State legislators across the country are accelerating their efforts to limit access to abortions by fast-tracking a new round of anti-abortion laws this year, according to a report exclusively shared with NBC News.
Over 500 abortion restrictions have been introduced in 44 states this year, compared to around 300 at this time in 2019, according to the report, which Planned Parenthood produced with data compiled by the Guttmacher Institute, an abortion-rights research organization.
"This legislative season is shaping up to be one of the most hostile in recent history for reproductive health and rights," said Alexis McGill Johnson, president and CEO of Planned Parenthood. "These abortion restrictions are about power and control over our bodies."
Ralph Reed, founder and chairman of the Faith & Freedom Coalition, said the flurry of measures is part of a decadeslong strategy of states' chipping away at abortion rights.
Like many of those who support such legislative efforts, Reed's organization has worked to elect anti-abortion legislators who champion what he called "incremental" limits.
"We're very bold and unapologetic in our aspirations that we want to see a day in America where the most vulnerable among us are protected," Reed said. "The ultimate goal of the pro-life movement is to see Roe v. Wade overturned."
Motivated by Justice Amy Coney Barrett's appointment as the sixth conservative vote on the Supreme Court and President Joe Biden's sweeping rollback of Trump-era anti-abortion efforts, state legislators have already passed a wave of laws this year aimed at giving the Supreme Court the opportunity to upend its landmark decision.
Enacting abortion restrictions at a rapid pace
South Carolina's governor recently signed a law banning most abortions, making it the first state to have passed an anti-abortion measure this year. The bill, SB 1, requires doctors to perform ultrasound tests to check for cardiac activity, and if it is detected, an abortion can be performed only if a person's life is in danger or in cases of rape or incest. Abortion-rights groups immediately sued, preventing the law from taking effect.
"We believe the Heartbeat Law is constitutional and deserves a vigorous defense to the U.S. Supreme Court if necessary," South Carolina Attorney General Alan Wilson said in a statement.
So far this year, 12 abortion restrictions have been enacted in six states, compared with only one that had been passed by this time in 2019, the report said.
Nancy Northup, president and CEO of the Center for Reproductive Rights, the nonprofit organization that filed the lawsuit against South Carolina's ban, said anti-abortion bills have become "more extreme."
"We used to see more backhanded laws that forced clinics to shut down through impossible regulations. ... But now politicians have dropped the smokescreen and are very open about their goal of banning abortion," she said.
Conservative-leaning states shift focus
For years, state legislators have passed bills to limit access to surgical abortions; meanwhile, medication abortion — a more convenient and private way to end pregnancies — have grown in popularity and now make up over a third of abortions in the U.S.
The Food and Drug Administration requires the drug mifepristone, one of two pills used to perform a medication abortion, to be dispensed in clinics or doctor's offices, rather than prescribed and picked up at pharmacies or by mail.
During the coronavirus pandemic, a group of doctors and advocates, led by the American College of Obstetricians and Gynecologists, challenged the rule. In mid-July, a federal judge suspended the restriction; the Supreme Court reinstated it in January.
The push to expand access to medication abortions during the pandemic and beyond fueled state legislators to propose limits on the method. As of now, 33 medication abortion restrictions and bans have been introduced. At this time in 2019, only 11 had cropped up in statehouses, according to the report.
In Montana, HB 171 would ban telemedicine abortions, prohibit medication abortions from being provided on school property and require informed consent from patients and state-mandated counseling before obtaining abortions.
"The abortion industry is changing, and chemical abortion is the new frontier, and states are motivated to upgrade their regulations," said Sue Liebel, state policy director for Susan B. Anthony List, an anti-abortion-rights advocacy group.
The American College of Obstetricians and Gynecologists is urging the FDA to lift its rules on mifepristone, saying medication abortions can be provided safely by telehealth. When medication abortions are obtained by telemedicine or in person, the likelihood of complications is less than 1 percent.
A rise in anti-abortion constitutional amendments
Even in liberal states that have taken steps to safeguard access, conservative lawmakers are seeking to add anti-abortion language to state constitutions.
Fourteen anti-abortion constitutional amendments have been introduced this year, more than three times the number at this time in 2019, according to the report.
Kansas legislators have already passed a constitutional amendment, HCR 5003, and next year, residents will decide whether the state constitution allows a right to the procedure.
"We want the people of Kansas to weigh in directly on the ballot so that we can pass laws, because right now their state Supreme Court makes that incredibly difficult," said Katie Glenn, government affairs counsel at Americans United for Life, an anti-abortion-rights advocacy group.
If voters approve it, the proposal would amend the state constitution to say that nothing in the constitution protects the right to an abortion or the funding of an abortion. It would reverse a 2019 state Supreme Court decision that affirmed the right.
Elizabeth Nash, the policy analyst for state issues at the Guttmacher Institute, said such amendments give states more leeway to regulate abortion procedures.
"If the U.S. Supreme Court overturns federal abortion rights and neither the federal nor state constitution protects abortion, it would make it very easy for states to pass bans and restrictions and push care even further out of reach," Nash said.