This is Issue 39 of the American Reports Series.
Twenty-six states are “abortion protection states,”[1] with laws that grant abortion a special legal status.[2] They have few, if any, health and safety regulations of abortion, such as clinic safety standards, parental involvement laws for minors, or adequate informed consent requirements. Nineteen states[3] and the District of Columbia protect abortion through “abortion protection statutes.” Also, six states with these statutes and four additional states have “abortion protection amendments” that establish abortion as a state constitutional right.[4] Kansas, Alaska, and Wyoming do not have these laws; however, their supreme courts have interpreted their state constitutions as protective of abortion,[5] and Kansas voters rejected a constitutional amendment to protect unborn children and their mothers in 2022.[6]
Many of these statutes and amendments were enacted, approved by ballot initiative, or broadened in recent years. While most claim to restrict or permit restrictions on abortion after viability or a certain gestational age, such limitations are not allowed if a pregnancy threatens a mother’s “health.” The term “health” is left undefined or is broadly defined to include nearly any reason for abortion, undermining efforts to enact laws that protect unborn children at any stage of pregnancy.[7]
Five states, Arizona, Michigan, Missouri, Montana,[8] and Ohio, that now have abortion protection amendments did not grant abortion a special status before Dobbs v. Jackson Women’s Health Organization.[9] In these states, discussed in section I, the amendments were adopted partly because out-of-state abortion advocates waged multimillion-dollar campaigns that obscured the breadth of the amendments and spread false claims that they were necessary to protect pregnant women’s health and safety. Now, abortion advocates are advancing legislation and filing lawsuits to repeal the many laws that protect unborn babies and their mothers in these formerly pro-life states. Section II examines these five ballot campaigns in detail. Section III discusses developments in older abortion protection states, including the enactment of “abortionist legal shields,” which shield abortionists from civil, criminal, or professional consequences when they violate other states’ pro-life laws. Finally, section IV reviews pro-life efforts within abortion protection states.
I. The New Abortion Protection States
After Roe v. Wade[10] was overturned in Dobbs, abortion advocates increased their efforts to impose abortion on pro-life states through litigation and heavily funded ballot initiatives. In January 2026, Wyoming became an abortion protection state when its Supreme Court struck down the state’s gestation-based abortion limit[11] and ban on abortion drugs. Before Roe, Wyoming protected unborn children from abortion unless it was necessary to preserve the mother’s life.[12] The law was declared unconstitutional on federal, not state, grounds[13] and was later repealed.[14] On March 17, 2023, in the wake of Dobbs,[15] the governor of Wyoming signed the “Life is a Human Right Act.” This law prohibited abortion throughout pregnancy unless it was necessary to prevent the mother’s death or there is “a substantial risk of death for the pregnant woman because of a physical condition or the serious and permanent impairment of a life-sustaining organ of a pregnant woman,” the pregnancy resulted from rape or incest, or “there is substantial likelihood that the unborn baby has a lethal fetal anomaly or the pregnancy is determined to be a molar pregnancy.”[16]
Just five days after the enactment of the gestation-based abortion limit, a trial court issued a temporary restraining order.[17] On November 18, 2024, the court granted the plaintiffs’ motion for summary judgment and issued a permanent injunction, holding that the law violated Article 1 § 38 of the Wyoming Constitution, the “Right of health care access.”[18] In its decision, the court conflated abortion with health care, rejected the existence of a “two-patient” paradigm in treating pregnant patients, and stated that “[t]he Health Care Amendment does not prohibit a person from making their own health care decision if their decision impacts any other person” (i.e., the unborn child).[19] In declaring the law facially unconstitutional, the court also found that it failed to serve any of the governmental interests identified by the state.
On January 6, 2026, the Wyoming Supreme Court affirmed that the law violated Article I, § 38. According to the court, the state’s constitutional right to make personal healthcare decisions includes “the decision to have an abortion.”[20] In a state where the legislature is so pro-life that lawmakers recently overrode the governor’s veto of an ultrasound requirement,[21] the court has ruled that all laws restricting abortion are now subject to strict scrutiny when challenged.[22] Wyoming lawmakers should pursue a state constitutional amendment to protect unborn children and their mothers.[23]
Abortion advocates have had more success with abortion protection amendments. Between 2022 and 2024, voters approved ballot initiatives in five formerly pro-life states: Arizona, Michigan, Missouri, Montana, and Ohio.[24] Each of these amendments is striking in scope. All require that any pre-viability abortion regulation advance a compelling state interest, achieved by the least restrictive means. The states that define “compelling state interest” limit the term to laws or regulations that protect the health of women seeking abortions, without interfering with their abortion decisions, thereby excluding statutes intended to protect unborn children. Also, post-viability regulations cannot prohibit any abortion that a healthcare professional (i.e., abortionist) deems necessary to protect the life or health of the pregnant woman, with the determination of what constitutes a health risk left to the abortionist. Finally, all five amendments shield anyone who aids a woman in obtaining an abortion from civil or criminal liability. Three states limit this protection to circumstances in which the pregnant woman has consented, but the amendments in Arizona and Ohio do not. Even where consent is required, however, this broad immunity may protect individuals or organizations who coerce women into abortions.
Without question, these abortion protection amendments undermine state efforts to protect unborn babies and their mothers. Yet pro-life advocates and lawmakers are challenging their reach through litigation, legislation, and new ballot initiatives. Each of these states is discussed below.
Arizona
In 1973, the Arizona Court of Appeals enjoined the state’s abortion law, which protected an unborn child throughout pregnancy, except when necessary to save the mother’s life, holding that it was unconstitutional under United States Supreme Court precedent.[25] However, the law was not repealed; rather, in 1977, the Arizona legislature recodified this abortion limit.[26]
In April 2024, the Supreme Court of Arizona ruled that the pre-Roe/1977 abortion law was enforceable in the absence of “the federal constitutional abortion right,” which was discarded in Dobbs. The court’s analysis addressed the state’s pro-life bent, noting that between 1973 and 2022, “the Arizona Legislature codified dozens of abortion statutes [and] … [t]o the extent permitted by Roe and its progeny, all of these statutes restricted abortions…”[27] The court also determined that the pre-Roe/1977 law did not conflict with other federal or state laws, including Arizona’s 15-week abortion limit enacted in 2022.[28] However, in close, party-line votes,[29] a measure to repeal the restriction passed the Arizona House in April 2024 and the Arizona Senate in May 2024, after which Governor Katie Hobbs signed it.[30]
Abortion advocates were not satisfied with the repeal of the pre-Roe/1977 law. According to Ballotpedia, the pro-abortion political action committee (PAC), Arizona for Abortion Access, spent over $36 million to promote an abortion protection ballot initiative, outspending a pro-life PAC by almost $35 million.[31] On Nov. 5, 2024, Arizona voters approved the abortion protection amendment, which states that “[e]very individual has a fundamental right to abortion,” and prohibits the state from denying, restricting, or interfering with abortion “before fetal viability unless justified by a compelling state interest that is achieved by the least restrictive means,” or “with an abortion after fetal viability that, in the good faith judgment of a treating health care professional, is necessary to protect the life or physical or mental health of the pregnant individual.” The amendment also prohibits penalizing “any individual or entity for aiding or assisting a pregnant individual in exercising the individual’s right to abortion…”[32]
Following the approval of Arizona’s abortion protection amendment, a court permanently enjoined the state’s 15-week gestational abortion limit[33] as unconstitutional under the amendment.[34] The amendment implies that the state’s limit on abortion after fetal viability may be enforceable,[35] but not when, in the abortion provider’s “good faith judgment,” an abortion is “necessary to protect” the mother’s “life or physical or mental health,” a term that is undefined and open to broad interpretation.
