Guttmacher Celebrates 40 Years of Bringing Science and Research to Reproductive Health

Sharon Camp

This year, the Guttmacher Institute celebrates forty years of promoting the core belief that scientific evidence can and should shape public policy.

This year, the Guttmacher Institute
celebrates its 40th anniversary. Although the Institute has evolved
in many ways over the past four decades, one thing has remained constant:
the core belief that scientific evidence can and should shape public
policy. Our experience has only strengthened our conviction that well-designed,
rigorously conducted research, compellingly presented and systematically
disseminated to the right people, can fundamentally shift the public
debate and help usher in critical policy and program reforms. 

Join me in looking back over
the past four decades, and in noting four of Guttmacher’s defining
institutional achievements that are testimony to the power of science
to drive human progress:  

1.
Helping to Create a National Network
of Family Planning Clinics
 

In 1970, landmark federal legislation
was enacted establishing a national family planning program. The purpose
of the new law — Title X of the Public Health Service Act — was to address
the unmet contraceptive needs of low-income women and narrow the wide
gap between rich and poor women in unintended pregnancy. Two years before,
as congressional deliberations were just getting under way, the Center for Family
Planning Program Development

was born. Alan
F. Guttmacher
,
one of the country’s most eminent obstetrician-gynecologists and then-president
of the Planned Parenthood Federation of America, recognized the need
for the Center and nurtured its development as a semiautonomous division
within Planned Parenthood.  

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The Center was determined not
just to shepherd the Title X legislation through Congress, but also
to ensure that the new program would endure — because it would be built
on sound science. Throughout the 1970s, the Center’s expert staff
provided hands-on assistance in developing the network of clinics authorized
under Title X by creating regional family planning councils; helping
state agencies and community clinics make an evidence-based case for
Title X funding; guiding prospective Title X grantees through the application
process; and fostering best practices in family planning services, as
documented by the Center’s ongoing research. 

In 1974, following Alan Guttmacher’s
death, the Center was renamed in his honor, and in 1977, it became an
entirely independent agency. Meanwhile, the Title X clinic network grew
to encompass more than 4,000 family planning clinics, serving more than
four million low-income women and teens. By the 1990s, Guttmacher research
was able to document a substantial narrowing of gaps in contraceptive
use and unintended pregnancy among women in different racial, ethnic
and income groups, proof of the public health benefits brought about
by Title X.  

Today, there are family planning
clinics in nine out of every 10 U.S. counties, which together constitute
a major national provider of preventive health care. According to Guttmacher
data
, one in four
U.S. women of reproductive age who obtain a contraceptive service, one
in three who obtain an STI service and one in six who obtain either
a Pap test or a pelvic exam do so at a Title X family planning clinic.  

While Title X funding continues
to play a key role in the U.S. family planning effort, Guttmacher research
has also documented a fundamental
transition in financing for family planning services
. Medicaid has gradually overtaken
Title X as the principal source of support, accounting, by 2005, for
more than 70% of all family planning public funding. This sea change
came about in no small measure because of innovative income eligibility
expansions first developed in a handful of states in the early 1990s.
The original advocate for these programs, Guttmacher has since served
as a clearinghouse for information on their operations and impact, as
well as provided technical assistance to states engaged in the arduous
process of obtaining the required federal approval to expand coverage.  

Thanks in part to our efforts,
three in four American women in need of publicly subsidized family planning
now live in a
state where expanded Medicaid coverage is available
. In 2006, Guttmacher
research showed

the potential these Medicaid program expansions have to reduce unintended
pregnancy and the need for abortion while saving federal and state dollars.
These findings helped accelerate efforts to extend these programs nationwide
and rocketed the issue to the top of the reproductive health and rights
agenda. 

2.  Putting–and
Keeping–Teenage Pregnancy on the Policy Agenda
 

The Institute’s blockbuster
report "11 Million Teenagers," published in 1976, was a wake-up
call for Americans, providing the first comprehensive picture of adolescent
sexual activity and its consequences. It documented that 11 million
teenagers — the overwhelming majority of whom were unmarried — were
already sexually active, and that one million of them were getting pregnant
every year. The report put teen pregnancy on the policy agenda and refocused
the debate in the United States, spurring the development of teen pregnancy
prevention programs across the country. The incidence of teenage pregnancy,
which peaked in 1991, had declined by a whopping 36% by 2005. 

