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.
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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.