The Supreme Court of Arizona, which has never “found” an unenumerated constitutional right to abortion in the Arizona Constitution, has not yet applied the state’s new abortion protection amendment. However, as additional pro-life laws are challenged in Arizona,[36] the courts will be compelled under the state’s abortion protection amendment to apply strict scrutiny and enjoin any laws that are not “justified by a compelling state interest that is achieved by the least restrictive means.” The amendment’s definition of “compelling state interest” does not include an interest in protecting an unborn child’s life when his or her mother has chosen abortion.[37] In the meantime, pro-abortion lawmakers have introduced legislation to repeal numerous state protections for unborn children and their mothers.[38]
Pro-life advocates have not given up. At least one concurrent resolution has been introduced in the Arizona legislature proposing a narrower amendment to the state constitution that would permit the prohibition of abortion after viability, with an exception to protect the mother’s life, and would permit abortion regulations before fetal viability that are “rationally related to a legitimate state interest.”[39] The resolution lists legitimate interests: “(A) Respect for and preservation of prenatal life at all stages of development. (B) The protection of maternal health and safety. (C) The elimination of particularly gruesome or barbaric medical procedures. (D) The preservation of the integrity of the medical profession. (E) The mitigation of fetal pain. (F) The prevention of discrimination on the basis of race, sex or disability.”[40] Pro-life lawmakers also continue to introduce pro-life measures, including health and safety protections related to the prescription of abortion-inducing drugs.[41]
Michigan
Like Arizona, after Roe was decided, Michigan did not repeal a pre-Roe abortion limit that protected unborn children throughout pregnancy except when necessary to save a mother’s life.[42] After Roe was reversed in Dobbs, however, Governor Gretchen Whitmer led a campaign to repeal the law and codify abortion protections. In 2022, the Michigan Court of Claims permanently enjoined the law in a lawsuit filed by Planned Parenthood.[43] The court held that enforcing the limit “would violate a woman’s constitutional right to bodily integrity” and violate the state’s equal protection clause.[44] This decision was followed by a party-line repeal of the pre-Roe law in April 2023.[45]
After the state’s pre-Roe abortion limit was repealed, Michigan’s abortion activists promoted an abortion protection amendment. The “Reproductive Freedom for All” PAC spent $46.7 million, compared with the $21 million spent by the pro-life “Citizens to Support MI Women and Children” PAC in opposition.[46] On Nov. 8, 2022, Michigan voters approved an amendment to the state constitution that provides: “Every individual has a fundamental right to reproductive freedom, … including … abortion…” That right cannot “be denied, burdened, nor infringed upon unless justified by a compelling state interest achieved by the least restrictive means.” The state may regulate abortion after fetal viability, “provided that in no circumstance shall the state prohibit an abortion that, in the professional judgment of an attending health care professional, is medically indicated to protect the life or physical or mental health of the pregnant individual.” The state also cannot “penalize, prosecute, or otherwise take adverse action against someone for aiding or assisting a pregnant individual in exercising their right to reproductive freedom with their voluntary consent.”[47]
Then, in 2023, Gov. Whitmer signed multiple bills as part of the “Reproductive Health Act,” which repealed numerous pro-life protections and codified an abortion protection statute.[48] The abortion protection statute largely mirrors the state’s abortion protection amendment, but adds a sweeping definition of “life or physical or mental health” that explicitly encompasses all possible justifications for an abortion after viability, effectively making abortion legal throughout pregnancy:
In determining whether an abortion is medically indicated to protect the life or physical or mental health of a pregnant individual … the attending health care professional may consider any factor that the attending health care professional considers relevant to the well-being of the pregnant individual, including, but not limited to, the pregnant individual’s age and physical, emotional, psychological, and familial considerations.[49]
In the wake of the enactment of these provisions, the Michigan Court of Claims permanently enjoined a 24-hour waiting period, informed consent requirements, and a prohibition on non-physicians performing abortions.[50] Despite Michigan’s history of valuing unborn children, the court in Northland Family Planning Center v. Nessel found it unconstitutional for the state, through the informed consent process, to “metaphorically put[] its finger on the scale” “in favor of completing a pregnancy.”[51] Remarkably, the decision states that presenting information about live birth and fetal development to a patient seeking an abortion is an encroachment on “the patient’s decision-making process” and a “burden and infringe[ment] upon a patient’s right to make and effectuate decisions about abortion care.”[52] In other words, the court held that ensuring a pregnant patient has all the information she needs before making a life-altering decision infringes on her decision-making.
The Michigan Supreme Court has never “found” an unenumerated constitutional right to abortion in the Michigan Constitution. However, if the Michigan Supreme Court reviews the decision in Northland Family Planning Center, the court may find that these commonsense protections are unconstitutional, as any abortion regulation must now be “justified by a compelling state interest[53] achieved by the least restrictive means.” Yet, as the remaining protections for unborn children and their mothers erode, efforts to protect them continue. Pro-life advocates are challenging Michigan’s abortion protection amendment as unconstitutional in federal court.[54]
Missouri
Before Roe, Missouri prohibited abortion unless it was necessary to preserve the mother’s life.[55] The law was declared unconstitutional on federal, not state, grounds[56] and was later repealed.[57] In 2019, Missouri enacted a trigger law prohibiting abortion throughout pregnancy except when necessary to protect the mother from death or “substantial and irreversible physical impairment of a major bodily function.”[58] The law was drafted to take effect once federal law restored or granted to Missouri the authority to enforce it. On June 24, 2022, after Roe was overturned, this abortion limit took effect.[59] As detailed in then-Attorney General Eric S. Schmitt’s June 24, 2022, opinion letter, Missouri has a long history of protecting unborn children to the extent permitted by federal law.[60]
Yet, on Nov. 4, 2024, voters in Missouri approved an abortion protection constitutional amendment that provides that “[t]he Government shall not deny or infringe upon a person’s fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including…abortion…” The right to abortion “shall not be denied, interfered with, delayed, or otherwise restricted unless the Government demonstrates that such action is justified by a compelling governmental interest achieved by the least restrictive means.” The government “may enact laws that regulate the provision of abortion after Fetal Viability provided that under no circumstance shall the Government deny, interfere with, delay, or otherwise restrict an abortion that in the good faith judgment of a treating health care professional is needed to protect the life or physical or mental health of the pregnant person.”[61] The amendment also provides that “any person assisting a person in exercising their right to reproductive freedom with that person’s consent” cannot be “penalized, prosecuted, or otherwise subjected to adverse action for doing so.”[62]
The abortion protection amendment states that Missouri may restrict abortion after viability, but not when an abortion is “needed to protect” the mother’s “life or physical or mental health,” a term that is undefined and open to broad interpretation. Abortion providers promptly challenged Missouri’s gestation-based abortion limits[63] after the state’s abortion protection amendment was approved. The lawsuit also challenges additional commonsense protections for unborn children and their mothers. After a trial court issued two preliminary injunctions against Missouri’s pro-life laws,[64] the Supreme Court of Missouri issued a Peremptory Writ ordering the trial court to vacate the injunctions and to reevaluate the requests for the injunctions under a different legal standard.[65] As expected, the trial court again enjoined Missouri’s gestation-based abortion limits and other pro-life provisions in July 2025.[66] However, Missouri Attorney General Andrew Bailey stated that he is appealing the decision,[67] and previously wrote that he will continue to enforce the state’s pro-life laws to the extent they are permitted under the new abortion protection amendment.[68]
The campaigns that supported the Missouri abortion protection amendment spent more than $31.4 million promoting the initiative. In stark contrast, the opposing campaigns spent almost $1.4 million.[69] Despite the $30 million spending difference, only about 96,000 more Missourians voted for the amendment than against it, a 3% margin (1,538,659 to 1,443,022; 51.60% to 48.40%).[70] Missouri Attorney General Andrew Bailey, describing the contrasting campaigns in an official opinion, wrote that “the ‘yes’ side was able in effect to rewrite the ballot summary language” and “received tens of millions of dollars in funding from out of state.”[71] These factors may explain why in Missouri, perhaps more than in any other new abortion protection state, there is a strong sense of voters’ remorse.
In May 2025, Missouri lawmakers passed a joint resolution to submit an amendment to the state’s voters, which, if approved, would repeal the state’s abortion protection amendment and replace it with new language. The amendment, which will be on the November 2026 ballot, provides that abortion may be performed in cases of “medical emergency, fetal anomaly, rape, or incest,” with abortions in cases of rape or incest limited to the first twelve weeks of pregnancy. The amendment lists numerous commonsense pro-life laws that are permitted, including health and safety regulations for abortion facilities, admitting privilege requirements, and examination and ultrasound requirements. The amendment also prohibits most discriminatory abortions (performed because of the unborn baby’s race, gender, or disability/anomaly),[72] public funding of abortion, and organ harvesting after an abortion; and it includes informed voluntary consent and parental involvement requirements. It affirms that women can continue to receive treatment for “miscarriages, ectopic pregnancies, and other medical emergencies.”[73]
Importantly, Attorney General Bailey clarified that if the state’s abortion protection amendment should “be construed more narrowly by courts or be amended or repealed in the future to permit greater protection for unborn life, that will automatically restore authority to the Attorney General and other officials to resume broader enforcement” of the state’s pro-life laws. The abortion protection amendment “does not remove these statutes from the books, so there will be no need to reenact them if [the] Amendment…is altered in the future.”[74] So, although the proposed 2026 amendment does not appear to include a general gestational limit on abortion, its approval would permit the state to enforce the state’s statutory gestation-based abortion limit, subject to the exceptions listed in the new amendment. Further, as in Arizona and Michigan, Missouri’s supreme court has never held that abortion is protected as an “unenumerated” right in the state constitution.
Montana
Before Roe v. Wade, Montana prohibited abortion except when it was “necessary to preserve the life of the mother.”[75] As in Missouri, the law was declared unconstitutional on federal, not state, grounds[76] and was later repealed.[77] However, in 1999, in Armstrong v. State, the Montana Supreme Court held that abortion was protected as a privacy right:
Implicit in this right of procreative autonomy is a woman’s moral right and moral responsibility to decide, up to the point of fetal viability, what her pregnancy demands of her in the context of her individual values, her beliefs as to the sanctity of life, and her personal situation. Moreover, the State has no more compelling interest or constitutional justification for interfering with the exercise of this right if the woman chooses to terminate her pre-viability pregnancy than it would if she chose to carry the fetus to term.[78]
In recent years, Montana’s lawmakers have enacted numerous protections for unborn children and their mothers. However, these laws have been enjoined at every turn, including a law requiring parental consent[79] for an abortion.[80] In June 2025, the Montana Supreme Court struck down the state’s 20-week gestational abortion limit, health and safety restrictions on drug-induced abortions, and a requirement that patients be offered the opportunity to view an ultrasound before an abortion.[81]
In stark contrast to the life-affirming measures enacted by the state’s elected lawmakers, Montana voters approved an abortion protection amendment to the state constitution on November 4, 2024. The amendment provides that: “There is a right to make and carry out decisions about one’s own pregnancy, including the right to abortion. This right shall not be denied or burdened unless justified by a compelling government interest[82] achieved by the least restrictive means.” The amendment further states: “The government may regulate the provision of abortion care after fetal viability provided that in no circumstance shall the government deny or burden access to an abortion that, in the good faith judgment of a treating health care professional, is medically indicated to protect the life or health of the pregnant patient.” The amendment also prohibits the government from penalizing, prosecuting, or otherwise taking “adverse action against a person for aiding or assisting another person in exercising their right to make and carry out decisions about their pregnancy with their voluntary consent.”[83]
As in other states, opponents of the amendment were dramatically outspent by supporters. The committee leading support for the amendment spent over $18 million, compared with approximately $200,000 spent in opposition.[84] The amendment purports to permit abortion regulation after fetal viability, but abortion must be allowed “to protect the life or health” of the mother, a term that is undefined and subject to broad interpretation. Given its past decisions on abortion, the Montana Supreme Court is unlikely to uphold any meaningful post-viability protections.
