Kate Dineen assumed she would always have access to reproductive healthcare because of where she lived. It came as a shock when she was denied an abortion in 2021 because of gestational limits to the procedure in Massachusetts law.

Dineen was 33 weeks into her pregnancy, the third trimester, when a routine ultrasound detected a problem with the fetus’s brain. An MRI showed that her son, whom she’d named Teddy, had suffered a catastrophic stroke in utero. A pediatric neurologist gave her the news over a Zoom call during the COVID-19 pandemic.

“I said, ‘What’s the best-case scenario? Is there any chance of a normal, healthy outcome?’ And he kind of cast his gaze downward and muttered, ‘No,’” Dineen said. “I had this fear that I was going to go into labor in Massachusetts, and there was going to be nothing I could do aside from watching my son suffer an unknown fate.”

Dineen’s story is rare among those seeking an abortion, and it’s one of the least-discussed types of abortion. Researchers and doctors say later abortions are complicated, expensive and difficult to access, with very few clinics nationwide that can or will provide them. Later abortions also are heavily criticized by anti-abortion groups and Republican elected officials, who often say states without viability limits allow doctors to kill a baby after birth, which is false.

In the four years since the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, access to all abortion in more than a dozen states has dramatically decreased. During that same time, some clinics have expanded later abortion offerings, and advocates — including Dineen — are pushing for many of the 21 states that have bans after 18 weeks to drop them.

Some project optimism about the support for repealing gestational bans, while others are taking a more incremental approach based on their assessments of political realities and general discomfort about the subject even from abortion-rights advocates. Other abortion-rights advocates continue to focus on expanded access earlier in pregnancy, including ballot initiatives to reverse abortion bans.

Frances Kissling, president of Catholics for Choice from 1982 to 2007, said laws that put some limitations on abortion after fetal viability strike the right balance in providing exceptions for certain circumstances without taking an extreme view.

“I think it works better for everybody if no one takes an absolutist position on this,“ Kissling said. “In a sense, there are no good answers, but it certainly is not good to take the position that no limitations in the third trimester would ever be acceptable.”

Kissling’s approach is at the heart of a split among abortion-rights advocates that has developed since Dobbs — whether to return to the way laws were made after the U.S. Supreme Court decided Roe v. Wade, which allowed abortion access to be limited after fetal viability, or whether to push for more.

Dineen’s pregnancy was well past Massachusetts’ cutoff of 24 weeks, around the time that the medical community recognizes a fetus can potentially survive, with medical intervention, outside of the womb.

The state law at the time included exceptions past that point for lethal fetal anomalies, but Dineen’s case was refused by the hospital where she sought care because doctors said they couldn’t guarantee the fetus wouldn’t survive after birth. She had to drive 500 miles to Bethesda, Maryland.

“It was something that I was just so floored by; I felt so naïve,” Dineen said.

‘We see all of these’

The most recent data from the federal Centers for Disease Control and Prevention, from 2022, showed about 1.1% of abortions nationwide took place after 21 weeks of pregnancy, although that total reflects voluntary reporting from only 46 states. More than 93% of abortions happen in the first trimester, before 13 weeks. But thousands of people will still need abortion options later in pregnancy every year for a host of reasons.

Nine states have laws protecting abortion access throughout pregnancy, but only four of those — Colorado, Illinois, Maryland and New Mexico — plus Washington, D.C., have clinics that provide abortion past 32 weeks, meaning people experiencing a problem like Dineen’s most often have to travel. Nationwide, about 20 clinics provide abortions past 24 weeks.

Among the states that protect access throughout pregnancy is Alaska. But unlike the other states, doctor availability at any stage is extremely limited, with two Planned Parenthood clinics statewide, neither of which provides abortion after 18 weeks.

Political rhetoric about third trimester abortion is misleading, experts say

One new all-trimester clinic opened in New Mexico since Dobbs, and a new clinic replaced Boulder Abortion Clinic in Colorado after it closed in 2025. The former chief operating officer of the Boulder clinic, Alicia Moreno, is now executive director of RISE Collective and said about two-thirds of the clinic’s patients come from other states or from Canada. Many times, they are patients like Dineen, who received grave news about a wanted pregnancy.

Other patients must seek a later abortion clinic because they were delayed by logistics such as time off work, travel and financial barriers, while still others are delayed because of abortion bans or bureaucratic hurdles, such as a healthcare provider taking weeks to determine whether a patient qualifies for a legal exception.

Or in some cases, she said, people go to an anti-abortion crisis pregnancy center without knowing what those centers are and are “led on for weeks” until they exceed the state’s legal limit.

“We see all of those on a weekly basis,” Moreno said.

Patients also include preteens and teenagers, who are more likely to not know they are pregnant until later.

National anti-abortion group Americans United for Life takes the view that there is never a good reason to terminate a pregnancy after fetal viability and that it should not be permitted.

Public support for legal abortion in all or most cases stood at 64%, according to a July 2025 AP-NORC poll, but it dropped significantly when broken out by trimester. A 2023 Gallup poll showed support for legal abortion in the second and third trimesters at 37% and 22%, respectively.

Support for legal access is lower for a person who just doesn’t want to be pregnant, such as Ayesha Perry-Iqbal, who didn’t discover she was pregnant until 24 weeks in 2021, referred to as a cryptic pregnancy.

“I was obviously in shock and was not sure what it was that I wanted to do because I felt like since I was past the limit in California, I didn’t really have a choice,” said Perry-Iqbal, who is from Wales but now lives in Los Angeles.

A doctor told Perry-Iqbal she could still go to Colorado. Amid feelings of guilt and frustration, she decided she didn’t want to have a child.

“When I sat down and was like, ‘Actually this is not something I want, this is not the path I deserve, and this is not the story that I want for my child,’ I decided to do what was best for me,” she said. “It didn’t sit well with a lot of people.”

She remembers arriving in a private car at the back of the health clinic to avoid protesters and walking through two different layers of security before making it to the waiting room. It made her feel like she was doing something wrong.

Culture changes

It’s been a decade since Erika Christensen had her own later abortion. At 31 weeks, her fetus was no longer growing and wasn’t swallowing. Doctors said her baby would not be able to breathe outside her body, and was likely to die shortly after birth. Terminating the pregnancy meant Christensen had to travel from her home in New York to Colorado.

Three years later, Christensen and her husband, Garin Marschall, founded Patient Forward and became staunch advocates for removing barriers to later abortion care. She remembers searching for options in 2016 and thinking of it as a desert, whereas now there are more clinics offering services later with more diverse staff and more public discussion of the issue.

As red states pass new abortion restrictions, Minnesota looks to shed them all

“It’s a completely different culture than it was 10 years ago,” Christensen said. “That is progress, even as we have so many more barriers to eliminate.”

Even in states that have made it easier to provide later abortion care since Dobbs, such as in Minnesota, where the legislature repealed laws targeted at abortion providers in 2023, the costs become prohibitive.

