Twenty-four of the 43 new abortion restrictions were enacted in just six states. Arizona led the way, enacting seven restrictions; Kansas, Louisiana, Oklahoma, South Dakota and Wisconsin each enacted at least three….some of the most high-profile debates occurred around legislation requiring that women seeking an abortion be required to first undergo an ultrasound….

Reproductive health and rights were once again the subject of extensive debate in state capitols in 2012. Over the course of the year, 42 states and the District of Columbia enacted 122 provisions related to reproductive health and rights. One-third of these new provisions, 43 in 19 states, sought to restrict access to abortion services. Although this is a sharp decrease from the record-breaking 92 abortion restrictions enacted in 2011, it is the second highest number of new abortion restrictions passed in a year.

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Against the backdrop of a contentious presidential campaign in which abortion and even contraception were front-burner issues —to a degree unprecedented in recent memory—supporters of reproductive health and rights were able to block high-profile attacks on access to abortion in states as diverse as Alabama, Idaho, Minnesota, Pennsylvania and Virginia. Similarly, the number of attacks on state family planning funding was down sharply, and only two states disqualified family planning providers from funding in 2012, compared with seven in 2011. That said, no laws were enacted in 2012 to facilitate or improve access to abortion, family planning or comprehensive sex education.

Abortion

Twenty-four of the 43 new abortion restrictions were enacted in just six states. Arizona led the way, enacting seven restrictions; Kansas, Louisiana, Oklahoma, South Dakota and Wisconsin each enacted at least three. Although some of the most high-profile debates occurred around legislation requiring that women seeking an abortion be required to first undergo an ultrasound or imposing strict regulations on abortion providers, most of the new restrictions enacted in 2012 concerned limits on later abortion, coverage in health insurance exchanges or medication abortion.

Mandating Non-Medically Necessary Procedures Prior to Abortion: Mandatory ultrasound provisions are intended to convince a woman to continue her pregnancy to term and require a provider to perform an ultrasound even when one is not medically necessary. At the beginning of 2012, it appeared that a number of states were poised to adopt such laws. However, in February, a firestorm erupted in Virginia when it became known that the proposed mandate would, in practice, necessitate performance of a transvaginal ultrasound. The controversy not only led to passage of a somewhat weaker requirement in Virginia but also is widely seen as having blunted efforts to mandate ultrasound in Alabama, Idaho and Pennsylvania. With the addition of Virginia, eight states now require an ultrasound prior to receiving an abortion.

Targeted Regulation of Abortion Providers (TRAP): In 2012, Arizona, Michigan and Virginia took steps to establish stringent regulations that affect only surgical and medication abortion providers, but not other providers of outpatient surgical and medical care. A law enacted in Arizona requires the state health department to develop regulations that include rules on follow-up procedures after a medication abortion, requirements for reporting abortion complications and penalties for noncompliance. In Michigan, legislation enacted at the very end of the year directs the state health department to develop regulations that will require providers that perform at least 120 abortions per year to meet the same architectural and licensing requirements as ambulatory surgical facilities. In Virginia, Gov. Bob McDonnell approved regulations requiring all abortion clinics performing at least five procedures a month to meet the same architectural standards as hospitals; the regulations now return to the Board of Health for the final review.

Hospital Privileges: Legislation to require abortion providers to have hospital admitting privileges was introduced in five states and enacted in three (Arizona, Mississippi and Tennessee); this provision is not mandated for other outpatient surgical and medical providers. In the most stringent of the new laws, the provision enacted in Mississippi requires abortion providers to have admitting privileges at a local hospital and to be certified in obstetrics and gynecology or eligible for certification. As soon as the restriction was signed into law, the state’s sole abortion clinic filed a legal challenge. In July, a U.S. district court judge ordered that the clinic be given time to apply for hospital privileges. By December, when all local hospitals had refused privileges to the clinic’s providers, the agency once again asked the court to enjoin enforcement so the clinic can remain open.

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