JULIA ROLLISON, SKYE A. MINER, MAYA BUENAVENTURA, RACHEL HOLZER, YOONY LEE, MEKDES SHIFERAW
Understanding the
State and Local Policies
Affecting Abortion Care
Administration, Access,
and Delivery
A Case Study in Virginia
T
he patchwork of laws and regulations that affect abortion access in the United States has
become increasingly complex since the 2022 Dobbs v. Jackson Women’s Health Organization
U.S. Supreme Court decision that gave states the right to enact and enforce policies facili-
tating or restricting abortion access.
1
In addition, local and institutional-level policies can
create further complexities and challenges. Local governments often vary in how they implement
state regulations, which contributes to differences in abortion provision and access.
2
Finally, facili-
ties can introduce another policy layer, ranging from additional restrictions on gestational age limits
to implementing policies that may ease access (e.g., telehealth options).
Although previous research has explored how state, local, and institutional policies affect abor-
tion provision, much of this work was performed prior to Dobbs.
3
Since Dobbs, many researchers
have shifted focus to comparing state policies, often focused on gestational age limits. However,
other provisions and policies might differentially affect access. In our initial study examining the
policy landscape within North Carolina, we found that North Carolina Senate Bill 20 significantly
influenced how facilities and clinicians provided abortion care and greatly affected patients’ access.
4
This was perhaps not surprising given the changes introduced through that bill and the timing of
our study, which was within a year of the bill’s implementation.
To further identify how state, local, and institutional policies intersect to affect access to abor-
tion care, we identified a second state, Virginia, with no recent legislative changes at the state level
around abortion access. Virginia offers a unique case study given that it is one of the only remaining
states in the South post-Dobbs with legal access to abortion care past 13 weeks gestational age.
Research Report