Later abortion care requires many more expensive medications, specialized equipment and other services, and healthcare costs keep going up while reimbursement rates remain stagnant or lag behind.

But costs can be more easily addressed than cultural norms. Amy Hagstrom Miller, president and CEO of Whole Woman’s Health, has one abortion clinic in Minneapolis, as well as others in Maryland, New Mexico and Virginia. She said more needs to be done to increase understanding of the complexities around later abortion and why it happens.

“The stigma gets compounded the later in pregnancy you are, even in places that are really progressive,” Hagstrom Miller said. “You hear people say, ‘Why did they wait so long, why didn’t they do something about it sooner?’”

Looking to the future

Patient Forward and other abortion-rights groups have been vocally opposed to ballot initiatives that include language about fetal viability, including in Missouri, where voters narrowly passed an initiative in 2024 to overturn the state abortion ban, and in Idaho, where a question that would overturn its near-total ban will likely be on the ballot later this year.

Initiatives that passed in Arizona and Nevada also allow the government to restrict access after fetal viability.

But some push back on allowing abortions at later stages, including Melanie Folwell, executive director of Idahoans United for Women and Families and lead organizer of the state’s initiative. The ballot language includes a line that says it is not a violation of reproductive freedom and privacy to regulate abortion after fetal viability except in cases of medical emergency, and Folwell said criticisms from national organizations on that subject are unwelcome.

“It’s disappointing that the national political class is painfully out of touch with our reality on the ground. I’d invite them to take a break from firing off press releases and selling tote bags and spend some time knocking doors with our grassroots volunteers in Chubbuck or Coeur d’Alene or Caldwell,” Folwell said. “This is the real work right now and we’re proud to be doing it.”

In Massachusetts, Kate Dineen says she is working to ensure other people aren’t denied care the way she was. In 2022, she successfully lobbied to change the language about legal abortion after 24 weeks to include an additional exception for “grave fetal diagnoses,” which she said has already allowed more patients to access later care.

The next step, she said, is a full repeal of the 24-week limit. Dineen said she’s excited that the bill, titled the Prioritizing Patient Access to Care Act, is moving through the state House and Senate.

“When we start talking about number of weeks and severity of fetal diagnosis or quality-of-life projections, we’ve already lost the conversation. We shouldn’t be talking about any of that,” Dineen said. “It’s about who gets to decide — the government, or the pregnant person.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

It might come as a surprise to many Wisconsinites to learn that more Wisconsin women are getting abortions today than were accessing abortion in the state four years ago, right before the U.S. Supreme Court overturned Roe v. Wade.

In large part, that’s because of the rise of telehealth abortion, with patients receiving prescription medication by mail and using it in the privacy of their own homes under remote supervision from a doctor. (Wisconsin law prohibits telehealth abortion, but shield laws in several less restrictive states protect providers there, so women here can access their care.) 

A chart created by University of Wisconsin researchers in the UW Department of Obstetrics and Gynecology’s Collaborative for Reproductive Equity (CORE) shows that abortion services at bricks-and-mortar clinics, which dropped to zero in Wisconsin immediately after the Supreme Court’s Dobbs decision, have not quite reached pre-Dobbs levels. But the steady increase in telehealth abortion, which now accounts for about one-third of all abortions in the state, pushes the total number of abortions slightly above a May 2022 pre-Dobbs spike.

Everyone remembers the bomb that dropped on June 24, 2022 when the Dobbs decision came down. All abortion care ceased in Wisconsin for more than a year, as healthcare providers who worried they could be charged with a felony under an antiquated 1849 law stopped providing abortion services. One woman was refused care and left to bleed for 10 days while suffering an untreated, incomplete miscarriage. 

Voter backlash to that sudden, forced return to the gynecological Dark Ages helped propel the landslide election of a female, pro-choice majority on the Wisconsin Supreme Court. Abortion services resumed in 2023 when a Dane County judge ruled that the 1849 law did not ban abortions. Then, finally, last summer the Court invalidated the 1849 law altogether. 

Abortion is not the central issue in the 2026 elections that it was in 2022. But in our tippy, polarized state, access to abortion could go either way. 

“There’s good news and bad news,” says Jenny Higgins, a professor in the UW’s OB-GYN department and the director of CORE. The good news is the rise in telemedicine abortion and the overall increase in abortion access in Wisconsin.

For a lot of women, telemedicine is considerably more appealing than the expense and stress of traveling long distances, running a gauntlet of protesters and paying hundreds of dollars out-of-pocket for in-person care that cannot be covered, under Wisconsin law, by Medicaid, public employee health insurance or Affordable Care Act plans. Telemed abortion is also cheap — as little as $5 on some sliding scale plans, Higgins says.

And there’s more good news: political momentum to defend abortion rights suggests that the many restrictions on abortion in Wisconsin could soon be legislated away — if voters stay activated.

“The bad news,” Higgins says, “is that abortion remains heavily, heavily restricted here, including with a telehealth ban, and so we don’t know how much longer shield laws will hold.”

A current case before the U.S. Supreme Court seeks to ban mifepristone, one of the two drugs used in combination for medication abortion. In addition to pressuring the Food and Drug Administration to rescind its longtime verdict that the drug is safe, anti-abortion groups and Republican state attorneys general are now trying to get the Environmental Protection Agency to ban mifepristone on the disingenuous grounds that it causes water pollution.

“We also don’t know the extent to which individuals will be criminalized for these things,” Higgins adds. There could be lawsuits against women in Wisconsin, as there have been in other states, “where people are bringing suits against folks who have ordered pills.”

All in all, “it’s an unsteady situation,” says Higgins.

It’s not clear how much abortion rights will motivate voters in the potentially life-changing elections this fall. 

“Abortion has been an unusually important issue in the decisions of voters in Wisconsin,” says Michael Wagner, a professor in the school of journalism and mass communications at the UW and the director of the Center for Communication and Civic Renewal, “especially in election cycles where voters can’t rely solely upon their partisanship to cast a ballot.” 

In the last three state Supreme Court races, Wagner notes, “abortion has been a huge issue in the advertising of the candidates, and since it has, the candidate that has won the election has been a pro-choice candidate, without fail, since Dobbs was before the court.”

In general, Wagner says, “the public has been quite supportive in Wisconsin of abortion rights,” including medication abortion. 

Four in 10 Republicans support legal abortion, along with 80% of Democrats. So Republicans are caught between their highly motivated anti-abortion base and a large group of voters who don’t favor outlawing abortion. 

Does that mean the Trump administration might hold off on banning medication abortion at the FDA or the EPA level, nodding to voter sentiment?

Don’t hold your breath.

“Almost every policy proposal the president has pursued in the second term is underwater in public opinion, and he hasn’t stopped pursuing most of them,” says Wagner.

Plus, Republican voters who don’t agree with the candidates on abortion aren’t necessarily abandoning them. “There hasn’t been a strong, stark trend that has lasted across four or five election cycles that leads me to think Republicans are, you know, committing malpractice politically if they don’t soften their view on abortion,” Wagner says. “I don’t think there’s evidence for that kind of conclusion.”

