New Report Shows States Accelerating Protections for Abortion Access in 2019, As Part of Passing Many of the Boldest and Most Proactive Laws in a Generation to Advance Reproductive Freedom

January 6, 2020
Contact: Marisa Rodriguez, [email protected], 956-607-9952

The National Institute for Reproductive Health (NIRH) worked to pass a number of proactive reproductive health and rights policies in states in 2019; its “Gaining Ground” Report Highlights that 38 States and D.C. Enacted a Record 147 Proactive Reproductive Health, Rights, and Justice Bills

New York – A new report from the National Institute for Reproductive Health (NIRH) highlights how 38 states and the District of Columbia stepped up for reproductive freedom this year by enacting a record 147 bills that protect and advance reproductive health, rights, and justice. NIRH worked to pass a number of these proactive policies, and its Gaining Ground: Proactive Reproductive Health and Rights Legislation in the States report is a review of all the proactive state legislation introduced, moved, or enacted to advance and protect reproductive freedom over the course of 2019. The report finds a total of nearly 1,000 bills in all and provides policy recommendations for state advocates and legislators to follow as they carry this momentum forward into 2020.

“Advocates and elected officials led a powerful movement for reproductive freedom in 2019, introducing nearly a thousand proactive and passing a record 147 bills — more protections for reproductive health, rights, and justice, including abortion access, than in any previous year,” said Andrea Miller, President of the National Institute for Reproductive Health. “NIRH worked early in the year to pass the Reproductive Health Act in New York, and with partner states apply the lessons learned from that early victory to pass proactive laws in other states. Our Gaining Ground report shows that the groundwork NIRH and our allies at the state level have laid for many years is coming to fruition, as many states are acting with a fierce urgency to protect access to reproductive health care, including abortion, in the face of mounting attacks from hostile state legislatures and the federal government.”

In 2019, dozens of states around the country stepped up to advance the full spectrum of reproductive health care, including access to abortion, maternal health care, and contraception. According to the report, significant trends in 2019 illustrate that even in the face of abortion bans and other egregious attacks on our rights, a full-fledged countermovement is in fact underway:

  • Expanding Abortion Access: A record nine states enacted legislation to protect and expand abortion rights and access. Among these wins, Illinois, New York, Rhode Island, and Vermont all enacted laws that codify a fundamental right to abortion. Maine guaranteed Medicaid coverage for abortion, and Nevada repealed a criminal ban on self-managed abortion.
  • Improving Maternal Health: A striking 41 states – from progressive states like New York, New Jersey, and Illinois to conservative strongholds like Arkansas, Georgia, and Oklahoma – took steps to improve maternal health outcomes. This included establishing maternal mortality review boards in a dozen states, reforms to Medicaid coverage for pregnant women, and expanding access to midwives and doulas.
  • Power of Electoral Wins: States across the country leveraged the power of electoral wins to advance proactive policy, as midterm electoral shifts in 2018 to pro-choice governing trifectas in Illinois, Maine, Nevada, and New York enabled these states to enact proactive abortion legislation within the first six months of 2019.
  • Preparing for Political Shifts: Even in states that have not yet achieved a pro-choice majority, state legislators used bill introductions as rallying cries to build a stronger movement in support of reproductive freedom, with states like Arizona, Minnesota, Texas, and Virginia each introducing a significant number of proactive reproductive health and rights bills, ranging from 23 bills in Arizona to 65 bills in Texas.

In addition to analyzing 2019 policies, the report offers specific policy recommendations for state lawmakers and advocates to move forward in 2020 — especially against the backdrop of the 2020 elections. NIRH points to nine bold policy priorities that states should consider for the new year, including: codifying into state law the right to decide to have an abortion; protecting the health of women, transgender men, and other people who can become pregnant who are incarcerated by prohibiting shackling during pregnancy, requiring nutrition standards, and supporting breastfeeding programs; and enacting legislation providing insurance coverage for the full range of reproductive health care.

“Significant progress has been made every year since NIRH started tracking proactive legislation — driven by voters’ demands and expectations that states prioritize abortion access, along with other essential reproductive health, rights, and justice policies,” Miller said. “This public demand that states take action to protect abortion access and other reproductive health matters has been made clear in 2019 through the popular uprising against abortion bans, through electoral wins in places like Kentucky and Virginia, and through the outpouring of support for the march of proactive legislation in state after state. NIRH is eager to head into 2020 with this year’s momentum at our backs, ready to push forward with our partners to establish bold protections for reproductive health, rights, and justice.”

“As we begin 2020, NIRH remains committed to pushing these efforts forward, working with even more states to ensure that their laws are as strong as they can be to advance reproductive freedom.”


The National Institute for Reproductive Health builds power at the state and local level to change public policy, galvanize public support, and normalize women’s decisions about abortion and contraception.

Using a partnership model, NIRH provides state and local advocates with strategic guidance, hands-on support, and funding to create national change from the ground up. We form strategic partnerships with a wide range of organizations to directly impact the reproductive health and lives of women across the country. Each year, NIRH works in about half the states and more than a dozen localities; to date, NIRH has partnered with 175 reproductive health, rights, and justice organizations in 43 states and 64 localities across the country.