Alabama just passed the most restrictive abortion bill in the nation, banning abortion in almost all circumstances and threatening to jail doctors who perform abortion for up to 99 years – a de facto life sentence. Like other recently-enacted abortion bills passed in Georgia, Ohio, Kentucky, Mississippi and elsewhere, the Alabama legislation will almost certainly be blocked by the lower courts because it runs counter to the 1973 Supreme Court Roe v Wade abortion rights ruling. And that’s the point. Anti-abortion state legislatures and governors want the Supreme Court’s new conservative majority to overturn, or at least significantly curtail, the abortion protections enshrined in Roe.

But Alabama’s new law will not be the first to reach the steps of the high court. Numerous lawsuits over restrictive laws in nine states – which don’t go as far as Alabama but nevertheless could topple Roe - are already well on their way up the Supreme Court pipeline, with some already reaching the appellate court level. These laws aim to dictate:

Patient Provider Timing Reason Method

Who can get an abortion Patient 1 case Who can perform an abortion Provider 5 cases When a woman can get an abortion Timing 1 case Why a woman can choose an abortion Reason 2 cases How a pregnancy is terminated Method 3 cases

Here are some of the lawsuits that could upend U.S. abortion rights if the high court chooses to hear them.


1 case

would make it harder for minors to get abortions.

Most U.S. states require minors seeking abortion to either notify or obtain consent from one or both parents — a policy critics say puts teens with abusive or neglectful parents at risk. Because the Supreme Court previously ruled that states can’t give parents an absolute veto over their daughter’s abortion, most state laws include some kind of “judicial bypass” allowing young women to petition a court to have an abortion without parental consent.

Alabama Parental consent for minors Plaintiff Reproductive Health Services Defendant Daryl Bailey About the case The Supreme Court has previously upheld laws requiring parental consent for minors seeking abortions as long as those minors can petition a court for a judicial bypass -- where they can argue, for example, that they shouldn't have to tell an abusive parent about their decision. In Alabama, plaintiffs are challenging a law that allows judges to appoint an advocate for the fetus to question the young woman in such court hearings about “the negative consequences of undergoing an abortion.”


5 cases

could impose new restrictions on providers that could impede access to abortions.

While some states are moving to ban abortion outright, others seek to curtail access through requirements on abortion providers commonly referred to as Targeted Regulation of Abortion Providers, or TRAP laws. These policies can include anything from dictating the width of a clinic hallway to requiring doctors to obtain admitting privileges at local hospitals. Many providers are unable to meet these requirements and clinics have closed their doors.

Louisiana Abortion doctors needing admitting privileges Plaintiff June Medical Services Defendant Rebekah Gee About the case Louisiana’s law requiring doctors who perform abortions to have admitting privileges to a hospital within 30 miles is currently blocked by the Supreme Court while both sides petition to have the case heard on the merits. If it goes into effect, it would leave just one abortion provider open in the state. The Supreme Court struck down a nearly identical Texas law in 2016, but two conservatives, Brett Kavanaugh and Neil Gorsuch, have joined the high court since then. Idaho Abortion provider documentation Plaintiff Planned Parenthood of the Great Northwest and the Hawaiian Island Defendant Lawrence G. Wasden About the case Planned Parenthood is challenging an Idaho law that requires abortion providers to document and report every complication, arguing the law unfairly singles out and stigmatizes one type of medical care and leaves private patient data vulnerable to being shared with the government. Kentucky Ambulance and hospital agreements Plaintiff EMW Women’s Surgical Center and Planned Parenthood of Indiana & Kentucky Defendant Adam Meier About the case Abortion providers are challenging a Kentucky law requiring clinics to obtain agreements with local ambulance services and hospitals to transport and admit patients in the event of a complication. The lawsuit argues that abortion-related complications that require hospitalization are extremely rare and the ambulances and hospitals are already required to care for patients in an emergency. Kentucky Mandatory ultrasounds Plaintiff EMW Women’s Surgical Center Defendant Andrew Beshear About the case Kentucky is one of 11 states that require abortion providers to perform an ultrasound on every woman seeking an abortion, and one of just three mandating that the provider show the woman the ultrasound and describe it in detail— even if the woman doesn't want that and it's not medically necessary. The American Civil Liberties Union is representing three doctors and their patients in the legal challenge. Texas Fetal tissue disposal Plaintiff Whole Woman’s Health Defendant Charles Smith About the case Health care providers are suing over a Texas law requiring doctors to bury or cremate fetal tissue from abortions. They argue that there is only one facility in the state able to process the fetal tissue, meaning the law places an undue burden on abortion access.