Maybe the silver lining of the Trump/Dobbs era is that the federal government is no longer the major player when it comes to protecting abortion rights.

“The governor’s race, the control of the state Legislature, state Supreme Court races, these are now the races that will determine whether abortion is legal in Wisconsin,” says Wagner.

“I think it’s going to be a big issue. It’s one of the things where Democrats can say, especially in the state, ‘Put us in charge and we can codify some things.’ You know, that’s something that they really can do in this particular election that they could not have done in prior elections, and so I wouldn’t be surprised to see it become a bigger issue, but I think it depends upon who the nominee ends up being for the Democrats for governor, especially.”

Higgins is optimistic. 

“While we’re seeing increases in abortion numbers, abortion is still highly, highly constrained in our state, and it doesn’t have to be that way,” she says. It was only after the 2010 election, when Republicans won control of the entire state government and cemented their power by passing gerrymandered voting maps, that Wisconsin began heavily restricting abortion access. 

“We have the ability to change that,” Higgins says. “Wisconsin was once considered as recently as 2009 a supportive place for abortion access. We have the ability to get back there.”

Carrie Frail was in the process of leaving an abusive relationship when she discovered she was pregnant. Her partner told her he could hit her in the stomach until she had a miscarriage, and it would save some money.

“I firmly believe he would have killed me at some point, whether accidentally or intentionally,” Frail said.

She had a medication abortion at a Planned Parenthood clinic in St. Louis, Missouri, in 2008 while serving in the U.S. Air Force. She was relieved to have the option of using medication instead of a procedure, and it let her take less time off work. It wasn’t an easy decision, she said, but she knew if she hadn’t done it, she never would have been able to get away from that partner.

“I was too wrapped up mentally and emotionally in my life with him that … I needed to be able to leave without giving him a phone number or letting him know where I was,” Frail said. “I still believe that an abortion saved my life.”

Access to telehealth prescriptions of mifepristone, one of two drugs used to terminate a pregnancy in the first trimester or to treat miscarriages, is threatened by an ongoing lawsuit in Louisiana. That state government has sued the U.S. Food and Drug Administration, trying to strike down the agency’s 2023 rule allowing the medication to be dispensed without an in-person visit.

Researchers, advocates and survivors of domestic violence say it’s vital to keep telehealth access available for people in abusive relationships who need discreet abortion options. The Louisiana lawsuit, however, argues in part that mifepristone has been weaponized against pregnant women in abusive relationships and shouldn’t be available by telehealth.

The 5th U.S. Circuit Court of Appeals temporarily blocked the FDA’s 2023 rule in early May, making in-person visits required for mifepristone prescriptions for two days before the U.S. Supreme Court paused that decision on emergency appeal. The court, with the exceptions of Justices Samuel Alito and Clarence Thomas, decided to keep the rule in place while the appeals case proceeds. But the rule could still be struck down again later, and the full case may end up in front of the Supreme Court.

Data from the federal Centers for Disease Control and Prevention’s National Intimate Partner and Sexual Violence Survey from 2023-24 showed about 34% of women and 17% of men experienced physical or sexual violence or stalking by an intimate partner. Those figures could be higher because of hesitance to report incidents of abuse. States with high rates of violence include many with near-total abortion bans, including Arkansas, Indiana, Oklahoma, Tennessee and West Virginia — meaning residents who are victims of reproductive coercion have less access to abortion medication.

Pregnancy is a time of heightened risk in a relationship with domestic abuse, according to research, and intimate partner violence is a leading non-obstetric related cause of death among pregnant and postpartum women. Those risks are highest among Black and Indigenous people in the United States.

Reproductive coercion 

The lawsuit over mifepristone access includes Louisiana resident Rosalie Markezich as a plaintiff, who says the availability of the drug without an in-clinic visit allowed her boyfriend to order the pills in 2023 and pressure her to take them. In her written statement in the case, Markezich said the pressure caused ongoing trauma, and that if she’d had to see a doctor beforehand, she could have told the provider she didn’t want an abortion and the pills would never have been prescribed.

Anti-abortion groups, including Susan B. Anthony Pro-Life America and Family Research Council, submitted amicus briefs to the U.S. Supreme Court about the type of coercion Markezich said she experienced. The telehealth option prevents in-person screenings for coercion, Susan B. Anthony Pro-Life America said, and the in-person requirement provided “a line of defense” against reproductive coercion. Family Research Council also argued that because the FDA’s initial approval of the telehealth provision did not include a thorough study of how it could be used for coercion, it should be struck down.

Liz Tobin-Tyler, professor of health services, policy and practice at the Brown University School of Public Health, said people in abusive relationships very commonly experience what researchers call reproductive coercion. According to the American College of Obstetricians and Gynecologists, that includes situations in which a partner tries to control when and how pregnancy occurs, either by intentionally causing a pregnancy or forcing someone to end it, as with Markezich.

Coercion can also occur when a partner interferes with contraceptive methods, such as trying to force the use of a certain method or intentionally failing to use contraception. Tobin-Tyler said sometimes the abusive partner attends medical appointments to try to influence decisions related to birth control and other medical care discussions.

“It all comes back to that aspect of control,” she said.

Robin Turner, Montana director at gender equity organization Legal Voice, said what happened to Markezich was terrible, but that Louisiana could prosecute Markezich’s partner under existing laws, including harm induced by drugs. She said reinstating the in-person requirement for mifepristone would harm many other people because it would apply nationwide.

“It’s not a reasonable or proportional way to address what happened to the client,” Turner said. “We have to take what happened to the plaintiff seriously — and understand that taking that (access) away is not effective.”

Turner co-authored a brief for Legal Voice submitted to the U.S. Supreme Court during the emergency appeal proceedings that centered on the importance of access to mifepristone for people in relationships marked by domestic violence.

“A lot of what being in these relationships is about is your world getting smaller, and we don’t want our systems to imitate the dynamics of abuse. But that’s what happens when the government takes away the access to the healthcare that they need,” Turner told Stateline.

Safety planning for hotline callers

Kaelah Oberdorf, 24, said she was on birth control when she discovered she was pregnant in 2023 in upstate New York.

She was in an emotionally abusive relationship, struggling financially and still recovering from the postpartum depression she experienced after having her first child when she was 20, despite thinking that she couldn’t get pregnant because of a medical condition. The depression was so severe she had to be hospitalized. She decided that ending the pregnancy was the right thing to do for her mental health and the daughter she already had.

“I didn’t want to be tied to him for life, I didn’t want my daughter, or any of my children, to be tied to him for life,” said Oberdorf, who now lives in Georgia. “I already had a living child who did not need to be kept in that situation, and if I’d had another one, even if I left him, I mentally would not have been able to handle it.”

