Arizona’s law also forbids abortion when the doctor knows “that the abortion is being sought based on the sex or race of the child, or the race of a parent of that child.”

Advocates are not aware of enforcement of any such laws in the states that have them.

“They’re trying to encroach on the right to abortion, step by step, and turn a woman’s health care decision into an issue of discrimination against the fetus,” said Sara Ainsworth, the director of legal advocacy at the National Advocates for Pregnant Women. “I can’t imagine how any of these laws would be enforceable.”

There have been no prosecutions under the 2013 North Dakota law, advocates on both sides say. Nor has the law changed anything at the state’s only abortion provider, the Red River Women’s Clinic in Fargo, said Tammi Kromenaker, its director.

“We have not had any women who presented saying they need an abortion because of a fetal diagnosis,” she said. “I believe there are real women affected by this, but not at our clinic. If someone did come in saying that, we would refer her to a clinic in Minneapolis.”

Here, in a leafy residential neighborhood on Cleveland’s east side, where Naral Pro-Choice Ohio shares offices with Preterm, a nonprofit abortion clinic, local abortion rights advocates say the bill drives a wedge between supporters of disability rights and backers of abortion rights.

“This is interference with a medical decision following a complicated diagnosis,” said Kellie Copeland, the executive director of Naral Pro-Choice Ohio. “For us, it comes down to who makes the decision and who’s going to have to live with it. Not knowing the family and the circumstances, the legislature can’t possibly take into account all the factors involved.”