U.S. abortion rights: Five major battlegrounds for 2025

• Abortion medication will be in crosshairs
• Anti-abortion advocates want action from Trump
• Democrat-led states push back to protect abortion care

RICHMOND, Virginia - With President-elect Donald Trump and his Republican party gaining full control of Washington, D.C. from Jan. 20, fears are rising of more restrictions on abortion care.

A little more than two years after the U.S. Supreme Court overturned a constitutional right to abortion, about half of all states have banned the procedure or severely limited access.

Despite Trump's repeated vow during the 2024 campaign to leave the issue to individual states, the reproductive rights battle is far from settled in the United States, with major implications both inside and outside the country.

Here are some of the major battlegrounds in 2025: 

Abortion pills

The U.S. Supreme Court in June declined to impose a ban on medication abortion in one of its major cases this year, but the battle is set to ramp up once again in 2025.

Three state attorneys general have already revived a lawsuit, and anti-abortion activists have eyed regulations the Trump administration could use to further curtail access, with or without the U.S. Congress.

"Medication abortion, since it is the most popular method of abortion, is the target of the anti-abortion movement," said Amy Williams Navarro, director of government relations at Reproductive Freedom for All, an abortion rights advocacy group.

Travel

As some conservative states look at imposing penalties for people who travel out-of-state to get an abortion or assist others who do so, Democrat-led states like California are trying to move in the other direction and position themselves as "havens" for reproductive health access.

Williams Navarro said such moves were encouraging, but there was only so much overburdened health care professionals could take on.

"Just because blue states have protected access, influxes of patients do have ramifications. It does mean that clinics have more patients that they're seeing; appointments can be pushed further down the line," she said. 

The option of out-of-state travel is an area being closely watched by advocates on both sides of the issue heading into 2025.

"You do have the travel abortions, right, the abortion tourism," said Jor-El Godsey with Heartbeat International, an anti-abortion advocacy group. 

National restrictions

Trump's team said during the campaign that he would not sign a national abortion ban if elected, and some anti-abortion advocates say Congress is unlikely to mount a serious effort at passing one.

"There is no consensus in Congress for any type of national law," said Carol Tobias, president of the National Right to Life Committee (NRLC), an anti-abortion advocacy group. "That's not going to happen."

But abortion rights advocates are wary of Trump's record, given that he appointed three U.S. Supreme Court justices who voted to overturn Roe v. Wade in what was ultimately a 5-4 decision in June 2022.

Asked about a possible veto of a national abortion ban, Trump-Vance Transition spokeswoman Karoline Leavitt said: "President Trump has long been consistent in supporting the rights of states to make decisions on abortion."    

Voter-approved initiatives

The handful of states where voters did back abortion rights and protections are now grappling with how to implement them, and are facing roadblocks from lawmakers in states like Missouri, for example, looking to undermine them.

A group of doctors recently sued in Arizona to try to repeal the state's more than century-old abortion ban after voters approved a constitutional amendment guaranteeing access.

"We hope the courts will quickly recognise the harms of Arizona's ban and strike it down once and for all," said Dr. Eric M. Reuss, an obstetrician and gynecologist in Scottsdale.

Madeline Gomez, senior managing policy counsel at Planned Parenthood Action Fund, said such energy behind the movement is not going to go away, but could take shape in other forms in states where voter-driven initiatives might not be possible.

"As long as there are people dying in states and being put through trauma and unnecessary delays to get the care that they need (where) their doctors are saying 'I know how to do this; I could do this for you; I wish I could, but the law won't let me' – you're going to see people organising to push back against that," she said.    

Foreign aid

Once in office, Trump is all but guaranteed to re-impose restrictions on U.S. aid to overseas groups that perform or promote abortions, a policy that has ping-ponged back and forth depending on the party in power dating back to Ronald Reagan's presidency in the 1980s.

During his first term in office from 2017 to 2021, Trump went further than past Republican presidents, though, by expanding the pool of money subject to the restrictions from about $600 million in family planning funding to the entire pot of U.S. global health assistance money – an estimated $12 billion or so.

"I would love for the administration to reinstate what Donald Trump did in his first (term)," said anti-abortion campaigner Tobias. 

Abortion rights advocates have decried the policy known as the Mexico City Policy or global gag rule, saying it threatens to significantly disrupt reproductive health services, like access to contraception, in countries from Kenya to Nepal.

(Reporting by David Sherfinski; Editing by Anastasia Moloney and Jonathan Hemming)