Three years after a miscarriage that caused a severe, nearly septic infection because a Tennessee hospital denied her an abortion, Katy Dulong was looking forward to telling her story in a trial that was scheduled to begin Monday.

But this week, the state appealed to a higher court based on a new law passed by the legislature in March, and the court put the trial on hold indefinitely. It will now be months before the lower court can proceed.

Dulong had complications that led to a miscarriage in November 2022 at 16 weeks of pregnancy, long before fetal viability. Under the state’s abortion ban, which had only been in place for a few months, the hospital sent her home to miscarry on her own. When that didn’t happen, severe infection started to set in 10 days later, when she was able to get doctors to agree to help. The experience left her with post-traumatic stress disorder.

Tennessee bill expands attorney general rights to appeal case rulings

The delay in the legal case feels like the state trying to silence her and the other plaintiffs, she said.

“It’s shocking to me that there’s anyone in this world that would have such opposing views to think that our voices don’t matter,” Dulong said in an interview. “How are they taking away our voice right now?”

In a motion to dismiss in February, the state argued it couldn’t be sued by the plaintiffs under a term called sovereign immunity, and in April, the Tennessee Legislature passed a law making it harder to sue the state on the constitutionality of a state or government action. Legislators passed another bill allowing the state to automatically appeal a decision related to sovereign immunity.

Nicolas Kabat, a staff attorney at the Center for Reproductive Rights who has been working on the case with the plaintiffs, said the state has tried to have the case dismissed four times without success, and said this is just the latest move to delay the trial. But he said the latest laws passed by the legislature allowing automatic appeals in the middle of a case, on the eve of a trial, make the situation unique.   

“There is nothing unusual about appealing an appealable order,” said Phil Buehler, press secretary for Tennessee Republican Attorney General Jonathan Skrmetti, in an email Thursday.

Similar lawsuits are ongoing or have already been resolved in several states with bans, including Texas and Idaho, where state residents have challenged the law based on their personal experiences. Plaintiffs in Idaho won their case in April 2025, when a judge said the near-total abortion ban does not mean a pregnant patient’s death has to be imminent or “assured” to perform an abortion. Complaints are also pending related to Texas hospitals allegedly not complying with federal law mandating emergency room treatment for a patient who needs an abortion as stabilizing care.

Women with serious pregnancy complications sue over state abortion bans

Allie Phillips, the lead plaintiff in Tennessee, joined several other women to sue the state in September 2023, alleging that the abortion ban put their health and lives in jeopardy when they were pregnant. They asked the state to clarify the law so that health is considered in an abortion decision, not just an immediate threat to a pregnant patient’s life. The way the law is written, attorneys argue, is too vague to allow for those exceptions.

Phillips and Nicole Blackmon, another plaintiff, had fetuses with anomalies related to the development of vital organs. Blackmon couldn’t afford to travel out of the state for an abortion, and eventually had to stop working because the pregnancy was affecting her health. She delivered a stillborn baby in her seventh month of pregnancy. Phillips raised enough money to seek an abortion in New York, only to find when she got there that the fetus had already died.

After the court granted a temporary block on the law as it relates to pregnancy complications, the state passed several laws that affected the case. The first bill, meant to clarify the state’s health exception for an abortion, was enacted in April 2025 but didn’t solve the issue, Kabat said. The language still wasn’t clear enough, and the court agreed and allowed the suit to continue.

Kabat said the legal team will continue its effort to clarify Tennessee’s laws so that stories like Dulong’s don’t happen to others.

“No matter how long this takes, we’re going to get the trial, we’re going to get these stories heard and we’re going to seek accountability from the state,” Kabat said.

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.

States with and without abortion bans are advancing bills that would shield anti-abortion pregnancy resource centers from certain government mandates and attempts at regulation, allowing them to sue for damages if any part of the law is violated.

At least four states introduced the legislation this session, and two of them, Kansas and Wyoming, made it law. Montana also passed a similar law in 2025. The bills are still pending in Oklahoma and New Hampshire.

They are based on model legislation drafted by the Alliance Defending Freedom, a conservative legal advocacy group that represented one of the large umbrella organizations for pregnancy centers around the country, National Institute of Family and Life Advocates, when the California government attempted to regulate the centers in 2018 by requiring signage to be placed informing clients of available abortion options at state-funded clinics.

“This really just reflects the legal reality that pregnancy care centers have been hauled into court when they’ve decided they are not interested in pushing abortion and (the government is) going to make them,” said Kristi Hamrick, vice president of media and policy for the anti-abortion group Students for Life Action.

