State Policy Trends 2025 Full-Year Analysis

New restrictions and criminalization target remaining avenues of care
Kimya Forouzan, Guttmacher Institute

In 2025, state policies on sexual and reproductive health and rights (SRHR) shifted away from the prevailing trends of recent years. In 2023 and 2024, the first two years after the Dobbs v. Jackson Women’s Health Organization decision, restrictive state policies focused largely on limiting access to abortion through bans on care provision. While 2025 saw some states reaffirming abortion bans, pausing and resuming care provision, and redefining exceptions to abortion bans, much of the past year’s legislative activity moved beyond the prior pattern.

In particular, the focus of anti-SRHR policymakers shifted to cutting off the ways that people in states with total and gestational bans are still accessing care in spite of these restrictions. For example, the anti-SRHR movement has increased attacks specific to medication abortion access, telehealth provision under state shield laws, and the remaining avenues through which young people can access SRH information and care. They have also targeted the abortion funds, community networks and individuals who help patients access care, while ramping up funding for anti-abortion centers and “alternatives to abortion” programs.

These legislative shifts have also demonstrated a further push toward criminalization of SRH patients and providers. While such criminalization is not a new phenomenon, there has been a marked trend toward leveraging criminal penalties in anti-SRHR efforts to restrict access to care. At the same time, protective states have taken proactive steps both to push back against criminalization and to bolster protections for other forms of sexual and reproductive health care, such as contraception and fertility treatments.

While not covered in this analysis, federal changes to SRHR policy loom over these shifts in state policy. National and federal developments such as the relentless attacks on medication abortion using mifepristone, the “defunding” of Planned Parenthood and severe cuts to the Medicaid program are also reshaping care and access at the state level.

These escalating attacks on SRHR have only widened the gap between protective and restrictive states—putting them at odds with each other as protective states attempt to mitigate the harms of abortion bans and preserve access to care through shield laws and other strategies.

Opportunities and Threats in 2026

When state legislatures go back in session in early 2026, the opportunities and threats facing SRHR will present an important crossroads. As Guttmacher data show, patients, providers, abortion funds and support networks have all demonstrated great resiliency in fighting for access to SRH care. However, anti-abortion advocates not content with overturning Roe v. Wade are increasingly looking to leverage the criminal legal system to cut off the remaining points of access to abortion, while moving to restrict other types of reproductive health care. At the same time, more protective states are moving to insulate providers, patients, abortion funds and support networks from these threats while shoring up access within their states. These dynamics are also unfolding in the shadow of federal attacks on reproductive health care and a devastating retreat from international assistance for SRH care. 

As we enter 2026, the United States will likely continue to grapple with growing divisions among states with regard to SRHR policies. While threats of pregnancy criminalization continue to multiply, innovative state solutions will become more critical than ever to protect the full spectrum of sexual and reproductive health and rights.

Acknowledgments

This analysis was edited by Ian Lague. Mollie Fairbanks provided counts of state bills and laws as a part of ongoing work with Guttmacher’s State Legislation Tracker, and also conducted fact-checking in tandem with Priyanka Sookhai. Krystal Leaphart coordinated quotes from state-based partner organizations. Michael Moran created the graphic for this analysis.


Source URL: https://www.guttmacher.org/2025/12/state-policy-trends-2025-full-year-analysis