverage if their life is at risk. The VA has reportedly announced internally that it will begin complying with the new opinion immediately, without going through the formal regulatory process for finalizing agency rules. This prohibition on coverage applies to all VA facilities, including those that serve the 51% of veterans that, according to the Center for Reproductive Rights, live in states that permit or protect abortion rights. 

• Abortion May Not Be As Motivating in the 2026 Midterms as in Elections Past:

• In the elections immediately following the overturn of Roe, abortion was a highly motivating issue for voters. Recent polling, however, shows that that may not be the case in the 2026 midterms. The Public Religion Research Institute found that the percentage of Democrats who stated that abortion was important to their voting choice dropped from 55% to 36% between 2024 and late 2025. Abortion importance among Republican voters stayed steady, seemingly showing that the electorate most motivated by the issue at this time is the group who would see abortion banned. With Democrats seeking to take back power and several states set to vote directly on abortion rights, it is important that reproductive autonomy is a central part of the conversation in the run up to the midterms. 

• The City of San Antonio Shuts Down its Abortion Travel Fund:

• Last year, the San Antonio City Council approved $100,000 to support abortion patients needing to travel. Texas Attorney General Ken Paxton brought suit almost immediately, arguing that the allocation of the funds conflicted with state policy banning abortion, and a Texas court agreed with him and temporarily blocked the funds. In August, the state passed SB 33, which bars the use of public funds for any logistical support related to abortion. As a result, San Antonio’s city attorney’s office determined that state law no longer permitted the allocation of funding to support abortion travel, and the case was non-suited. Paxton’s office issued a statement referring to San Antonio’s actions as attempted funding for “abortion tourism” and claiming that he will do everything possible “to prevent radicals from manipulating the system to murder innocent babies.” 

• Senate Health Committee Holds Hearing Over Safety of Mifepristone:

• On Wednesday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing purportedly to examine the safety of medication abortion. This hearing comes as FDA Commissioner Marty Makary and the Department of Health and Human Services under RFK Jr. have committed to reviewing the safety of mifepristone. Mifepristone has been used safely and effectively for abortion care and miscarriage management for decades; however, as medication abortion rises in popularity, anti-abortion groups have escalated their calls to restrict access to the drug. Throughout the Senate hearing, Republican lawmakers repeated debunked talking points about the purported dangers of medication abortion, while Democrats and their witness attempted to redirect the conversation towards the settled science around the safety of the drug. Continued access to mifepristone - particularly through telehealth - has acted as a post-Roe lifeline for individuals in need of care. 

REPRODUCTIVE HEALTH DIGEST (12/18/2025)

Developments in Abortion, Autonomy, and Access:

As we near the close of 2025 and publish our final Digest of the year, I want to open with a sincere thank you. This has been a challenging year for everyone in our community, and your presence here and engagement with these critical  issues matters. This space exists because of a shared belief in the importance of bodily autonomy, reproductive freedom, and equity and dignity for all people, and I am so grateful for the community that we have built. Thank you for sticking with us this year, and we look forward to continuing this work in 2026. 

This week’s Digest discusses the new lawsuit brought by Texas and Florida challenging access to mifepristone, an update in the Trump Administration’s efforts to defund Planned Parenthood, new details about the ongoing attacks against the transgender community, ballot initiative news, and more. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Ms. Magazine and outlines the 2026 policy priorities that the Heritage Foundation – the group behind Project 2025 – released to the public this week. As Ms. Magazine reports, the new document “picks up where Project 2025 left off: banning abortion pills, weaponizing the 150-year old Comstock Act to criminalize medication by mail, embedding fetal personhood across federal agencies, and stripping every federal safeguard protecting reproductive freedom.” The Heritage Foundation has already been exceedingly successful in implementing its Project 2025 agenda, but many conservatives have been frustrated with what they perceive as a lack of effort to restrict abortion on the Trump Administration’s part. Going into 2026, it is critical that we are prepared for attacks on all aspects of reproductive freedom and autonomy to escalate. 

Legislation & Litigation:

• Overview:

• Texas and Florida have filed a new lawsuit in the Northern District of Texas challenging the FDA’s approval of mifepristone and two subsequent generic versions and the FDA’s relaxation of certain regulations for the medication’s use, including removing in-person dispensing requirements; 

• A federal appeals court has sided with the Trump Administration in its ongoing efforts to defund Planned Parenthood, placing over a million Americans access to healthcare at risk; 

• Texas Attorney General Ken Paxton has expanded his lawsuits against Texas clinicians who he alleges violated the state’s ban on gender-affirming care for minors; and 

• A Missouri appeals court rewrote ballot measure language for an initiative that will go before voters next year, finding that the state’s proposed language failed to inform voters of the fact that the new initiative would put a total abortion ban back in place. 

• Texas and Florida File a New Lawsuit Challenging Mifepristone Access:

• Florida and Texas have filed a new lawsuit in the Northern District of Texas seeking to restrict access to medication abortion. The suit challenges 1) the FDA’s original approval of mifepristone in 2000 (a claim that the Fifth Circuit has previously found to be untimely); 2) changes made in 2016 to relax mifepristone’s regulations for use; 3) the removal of in-person dispensing requirements; and 4) the FDA’s approval of generic versions of mifepristone in 2019 and 2025. 

