State legislatures across the country are planning to completely restrict abortion access.
Twenty-one abortion restrictions have been enacted across the U.S. this year, according to the Guttmacher Institute, which tracks data for research and policy analysis on abortion in the U.S. And with another eight months left, lawmakers in 28 state legislatures have introduced bills that seek to add even more restrictions.
The efforts are part of ramped-up, grassroots efforts by conservative, anti-abortion activists to make the medical procedure inaccessible, illegal, and in the most extreme cases, a potential capital murder charge.
Abortion rights have been under attack for decades, but in recent months anti-abortion activists have pushed more legislation at the state level, as they see an opportunity to overturn the landmark 1973 Roe v. Wade decision, which secures the federal legal right to abortion.
The current efforts to push anti-abortion legislation are a response to the further right-leaning Supreme Court, with the appointments of conservative Justices Neil Gorsuch, and especially Brett Kavanaugh.
“What we’re seeing now is much more a full frontal attack on abortion rights,” Elizabeth Nash, a senior state issues manager at the Guttmacher Institute, told Fortune.
Restrictions on abortion rights introduced this year range from gestational age bans, to trigger bans, as anti-abortion activists seek to reverse access to reproductive healthcare in the U.S.
Here are all the different types of bans that have been introduced so far in 2019.
Bans on abortion in cases of genetic anomalies
These bans, sometimes called “reason bans” will prohibit anyone from getting an abortion based on the characteristics of a fetus, including race, sex, or disabilities.
Reason bans have been criticized as one attempt by state lawmakers to take away a person’s agency in their decision to terminate a pregnancy. These bans require abortion providers to question a person’s reasons for their abortion, making them less accessible.
In 2019, reason bans have been introduced in the following nine states: Arkansas and Utah—where bills were signed into law, Georgia, Illinois, Kentucky, Missouri, Pennsylvania, South Carolina, and Texas.
The legislation introduced in Kentucky was blocked and challenged by the ACLU, which filed a lawsuit on behalf of the last remaining clinic in the state.
Bans on procedure methods
At least 16 states have introduced bills that would prohibit abortion providers from performing specific types of abortions. The bans usually focus on the dilation and evacuation method, which are often referred to as “dismemberment abortion bans”—a non-medical term—in legislation.
These bans would prohibit people from accessing abortion techniques that are commonly used in second-term abortions.
The following states introduced method bans on dilation and evacuation: Indiana, Michigan, South Carolina, North Carolina, Rhode Island, Washington, and North Dakota, where it was signed into law.
While several of these legislative bans have popped up this year, Nash said the overall strategy is different than in previous years. The “focus is more on near total abortion bans versus abortion bans later in pregnancy or banning methods or reason for abortion,” said Nash.
Six states currently have “trigger laws” in place that would immediately ban abortion if Roe is overturned, while at least four other states have introduced such laws.
Louisiana, Mississippi, North Dakota, and South Dakota all previously had trigger laws on the books, while Arkansas and Kentucky both passed them earlier this year. Abortion rights advocates say these laws are designed to immediately outlaw abortion at the state level, while also targeting abortion clinics for closure. Georgia and Tennessee have both introduced trigger bans this year, as well.
“We haven’t seen this issue pop up in a long time,” said Nash, who added that lawmakers are sending a message with trigger bans “that the state is very ready to ban abortion.”
Gestational age bans
These bans have been a bigger focus of the anti-abortion movement this year, and would prohibit abortion at a specific point in pregnancy. More recently, a number of states are introducing and passing bans on abortion anywhere from six weeks to 20 weeks gestation.
Sometimes called “heartbeat bills,” legislation that would ban abortion as early as six weeks restrict access to the procedure before most people know they’re pregnant.
“They’re calling it a heartbeat bill but we know if you’re putting this restriction at six weeks it’s essentially a ban, so we’re calling it an abortion ban,” Oriaku Njoku, the co-founder of the Georgia-based Access Reproductive Care-Southeast told Fortune. ARC-Southeast is an abortion fund that serves people living in Georgia, Florida, Mississippi, Alabama, South Carolina, and Tennessee.
So far this year, the following 15 states have introduced heartbeat bills that would ban abortions after six weeks: Georgia, Illinois, Florida, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New York, South Carolina, Tennessee, Texas, West Virginia, and Mississippi and Ohio, where the bills were signed into law.
Mississippi now faces a lawsuit filed by the Center for Reproductive Rights and Mississippi Center for Justice, while the ACLU of Ohio will also take legal action to stop the law.
“Some of these bills, the way they’re worded, someone took time to write these bills and it’s been shared across the country with some minor changes, and it’s a calculated attack on people’s bodily autonomy,” said Njoku.
Abortion rights advocates see the frequency of these bills in particular as an anti-choice strategy to get a case to the Supreme Court.
“These legislatures have been moving toward this point for a long time, adopting restriction after restriction,” said Nash. “So now the only thing left to do is to ban abortion.
The progressive fight for abortion rights
Abortion advocates see how the various anti-abortion legislation can lead to disinformation.
“It’s already created a level of fear,” said Njoku, who added that ARC-Southeast has had to reassure people that they can still access the care they need. “We’re going to have to do some community education so people know their rights.”
Progressive activists are building bases and coalitions across social justice movements. Pro-choice lawmakers are also pushing legislation that would establish legal protections for abortion, as New York did earlier this year.
“We are very much committed and rooted in our fierceness to fight for the right to abortion,” Kamyon Conner, the executive director of the Texas Equal Access Fund told Fortune. “We all need to be working together.”
Both Kamyon and Njoku spoke of progressive efforts to build bases across movements, which include working with economic and environmental justice advocates, and immigration advocates.
“There are folks in big cities, small cities, and rural communities coming together to make sure that our voices are being heard,” said Njoku. “It’s going to take all of us.”