In June 2025, the Montana Family Foundation and some Montana voters filed a lawsuit to challenge Montana’s abortion protection amendment. The plaintiffs argued that the full text of the amendment should have been included on the ballot rather than a summary. Voters who registered on election day did not receive the state-distributed voter guide and therefore could not read the full text of the amendment before voting.[85] The state supported the plaintiffs in the lawsuit;[86] however, the Montana Supreme Court unanimously refused to hear the case. The Montana Family Foundation is continuing the fight in district court.[87]
Ohio
Before Roe, Ohio prohibited abortion unless it was necessary to preserve the mother’s life.[88] As in Missouri and Montana, the law was declared unconstitutional on federal, not state, grounds in 1973,[89] and was repealed in 1974.[90] In 2019, Ohio enacted a six-week gestational abortion limit, which a federal district court promptly enjoined.[91] However, on June 24, 2022, after the U.S. Supreme Court announced its decision in Dobbs, the district court granted the Ohio Attorney General’s emergency motion to dissolve the preliminary injunction, thereby making the law enforceable.[92]
In the fall of 2022, a state trial court issued a temporary restraining order against the six-week limit[93] and later entered an injunction.[94] The state appealed to the Ohio Supreme Court, which granted review. However, after Ohio voters approved an abortion protection amendment, the court dismissed the appeal “due to a change in the law.” Importantly, the court did not consider whether the Ohio Constitution includes unenumerated protections for abortion.[95] On remand, a trial court permanently enjoined the gestational abortion limit and additional pro-life provisions as unconstitutional under Ohio’s new abortion protection amendment.[96] The state is appealing the trial court’s decision to enjoin other statutes enacted in the same bill as the gestational abortion limit.[97]
The state’s abortion protection amendment, which took effect in December 2023, provides that: “Every individual has a right to make and carry out one’s own reproductive decisions, including but not limited to decisions on … abortion.” The amendment prohibits actions against a “person or entity that assists an individual exercising this right, unless the State demonstrates that it is using the least restrictive means to advance the individual’s health in accordance with widely accepted and evidence-based standards of care.” The amendment allows abortion to be prohibited after fetal viability. However, “in no case may such an abortion be prohibited if in the professional judgment of the pregnant patient’s treating physician it is necessary to protect the pregnant patient’s life or health.”[98]
The PACs supporting the Ohio abortion protection amendment spent $53.4 million campaigning for the amendment. The opposition PACs spent nearly $17 million less, at almost $36.5 million.[99] As with other new abortion protection amendments, the Ohio amendment purports to permit abortion prohibitions after viability. However, abortions must be allowed to protect the mother’s “life or health,” a term that is undefined and subject to broad interpretation.
Ohio’s “20-week” gestational abortion limit remains in effect for now. Unborn babies are protected “when the probable post-fertilization age of the unborn child is twenty weeks or greater.”[100] “It is an affirmative defense” that “the physician determined, in the physician’s reasonable medical judgment, … that … [t]he abortion was necessary to prevent the death of the pregnant woman or a serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.”[101] The undefined health exception in the abortion protection amendment, however, may undermine Ohio’s 20-week limit and other commonsense safety limits on abortion.[102]
II. Characteristics of the Ballot Campaigns in the New Abortion Protection States
With millions of dollars from out-of-state donors, the committees that initiated and promoted the abortion protection ballot initiatives in Arizona, Michigan, Missouri, Montana, and Ohio heavily outspent opposition campaigns.[103] The abortion initiative campaigns used this funding to bombard voters with emotionally manipulative and misleading propaganda that the pro-life campaigns did not have the means to counter effectively.
It is beyond the scope of this paper to trace and examine every funding source for these initiatives. Nevertheless, it is undeniable that these amendments are part of an ideological movement to impose abortion-on-demand in states that had previously protected unborn babies. The Fairness Project, the self-proclaimed “largest U.S. funder and strategic partner of abortion rights ballot measures in the country,”[104] contributed over $13 million to these initiatives.[105] The Fairness Project states that it promotes ballot measures as a form of “direct democracy,” enabling people to “take matters into their own hands and make meaningful change on issues they care about.”[106] This claim is ironic, however, given that the “grassroots” campaigns to collect signatures for the ballot initiatives were anything but homegrown, locally funded, or transparent. While Ohioans United for Reproductive Rights identifies on its landing page as “a coalition of statewide reproductive health, rights, and justice organizations,”[107] that description does not indicate the millions of dollars in funding the campaign received from out-of-state sources.
The Sixteen Thirty Fund, referred to by The Atlantic as “the indisputable heavyweight of Democratic dark money” and which gave “roughly $61 million of effectively untraceable money to progressive causes” in 2020,[108] contributed more than $20 million in support of abortion protection amendments.[109] Other organizations that contributed millions in support included Advocacy Action Fund, Inc., Planned Parenthood Action Fund, Strategic Victory Fund, the American Civil Liberties Union, George Soros’ Open Society Policy Center, Our American Future, the Global Impact Social Welfare Fund, and the Tides Foundation.[110] These organizations, in turn, are funded by donors whose identities are often difficult or impossible to ascertain.
The support provided by these organizations was not merely financial. According to state-level organizers of the campaigns, the Fairness Project “were strong strategic partners,” provided “early support and steady leadership,” and proved to be an “invaluable partner,” a “trusted strategist,” “in every way a full-on collaborator,” and “provided hands-on technical support.”[111] Other organizations that funded the campaigns also boast on their websites about their hands-on approach to supporting the abortion protection ballot initiatives.[112] It is no wonder that, with this level of funding and other tangible support, the abortion amendment campaigns were able to obtain the signatures necessary to place the amendments on state ballots and later secure the votes needed to enact them.
The abortion initiative campaigns were also highly strategic and disciplined in their messaging. The campaigns emphasized that “private and personal [pregnancy-related] decisions” should be made by “patients, their family and their provider—not politicians.”[113] To bolster this argument, they exploited tragic stories[114] that represent only a small fraction of abortions[115] and conflated abortion with miscarriage-related care,[116] which is legal in every state.
Abortion advocates carefully avoided addressing how the amendments would strip unborn children and their mothers of protections, nullifying popular commonsense laws such as informed consent requirements, parental involvement laws, and health and safety standards for clinics. For example, the official ballot summary for the abortion protection amendment in Missouri stated that the amendment “allows regulation of [abortion] to improve or maintain the health of the patient,”[117] without disclosing that under the amendment, many of the state’s regulations that were written for the very purpose of protecting women from the unique risks posed by abortion would be deemed too restrictive. As discussed above, legislative and judicial challenges to laws enacted to protect women are occurring in all five states.
Further, any limitations on abortion that could apply before viability, including prohibitions on discriminatory abortions,[118] face strict scrutiny under the amendments and must advance a “legitimate state interest” that excludes protecting unborn children. Few voters likely knew, based on the propaganda disseminated by the pro-amendment campaigns, that even after viability, the amendments would permit abortion in virtually any circumstance, so long as an abortionist states that it is needed to protect a mother’s health.
III. The Older Abortion Protection States
Most blue states had pre-Roe abortion limits that essentially mirrored those in pro-life states. However, support for abortion has become so ingrained in liberal politics since Roe that blue state voters and lawmakers support even the most extreme pro-abortion measures. Today, the 19 states[119] with abortion protection statutes pose the greatest challenges to protecting unborn children and their mothers.
After Roe, some state supreme courts “found” abortion rights in their state constitutions that were as extensive as, or more extensive than, those the U.S. Supreme Court “found” in the U.S. Constitution.[120] With federal and some state courts heavily on their side, there was relatively little motivation among pro-abortion state lawmakers to enact statutes protecting abortion during the 1970s and 1980s. Consequently, most abortion-related state legislation during those years was introduced by pro-life lawmakers seeking to regulate abortion to the extent permitted under Roe, its progeny, and state supreme court decisions.
However, the confirmations of Justices Anthony M. Kennedy in 1988, David H. Souter in 1990, and Clarence Thomas in 1991 to the U.S. Supreme Court raised concerns among abortion supporters that the court was tipping right. In 1992, in Planned Parenthood v. Casey, the Court affirmed Roe’s central tenets but ostensibly permitted more abortion regulation.[121] These developments challenged the complacency of pro-abortion lawmakers, leading Connecticut,[122] Nevada,[123] Washington,[124] Maryland,[125] and Maine[126] to enact abortion protection statutes between 1990 and 1993,[127] and California[128] in 2002. Between 2017 and 2023, twelve states[129] enacted abortion protection statutes as the composition of the Supreme Court shifted further to the right with the confirmations of Justices Neil M. Gorsuch in 2017, Brett M. Kavanaugh in 2018, and Amy Coney Barrett in 2020, followed closely by the Court’s overturning of Roe in 2022.