The case closely mirrors and expands upon the Alliance for Hippocratic Medicine v. FDA case that the Supreme Court dismissed for lack of standing in 2024. Following the Supreme Court’s dismissal, Missouri, Kansas and Idaho intervened in that case, and Texas and Florida attempted to do so as well. However, the case was transferred to Missouri, and Florida and Texas’s request was found to be moot. The new case is the latest in a series of aggressive attacks on access to medication abortion, including a campaign to discredit the drug’s safety record, attempts to link it to water safety issues, and calls by anti-abortion groups for FDA Commissioner Marty Makary to be fired for failing to take swift action to limit access to the drug. 

• Appeals Court Sides with Trump Administration in Attempt to Defund Planned Parenthood: 

• The First Circuit Court of Appeals has issued a ruling allowing the Trump Administration to move forward in its attempt to defund Planned Parenthood. The court found that the challenged provision does not constitute an unconstitutional bill of attainder and overturned a district court injunction temporarily blocking it. A separate lawsuit brought by 22 states and D.C. is ongoing in the district court, and the defund provision is currently blocked for those states. If the law takes full effect, entities that provide abortions and received more than $800,000 in Medicaid funds in 2023 will be stripped of Medicaid funding for a year. 

Although certain states may attempt to use state funds to mitigate the harm and keep clinics open, the reality is that this is not sustainable and Americans will lose critical access to services like cancer screenings, pregnancy testing, contraception, prenatal care, and STI testing. As we have reported on before, despite the fact that federal funds are already prohibited from paying for abortion care, ‘defunding’ Planned Parenthood has long been a key part of the anti-abortion right’s strategy. Already in 2025, nearly 50 Planned Parenthood clinics have closed their doors as a result of losing Medicaid and Title X funding, and 1.1 million Planned Parenthood patients are on the brink of losing basic healthcare. 

• Texas Attorney General Continues to Pursue Healthcare Providers: 

• Texas Attorney General Ken Paxton is continuing to aggressively target gender-affirming care in the state, announcing on December 10 that his office has expanded its lawsuits against two physicians who he claims unlawfully provided care to minors after the state banned it. Initial suits were brought against the providers in October and November; however, he now claims that “[n]ew evidence gathered by the Office of the Attorney General shows that there were deliberate efforts to conceal illegal activity by falsifying records, altering diagnosis codes, and submitting deceptive billing information.” He described the defendants’ alleged conduct as “evil” and “cruel child abuse.” According to the Texas Newsroom, an attorney for one of the doctors said that Paxton’s allegations were “false in every material aspect,” and that she “did not force any treatment on any of her patients and her care complied with Texas and federal law in every respect.” Notably, Paxton’s office brought a similar lawsuit against another provider last year and ultimately dropped the case after finding no evidence of wrongdoing. 

• Missouri Appeals Court Rejects Biased Ballot Initiative Language 

• Missouri is continuing its battle to overturn a citizen-passed constitutional amendment protecting pre-viability abortion rights and reinstate a total abortion ban. Earlier this month, a Missouri appeals court found that the state’s proposed ballot language and summary statement failed to adequately inform voters of the impact of the proposed abortion ban amendment. The now-rejected language stated that the proposed amendment would “Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest.” It failed to directly inform voters that it would reinstate a near-total abortion ban and constitutionally enshrine a ban on gender-affirming care for minors. The state may appeal to the Missouri Supreme Court. The Appeals Court’s revised language now asks voters whether the Missouri Constitution should be amended to: 

• “Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability;

• Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies;

• Allow legislation regulating abortion;

• Ensure parental consent for minors’ abortions;

• Prohibit gender transition procedures for minors?”

Trend and Policy Watch:

• Telehealth Abortions are on the Rise: 

• Post-Dobbs, telehealth abortion has taken on new significance, as pregnant people in ban states struggle to access care and rely on telemedicine services. New data from the Society of Family Planning shows that telehealth abortion has increased substantially – from 5% in 2022 to 27% in 2025, with more than half of those abortions provided through shield laws. The rise in telehealth abortion and the access that it allows people is exactly why anti-abortion activists are aggressively pushing to limit medication abortion access through every available avenue, including prolific litigation challenging mifepristone’s availability and the recent calls for the firing of FDA Commissioner Marty Makary, as discussed above. In 2026, it is critical that states do everything in their power to continue to protect and expand access to telehealth and medication abortion. Without it, countless people in states where abortion is banned or severely limited will be left with no viable options for care. 

• South Dakota Issues Cease and Desist Against Telehealth Provider: 

• South Dakota is also working to restrict access to information about abortion pills and telehealth. Last week, the state’s Attorney General issued a cease and desist to Mayday Health, a nonprofit that assists with the provision of contraception and abortion medications. Mayday had launched a campaign placing advertisements that read “Pregnant? Don’t want to be?” at gas stations around the state. In response, the state is threatening a lawsuit under consumer protection laws. Mayday provided the South Dakota Searchlight with the following statement: “Mayday Health spreads awareness that abortion pills are safe, effective, and have been FDA approved for over 20 years…[t]his is First-Amendment protected free speech. Mayday is an education nonprofit. We don’t sell abortion pills, we just believe people should know their options.” 

