What to know about abortion policy developments in states, courts as Donald Trump takes office

An incoming new president and state legislative sessions ramping up are likely to bring more changes to abortion policy across the U.S., which is still settling after the seismic shift in 2022 when the U.S. Supreme Court overturned Roe v. Wade and opened the door to state bans.

State lawmakers across the country have introduced at least 400 abortion-related bills so far.

On Monday, President-elect Donald Trump will be sworn in for a second term. His positions on abortion have sometimes been inconsistent. But no matter where he lands on some issues, his administration will be a contrast with President Joe Biden, who has favored abortion rights at every turn.

Here is a look at the latest developments.

3 states can keep trying to roll back abortion pill access

Most U.S. abortions are now performed with medication rather than surgical procedures and much of the anti-abortion effort is aimed at limiting access to those pills. A lawsuit seeking to restrict access to mifepristone, one of the two drugs usually used together for medication abortions, picked up some steam this week.

A federal judge on Thursday ruled Idaho, Kansas and Missouri can revive an attempt to roll back the federal approval of mifepristone, making it harder to get.

The states want it to be allowed only in the first seven weeks of pregnancy, rather than the current 10, and to require three in-person doctor’s visits, eliminating telehealth prescriptions. The states argue that efforts to provide access to the pills “undermine state abortion laws and frustrate state law enforcement,” according to court documents.

The Supreme Court rejected a similar effort last year, saying anti-abortion doctors and their organizations did not have the legal standing to challenge the U.S. Food and Drug Administration’s approvals.

Stockpiling abortion pills

Abortion rights advocates worry Trump’s administration could start enforcing the Comstock Act, a 19th century law barring materials used in abortions from being mailed, which hasn’t been enforced for close to 100 years.

While Trump has said he doesn’t plan to restrict medication abortion, he also said “things change,” leaving open the possibility.
This month, New Jersey became the latest Democratic-controlled state to start stockpiling abortion pills. Other liberal-leaning states, including California and Massachusetts were already stockpiling them.

An Indiana lawmaker has proposed criminalizing shipping the drugs to individuals in the state. Several other states already have similar laws, which are among the priorities for anti-abortion groups.

Some blue states have laws intended to protect providers who use telehealth to prescribe pills and mail them to states with bans. The practice accounted for about one-tenth of abortions in the U.S. by June 2024, one study found.

Lawmakers considering new round of ballotquestions

Voters in seven states approved ballot measures for constitutional amendments on reproductive freedom in November and more states could see ballot measures in coming years.

Lawmakers in Hawaii and Virginia, where the legislature is controlled by Democrats, have proposed reproductive freedom amendments for 2026. The Virginia resolution passed the House of Delegates last week. But it needs approval from the Senate and then from both chambers again next year.

Missouri was the only state with a ban on abortion at all stages of pregnancy to adopt an abortion-rights amendment in November. A judge invalidated the ban, but no clinic has opened as abortion rights advocates press courts undo other regulations that they say make it impossible to operate. Missouri lawmakers already are pushing measures to ask voters to roll back the abortion protections they adopted.

Conservative lawmakers propose tougher restrictions

Lawmakers in three states that now ban abortion at all stages of pregnancy are considering further restrictions.

In Oklahoma, a GOP lawmaker is proposing a law that would allow women who obtain abortions to be charged with murder.

A similar measure was introduced in South Carolina in 2023 but quickly stalled. The National Right to Life Committee, Susan B. Anthony Pro-Life America and other anti-abortion groups oppose penalizing women who seek or obtain abortions.

A measure introduced in Mississippi, which echoes laws adopted in the past two years in Idaho and Tennessee, criminalizes helping a minor obtain an abortion without the consent of a parent or guardian. A key difference: Mississippi’s calls for penalties up to life in prison.

The Tennessee law, which has been put on hold by a judge, has a maximum punishment of a year in prison while Idaho’s law calls for up to five years.

It is too early in legislative sessions to tell which measures could advance.

Emergency care has an uncertain future

Biden’s administration sued Idaho over its abortion ban two years ago, arguing that under federal law it should not be enforced during life- and health-threatening emergencies.

The Supreme Court ruled last year that such abortions can be provided while the issue works it way through the courts.

The Trump administration is expected to abandon the lawsuit. St. Luke’s Health System, Idaho’s largest health care provider, this week sued the state over the same topic, which would have the effect of keeping litigation on the topic alive.
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Associated Press writer Summer Ballentine in Jefferson City, Missouri, contributed to this article.

More abortion policy stories: 

• Study shows how self-managed abortion became more common, as Supreme Court abortion drug hearing looms
• SCOTUS unanimously preserves access to abortion pill