Shifts in access to abortion care
In 2025, there were significant shifts in abortion access in two states, Wyoming and Missouri. In both of these states, restrictions completely shut off access or significantly limited access to abortion care at various points throughout the year, going beyond state bans based on gestational duration. Currently, 13 states have total abortion bans in place—including North Dakota, which reinstated its total ban in late 2025—and an additional 28 states have bans based on gestational duration that fall somewhere between six weeks and viability.
In Wyoming, the legislature passed two bills targeting the state’s only remaining procedural abortion clinic, Wellspring Health Access. The first restriction was a TRAP (Targeted Regulation of Abortion Providers) law, which required abortion clinics providing procedural care to meet the same standards as ambulatory surgical centers and for abortion providers offering procedural care to have admitting privileges at a hospital within 10 miles of their clinics. The second restriction required patients to get an ultrasound 48 hours prior to initiating a medication abortion.
The enactment of these laws resulted in Wellspring Health Access pausing care provision, meaning that procedural abortion was unavailable throughout Wyoming. However, on April 21, Judge Thomas Campbell of the Natrona County District Court issued a preliminary injunction and temporary restraining order on both abortion restrictions. As a result, Wellspring was able to resume care provision while the litigation proceeds.
“Abortion bans have never been about protecting life—they’ve always been, and continue to be, about politics and stripping away people’s right to bodily autonomy and a woman’s right to make deeply personal medical decisions. In Wyoming and across the country, these bans are dangerous and threaten the little access that continues to exist in the Mountain West while putting lives at risk—especially for those already marginalized by distance, poverty or circumstance. We must trust patients and providers, not politicians, to safeguard dignity, autonomy and the fundamental right to health care for everyone no matter where they live.
— Julie Burkhart, Founder and President, Wellspring Health Access
Similarly, in 2025 Missouri residents experienced both pauses and resumptions of clinical abortion care due to a series of legal reversals. In November 2024, Missouri residents voted to amend their state’s constitution to protect abortion rights. Following the constitutional amendment, advocates filed a lawsuit to remove existing restrictions on abortion care in the state, including the state’s total abortion ban.
In December 2024, the state’s total ban and several other restrictions on abortion care were enjoined as litigation continued, and additional restrictions were enjoined in February 2025, eventually allowing some care provision to resume in the state. However, on May 28, the Missouri Supreme Court ruled that an incorrect legal test was applied when issuing the injunctions and ordered that the total ban and restrictions be reinstated. Eventually, the ban and accompanying restrictions were again enjoined in July.
Beyond this complicated legal back and forth, providers in Missouri are also engaged in a legal battle over the requirement that clinics have a “medication abortion complication plan” approved by the state’s Department of Health. This bureaucratic barrier, premised on misinformation about the safety of medication abortion, has further limited the availability of medication abortion care in the state.
In addition to Wyoming and Missouri, North Dakota also experienced a shift in the legal status of abortion care. In November, the North Dakota Supreme Court reinstated the state’s total abortion ban, reversing a lower court decision. Unlike the legal decisions in Wyoming and Missouri, however, this shift did not immediately change the landscape of abortion access in North Dakota, as there has not been an abortion provider operating there since 2022 and the state requires in-person visits for medication abortion. However, the reinstated abortion ban will prevent any new clinics from opening and will have a profound impact on North Dakotans’ future access to procedural and medication abortion.
Abortion ban exceptions
In 2025, legislators in 12 states introduced 45 bills to add exceptions to existing abortion bans, and two were enacted. Typically, exceptions to abortion bans purport to allow access to abortion care in circumstances involving risk to the life or health of the pregnant person or when the pregnancy is the result of sexual violence. However, these exceptions are inaccessible to many pregnant people and often involve onerous documentation and other requirements before abortion care can be provided. Although these narrow exceptions may allow some people to access the care that they need, efforts to access them often still result in denials of care.
While many of these exception bills are intended to mitigate the harm caused by abortion bans, their passage does not ensure greater access to care and, at times, can cause additional harm. For example, a law enacted in Kentucky redefined exceptions to the state’s abortion ban with a list of specific medical situations in which a physician can provide care, rather than leaving such designations up to the physician’s clinical judgment, as had previously been the case. In doing so, the bill’s authors also removed mention of “abortion” in the section related to medical exceptions, both furthering abortion stigma and creating confusion about when abortion care is medically necessary.
In August, Texas enacted Senate Bill 31/House Bill 44, which purported to clarify exceptions to the state’s ban on abortion care. However, the new law was designed to revive the state’s 100-year-old abortion ban, which imposes criminal penalties not just on abortion providers but also on those who support abortion patients and (potentially) on patients themselves. Attorney General Ken Paxton had previously signaled his intention to use the more than 100-year-old law to prosecute abortion providers post-Dobbs. While the state legislature amended the bill before it was enacted—to insist that it not be construed to “affirm or reject the validity” of the 100-year-old ban—this language has done little to assure abortion providers, supporters and patients that they will be safe from liability.
Funding for anti-abortion centers and “alternatives to abortion” programs
In 2025, states continued their funding of anti-abortion centers, one means by which anti-abortion policymakers seek to reduce access to the remaining avenues of care. Anti-abortion centers (also called “crisis pregnancy centers”) aim to prevent pregnant people from obtaining abortion care and contraception by providing misleading and stigmatizing information about these services and about human development. Although they are usually not licensed medical facilities, these centers often pose as abortion clinics and target people with few financial resources by providing free but very limited services such as pregnancy tests and ultrasounds. Similarly, “alternatives to abortion” programs are state-run initiatives that offer (often inaccurate) information and time-limited services to pregnant people with the specified goal of dissuading them from seeking abortion care. Frequently, both anti-abortion centers and “alternatives to abortion” programs are designed to delay individuals’ receiving care, with the goal of pushing their pregnancies past gestational duration limits and rendering abortion care inaccessible. They also often collect extensive personal information about patients despite having few obligations to honor patient privacy laws, as they are typically not legitimate or certified health care providers.
In 2025, legislators in 16 states introduced 29 bills to grant or extend funding for anti-abortion centers, and 10 were enacted (Alabama, Florida, Louisiana, Missouri, Ohio, South Carolina, Texas, Utah and West Virginia). Of those, 6 states allocated amounts in the millions to anti-abortion centers or “alternatives to abortion” programs, including in Texas ($90 million to the “alternatives to abortion” program), Florida ($29.5 million to the “alternatives to abortion” program), and South Carolina ($2.4 million to anti-abortion centers). Additionally, Missouri allocated $12.4 million to the “alternatives to abortion” program, with $10 million of that coming from federal funding for Temporary Assistance for Needy Families (TANF).