When an Alabama clinic’s only OB-GYN left the state to provide abortion care in Colorado, the head of operations thought the facility would have to close. 

But Robin Marty, executive director at WAWC Healthcare in Tuscaloosa, hired a doctor in August who she called a “unicorn” — someone who’s from Alabama and, after training outside of the state, returned home to practice medicine. 

Marty said Alabama’s near-total abortion ban could cause physicians to practice elsewhere after they finish their residencies. 

“Doctors don’t want to worry about surveillance, potential arrests and other legal issues,” she said. 

A study published this month found that applications to medical residency programs in states with abortion restrictions have declined compared to states where abortion remained mostly legal. The findings are an “early signal” that the U.S. Supreme Court’s decision nearly four years ago overturning federal abortion rights protections may exacerbate health care shortages, said lead author Dr. Anisha Ganguly.

A majority of doctors end up practicing medicine in states where they trained. Obstetrician and gynecology training programs typically take four years to complete, so the full scope of how abortion restrictions affect where physicians work after they complete their residencies remains to be seen. 

Still, experts said the findings could spell trouble for the future of the reproductive health care workforce in states with abortion restrictions, some of which are already plagued with maternity care deserts. 

Doctors say bans limit training, standards of care

OB-GYNs affiliated with Physicians for Reproductive Health who either trained or work in states with abortion bans told States Newsroom that restrictions after the Supreme Court decision hamstrung their ability to offer reproductive care and affected the education of medical residents. 

Dr. Neha Ali grew up in Texas and trained there, too. But by the end of her OB-GYN residency’s second year, the state enacted SB 8, a six-week abortion ban that allowed residents in the state to sue providers or anyone who helped someone terminate a pregnancy. After the Dobbs decision in June 2022, a near-total abortion ban took effect in Texas.

“I knew I wanted to be an abortion provider before I started OB-GYN residency, and I chose to be in Texas for my residency training because I wanted to experience what that’s like in a state with barriers. But ultimately, the barriers became too large,” Ali said. 

After she finished residency in 2024, Ali moved to Colorado, a state with strong abortion-rights protections, where she practices complex family planning.

Ali said she talks to medical students about her experience training in Texas, where she was not able to perform any dilation and evacuations — a second-trimester abortion procedure — during residency. 

“I do think it’s very valuable to see what it’s like to be in a restrictive state and understand what that is like to be a provider there, but that doesn’t sell people on a residency for four years,” she said.

OB-GYN Dr. Louis Monnig trained in Kentucky before the state banned abortion. 

“Making it difficult or putting up barriers to that training just limits the abilities of any doctor who provides reproductive care to have opportunities to get exposure and experience, and just get better at what they’re doing,” he said. 

Monnig completed his residency in June 2023 and moved back to his home state of Louisiana because of his connections to the region and its health care disparities. “It felt like it was worth it to come back,” he said. 

In October 2024, a Louisiana law classifying mifepristone and misoprostol as controlled dangerous substances took effect. 

“It made me lose faith that lawmakers were doing any of these things to actually protect patients or patient safety,” he said. 

The medications are used not only for abortions, but miscarriages and other conditions, too. The law has sowed confusion among health care providers and led some to practice emergency drills to access the drugs during obstetric emergencies, Louisiana Illuminator reported. Monnig said the law has “changed some of the day-to-day operational workflow for patient care,” especially for situations where misoprostol is used, such as labor induction and postpartum hemorrhaging. 

Patients have faced issues when trying to get prescriptions filled: Pharmacists have called Monnig’s office to make sure a patient wasn’t having an abortion after he prescribed misoprostol for conditions such as cervical stenosis — when it’s difficult to insert a medical instrument in the cervical canal.

Drop in applications to ban states’ residency programs

Out of more than 22 million applications to 4,315 residency programs across the U.S., 67% were submitted to programs in states without abortion restrictions between 2018 and 2023, the new research showed. Thirty-three percent went to programs in states with restrictions. 

Fewer women than men applied to train in states with abortion restrictions before the Supreme Court’s landmark abortion ruling, according to the study, and that disparity widened after more than a dozen states enacted abortion bans. The number of men applying to residency programs in states with abortion restrictions — mostly in the South and the Midwest — also decreased significantly. 

“When there’s a decreased level of interest in these states, it suggests to us that there’s an evolving health care workforce shortage in these states,” said Ganguly, an internal medicine physician and an assistant professor at University of North Carolina’s Division of General Medicine and Epidemiology. 

