NEW REPORT: Five Most Abortion-Forward Cities in Abortion-Ban States

December 13, 2023
For immediate release
Contact: [email protected]

The National Institute for Reproductive Health releases research that shows cities are becoming an effective tool against anti-abortion state majorities.  

NEW YORK — Today, the National Institute for Reproductive Health (NIRH) released a new report identifying the nation’s five most abortion-forward cities in states with anti-abortion state majorities that have banned abortion at some point in pregnancy — St. Louis, MO; Cleveland, OH; Austin, TX; Madison, WI; and Columbus, OH. This data, collected from January 1, 2021 – December 31, 2022, shows cities and counties are emerging as leaders in resisting state led anti-abortion agendas. 

Statement from Kelli García, Interim Vice President of Programs and Partnerships, National Institute for Reproductive Health:

“This is a message to elected allies in cities and counties across this country — the power sits with you. We commend allies, advocates, and activists for resisting anti-abortion state majorities, especially in a post-Roe era, and advancing bold and transformative reproductive freedom policies. This is what proactive power looks like.”

Statement from Virginia Mayer, Executive Director of the Democratic Mayors Association:

 “Mayors have taken action to protect and expand reproductive freedom, including access to abortion. We are proud to see Mayors and other local officials proactively supporting reproductive health including abortion access, especially in the face of hostile state political climates. We support a common vision for progress and inclusive growth across communities, and supporting access to abortion care embodies the mayoral values we’re proud to support.”

NIRH scored the 26 most populous cities in abortion ban states on a zero to five scale based on the following proactive policy categories:

  • Protecting abortion access
  • Funding and coverage of reproductive health care
  • Supporting young people
  • Supporting families
  • Building healthy and just communities
  • Proclaiming local values


These cities, listed below, demonstrated a deep understanding of the impact and importance intersecting policies have on a community’s reproductive freedom. Already, we’ve seen record-breaking state and local dollars allocated to reproductive health care programs in the one year since Roe v. Wade was overturned. Advocates aren’t stopping at funding. They’re also addressing discrimination for reproductive health decisions and shattering stigma through resolutions supporting abortion rights and access. 

The Top Five Abortion-Forward Cities In Hostile States: 

St. Louis, Missouri (3.5 stars): Missouri bans all abortion and has anti-abortion state majorities, but the city of St. Louis:

  • Protects abortion access with anti-discrimination ordinances for employees and for housing, based on reproductive health decisions, and providing public awareness about access to abortion care 
  • Bolsters funding and coverage for reproductive health by funding logistical support to access abortion out of state
  • Stands strong in the political climate by creating a positive public awareness campaign to educate people who may need to access abortion care out-of-state..  


Cleveland, Ohio (3 stars): Ohio bans abortion after 22 weeks and has anti-abortion state majorities, but the city of Cleveland: 

  • Protects abortion access with anti-discrimination ordinances for employees based on reproductive health decisions  
  • Bolsters funding and coverage for reproductive health by providing funding for logistical support to access abortion care; 
  • Protects abortion clinics and providers 
  • Stands strong in the political climate by making key commitments related to fighting the criminalization of care, funding for travel and other logistics related to accessing abortion care, and insurance coverage of abortion care for municipal employees. 


Austin, Texas (3 stars): Texas bans all abortion and has anti-abortion state majorities, but the city of Austin: 

  • Protects abortion access with anti-discrimination ordinances for employees and housing based on reproductive health decisions, and local protections for abortion clinics and providers; 
  • Bolsters funding and coverage for reproductive health by providing funding for logistical support to access abortion care out of state;    
  • Stands strong in the political climate by passing the GRACE Act, limiting the involvement of law enforcement in reproductive health care decisions and protecting and educating people seeking abortion care and birth control.  


Madison, Wisconsin (2.5 stars): Wisconsin bans abortion after 22 weeks and has an anti-abortion state legislature, but the city of Madison: 

  • Bolsters funding and coverage for reproductive health by providing logistical support to municipal employees seeking abortion care;  
  • Protects abortion access with local protections for abortion clinics and providers and providing public awareness about access to abortion care; 
  • Stands strong in the political climate with support for abortion coverage. 


Columbus, Ohio (2.5 stars): Ohio bans abortion after 22 weeks and has anti-abortion state majorities, but the city of Columbus:

  • Bolsters funding and coverage for reproductive health by providing logistical support funding to access abortion;  
  • Stands strong in the political climate by opposing the deceptive practices of anti-abortion pregnancy centers and deprioritizing criminal investigations of abortion providers and patients seeking abortion care.  


NIRH was the first national reproductive rights advocacy organization focused on proactive state and local policies. Proactive policies at the local level are becoming a more popular tool in states where anti-abortion politicians hold the majority or pro-abortion state majorities leverage local level re-enforcements.   

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The National Institute for Reproductive Health (NIRH) works to protect and advance just and equitable access to reproductive health care. Our strategy is to go on the offensive to pass laws that safeguard reproductive freedom. NIRH builds coalitions, launches campaigns, and successfully advocates for policy change in partnership with state and local reproductive health, rights, and justice organizations and allied groups. We work together so that the fabric of reproductive freedom is harder to tear apart.