Blog: The Ongoing Fight for Reproductive Freedom: Highlighting 2025 State Legislative Trends

Written by Taryn Graves

MPP Candidate at George Washington University, Trachtenberg School of Public Policy and Public Administration

Policy Intern, Reproductive Rights at SiX

The Ongoing Fight for Reproductive Freedom: Highlighting 2025 State Legislative Trends

In 2025, the legal and political landscape surrounding reproductive health, rights, and justice in the United States has grown increasingly complex. Individual states now vary widely in their levels of access to reproductive health care; some have implemented gestational age limits, partial abortion bans, or total abortion bans. Across the country, lawmakers have taken different approaches to these issues, with some introducing bills to restrict access to medication abortion, criminalize reproductive health decisions, and limit young people’s right to comprehensive sex education. This blog highlights recent trends in state-level legislation, including efforts to restrict access to mifepristone, introduce fetal personhood laws, and control how reproductive health care is taught in schools. In contrast, it also reports positive developments in reproductive health care legislation, such as new protections for contraception, doula care, and maternal health—demonstrating that reproductive freedom remains a vital and urgent policy battleground in the states.

Medication Abortion 

Since the overturn of Roe v. Wade and the U.S. Supreme Court (SCOTUS) case Alliance for Hippocratic Medicine v. FDA, which preserved access to mifepristone in the U.S., State Innovation Exchange (SiX) has witnessed numerous bills attempting to restrict access to abortion medication and reproductive health care. Regardless of SCOTUS’s decision, anti-abortion legislators have continued to introduce anti-abortion legislation that not only tries to outright ban individuals from using mifepristone, but also attempts to reclassify medication abortion pills as “controlled substances” and criminalize the purchase, sale, or distribution of abortion medication. For instance, Texas and North Carolina have both introduced legislation to restrict and regulate residents’ access to abortion pills by attacking telehealth and attempting to restrict the mailing of these essential medications within the state. Anti-abortion politicians in Maine, Iowa, and Montana have also introduced bills to delay the process of receiving medication, including in-person requirements, showing patients pictures of fetuses before receiving their medication, and requiring health care providers to give harmful and inaccurate information about “abortion pill reversal” to patients seeking care. Other states, such as Alabama, Oklahoma, and Tennessee, have also introduced more severe restrictions on abortion medication, criminalizing the purchase and distribution of abortion medication and implementing civil or criminal penalties against anyone who uses abortion medication.

Proactive Reproductive Health Care Legislation

States also took proactive steps to expand and protect access to reproductive health care, specifically with abortion funding, access to contraception, and access to sex education. For example,

Colorado passed a law that would mandate comprehensive abortion care coverage in the state, which would be funded through state resources, and has passed shield laws enhancing state protections for gender-affirming care and reproductive health. Additionally, Tennessee passed a law that would affirm the right to fertility care and contraception in alignment with other states, including North Carolina, Virginia, and Hawaii. These states have all attempted to pass legislation to enshrine the right of contraception into state law and provide full coverage for contraceptives. There have also been advancements in sex education legislation. Maryland has passed legislation to establish a comprehensive health education framework for primary and secondary schools to address mental health, substance abuse prevention, family life, gender identity, safe social media use, healthy eating, and disease prevention in the state.

Fetal Personhood Laws

In addition to introducing legislation to restrict and outright ban access to medication abortion care, anti-abortion politicians have also introduced fetal personhood bills attempting to establish the rights of developing embryos and fetuses. Politicians in Maine, Montana, and North Dakota have attempted to pass laws that redefine certain terms such as “person” and “human being” to include all stages of human development, as well as defining fetuses from conception as “unborn children.” Additionally, Florida and Kansas have recently introduced laws to codify fetal personhood in statutes regarding child support during pregnancy and wrongful death actions. This harmful language is utilized as a strategy to control the reproductive health and status of pregnant people to limit their bodily autonomy, only further criminalizing pregnant people and legitimizing detrimental fetal personhood laws.

Maternal Health

Legislative efforts around sexual and reproductive health care have also included proactive measures to address maternal mortality, with recently introduced efforts to provide general maternal health support and expand doula care and coverage across states. For example, Virginia has passed a bill to provide  state medical assistance services to include postpartum doula care, allowing up to ten visits for eligible individuals. It mandates annual reporting on its implementation and outcomes. Alabama has also passed a bill in which Medicaid would pay for a pregnant person’s outpatient medical care for up to 60 days, while applications for government-funded insurance programs are being considered. These bills would expand insurance coverage for postpartum individuals, addressing existing health care inequities that could help eliminate the barriers to accessing adequate maternal health services. Policies such as these reflect the importance of providing maternal health care pre- and post-partum to ensure parents and their families can live long, healthy lives.

Young People: Restricting Access to Reproductive Health Care

Politicians have continued to attack access to reproductive health care and sex education for young people, impacting their bodily autonomy. The anti-abortion movement is utilizing a parental rights framework, causing an increase in several bills attempting to restrict young people’s access to sex education that pushes for abstinence-only sex education and limits discussions on gender identity, sexual orientation, abortion care, and sexually transmitted infections. For example, Louisiana has introduced a bill that would require school health centers to display information about pregnancy, adoption, and neonatal care at school health centers, while prohibiting information on abortion care. Utah passed legislation reinforcing abstinence-based sex education and restricting the discussion of contraceptive usage. Similarly, Texas has moved legislation that would prohibit the use of national sex education standards in Texas public schools, emphasizing abstinence-only education. These bills only perpetuate the discrimination LGBTQ+ students already face. It hinders access to vital information that enables students to make informed decisions about their health and their identities.

Overall, state legislators are continuing to make policy decisions on our access to reproductive health care amidst a clear divide within the legislative landscape in terms of sexual and reproductive health including medication abortion, sex education, maternal health, and contraceptive access. Some states are enforcing reproductive health care bans and restrictions, whereas others are working to expand access to various reproductive health services. Those that are restricting this care limit bodily autonomy and disproportionately impact young people, communities of color, LGBTQ+ individuals, disabled folk, and low income communities. The reality is that banning reproductive health care at all levels, including abortion care, exacerbates existing inequities in health care and harms people. Specifically, it harms those already impacted by systemic racism and economic injustice. This, along with the knowledge that abortion bans have a far-reaching impact on young people seeking health care, contributes to support for abortion rights. In this political landscape, it is crucial for policy advocates, legislators, and communities to remain engaged and push back against efforts to restrict reproductive freedoms and support proactive measures to ensure everyone has the opportunity to access the comprehensive reproductive and sexual health care services they deserve.

Here is the full report: 2025 State Policy Trends Midyear Analysis