At this time when the Trump administration is using every lever at its disposal to limit women’s access to reproductive health care and roll back our rights, states too are passing laws that disregard science and evidence-based policies in ways that threaten women’s health and dignity. The South and the Midwest are the worst regions in the nation when it comes to anti-abortion “bad medicine” laws that interfere with women’s constitutional right to abortion, according to a report the National Partnership for Women & Families released today. In total, 44 states have passed bad medicine laws, which undermine women’s access to abortion by mandating burdensome, medically unnecessary requirements that are not aligned with evidence or patients’ needs.

The third edition of Bad Medicine: How a Political Agenda is Undermining Abortion Care and Access looks at five categories of bad medicine abortion restrictions: biased counseling laws, ultrasound requirements, mandatory delays, medication abortion restrictions and targeted regulation of abortion providers (TRAP laws). It finds that, as of February 1, 2018, 44 states have passed at least one of the five types of bad medicine restrictions. Nineteen states have passed all five: Alabama, Arizona, Arkansas, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas and Wisconsin. (Some of these restrictions have been enjoined by the courts; see the full report for details.)

Updates since the second edition, published in 2016, include counts of additional types of TRAP laws and in-depth features on a number of topics, such as the fake women’s health centers at issue in the U.S. Supreme Court case NIFLA v. Becerra, which will be heard later this month.

“We all deserve access to affordable health care that meets our needs and preferences and is based on the best available medicine. That is as true for abortion care as for any other kind of health care. It is shameful that abortion opponents continue to pass bad medicine anti-abortion laws that disregard scientific evidence, usurp health care providers’ medical judgment and ignore what patients need and want,” said Debra L. Ness, president of the National Partnership. “The number and impact of bad medicine laws is truly alarming. This report is a powerful call to action to fight back every time elected officials imperil our health, constrain our lives and endanger our communities.”

Specific findings include:

Biased Counseling Laws: Thirty states have passed measures requiring that health care providers give or offer the patient abortion-specific, state-developed written materials. Twenty states have requirements that providers give or offer verbal or written statements that are medically inaccurate, biased or false. These statements misinform women seeking abortion and frustrate providers who must work to correct these inaccuracies aloud when counseling the patient for informed consent.

Ultrasound Requirements: Twenty-seven states regulate ultrasound by abortion providers in various ways, such as by mandating an ultrasound and requiring providers to describe and display the image to a woman seeking abortion care, even if she objects.

Mandatory Delays: Thirty-two states have passed mandatory delay laws, which force a health care provider to withhold time-sensitive care regardless of his or her medical judgment or the patient’s needs and wishes. Of these states, most have a 24-hour mandatory delay; some delay care even longer, up to 72 hours.

Medication Abortion Restrictions: Twenty states have passed measures prohibiting providers from administering medication abortion via telemedicine. Five states have passed laws preventing providers from administering medication abortion in accordance with the standard of care that reflects the most up-to-date evidence.

Targeted Regulation of Abortion Providers (TRAP Laws): TRAP laws impose onerous and medically unnecessary requirements on abortion providers and clinics, often forcing clinics to close or driving trusted and experienced health care providers out of practice. Despite the Supreme Court’s 2016 decision in Whole Woman’s Health v. Hellerstedt, striking down Texas’ burdensome requirement that clinics meet specifications comparable to ambulatory surgical centers and that providers have admitting privileges with local hospitals, too many states still have harmful TRAP laws on the books. The third edition of Bad Medicine also describes physician-only laws and burial or cremation requirements for embryonic and fetal tissue. A vast majority of states – 41 in total – have passed physician-only laws, which unnecessarily limit who can provide abortion care.

“When anti-abortion lawmakers actively promote junk science and enshrine it into statute, women suffer,” said Sarah Lipton-Lubet, vice president for reproductive health and rights at the National Partnership. “Bad medicine abortion restrictions are the result of this kind of harmful, ideological policymaking, and it must stop. We’ll keep fighting back – in partnership with state advocates and activists – to protect women’s health, autonomy and dignity.”

Visit NationalPartnership.org/BadMedicine for an interactive digital map and to read the full report.