Many crisis pregnancy centers are faith based, with a mission of preventing anyone who walks in from choosing an abortion. In a recent 50-state analysis, States Newsroom found that 21 states allocated more than $491 million of taxpayer funds to crisis pregnancy centers since the U.S. Supreme Court’s Dobbs decision in 2022 that upended federal abortion rights. Medical experts, including the American College of Obstetricians and Gynecologists, say the centers can endanger public health by delaying legitimate health care and some centers that advertise services like free ultrasounds can miss diagnoses like ectopic or molar pregnancies, which are nonviable and can be life-threatening conditions.

The centers have also been criticized by advocates for misleading potential clients about their services, making it look like they provide abortion care, and for promoting treatments like abortion pill reversal that are unproven and potentially dangerous.

California’s law, which the U.S. Supreme Court struck down in 2018 on free speech grounds, also mandated disclosure if the pregnancy resource center was unlicensed. Violators would be fined $500 for a first offense.

Hamrick said the center protection bills are an “inoculation” against what she called malicious lawsuits that would punish them for refusing to go against their anti-abortion mission.

Samantha Nagler, a legal fellow with the Equal Justice Works program at Gender Justice, said the bills are carving out an area of health care where providers can omit information during a visit and face no consequences for it.

“No other health care provider I can think of is just exempted from regulation,” Nagler said.

Israel Cook, legislative counsel for the Center for Reproductive Right’s policy and advocacy team, said this type of legislation is becoming more popular as reproductive rights advocates push for regulation of crisis pregnancy centers.

Colorado passed a law in 2023 making it a deceptive trade practice to disseminate any public advertisement that indicates a facility provides abortions or emergency contraceptives when they do not. The law included a similar provision barring advertisement of abortion pill reversal, but a federal judge blocked enforcement of that part of the law in August. Alliance Defending Freedom also assisted with that lawsuit.

“It’s very scary for (the centers) to not be on the hook for the kind of harm that they perpetuate,” Cook said.

Oklahoma sponsor: Law allows centers to ‘stay in their lane’

The bills prohibit a state or local government from adopting or enacting a law, rule, ordinance or any other type of regulation that would require a center to offer or perform abortion, make referrals for abortion or abortion medication, or post any type of advertisement or material promoting abortion or abortion medication. Every bill, with the exception of Kansas, also says the centers cannot be compelled to offer or refer for contraception.

The Kansas Legislature passed House Bill 2635 on March 12 and overturned a veto by Democratic Gov. Laura Kelly on Friday. Kelly said she vetoed it because Kansans already voted to keep the government out of private medical decisions in 2022, preventing lawmakers from passing an abortion ban. Kelly also opposes the funding that crisis pregnancy centers receive from the state on an annual basis — the legislature approved $3 million in 2025, on top of a $10 million tax credit program.

Oklahoma’s House of Representatives overwhelmingly passed a similar bill in early March, but it hasn’t yet been heard by the Senate. It was sponsored by Republican Rep. Denise Crosswhite Hader, who said it was legislation that allowed the centers to continue their mission.

Oklahoma’s bill prescribes the largest penalties with an allowance for treble damages, which means a successful lawsuit could yield three times the amount of damages proven in court. A pregnancy center would be entitled to at least $10,000.

“I don’t see abortion as care. I see abortion as ending a pregnancy,” she said on the House floor during debate. The centers want to help with continuing a pregnancy, she said, but when they avoid abortion, they’re getting sued, “and what we’re trying to do is help it so that they can stay in their lane and not fight lawsuits over and over.”

The state government allocated $18 million to a revolving grant fund for crisis pregnancy centers in 2024 that will last through November 2027.

Oklahoma has a near-total abortion ban, with no exceptions for rape or incest, only an exception to save a pregnant person’s life. With that in mind, Democratic Rep. Cyndi Munson told States Newsroom she doesn’t see the need for the legislation.

“If a private organization has a policy, they can stick to their policy. I don’t know why we need to put additional protections into law,” Munson said.

Meanwhile, Oklahoma’s health care struggles continue, according to Munson. The state ranked 46th in infant mortality in a report from the nonprofit March of Dimes, and 31st in maternal mortality. But reproductive health care in general can also be difficult to obtain. Munson said she recently had to wait an entire year to receive her annual gynecological exam because her provider is overbooked.

She worries that at a certain point, crisis pregnancy centers will be the only type of health care that’s left, especially in more rural parts of the state.

“Not every woman is looking for abortion access, but they all need reproductive health care,” Munson said.