Today, abortion activists remain firmly on the offensive. According to Guttmacher, in 2025, 622 state bills were introduced to protect abortion, whereas 498 bills were introduced to defend life.[130] Since abortion protection states already permit abortion throughout pregnancy, lawmakers in these states have turned to enacting laws that encroach on pro-life states. At least 22 states and the District of Columbia[131] have implemented “abortionist legal shields”[132]—statutes and/or executive orders that immunize abortionists and abortion “facilitators” from criminal, civil, and professional repercussions when they violate other states’ abortion laws. Abortionist legal shields also prohibit state and local cooperation in civil actions[133] and criminal investigations[134] initiated in other states against abortionists. According to Guttmacher: “In 2025, legislators in 16 states introduced 39 bills to improve shield law protections for abortion providers and patients, and 8 were enacted (in California, Colorado, the District of Columbia, Delaware, Massachusetts, North Carolina, Vermont, and Washington).”[135]
Abortionist legal shields breach the lines between pro-life and abortion protection states, reducing the ability of pro-life states to protect unborn babies and their mothers effectively. Perhaps the most egregious shield provisions are “abortion drug shields.” At least eight states explicitly shield abortionists who prescribe and ship abortion-inducing drugs to women and girls who are living in pro-life states where the prescribers are not licensed.[136] Seven of the states with abortion drug shields now permit prescribers to omit their names from the labels of abortion-inducing drugs.[137] These provisions render it virtually impossible for pro-life states to discover the identities of individuals who break their state laws.
Because states generally cooperate when civil and criminal investigations cross state lines and do not encourage their citizens to intentionally violate the laws of sister states, abortionist legal shields unequivocally harm state relationships. David S. Cohen, Greer Donley, and Rachel Rebouché,[138] law professors who helped create the abortionist legal shield strategy, acknowledge that these laws “threaten basic principles of comity between states, possibly resulting in the breakdown of state-to-state relations and ultimately retaliation.”[139] The Full Faith and Credit clause of the U.S. Constitution was written to “assure that the courts of one state will honor the judgments of the courts of another state without the need to retry the whole cause of action.”[140]
In fact, the United States Supreme Court has strictly required states to recognize and enforce sister-state civil judgments, “even those that offend the public policy of the enforcing state.”[141] The vast majority of states have enacted an Interstate Depositions and Discovery Act, which “provides simple procedures for courts in one state to issue subpoenas for out-of-state depositions.”[142] Interstate cooperation is similarly expected in criminal cases. Every state has some form of the Uniform Act to Secure the Attendance of Witnesses from Without a State in Criminal Proceedings,[143] which governs how to compel witnesses and obtain documents from other states. Proponents of abortionist legal shields argue that because “abortion is special,” states are unlikely to enact similar laws to protect against lawsuits and prosecutions for other behaviors.[144] Even if this is true,[145] citizens and lawmakers in states that protect both unborn children and their mothers do not support affording abortion “special” treatment.
Through the enactment of abortionist legal shields, states go beyond refusing to cooperate with other states’ investigations; they unapologetically facilitate abortionists in breaking sister-state laws and have altered locale-of-care standards.[146] This is now occurring by the thousands. According to the Society of Family Planning (SFP), in 2024, “the monthly average number of abortions provided under shield laws was about 10,000 per month,”[147] and “[b]y June 2025, abortions provided under shield laws totaled 14,770 per month.”[148] Further, “[a]bortions provided under shield laws accounted for 49% of all abortion provided via telehealth in 2024,”[149] and “[a]s of June 2025, more than half (55%) of telehealth abortions are provided under shield laws.”[150]
The SFP defines “[p]roviding abortions under shield laws” as involving “mailing medication abortion pills to people in states with telehealth restrictions, 6-week bans, or total abortion bans.”[151] The number of abortions provided under shield laws is likely larger. The SFP’s December 2025 report notes that: “Abortions provided by individual hospitals and private practice clinicians may be underreported. These counts also do not include abortions that take place in the US outside of the formal healthcare system.”[152] Conversely, the SFP does not have “estimates of the proportion of people who did not take the medications sent to them.”[153]
One abortion provider in an abortion pill shield state, the Massachusetts Medication Abortion Access Project (MAP), claims that it sends “between 2,000 and 3,000 packages of abortion pills a month, 95% of them to states where the procedure has been banned.”[154] They explain their process: “women fill out some online forms … and send $5.”[155] Abortionists in abortion pill shield states are “suggesting people of reproductive age stock up on abortion pills through a practice known as advance provision,”[156] even though this practice violates federal regulations that apply to mifepristone.[157]
On July 29, 2025, sixteen state attorneys general submitted a letter to congressional leadership requesting that Congress consider legislation to preempt state shield laws. The legislation would “ensure that each State retains the ability to restrict abortions as it sees fit within its borders without interference from other States and preserve[] federalism principles.”[158] The state attorneys general argue that abortionist legal shields “are antithetical to the spirit of federalism and the Dobbs decision by not allowing each State to regulate abortion as it sees fit.”[159] With or without congressional action, the U.S. Supreme Court will inevitably need to settle the legal conflicts created by abortionist protection states.
Further, proponents of abortion-inducing drugs, including the drug manufacturers, are challenging the authority of pro-life states to ban the drugs. In GenBioPro, Inc. v. Raynes, the generic manufacturer of mifepristone, GenBioPro, claimed that federal abortion drug regulations preempt West Virginia’s abortion laws. Though the district court dismissed the case, and the Fourth Circuit affirmed,[160] the question of preemption may ultimately come before the U.S. Supreme Court.
IV. Pro-life Efforts in Abortion Protection States
In states with abortion protection laws, pro-life advocates continue to press for protections for unborn children and their mothers. Pro-life lawmakers are particularly focused on maintaining and enforcing laws that protect minors considering abortion. In State of Missouri v. Planned Parenthood, the state seeks an injunction to stop Planned Parenthood from violating Missouri’s parental consent law by directly or indirectly helping minors obtain abortions out-of-state.[161] In April 2025, the trial court denied Planned Parenthood’s motion to dismiss, permitting the case to proceed.[162] Montana sought the U.S. Supreme Court’s review of a decision by Montana’s state supreme court that permanently enjoined the state’s parental consent law, but the Court declined review.[163] In March 2025, a federal district court in Nevada granted the state’s request to lift a permanent injunction on a long-enjoined parental notification law.[164]
In Minnesota Women’s Life Care Center v. Ellison, plaintiffs challenged Minnesota’s abortion protection statute in federal court under 42 U.S.C. § 1983. The plaintiffs argued that the statute violated the 14th Amendment by permitting the involuntary and unwanted termination of a “pregnant mother’s constitutionally protected relationship with her child by terminating the life of her child without providing any due process protections or the equal protection of the law.”[165] While the Eighth Circuit dismissed the case in June, pro-life Minnesotans are unlikely to abandon efforts to protect unborn children and their mothers.
Even in New York, pro-life advocates are pushing back against the breadth of the state’s 2019 abortion protection statute.[166] Plaintiffs challenged[167] the law’s constitutionality, which permits abortion after 24 weeks when the mother’s life or health is at risk, without defining health; removes abortion from the penal law; and strips unborn children after 24 weeks from the definition of homicide even when they are killed against their mothers’ wishes[168] The Second Circuit Court of Appeals affirmed a district court decision denying the plaintiffs’ standing.[169]
Pro-life advocates and lawmakers continued to fight for unborn babies and their mothers during the challenging decades between Roe and Dobbs. That will not change, even in states with the most draconian abortion protection laws. While efforts in most of these states to establish gestational limits on abortion will fail, advocates can continue to push for laws that were frequently upheld during the post-Roe years, such as informed consent requirements, parental involvement laws, and health and safety regulations. Further, advocates must continue to protect the First Amendment rights of sidewalk counselors and pregnancy care centers.
Mary E. Harned, J.D., is an associate scholar at the Charlotte Lozier Institute. Research and editing assistance for this series: Genevieve Plaster (during her employment as CLI Senior Editor & Director of Publications), Tessa Cox, Elyse Gaitan, Mariana Timler. The author consulted Paul Benjamin Linton’s book, Abortion under State Constitutions: A State-by-State Analysis, 2nd ed. (Carolina Academic Press 2012), when reviewing states’ pre-Roe history.
[1] This is the second paper in the series Abortion Law in America Today. The first paper, Abortion Law in America Today: Introduction and the Pro-Life States, can be found here: https://lozierinstitute.org/abortion-law-in-america-today-introduction-and-the-pro-life-states/.
[2] Alaska, Arizona, California, Colorado, Connecticut, Delaware, Kansas, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Washington, and Wyoming. The District of Columbia also affords abortion special legal protections.
[3] California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
[4] Arizona, California, Colorado, Maryland, Michigan, Missouri, Montana, New York, Ohio, and Vermont. The states in italics do not have abortion protection statutes. Michigan enacted an abortion protection statute after its abortion protection amendment was approved.
[5] See Valley Hosp. Ass’n v. Mat-Su Coalition for Choice, 948 P.2d 963 (Alaska 1997) (abortion protected by Alaska’s privacy clause, article I, § 22); Hodes & Nauser v. Schmidt, 440 P.3d 461, 486 (Kan. 2019) (Kansas’s constitution’s “proclamation of natural rights … protects the right” to abortion); State of Wyoming v. Johnson, 2026 WY 1, ¶¶107-08 (WY 2026) (“A woman has a fundamental right to make her own health care decisions, including the decision to have an abortion….the Abortion Laws violate Article I, § 38” of the Wyoming Constitution.). Alaska has had little success in maintaining pro-life policy. The Kansas legislature has declared that “the life of each human being begins at fertilization.” Kan. Stat. Ann. § 65-6732. Further, the state restricts abortion after 22 weeks of gestation (Kan. Stat. Ann. § 65-6723 et seq.) and has enacted numerous other pro-life laws. However, the state supreme court routinely strikes them down. See., e.g., Hodes & Nauser v. Kobach, 551 P.3d 37 (Kan. 2024) (holding that a dismemberment abortion ban is unconstitutional); Hodes & Nauser v. Stanek, 551 P. 3d 62 (Kan. 2024) (holding that abortion clinic health and safety requirements are unconstitutional). In January 2026, Wyoming’s Supreme Court struck down the state’s gestation-based abortion limit and ban on abortion drugs, finding a constitutional right to abortion. Other pro-life laws remain in effect for now; however, the court will begin applying strict scrutiny when reviewing any laws that restrict “a woman’s fundamental right to make her own health care decision to have an abortion.” See State of Wyoming, ¶73.
