Dispatch by Visiting Scholar Aashraya Seth
A new administration was sworn into power in the United States this month and has already made moves to restrict information on reproductive health. The new administration under President Donald Trump was anticipated to pose a threat to reproductive rights, with some Republicans pushing for legislation that attacks women's healthcare.
These attacks on reproductive rights come two years after the Supreme Court’s decision in Dobbs v. Jackson that effectively removed the constitutional right to abortion in the United States. The battle for access to reproductive healthcare has been raging since — with the majority of Americans supporting reproductive rights — and all evidence suggests it will have to rage on.
While we don’t know yet what will happen in 2025, we know that 2024 saw a stark divide on the issue in the U.S.: some states expanded access to reproductive healthcare, including abortion, while others intensified their efforts to criminalize it. The Center for Reproductive Rights' (CRR) new 2024 State Legislative Wrap-up report highlights both the victories achieved and the challenges that lie ahead.
Victories for Reproductive Freedom
1. Constitutional Amendments Solidify Abortion Rights
A wave of voter-approved constitutional amendments swept the nation in 2024, showcasing the public's overwhelming support for reproductive freedom. Eleven states have now amended their constitutions to protect abortion access, with voters in three additional states defeating anti-abortion ballot initiatives. This trend, consistent since 2022, underscores the disconnect between anti-abortion lawmakers and the will of their constituents. The success of Amendment 3 in Missouri, a state with a total abortion ban, marks a historic turning point. This victory opens new legal avenues to challenge the existing ban and serves as a beacon of hope for other states grappling with similar restrictions.
2. Shield Laws Protect Providers and Patients
Recognizing the need to safeguard access in a post-Dobbs world, many states have enacted shield laws, which offer protection against extradition and out-of-state criminal investigations for those seeking or providing legal reproductive health care. Maine and Rhode Island joined the ranks of shield law states in 2024, extending these crucial protections to providers, patients, and helpers involved in fertility care, miscarriage care, and gender-affirming health care. These comprehensive shield laws protect telehealth abortion providers and establish data privacy measures to safeguard sensitive patient information. Importantly, they allow individuals to take legal action against hostile civil lawsuits originating from states with abortion bans. The enactment of these laws is a testament to the unwavering commitment of advocates and lawmakers to ensure access remains a reality.
3. Expanding Access to Medication Abortion
Medication abortion, the most common method of abortion in the U.S., faced renewed attacks in 2024. While the Supreme Court upheld the FDA's regulation of mifepristone, states hostile to abortion persisted in introducing legislation to restrict access to this safe and effective method. In a positive development, Washington State enacted a law allowing medication abortion labels to include the health care facility's name instead of the prescriber's, enhancing patient privacy and security. Delaware took a significant step by requiring universities receiving state funding to offer medication abortion at their health centres, further broadening access for students.
4. Progress in Maternal Health Care
Recognizing the urgent need to address the maternal health crisis in the U.S., states made strides in expanding access to essential care. A total of 48 states have now implemented postpartum Medicaid extensions, ensuring continued coverage for mothers up to a year after childbirth. This expansion is vital, as it addresses the critical period when pregnancy-related deaths are most common. States also moved to improve access to doula care, which has been shown to improve birth outcomes and reduce racial disparities in maternal health. Pennsylvania enacted legislation to provide Medicaid coverage for doula services, joining the growing number of states recognizing the value of this support. Delaware and New York expanded their existing doula coverage programs, further enhancing access for those who need it most.
Ongoing Challenges & Threats
He studied Physics and Information Systems, before getting his first Public Policy fellowship at Churchill College, University of Cambridge, followed by at the University of Chicago Harris School of Public Policy, Korean Development Institute, United Nations, and HSF Germany. For close to a decade, Aashraya has advised and managed programs for the British, Indian, and Australian governments in the areas of science, technology, space, education, and gender equity, and has contributed to dialogues and policy discussions at the UN and World Economic Forum. He was recently placed amongst the top 80 social innovators in India and the top 50 emerging policy leaders in the world.
Aashraya enjoys writing Op-Eds, and the most recent one was for The Minnesota Daily on The 2024 U.S. elections — a critical juncture for reproductive rights
1. Fetal and Embryo Personhood
The introduction and enactment of fetal and embryo personhood laws represent one of the most alarming trends in 2024. These laws, which seek to grant legal rights to fertilized eggs and embryos, pose a direct threat to reproductive freedom and access to essential health care. The implications of these laws were starkly illustrated in Alabama, where a state Supreme Court decision temporarily halted in-vitro fertilization (IVF) services at the state's major fertility clinics. The ruling, which held IVF providers liable for wrongful death following the destruction of embryos, sent shockwaves through the reproductive health community and underscored the far-reaching consequences of such legislation. While Alabama ultimately enacted a law granting immunity to IVF providers, the underlying threat of fetal and embryo personhood persists nationwide.