Research also shows that pregnant and postpartum women in rural areas experience higher rates of intimate partner violence, possibly because they’re farther from in-person medical care, which could contribute to lower rates of preventive screenings for abuse.

Elizabeth Ling, associate director of legal services at nonprofit hotline If/When/How, which offers reproductive legal aid, estimated the hotline receives between five and 10 calls a week from people who talk about experiencing intimate partner violence, whether it’s physical, emotional or some form of coercion. She said callers in rural communities are some of those who need access to medication abortion by telehealth and via mail because they are often the furthest away from a clinic and can’t travel because a partner is actively watching their movements.

If/When/How talks callers through their legal options and counsels them about legal risks, which Ling said is a top concern for people in abusive relationships. It’s common for them to be fearful of their partner reporting them for having an abortion, which can bring unwanted attention from police and investigations even if it doesn’t result in charges.

The hotline also helps people make a safety plan for receiving abortion medication, talking through steps such as where medication will be mailed, who has access to that mailbox and how to navigate a situation with a partner tracking their movements.

“Abortion pills really are a lifeline for those who call and share their experiences with us,” Ling said.

Frail, who still lives in Missouri, now has a daughter and a son who are in their 20s. She has left many voicemail messages recently for Republican U.S. Sens. Josh Hawley and Eric Schmitt, who have advocated for the withdrawal of FDA approval for mifepristone and called for federal investigations into drug manufacturers. In her messages, she says that being able to choose when she had her children made her a better parent.

“I know if I had not had an abortion, I would not have ever been able to get away from that abusive partner,” Frail said.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

The U.S. Supreme Court decided Thursday to preserve telehealth access to the abortion drug mifepristone until after the U.S. 5th Circuit Court of Appeals has ruled on the merits of the high-stakes federal lawsuit Louisiana v. Food and Drug Administration.

Justices Samuel Alito and Clarence Thomas issued dissenting opinions.

In his dissent, Thomas said the rule violates the Comstock Act, a long unenforced 1873 law that bans the mailing of “obscene” material. During the 2024 presidential campaign, President Donald Trump said he didn’t support using the Comstock Act to stop mail delivery of abortion pills, saying he thought the federal government should have nothing to do with the issue.

Mifepristone’s manufacturer “makes a passing reference to the possibility of lost sales,” Alito wrote in his dissent. “But lost sales in states where abortifacients are generally illegal are not ‘irreparable injuries’ that can justify granting a stay.”

Abortion-rights advocates around the country called the decision a relief after two weeks of uncertainty.

On May 1, the appellate court sided with Louisiana, where state officials sued the FDA in October, arguing that a rule allowing telehealth access to mifepristone, one of two drugs used to terminate a pregnancy in the first trimester or to treat miscarriage, undermines the state’s abortion ban. Danco Laboratories and GenBioPro, two manufacturers of mifepristone, filed emergency appeals, leading the Supreme Court to issue a 10-day stay on May 4, extended until today.

“Though today’s decision means that mifepristone remains available through telehealth for now, this fight is not over,” said Dr. Camille A. Clare, president of the American College of Obstetricians & Gynecologists, in an emailed statement. “The chaos and confusion wrought by competing decisions and the revocation and restoration of access on an almost daily basis do real harm to patients and to the clinicians who care for them.”

Abortion opponents decried Thursday’s decision.

“Women deserve better than dangerous abortion drugs sent through the mail without physician oversight or in-person support,” said Jor-El Godsey, president of Heartbeat International, a major network of anti-abortion crisis pregnancy centers. “A state like Louisiana that values life in its laws should be able to protect its smallest residents as well as their moms.”

The FDA’s approved two-drug regimen via telemedicine is an increasingly common abortion method, especially for people living in parts of the country where abortion is banned or difficult to access.

Last month, a federal district court paused the lawsuit at the request of the FDA until after the completion of a safety review on mifepristone. That review was prompted by non-peer reviewed, anti-abortion research and in spite of the drug’s record of safety and efficacy since 2000. The state appealed to the 5th Circuit.

Due to multiple ongoing efforts to restrict or block mifepristone, abortion providers have told Stateline they are ready to eventually switch to a misoprostol-only method, which researchers have found to be as safe as the two-drug regimen but typically involves more symptoms and is slightly less effective.

National groups have tried to pressure the Trump administration to drop the Biden-era rule allowing telehealth abortion and called for the head of FDA Commissioner Marty Makary for reportedly slow-walking a safety review of the drug until after the midterm elections. Makary resigned on Tuesday, and anti-abortion groups wasted no time in getting Acting Commissioner Kyle Diamantas on the phone.

Live Action founder and president Lila Rose, in a written statement, said she talked to the acting commissioner on Wednesday and that he said he was morally opposed to abortion. “Diamantas told me that reviewing the abortion pill is a top priority for him and the administration,” Rose posted on X.

Students for Life of America President Kristan Hawkins wrote a similar message to supporters in an email on Thursday, saying Diamantas will be the “most pro-life FDA commissioner in American history.”

But many doctors around the country say curbing access to telehealth abortion is likely to cause harm to people in states with bans who may face more barriers to obtaining an abortion without that option.

“Women will be forced to travel long distances — at times hundreds of miles — to access safe, essential health care at a doctor’s office, no longer having the option to receive mifepristone via telemedicine,” wrote Rob Davidson, an emergency physician in Michigan and executive director of the Committee to Protect Health Care, in a letter asking the Supreme Court to maintain access to telehealth abortion. The letter was cosigned by more than 2,200 physicians.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.  Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org. 

WASHINGTON — U.S. Food and Drug Administration Commissioner Marty Makary on Tuesday became the latest member of President Donald Trump’s administration to leave their post this year. 

“I want to thank Dr. Marty Makary for having done a great job at the FDA. So much was accomplished under his leadership,” Trump wrote on social media. “He was a hard worker, who was respected by all, and will go on to have an outstanding career in Medicine. Kyle Diamantas, a very talented person, will be put in the Acting position.”

Diamantas was working as the deputy commissioner for food, leading the program that focuses on nutrition and food safety.

Health and Human Services Secretary Robert F. Kennedy Jr. wrote in a social media post that Makary “pushed forward critical reforms and helped advance our mission to Make America Healthy Again.”

“I also want to thank Kyle Diamantas for stepping in as Acting Commissioner — his leadership has already delivered remarkable wins on the MAHA food agenda, and I have full confidence in his continued work,” Kennedy added. “We have an outstanding team at FDA, and the work continues without pause. The search for a new Commissioner is already underway, and we will move forward with urgency.”

Makary’s resignation marks the fourth time a senior member of the Trump administration has either left or been forced out during the last few months. 

Kristi Noem was ousted as Homeland Security secretary in early March, moving to a different job as a special envoy. Pam Bondi resigned as attorney general in early April to move back to the private sector. And Lori Chavez-DeRemer stepped down as Labor secretary in late April, following scandals.

The Senate voted to confirm Makary to lead the FDA in March 2025, with Democratic Sens. Dick Durbin of Illinois as well as Maggie Hassan and Jeanne Shaheen of New Hampshire supporting him. 