1 case

could impose restrictions on when a woman can obtain an abortion.

Some states already require waiting periods before a woman can have an abortion. Others states have moved to ban abortions after 20 weeks — or as early as six weeks, before many women even know they are pregnant. Several federal courts are weighing whether these constitute an “undue burden” on women seeking to terminate a pregnancy.

Mississippi Abortion after 15 weeks Plaintiff Jackson Women’s Health Organization Defendant Thomas Dobbs About the case The lawsuit challenges Mississippi laws that prohibit abortions after 15 weeks. It also mandates a 24-hour waiting period before the abortion.


2 cases

could let states decide that some reasons for seeking an abortion are invalid.

Some states would prohibit women at any point in a pregnancy from getting an abortion based on the “race, color, national origin, ancestry, sex” or disability of the fetus. Supporters say the ban prevents eugenics, while opponents say it unconstitutionally inserts the state into a private medical decision.

Indiana Race, sex, disability of fetus Plaintiff Planned Parenthood of Indiana and Kentucky Defendant Commissioner of the Indiana State Department of Health About the case Medical advances make it possible to detect disabilities and potential disabilities earlier in pregnancy. Both Planned Parenthood and the state of Indiana recognize that access to this testing could lead to more women seeking abortion on the basis of fetal disability. The Indiana Enrolled Act prevents a woman from seeking an abortion based solely on the fetus’ disability, as well as gender or race. Planned Parenthood, the plaintiff, argues that this imposes an undue burden on a woman’s right to choose. Ohio Fetus with Down syndrome Plaintiff Planned Parenthood of Southwest Ohio Defendant Lance Himes About the case Planned Parenthood is challenging an Ohio law — one of the last then-Gov. John Kasich signed in office — that would prevent women from obtaining an abortion following a fetal Down syndrome diagnosis. A provider who performed such an abortion would face felony charges.

3 cases

could outlaw a common abortion method

Several states are moving to ban dilation and evacuation (D&E), a surgical method for second-trimester abortions. Louisiana, Arkansas, Kansas, Kentucky, Mississippi, Ohio, Oklahoma, Texas and West Virginia have all passed these bans, though most have been blocked by courts. Most abortions take place in the first trimester, but those performed after 13 weeks frequently use D&E.

Texas D&E abortion Plaintiff Whole Woman’s Health Defendant Ken Paxton About the case A new law in Texas requires confirmation that a fetus’ life is terminated in utero before completing the evacuation phase of a D&E abortion. The law specifically prohibits “dismemberment abortions,” which it defines as “dismember[ing] the living unborn child and extract[ing] the unborn child one piece at a time from the uterus …” Whole Woman’s Health argues that while dismemberment abortion is not a medical term, its definition restricts women from choosing D&E abortions even when the fetus is not viable. Arkansas D&E abortion Plaintiff Frederick W. Hopkins Defendant Larry Jegley About the case Several aspects of Arkansas’ abortion law face challenges, including the requirement that patients receive state counseling before receiving an abortion 18 to 26 weeks into pregnancy — which mandates at least three trips to the clinic, sometimes over long distances in the rural state. The plaintiff, an OB-GYN, argues that only one abortion clinic in the state performs D&E procedures and the repeat clinic visits constitute a burden on women without means of transport, paid time off, or child care if they have other children. Alabama D&E abortion Plaintiff West Alabama Women’s Center Defendant Thomas M. Miller About the case The Women’s Center argues that reducing access to second-trimester abortions falls disproportionately on the “most vulnerable residents.” These restrictions, it contends could subject women to significant medical risks.