Seven Southern Cities Ranked Among the Lowest in Reproductive Freedom

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The National Institute for Reproductive Health (NIRH) today released the Local Reproductive Freedom Index to evaluate the reproductive health, rights and justice policies of 40 U.S. cities including eight southern cities.

Using 37 unique policy indicators, the Local Reproductive Freedom Index calculates how individual cities are protecting and advancing reproductive freedom across a range of categories including access to abortion clinics, funding and coverage for reproductive health care, support for young people and families and advancement of inclusive policies for all people.  

Of the 40 U.S. cities analyzed in the Local Index, San Francisco was found to be best equipped to protect and advance reproductive freedom for its residents followed closely by New York City, Chicago, Los Angeles, Seattle and Philadelphia.



These seven southern cities evaluated in the Index are among the lowest scoring overall: New Orleans and Miami each scored two stars out of five – the average score for the 40 cities – while Atlanta, Charlotte, Nashville, Memphis and Louisville only earned 1.5 out of 5, the highest possible score. Cities in the southeast have some of the lowest scores of cities across the country, reflecting a restrictive political climate on the state level, as well as policies in many states, especially North Carolina and Tennessee, that preempt much of these cities’ abilities to implement policies that would benefit their community.

“Andrea Miller of NIRH sharing horror story of $12k costs 4 legal abortion when health insurance won’t pay.

The NIRH asserts that the Trump administration has assaulted women’s individual freedoms, bodily autonomy, and reproductive health care. “As the federal government works to strip women of control over their reproductive and sexual lives, and many states move to pass even more draconian anti-abortion restrictions than in previous years, local action is becoming increasingly important,” said Andrea Miller, president of NIRH and the NIRH Action Fund. “If the White House and State Houses won’t stand up for women, then City Hall has the opportunity to lead.”

None of the seven cities have abortion funding provisions in place, as none of their states provide Medicaid coverage of abortion. Only Miami and New Orleans have received funding for sex education. Signs of promise in these Southern cities include Charlotte, NC’s efforts to protect the LGBTQ community from discrimination, advocacy and organizing in Louisville to protect Kentucky’s only abortion clinic from harassment by protesters, innovative women of color-led community organizing around comprehensive sexuality education in Memphis, and policies in Atlanta and Nashville that provide paid family leave to municipal employees.

Nine cities, according to the NIRH, are striking back against Congress’ “repeated attacks on reproductive freedom,” passing progressive measures urging Congress to act on federal policy solutions, such as repealing the Hyde Amendment and similar bans.

“As a Louisville Clinic Escort, I am grateful to have the Local Index as a call to action and a roadmap for our communities,” said Meg Stern a clinic escort in Louisville, KY. “We know that Kentucky has a long way to go in ensuring that all residents have the reproductive health care they need, and we look to Louisville policymakers and advocates to use the Local Index to identify opportunities for progress and provide models we can look to for inspiration.”

Kicking-off today in San Francisco, Miller is beginning a tour of four key cities in the Index: San Francisco, Boston, Detroit and St. Louis. She’ll meet with advocates, partners, community member and lawmakers alike for conversations around the importance of city leadership when it comes to ensuring residents’ reproductive freedoms, and to learn more about what those cities need to succeed.


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