Unfortunately, increased support
for adolescent services and sex education generated its own opposition
in the form of the abstinence-only-until-marriage education movement
and a wave of "junk science" claiming a key role for abstinence
in recent teen pregnancy declines. Guttmacher moved quickly to counter
this growing threat to evidence-based policies with a series of analyses
showing that declines in teen pregnancy were due mainly to improved
contraceptive use
,
not less sex. As federal abstinence-only programs became more hard-line,
targeting not only young teens but also unmarried adults as old as 29,
Guttmacher countered with research showing that 95% of
Americans have sex before marriage
— and
have done so for three generations.  

The Institute has also expanded
its focus to include teens in the developing world as well. Early this
year, the Institute released the last of a dozen studies based on qualitative
research and national surveys of nearly
20,000 African adolescents aged 12-19
.
The studies make clear that meeting their needs will be critical to
preventing unintended pregnancy and halting the AIDS epidemic in Africa. 

3. Achieving Contraceptive
Equity in Prescription Drug Coverage
 

In addition to charting the
path toward sexual and reproductive health coverage in the public sector,
Guttmacher has played a pivotal role in the fight to increase coverage
of these services by private health insurance plans. Amidst the Clinton-era
uproar over health care reform, Guttmacher’s 1993 study of insurance
coverage for reproductive health care put the issue of contraceptive
coverage on the map. It showed that coverage patterns, in the words
of the study report’s title, were wildly "uneven and unequal."
The Institute’s study galvanized broad support for change at the federal
and state levels.

In 1997, a bipartisan group
of members of Congress introduced legislation requiring coverage of
contraceptive services and supplies in health plans nationwide. Although
that bill has yet to pass, Congress did move in 1998 to require coverage
in the largest employer-sponsored health insurance program in the country,
the constellation of plans offered to federal employees, retirees and
their dependents.  

Meanwhile, even more significant
progress was occurring at the state level. Beginning with California
in 1994, only months after publication of the Guttmacher study, measures
to require coverage of contraceptive services began to be introduced
in state legislatures. Maryland was the first state to enact such a
law, in 1998; eight states followed suit the next year. Today, fully 27
states mandate coverage
,
and 54% of women of reproductive age live in a state that requires contraceptive
coverage in insurance plans that offer presecription drug coverage. 

A follow-up Guttmacher study
conducted in 2002 cast this progress in sharp relief. By that year,
nearly nine in 10 group insurance plans purchased by employers for their
employees covered a full range of prescription contraceptives-three
times the proportion just a decade earlier. Moreover, the proportion
of plans covering no method at all plummeted from 28% to only 2%. 

4. Understanding Abortion
in Women’s Lives
 

The legalization of abortion
in 1973 was an immense stride forward in self-determination for American
women. Given the different levels of abortion reporting among states,
however, there was no accurate count of how many women chose abortion,
much less any clear picture of who they were, what kind of care they
received or why they chose to terminate a pregnancy. 

The Institute recognized that
a lack of reliable data on abortion would only work to the advantage
of a growing antiabortion movement. In 1974, Guttmacher helped fill
in the blanks with its first of 14 periodic censuses of U.S. abortion
providers. In its most
recent survey of abortion providers
,
released in January 2008, Guttmacher documented the continuing — if
somewhat slowed — decline in U.S. abortions. These surveys still provide
the most comprehensive estimate of abortion incidence in the United
States. Although abortion remains one of the most divisive issues in
American politics, partisans on all sides of the abortion debate accept — and
use — Guttmacher data.  

Guttmacher’s periodic counts
of U.S. abortion procedures have also helped make possible accurate
calculations of unintended pregnancy — the underlying cause of nearly
all abortions. In addition, the Institute’s quantitative and qualitative
research on U.S. abortion patients has helped
put a human face on abortion
,
showing, for example, that fully six in 10 women seeking abortion already
have one or more children and that nearly all women make the decision
to terminate a pregnancy out of concerns for their responsibilities
to other family members.  

Recent Guttmacher studies also
document the growing
disparities in unintended pregnancy and
abortion
between
rich and poor women in America. After years of declining unintended
pregnancy rates among low-income women (largely a result of public support
for family planning services), the
gap between rich and poor is again increasing

Women living in poverty are
now four times as likely to have an unintended pregnancy, three times
as likely to have an abortion and five times as likely to have an unplanned
birth as are other women. Poor women seeking abortion are also more
likely to have their abortions later than they want — an average of
two weeks later than nonpoor women — because in the absence of public
funding, they face multiple financial and logistical barriers to timely
procedures.  

