State Abortion Laws

State Laws and Their Relationship to Practice Authority

Locations Where Advanced Practice Clinicians (APCs) Can Provide Abortion Care

  • Procedural and medication
  • Medication only
  • Neither

DC is included. Restrictions apply for some APC types in Kansas.

© 2026 by National Abortion Federation's Clinicians in Abortion Care Program. All Rights Reserved.

State Abortion Laws and Provision

Research shows that state abortion laws often do not reflect the state of evidence regarding abortion safety when performed by Advanced Practice Clinicians (APCs) (NASEM, 2018). Previously, most abortion laws laws did not reflect APCs practicing within their full scope. Over the last decade, these laws have been revised to remove APC bans and other restrictive clauses, to reflect APCs providing abortion care as part of practicing to their full scope. Currently, over half of all states that provide abortion include APCs in abortion practice, for both medication and procedural abortion. However, remnants of the previous restrictions remain. Despite consistent evidence that that APCs provide safe and quality medication and procedural abortion care – and despite the fact that APCs routinely provide much more complex care like attending births – in some states outdated laws have become a de facto restrictive legacy. (Jenkins et al., 2023)

APCs are safely and effectively providing medication and procedural abortion care. In states where APCs are practicing to full scope, this may be because the state does not have an APC ban, or has had their APC ban repealed through legislation, or because the state Attorney General, a regulatory body, or some other entity have narrowly interpreted the APC ban. Since 2018, the APC legislative map has changed significantly as we have seen an increase in the states that have overturned their APC bans and recognized APCs as qualified and skilled abortion providers. In late 2018 only 12 states supported APCs providing medication abortion and only 6 states supported APCs providing procedural abortion care. Then in 2019, three states--Maine, New York, and Washington--overturned their APC bans, bringing the numbers of states where APCs could provide medication abortion to 15 and states where they could provide procedural abortion care to 9. Since then, we have seen a significant shift in laws governing APCs and abortion care and as by October of 2026, those numbers had shifted to 25 states where APCs could provide medication abortion and 22 states where APCs could provide procedural abortion care. (Jenkins et al., 2023)

State-specific abortion laws must be considered within the context of Midwifery, Nursing, Nurse Practitioner, and Physician Associate practice acts which also vary from state to state. It is beyond the scope of this Toolkit to provide detailed description of each state’s practice acts regulating APCs. Regularly updated reference documents provide current state-by-state information on practice regulation including state practice acts and legislative changes to scope of practice: AANP Fact Sheet, ACNM State Fact Sheets (members only), and AAPA State Laws and Regulations Resource (members only). Additionally, national clearing houses such as the Guttmacher Institute keep an up-to-date online record of abortion regulations.

State Laws and Regulations Governing Midwifery, Nurse Practitioner, and Physician Associate Practice: Where to Find Information

This section examines who defines APC professional practice, explaining the roles of professional organizations, state legislatures, and licensing boards.

Since there is no federal law governing APC practice authority, it is necessary to go to each state licensing board to access the specific practice act and rules and regulations. Fortunately, there are websites which summarize and update these state practice laws and regulations. The CASS Project also keeps an updated list of licensure requirements for practice in each state where APCs can provide abortion care. For more state-specific information about abortion provision and legislation, the Toolkit will soon be offering a state-by-state APC abortion provision document and a map specific to midwifery scope of care.

Midwives

The American College of Nurse-Midwives (ACNM) provides information on state laws and regulations specific to CNMs and CMs. ACNM’s State Fact Sheets and Legislative Tracking Tool are available online to ACNM members only. Topics include the identity of the regulatory board, scope of practice, prescriptive authority, recognized midwifery credentials, Medicaid coverage, and other statutory provisions governing midwifery practice.

Certified Nurse Midwives (CNMs) and Certified Midwives (CMs) are credentialed nationally by the American Midwifery Certification Board (AMCB), in addition to state-based licensure requirements. AMCB conducts research on the number of midwives credentialied nationally and by state along with demographic information here.

Nurse Practitioners

Since 1988, The Nurse Practitioner has provided an annual APRN legislative and regulatory update, including a recap of each state’s nurse practice act and related rules and regulations about CNPs (Certified Nurse Practitioners) with limited information on CNMs, CRNAs, and CNSs. The “Annual Legislative Update” is available in print and electronic formats with a condensed version of each state/DC/US Territory report appearing annually in January. The electronic version of “The Annual Legislative Update” is available to the public free of charge.

The American Association of Nurse Practitioners (AANP) also provides electronic information on state practice environments for NPs. Public access includes state information on the regulatory structure and agency, licensure requirements, a link to the Nurse Practice Act, and links to state NP organizations. AANP members have electronic access to State Policy Sheets , which provide additional information on continuing education requirements, medical staff membership, collaborative agreement ratios, and signature recognition.

Physician Associates

The American Academy of Physician Associates (AAPA) regularly revises Physician Associates: State Laws and Regulations with the most recent online edition. This resource provides summaries of more than two dozen key provisions of each state’s statute and regulations complete with legal citations. The AAPA website also provides contact information and links to each state PA regulatory agency.

Even in states where abortion is restricted by law to licensed physicians, there are non-legislative strategies that clinicians can pursue to try to gain authority to incorporate abortion care into their practices through state directives, litigation, and agency policy. If a statute in your state includes an APC-ban that prohibits you from providing abortion care, you can still play an active role in providing reproductive health services to the patients in your community! 

You can:

  • Become part of a network of health professionals that advocates for improved reproductive health services, including access to abortion care.

  • Fight back against efforts to stigmatize, burden, and harass patients who need abortions and the providers who care for them.

  • Become competent to provide the most comprehensive pregnancy options counseling available and educate patients about both medication and procedural abortion.

  • Train to provide abortion-related care (e.g., ultrasounds, counseling) and early pregnancy loss management.

  • Train to provide abortion care in another state that does not have an APC ban.

  • For a deeper dive into advocacy and more ways to promote APCs as abortion care providers, please see the Advocacy section of this toolkit.