In 2021, state legislatures set an alarming record of 108 abortion restrictions enacted in 19 states. With the fate of Roe v. Wade hanging in the balance at the US Supreme Court, 2022 is shaping up to be even more devastating for abortion rights and access.

Already, a number of state bills have grabbed headlines for proposing outrageous and shocking abortion restrictions. Efforts from banning treatment for ectopic pregnancies to prohibiting people seeking abortions from leaving their home state show just how radical the anti-abortion agenda truly is. While these measures are attracting media coverage, often they are not the main focus of anti-abortion policymakers, but pull attention away from other abortion restrictions and bans that are moving quickly through some state legislatures. Moreover, these types of headline-baiting restrictions can make other devastating provisions, such as Texas-style bans or gestational age bans, seem less radical and harmful than they really are.

In addition, court cases continue to compound the harm of restrictions enacted in previous years, chief among them Texas’ ban on abortions at six weeks of pregnancy. The state’s top court recently rejected a challenge by abortion providers, ruling that there are no public officials who can be sued to stop the law. That decision exhausts the legal options to stop this immensely harmful law that has been in effect for more than six months and may embolden other states to adopt their own Texas-style bans this year.

Among restrictions introduced and moving since the start of state legislative sessions in January, two key themes emerging are anti-abortion policymakers’ continued pursuit of various types of abortion bans and restrictions on medication abortion.

State Policy Developments on Abortion January 1–March 15, 2022

So far this year, 1,844 total provisions related to sexual and reproductive health and rights have been introduced across 46 states and the District of Columbia. This includes both restrictions and proactive measures.

  • Abortion restrictions introduced: 519 restrictions in 41 states
  • Abortion restrictions passed at least one chamber: 46 in 13 states
  • Abortion restrictions enacted: None

Abortion Bans January 1–March 15, 2022

Even before the US Supreme Court rules on Mississippi’s 15-week abortion ban in Dobbs v. Jackson Women’s Health Organization by the end of June, anti-abortion policymakers are banking on the Court’s 6–3 anti-abortion majority to weaken or outright overturn Roe. They are preemptively flooding statehouses with restrictive bills in hopes that federal protections for abortion rights will soon be gone.

As part of this strategy, anti-abortion policymakers are attempting to pass abortion bans that blatantly violate the core holding of the Roe decision and that would devastate access to abortion care in their state if allowed to be enforced.

  • Bans introduced: 82 bans in 30 states
  • Bans passed at least one chamber: 7 (Arizona, Florida, Idaho, Kentucky, Oklahoma and West Virginia)
  • Bans enacted: 1 (Wyoming)

Out of all the proposed bans, anti-abortion policymakers have been focusing primarily on three types: 15-week bans, “Texas-style” bans and bans designed to be triggered if Roe is overturned.

  • Bans at 15 weeks of pregnancy
    • Introduced: 5 in 4 states
    • Passed at least one chamber: 4 (Arizona, Florida, Kentucky and West Virginia)
    • Enacted: None
  • Texas-style” bans that rely on a bounty-hunter enforcement mechanism (with a total, six-week or other gestational age ban)
    • Introduced: 19 in 13 states
    • Passed at least one chamber: 2 (Idaho and Oklahoma)
    • Enacted: None
  • “Trigger” bans to quickly prohibit abortion in the state
    • Introduced: 12 in 9 states
    • Passed at least one chamber: 1 (Oklahoma)
    • Enacted: 1 (Wyoming)

Medication Abortion Restrictions January 1–March 15, 2022

With the US Supreme Court primed to severely weaken or overturn Roe, medication abortion is likely to become even more critical in the delivery of care to many people. Guttmacher research shows that following two decades of safe and effective use, medication abortion accounted for 54% of all US abortions in 2020—powerfully illustrating that the method has gained broad acceptance from both abortion patients and providers.

However, medication abortion has become a primary target of anti-abortion politicians and activists seeking to restrict care in and out of clinical settings. Anti-abortion state policymakers have shown they are focused on further restricting access to medication abortion this year.

  • Restrictions on medication abortion introduced: 104 restrictions in 22 states, including 8 measures that would ban medication abortion outright
  • Restrictions on medication abortion passed at least one chamber: 17 (Georgia, Kentucky, South Dakota and Wyoming)
  • Restrictions on medication abortion enacted: None

Among the total count of medication abortion restrictions that have been introduced are bills that seek to ban medication abortion entirely. Others would make it much harder to administer and access care, including by prohibiting the mailing of pills, limiting provision to physicians (leaving out other qualified medical professionals) and limiting the gestational age for use.

  • Bans use of medication abortion
    • Introduced: 8 in 8 states
    • Passed at least one chamber: 2 (South Dakota and Wyoming)
    • Enacted: None
  • Prohibits mailing of abortion pills
    • Introduced: 9 in 7 states
    • Passed at least one chamber: 2 (Georgia and Kentucky)
    • Enacted: None
  • Restricts administration to physicians
    • Introduced: 11 in 9 states
    • Passed at least one chamber: 3 (Georgia, Kentucky and South Dakota)
    • Enacted: None
  • Limits provision at a specific gestational age
    • Introduced: 5 in 4 states
    • Passed at least one chamber: 1 (South Dakota)
    • Enacted: None