In the first six months of 2019, states passed more laws than ever before to protect and expand abortion access.

The National Institute for Reproductive Health’s 2019 Midyear Report details the progress states have made so far this year in proactively advancing reproductive rights, health, and justice.

Against the backdrop of multiple states passing severe abortion bans, these proactive bills represent a countermovement to advance reproductive freedom.

Some of the most striking legislative advancements involve efforts to protect abortion rights and expand access, improve affordability and availability of contraception, address maternal mortality and morbidity, and address the reproductive health needs of incarcerated women

Download the Report


In the first half of 2019, 49 states and the District of Columbia (DC) introduced 831 pieces of proactive legislation to advance access to abortion, contraception, pregnancy care, sexuality education, support for parents and families, and to prohibit discrimination based on reproductive decisions. Overall, 94 bills were fully enacted, including 10 bills improving access to abortion in six states, and nine bills to improve contraceptive access in eight states.

2019 Midyear Trends

  • A Fierce Urgency Drove Abortion Protections: This year, states are ground zero in the anti-abortion politicians’ race to the bottom. After New York passed the Reproductive Health Act in January, anti-abortion politicians led by Donald Trump waged a campaign of misinformation and legislative extremism, passing abortion bans in seven states. Rather than being cowed, six states – many of which had not passed abortion protections in decades – took bold action to pass protections, such as codifying the fundamental right to abortion, expanding insurance coverage, and decriminalizing abortion. Of 112 bills introduced in 25 states, 10 bills were fully enacted, including in CaliforniaIllinois, Maine, Nevada, New York, Rhode Island, and Vermont. What’s more, New Jersey passed a law that is awaiting the Governor’s signature, and Rhode Island enacted a significant abortion protection after the June 15 cutoff for this report.
  • Ensuring Access to Contraception: In light of ongoing efforts by the federal government to limit access to contraception — including through attempts to cut the federal family planning program (Title X) and regulations that allow more employers to refuse to provide the contraceptive coverage required by the Affordable Care Act (ACA) — 33 states this year introduced policies to ensure access to and coverage for contraception, with nine bills becoming law in eight states.
  • Confronting the Crisis in Maternal Health: This year, the reprehensible levels of maternal mortality and morbidity among black women and other women of color came to the fore, and a number of states committed to understanding and addressing this crisis. So far this year, ten states have already enacted bills to create or expand maternal mortality review committees, more than twice the number of state committees created in all of 2018.
  • Protecting Incarcerated Women: Bridging criminal justice reform and reproductive health, this year, states went beyond banning the use of shackles on pregnant women to address broader areas of criminal justice reform. Georgia, Maryland, and Texas passed bills prohibiting or limiting solitary confinement for pregnant and/or immediately postpartum women, amid other reforms that attend to the needs of pregnant women.