The U.S. Supreme Court appears poised to overrule the landmark abortion decision Roe v. Wade, according to a leaked draft opinion first reported by Politico. The drafted decision is not binding and does not change Americans’ access to abortion unless states take the unlikely step of recognizing it as the rule of law. But 13 states have so-called “trigger laws” that will codify complete abortion bans if the justices overturn Roe.
Each trigger law is different with only some specifying exceptions for rape, incest and the health of the pregnant person or fetus. Some of the 13 laws will go into effect immediately if the court nullifies Roe. That is the case in South Dakota. Others have buffer periods that will delay the states’ full ban, such as Tennessee and Texas, which will completely ban abortion 30 days after the Supreme Court’s decision. Others don’t specify the timing; some require the state Attorney General to formally approve a change. Most of the trigger laws make performing an abortion a felony.
The draft addresses a challenge to Mississippi’s 15-week abortion ban. The justices confirmed the authenticity of the draft but said the decision was not final. The ruling and reasoning of the court could still change before an official decision is issued in the coming weeks.
With compounding regulations and ongoing efforts to enact new restrictions in different states, the current landscape is confusing and time-consuming for pregnant people to navigate. Despite patchwork access in the South and Midwest, abortion is still legal across the country — but increasingly, access depends on where you live. The interactive map below highlights five main types of abortion restrictions in all 50 states, using Guttmacher Institute and Kaiser Family Foundation data. See below for further context.
Across the U.S. in 2021, state legislatures enacted the most-ever abortion restrictions. On Sept. 1 Texas became the first state since Roe v. Wade was decided in 1973 to implement a de facto ban on abortions as early as six weeks of gestation — before many people know they’re pregnant. Immediately, advocates and lawmakers on both sides of the abortion debate across the country geared up for continued battles in statehouses and courts. But the impact on pregnant Texans was immediate, where abortions dropped by 60% in the first month of the new law.
On Dec. 1, 2021, the U.S. Supreme Court heard a case from Mississippi over its 2018 law banning abortion after 15 weeks — about nine weeks before the point of viability. It’s the first federal level abortion case that threatens to topple Roe, and the first time the Court — which currently has a solid conservative majority — has ever considered a case over a state law banning abortion that early in the gestation period.
The United States has already become a patchwork of abortion restrictions, and 26 states plan to completely outlaw abortion if Roe falls. In 2021 alone, over 108 anti-abortion laws were enacted — more than any other year since Roe — according to the Guttmacher Institute, a nonprofit research center focused on reproductive and sexual health.
These restrictions run the gamut from outright abortion bans to laws that prohibit abortions based on a pregnant person’s reasoning for wanting to end a pregnancy. Lawmakers in multiple states also passed legislation making it more difficult to access medication abortions, a safe and highly effective method of termination in early pregnancy, according to the Kaiser Family Foundation — even as the federal government loosened restrictions on the medication and allowed prescribing by telemedicine and delivery by mail.
A comprehensive list of restrictions for each state struck us as too much and too confusing to include on a single map. So we focused on three categories of abortion restrictions: targeted restrictions of abortion providers (known as TRAP laws), abortion bans and insurance restrictions. We chose these categories because they represent some of the biggest developments, and most restrictive barriers, in anti-abortion legislation in the last few decades.
In updating the map, we’ve added more restrictions like waiting periods, along with color coding. Note that, as indicated, the colors correlate to gestation bans, not the degree of overall restriction in the state — this map does not include other barriers to pregnancy termination, such as mandated “counseling” requirements, which force patients to hear often medically inaccurate material on abortions and parental consent requirements.
Glossary of terms
TRAP (Targeted Restrictions of Abortion Providers) Laws
As the name suggests, these laws specifically target providers rather than abortion seekers, and restrict their ability to provide abortions. These laws are often created under the guise of “protecting women’s health” and can include policies that require providers to include a second physician in an abortion procedure. These laws affect not only providers, but also the ability of patients to procure care.
These laws ban abortion after a certain point in pregnancy or ban specific methods of abortion and include, perhaps most notably, the Texas six-week ban.
These are limitations on the ability of health insurance plans to pay for abortion procedures. Most states block public funds, such as the state Medicaid program, from paying for abortion procedures, often with exceptions for life endangerment, rape and incest. Federal law prevents federal public spending on abortions. Therefore, people in states with such restrictions often have to pay out of pocket for abortions, which can cost hundreds or even thousands of dollars.
Roe v. Wade
A landmark Supreme Court case that enshrined the constitutional right to an abortion in 1973.
Viability is the point in a pregnancy when a fetus could survive outside of the womb. Viability generally occurs after 24 weeks of gestation.
A period of time required between receiving pre-abortion counseling and the procedure itself, some carrying an in-person appointment requirement.
The federal government in 2021 formally allowed medication abortions by telemedicine. Medication abortion uses pills instead of a procedure to end a pregnancy. Over the past few years, this form of abortion has become more common, now accounting for more than half of all abortions in the U.S., and even more in some states like Mississippi (70%) and Wyoming (97%). Though the federal government allows medication abortion through telemedicine, many states have banned it and require in-person visits — often, multiple — to obtain the pill.
The states that appear in grey may have restrictions in categories not represented by this map. For example, in Colorado, minors are required to notify their parents before they’re able to receive an abortion. Importantly, our map only shows the legal framework in each state, which often doesn’t reflect actual access. For example, currently abortions are allowed in Mississippi up to 20 weeks of pregnancy, but the sole abortion clinic in the state offers the procedure only up to 16 weeks.
Editor's Note: This post is periodically updated and was last updated on Monday, May 23, 2022.