Abortion, Contraception, and Sex Ed in the States in 2008

Rachel Gold and Elizabeth Nash

In 2008, a few state legislatures took steps to promote reproductive health, by requiring hospitals to provide information on EC to rape survivors and laying the groundwork for expanding Medicaid family planning coverage.

Social issues, including those
related to reproductive health and rights, were not the top priority
in 2008 for state legislators, who mostly spent the year grappling with
budget crises and infrastructure issues even as they sought to shorten
their sessions so they could hit the campaign trail in advance of the
November elections. Nevertheless, 1,001 measures relating to reproductive
health and rights were introduced in 44 states and the District of Columbia
over the course of the year, and 33 new laws were enacted in 20 states.
(Six state legislatures did not meet in 2008.) 

While none of the 17 new abortion-related
laws expand access to services, a few states took significant steps
to promote reproductive health by requiring hospitals to provide information
on emergency contraception to women who have been sexually assaulted,
laying the groundwork for expanding Medicaid family planning coverage
and mandating insurance coverage of the human papillomavirus (HPV) vaccine. 

Meanwhile, voters in three
states cast ballots on abortion-related ballot initiatives in November,
all of which failed. The initiatives defeated in Colorado and South
Dakota would have banned abortion, the former by establishing personhood
at conception and the latter by banning abortion except in cases of
life endangerment, rape, incest or when the woman’s physical health
is extremely endangered. The measure defeated in California would have
required notification of a parent before a minor obtains an abortion;
this was the third time in four years that a parental notification proposal
was rejected by voters. 


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Over the course of the year,
nine states enacted new provisions, amended current law or continued
funding requirements related to abortion. Among the new laws is an omnibus
measure in Oklahoma -enacted over Gov. Brad Henry’s (D) veto – that
includes seven separate provisions.

  • Four states imposed
    ultrasound requirements on abortion providers, bringing the total number
    of states with these provisions to 16. Oklahoma’s new omnibus law
    requires all abortion providers to have ultrasound equipment on-site
    and to perform an ultrasound on every woman obtaining an abortion. 
    The provider is also required to verbally describe the image to the
    woman and position the monitor so she is able to see it, although the
    law explicitly permits the woman to avert her eyes if she desires. (This
    law is not in effect pending the outcome of a legal challenge.) 
    In Ohio and South Carolina, new laws require that the woman be offered
    the option to view an ultrasound image if the provider performs the
    test in preparation for the abortion. In South Dakota, the woman must
    be offered the option of undergoing an ultrasound. (See Requirements for

  • Two states enacted
    laws that purport to address the issues of coerced abortion. The omnibus Oklahoma
    measure requires abortion providers to post notices informing women
    that coerced abortion is illegal and that they can contact the authorities
    for assistance if needed. A new Idaho law makes it a crime to coerce
    a woman into having an abortion by either physically harming her or
    threatening to do so. These new laws are the result of efforts by abortion
    opponents to characterize abortion providers as often being complicit
    in forcing women to have abortions, despite the absence of data to substantiate
    their claims.

  • Six states addressed
    funding for abortion or alternatives to abortion. As part of its annual
    appropriations process, Maryland continued a long-standing limitation
    on the use of state Medicaid funds for abortions necessary in cases
    of life endangerment, rape, incest, fetal abnormality or when the woman’s
    physical or mental health is at risk. Iowa also used its budget process
    to continue its policy of paying for medically necessary abortions under
    Medicaid. (See State
    Funding of Abortion Under Medicaid

  • Oklahoma’s omnibus
    abortion law contains two provisions related to medication abortion.
    The first requires providers to follow the FDA-approved protocol, which
    would preclude offering women newer, widely used lower-dose regimens
    of the medication that have been found to be as effective with fewer
    side effects. The new law also limits the provision of medication abortion
    to physicians, despite the fact that advanced practice clinicians (such
    as physician assistants, certified nurse midwives and advanced nurse
    practitioners) are permitted to provide medication abortions (as opposed
    to surgical abortions) in many states; research has shown that they
    do so with the same level of safety and efficacy as physicians.

  • The Oklahoma law
    also has two provisions not found in any other measure enacted last
    year. One prohibits a woman from suing a medical provider who does not
    give full and accurate information about her pregnancy if the misinformation
    results in her carrying the pregnancy to term, provided that the wrongful
    act or omission does not place the woman’s life or health at risk.
    The other greatly expands the ability of health care professionals and
    facilities in the state to refuse to provide or refer for abortion.
    (See Refusing
    to Provide Health Services.


Contraception and Prevention 

  • Three laws enacted
    in 2008 were designed to improve access to contraceptives and other
    preventive services, while two new laws continued existing restrictions
    on state family planning funds.

  • Wisconsin became
    the 16th state to require hospitals to provide medically accurate and
    unbiased information about emergency contraception to women who have
    been sexually assaulted. Hospitals must also provide the medication
    upon request. (See Emergency

  • A new law in Colorado
    clears the way for the state to seek federal permission to expand Medicaid
    eligibility for family planning services. A fiscal note accompanying
    the bill indicates that the state Medicaid agency expects to seek to
    raise the ceiling to 200% of the federal poverty level. Currently, 27
    states have similar programs in place. (See Medicaid
    Family Planning Eligibility Expansions

  • Iowa enacted a provision
    requiring health plans issued in the state to cover the HPV vaccine
    if they include coverage for any immunization or vaccination. Four states
    (Colorado, Illinois, Nevada and New Mexico) adopted similar provisions
    in 2007.

  • Also in 2008, Colorado
    and Michigan re-enacted long-standing restrictions on state family planning
    funds. The Colorado law prohibits state family planning funds from going
    to organizations that provide abortion services with their own funds.
    Michigan barred the use of state family planning funds for abortion
    services, including counseling and referral. Two other states have similar
    restrictions. (See State
    Family Planning Funding Restrictions

Sex Education 

Unlike in 2007, when four states
took steps related to sex education, including measures in two states
to expand access to comprehensive sex education, the subject did not
elicit significant attention in 2008. In fact, the only enacted measure
related to sex education was one in New Hampshire, which permits a student
to be excused from health or sex education for religious reasons. With
this new law, 36 states and the District of Columbia permit students
to be excused from sex education classes. (See Sex and STI/HIV

For summaries of major state
legislative actions in 2008, click

For a table showing legislation
enacted in 2008, click

For the status of state law
and policy on key reproductive health and rights issues, click here.

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