NIRH Launches 2021 Local Reproductive Freedom Index: Analysis and Call for Local Action Across the Country

November 8, 2021
Contact: [email protected]

Reproductive freedom advocacy group publishes extensive policy analysis,  calls for municipalities to protect abortion access, support families, and more 

NEW YORK — Today, the National Institute for Reproductive Health published the 2021 Local Reproductive Freedom Index, a one-of-a-kind analysis of how 50 cities across the U.S. are addressing reproductive health, rights, and justice issues across 34 policies — and a call to action for local elected officials to use all the tools at their disposal to fight for reproductive freedom.  

NIRH has long worked at the local levels of government and advocacy, pushing elected leaders to innovate through local action to mitigate harm by state and federal government. With the Supreme Court poised to shred Roe vs. Wade, it’s never been more relevant to move forward city-level proactive policies.  

This year’s report looks at how cities addressed the intersection of reproductive freedom with the major events of 2019-2020, such as the onset of the COVID-19 pandemic, uprisings for racial justice, unprecedented restrictions on abortion care, and attacks upon voting. 

 “Cities are at the forefront of the battle to protect and advance reproductive freedom,” said Andrea Miller, president of the National Institute for Reproductive Health. “From funding abortion to addressing maternal health disparities to passing paid leave, every city has a role to play in this fight. With municipal elections in major cities across the country last week, the Local Index is an important tool for newly elected officials and administrations looking to fight for reproductive freedom.”  

Highlights from the 2021 Local Index 

  • The nation’s first Reproductive Justice Commission, Atlanta: In October 2019, NIRH worked with advocates in the Amplify GA coalition and elected officials in the Atlanta City Council to establish a first-of-its-kind Reproductive Justice Commission in Atlanta, GA. This commission is now up and running, with five champions for repro freedom, including abortion providers, and commissioners 
  • Funding Abortion Access, Austin & New York City: In 2019, NIRH helped Austin, TX, and New York, NY become the first cities in the country to directly fund abortion care through their municipal budgets; renewed in 2020 and 2021 
  • Recognizing Abortion Provider Appreciation Day, Multiple Cities: To honor abortion providers, Austin, TX; Atlanta, GA; Minneapolis, MN; St. Louis, MO; and St. Paul, MN all issued proclamations recognizing Abortion Provider Appreciation Day. 2020 
  • Free Diapers During COVID-19 Pandemic, Baltimore: The Baltimore City Health Department distributed 500,000 diapers to city residents during the pandemic in 2020 
  • Addressing Maternal Health Disparities, Richmond, VA: In 2019 the mayor of Richmond and the Richmond City Health Department convened Greater Richmond Regional Maternal Child Health Taskforce, to address racial disparities in maternal health outcomes (continues through today) 

In addition to a policy agenda for cities to follow, the 2021 Local Reproductive Freedom Index offers cities a scorecard, with a star rating from 0-5, to assess how a city is progressing on advancing reproductive freedom. The average score for cities in the 2021 Local Index is 2.2, with cities ranging from a low of .5 to a high of 4.5.  The higher-scoring cities tend to be the more well-resourced cities on the coasts as you might expect (like San Francisco, New York, Los Angeles, Washington, DC) but several mid-sized cities in the middle of the country – like Columbus, Madison, Minneapolis/St. Paul, Nashville, and St. Louis – also stand out for taking a host of actions aimed at advancing reproductive freedom.   

“We know that real progress often starts at the local level – and now is the time for cities to stand tall and protect their residents against harmful actions by state lawmakers and the federal judiciary who are hostile to reproductive freedom,” Miller continued. “Whether a city has yet to act, or if it’s one of the highest-scoring cities in the Local Index, every municipality has a role to play to improve the lives of its residents and support their ability to make decisions about their reproductive lives – and the 2021 Local Index charts the course for how to do so.” 



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.