Medication abortion

Makary’s decision to leave the FDA comes several months after anti-abortion organizations and some Republicans in Congress called for Trump to fire him over his record on access to medication abortion. 

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, and Lila Rose, founder of Live Action, both released statements in December pressing for the FDA to restrict access to mifepristone. 

“The FDA needs a new commissioner who will immediately reinstate in-person dispensing as it existed under President Trump’s first term and immediately conduct a comprehensive study,” Dannenfelser wrote in a statement at the time. “Commissioner Makary is severely undermining President Trump and Vice President Vance’s pro-life credentials and their position that states should have the right to enact and enforce pro-life protections. Makary must go.”

Missouri U.S. Sen. Josh Hawley sent a letter to Makary the following day urging him to wrap up a review of the current prescribing guidelines for mifepristone. 

Their frustration followed a Bloomberg Law news article that said Makary didn’t want to release the results of the study until after November’s midterm elections, which will determine which political party controls Congress for the next two years.

The U.S. Supreme Court on Monday extended a highly anticipated stay blocking an appellate court’s pause on telehealth abortion access until May 14.

The U.S. Food and Drug Administration’s approved medication-abortion regimen remains available via telehealth until then, following a week of uncertainty among abortion patients and providers.

“With this critical temporary administrative stay extended, we hope that some of the chaos and confusion inflicted on patients and providers last weekend will be abated,” said Evan Masingill, CEO of abortion-pill manufacturer GenBioPro, one of the defendants in the case, in a statement.

On May 4, the Supreme Court temporarily stayed the 5th Circuit Court of Appeals’ ruling to reinstate the FDA’s in-person dispensing requirement for mifepristone that the Biden administration officially lifted in 2023. Over the past week, several doctors groups submitted friend-of-the-court briefs arguing that cutting off access to mifepristone could harm many women seeking abortions and miscarriage management. Republican attorneys general from 23 states, meanwhile, urged the Supreme Court not to allow providers to send mifepristone through the mail. 

People in states with abortion bans or diminished abortion access continue to depend on abortion providers prescribing FDA’s approved mifepristone-misoprostol regimen through telemedicine and sending it to patients by mail.

According to new preliminary findings from the Society of Family Planning, telehealth abortion comprised 28% of all abortions at the end of 2025, an increase from 25% at the end of 2024.

Attorneys representing Louisiana have argued that in addition to undermining a state abortion ban, the federal rulemaking process allowing telehealth prescriptions of medication abortion was flawed.  

University of Michigan law professor Samuel Bagenstos, who served as general counsel of the U.S. Department of Health and Human Services at the time the Biden-era rule was implemented, said the policy was well considered and based on evidence. 

“The 2023 update was the result of an incredibly careful, deliberate, time-consuming, painstaking process to make sure that they were following what the evidence was,” Bagenstos said. If, the plaintiffs were to prevail, he added, ending telehealth access to mifepristone nationwide would have “really harmful effects on women across the country, as well as really destabilizing effects on the drug approval system.” 

Louisiana’s lawsuit against mifepristone has nationwide implications and could threaten residents in states with abortion access and so-called abortion shield laws, such as Maryland. 

Regardless of what happens in this case, abortion providers told Stateline they are determined to continue providing telehealth abortions, though potentially without mifepristone. Dr. Angel Foster, a telehealth provider in Massachusetts, a shield law state, said in the past week, about 100 patients have requested pills for future use, compared with 34 in the entire month of April. She said constantly changing rules around abortion access followed by sensational news headlines continue to create confusion for people seeking termination or miscarriage management.

“I live and breathe abortion at this point, and I find it can be hard to keep up with the ever-changing legal environment and the way that things are getting framed and phrased,” Foster said. “When you’re a patient and what you see are just the headlines, and you’ve got to figure out what it means for you, it’s really complicated.”

Editor’s note: This story has been updated to correct the number of Republican attorneys general who asked the Supreme Court to keep mifepristone from being prescribed via telehealth visits. It should be 23. 

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.

Advocates and opponents of abortion access say they’re wondering what happens next in a critical telehealth medication case that created chaos and confusion over the past week after an appeals court blocked nationwide access to the drug and, days later, U.S. Supreme Court Justice Samuel Alito issued a temporary stay.

Alito’s stay preserves telehealth access until May 11. But it’s unclear what happens next for patients and providers.

The Supreme Court on Monday temporarily blocked the 5th U.S. Circuit Court of Appeals’ Friday ruling to suspend a federal rule allowing telehealth prescriptions of the drug mifepristone while the lawsuit Louisiana v. U.S. Food and Drug Administration unfolds. Abortion providers are determined to continue providing the service, though potentially without mifepristone, the drug at the center for the case, which has had a high record of safety and efficacy since 2000.

Anti-abortion advocates have pushed to reverse the 2023 policy, enacted under former Democratic President Joe Biden, that allowed the FDA to drop its requirement that a patient see a provider in person before the medication can be prescribed. One similar national case already failed unanimously before the Supreme Court, but anti-abortion advocates are hoping this time around, with a more tailored approach, they will be successful.

Abortion-rights advocates say they’re prepared for whatever might happen in the courts, with contingency plans and a message that abortion will still be available even if the particular medication — mifepristone — is not.

Has the abortion pill been banned?

No. Mifepristone is still a legally approved FDA drug commonly used to terminate a pregnancy before 10 weeks’ gestation and is used off-label to treat miscarriages.

Is telehealth abortion still legal?

Yes, for now. Under the U.S. Supreme Court’s administrative stay that expires on May 11, it is still legal to obtain abortion medication through telemedicine under the FDA’s regulations. Mifepristone is commonly used with a second drug, misoprostol, in medication abortions. The case doesn’t include misoprostol.

Who would be affected if telehealth access is struck down?

According to the Society of Family Planning’s #WeCount report, 27% of all abortions in the first six months of 2025 were obtained through telehealth, adding up to more than 162,000 cases.

Mifepristone is also used for patients experiencing a miscarriage; those patients also would have to visit a provider in person.

The ruling would apply nationwide, meaning that health providers couldn’t prescribe mifepristone without an in-person visit with the patient, even in states with abortion access.

What are the arguments on each side in Louisiana v. FDA?

Louisiana says the Biden-era policy undermines a state law banning abortion, and that the federal rulemaking process allowing telehealth prescriptions was flawed.

The Food and Drug Administration says the state doesn’t have standing to sue, but also notes that it’s taking more time to review the drug’s safety.

Two mifepristone drugmakers, meanwhile, have intervened on the FDA’s side.

What could happen next?

The Supreme Court has many options available moving forward, but a few options are most likely, said Katie Keith, founding director of the Center for Health Policy and the Law at the Georgetown University Law Center. The justices could extend the stay when it expires May 11, or the court could make a longer-term ruling.