Worldwide
and regional abortion estimates

jointly released in October 2007 by the Guttmacher Institute and the
World Health Organization showed that the lowest rates of abortion are
in the western European countries that place few restrictions on abortion
and provide easy access to contraceptives and comprehensive sex education.
The sharpest declines in abortion over the past decade occurred in neighboring
eastern Europe, where access to and use of modern methods of contraception
soared after the collapse of the Soviet Union. The highest rates are
in Latin America and Sub-Saharan Africa, where almost all abortions
are illegal. These data are crucial to informing better, evidence-based
policies and interventions in countries around the world. 

Visit the Guttmacher Institute’s
website
for more information about the Institute and its work.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

Analysis Abortion

Legislators Have Introduced 445 Provisions to Restrict Abortion So Far This Year

Elizabeth Nash & Rachel Benson Gold

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

So far this year, legislators have introduced 1,256 provisions relating to sexual and reproductive health and rights. Of these, 35 percent (445 provisions) sought to restrict access to abortion services. By midyear, 17 states had passed 46 new abortion restrictions.

Including these new restrictions, states have adopted 334 abortion restrictions since 2010, constituting 30 percent of all abortion restrictions enacted by states since the U.S. Supreme Court decision in Roe v. Wade in 1973. However, states have also enacted 22 measures this year designed to expand access to reproductive health services or protect reproductive rights.

Mid year state restrictions

 

Signs of Progress

The first half of the year ended on a high note, with the U.S. Supreme Court handing down the most significant abortion decision in a generation. The Court’s ruling in Whole Woman’s Health v. Hellerstedt struck down abortion restrictions in Texas requiring abortion facilities in the state to convert to the equivalent of ambulatory surgical centers and mandating that abortion providers have admitting privileges at a local hospital; these two restrictions had greatly diminished access to services throughout the state (see Lessons from Texas: Widespread Consequences of Assaults on Abortion Access). Five other states (Michigan, Missouri, Pennsylvania, Tennessee, and Virginia) have similar facility requirements, and the Texas decision makes it less likely that these laws would be able to withstand judicial scrutiny (see Targeted Regulation of Abortion Providers). Nineteen other states have abortion facility requirements that are less onerous than the ones in Texas; the fate of these laws in the wake of the Court’s decision remains unclear. 

Ten states in addition to Texas had adopted hospital admitting privileges requirements. The day after handing down the Texas decision, the Court declined to review lower court decisions that have kept such requirements in Mississippi and Wisconsin from going into effect, and Alabama Gov. Robert Bentley (R) announced that he would not enforce the state’s law. As a result of separate litigation, enforcement of admitting privileges requirements in Kansas, Louisiana, and Oklahoma is currently blocked. That leaves admitting privileges in effect in Missouri, North Dakota, Tennessee and Utah; as with facility requirements, the Texas decision will clearly make it harder for these laws to survive if challenged.

More broadly, the Court’s decision clarified the legal standard for evaluating abortion restrictions. In its 1992 decision in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court had said that abortion restrictions could not impose an undue burden on a woman seeking to terminate her pregnancy. In Whole Woman’s Health, the Court stressed the importance of using evidence to evaluate the extent to which an abortion restriction imposes a burden on women, and made clear that a restriction’s burdens cannot outweigh its benefits, an analysis that will give the Texas decision a reach well beyond the specific restrictions at issue in the case.

As important as the Whole Woman’s Health decision is and will be going forward, it is far from the only good news so far this year. Legislators in 19 states introduced a bevy of measures aimed at expanding insurance coverage for contraceptive services. In 13 of these states, the proposed measures seek to bolster the existing federal contraceptive coverage requirement by, for example, requiring coverage of all U.S. Food and Drug Administration approved methods and banning the use of techniques such as medical management and prior authorization, through which insurers may limit coverage. But some proposals go further and plow new ground by mandating coverage of sterilization (generally for both men and women), allowing a woman to obtain an extended supply of her contraceptive method (generally up to 12 months), and/or requiring that insurance cover over-the-counter contraceptive methods. By July 1, both Maryland and Vermont had enacted comprehensive measures, and similar legislation was pending before Illinois Gov. Bruce Rauner (R). And, in early July, Hawaii Gov. David Ige (D) signed a measure into law allowing women to obtain a year’s supply of their contraceptive method.