• Missourians Still Struggle to Access Care, Despite Passing Constitutional Protections: 

• Despite having passed a citizen-led ballot measure last year legalizing pre-viability abortion, Missourians are still struggling to access care. Reportedly, between January and October, only 80 procedures were performed in clinics across the state, with another 79 abortions performed in hospitals as a result of medical emergencies. Following the passage of the abortion rights amendment, the state began the process of aggressively defending remaining abortion restrictions, including a restriction on telehealth. Those battles are continuing to play out in court. Compounding challenges to access is the fact that Planned Parenthood is currently the only operating abortion provider in the state as a result of Missouri’s long track record of instituting anti-abortion policies. As discussed above, the state is now attempting to nullify abortion rights altogether once again by putting an anti-abortion ballot measure before voters in 2026. 

• IVF Coverage for Military Members Remains Limited: 

• On Wednesday, the Senate passed the 2026 National Defense Authorization Act (NDAA), which provides for $900 Billion in defense spending. IVF coverage for service members was a subject of significant debate throughout the process, with Speaker Mike Johnson reportedly working to remove coverage from the bill due to his opposition to abortion. At present, TRICARE - the military healthcare program – only covers IVF in instances where infertility was caused by an active duty injury or illness. A bipartisan provision would have expanded TRICARE’s coverage to all enrollees; however, that expansion failed to make it to the finish line, despite President Trump’s campaign promises to expand access to IVF. The bill now goes to the President’s desk for his signature. 

• Anti-Abortion Lawmaker Josh Hawley Starts New Dark-Money Group: 

• Missouri Senator Josh Hawley and his wife Erin Hawley, an attorney who argued in favor of restricting access to mifepristone at the Supreme Court, have launched a new ‘dark money’ group to fund anti-abortion campaigns, advertising, and candidates. According to reports, the group, called “Love Life Initiative” will focus both on opposing abortion and promoting families. Senator Hawley is ardently anti-abortion and has been a vocal member of the coalition calling for the FDA to review mifepristone’s safety record. Hawley’s creation of the new organization has stirred up disagreements in the Trump Administration, which has appeared reluctant to make abortion a key agenda item in the President’s second term. 

REPRODUCTIVE HEALTH DIGEST (12/4/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest discusses the federal government’s attempts to defund Planned Parenthood, the reinstatement of North Dakota’s abortion ban, continued attacks on access to medication abortion, rulings and policy decisions limiting the rights of trans people, some important flags for the 2026 elections, and more. We thank you for your patience while we took a break last week for the Thanksgiving holiday. We will publish one final 2025 Digest on December 18th, prior to our office’s winter closure, and we will back in the New Year with all of the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from ProPublica and details the story of 37-year old Tierra Walker – yet another Texas woman who has died as a result of being denied an abortion. When she became pregnant, Walker was dealing with multiple health conditions, including seizures, hypertension, and diabetes, that put her at an extremely high risk for severe pregnancy complications like preeclampsia. She inquired about whether it would be safe for her to continue her pregnancy, but she was repeatedly told that there was no emergency - the only circumstance under which abortion is legal in Texas. At 20-weeks pregnant, her teenage son found her lifeless in bed. She had died of preeclampsia. Had Walker been given the choice to decide what care was best for her, experts agree that she would be alive today.  

Legislation & Litigation:

• Overview:

• A federal judge has once again ruled against the Trump Administration’s attempt to defund Planned Parenthood; 

• The North Dakota Supreme Court has ruled that the state can enforce its total abortion ban, reversing a lower court ruling blocking the law from taking effect. 

• The Supreme Court will allow the Trump Administration to enforce its new policy blocking people from changing their gender markers on their passports, even in cases where their gender markers have been legally changed on other documents; 

• The ACLU has filed a lawsuit seeking information about the scope of Congress’s reported review of the safety record of mifepristone, a common medication abortion drug; 

• A draconian South Carolina anti-abortion bill has hit a roadblock and is unlikely to pass; and 

• Three states have launched a challenge to the FDA’s recent approval of another generic version of mifepristone.

• Federal Judge Rules Against Trump Administration’s Attempt to Defund Planned Parenthood:

• The spending bill passed by Congress in July - known as the “One Big Beautiful Bill Act’ - included a provision that effectively defunded Planned Parenthood. As we have reported on previously, that provision was immediately subject to litigation and partially blocked by a federal judge on constitutional grounds.

This week, U.S. District Judge Indira Talwani once again ruled in favor of Planned Parenthood. In a lawsuit brought by 22 Democratic states, she found, among other deficiencies, that the provision attached conditions to state funding without providing clear notice of how and to whom those conditions apply. She also found that the plaintiff states could be irreparably harmed by the defund provision, as Planned Parenthood is a critical source of general healthcare in many states. The fight over Planned Parenthood’s funding is likely to be a lengthy one as multiple cases wind their way through federal courts. 

