Abortion bans and restrictions limit women's participation in the workforce, according to a new analysis that quantifies the negative impacts on state economies.

South Dakota saw an average loss in GDP of nearly 1% per year between 2021 and 2023, due to a drop in labor force participation by people who became pregnant and didn't have access to abortion care, according to data from the Institute for Women's Policy Research. That adds up to nearly $641 million in economic losses to the state.

Jamila Taylor, president and CEO of the Institute for Women's Policy Research, said the 16 states with abortion bans or extreme restrictions, including South Dakota, are costing the national economy $68 billion annually.

"Not only do these restrictions and bans have a clear impact on the health and well being of people with the ability to get pregnant, they also have an impact on their productivity and their economic position in life," Taylor said.

Taylor added abortion access not only helps family finances, but also allows women ages 15 to 44 to engage more broadly in society -- in local communities or politics, for example.

Despite restrictions, abortion numbers are rising. The first full calendar year after the Dobbs decision overturned Roe v. Wade saw an 11% increase in abortions since 2020 - or over one million abortions in the formal health care system in 2023, according to The Guttmacher Institute.

If voters pass South Dakota's constitutional Amendment G in November, it will enshrine protections to abortion.

Hannah Haksgaard, University of South Dakota law professor, said even if it passes, people seeking an in-state abortion would likely see a lag time before services become available.

"There would still likely be state legislation that would try to restrict abortion in certain ways, and then the question would become whether those restrictions violated the new constitutional amendment," she said.

Haksgaard added that could make providers move slowly on offering abortion services in the state, until the legal issues are settled.


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In an unusual set of circumstances, the Nebraska Supreme Court will hear arguments in three lawsuits about the two abortion-related ballot initiatives, each of which had successful petition drives for the November ballot.

The first two lawsuits ask the Nebraska Supreme Court to rule to keep "Protect our Rights," which would legalize abortions until fetal viability, off the ballot. They claim it violates the state's "single subject" rule.

The third suit was filed in response to these on behalf of 29 Nebraska physicians who support Protect Our Rights.

Joshua Livingston, an attorney at the Koenig Dunne law firm in Omaha, which filed the lawsuit, said there are two types of access at stake.

"These physicians spend their days working with Nebraska patients, and they understand what Nebraskans need and what Nebraskans are asking for," Livingston explained. "Over 200,000 Nebraskans signed this petition asking for their voices to be heard. So the goal is access to health care and access to the ballot."

Livingston maintained the only fair outcome would require both initiatives to remain on the ballot or both to be removed. The "Protect Women and Children" initiative would prohibit abortions after the first trimester. The Nebraska legislature passed a 12-week abortion ban in 2023.

Livingston noted their position is that the "single-subject" rule would allow both initiatives to remain on the ballot.

"What we're really seeing is that the opponents to Protect Our Rights, the activist opponents, are scared of what the outcome is going to be," Livingston contended. "They're scared that if Nebraskans have the opportunity to expand abortion health care, they're going to vote in favor of that."

Livingston stressed Nebraska voters' right to be heard is really what is at stake here. He added they hope the Nebraska Supreme Court will rule before the Sept. 13 deadline for Nebraska ballots to be finalized.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, voters in six states have passed constitutional amendments to protect abortion rights.


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The Commonwealth has the second-highest maternal mortality rate in the nation, and within the state maternal deaths are twice as high among Black women.

Tamara Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said the lack of OBGYN's in the state is part of the problem. Wieder is one of the recipients of this year's Healthy Kentucky Champions Award, given by the Foundation for a Healthy Kentucky, and says legislative efforts such as the Momnibus Bill passed earlier this year will make a huge difference in improving women's outcomes.

"These are nonpartisan bills that we can find common ground on in a state that lacks equitable access to care. We can really have a dialog that brings everybody to the table, and that is something that's really important to me," she said.

The Momnibus Bill adds pregnancy to the list of qualifying life events for health coverage, increasing the odds of women receiving prenatal care; and expands programs that provide free lactation counseling, telehealth assistance, and mental health support for new moms. According to the CDC, more than 80% of maternal deaths are preventable.

Dr. Elizabeth Ottman, an obstetrician-gynecologist with Ohio County Healthcare, said perinatal mental health disorders are the most common complication of pregnancy. Several years ago she launched an innovative program to treat women suffering from postpartum depression with the first FDA-approved drug for the condition. She said the state's efforts to expand broadband access have helped more rural women get help.

"It's allowed us to do more and more telehealth and do meetings with patients to make access easier for them, because it's very difficult when you're depressed to pick up the phone and make an appointment and drive to the doctor. It is super difficult when you're a rural community and you have to drive miles to the doctor with a new baby," she continued.

According to federal data, 76 of Kentucky's 120 counties lack an OBGYN doctor.

Legal disputes still surround North Dakota's abortion ban.

Underneath the court activity is the influence of "crisis pregnancy centers" and debate over the state's role in supporting them. The facilities have become controversial in recent years. Opponents said they pose as a non-biased resource with services such as peer counseling and infant supplies but instead have a mission to steer women toward keeping their pregnancy. North Dakota is one of several states with abortion restrictions to set aside funding for these centers.

Kali Bauer, executive coordinator of the Minot Women's Network, said it is troubling.

"This state funding is allowing them to continue a lot of these practices that are not evidence based and do not adhere to the same medical standards that traditional clinics have to abide by," Bauer pointed out.

Bauer added the centers are often staffed by untrained and unlicensed individuals. North Dakota is currently providing $1 million to fund its "Alternative to Abortions" program. Opponents want lawmakers to revisit the issue next session and establish accountability measures. A Republican sponsor has vowed to block such efforts, arguing the initiative is not harmful to clients.

After the U.S. Supreme Court overturned federal abortion protections, North Dakota joined the wave of conservative-led states to enact bans. In response, other states, such as neighboring Minnesota, have expanded access to assist patients living under restrictions elsewhere.

Sen. Janne Myrdal, R-Edinburg, contended North Dakota's program is trying to help women with an unwanted pregnancy succeed.

"Women that find themselves in crisis pregnancy need the support from volunteerism, from the local communities," Myrdal contended. "But also we stepped in as a state and said, 'We're going to fund these places because they affirm life, like our law said.'"

Because of other budget priorities, Myrdal does not anticipate pushing for increased funding for the centers, but she feels they are transparent and no additional oversight is needed.

Bauer suggested the descriptions of crisis centers leave out practices she feels are dangerous.

"Even providing medically inaccurate information, such as information on how to reverse a medical abortion," Bauer noted.

Meanwhile, a judge recently announced he would decide whether to dismiss a legal challenge to North Dakota's abortion ban. The request blocked a trial in the case from getting underway last month.


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