[6] See Ballotpedia, Kansas No State Constitutional Right to Abortion and Legislative Power to Regulate Abortion Amendment (August 2022), https://ballotpedia.org/Kansas_No_State_Constitutional_Right_to_Abortion_and_Legislative_Power_to_Regulate_Abortion_Amendment_(August_2022) (last visited Dec. 31, 2025).
[7] See Elizabeth Kirk, Abortion Jurisprudence Primer, Charlotte Lozier Institute (Oct. 21, 2021), https://lozierinstitute.org/abortion-jurisprudence-primer/: “In Doe v. Bolton, a case decided at the same time as Roe, the Court held that the determination of health may be made by the physician ‘in the light of all factors—physical, emotional, psychological, familial, and the woman’s age—relevant to the wellbeing of the patient. All these factors may relate to health.’ [Decided at the same time as Roe, and intended to be read together with it, was Doe v. Bolton, 410 U.S. 179 (1973) at 212.] This broad and indeterminate interpretation of health for purposes of legislative exceptions is the basis for the fact that, despite efforts to restrict abortion, the reality is that it is permitted in this country in nearly all circumstances up until the moment of birth.” While Doe was overturned along with Roe in Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022), the health definition from Doe has been adopted in abortion protection states, most recently in Michigan (see section A).
[8] While, in 1999, the Supreme Court of Montana held that abortion was protected as a privacy right, lawmakers continued to enact pro-life laws and defend them in court (see section A). Armstrong v. State, 989 P.2d 364, 377 (Mont. 1999).
[9] 597 U.S. 215 (2022).
[10] 410 U.S. 113 (1973).
[11] This paper defines “Gestation-based abortion limits” as laws that restrict abortion, with limited exceptions, throughout or for most of pregnancy. Gestation-based abortion limits are distinct from bans on specific abortion procedures or abortions performed for specific reasons.
[12] Wyo. Stat. § 6-77 (1957).
[13] Doe v. Burk, 513 P.2d 643, 644-645 (Wyo. 1973).
[14] 1977 Wyo. Sess. Laws 11, 14, ch. 11, §2.
[15] 597 U.S. 215 (2022).
[16] Wyo. Stat. § 35-6-120-128.
[17] See Johnson et al. v. State of Wyoming, et al., Summary Judgment Order, Civil Action No 2023-CV-18853, ¶ 25. The court also issued a temporary restraining order, effective June 22, 2023, against a newly enacted Medication Abortion Ban. Id. ¶ 26.
[18] Id. at ¶ 4.
[19] Id. at ¶ 52.
[20] Wyoming v. Johnson, 2026 WY 1, ¶107 (WY 2026). In contrast, the Supreme Court of Wisconsin declined to “find” a right to abortion in the state constitution when it struck down the state’s gestation-based abortion limit. On July 2, 2025, in a sharply divided opinion, the Court ruled that 50 years of state abortion legislation in the wake of Roe “was meant as a substitute for the 19th century near-total ban on abortion;” therefore, “the legislature impliedly repealed” the law as it applied to abortion. Kaul v. Urmanski, 2025 WI 32 (Wis. July 2, 2025). However, the court also dismissed a case filed by Planned Parenthood asking the court to find a constitutional right to abortion in the state constitution. Planned Parenthood of WI v. Urmanski, 2024 WI 33 (Wis. July 2, 2025). Abortion is presently prohibited in Wisconsin at 20 weeks post-fertilization age (22 weeks gestational age) except when necessary to prevent a mother’s death or a “serious risk of substantial and irreversible impairment of one or more of the woman’s major bodily functions.” Wis. Stat. §§ 253.107(3), 253.10(2)(d)). Wisconsin is now one of four states that have neither a broad abortion protection law or a strong gestation-based abortion limitation (the other three states are New Hampshire, Pennsylvania, and Virginia).
[21] See State of Wyoming, 68th Legislature, HB0064 – Chemical abortions-ultrasound requirement, https://www.wyoleg.gov/Legislation/2025/HB0064 (last visited, Jan. 14, 2026).
[22] Wyoming v. Johnson, ¶72.
[23] Citizens approved Wyoming Constitution Article 1 § 38, Right of health care access, in response to the Affordable Care Act. Lawmakers and voters wanted to ensure that they could make their own healthcare decisions without federal encroachment. See Nick Healey & Teddy Boyer, The Shield Becomes a Sword: Wyoming’s constitutional right to make healthcare decisions, Wyoming Medicine 10 (Spring 2023), https://www.wyomed.org/wp-content/uploads/2024/01/The-Shield-Becomes-a-Sword-Wyomings-constitutional-right-to-make-healthcare-decisions-BY-NICK-HEALEY-and-TEDDY-BOYER.pdf. Because Wyoming’s Supreme Court used the broad language in this amendment to find a state right to abortion, lawmakers can propose an amendment to Article 1 § 38 or a separate amendment clarifying that there is not a right to abortion in Wyoming.
[24] In the 2026 general election, Nevada voters will consider an abortion protection ballot initiative for the second time. While voters approved the measure in 2024, state law requires its approval in two even-numbered elections years. See Ballotpedia, Nevada Question 6, Right to Abortion Initiative (2026), https://ballotpedia.org/Nevada_Question_6,_Right_to_Abortion_Initiative_(2026) (last visited, Dec. 31, 2025). Abortion advocates are attempting to place similar initiatives on the ballots in Idaho and Virginia, which are not presently abortion protection states. See Riley Shoemaker & Kate Jacobson, Idaho Supreme Court orders revisions to abortion ballot initiative language, Idaho News 6, June 27, 2025, https://www.kivitv.com/news/idaho-supreme-court-orders-revisions-to-abortion-ballot-initiative-language.
[25] Nelson v. Planned Parenthood Ctr., 505 P.2d 580 (Ariz. Ct. App. 1973).
[26] 1977 Ariz. Sess. Laws ch. 142, § 99 (1st Reg. Sess.).
[27] Planned Parenthood Ariz., Inc. v. Mayes, 545 P.3d 892, 896 (Ariz. Sup. Ct., Apr. 9, 2024).
[28] Id. at 895. Arizona SB 1164, 55th Leg., 2nd Reg. Sess. (2022); A.R.S. §§ 36-2321-2326.
[29] Votes: AZ HB 2677, https://legiscan.com/AZ/votes/HB2677/2024.
[30] AZ HB2677, CH. 181 of 2024, Fifty-sixth Legislature 2nd Regular, Chaptered.
[31] Ballotpedia, Arizona Proposition 139, Right to Abortion Initiative (2024), https://ballotpedia.org/Arizona_Proposition_139,_Right_to_Abortion_Initiative_(2024)#cite_note-finance-12 (last visited Dec. 19, 2025).
[32] A.R.S. Const. Art. II, § 8.1 (emphasis added).
[33] A.R.S. §§ 36-2321-2326.
[34] Reuss v. Arizona, No. CV 2024-034624 (Ariz. Sup. Ct., Mar. 5, 2025).
[35] Ariz. Rev. Stat. Ann. § 36-2301.01.
[36] See Isaacson v. Arizona, No. CV-2025-017995 (Ariz. Super. Ct. Maricopa Co.). Plaintiffs are seeking a preliminary injunction against life-affirming laws, including: a ban on telemedicine abortion; a ban on abortions sought because of the unborn baby’s sex, race, or disability; and informed consent requirements. https://www.aclu.org/cases/isaacson-v-arizona?document=Motion-for-Preliminary-Injunction-Isaacson-v-Arizona.
[37] “‘Compelling state interest’ means a law, regulation, policy or practice that meets both of the following: (a) Is enacted or adopted for the limited purpose of improving or maintaining the health of an individual seeking abortion care, consistent with accepted clinical standards of practice and evidence-based medicine. (b) Does not infringe on that individual’s autonomous decision making.” A.R.S. Const. Art. II, § 8.1. The definition does not include laws written to protect unborn babies.
[38] E.g., 2025 Bill Text AZ S.B. 1553 (introduced Feb. 3, 2025); 2005 Bill Text AZ H.B. 2746 (introduced Feb. 4, 2025); 2025 Bill Text AZ H.B. 2743 (introduced Feb. 4, 2025); 2025 Bill Text AZ H.B. 2465 (introduced Jan. 16, 2025); 2025 Bill Text AZ H.B. 2464 (introduced Jan. 16, 2025).
[39] 2025 Bill Text AZ H.C.R. 2058 (introduced, Feb. 10, 2025).
[40] Id.
[41] 2025 Bill text AZ H.B. 2681 (Engrossed House, Feb. 26, 2025).
[42] Mich. Comp. Laws § 750.14.
[43] Planned Parenthood of Mich. et. al. v. Att’y Gen. of Michigan, No. 22-00044-MM (Mich. Ct. Cl. Sep. 7, 2022).
[44] Id.
[45] HB 4006 of 2023 (Public Act 11 of 2023), repealing Mich. Comp. Laws §§ 750.14, 750.15.
[46] Ballotpedia, Michigan Proposal 3, Right to Reproductive Freedom Initiative (2022), https://ballotpedia.org/Michigan_Proposal_3,_Right_to_Reproductive_Freedom_Initiative_(2022) (last visited Dec. 8, 2025).
[47] Mich. Comp. Laws Const. Art. I § 28, emphasis added.
[48] See, e.g., SB 474, Public Act 209 of 2023 (repeal of clinic health and safety regulations); 2023 H.B. 4949, Public Act 286 of 2023 (abortion protection statute). See also Governor Gretchen Whitmer, Governor Whitmer Signs Reproductive Health Act (Nov. 21, 2023), https://www.michigan.gov/whitmer/news/press-releases/2023/11/21/governor-whitmer-signs-reproductive-health-act.