• North Dakota Abortion Ban Reinstated:

• On November 21, the North Dakota Supreme Court issued a ruling allowing the state’s total abortion ban to take effect. Last year, a lower court had blocked the ban, finding that it was unconstitutionally vague. The State appealed that ruling. Although three of the five North Dakota Supreme Court justices agreed with the lower court that the ban is unconstitutional, North Dakota law requires a supermajority of four out of five justices in order to declare a law unconstitutional. 

For the moment, the ruling does not functionally change access to abortion in the state, as the state’s only abortion clinic moved to Minnesota shortly after the Dobbs decision. However, it does not bode well for the future of reproductive rights in the state and will increase fear and uncertainty around when physicians are able to intervene to provide emergency terminations. 

• The Supreme Court Allows Anti-Trans Passport Policy to Take Effect:

• The U.S. Supreme Court ruled in early November that the Trump Administration can enforce its discriminatory passport policy, which prohibits individuals from changing the gender marker on their passports. The policy stems from a January Executive Order that effectively denied trans existence by declaring that there are only two sexes and that they are unchangeable. 

A Massachusetts federal court had previously blocked the policy, but the Supreme Court’s conservative majority overturned that order. Justices Kagan, Jackson, and Sotomayor dissented, with Justice Jackson calling out the Administration’s failure to explain how it can claim to face urgent harm when it intends to allow people whose gender markers have been changed to continue to use those documents until expiration. She described the Court’s actions as “an abdication of [its] duty to ensure that equitable standards apply equally to all litigants—to transgender people and the Government alike.” The new passport policy fails to plausibly justify itself or explain why the harm that it will cause to the dignity and privacy of Americans is somehow necessary for the wellbeing of the country. It will additionally create significant challenges for individuals who have already changed their gender markers on other legal documentation, like their drivers license and birth certificate. 

• The ACLU is Seeking Information About Congress’s Review of Mifepristone: 

• The ACLU has filed a Freedom of Information Act (FOIA) lawsuit seeking information about the FDA’s planned review of mifepristone, a medication commonly used for medication abortions. In August, the ACLU sent a FOIA request to the FDA seeking details about the scope of the intended review and communications that the agency has had with anti-abortion groups and lawmakers. The FDA failed to respond to that FOIA request. Of particular concern is the FDA’s seeming reliance on a widely criticized paper, publicized by an anti-abortion group that attempts to cast doubt on mifepristone’s well-established safety and efficacy record. This lawsuit follows on the heels of a similar case brought by the Center for Reproductive Rights. Although the case will likely take a while to yield any concrete outcomes, it will hopefully shed light on the current Administration’s decision making framework  around abortion access. 

• Draconian South Carolina Anti-Abortion Bill Hits Roadblocks: 

• A South Carolina bill that would have outlawed nearly all abortion care has failed to advance in the state Senate. The bill, which the ACLU of South Carolina called “an egregious attack on our autonomy, privacy, speech, and safety,” would have removed exceptions for rape, incest, and fatal fetal anomalies, and punished pregnant people and anyone who helped them access  abortion care with up to 30 years in prison. 

The bill also appeared to ban any form of contraception that prevents a fertilized egg from implanting, which would have effectively prohibited intrauterine devices (IUDs) and could have limited access to in vitro fertilization. The proposal also included language that would have made it illegal for doctors to provide patients with information about abortion, which critics of the bill said raised significant First Amendment concerns.

After four of the six Republicans on the Senate subcommittee declined to vote on the bill, the three Democrats on the subcommittee were able to block the measure from advancing. Notably, one of the bill’s own sponsors abstained from the vote, citing his concerns about the bill penalizing mothers. Although the bill is not officially dead, it is unlikely to move forward and become law.

• States Challenge FDA’s Approval of Generic Mifepristone:

• A group of anti-abortion states have moved to challenge the federal government’s recent decision to approve another generic form of mifepristone. Idaho, Missouri, and Kansas have filed an amended complaint in the pre-existing case challenging the FDA’s RIsk Evaluation and Mitigation Strategies (REMS) for mifepristone. 

The original lawsuit, formerly known as Alliance for Hippocratic Medicine vs. FDA, was filed in 2022  by anti-abortion doctors and organizations seeking to wholly undo the FDA’s approval of mifepristone. Following the Supreme Court’s dismissal of the case on standing grounds, the three states took up the charge, arguing that the FDA’s relaxation of conditions for mifepristone’s use was unlawful and posed a threat of harm to the states and their citizens.

The FDA has asserted that, because federal law requires approval of a generic version when it is identical to an already-approved drug, its approval of another generic version was merely a procedural matter. Medication abortion, which accounts for  two thirds of all abortions in the U.S., has been under relentless attack since the Dobbs decision overturned Roe. States like Texas and Louisiana have passed laws to curtail and criminalize possession of mifepristone. Anti-abortion state lawmakers and leaders have urged Congress to reevalute mifepristone’s safety and launched multiple lawsuits challenging its approval. And, the federal government has indicated that it is reviewing mifepristone’s safety record.

