The National Institute For Reproductive Health Releases City And County Scores On Reproductive Freedom     

The National Institute for Reproductive Health’s Local Reproductive Freedom Index shows promising growth and important opportunities to improve reproductive health, rights, and justice

[New York City, NY] – Today, the National Institute for Reproductive Health (NIRH) released its Local Reproductive Freedom Index (LRFI), a biennial scorecard that analyzes the reproductive freedom landscapes in the 50 most populous cities and counties across the country.

This report gives cities and counties a clear roadmap to becoming an LRFI Model City, which would support the freedom and ability of each person to control their sexual and reproductive lives, foster thriving families, and de-stigmatize abortion and contraception. The LRFI also highlights concrete actions cities can take to bolster abortion access, including cities in states that are politically hostile to abortion.  

With data collected from January 1, 2021, to December 31, 2022, the LRFI looks back on a time of intense turmoil in our country, including the year before the overturn of Roe v. Wade.  

Statement from Kelli García, NIRH Interim Vice President of Programs and Partnerships: “The National Institute for Reproductive Health’s LRFI is an important health check on the reproductive freedom landscape across localities. While state-level policies play a central role in reproductive freedom – including access to abortion – cities and counties can and should use all their levers of power to build healthy communities. We are proud to provide not only this unique analysis of city-based policy, but a clear roadmap for elected leaders and advocates to build model cities for reproductive freedom.”

NIRH scored the 50 cities and counties 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

Several cities stood out as especially abortion-forward despite their location in a state hostile to abortion access. St. Louis, MO; Cleveland, OH; Madison, WI; Austin, TX; and Columbus, OH each demonstrated a deep understanding of the impact and importance intersecting policies have on a community’s reproductive freedom.  

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.

The LRFI also includes a self-scoring tool for elected leaders and advocates to use anywhere they live. This tool will give a clear picture of where their city stands in building reproductive freedom.  


The National Institute for Reproductive Health (NIRH) is an advocacy group that works directly with state and local reproductive health, rights, and justice organizations and allied groups to protect and advance just and equitable access to reproductive healthcare. Our strategy is to go on the offensive to pass laws that safeguard reproductive freedom. NIRH partners with communities to build coalitions, launch campaigns, and successfully advocate for policy change, so the fabric of reproductive freedom is harder to tear apart.