[49] Mich. Comp. Laws § 333.26103.
[50] Northland Family Planning v. Dana Nessel, No. 24-000011-MM (Mich. Ct. Cl. May 13, 2025).
[51] Id. at 55.
[52] Id. at 54.
[53] As in other abortion protection states, a “compelling state interest” excludes protecting unborn children when their mothers choose abortion. “A state interest is ‘compelling; only if it is for the limited purpose of protecting the health of an individual seeking care, consistent with accepted clinical standards of practice and evidence-based medicine, and does not infringe on that individual’s autonomous decision-making.” Mich. Comp. Laws Const. Art. I § 28.
[54] Right to Life of Michigan v. Whitmer, W.D. Mich. No. 1:23-cv-1189.
[55] Mo. Ann. Stat. § 599.100 (1969).
[56] Rodgers v. Danforth, Civ. No. 18360-2 (W.D. Mo. May 18, 1973).
[57] 1977 Mo. Laws 658, 662-63.
[58] § 188.017 R.S. Mo. (definitions in § 188.015 R.S. Mo.).
[59] 22 Op. Att’y. Gen. 2022 (2022).
[60] Id., citing, e.g., §§ 1.205.1,.2; 188.010 R.S. Mo.
[61] Mo. Const. Art. I, § 36 (emphasis added).
[62] Mo. Const. Art. I, § 36.
[63] Mo. Rev. Stat. §§ 188.017, 188.056, 188.057, 188.058, 188.375.
[64] Comprehensive Health of Planned Parenthood Great Plains et al. v. Missouri, Case No. 2416-CV31931, Order (Jackson Cnt. Cir. Ct. Dec. 20, 2024); Order (Jackson Cnt. Cir. Ct. Feb. 14, 2025).
[65] State ex rel. Michael Kehoe v. The Honorable Jerri Zhang, No. SC101026, Peremptory Writ (Mo. May 27, 2025). December 20, 2024 and February 14, 2025 injunctions vacated: Comprehensive Health of Planned Parenthood Great Plains et al. v. Missouri, Case No. 2416-CV31931, Order (Jackson Cnt. Cir. Ct. May 28, 2025).
[66] Comprehensive Health of Planned Parenthood Great Plains et al. v. Missouri, Case No. 2416-CV31931, Order (Jackson Cnt. Cir. Ct. Jul. 3, 2025).
[67] Matthew Sanders, Missouri attorney general pledges appeal over abortion decision, KMIZ, Jul. 7, 2025, https://abc17news.com/politics/2025/07/07/missouri-attorney-general-pledges-appeal-over-abortion-decision/.
[68] In particular, Attorney General Bailey would continue to enforce parental consent requirements: “Under the U.S. Constitution, parents have a ‘fundamental right … to make decisions concerning the care, custody, and control of their children.’ Troxel v. Granville, 530 U.S. 57, 66 (2000). This includes the ‘right to refuse unwanted medical treatment.’ Washington v. Glucksberg, 521 U.S. 702, 725-26 (1997). Amendment 3 cannot displace that fundamental constitutional right.” Attorney General of Missouri, Andrew Bailey, Op. Letter No. 22-2024 (Nov. 22, 2024), https://ago.mo.gov/wp-content/uploads/22-2024.pdf.
[69] Ballotpedia, Missouri Amendment 3, Right to Reproductive Freedom Initiative (2024), https://ballotpedia.org/Missouri_Amendment_3,_Right_to_Reproductive_Freedom_Initiative_(2024) (last visited Dec. 19, 2025).
[70] Denny Hoskins, CPA, Missouri Secretary of State, Missouri Election Results, https://www.sos.mo.gov/elections/results. See file entitled, “General Election November 5, 2024” (p. 36, “Constitutional Amendment 3”).
[71] Op. Letter No. 22-2024, supra.
[72] “Discriminatory abortions” are abortions performed because of the unborn baby’s race, gender, or disability/anomaly.
[73] Missouri House Joint Resolution No. 73 (103rd General Assembly).
[74] Op. Letter No. 22-2024, supra.
[75] Mont. Code Ann. § 94-401 (1969).
[76] Doe v. Woodahl, 360 F. Supp. 20 (D. Mont. 1973).
[77] 1977 Mont. Laws ch. 359.
[78] Armstrong v. State, 989 P.2d 364, 377 (Mont. 1999).
[79] §§ 50-20-501-11, MCA.
[80] Planned Parenthood of Montana v. State, Case No. DA 23-0272 (Aug. 14, 2024). The state sought review from the United States Supreme Court (State of Montana v. Planned Parenthood of Montana, No. 24-745, asking “Whether a parent’s fundamental right to direct the care and custody of his or her children includes a right to know and participate in decisions concerning their minor child’s medical care, including a minor’s decision to seek an abortion”), but it was denied. Montana v. Planned Parenthood of Montana, 606 U.S. ___ (2025). Justice Alito, with whom Justice Thomas joined, wrote that this case is “a poor vehicle” for deciding the question submitted by the state. However, he also wrote, “It is [] especially important that the denial of review is not read by interested parties or other courts as a rejection of the argument that the petition asks us to decide.”
[81] Planned Parenthood of Mont. v. State, 2025 MT 120 (Mont. June 9, 2025).
[82] As in other abortion protection states, a “compelling state interest” excludes protecting unborn children when their mothers choose abortion: “A government interest is ‘compelling’ only if it clearly and convincingly addresses a medically acknowledged, bona fide health risk to a pregnant patient and does not infringe on the patient’s autonomous decision making.” Montana Article II, Section 36.
[83] Montana Article II, Section 36 (emphasis added).
[84] Ballotpedia, Montana CI-128, right to abortion initiative (2024), https://ballotpedia.org/Montana_CI-128,_Right_to_Abortion_Initiative_(2024)) (last visited Dec. 19, 2025).
[85] Keila Szpaller, Montana Family Foundation sues over Constitutional amendment to protect abortion, Daily Montanan, June 23, 2025, https://dailymontanan.com/2025/06/23/montana-family-foundation-sues-over-constitutional-amendment-to-protect-abortion/.
[86] See Id.
[87] Darrell Ehrlick, Montana Supreme Court won’t hear case challenging abortion amendment, Daily Montanan, Jul. 2, 2025, https://dailymontanan.com/2025/07/02/montana-supreme-court-wont-hear-case-challenging-abortion-amendment/.
[88] Ohio Rev. Code Ann. § 2901.16 (1953).
[89] State v. Kruze, 295 N.E.2d 916 (Ohio 1973).
[90] 135 Ohio Laws 988 (1974).
[91] Preterm-Cleveland v. Yost, 395 F.Supp.3d 796 (S.D. Ohio 2019).
[92] Preterm-Cleveland v. Yost, 2022 U.S. Dist. LEXIS 112700 (S.D. Ohio Case No. 1:19-cv-00360, June 24, 2022).
[93] Preterm-Cleveland v. Yost, Case No. A2203203 (Ct. C.P. Ohio, Sept. 14, 2022).
[94] Preterm-Cleveland v. Yost, Case No. A2203203 (Ct. C.P. Ohio, Oct. 12, 2022).
[95] Preterm-Cleveland v. Yost, 178 Ohio St. 3d 1 (Ohio 2023).
[96] Preterm-Cleveland v. Yost, 2024 Ohio Misc. Lexis 1477 (Ct. C.P. Ohio, Oct. 24, 2024).
[97] Preterm-Cleveland v. Yost, Case No. 2400668, Brief of State Defendants-Appellants (First App. Dist., Mar. 21, 2025).
[98] Ohio Constitution, Article I, Section 22.
[99] Ballotpedia, Ohio Issue 1, Right to Make Reproductive Decisions Including Abortion Initiative (2023), https://ballotpedia.org/Ohio_Issue_1,_Right_to_Make_Reproductive_Decisions_Including_Abortion_Initiative_(2023) (last visited Dec. 19, 2025).
[100] Twenty weeks post-fertilization is about 22 weeks of gestation. See The Science Behind Embryonic Heartbeats—A Fact Sheet, Charlotte Lozier Institute (Nov. 3, 2021), https://lozierinstitute.org/the-science-behind-embryonic-heartbeats-a-fact-sheet/: “Weeks of gestation refers to pregnancy based on the woman’s last menstrual period, in which the number of weeks referenced is typically 2 weeks greater than fertilization age.”
[101] Ohio Rev. Code Ann. § 2919.201.
[102] See, e.g., Preterm-Cleveland, et al. v. Yost, et al., Case No. 24-CV-2634 (Ct. of C.P Aug. 23, 2024) (Preliminary injunction issued against “(1) Ohio’s waiting period; (2) the in-person visit requirement; and (3) the state-mandated information requirements for abortion…”).
[103] Yes on Proposition 139, Arizona for Abortion Access, https://www.arizonaforabortionaccess.org (last visited Dec. 19, 2025); Reproductive Freedom for All, Michigan, https://reproductivefreedomforall.org/state/michigan/ (last visited Dec. 19, 2025); Stop the Missouri Abortion Ban, https://moconstitutionalfreedom.org/missourians-for-constitutional-freedom-shows-grassroots-strength-with-strong-fundraising/ (last visited Jul. 31, 2025); Abortion Action, Missouri, https://abortionactionmissouri.org (last visited Dec. 19, 2025); Montana Free Press, Following the governor’s money (Sept. 9, 2024), https://montanafreepress.org/2024/09/09/next-week-help-us-cut-through-political-noise-2/; Influence Watch, Montanans Securing Reproductive Rights, https://www.influencewatch.org/organization/montanans-securing-reproductive-rights/ (last visited Dec. 19, 2025); Yes on Issue 1, https://ohioansunitedforreproductiverights.win (last visited Dec. 19, 2025); Ohioans for Reproductive Freedom, see https://www.acluohio.org/press-releases/introducing-ohioans-reproductive-freedom-cohort-secure-explicit-abortion-access-state/; Ohio Physicians for Reproductive Rights, https://ohioreprorights.org (last visited Dec. 19, 2025); See Ballotpedia, 2022 abortion-related abortion ballot measures, https://ballotpedia.org/2022_abortion-related_ballot_measures (last visited Dec. 19, 2025); Ballotpedia, 2023 and 2024 abortion-related ballot measures, https://ballotpedia.org/2023_and_2024_abortion-related_ballot_measures (last visited Dec. 19, 2025).