Trend and Policy Watch:

• Anti-Abortion Group to Invest $80 Million in 2026 Midterm: 

• In the runup to the 2026 midterm elections, anti-abortion groups are mobilizing to elect pro-life candidates. As reported by Politico, Susan B. Anthony Pro-Life America and its Super PAC have announced that they will invest $80 million into anti-abortion candidates in battleground states. Their multi-pronged campaign includes door-knocking, digital advertising, and extensive canvassing. This push comes after the Post-Roe success of pro-choice candidates and ballot measures highlights the salience of abortion access as an issue within the American electorate.

• U.S. Bishops Vote to Ban Gender Affirming Care at Catholic Hospitals: 

• In another attack on access to healthcare, U.S. Catholic Bishops have voted to ban gender-affirming care at Catholic hospitals nationwide. Catholic hospitals have been expanding for years, and the Associated Press reports that more than one in seven patients treated in America every day are treated at Catholic hospitals. Although the Church had already made its stance on the issue of gender-affirming care clear, the new vote solidifies that policy at a time when both federal and state governments are taking aggressive actions to limit access to healthcare for trans people.

• Wisconsin Introduces Bill that Would Require Miscarriage and Abortion ‘Catch-Kits’:

• A group of Wisconsin Republicans has introduced the “Clean Water for All Life Act,” a bill that would require patients who use medication abortion drugs to be issued ‘catch kits’ to collect blood and tissue and return it to their provider for disposal. The Republicans leading the bill claim - without evidence - that it is a water safety issue and that endocrine disruptors from the medications pose a danger to public health. This echoes an argument championed by Students for Life. In addition to the obvious surveillance and privacy concerns created by this bill, it raises concerns about patients experiencing miscarriages, who often are prescribed the same medications targeted by the bill. The bill also singles out medication abortion for particular treatment while ignoring wholesale all other medications that individuals take on a daily basis that may  enter the state’s wastewater.

• Ballot Measure to Overturn Idaho Abortion Ban Makes Progress:

• We have reported in the past on the overwhelming success of citizen-led ballot initiatives for constitutionally protecting reproductive rights at the state level. Reproductive rights have gone before voters in 16 states since the Dobbs decision, and they have succeeded in 13 of those instances. Voters in several states, including Idaho, are now gearing up for the 2026 elections. The group spearheading the efforts reports that it has amassed more than 50,000 of the 71,000 signatures needed to qualify for the ballot. If passed, the measure would override one of the strictest abortion bans in the country and enshrine pre-viability abortion rights into the state constitution. 

• Research Shows How Texas Abortion Ban Adversely Impacted Minors:

• New research from the American Journal of Public Health shows how Texas’s abortion bans have disproportionately impacted minors. As summarized by KUT News, researchers compared statistics from the two-year period after Texas enacted its initial 6-week abortion ban to the two years prior. They found that “facility-based abortions” received by minors decreased by almost 60%. Factoring in patients traveling out of state for care, minors overall received 26% fewer abortions than during the pre-ban time period. The stark impact is likely attributable to factors like minors’ access to a car or other transportation, financial resources, ability to miss school, and the logistical challenges of making an out-of-state medical appointment. Every state bordering Texas, with the exception of New Mexico, is now enforcing a total abortion ban, compounding barriers to care. 

REPRODUCTIVE HEALTH DIGEST (11/13/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest covers a preliminary injunction hearing in Arizona; a federal ruling that the FDA violated the law by maintaining restrictions on the abortion medication mifepristone in 2023; a New York judge blocking Texas Attorney General Ken Paxton’s attempt to force a county clerk to enforce a Texas default judgment against provider Margaret Carpenter; Florida’s Attorney General using consumer protection laws to target Planned Parenthood in efforts to restrict access to mifepristone; and other policy and access developments across the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day– so you’re always up to speed. 

Also, check out our Repro Blog of the Month, which explores how authoritarian governments manufacture public anxiety around gender and sexuality– and then weaponize those fears to undermine democratic institutions.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Politico; this exclusive report details how a major anti-abortion group, the Susan B. Anthony Pro-Life America along with its affiliated super PAC, is planning on  investing $80 million to back anti-abortion candidates in key battleground states ahead of the 2026 election. Abortion rights remain highly popular– evidenced by what Politico describes as a “string of post-Roe defeats at the ballot box.” In response, the anti-abortion group is using the millions in funding to launch an outreach campaign aimed at winning over swing voters.

Legislation & Litigation:

• Overview:

• Arizona called anti-abortion witnesses who have never performed an abortion during a preliminary injunction hearing challenging state laws that require women to wait 24 hours and undergo an ultrasound before an abortion.

• A federal judge in Hawaii ruled that the Food and Drug Administration (FDA) violated the Administrative Procedure Act (APA) when it maintained access restrictions on abortion medication in 2023.

• A New York judge dismissed a petition by Texas Attorney General Ken Paxton that sought to force a New York court clerk to enforce a Texas judgment against a New York doctor who allegedly prescribed abortion medication to a patient in Texas. 

