US states with the best access to abortion services compared to the worst


  • The right to abortion is protected by federal law, but state policies dictate different levels of abortion access.
  • Some states, such as New York and California, have adopted policies aimed at expanding access to abortion and protecting the right under state law.
  • Other states, namely those in the south and the Rust Belt, have historically been hostile to abortion.
  • TRAP laws, mandatory waiting periods, and gestational limits can all restrict access to abortion.
  • Visit Insider’s homepage for more stories.

A landmark Supreme Court case called Roe v. Wade protects the right to abortion without undue government interference at the US federal level. But when it comes to the state legislature, each jurisdiction has its own set of laws that affect access to abortion services.

Since the appointment of the curator and historically anti-abortion justice Amy Coney Barrett to the Supreme Court, states like Mississippi have sent abortion rights case to the highest court in hopes of setting a new precedent of bans and restrictions.

Both Louisiana and Colorado posed ballot initiatives regarding abortion rights in the 2020 presidential election, with Louisiana officially change its state constitution of not explicitly protecting abortion and Coloradoans refusing to pass a ballot measure that prohibit abortion after 22 weeks of pregnancy.

Elisabeth Smith, Chief State Policy and Advocacy Advisor at the Center for Reproductive Rightssaid that while these state laws cannot outright ban abortion while it is federally protected, they can seriously affect access.

“Federal law creates a floor that says abortion is a right, and then state law has the potential to increase access or actually prohibit access,” she said.

Here’s a breakdown of how state laws expand, protect, or restrict access to abortion in the United States.

New York, Vermont, Connecticut, California, Oregon, Washington and Hawaii have all expanded access to abortion

According to a “What if Roe fell?” tool edited by CRR.

In 2019, New York adopted a reproductive health law which protected the right to abortion under state law, ensuring it would remain so even if Roe v. Wade was canceled. The law also removed abortion from the state criminal code and allowed clinicians to perform abortions after 24 weeks or more of pregnancy if the mother’s life is in danger or the fetus is not viable.

“If you look at a state like New York, which in state law protects the right to abortion, allows advanced practice clinicians to provide abortion care, and covers abortion in a Medicaid program, you can see they’re pretty comprehensive access,” Smith said.

Allowing advanced practice clinicians such as physician assistants or nurse midwives to provide abortion care makes the service more widely available compared to states where only physicians have this authority. Most expanded access states also require both private insurance and Medicaid to cover the cost of abortion care.

However, some expanded-access states — Connecticut, Vermont, Washington and Oregon — still have TRAP laws, or laws imposed on abortion providers that are not required for other medical providers.

14 other states and the District of Columbia protect the right to abortion

As recently as 2019, states recognized the right to abortion in laws and legal precedents.

Illinois passed comprehensive abortion laws in 2019, which not only protected the right to abortion, but also repealed restrictive laws that required husbands to give consent for their wives and exposed doctors to criminal penalties.

Even in Kansas, where abortion remains heavily restricted, the state Supreme Court has ruled that women have autonomy about decisions that affect their bodies and their health. The state maintains a 22-week gestation ban and allows only certain methods of abortion.

Alaska, Delaware, District of Columbia, Florida, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nevada, New Jersey and Rhode Island also protect the right to ‘abortion. Most states have imposed some degree of restriction, such as gestation limits or requiring young people to obtain parental consent.

Abortion rights could be threatened in more than half of US states if Roe v. Wade was canceled

If Roe v. Wade were challenged or overturned, abortion rights would be protected in less than half of US states. Not all of these states restrict access to abortion, but they leave all reproductive rights vulnerable under a predominantly conservative Supreme Court.

New Hampshire, Virginia, Wyoming, Colorado and New Mexico do not protect the right to abortion but are not considered abortion-friendly, according to the CRR. Most of these states have certain restrictions, such as Virginia ban on third-trimester abortions.

Colorado, however, is one of seven states that does not ban abortion at any time during pregnancy. Only 1% of abortions take place after 21 weeks, usually in cases of poor maternal health or a non-viable fetus, according to the Guttmacher Institute. But because abortions after this point are so limited, women across the country trip to colorado for late abortions.

Southern and Rust Belt states have always been hostile to abortion rights

By regulating who can have an abortion, when, and who must pay, many states have established themselves as anti-abortion zones.

Alabama has the most restrictive abortion law in the United States, which prohibits abortion at any stage of pregnancy under all circumstances. District Courts ruled the law unconstitutional in 2019, so it is currently on hold.

In the meantime, Alabama is maintaining medically unnecessary restrictions, including mandatory ultrasounds at abortion appointments and a 48 hour waiting period before the procedure can take place.

Arkansas, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, South Dakota and Tennessee all have “trigger bans” that could ban abortions if Roe falls. However, Smith said the bans would likely not be put in place automatically as the name suggests, and would require some legal process to pass.

Read more:

Here’s The Last Time In Pregnancy You Can Get An Abortion In All 50 States

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