[104] Fairness Project Commits $30 Million to Protect Reproductive Rights Ballot Measure Campaigns in 2024 Election Cycle, Fairness Project (Sept. 25, 2024), https://thefairnessproject.org/blog/2024/09/25/fairness-project-commits-30-million-to-protect-reproductive-rights-ballot-measure-campaigns-in-2024-election-cycle/.
[105] According to Ballotpedia, the Fairness Project contributed the following amounts to these abortion protection amendment campaigns: Arizona, $4,754,833.11; Missouri, $4,573,806.75; Montana, $1,263,755.00; Ohio, $2,800,000.00. The organization’s contribution to the Michigan campaign appears to be undisclosed. See fns 31, 46, 69, 84, & 99.
[106] See Fairness Project, Ballot Measures FAQ, https://thefairnessproject.org/ballot-measure-faq/.
[107] Yes on Issue 1, supra. See also, e.g., Stop the Missouri Abortion Ban, supra, where Missourians for Constitutional Freedom claims on the landing page that the ballot initiative campaign is “a statewide coalition of organizations and concerned citizens,” also without mentioning the millions of dollars in funding from out-of-state sources.
[108] Emma Green, The Massive Progressive Dark-Money Group You’ve Never Heard of, The Atlantic (Nov. 2, 2021), https://www.theatlantic.com/politics/archive/2021/11/arabella-advisors-money-democrats/620553/. The Sixteen Thirty Fund also receives funding from foreign sources. See Brittany Bernstein, Democrats are Increasingly Relying on Ballot Initiatives to Shape Policy. Foreigners Have Noticed, National Review (Apr. 8, 2025), https://www.nationalreview.com/news/democrats-are-increasingly-relying-on-ballot-initiatives-to-shape-state-policy-foreigners-have-noticed/?bypass_key=Y1RxOWlJYStHWEY2eFNVckk5NGhJQT09OjpOMHNyYW10eVVWZG5WR0lyYlNzME5GWTNVbE5FWnowOQ%3D%3D?utm_source%3Demail&utm_medium=breaking&utm_campaign=newstrack&utm_term=39340309&utm_source=Sailthru.
[109] See Americans for Public Trust, APT Report: 2024 Dark Money Spending on Abortion Ballot Measures in Battleground States (Nov. 26, 2024), https://americansforpublictrust.org/document/apt-report-dark-money-abortion/; See also Ballotpedia, Missouri Amendment 3, Right to Reproductive Freedom Initiative (2024), https://ballotpedia.org/Missouri_Amendment_3,_Right_to_Reproductive_Freedom_Initiative_(2024) (last visited Dec. 19, 2025); Ballotpedia, Montana CI-128, Right to Abortion Initiative (2024), https://ballotpedia.org/Montana_CI-128,_Right_to_Abortion_Initiative_(2024) (last visited Dec. 19, 2025); Ballotpedia, Ohio Issue 1, Right to Make Reproductive Decisions Including Abortion Initiative (2023), https://ballotpedia.org/Ohio_Issue_1,_Right_to_Make_Reproductive_Decisions_Including_Abortion_Initiative_(2023) (last visited, Dec. 19, 2025).
[110] See fns 31, 46, 69, 84, & 99.
[111] See, e.g., quote from Athena Salman, Director of Arizona Campaigns, Reproductive Freedom for All Arizona, “The Fairness Project were strong strategic partners throughout the Arizona for Abortion Access/Yes on 139 Campaign. Through their early support and steady leadership, the campaign got off the ground and stayed focused on our north star;” Quote from Emily Wales, President and CEO, Planned Parenthood Great Plains, “Since the start of our fight to restore abortion access in Missouri, the Fairness Project has been an invaluable partner. They’ve helped guide in-state organizations through an effort that’s unlike any other we’ve undertaken;” Quote from J. Bennett Guess, Executive Director, ACLU of Ohio, “The Fairness Project was, in equal parts, both a major funder and trusted strategist, and in every way a full-on collaborator, in Ohio’s big win for abortion rights in 2023. TFP opened doors for us, built trusting relationships, and provided hands-on technical support that we didn’t even know we would need.” https://thefairnessproject.org (last visited Dec. 19, 2025).
[112] See, e.g., website for Healthcare Rising Arizona, which is funded by SEIU United Healthcare Workers West Political Issues Committee PAC (Transparency USA, https://www.transparencyusa.org/az/committee/arizonans-fed-up-with-failing-healthcare-healthcare-rising-az-100082-pac.): “Healthcare Rising members led the coalition effort to collect signatures to get Prop 139 on the ballot, collecting more than 70,000 signatures. Healthcare Rising also contributed petitioners, notaries, training, and more to secure a record-breaking 823,685 signatures overall. That’s the most signatures collected in Arizona history, since Healthcare Rising last collected signatures to fight medical debt in 2022! After Prop 139 qualified for the ballot, we talked to our neighbors, we talked to our friends, we talked to our family, we talked to the media. We mobilized people who had never been involved in something like this before by connecting with them, person to person, as human beings — and we won!” https://www.healthcarerisingaz.org/2024-abortion-access-initiative/ (Last visited Dec. 19, 2025). See also, e.g., The Sixteen Thirty Fund model, “Sixteen Thirty Fund is a platform to help nonprofits, advocates, institutions, and progressive causes quickly and efficiently launch new projects. … Once Sixteen Thirty Fund becomes a project’s fiscal sponsor, the project is able to quickly launch and get to work while operating under Sixteen Thirty Fund’s legal and tax-exempt status. Like other fiscal sponsors, Sixteen Thirty Fund is not the original source of funding for the projects it incubates. When a foundation or funder makes a donation to support a project, the fiscal sponsor receives the donation on behalf of the project. Sixteen Thirty Fund follows all local, state, and federal law with respect to the disclosure of individual donors. Instead of projects setting up their own infrastructure, which is time-consuming and expensive, Sixteen Thirty Fund provides projects with a variety of administrative supports, such as legal and compliance, HR, and accounting and payroll. This streamlined model means projects can launch within weeks rather than months or even years. Once a project has been incubated, the project can choose to have Sixteen Thirty Fund remain its fiscal sponsor, become its own independently operating entity, or in some cases, end its activities.” https://www.sixteenthirtyfund.org/our-approach/ (last visited Dec. 19, 2025).
[113] Yes on Proposition 139, supra. (last visited Dec. 19, 2025). See also “Missourians should have the freedom to make their own personal health decisions, without interference from politicians.” Stop the Abortion Ban, supra; “Decisions around pregnancy, including abortion, … are personal and private and should be left up to women and their families.” Yes on Issue 1, supra.
[114] See, e.g., Stories, Yes on Proposition 139 for Abortion Access, https://www.arizonaforabortionaccess.org/stories/ (last visited Dec. 19, 2025).
[115] “Overall, common exceptions to abortion limits are estimated to account for less than 5% of all abortions. Rape and incest: 0.4%; Risk to the woman’s life or a major bodily function: 0.3%; Other physical health concerns: 2.2.%; Abnormality in the unborn baby: 1.2%; Elective and unspecified reasons: 95.9%.” Elyse Gaitan, Mia Steupert, & Tessa Cox, Fact Sheet: Reasons for Abortion, Charlotte Lozier Institute (May 24, 2024), https://lozierinstitute.org/fact-sheet-reasons-for-abortion/. See internal sources in article.
[116] See, e.g., Arizona for Abortion Access’s assertion that Arizona’s 15-week gestational abortion limit “force[d] doctors to wait to provide care to patients who are miscarrying until their conditions worsen. Women with serious pregnancy complications are being turned away by hospitals afraid of investigations and lawsuits, putting their health at risk.” About Yes on Proposition 139, Talking Points, https://www.arizonaforabortionaccess.org/wp-content/uploads/2024/10/Yes-on-139-Talking-Points-and-Summary-One-Pager-v3.0.pdf (last visited Dec. 19, 2025).
[117] Ballotpedia, Missouri Amendment 3, Right to Reproductive Freedom Initiative (2024), https://ballotpedia.org/Missouri_Amendment_3,_Right_to_Reproductive_Freedom_Initiative_(2024) (last visited Jan. 20, 2026).
[118] Discriminatory abortions” are abortions performed because of the unborn baby’s race, gender, or disability/anomaly.
[119] California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
[120] Those decisions have not been overturned in at least nine states: Alaska, California, Illinois, Kansas, Massachusetts, Minnesota, Montana, New Jersey, and New York. Alaska and Kansas do not have abortion protection statutes or amendments; state supreme court decisions form the only basis for an “abortion right” in those states.
[121] Planned Parenthood v. Casey, 505 U.S. 833 (1992).
[122] Conn. Gen. Stat. Ann. § 19A-602(b) (1990).
[123] Nev. Rev. Stat. § 442.250 (1990).
[124] Wash. Rev. Code Ann. § 9.02.100; § 9.02.110 (1991).