• Florida Attorney General James Uthmeier has brought a $350 million lawsuit against Planned Parenthood for “deceptive marketing practices.” The complaint cites multiple anti-abortion sources, including the anti-abortion group Live Action and a non-peer reviewed report from the conservative think tank, Ethics and Public Policy Center (EPPC). 

• Arizona GOP Relies on Vocal Anti-Abortion Witnesses to Defend Abortion Restrictions 

• Earlier this month, Arizona Senate President Warren Petersen and House Speaker Steve Montenegro defended state laws that require women to wait 24 hours and have an ultrasound before getting an abortion, despite voters approving a constitutional right to abortion in 2024. To support their claim that the abortion restrictions do not offend this constitutional right, they called anti-abortion witnesses, none of whom have performed abortions. One witness, Maureen Curley, testified that she has made at least $22,000 for her anti-abortion testimony in other anti-abortion cases in North Dakota and Missouri. 

• Meanwhile, the reproductive rights attorneys who brought the legal challenge in May, relied on testimony from local abortion providers and medical experts to support their argument that the court should at least temporarily pause enforcement of the laws while the lawsuit proceeds.  

• Federal Judge Rules that the FDA Violated Law by Restricting Abortion Medication

• In October, a federal judge in Hawaii ruled that the FDA violated the Administrative Procedure Act “by failing to provide a reasoned explanation for its restrictive treatment of the drug” when it maintained restrictions on access to the abortion medication mifepristone in 2023. The court has ordered the FDA to review evidence it allegedly overlooked, including “the wealth of peer-reviewed evidence proving mifepristone’s safety, including when delivered by telemedicine, as well as how FDA’s restrictions burden patient access.”

• While the restrictions on access remain in effect for now, Julia Kaye, senior staff attorney with the ACLU Reproductive Freedom Project said in a statement that the court’s “decision is a victory for everyone who believes that our access to safe and essential medicines should be dictated by science, not politics.”

• New York Judge Blocks Texas Attempt to Enforce Abortion-Pill Judgment

• A New York trial court dismissed Texas’s petition seeking to compel a county clerk to enforce a Texas judgment against Dr. Margaret Carpenter, who allegedly prescribed abortion pills to a Texas woman. 

• In December 2024, Texas Attorney General Ken Paxton sued Carpenter, and after she declined to respond, a Texas judge entered a default judgment in February 2025, ordering her to pay a $113,000 fine. Paxton attempted to collect the fine in Ulster County, New York  but a county clerk refused, citing New York’s shield law, which bars state officials from enforcing out-of-state penalties against protected healthcare providers. In July, Paxton sued Bruck, arguing the shield law violates the Constitution’s Full Faith and Credit Clause, and in September, New York Attorney General Letitia James intervened to defend the law. 

• On October 31, Ulster County Supreme Court Judge David Gandin dismissed the case, ruling that Carpenter’s services are legal in New York and fall “squarely within the definition of ‘legally protected health activity’” under the shield law. The state has not yet confirmed whether it is planning on appealing the ruling. 

• Florida Goes After Planned Parenthood 

• In the latest move by anti-abortion Republicans targeting abortion medication, Florida Attorney General James Uthmeier brought a $350 million lawsuit alleging that Planned Parenthood misrepresented that abortion medication mifepristone is safer than Tylenol. According to Mother Jones, the lawsuit is “riddled with familiar anti-abortion arguments and misinformation” and cites openly anti-abortion sources. While UC Davis School of Law Professor Mary Ziegler wrote for MSNBC that Florida Judges may see this lawsuit as a “mere smokescreen for suppressing” reproductive rights in the state, she also warned that this lawsuit represents a new tactic anti-abortion Republicans are using in their “efforts to eliminate mifepristone.”

Trend and Policy Watch:

• Pro-abortion Candidates Win Big on Election Day 

• Reproductive rights scored major victories in New Jersey, Pennsylvania, and Virginia on November 4. 

• In New Jersey, reproductive rights supporter Mikie Sherrill was elected governor. Sherill has vowed to protect abortion access during her tenure as governor. 

• In Pennsylvania, three liberal justices secured new 10-year terms on the Pennsylvania Supreme Court, allowing Democrats to keep their 5-2 majority on a court that could play a crucial role in future rulings on abortion rights in the state. 

• In Virginia, voters elected “reproductive freedom champion” Abigail Spanberger to be the state’s first female governor. Democrats also secured control of both chambers of the Virginia legislature, helping to protect abortion access for both state residents and for people from neighboring states with strict abortion bans.

• The GOP Accused of Trying to Sneak Abortion Ban into Funding Bill

• Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, warned on November 8 that “Republicans said they might vote to lower Americans’ health care costs, but only if we agree to include a backdoor national abortion ban.” While Republicans reportedly had demanded that any extension of Affordable Care Act (ACA) subsidies include a provision preventing the tax credits from being applied to plans that cover abortion, Wyden noted that “[z]ero federal dollars [currently] pay for this care in ACA plans.” 