That could mean sending it back to the 5th U.S. Circuit Court of Appeals, with or without upholding the initial ruling blocking the 2023 provision while the appeals case proceeds. Or justices could decide to take up the case and bypass the rest of the 5th Circuit appeal.

If it did that, the manufacturer defendants Danco Laboratories and GenBioPro have asked for an expedited process with a decision by June. That seems unlikely, Keith said, but the court has conducted expedited cases related to abortion before, such as the Moyle v. United States case in 2024 related to the federal Emergency Medical Treatment and Labor Act.

What will providers do if they can’t use the combination of mifepristone and misoprostol?

Brittany Fonteno, president and CEO of the National Abortion Federation, said providers have been preparing since 2023 for the possibility of losing access to mifepristone. There have long been plans to switch to a misoprostol-only protocol, which is the main method of pregnancy termination across much of the world, she said.

“A lot of providers had created these policies and just needed to dust them off,” Fonteno said.

Dr. Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project, which provides telehealth abortions to patients in all 50 states, said she and her team spent the weekend scrambling to contact patients waiting on medication abortion pills they had ordered before the ruling, and implementing a contingency plan that many abortion providers have been planning for since the lawsuits against mifepristone began in 2023.

That contingency involves pivoting from the FDA-approved mifepristone-misoprostol regimen to a misoprostol-only regimen.

Early Monday, Foster said her team was getting ready to ship misoprostol-only packages to patients at 2 p.m., but after the Supreme Court stayed the appeals court’s ruling on Monday morning, she said they were able to switch back to the mifepristone-misoprostol regimen.

Foster also said her organization was inundated with requests for pills that people could stockpile — people who didn’t need an abortion but were worried about losing access to the pills. Normally that’s a small fraction of the requests they receive, she said, but on Tuesday, they sent out more than had been sent in the entire month of April.

“Over the last two days, we’ve had a huge increase in the number of people from Louisiana requesting pills, especially pills for future use,” Foster said.

What are the pros and cons of the misoprostol-only regimen?

Dr. Maya Bass, a family physician in New Jersey who also provides abortions in Delaware, said misoprostol-only regimens are still safe and highly effective, but that the regimen has a lower efficacy rate than the combination of the two drugs and comes with potentially more side effects and risks.

Misoprostol-only regimens vary between 85% and 90% effective, while the combination is between 93% and 99% effective. The effective rates are lower as the gestational age increases.

The combination works well, Bass said, because mifepristone stops the hormone that allows the pregnancy to continue and signals to the body that the pregnancy is over. The misoprostol then helps soften the cervix and prompts the uterus to contract and expel the pregnancy tissue.

Without that hormonal signal, Bass said, a higher dose of misoprostol is needed to empty the uterus. The usual side effects of nausea, diarrhea, chills and sometimes fevers can be more severe because of the higher dosage. And it may lead to more people needing to seek in-person follow-up care to fully remove all of the pregnancy tissue, which can cause infection if it stays in the uterus.

“A lot of the people who are using telehealth for their medication abortion are not necessarily in places where they can safely access that care,” Bass said. “So it is concerning that we might be relying more on a regimen that means that many more people needing to seek care.”

What are the details of the legal arguments?

Louisiana officials, including Republican Attorney General Liz Murrill, argue that the state is harmed by the 2023 telehealth policy because it undermines a state law banning abortion at all stages of pregnancy, with few exceptions that don’t include rape or incest. The state also challenged the Food and Drug Administration’s process in deciding to eliminate the in-person dispensing requirement, saying it was based on flawed or nonexistent data.

The state also said the rule has resulted in $92,000 in Medicaid bills from two women who went to the emergency room because of complications related to mifepristone in 2025. And the state says the rule harmed the other plaintiff in the case, Louisiana resident Rosalie Markezich, who said her ex-boyfriend ordered the medication online and pressured her into taking it. That wouldn’t have been possible if the medication had to be dispensed through an in-person visit, the state argues.

“The priority of safety supersedes the priority of access, and that is what ultimately, I believe, needs to be looked at directly,” Sarah Zagorski, senior director of public relations at Americans United for Life, told Stateline on Wednesday. The anti-abortion organization submitted a brief supporting Louisiana’s case to the U.S. Supreme Court this week.

The FDA’s response has been to try to dismiss the claims in part on the grounds that Louisiana doesn’t have standing to sue, but agency officials have also said they are in the middle of conducting a safety review of mifepristone and need more time.

GenBioPro and Danco Laboratories, two of the manufacturers of mifepristone, intervened as defendants in the case, which can happen when the party that is sued may not be willing to fully defend the case for various reasons.

The two companies argue that Louisiana does not have proper standing to sue because the state does not prescribe or use mifepristone and is an “unregulated party” as it relates to the 2023 telehealth provision. They also noted that the FDA reviewed 15 studies evaluating medication abortion outcomes for more than 55,000 patients before approving the rule, “all of which supported the safety and effectiveness of dispensing mifepristone by mail, courier, or through pharmacies.”

How does this compare to the 2023 case Alliance for Hippocratic Medicine v. FDA?

Both lawsuits were designed to restrict access to mifepristone. The plaintiffs in the Alliance for Hippocratic Medicine case included a group of anti-abortion doctors who said they would be harmed by having to care for people who took mifepristone. They also argued that the FDA’s approval of the drug was improper.

The 5th U.S. Circuit Court of Appeals was involved in that case as well, and determined that the FDA should roll back its decision to ease restrictions on the drug, including the 2023 telehealth rule. But the U.S. Supreme Court unanimously decided in June 2024 that the Alliance plaintiffs didn’t have proper standing and sent it back to the lower court.

After that ruling, the attorneys general of Missouri, Idaho and Kansas stepped in as plaintiffs, and the case was transferred to Missouri’s U.S. district court, where it’s still pending.

The Louisiana case is more limited because it would strike down one provision of mifepristone regulation, noted Jenna Hudson, senior counsel at the Center for Reproductive Rights. The Alliance plaintiffs sought to revoke the drug’s approval altogether.

Stateline reporters Kelcie Moseley-Morris can be reached at kmoseley@stateline.org and Sofia Resnick can be reached at sresnick@stateline.org.  

A recent decision from a federal appeals court could impact Wisconsin residents seeking to get the abortion pill mifepristone from providers in other states through the mail.

The post Here’s how recent legal decisions around abortion pill access could impact Wisconsinites appeared first on WPR.

The U.S. Supreme Court issued a temporary stay on an appeals court ruling from Friday that was blocking remote access to an abortion drug, restoring access until at least May 11.

The administrative stay, issued by Justice Samuel Alito, pauses Friday’s decision by the 5th Circuit Court of Appeals. That ruling blocked a 2023 rule adopted by the U.S. Food and Drug Administration allowing mifepristone, one of two drugs used to terminate a pregnancy before 10 weeks and to treat miscarriages, to be prescribed without an in-person visit with a health care provider and also allowed it to be mailed to recipients in states with abortion bans.

