For decades, states have attempted to limit access to abortion after the first trimester by enacting restrictions on specific abortion methods. This type of legislation often draws on misleading, medically inaccurate terms coined by the National Right to Life Committee, such as “dismemberment abortion” or “partial-birth abortion.” These terms were created for political purposes and have no basis in medical procedures. In practice, such restrictions often completely ban dilation and evacuation (D&E) or dilation and extraction (D&X), allowing use only in the rarest circumstances. Since these methods are generally used in the second trimester, prohibiting them can limit the gestational duration at which an individual is able to obtain abortion care.

Many, but not all, of these state-level restrictions from the 1990s and early 2000s were struck down by courts. However, the US Supreme Court upheld a federal version in 2007 in Gonzales v. Carhart. That law, which applies across the country, bans “partial-birth” abortion except when the pregnant person’s life is endangered and does not contain an exception to protect the patient’s health. Although the law does not include a precise medical definition of what is banned, the Court found the federal law’s definition sufficient to pass constitutional muster and applied it to D&X. The federal law is currently in effect, along with 25 state laws that allow for state and local enforcement of the method ban and, potentially, stiffer penalties for violations.

After 2007, states began enacting laws that ban the abortion method most commonly used in the second trimester, standard D&E. These statutes often have very limited exceptions, allowing an individual to obtain an abortion using this method only when necessary to protect their life or in case of a “serious risk of substantial and irreversible physical impairment of a major bodily function.” These laws do not make an exception for serious mental health conditions.

Several states’ enacted restrictions were litigated and blocked from taking effect in the years prior to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization that overturned the federal constitutional right to abortion. While these laws technically remain blocked as litigation has not progressed further, the Dobbs ruling has allowed even stricter laws to be enacted that prohibit provision of almost all abortions regardless of the method used.