Mapping abortion regulation in US states: a subnational application of a global framework

Background Following the overturning of Roe v. Wade by Dobbs v. Jackson Women's Health Organization , abortion regulation in the United States (US) is now regulated by individual states, producing a fragmented legal landscape that complicates efforts to assess how state laws align with human rights standards and public health guidance. A recently developed global framework classifies abortion regulation into several models grounded in human rights standards and public health guidance. When adapted, this framework can classify US states, situate them within a global context, and support comparison of state law against these standards. Methods A state-level comparative legal and policy analysis was conducted using data from four organizations that track US abortion law (Bloomberg Law, Center for Reproductive Rights, Guttmacher Institute, and Kaiser Family Foundation), extracted between June 22 and July 4, 2026. The framework was adapted into six models, each representing a different abortion legal environment. States were categorized through a sequential coding process based on four pre-specified criteria: legal status, exceptions, criminal penalties, and healthcare integration. Results No state fell within the criminalization or decriminalization-without-legalization models. 13 states were classified under the restrictive model, 23 under abortion-specific laws and policies with partial decriminalization, ten under abortion-specific laws and policies with full decriminalization, and four (California, Massachusetts, New Jersey, and New York) under legalization as healthcare. Conclusion The distribution of states supports the framework's central claim that decriminalization and legalization are distinct processes that do not necessarily advance together. Most states fall in the middle of the spectrum, with only four integrating abortion into healthcare, consistent with the literature on abortion exceptionalism. The adapted framework offers a replicable, updatable method for situating US states within a global context and monitoring where their abortion laws sit relative to human rights standards and public health guidance, which current international mechanisms, focused on the national level, do not fully capture.