“The administrative stay is temporary, and I am confident life and law will win in the end,” said Louisiana Republican Attorney General Liz Murrill in a statement. 

Thirteen states have near-total abortion bans, including Louisiana. Murrill sued the FDA in October, saying the rule undermines the state’s laws and causes financial harm because the state paid $92,000 in Medicaid bills for two women who needed emergency care in 2025 from complications related to mifepristone. 

In the years since the 2022 U.S. Supreme Court decision allowing states to regulate abortion access, telehealth prescriptions of abortion medication have become increasingly popular, with more than 27% of all abortions provided that way in 2025, according to data from the Society of Family Planning.

“While this is a positive short-term development, no one can rest easy when our ability to get this safe, effective medication for abortion and miscarriage care still hangs in the balance,” said Julia Kaye, senior staff attorney for the Reproductive Freedom Project at the American Civil Liberties Union, in a statement. “The Supreme Court needs to put an end to this baseless attack on our reproductive freedom, once and for all.”

The case could follow a similar pattern to one that played out in 2023, after U.S. District Court Judge Matthew Kacsmaryk of Texas issued a ruling that would have revoked access to the abortion drug mifepristone altogether. 

The U.S. Supreme Court intervened shortly after that ruling and kept mifepristone available while the case proceeded in the 5th Circuit appeals court, which eventually decided that more restrictions were warranted, but not pulling the drug’s approval. The Supreme Court officially took the case several months later, and unanimously ruled in June 2024 that the plaintiffs suing the FDA did not have standing, keeping access to mifepristone intact.

Responses from the attorneys in the latest case are expected to be filed with the Supreme Court by Thursday, according to Alito’s order.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

At Family Planning Associates in Chicago, in the office where staff take phone calls from potential abortion patients, a U.S. map colored in with red and green dry-erase markers notes the latest status of abortion access in every state. The map can change at any time.

In the center of the map’s biggest sea of red is Illinois, outlined in green — showing it’s a state with strong abortion access — surrounded by several states that ban or severely restrict abortion. Illinois is the destination for nearly 1 in 4 people traveling to another state for abortion care, according to a report from the Guttmacher Institute, an advocacy and research organization that supports abortion access and tracks data nationwide.

“Illinois really became kind of a haven state for the Midwest and much of the South immediately post-Dobbs,” said Megan Jeyifo, executive director of the Chicago Abortion Fund, which provides logistical and financial support to people who need abortions.

The state’s geography explains part of its popularity; in five of the six border states, abortion is either banned or largely inaccessible. But Illinois also is among the states that have put in place new policies — along with millions of dollars — to welcome patients who aren’t their residents. Advocates and providers say other safe-haven states should replicate the investments.

That’s happened most recently in Maine and Washington state, where governors approved funding to support family planning and abortion care, including for out-of-state patients.

Since the U.S. Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision that overturned the constitutional right to abortion and allowed states to regulate the procedure, 13 states have implemented near-total abortion bans, and seven others have bans after six to 12 weeks. Although about one-quarter of people who need an abortion now obtain medication by telemedicine, many who live in states with bans still have to travel elsewhere for various reasons, including fear of prosecution.

Guttmacher’s data showed that fewer people traveled for care in the past two years than the peak of 170,000 who traveled in 2023, the year after Dobbs.

That number fell to about 155,000 in 2024, including 35,000 who went to Illinois, the data showed. Last year, an estimated 142,000 abortion patients traveled out of state, with a fairly consistent number, about 32,000, going to Illinois.

The next-highest destination after Illinois was North Carolina, followed by New Mexico and Kansas.

Guttmacher and other advocates attribute part of that decrease in the national numbers to wider availability of telehealth access to abortion medication that can be mailed to patients in other states. There were an estimated 1.1 million abortions across the United States in 2025, about the same amount as 2024 but the highest number since 2009, according to Guttmacher.

Shield laws protect health care providers in many states, including California, Illinois and New York. Those laws have prevented Republican attorneys general in other states, such as Texas and Louisiana, from trying to punish providers who prescribe the drugs.

Louisiana has unsuccessfully tried to charge and extradite doctors from California and New York, and is also suing the federal government to remove the provision that allows abortion medication to be prescribed by telehealth. A federal judge put the case on hold for now as the U.S. Food and Drug Administration completes a safety review.

Policy changes in Illinois

Illinois’ “haven” status is derided by anti-abortion groups, who call the state’s policies extreme.

“The abortion industry in Illinois is the wild west, which is clear by these numbers,” said Mary Kate Zander, president and CEO of Illinois Right to Life, to the Chicago Sun-Times, speaking about the Guttmacher report.

One state changing its laws to restrict abortion access can lead to a significant influx of patients traveling to clinics in other states. Dr. Allison Cowett, chief medical and advocacy officer for Family Planning Associates, said when six-week abortion bans went into effect in Florida and Georgia in May and October of 2024, respectively, many more patients from the South started coming to Chicago.

“Within the first few months after Dobbs, we had more than 1 in 3 patients coming from outside Illinois, and that has maintained for those three, almost four years,” Cowett said.

Illinois also borders Indiana, which has a near-total abortion ban in place. Cowett said Indiana residents were the largest percentage of out-of-state abortion patients at her clinic before 2022, and it has stayed that way.

Restricting, cutting Medicaid funding shifts more reproductive health care to telemedicine

Jeyifo said when she started as a volunteer with the Chicago Abortion Fund in 2016, the organization couldn’t financially support large numbers of out-of-state patients because Illinois didn’t invest in access the way it does now. The biggest change came in 2018, when Illinois allowed its state Medicaid program to cover abortion procedures.

“We would not have been able to expand our support outside of Illinois residents without that coverage,” Jeyifo said.

Nineteen other states allow their Medicaid program to cover abortion procedures, according to KFF, a health policy research group.

In 2023, Democratic lawmakers in Illinois allocated $10 million from the state health department to establish the Complex Abortion Regional Line for Access, known as CARLA, a hotline for the Chicago Abortion Fund and four area hospitals to help coordinate care. Jeyifo said more than 1,000 people have received assistance through that hotline in the years since.

The state has also helped fill in lost Medicaid funding after Congress passed a provision blocking federal Medicaid payments to certain abortion providers, mainly targeting Planned Parenthood, and it has helped pay for training and other programs that help connect people with care.

In January, the state launched a new partnership with the Chicago-based Michael Reese Health Trust to establish the Prairie State Access Fund, which will provide aid to out-of-state patients in need of reproductive and gender-affirming health care.

“(Illinois) is this model for other receiving states around the country to take up and learn about, because the proximity on a map is important, but the resources that are available once you get to a place are so much more important,” Jeyifo said.

Finding nearby states

The Guttmacher report showed 62,000 of the 142,000 people who traveled came from states with near-total bans, more than double the number who traveled from those states before 2022. But it has declined over the past year, down from 74,000 who traveled from those states in 2024.

