In 2025, sexual and reproductive health care access in the United States faces serious challenges on both the state and federal levels. Three years after the Dobbs decision, abortion funds, practical support networks, providers and patients continue to demonstrate great resilience and courage in the face of severe restrictions. While organizations and individuals across the country work tirelessly to support sexual and reproductive health and rights (SRHR), the anti-abortion movement continues to expand the scope of its goals and targets.
Currently, 13 states have total abortion bans and 28 additional states ban abortion somewhere between 6 weeks gestation and “viability,” with access to care interrupted in both Missouri and Wyoming at different points in the year thus far. While state policy trends in 2025 encompass a variety of topics, the emerging pattern shows that abortion bans based on gestational duration are only the beginning of the contemporary anti-abortion agenda. In the first half of the year, anti-abortion state lawmakers have continued to push the envelope toward pregnancy criminalization, restrictions on bodily autonomy, and laws that recognize fetal and embryonic personhood. At the same time, they have decimated funding for critical resources such as sex education in schools.
These state restrictions are amplified in the context of federal policies hostile to SRHR. During its first 100 days, the Trump administration limited enforcement of the Freedom of Access to Clinic Entrances (FACE) Act—a federal law intended to protect patients and providers from violence at abortion clinics—and pardoned 23 people convicted under the act. These shifts raise new concerns about patient and provider safety and may dissuade people from accessing abortion and other SRH care. The Trump administration also immediately revoked two Biden-era executive orders designed to safeguard access to abortion, including protections for patient privacy under HIPAA, and has begun undoing the actions that resulted from those orders. This includes rescinding guidance reaffirming that access to emergency abortion care is required under the Emergency Medical Treatment and Labor Act (EMTALA).
The federal administration has also withheld much of the funding for Title X, a program that provides vital reproductive health care services to people with lower incomes, a move that is estimated to impact up to 30% of Title X patients. In addition, anti-SRHR majorities in Congress are pushing for severe cuts and restrictions to SRHR through the federal budget reconciliation process, policies that would harm patients and strip health coverage away from an estimated 16 million people by 2034.
In response to these new and ongoing federal threats to SRHR, multiple states have enacted proactive policies in 2025 to shield individuals and organizations from the growing threat of criminalization. States have also improved access and insurance coverage for reproductive health services, including abortion, contraception and maternal care. Many states may also call special legislative sessions in the second half of 2025 to address the fallout from proposed federal budget cuts.