Navigating the new landscape: A review of evolving abortion legislation impacting genetic counselors' scope of practice in the United States

The 2022 Dobbs v. Jackson Women's Health Organization ruling, which returned abortion regulation to individual states, has created a fragmented and rapidly changing legal landscape in the United States. These legislative changes have profound implications for healthcare professionals, including genetic counselors (GCs), whose roles encompass providing comprehensive, client-centered reproductive counseling and facilitating access to abortion care. This study conducted a legislative scan of post-Dobbs abortion laws from 2023 to 2024 to assess how specific provisions intersect with the established genetic counseling practice competencies. Using a framework rooted in the genetic counseling scope of practice, state-level abortion laws were categorized into four domains: gestational age limits, fetal condition-specific laws, public funding or insurance coverage, and abortion care coordination. Legislative provisions were classified as restrictive, protective, or intermediate. A Restrictiveness Score (RS) and Protectiveness Score (PS) were calculated to quantify the impact of these laws on GCs' ability to deliver care. Of the 192 legislative provisions identified, 111 (58%) were classified as restrictive; overall, gestational age laws (n = 65, 34%) and insurance coverage/public funding provisions (n = 65, 34%) were the most prevalent. States with high RS values often overlapped with geographic areas of limited access to genetic counseling services. Furthermore, 18 states included “reason bans” targeting fetal conditions, including sex, anomalies, and genetic conditions, directly challenging GCs' ability to provide comprehensive counseling. This study underscores the need for ongoing monitoring of abortion legislation and proactive policy advocacy to protect reproductive health services and genetic counseling practice. By providing a detailed framework for legislative scans, this work offers a replicable model to track evolving legal landscapes and their implications for healthcare delivery.