Abortion policy at the federal and state levels has continued to shift in the United States three and a half years since the Supreme Court overturned Roe v. Wade in its June 2022 Dobbs v. Jackson Women’s Health Organization decision.

At the federal level, President Donald Trump’s administration and congressional Republicans made strides to pull back funding for organizations that advocate for abortion access and to reinstate conscience protections. Yet the administration also approved a generic abortion pill and failed to further regulate chemical abortion drugs.

Some states adopted new restrictions on abortion, but others expanded policies to increase abortion access. In most states, changes to abortion policy were minimal, as many states already set their post-Dobbs abortion policies in the previous years.

Federal: Trump administration shifts

Abortion policy at the federal level shifted shortly after Trump took office, with the administration reinstating many policies from Trump’s first term that had been abandoned for four years under President Joe Biden’s administration.

Trump reinstated the Mexico City Policy during his first week in office, which requires foreign organizations to certify they will not perform, promote, or actively advocate for abortion to receive U.S. government funding. In June, the Centers for Medicare and Medicaid Services rescinded Biden-era guidelines that had required emergency rooms to perform abortions when a pregnant woman had a life-threatening emergency (like severe bleeding, ectopic pregnancy, or risk of organ failure) to stabilize her condition — even in states where abortion is otherwise banned.

Other changes within federal departments and agencies included rescinding a Department of Defense policy that provided paid leave and travel expenses for abortion and a proposed rule change to end abortion at Veterans Affairs facilities.

The Department of Health and Human Services has also withheld Title X family planning funds from Planned Parenthood. Trump also signed a government spending bill that withheld Medicaid reimbursements from Planned Parenthood. Federal tax money was not spent directly on abortion before those changes, but abortion providers did receive funds for other purposes.

Nearly 70 Planned Parenthood abortion clinics shut down in 2025 amid funding cuts.

Those closures came as the administration advanced changes affecting abortion medication. Although the administration announced it would review the abortion pill, the Food and Drug Administration approved a new generic version of the drug mifepristone. Bloomberg Law reported the review has been delayed, although officials deny it.

The state-level results in 2025 have also been mixed, with a few states adding pro-life laws and others expanding access to abortion.

In Texas, where nearly all abortions are illegal, lawmakers passed a bill that allows families to sue companies that manufacture or distribute chemical abortion pills. This comes as state laws related to chemical abortions often conflict, with states like New York enforcing “shield laws” that order courts to not cooperate with out-of-state lawsuits or criminal charges against abortionists within their states.

Lawmakers in Wyoming passed a law overriding a veto from the governor that requires women to receive an ultrasound before they can obtain an abortion. However, the law was blocked by a court and is not in effect.

There were two pro-life legal wins for states in 2025 as well.

In November, the North Dakota Supreme Court ruled in favor of the state’s near-total abortion ban after it was temporarily blocked by a lower court. Under the law, unborn life is protected at every stage in pregnancy in most cases, but it remains legal in the first six weeks in cases of rape and incest and for the duration of pregnancy when the mother is at risk of death or serious physical harm.

(Story continues below)

The U.S. Supreme Court ruled in June that a South Carolina policy to withhold Medicaid funding for Planned Parenthood could stay in place. This ruling also opened the door for other states to adopt similar policies moving forward.

In at least 10 states, lawmakers enacted bills to provide more funding for pro-life pregnancy centers, which offer life-affirming alternatives to abortion for pregnant women.

Alternatively, a handful of states in 2025 expanded their shield laws, which prevent courts from complying with out-of-state criminal or civil cases against abortionists. This includes new laws in California, Vermont, Massachusetts, and New York. Several states expanded these laws by allowing pharmacies to provide chemical abortion pills without listing the name of the doctor who prescribed them to prevent out-of-state legal action.

About a dozen states expanded funding for abortion providers, such as California directing $140 million to Planned Parenthood to counteract federal defunding efforts. Maryland established a new program called the Public Health Abortion Grant Program, which offers abortion coverage through Affordable Care Act funds.

New laws in Colorado and Washington require emergency rooms to provide abortions when the procedure is deemed “necessary.” A law adopted in Illinois requires public college campuses to provide the abortion pill at their pharmacies.

Connecticut removed its parental notification policy regarding abortion, which means that minors are allowed to obtain abortions without the consent of their parents.

As of December, 13 states prohibit most abortions, four states ban abortions after six weeks’ gestation, two have bans after 12 weeks, and one has a ban after 18 weeks. The other 30 states and the District of Columbia permit abortion up to the 22nd week or later. Nine of those states allow elective abortion through nine months until the moment of birth.