What's happening with abortion laws in the U.S. right now?

It’s been nearly nine months since the U.S. Supreme Court overturned Roe v. Wade, abolishing the constitutional right to abortion.

Now, a patchwork of abortion restrictions, bans and lawsuits are left in its wake, creating confusion and uncertainty among patients and abortion providers across the country.

Twelve states have near-total abortion bans in place, and access to medication abortions is restricted in 15 states, according to the Guttmacher Institute, a research organization that supports abortion rights.

But the battle over reproductive rights rages on as state legislatures have reconvened in 2023, many for the first time since Roe was overturned, with some proposing even stricter abortion bans. Lawsuits on both sides of the debate have made headlines with regard to medication abortion and existing abortion bans. A lot has happened in March. Here’s a roundup of what has taken place.

What's going on with medication abortion?

In the courts

An impending decision by a conservative Texas federal judge, appointed by President Donald Trump, could affect nationwide access to a key abortion drug, mifepristone, even in Democratic-led states where abortion rights remain intact. The first hearing in the case will be held Wednesday after Judge Matthew Kacsmaryk planned to delay telling the public about it. After the hearing, Kacsmaryk could issue a ruling at any time. The lawsuit was filed by Alliance Defending Freedom, a faith-based organization that has long sought to ban abortion nationwide. The group wants to overturn the Food and Drug Administration’s decades-old approval of mifepristone, one of two widely used drugs in a medication abortion through 10 weeks' gestation.

Mifepristone, which is often paired with another drug called misoprostol, is used to induce an abortion without the need to undergo a surgical procedure. It is also used in the treatment of miscarriages.

Abortion rights advocates argue the drug is safe, effective and has been used by more than 5 million people since the FDA’s approval more than 20 years ago. Critics of the suit also accuse the litigants of “judge shopping” by filing the case in Amarillo, where Kacsmaryk is the only federal judge.

At the pharmacy

Last week, Walgreens said it will no longer dispense abortion pill mifepristone in 21 states where Republican attorneys general threatened legal action against pharmacies that dispense it, even in states like Alaska, Florida, Iowa and Montana, where abortion remains legal. The announcement prompted swift action from some Democratic-led states where abortion access is guaranteed.

New York Gov. Kathy Hochul, a Democrat, and Attorney General Letitia James called on CVS, Walgreens and Rite Aid to commit to dispensing mifepristone at FDA-certified pharmacies and via mail with a doctor’s prescription in the state.

The state already guarantees abortion access and doesn’t have any restrictions on abortion medication.

In California, Democratic Gov. Gavin Newsom said the state would not renew its $54 million contract with Walgreens as a result of its policy on abortion drug access.

“California won't be doing business with @walgreens — or any company that cowers to the extremists and puts women's lives at risk,” Newsom tweeted. “We’re done.”

Walgreens spokesman Fraser Engerman said that the company was "deeply disappointed” by the decision over what he said was “false and misleading” information.

What's the latest with state abortion bans?

South Carolina

Republican state lawmakers in South Carolina proposed a bill this week that would make anyone who has an abortion eligible for the death penalty. It has 21 co-sponsors.

The bill, known as the South Carolina Prenatal Equal Protection Act of 2023, would modify the meaning of “person” to include a fertilized egg. At the point of conception, that zygote would have equal protection under the state’s homicide laws. The bill has no exceptions for rape or incest. It does contain exceptions to save the life of the mother or if the pregnant person faces the “threat of imminent death or great bodily injury.”

House Rep. Nancy Mace, R-S.C., called attention to the bill on the House floor last Friday and condemned her party for a “deeply disturbing” trend in restrictive abortion bans.

Texas

In a test of state-enforced bans, a Texas man is suing three women for allegedly helping his now-ex-wife obtain an abortion in a wrongful death lawsuit. It’s the first case of its kind since Roe v. Wade was overturned last summer.

According to the lawsuit, the plaintiff, Marcus Silva, alleges that his ex-wife and two friends talked about how to end the pregnancy via text messages, and a third friend delivered the abortion pills. The text messages suggest Silva’s ex-wife self-managed an abortion at home.

The suit alleges that assisting in a self-managed abortion is equivalent to murder under the state’s wrongful death statute, saying, “A person who assists a pregnant woman in obtaining a self-managed abortion has committed the crime of murder.” Under Texas’s abortion laws, the pregnant person is specifically exempt from prosecution, and the women named in the lawsuit have not been criminally charged.

In 2021, before the fall of Roe, a law known as Texas Senate Bill 8 passed that made most abortions illegal after around six weeks of pregnancy. It also gave citizens the right to sue anyone who "knowingly engages in conduct that aids or abets the performance or inducement of an abortion."

The lawsuit says that Silva’s then-wife realized she was pregnant in July 2022, after the Texas law was passed.

Silva's ex-wife is not named as a defendant in the lawsuit because under the law, the pregnant person is exempt from prosecution.

Silva is seeking $1 million in damages from the three women. Abortion rights advocates have condemned the lawsuit, saying it’s an intimidation method.

Also in Texas…

Five women are suing the state over its abortion ban, which, they say, put their lives at risk.

The Center for Reproductive Rights filed the lawsuit last week on behalf of five women who said they were denied abortions despite facing major risks to their health while suffering from pregnancy complications.

Texas law threatens criminal charges for doctors who perform abortions, with limited exceptions for a “medical emergency,” including where the mother’s life is in danger.

The suit seeks a clarification from Texas about what constitutes a “medical emergency,” arguing that doctors are afraid of being held liable under the new state bans.

A spokesman for Texas Attorney General Ken Paxton said in a statement that Paxton is “committed to doing everything in his power to protect mothers, families and unborn children, and he will continue to defend and enforce the laws duly enacted by the Texas Legislature.”

Florida

Republican lawmakers in Florida introduced bills that would ban abortion after six weeks of pregnancy, tightening restrictions from a 15-week ban approved last year.

The bills include exceptions to save the life of the mother and in cases of rape or incest up to 15 weeks of pregnancy, but only if the victim can provide documentation of the crime.

Gov. Ron DeSantis has indicated his support for the proposal, saying, “We welcome pro-life legislation.”