No state has a better track record on reproductive rights than Oregon, according to a new report.

Seven states and the District received the highest grade, an A-, based on nine indicators chosen by the Institute for Women’s Policy Research (IWPR), a think thank that promotes women’s rights, which did the report as part of its Status of Women in the States series. Ten states earned B’s, 20 earned C’s, nine earned D’s and four states — South Dakota, which ranked last, Nebraska, Kansas and Idaho — received F’s. The Northeast and the West are home to the highest grades, while the South and Midwest scored lowest.

Oregon earned the highest marks, up from 19th in the nation in 2004, when the series was first published. Its top ranking is the result of, among other things: the accessibility to, funding for and political support of abortion; the availability of sex education; and the state’s recognition of same-sex marriage.

[Map: Where working women have it best]

In addition to those metrics, the report also considered whether a state: imposed an abortion waiting period; made minors seeking abortions notify or get consent from parents; required insurance coverage of infertility treatments; or expanded Medicaid either under the Affordable Care Act or through family planning expansions.

Since the 2004 report was published, states have imposed many new abortion restrictions with a particularly large surge in 2011, 2012 and 2013. States passed slightly more abortion limits in those three years than they had in the decade prior, according to the Guttmacher Institute, a reproductive rights think tank.


(Guttmacher)

Overall, states have improved their record on reproductive rights in two areas since 2004, while backtracking or stagnating in five others, according to the IWPR.

[In Arizona, Arkansas, women must be told that abortion can be ‘reversed’]

How reproductive rights improved

Infertility treatments are a reproductive choice unavailable to many men and women thanks to high costs. But, as of June, a dozen states — Arkansas, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island and West Virginia — had passed measures requiring insurers to cover infertility treatments, up from just nine in 2004, according to National Conference of State Legislatures data. But the number requiring insurers to at least offer infertility coverage to policy holders shrank from five to two, with only California and Texas now requiring that option.

Since 2004, access to abortion — measured as the share of women in a county with at least one abortion provider — expanded in 24 states but also shrank in 22 states, according to an IWPR analysis of data compiled by the Guttmacher Institute.


Where reproductive rights declined

The number of states imposing some kind of waiting period — allowing physicians to perform abortions only after notifying patients of their options and waiting a certain number of hours — grew from 26 to 30. In four states — Delaware, Massachusetts, Montana and Tennessee — waiting periods remain on the books even though they are not enforced, according to Guttmacher.


Meanwhile, the share of public officials — governors and legislators — who support abortion rights shrank in 22 states from 2004 to 2015 and grew in only 14, according to NARAL Pro-Choice America’s rankings. The share was unchanged in the remaining 14 states and the District. The governor and the majority of legislators are abortion rights advocates in the District and five states: California, Connecticut, Hawaii, Oregon and Vermont.


(Niraj Chokshi)

The reproductive rights that remained the same

The number of states requiring minors to notify or get consent from their parents before getting abortions held steady, at 43, as of March, according to the report and Guttmacher. Five of those states do not enforce those laws. Among the rest, a dozen require notification, while 21 states require consent. Both are required in five states: Oklahoma, Texas, Utah, Virginia and Wyoming.


There was no change to the jurisdictions that require sex education in school, with 22 states and the District imposing such a mandate. In Tennessee, the requirement kicks in only if the pregnancy rate among 15- to 17-year-olds is 1.95 percent or higher. All but two of those jurisdictions — Mississippi and North Dakota — require HIV education. And 18 of the states and the District require that sex education includes information about contraception. Abstinence information must be provided in 37 states.

Public funding is available for poor women seeking abortions in 17 states, the same as in 2004, the IWPR reports based on Guttmacher data. In 27 states and the District, state funding for abortion was available only when a women’s life was in danger or when a pregnancy was the result of rape or incest.