Many states with abortion bans — Idaho, Iowa, Georgia and Missouri, for example — are also facing labor and delivery unit closures, particularly in rural areas where hospitals struggle with provider recruitment. Health officials in these states listed improvements to maternal health as a priority in their applications to the federal Rural Health Care Transformation Program, but solutions will take years to implement. 

Shortages affect more than one specialty. Ganguly said OB-GYNs have historically offered the bulk of abortion-related care in the U.S., but it’s increasingly important in emergency medicine, family medicine and internal medicine. Primary care providers and emergency medicine doctors often diagnose pregnancy complications such as miscarriages, and internists help women who have chronic disease manage and plan for pregnancy. 

Dr. Hector Chapa, an OB-GYN who teaches obstetrics and gynecology at Texas A&M University and is a member of the American Association of Pro–Life Obstetricians and Gynecologists, took issue with the study’s approach. 

“It’s essential to understand that this study is not specific to OB‑GYN residency programs, and by grouping OB‑GYN with family medicine, internal medicine and emergency medicine, the study assumes that all specialties are affected equally, despite their very different levels of involvement in abortion. This broad grouping risks introducing bias into the results,” he said in a statement. 

Ganguly said her team did examine applications to OB-GYN residency programs in isolation to affirm findings of a decline among applicants in abortion-restricted states. Looking at other specialties, too, was meant to provide clarity about how bans affect the health care workforce more broadly.

OB-GYN education and the maternal health care workforce 

The latest study adds to a body of research examining how the Supreme Court’s decision on abortion in 2022 affected training after medical school, particularly for those specializing in reproductive health care. 

In the 2023-2024 application cycle, the number of applicants to training programs in states with abortion bans decreased by 4.2% compared to the previous cycle, while there was less than a 1% decrease in applications to residency programs in states where abortion is legal, according to the American Association of Medical Colleges. 

In some states, abortion bans have definitively led to an exodus of OB-GYNs and maternal fetal medicine specialists. Idaho lost 35% of its doctors who provide obstetrics between August 2022 and December 2024, according to a study published in July. 

Having reproductive health providers flee states with abortion bans is “devastating,” according to Pamela Merritt, the executive director of Medical Students for Choice. 

“It’s a public health disaster that we’re going to see the consequences of decades to come,” she said. 

Merritt’s organization has chapters at several medical schools in states with abortion bans. She said students are not getting adequate training, and some are even discouraged from discussing abortion. 

In February, Texas Tech University Health Sciences Center canceled a Medical Students for Choice chapter’s talk with an OB-GYN who wrote a book about providing abortion care later in pregnancy. School officials told The Texas Tribune hosting the event on campus was not in the university’s best interests.   

“Everybody who graduates from medical school in Texas should know that there’s this thing called third-trimester abortion, that when the life of the mother is at risk, you legally can provide this care,” Merritt said. 

Republican Gov. Greg Abbott signed legislation last year clarifying that doctors can offer pregnant women abortions during medical emergencies. The Texas Medical Board released guidelines for the abortion law this year, nearly half a decade after the state banned most abortions and at least four Texans died after being denied prompt abortion care, ProPublica reported. 

Program helps residents in restrictive states get abortion care training 

“Every single physician, nurse and health care provider needs to be educated about abortion care,” said Dr. Jody Steinauer, an OB-GYN and the director of the Bixby Center for Global Reproductive Health at the University of Southern California in San Francisco. “This is a huge crisis in OB-GYN specifically: All OB-GYNs must have the competence and the skill to safely empty the uterus. Even if the individual is personally uncomfortable providing abortion care, they have to be able to empty the uterus to save someone’s life in an emergency.”

Steinauer leads the Ryan Residency Training Program, which works with OB-GYN residencies across the country to ensure comprehensive abortion and family planning rotations. Nearly a dozen states lack Ryan programs, and most of them have near-total abortion bans. 

She said residencies in states with abortion bans are struggling to make sure their students have the skills to provide abortion: “We’re at risk of having a whole generation of OB-GYN graduates who are not skilled to provide the care they need to provide.” 

To remedy this issue, the Ryan Program has helped to establish 20 partnerships with schools in abortion-restrictive states to train OB-GYN medical residents in states with reproductive rights protections. 