• Subsidies under the ACA were at the center of the government shutdown. Earlier this week, a handful of Senate Democrats broke ranks to pass a stopgap funding bill, which does not include an immediate extension of certain healthcare subsidies and will likely exponentially increase healthcare costs for millions of Americans.  

• FDA to Remove Black Box Warnings from Women’s Estrogen HRT Products

• Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced on November 10th, that the black box warning on women’s estrogen-based hormone replacement therapy (HRT) products will be removed. Women’s health celebrated the move and the American College of Obstetricians & Gynecologists has said that the label change will “increase access to hormone therapy.” 

• At the same time, the Trump administration has made restricting HRT access for transgender youth a central policy priority.

• Oklahoma Health Care Authority rejects abortion attestation rule

• In July, Oklahoma Gov. Kevin Stitt signed an executive order directing the Oklahoma Health Care Authority (OHCA) to stop funding any individual or organization connected to prohibited abortion providers. The order also required Oklahoma Medicaid, or SoonerCare, providers to submit a signed attestation confirming whether they, or any associated entities, “[p]erforms, refers for, or is affiliated with the performance of abortions not permitted under state law.” 

• At a special meeting on November 9, the  OHCA board declined to approve the emergency rule, citing concerns over its legality and potential impacts on providers. The board unanimously voted to request an opinion from the attorney general on the rule and asked OHCA CEO Clay Bullard and board chair Marc Nuttle to consult with Gov. Stitt to clarify the executive order and delay enforcement of the attestation requirement until formal rules are established.

REPRODUCTIVE HEALTH DIGEST (10/23/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest discusses a new lawsuit out of Louisiana that challenges the FDA’s handling of mifepristone, the continued fight over abortion access in Missouri, abortion-related prosecutions in Texas, an ongoing case in Tennessee, and policy and practical-access developments in the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Rewire News; it describes how increased restrictions on reproductive freedom and choice are a hallmark and warning sign of growing authoritarianism. Looking to international examples, the piece makes the case that “reproductive rights . . . are an essential element of democracy.”

Legislation & Litigation:

• Overview:

• Louisiana filed a lawsuit challenging the FDA’s regulations for mifepristone’s use and seeking to reinstate in-person distribution requirements; the state argues that telehealth is allowing Louisianians to continue to have abortions, despite the state’s ban; 

• A Missouri court has affirmed a lower court's decision pausing medically unnecessary requirements for care, allowing abortions to continue consistent with the state’s recently passed constitutional protections; 

• Texas Attorney General Ken Paxton announced that eight more individuals have been arrested in connection with the state’s first prosecution under its abortion ban; counsel for those arrested deny the charges that they engaged in illegal activity; and 

• A Tennessee court has ruled to allow a lawsuit challenging the state’s extremely narrow life and health exceptions to move forward. 

• Louisiana Brings a Lawsuit Challenging FDA’s Mifepristone Regulations:

• If you have read this Digest for a while, you are well aware that anti-abortion groups and states have been using every tool available to attack access to medication abortion post-Dobbs. As we discussed in the last issue, Texas Judge Matthew Kacsmaryk recently transferred a case challenging FDA’s approval and subsequent relaxations of regulations for use of mifepristone to the Eastern District of Missouri, where it is likely to be allowed to progress. Now, Louisiana Attorney General Liz Murrill has filed a separate lawsuit against FDA, challenging its approval of the use of telehealth for distribution of mifepristone. 

• In the Complaint, Louisiana alleges that telehealth has allowed “pro-abortion activists … to blanket pro-life states with mifepristone – with impunity and without any fear of liability” and that “hundreds of unlawful abortions occur every month in Louisiana.” The state argues that the FDA’s actions are a violation of both the Administrative Procedure Act and the Comstock Act. This direct invocation of the Comstock Act is particularly significant. The 1873 anti-vice law, by its language, bans the mailing of any materials involved in abortions; however, it has been largely treated as a dead law for decades. Anti-abortion activists are now attempting to revive it in order to block telehealth abortions, or – if read and enforced broadly – to halt the mailing of materials used for any type of abortion, including in-clinic procedural care. 

• Missouri Court Affirms Decision Allowing Abortions to Continue:

• Since last November’s passage of a constitutional amendment protecting reproductive healthcare in the state, Missouri has been locked in a battle to restrict access and block the implementation of that amendment by any legally available means. On paper, Missourians have a constitutional right to abortion pre-viability; however, the state has argued to enforce a number of practical barriers to access that have effectively halted care at multiple points in the past year. These include licensing requirements for clinics, state approval of complication plans, a 72-hour waiting period, and restrictions on telemedicine. Litigation challenging these restrictions has been making its way through Missouri courts, including the state supreme court. On October 14th, a panel of three judges in a Missouri appeals court affirmed a lower court's ruling that temporarily blocked many of the challenged restrictions, allowing care to continue in the state. While the state’s battle to restrict access plays out in the courts, anti-abortion lawmakers have also put forth a second constitutional amendment that, if passed, would undo the first and reinstate a total abortion ban, with limited exceptions. The proposed constitutional amendment will go before voters next November. 