071midyearstatecoveragetable

But the Assault Continues

Even as these positive developments unfolded, the long-standing assault on sexual and reproductive health and rights continued apace. Much of this attention focused on the release a year ago of a string of deceptively edited videos designed to discredit Planned Parenthood. The campaign these videos spawned initially focused on defunding Planned Parenthood and has grown into an effort to defund family planning providers more broadly, especially those who have any connection to abortion services. Since last July, 24 states have moved to restrict eligibility for funding in several ways:

  • Seventeen states have moved to limit family planning providers’ eligibility for reimbursement under Medicaid, the program that accounts for about three-fourths of all public dollars spent on family planning. In some cases, states have tried to exclude Planned Parenthood entirely from such funding. These attacks have come via both administrative and legislative means. For instance, the Florida legislature included a defunding provision in an omnibus abortion bill passed in March. As the controversy grew, the Centers for Medicare and Medicaid Services, the federal agency that administers Medicaid, sent a letter to state officials reiterating that federal law prohibits them from discriminating against family planning providers because they either offer abortion services or are affiliated with an abortion provider (see CMS Provides New Clarity For Family Planning Under Medicaid). Most of these state attempts have been blocked through legal challenges. However, a funding ban went into effect in Mississippi on July 1, and similar measures are awaiting implementation in three other states.
  • Fourteen states have moved to restrict family planning funds controlled by the state, with laws enacted in four states. The law in Kansas limits funding to publicly run programs, while the law in Louisiana bars funding to providers who are associated with abortion services. A law enacted in Wisconsin directs the state to apply for federal Title X funding and specifies that if this funding is obtained, it may not be distributed to family planning providers affiliated with abortion services. (In 2015, New Hampshire moved to deny Title X funds to Planned Parenthood affiliates; the state reversed the decision in 2016.) Finally, the budget adopted in Michigan reenacts a provision that bars the allocation of family planning funds to organizations associated with abortion. Notably, however, Virginia Gov. Terry McAuliffe (D) vetoed a similar measure.
  • Ten states have attempted to bar family planning providers’ eligibility for related funding, including monies for sexually transmitted infection testing and treatment, prevention of interpersonal violence, and prevention of breast and cervical cancer. In three of these states, the bans are the result of legislative action; in Utah, the ban resulted from action by the governor. Such a ban is in effect in North Carolina; the Louisiana measure is set to go into effect in August. Implementation of bans in Ohio and Utah has been blocked as a result of legal action.

071midyearstateeligibilitytable

The first half of 2016 was also noteworthy for a raft of attempts to ban some or all abortions. These measures fell into four distinct categories:

  • By the end of June, four states enacted legislation to ban the most common method used to perform abortions during the second trimester. The Mississippi and West Virginia laws are in effect; the other two have been challenged in court. (Similar provisions enacted last year in Kansas and Oklahoma are also blocked pending legal action.)
  • South Carolina and North Dakota both enacted measures banning abortion at or beyond 20 weeks post-fertilization, which is equivalent to 22 weeks after the woman’s last menstrual period. This brings to 16 the number of states with these laws in effect (see State Policies on Later Abortions).
  • Indiana and Louisiana adopted provisions banning abortions under specific circumstances. The Louisiana law banned abortions at or after 20 weeks post-fertilization in cases of diagnosed genetic anomaly; the law is slated to go into effect on August 1. Indiana adopted a groundbreaking measure to ban abortion for purposes of race or sex selection, in cases of a genetic anomaly, or because of the fetus’ “color, national origin, or ancestry”; enforcement of the measure is blocked pending the outcome of a legal challenge.
  • Oklahoma Gov. Mary Fallin (R) vetoed a sweeping measure that would have banned all abortions except those necessary to protect the woman’s life.

071midyearstateabortionstable

In addition, 14 states (Alaska, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, South Carolina, South Dakota, Tennessee and Utah) enacted other types of abortion restrictions during the first half of the year, including measures to impose or extend waiting periods, restrict access to medication abortion, and establish regulations on abortion clinics.

Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.