Steinauer said the rotations are between two to four weeks and complicated to plan, but they help doctors learn procedural skills, how to manage medication abortions and counseling. 

The rotations also help OB-GYNs navigate pain management during obstetric procedures, communicate effectively with abortion patients and familiarize themselves with ultrasounds, she said. These skills are important for providing the full spectrum of reproductive health care, from inserting IUDs to treating miscarriages, the doctor said. 

“It’s such a refreshing experience for them to be working in a state without a ban, and they get to see abortion as normal health care,” she said. 

Some Republican lawmakers have routinely proposed criminally prosecuting women for getting abortions since the U.S. Supreme Court overturned Roe v. Wade, despite bipartisan condemnation and criticism from national anti-abortion organizations. 

These bills never made it to the finish line, but they keep circulating in legislatures across the country. So-called “abortion abolitionists” who believe that abortion should be classified as homicide, and that fetuses, embryos and zygotes should have the same legal protections as people are often behind these measures, States Newsroom reported. 

This year, the Foundation to Abolish Abortion praised Republican lawmakers in Illinois, Kentucky and Tennessee who introduced bills that would punish people who get abortions. 

In Illinois, Republican Sen. Neil Anderson filed a bill that would have banned abortion from the moment of fertilization and classified abortion as homicide in the Democratic-led state. Anderson’s bill did not move past introduction, and he lost a leadership position in the chamber this month, Capitol News Illinois reported. 

In Tennessee, legislation concerning an anti-abortion monument was amended to criminalize abortion, potentially allowing women who seek abortion to be charged with murder. Sen. Mark Pody, the bill’s GOP sponsor, said he doesn’t have the votes in the Senate to pass the bill with the criminalization amendment, Tennessee Lookout reported. 

Elsewhere, proposals to crackdown on the availability of abortion medication — the most common way to terminate a pregnancy — are advancing in several Republican-led legislatures, while Democratic lawmakers are moving to fortify shield laws. 

Our reproductive rights reporting team will be tracking related bills through biweekly roundups as sessions continue this winter and into the spring. Depending on the partisan makeup of a state’s legislature and other state government officials, some bills have a better chance of passing and becoming law than others.

GOP legislators still introducing bills classifying abortion as homicide

Kentucky   

House Bill 714: Abortion is already illegal in Kentucky with no exceptions for victims of rape and incest. This bill, called the “Prenatal Equal Protection Act,” would go further by classifying abortion as homicide unless it’s needed to treat miscarriages or save a pregnant woman’s life. The penalties would be the same as those for killing a person, so violators could face anywhere from one year to life in prison. 

GOP Rep. Richard White introduced a similar bill last year that didn’t go anywhere. The Foundation to Abolish Abortion praised the new measure in a Tuesday news release. The organization criticized a Kentucky prosecutor’s decision last month to drop a fetal homicide charge against a woman who was accused of taking abortion medication.  

Status: Introduced in the House on Tuesday, Feb. 24, and sent to the Committee on Committees 

Sponsors: Republican Reps. Josh Calloway and Richard White  

South Carolina 

House Bill 3537: Legislation introduced by GOP Rep. Rob Harris would ban abortion from the moment of fertilization. Harris’ bill would also allow the prosecution of people who get abortions unless it’s necessary to manage miscarriages or save a pregnant person’s life. 

Harris filed this bill in previous legislative sessions, but it hasn’t gained traction, SC Daily Gazette reported. “Bills like these do nothing but terrify women out of wanting to get pregnant,” Tori Nardone, a woman who had to leave South Carolina to get an abortion for a fatal fetal anomaly, told lawmakers last month. “Please don’t make it worse than it already is.”

Status: Stalled in the House Judiciary Committee 

Sponsor: Republican Rep. Rob Harris 

South Dakota   

House Bill 1212: South Dakota bans abortion in most cases, but this bill would have codified abortion as fetal homicide in state law and defined abortion as a Class B felony, which carries punishment of up to life in prison and a fine of up to $50,000. The proposal included exceptions for miscarriage treatment or when a pregnant patient’s life is in danger.

The bill was deferred to the last day of the legislation session by the House Health and Human Services Committee, essentially preventing it from advancing.  

