Lawmakers in some states where abortion is already banned are seeking to explicitly bar abortion pills or take a step that most leading anti-abortion groups oppose: punish women who seek to end their pregnancies.
It's too early in some legislative sessions to know whether the measures will get serious consideration. But it does show that the policy debate continues to evolve following the Supreme Court's 2022 ruling that overturned Roe v. Wade and opened the door to state bans on abortion.
Here's a look at where things stand:
Some lawmakers target pills that are used in most abortions
Lawmakers in several states have introduced measures to classify the drugs mifepristone and misoprostol — which are used together in the majority of U.S. abortions — as controlled dangerous substances, making it a crime to possess them without prescriptions.
Louisiana last year became the first state to adopt such a law, despite concerns from doctors who contended that the restrictions would make it harder for them to access the drugs to perform life-saving procedures.
The measures have been introduced in states where Republicans control the government and where there are bans on abortion at all stages of pregnancy, with some exceptions.
The legislation has died or appears unlikely to advance in Indiana and Mississippi.
Elsewhere — including Idaho, Oklahoma, Tennessee and Texas — it's too early to know whether they have a chance.
In Oklahoma, Gov. Kevin Stitt, a staunch opponent of abortion, has vowed to sign any anti-abortion measure that comes to his desk.
And one scholar who follows abortion policy said that the bills can affect the debate even if they don't pick up momentum.
“The more often that they’re introduced, the more normalized these sorts of bills and these sorts of concepts that they’re pushing become,” said Laura Hermer, a professor at Mitchell Hamline School of Law in St. Paul, Minnesota.
The pill fight is roaring even without additional state laws
Authorities in two states with stringent abortion laws have targeted a New York doctor for allegedly sending abortion pills to patients in those states.
Last month, a Louisiana grand jury indicted Dr. Maggie Carpenter on charges of criminal abortion by means of abortion-inducing drugs, a felony. Texas Attorney General Ken Paxton sued Carpenter in civil court under similar circumstances.
The legal actions set up a test of laws in some Democratic-controlled states, including New York, that seek to protect health care providers who use telehealth to prescribe and then mail abortion pills to patients in states where they're banned. New York officials say they will not extradite the doctor to Louisiana.
Since Carpenter's indictment, New York Gov. Kathy Hochul signed a law that allows doctors to leave their names off prescription bottles for abortion pills as a way to further insulate them. Similar legislation has been introduced in Maine.
The attorneys general of Idaho, Kansas and Missouri are also suing in federal court to roll back federal approvals for mifepristone and bar prescriptions for it by telehealth.
Some advocates are calling on President Donald Trump to enforce an 1873 law to ban mailing medication or instruments used in abortion, but he has not done so.
While critics say the drugs are unsafe, some major medical groups disagree. The American College of Obstetricians and Gynecologists says there is decades of evidence that mifepristone and misoprostol are safe and effective. The group cited a study showing that major adverse events such as significant infection and excessive blood loss occur in less than 0.32% of patients taking mifepristone for a medication abortion. Medical organizations say mifepristone’s safety compares to that of the over-the-counter pain medication ibuprofen.
There are attempts to punish women, though they rarely gain traction
Bills in several states would open the door to criminal charges against women who seek or obtain abortions on charges including murder.
That's a step no state has taken so far, and which leading anti-abortion groups such as Susan B. Anthony Pro-Life America and the National Right to Life Committee oppose.
Still, such bills have been introduced in Idaho and Indiana, where they're unlikely to advance, and Oklahoma, North Dakota and South Carolina, where they're all early in the legislative process.
Reached by phone, South Carolina Rep. Luke Rankin, a Republican who added his name to a list of bill sponsors last week, said, “I've always been pro-life.” When asked about the provision to allow prosecution of women seeking abortion, he said: “I can't help you there” and declined to answer questions.
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Associated Press writers Rebecca Boone in Boise, Idaho; Kimberlee Kruesi in Nashville, Tennessee; Nadia Lathan in Austin, Texas; Sean Murphy in Oklahoma City; Laura Ungar Louisville, Kentucky; and Isabella Volmert in Lansing, Michigan, contributed to this article.
Geoff Mulvihill, The Associated Press