2. Criminalization of Abortion and Support Networks
Emboldened by the Dobbs decision, anti-abortion lawmakers ramped up their efforts to criminalize abortion and punish those who support individuals seeking this essential care. States introduced bills imposing severe criminal penalties on pregnant people seeking abortions and creating new crimes related to abortion support. The chilling effect of these laws cannot be overstated, as they instill fear and uncertainty among both patients and providers.
4. Inadequate Parental Leave Policies
The lack of comprehensive paid parental leave policies in the U.S. remains a major obstacle to achieving true reproductive justice. While states made some progress in expanding leave for state employees, these measures often fall short of providing the 12 weeks recommended by experts. Paid family leave insurance programs, while offering some choice to employers, do little to change the status quo and leave many workers without the necessary support to recover and bond with their newborns.
3. Attacks on Young People’s Access to Abortion Care
Young people seeking abortion care found themselves increasingly targeted in 2024, with states hostile to abortion enacting and introducing legislation aimed at restricting their access and punishing those who assist them. Abortion support bans, framed under the guise of combating human trafficking, seek to criminalize those who provide logistical, financial, or emotional support to young people seeking legal abortion care in another state. These bans, rooted in the broader "parental rights" movement, are a blatant attempt to control young people's bodies and limit their access to essential health care. The alarming parallels between these laws and those targeting access to gender-affirming care underscore the coordinated assault on bodily autonomy being waged across the country.
A Call to Action
The fight for reproductive freedom is far from over. As we look ahead to 2025 and beyond, it is imperative that we build on the momentum gained in 2024 while vigilantly addressing the persistent threats to reproductive rights.
Repeal Harmful Laws: States must prioritize the repeal of all abortion bans and restrictions, including those that are currently unenforceable or considered "dead letter." The Arizona Supreme Court's ruling in 2024, which threatened to reinstate a pre-Roe total abortion ban, serves as a stark reminder of the dangers of leaving these laws on the books. Efforts to enact fetal and embryo personhood laws must be met with fierce resistance. These laws are fundamentally incompatible with reproductive freedom and threaten access to a wide range of essential health care services.
Enact Comprehensive Shield Laws: All states must enact robust shield laws that protect providers, patients, and helpers involved in all aspects of reproductive health care, including abortion, fertility care, and gender-affirming care. These laws must encompass data privacy protections, prohibit cooperation with out-of-state investigations, and safeguard telehealth abortion providers.
Expand Access to Medication Abortion: States should prioritize policies that increase access to medication abortion, recognizing its safety and effectiveness. Removing unnecessary restrictions, such as physician-only dispensing requirements and in-person visit mandates, is crucial to ensuring that all individuals can access this essential care
Ensure Equitable Access to Fertility Care: States must work to dismantle the barriers that prevent individuals and couples from accessing fertility care, including IVF. Enacting insurance mandates that cover the full spectrum of fertility services, including IVF and fertility preservation, is essential to making this care a reality for all who need it. Addressing discriminatory eligibility restrictions and prohibitive out-of-pocket costs is paramount to achieving true reproductive equity.
Invest in Maternal Health Care: States must prioritize comprehensive investments in maternal health care, addressing the systemic inequities that contribute to the alarmingly high rates of maternal mortality and morbidity in the U.S. Expanding access to quality prenatal and postpartum care, doula services, and mental health support is crucial to improving outcomes for all pregnant and postpartum people.
Champion Paid Family Leave: The U.S. must join the ranks of developed nations that provide comprehensive paid family leave for all workers. States should enact universal paid parental leave programs that offer a minimum of 12 weeks of paid leave, ensuring that all individuals have the time and resources to recover and bond with their newborns.
The fight for reproductive rights is a fight for bodily autonomy, for the right to make decisions about our own bodies and lives without fear of punishment or interference. The legislative landscape of 2024 demonstrated both the power of collective action and the unwavering determination of those who oppose reproductive freedom. We must remain vigilant, engaged, and committed to building a future where all individuals can access the full spectrum of reproductive health care they need and deserve.