Status: Sidelined 

Sponsors: Rep. Tony Randolph and Sen. John Carley, Republicans 

Republican-led states push bills to crack down on abortion pills

Mississippi   

House Bill 1613: This legislation would make it illegal to sell, manufacture, distribute or dispense abortion-inducing drugs in the state, which bans all abortions unless the mother’s life or health is at risk, and if rape or incest is reported to law enforcement. 

Violators could face between one and 10 years in prison, and the state attorney general could enforce civil penalties against the person, too, Mississippi Free Press reported. The House passed the bill on Wednesday, Feb. 11. If the bill becomes law, it would take effect in July. 

Status: Referred to Senate Judiciary Committee last week 

Sponsors: Republican Reps. Kevin Horan and William Tracy Arnold 

South Dakota  

House Bill 1274: The state House passed a bill this week that would make dispensing, distributing, selling or advertising abortion pills and any other abortion-related “instrument” or “article” illegal, South Dakota Searchlight reported. 

Under the measure, the attorney general could seek penalties of up to $10,000 for each violation, and the money would go in a fund used to pursue anti-abortion litigation, according to Searchlight. South Dakota’s AG is already involved in a legal battle with a New York-based nonprofit over abortion medication ads it ran at gas stations across the state last year. 

Status: Approved in the House on Tuesday, Feb 24; in the Senate State Affairs committee 

Sponsors: Republican Reps. John Hughes and Greg Blanc 

Democratic lawmakers move to strengthen abortion-rights protections 

New Hampshire   

Senate Bill 551: New Hampshire, which has a Republican trifecta in government, is the only state in New England without a law that protects abortion providers and patients from out-of-state investigations into reproductive health care. Legislation introduced by Democratic Sen. Debra Altschiller in February would secure the right to reproductive health care and prohibit law enforcement from cooperating with investigations into related health care, New Hampshire Bulletin reported. 

The bill would make it illegal for the governor to comply with extradition requests for abortion providers and patients. It would also ban insurers from penalizing reproductive health care providers and let residents sue people or agencies that attempt to interfere with their reproductive rights, the Bulletin reported. 

Status: The Senate Judiciary Committee voted 3-2 on Tuesday, Feb. 17, that the bill was “inexpedient to legislate.” 

Sponsor: Democratic Sen. Debra Altschiller

Oregon   

House Bill 4088: An Oregon law approved in July 2023 protects providers who offer reproductive health care from losing their licenses, and shields patients and providers from related out-of-state investigations. Legislation introduced this year would beef up those safeguards. 

This bill would bar the governor from accepting extradition requests from other states against providers who offer legally protected reproductive health care and prohibit law enforcement from cooperating with interstate investigations into related care, Oregon Capital Chronicle reported. It would also block state officials from revoking midwifery licenses for people who face prosecution for reproductive health care in other states. 

Status: Approved by the House on Monday, Feb. 16; approved by the Senate Judiciary Committee Wednesday, Feb. 25

Sponsors: Rep. Lisa Fragala and Sen. Lisa Reynolds, Democrats 

A hearing is set for Tuesday in a federal lawsuit led by Louisiana seeking to further restrict access to mifepristone by asking the courts to stop abortion pills from being mailed across the country. 

The Department of Justice has argued plaintiffs lack standing to bring the case and asked the judge to halt legal proceedings until the Food and Drug Administration wraps up a review of the medication. 

Hundreds of studies have concluded that the drug is safe and effective for abortions early in pregnancy, but a paper released by a conservative think tank last year compelled Health and Human Services Secretary Robert F. Kennedy Jr. to order a reevaluation of mifepristone.  

The state of Louisiana and a woman who said her ex-boyfriend made her take abortion medication sued the FDA in October and asked for a preliminary injunction against a 2023 rule that allows abortion pills to be prescribed through telehealth or mailed to patients, and pharmacies to apply for certification to dispense mifepristone. 

Julie Kay, the founder and CEO of legal advocacy group Reproductive Futures, told States Newsroom the lawsuits in Louisiana and elsewhere are “thinly veiled attempts” to block access to telehealth medication abortion. 

“We’ve seen that telemedicine abortion has become incredibly popular in all 50 states and particularly vital for women in under-resourced areas,” Kay said. 

Missouri, Idaho, Kansas, Texas and Florida are also suing the FDA over mifepristone’s regulations and asking the courts to restrict or rescind approval of the drug altogether.

Nearly 30% of abortions provided in the first half of 2025 were through telehealth, according to the Society of Family Planning’s latest #WeCount report. 