• Texas Has Arrested Eight More People In Connection with an Investigation Into Alleged Unlawful Abortions:

• Texas has reportedly arrested eight more people in connection with a prosecution for the alleged provision of unlawful abortions. In March, a Houston-area midwife was arrested on charges of practicing medicine without a license and performing abortions in violation of state law.  Her attorneys vigorously deny these claims, arguing that the state relied heavily on circumstantial evidence that did not prove any of its allegations. Now, Texas Attorney General Ken Paxton has announced that the state is bringing felony-level charges against eight additional people associated with the previously-arrested midwife and her clinics. This case appears to be the first prosecution brought directly under Texas’s abortion ban. Paxton’s press release announcing the arrests was rife with inflammatory language, including labeling several of the individuals involved “foreign nationals,” despite that having no apparent relevance to the case. He also referred to the arrestees as a “cabal of abortion-loving radicals” and “dens of fake doctors” engaged in conduct that he described as “evil.” 

• Tennessee Chancery Court Allows Lawsuit Challenging State’s Ban to Move Forward:

• A three-judge panel in a Tennessee Chancery Court has ruled that a 2023 lawsuit challenging Tennessee’s extremely narrow life and health exceptions to its otherwise total abortion ban can move forward. The original lawsuit was brought by a group of Tennessee physicians and patients who had suffered medical harm as a result of the law’s vagueness and extremely punitive nature.  A court previously partially sided with those plaintiffs, temporarily blocking doctors from facing professional discipline for emergency abortion care. In 2025, Tennessee amended its ban to allow abortions in cases of previable preterm premature rupture of the membranes (PPROM), inevitable abortion, and fatal fetal diagnoses that lead to severe maternal health conditions or infections causing uterine rupture or loss of fertility. The state argued that this amendment rendered the plaintiffs’ case moot.  The court disagreed, writing that the “changes made by the 2025 amendment do not significantly alter the status” of the case, and plaintiffs “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk.” 

Trend and Policy Watch:

• Republican Senators Ask HHS and FDA to Restrict Access to Medication Abortion:

• In yet another attack on mifepristone, every Republican senator aside from Susan Collins (ME) and Lisa Murkowski (AK), has signed a letter published to FDA and HHS calling for restrictions on access to the safe, effective medication. Relying on anti-abortion talking points and slanted ‘studies,’ the senators ask the agencies to, among other things, conduct a new REMS safety review, suspend approval of any new generic versions of mifepristone, reinstate in-person dispensing requirements, “suspend the distribution of mifepristone” as an “imminent hazard under Section 505(e) of the Federal Food, Drug and Cosmetic Act (FDCA),” and withdraw permissions for pharmacy distribution of mifepristone. Earlier this year, 22 Attorneys General sent a similar letter urging FDA and HHS to reevaluate mifepristone’s regulations. The Administration has indicated that it is currently undertaking a review of the drug’s safety and efficacy, despite decades of reliable science supporting its use for early abortion care. 

• Virginia’s Upcoming Election May Determine the Future of Reproductive Rights in the State:

• Although Virginia remains a bastion of abortion access in an otherwise restricted South, that could change with the state’s upcoming election. This November, voters will choose their next governor (and the state’s first woman governor) and determine control of the Virginia House of Delegates. The outcome will be substantially determinative of the state’s reproductive rights policy moving forward. Current Republican Governor Glenn Youngkin has repeatedly vetoed pro-choice bills passed by the state legislature; however, if Virginians elect Democratic Candidate Abigail Spanberger and hold control of the house and senate, they could see expanded reproductive freedoms and rollbacks on medically unnecessary restrictions. Virginia’s elections will serve as an important signal of where abortion sentiment sits in the state and how powerful of a factor reproductive rights are in electoral decisions three years post-Roe. 

• Planned Parenthood Southeast Launched an Investigation into Anti-Abortion Sentiment From New Leadership:

• The Board of Directors at Planned Parenthood Southeast has reportedly hired a law firm to conduct an investigation into “troubling allegations” made about its Executive Leadership team and Board. A petition circulated earlier this year described a culture in which new leadership had systematically de-emphasized abortion policy and removed public policy and organizing staff. Reportedly, newly hired leadership included an executive director who once referred to herself as pro-life in an interview, and a VP for external affairs who raised the question of working with Students for Life. Former leadership also alleged that support for the LGBTQ+ community had waned. This internal investigation comes as Planned Parenthood nationwide faces attempts by the federal and some state governments to defund its operations. 

• Clinic Closures Continue Following Passage of the So-Called “Big Beautiful Bill”: 

• Maine Family Planning, a network of 19 clinics that serve primarily low-income Medicaid patients across the state, will cease providing primary care at the end of this month. As we reported on in our last Digest, clinics across the country are closing their doors or ceasing care following the federal administration’s rescission of Medicaid funding for clinics that provide abortions and received more than $800,000 in Medicaid funding in 2023. This is the case even for clinics where abortion is only one of many services offered. Clinics like Maine Family Planning are unable to absorb the cost of that loss, and thousands of state residents will lose critical primary healthcare services as a result. Although Maine Family Planning is attempting to fight the funding cuts in court, it has thus far been unsuccessful.