The next-highest state for travelers, North Carolina, is relatively close to Georgia and Florida. The number of out-of-state travelers has remained steady there since 2024, even though North Carolina has a 12-week ban and a three-day waiting period for abortions.

In New Mexico and Kansas, about two-thirds of all abortions provided were for people traveling from outside the state, but those numbers are going down. New Mexico is often a destination for people from Texas, and Kansas borders Oklahoma, two states with strict bans. Kansas also borders Missouri; voters in 2024 passed a constitutional amendment legalizing abortion, but access has not returned, and lawmakers are trying to reverse the amendment in this year’s midterm elections.

Family Planning Associates is one of the largest independent abortion clinics in Illinois. It expanded its staff — including doctors, nurses and front desk workers — during the first year after Dobbs from about 40 people to more than 70 to handle the new patient volume, Cowett said. The clinic also expanded its physical space by about two-thirds.

Many of those who come from the South have never left their home state, Cowett said, and it can be overwhelming for them to come to a big city during an already emotional event. The abortion fund and others help supply a closet in the clinic that is stocked with toiletries, basic clothing, shoes and other items to assemble care packages for patients.

The state has also provided security infrastructure grants to nonprofits to protect against potential attacks, such as a clinic firebombing in Peoria, Illinois, in 2023, two days after Democratic Gov. JB Pritzker signed abortion protections into law. No one was in the building at the time.

Such aid was especially important for the Choices: Center for Reproductive Health clinic in Carbondale, a city at the southern tip of Illinois and the intersection of neighboring states with strong anti-abortion laws: Arkansas, Kentucky and Tennessee.

It’s a much shorter drive to Carbondale for people in those states than it is to Chicago, said Jennifer Pepper, Choices president and CEO, and it’s a more familiar, smaller area.

The state grant allowed them to harden the physical security of the clinic in Carbondale, Pepper said, which is something they haven’t been able to do for their sister location in Memphis, Tennessee. That clinic provides birth control, wellness exams and midwifery services, but receives no state support.

“We’ve never had state support in all of our 52 years in Tennessee,” Pepper said.

State assistance

Other states with Democratic leadership and protective abortion laws are starting to approve more funding to support reproductive health care.

Maine Gov. Janet Mills signed a budget bill Friday that includes funding for lost Medicaid reimbursements and creates an ongoing $5 million annual appropriation for family planning services. Washington Gov. Bob Ferguson signed a law in late March establishing a new revenue source for abortion care by implementing a tax on health insurance companies that is expected to generate about $10 million in the first year and about $2 million in each subsequent year.

Jeyifo, of the Chicago Abortion Fund, said she hopes to see more of those efforts in other states with laws that are supportive of reproductive health care, including ones with Democratic leadership that could be doing more to expand clinic availability and rescind waiting periods, such as the 24-hour waiting requirement that still exists in Wisconsin before a patient can get an abortion.

“So many states in our region could be doing more just for their own residents, let alone people traveling,” Jeyifo said.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

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State Rep. Lisa Subeck, D-Madison, this month introduced legislation requiring crisis pregnancy centers to obtain permission from clients before sharing their sensitive health information.

Crisis pregnancy centers (CPCs), also known as unregulated pregnancy centers or pregnancy resource centers, provide some services for pregnant people but largely aim to dissuade clients from choosing abortion care. Importantly, most CPCs are not licensed medical facilities and are intentionally vague about their inability and unwillingness to provide abortions or make referrals. They attract clients with targeted advertising that promises free pregnancy testing, ultrasounds and options counseling.

Without the restrictions proposed by Subeck and more like it, Wisconsinites will continue to be victimized by this industry.

Since CPCs are not medical providers and do not charge for services,they are not subject to the same consumer protection laws and licensing requirements, including the Health Insurance Portability and Accountability Act, or HIPAA.

Without confidentiality protections, CPCs are not required to protect sensitive client information and may misuse private client data with no accountability. Subeck’s bill would help close this loophole and ensure that client information is secure.

While this legislation would be a step in the right direction, privacy is just one of many instances in which CPCs violate medical ethics.

With the funding they receive from faith-based organizations, anti-abortion advocacy groups and taxpayer dollars, CPCs may present themselves in ways that resemble medical settings. Staff and volunteers may wear white coats, visit with clients in exam rooms and adopt language used by clinicians. But many of their services fail to meet evidence-based standards of care.

For example, CPCs have been reported to overestimate gestational age to convince clients they are too far along in pregnancy to legally access abortion. They also readily share medically inaccurate information about abortion.

CPCs across Wisconsin claim that abortion can lead to depression, substance abuse, nightmares, and future fertility issues. Major medical organizations say there is no evidence that abortion leads to mental illness or negative impacts on future fertility. In fact, research suggests that denying people abortion care is associated with worse outcomes to their long-term health and well-being.

Many CPC websites list “abortion reversal” as a service. This involves taking progesterone to “reverse” the effects of mifepristone, the first medicine used in medication abortion. University of California-Davis researchers attempted to test the effectiveness of this treatment, but the study was stopped early due to ethical and safety concerns. The American College of Obstetricians and Gynecologists has determined that abortion reversal is “not supported by science.”

Despite their questionable practices, CPCs in Wisconsin continue to benefit from public funding, and some state legislators want them to receive even more. In 2023, Sen. Robert Quinn, R-Birchwood, proposed legislation that would give $1 million a year to Choose Life Wisconsin, a statewide network of CPCs.

Funds raised through Choose Life license plates are also directed to CPCs. Meanwhile, some of Wisconsin’s legislative Republicans have not supported measures that would benefit pregnant people and new parents. Assembly Speaker Robin Vos, R-Rochester, repeatedly blocked proposals to expand postpartum Medicaid coverage, calling it “an expansion of welfare,” until the Assembly this session finally sent the bill to Gov. Tony Evers’ desk.

In Wisconsin, legitimate providers of abortion care must navigate a litany of restrictions. Targeted Regulation of Abortion Providers, or TRAP laws, are widely criticized by medical groups and exist only to make obtaining and providing abortion care harder. Yet CPCs are free to operate under limited regulations while they enjoy our tax dollars.

In other states, efforts to regulate CPCs have failed on the grounds that these organizations are protected under the First Amendment. But these centers are a growing public health risk, and protecting people’s health and safety should take priority. This is especially important as the network of CPCs continues to grow. In Wisconsin, there are just five clinics that provide abortion care, compared to an estimated 60 CPCs.

When pregnant people reach out for support, they deserve to be met with compassion, honesty and the opportunity to consider all of their options. The ongoing failure of our lawmakers to regulate these facilities is an affront to evidence-based sexual and reproductive healthcare. It is time that Wisconsin’s lawmakers uphold respect and humanity, not deception and manipulation.

Layne Donovan was born and raised in Wisconsin and holds a degree from Barnard College. She has studied the history of abortion in the United States, and currently works in reproductive health, rights, and justice. 

Opinion: Wisconsin must regulate crisis pregnancy centers to protect patients  is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.