[125] Md. Health-Gen. Code Ann. § 20-209 (1991).
[126] ME Rev. Stat. tit. 22, § 1598 (1993).
[127] Hawaii is an outlier with the oldest abortion protection statute, enacted in 1970. Haw. Rev. Stat. § 453-16.
[128] Cal. Health & Saf Code § 123460-64 (2002).
[129] Delaware (Del. Code Ann. tit. 24 § 1790 (2017)), Oregon (Or. Rev. Stat. § 435.210; § 435.240 (2017)), Illinois (775 ILL Comp. Stat. 55/1-1-97 (2019)), New York (NY CLS Pub Health § 2599-bb (2019)), Rhode Island (R.I. Gen. Laws Ann. § 23-4.13.2 (2019)), Vermont (Vt. Stat. Ann. tit. 18 § 9494 (2019)), Massachusetts (Mass. Gen. Laws ch. 112 §§ 12L-N1/2. (2020)), Colorado (Colo. Rev. Stat. § 25-6-403 (2022), New Jersey (N.J. Stat. § 10:7-2 (2022)), Michigan (Mich. Comp. Laws § 333.26103 (2023)), Minnesota (Minn. Stat. § 145.409 (2023)), New Mexico (2023 NM ALS 11 (2023)).
[130] Another 45 provisions were introduced that would “add or expand existing exceptions to abortion bans.” Kimya Forouzan, State Policy Trends 2025 Full-Year Analysis: New restrictions and criminalization target remaining avenues of care, Guttmacher (December 2025), https://www.guttmacher.org/2025/12/state-policy-trends-2025-full-year-analysis.
[131] Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan (executive order only), Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina (executive order only), Oregon, Pennsylvania (executive order only), Rhode Island, Vermont, and Washington. See Interactive Map: US Abortion Policies and Access After Roe, Guttmacher, https://states.guttmacher.org/policies?protections=shield-law-protecting-providers; Shield Laws for Reproductive and Gender-Affirming Health Care: A State Law Guide, UCLA Center on Reproductive Health, Law, and Policy, https://williamsinstitute.law.ucla.edu/wp-content/uploads/Shield-Law-NC-Sep-2024.pdf.
[132] Portions of this section were adapted from my earlier work, Mary E. Harned, Abortion “Shield Laws:” Pro-Abortion States Seek to Force Abortion on Life-Affirming States, Charlotte Lozier Institute (Aug. 24, 2023).This paper uses the term “abortionist legal shields” rather than “abortion shield laws” or just “shield laws” because the primary purpose and the effect of these laws is to shield those who perform abortions (i.e., the abortionists) from civil, criminal, or professional repercussions.
[133] The laws generally require the states to decline enforcing judgments or penalties issued against an abortionist in another state and prohibit negative professional consequences.
[134] The laws generally require the states to refuse to extradite abortionists or cooperate with any extra-jurisdictional investigation of abortions that are legal in the pro-abortion state.
[135] Forouzan, supra.
[136] California (Ca. Health and Saf. Code § 123468.5; Added by Stats 2023 ch 260 (SB 345), s 13, eff. 1/1/2024); Colorado (C.R.S. § 12-30-121, Added by 2023 Ch. 68, § 5, eff. 4/14/2023); Maine (L.D. 227, 131st Leg., 2nd Reg. Sess. (Me. 2024) (amending Me. Rev. Stat. Ann. tit. 14)); Massachusetts (Mass. General Laws Part I, Title II, Chapter 9A, Section 1), New York (Section 570.17 of the criminal procedure law, as amended by chapter 101 of the laws of 2023); Rhode Island (R.I. Gen. Laws § § 23-101-2—9, 23-17-53); Vermont (Vermont Statutes Title 1. General Provisions, § 150); Washington (Rev. Code Wash. (ARCW) § 18.130.450).
[137] Forouzan, supra. California, Colorado, Maine, Massachusetts, New York, Vermont, and Washington. Further, a bill was introduced in California to exclude even the patients’ names from labels. See Shefali Luthra, Prescribers Push to keep their names off labels for abortion medication, Truthout, June 23, 2025, https://truthout.org/articles/prescribers-push-to-keep-their-names-off-labels-for-abortion-medication/.
[138] See David S. Cohen, Greer Donley, & Rachel Rebouché, The New Abortion Battleground, 123 Col. Law Rev. 1, 43, fn. 238 (2023).
[139] Id. at 52.
[140] Heritage Guide to the Constitution (2005), 267.
[141] Id. at 268. A defendant can argue that his circumstances meet a narrow exception to this rule, namely that the court issuing the judgment did not have personal jurisdiction over the defendant or that the judgment was penal in nature.
[142]Interstate Depositions and Discovery Act, Uniform Law Commission, https://www.uniformlaws.org/committees/community-home?CommunityKey=181202a2-172d-46a1-8dcc-cdb495621d35.
[143] Subpoenaing Out-of-State Witnesses in Criminal Proceedings: A Step-by-Step Guide, National Association of Attorneys General, https://www.naag.org/attorney-general-journal/subpoenaing-out-of-state-witnesses/.
[144] Abortion becomes more common in some US states that outlawed it, The Economist, Apr. 15, 2025, https://www.economist.com/united-states/2025/04/15/abortion-becomes-more-common-in-some-us-states-that-outlawed-it.
[145] Some states have enacted shield laws relating to transgender treatment. See Transgender Healthcare “Shield” Laws, Movement Advancement Project, https://www.mapresearch.org/equality-maps/healthcare/trans_shield_laws (last visited Dec. 19, 2025).
[146] “The Federation of State Medical Boards (FSMB), which represents and supports all state medical boards, states that ‘[a] physician must be licensed, or appropriately authorized, by the medical board of the state where the patient is located … Physicians who diagnose, treat, or prescribe using online service sites are engaging in the practice [of] medicine and must possess appropriate licensure in all jurisdictions where their patients receive care.’ Further, Cohen, et al. explain that ‘a typical’ state medical practice act ‘includes some version of this statement: ‘the practice of medicine is determined to occur where the patient is located in order that the full resources of the state are available for the protection of that patient.’ They concede that ‘there are important reasons for defining care as occurring where the patient is located—the state where the patient resides typically has the strongest interest and best means of protecting the safety of the resident patient.’” Mary E. Harned, Abortion “Shield Laws”: Pro-Abortion States Seek to Force Abortion on Life-Affirming States, Charlotte Lozier Institute, Aug. 24, 2023 (quoting David S. Cohen, Greer Donley, & Rachel Rebouché, Abortion Pills, 76 STAN. L. REV. 317 (2024)), https://lozierinstitute.org/abortion-shield-laws-pro-abortion-states-seek-to-force-abortion-on-life-affirming-states/.
[147] Society of Family Planning, #WeCount Report April 2022 through December 2024. 23 Jun. 2025 (June 23, 2025), https://societyfp.org/wecount-report-9-december-2024-data/.
[148] Society of Family Planning, #WeCount Report April 2022 to June 2025. 9 Dec. 2025 (Dec. 9, 2025), https://societyfp.org/research/wecount/wecount-june-2025-data/.
[149] #WeCount, June 23, 2025, supra.
[150] #WeCount, Dec. 9, 2025, supra.
[151] #WeCount, June 23, 2025, supra.
[152] #WeCount, Dec. 9, 2025, supra.
[153] Id.
[154] Abortion becomes more common in some US states that outlawed it, The Economist, Apr. 15, 2025, https://www.economist.com/united-states/2025/04/15/abortion-becomes-more-common-in-some-us-states-that-outlawed-it.
[155] Id.
[156] Sofia Resnick, Abortion providers in shield law states say they are undeterred by legal threats, Arkansas Advocate/State Newsroom, Feb. 21, 2025, https://arkansasadvocate.com/2025/02/21/repub/abortion-providers-in-shield-law-states-say-they-are-undeterred-by-legal-threats/.
[157] “Mifeprex (mifepristone) and its generic, Mifepristone Tablets, 200 mg (collectively mifepristone) are approved, in a regimen with misoprostol, to end an intrauterine pregnancy through ten weeks gestation (70 days or less since the first day of a patient’s last menstrual period),” not for advance provision. See https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation (last visited Jan. 20, 2026).
[158] Letter from Attorneys General to The Honorable John Thune, et al. (July 29, 2025), https://media.ark.org/ag/2025-07-29-Letter-to-Congress-Shield-Laws.pdf.
[159] Id.
[160] 4th Cir. No. 23-2194 (4th Cir. Jul. 15, 2025).
[161] Missouri v. Planned Parenthood Great Plains, 24BA-CV00990, State of Missouri’s Petition for Declaratory Judgment and Injunctive Relief (Feb. 29, 2024).
[162] Missouri v. Planned Parenthood Great Plains, 24BA-CV00990, Order (April 28, 2025).
[163] Montana v. Planned Parenthood of Montana, 606 U.S. ___ (2025). Justice Alito, with whom Justice Thomas joined, wrote that this case is “a poor vehicle” for deciding the question submitted by the state. However, he also wrote, “It is [] especially important that the denial of review is not read by interested parties or other courts as a rejection of the argument that the petition asks us to decide.”
[164] Planned Parenthood Monte Mar, Inc. v. Ford, Case No. 3:85-cv-00331 (D.NV Mar. 31, 2025).
[165] D. Minn. 0:24-cv-4250, Complaint ¶ 1 (Nov. 22, 2024).
[166] NY CLS Pub Health § 2599-bb.
[167] Smith v. Hochul, 5:21-CV-0035, Complaint for Declaratory and Injunctive Relief and Damages, January 12, 2021, Northern District of New York.
[168] NY CLS Pub Health § 2599-bb.
[169] Smith v. Hochul, 2nd Cir. No. 23-686 (June 3, 2025).