By June 2025, about 15,000 abortions per month were provided by physicians shielded by state laws, allowing them to prescribe abortion medication remotely to people living in states where abortion is banned or restricted, the report found. Shield laws protecting health care professionals from out-of-state investigations have held up in court so far, despite efforts from prosecutors in Texas and Louisiana. 

Republican Louisiana Attorney General Liz Murrill vowed to defend anti-abortion laws in her state, which has had a ban with no exceptions for rape or incest since August 2022. She indicted a California doctor in January, accusing him of mailing abortion pills to Rosalie Markezich, a plaintiff in the lawsuit before federal courts. 

Lawyers for Louisiana argue that the Biden administration’s decision to nix the in-person dispensation requirement for mifepristone is an affront to states that ban abortion. 

Alliance Defending Freedom Senior Counsel Erik Baptist framed the lawsuit as an intimate partner violence issue, saying Markezich’s former boyfriend ordered abortion pills online from Dr. Rémy Coeytaux in California without any in-person interaction. 

“So what this lawsuit would do is protect women across the country, in particular in Louisiana, from this mail-order abortion scheme that enables and emboldens people in coercive situations, such as men and abusers who can now obtain these drugs through remote means,” Baptist said. 

Reproductive coercion — when an abusive partner controls a person’s bodily autonomy — has been brought up in recent legal challenges to abortion pill access by other GOP attorneys general in bids to restrict mifepristone, according to Rachel Rebouché, a University of Texas at Austin law professor who specializes in reproductive rights. 

“There’s really not evidence that people are being coerced or forced into taking pills. It’s, of course, awful if someone has felt coerced, but I’m not sure it changes the argument of what the FDA should do as an agency committed to reviewing evidence,” Rebouché said. 

For their part, DOJ attorneys have said an injunction would interfere with the FDA review and Risk Evaluation and Mitigation Strategies, setting off an avalanche of other lawsuits. 

“Plaintiffs now threaten to short circuit the agency’s orderly review and study of the safety risks of mifepristone by asking this Court for an immediate stay of the 2023 REMS Modification approved three years ago,” they wrote in a memo filed on Jan. 27 in the U.S. District Court for the Western District of Louisiana. 

Kay said she views the Trump administration’s motion to pause the case as a legal delay tactic that is more about politics than science, because most Americans believe abortion should be accessible. A Pew Research Center poll from June 2025 showed 63% of respondents said abortion should be legal in all or most cases.

“This federal administration is very aware of that popularity, and I think they’re saying they want to wait until after the midterms,” Kay said.

Baptist said the FDA can conduct their review while the in-person requirement is restored. 

Mifepristone’s manufacturers intervened in the case earlier this month, Louisiana Illuminator reported. But unlike the federal government, GenBioPro and Danco, the companies behind the generic and name brand versions of the drug, asked the court to dismiss Louisiana’s lawsuit entirely. 

In a memo filed on Tuesday, Feb. 17, lawyers for the plaintiffs argued that the 2023 regulatory change “was intended to authorize a direct attack” on anti-abortion states. 

The filing also rejects arguments that Louisiana and Markezich lack standing in the same way that a group of anti-abortion doctors did in a lawsuit against the FDA over mifepristone’s previous regulations, according to a 2024 U.S. Supreme Court ruling. Justices rebuffed the Alliance for Hippocratic Medicine’s requests but did not rule on the merits of the case.

Baptist also said judicial panels on the 5th U.S. Circuit Court of Appeals in Louisiana — a conservative-leaning court where this lawsuit could go next — have twice ruled that it was “arbitrary and capricious” for the FDA to allow abortion medication without an in-person doctor visit. 

In Louisiana’s corner are major anti-abortion players: Students for Life of America, 60 Republican members of Congress, 21 GOP attorneys general and the Ethics and Public Policy Center filed briefs backing the state. 

Rebouché, the University of Texas professor, said there would be conflict between the federal courts if the district court judge rules in favor of Louisiana. There are nearly a dozen lawsuits over abortion pills seeking to restrict and deregulate mifepristone, States Newsroom reported.

Guttmacher Institute Principal Federal Policy Adviser Anna Bernstein said in a statement Friday that reinstating the in-person dispensation requirement for mifepristone would hinder abortion access. 

