Local Reproductive Freedom Index Series Local Reproductive Freedom Index: Evaluating U.S. Cities 2019

October 21, 2019
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Increasing Access to ContraceptionEliminating Racial & Economic DisparitiesExpanding Abortion Access

The Local Reproductive Freedom Index is a biennial initiative that evaluates the reproductive health, rights, and justice policies of 50 U.S. cities and municipalities. Amid the wave of attacks from both federal and state governments, cities have emerged as a collective counterweight, standing up to advance reproductive health, rights, and justice. The Local Index analyzes what policies have been enacted, where cities fall short, and what more can be done. It also offers advocates and policymakers a roadmap of concrete steps they can take to build stronger, healthier communities. 

NIRH analyzed the policies of 50 cities along 34 indicators, awarding each city zero to five stars based on the policies the city has in place, including access to abortion care, comprehensive sexuality education, and paid family leave. The report demonstrates that many bright spots exist — even in red states — and charts a road map for other cities to follow suit.

Just two years after NIRH released its inaugural Local Index in 2017, which established a baseline of what can be done at the local level, cities across the country have embraced and expanded the vision of protecting reproductive freedom at the local level. 

Key findings from the 2019 Local Index include cities that are protecting abortion access, improving the financial wellbeing of residents, and addressing broad reproductive health care needs: 

  • Columbus, OH: Having protected access to its abortion clinics in 2016, Columbus further expanded a pilot program to offer free menstrual hygiene products at all rec centers and homeless shelters and passed an ordinance that makes it illegal to deny someone services based on their immigration status. The city also adopted a resolution opposing changes to the Title X program.
  • Detroit, MI: The city of Detroit launched a network of teen-friendly reproductive health care providers offering contraception and STI testing and treatment. Detroit also passed an anti-discrimination resolution in 2017 officially opposing the Trump-Pence administration’s immigration policies. 
  • Hartford, CT: Passed an ordinance requiring any anti-abortion pregnancy centers in the city to disclose whether they have a licensed medical provider on site providing or supervising medical services. That ordinance became the model for a statewide bill.
  • Portland, OR: The Portland Public Schools Board of Education allocated $25,000 in the FY 2018/19 budget to fund free menstrual products for the entire district.
  • Shelby County, TN: Although Tennessee preempts cities from raising the minimum wage, Shelby County raised the minimum wage for all county employees, including temporary workers.
  • St. Louis, MO: The St. Louis Board of Aldermen passed an ordinance in February 2017 to prohibit employers or landlords from discriminating against anyone based on their pregnancy status or reproductive health decisions, including abortion care.

The 2019 Local Index also includes resources for advocates and policymakers, and a “model city,” which contains ideas that even the highest-scoring cities can implement to improve the lives of residents. 

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