Background

In the years immediately following the Supreme Court decision in Roe v. Wade, several states moved to impose strict regulations on abortion clinics, beyond what is necessary to ensure patients’ safety. Since many of these requirements were struck down by lower federal courts starting in the early 1980s, states moved on to other ways to restrict access to abortion, such as limitations on public funding. Efforts to use clinic regulation to limit access to abortion, rather than to make its provision safer resurfaced in the 1990s and have gained steam since 2010. However, in June 2016, the U.S. Supreme Court struck down some of the most burdensome of these restrictions that had been enacted in Texas.

While all abortion regulations apply to abortion clinics, some go so far as to apply to physicians’ offices where abortions are performed or even to sites where only medication abortion is administered. Most requirements apply states’ standards for ambulatory surgical centers to abortion clinics, even though surgical centers tend to provide more invasive and risky procedures and use higher levels of sedation. These standards often include requirements for the physical plant, such as room size and corridor width, beyond what is necessary to ensure patient safety in the event of an emergency. State standards, however, do vary, with the most burdensome standards in place in states such as Michigan, Missouri, Pennsylvania, Tennessee and Virginia.

They also often require that facilities maintain relationships with hospitals, provisions that add nothing to existing patient protections while granting hospitals effective veto power over whether an abortion provider can exist. Several states mandate that clinicians performing abortions have relationships with local hospitals, requirements that do little to improve patient care but that set standards that may be impossible for providers to meet.

Highlights

Targeted Regulation of Abortion Providers   

STATE

REGULATIONS APPLY TO SITES WHERE:*

FACILITY REQUIREMENTS:

CLINICIAN REQUIREMENTS:

 

Surgical Abortion Is Provided

Medication Abortion Is Provided

Structural Standards Comparable to Those for Surgical Centers

Procedure Room Size Specified

Corridor Width Specified

Maximum Distance to Hospital Specified

Transfer Agreement with Hospital

Requires:

OB/GYN Certification or Eligibility

Outpatient Clinics

Private Doctor Offices

Hospital Privileges

Hospital Privileges or Alternative Agreement

Alabama

X

X

X

X

 

X

 §

 

X

 

Arizona

X

X

X

X

 

 

30 miles*

 

 

X

 

Arkansas

X

X

X

X

X

 

30 miles

 

 

§

 

Connecticut

X

 

 

 

 

 

 

 

 

 

 

Florida

X

 

X

 

 

 

 §

§ 

 

X§​

 

Illinois†​

 

 

 

 

 

 

 

 

 

 

 

Indiana

X

X

X

X

X

adjacent county

 

 

X

 

Kansas

§

§

§

§

 

 

§

 

§

 

 

Kentucky

X

 

X

X

 

 

 

X

 

 

 

Louisiana

X

X

 

X

X

 

§

 

X

 §

Maryland

X

 

 

 

 

 

 

 

 

 

 

Michigan

X

 

X

X

X

X

30 minutes

X

 

 

 

Mississippi

X

X

X

X

X

X

 

X

X

Missouri

X

 

 

X

 

X

30 miles

 

§

 

 

Nebraska

X

X

X

X

X

 

 

 

 

 

 

North Carolina

X

 

X

X

 

 

 

 

 

 

 

North Dakota

 

 

 

 

 

 

30 miles

 

X

 

 

Ohio

X

 

 

X

 

 

30 miles

X

 

 

 

Oklahoma

X

 

X

X

X

 

§

 

§

X

 

Pennsylvania

X

X

 

X

X

X

 

X

 

 

 

Rhode Island

X

X

X

X

 

 

 

 

 

 

 

South Carolina

X

X

X

X

 

X

 

 

 

X

θ

South Dakota

X

X

X

X

 

X

 

 

 

 

 

Tennessee

 

 

 

 

 

X

 

 

Texas

X

X

X

 

 

 

 X

 

Utah

X

X

X

X

X

 

15 minutes

 

X

 

 

Virginia

X

X

X

 

 

 

 

 

 

 

 

Wisconsin

X

 

X

 

 

 

 §

X

§

 

 

TOTAL

24

14

18

18

9

8

8

6

2

8

1

§   This law is temporarily enjoined pending a final decision in the courts. 

▼ This law is permanently enjoined and is not in effect.
*   Applies only to surgical abortions.
 In most states, regulations apply to all abortion providers or apply to providers who perform or administer more than a small number of abortions. In Illinois, requirements apply only to sites where abortion is the primary service.
   Indiana law requires an abortion provider to either have admitting privileges or an agreement with another physician who has admitting privileges at a local hospital. A court has blocked a requirement that would have required the agreement with another physician who has privileges to be renewed annually and filed in every hospital in the local area.
θ   Only an obstetrician/gynecologist may provide abortions after 14 weeks of pregnancy.