“If access to telehealth and mifepristone by mail is curtailed, more patients would be pushed toward in-clinic care, straining provider capacity and increasing wait times in an already chaotic landscape,” she said. “Given that travel is out of reach for many people, the result would likely be increased delays and more people unable to get the abortion care they need and deserve.” 

Kelcie Moseley-Morris contributed to this report. 

The Trump administration is using a law Congress passed in the 1990s after a wave of deadly violence at abortion clinics to prosecute demonstrators and reporters who were at a immigration-related church protest in Minneapolis last month. 

Independent journalists Don Lemon and Georgia Fort, along with several activists, are accused of violating a 1994 law that made physically obstructing access to reproductive health clinics and places of worship a federal crime. Lemon pleaded not guilty Friday, while Fort is set to be arraigned next week and has denied any wrongdoing. Other plaintiffs have vowed to fight the charges — they’re also accused of conspiring against churchgoers’ right to worship — and maintained they were exercising their First Amendment rights. 

Some abortion opponents say the law should be repealed entirely, even though the statute also protects access to anti-abortion crisis pregnancy centers. Reproductive rights advocates say getting rid of the law altogether could spur more attacks on clinics and providers, which already increased in recent years. 

“It would give an even stronger signal to the zealots who would wish to shut us down to intimidate and harm our clinic folks and patients,” said Julie Burkhart, who owns clinics in Wyoming and Illinois. 

The Minnesota indictment is only the second time that the Department of Justice has brought charges under the religious provision tucked in the Freedom of Access to Clinic Entrances Act. In September, the federal government filed a civil complaint against pro-Palestinian groups and demonstrators, accusing them of violating the FACE Act after they protested outside a New Jersey synagogue in 2024.

During a news conference announcing the charges, Harmeet Dhillon, the assistant attorney general for the DOJ’s civil rights division, said the New Jersey case was the “first time in history” the FACE Act was used to “prosecute an attack civilly on a house of worship.”  

While the Trump administration has started to use the FACE Act in religion-related cases, it has also relaxed enforcement of the law against people who interfere with access to abortion clinics. 

Republican President Donald Trump pardoned 23 anti-abortion protesters convicted of violating the law within weeks of taking office in January 2025, and the DOJ released a memo that stated abortion-related cases should only be pursued in “extraordinary circumstances,” such as death, serious bodily harm or severe property damage. 

“This sent a very clear signal to anti-abortion extremists that this administration was OK and even encouraged anti-abortion violence, and we’ve seen the same people that were pardoned within Trump’s first week in office go right back out and start harassing abortion providers and their patients, whether that is putting together blockades or clinic invasions,” National Abortion Federation President and CEO Brittany Fonteno told States Newsroom. 

FACE Act followed murder of abortion provider, clinic sieges 

Tactics by the anti-abortion movement were starting to reach a fever pitch in the U.S. before the FACE Act’s passage. In 1988, hundreds of protesters were arrested in Georgia during the “Siege of Atlanta,” where abortion opponents staged routine clinic blockades over a three-month period. In 1991, thousands of anti-abortion protesters were arrested by local officials for invading abortion clinics in Kansas during the “Summer of Mercy.” 

“We were literally unable to do our jobs,” said Burkhart, who worked in Wichita that summer with Dr. George Tiller, a provider who was later killed by an anti-abortion extremist. 

In 1993, Dr. David Gunn was murdered by an anti-abortion protester outside a Florida clinic, and six months later, Tiller was shot outside his Kansas clinic. Tiller survived that attack, but he was assassinated at his church in 2009.  

Sen. Ted Kennedy and then-Rep. Chuck Schumer, both Democrats, introduced the FACE Act in Congress alongside former Republican Rep. Connie Morella, and President Bill Clinton signed the legislation the following year. 

Legal experts said the religious part of the reproductive health law was added to broaden legislative support for the bill. 

The law protects reproductive health clinics and places of worship from being physically obstructed or damaged, and makes it a federal crime to intentionally injure, intimidate or interfere with access to those places. Violators face up to a year in prison or a $10,000 fine, and up to six months in prison for nonviolent obstruction. A defendant could face 10 years if they inflicted bodily harm or life behind bars if someone is killed.  

Mary Ziegler, an abortion historian and professor at the University of California, Davis School of Law, said the measure was modeled on other civil rights laws, which typically include protections for religious institutions. She said Congress already had a Democratic majority at the time, but the religious part of the law could have been added to avoid accusations of viewpoint discrimination. 

“Even people who saw themselves as pro-life were disturbed by some of the violence,” Ziegler said. 

After the law took effect, violence against abortion clinics declined by 30%, according to the National Abortion Federation. 

The power of anti-abortion groups like Operation Rescue, known for orchestrating mass clinic blockades, waned. 

“The FACE Act was created to suppress civil disobedience at abortion centers, so it’s had a massively negative impact on the anti-abortion movement,” said Terrisa Bukovinac, the founder of Progressive Anti-Abortion Uprising. 

Bukovinac’s group along with Students for Life of America and Alliance Defending Freedom have called for the law’s demise since the U.S. Supreme Court overturned the federal right to an abortion in June 2022. 

Trump reconfigures enforcement while abortion opponents call for repeal

Violence against abortion clinics increased after the Dobbs v. Jackson Women’s Health Organization decision. From 2021 to 2022, clinics saw a 100% increase in arsons, a 25% increase in invasions and a 20% increase in death threats or threats of harm, according to the National Abortion Federation. 

The Biden administration pursued enforcement of the FACE Act by prosecuting people convicted of blocking access to abortion clinics in Michigan, Tennessee and Washington, D.C. 

Trump pardoned all of those defendants. But for some abortion opponents, the Republican administration’s narrow use of the FACE Act does not go far enough. 

“It should be repealed because it’s a draconian law,” Bukovinac said. “There are local laws that address trespass, disorderly conduct, disruptions of churches, and various other violations of statutes, but the FACE law adds the full weight of the federal government in these situations.” 

Ziegler said the law isn’t a trespassing statute, it’s about conduct and obstruction. No legal challenges against the law have held up in court before or after Dobbs, she said. 

“If you’re shooting someone in the head because they’re trying to go to a synagogue or they’re trying to go into an abortion clinic — or you’re threatening to kill them or you’re physically blocking all the entrances — that’s not speech protected by the First Amendment,” Ziegler said. 

Matthew Cavedon, a criminal justice and religious liberty expert at the libertarian CATO Institute, has written that the law may be unconstitutional. He said the federal government has typically defended the FACE Act’s constitutionality based on the Commerce Clause and the 14th Amendment.

“Pro-lifers have made the point that in order to defend the FACE Act under the 14th Amendment, you have to have some sort of federal constitutional right to have an abortion,” Cavedon said. “Back in 1994 when the act passed, the Supreme Court said that you did have that right. It doesn’t anymore. That’s been reversed. So I think that’s a very strong argument.” 

U.S. Rep. Chip Roy, a Texas Republican, introduced a bill last year that would repeal the law. The House Judiciary Committee advanced the measure in June, States Newsroom reported. 

Roy did not respond to requests for comment, but during a hearing for the bill, he said he has been criticized by Trump administration officials who wanted to use the law to defend churches. 

“That’s not what my goal is,” he said. “My goal is to alleviate the politicization in the first place.”

Renee Chelian, the founder and CEO of Northland Family Planning Centers in Michigan, testified before the committee about the importance of the FACE Act and the invasion of one of her clinics during the first Trump administration. 

“Once the law went into effect, the violent blockades immediately stopped. This all ended when President Trump took office for his first term, emboldening extremists to resume their attacks,” she said. 

In August 2020, a group of protesters blocked the entrance to Chelian’s Sterling Heights clinics, preventing patients and staff from entering the clinic. 

“Patients were stuck in their cars, including three women who were coming in for abortions following the detection of fatal fetal anomalies,” Chelian said. One of those patients was losing amniotic fluid and needed to get to her appointment for the second day of her procedure, but protesters surrounded her car and chanted at her, her mother and her husband, according to the DOJ. 

Trump’s decision to pardon seven people who invaded her clinic “left us reliving our trauma and feeling abandoned by the government that is supposed to protect us,” Chelian told lawmakers. 

Last month, the Center for Reproductive Rights sued the Trump administration after the government did not respond to Freedom of Information Act requests about “selective enforcement” of the FACE Act and Trump’s pardons of 23 anti-abortion protesters convicted under the law. 

“This is straight out of the anti-abortion movement’s playbook,” said Sara Outterson, the center’s chief federal legislative counsel. “They know they can’t ban abortion outright in a number of states, so they’ll try everything they can to restrict access to care, including allowing criminals to harass people as they try to go in to get care.”