Just hours after the Supreme Court overturned Roe v. Wade, Nashville Metropolitan Council member Delishia Porterfield got to work. She knew abortion would soon be illegal under Tennessee’s trigger ban. But Porterfield was determined to blunt the law’s impact. She started with a resolution asking police to make investigating abortions their lowest priority.

“From the very moment that this was overturned, we kicked into gear as a city to do everything we could to protect the residents,” Porterfield told me. In the three months following the Supreme Court decision Dobbs v. Jackson Women’s Health Organization, she and her colleagues on the metropolitan council—a body that represents Nashville and its surrounding county of Davidson—have passed at least four measures to protect abortion rights, including the one deprioritizing abortion enforcement and another that allocates $500,000 to Planned Parenthood of Tennessee and North Mississippi. “We’ve tried to be as creative as we can in just thinking through every single option available to us,” Porterfield said.

Her work is part of a record-setting flurry of legislation at the state and local level to promote abortion access, according to a report released today by the National Institute for Reproductive Health, an organization that works with local policy-makers to promote reproductive health care access. In the first three months since the fall of Roe, a total of 17 states and at least 24 municipalities have passed measures or issued executive orders to expand or protect abortion access.

“The level of affirmative policy-making that happened in this three-month window is unlike anything I’ve ever seen,” Andrea Miller, president of NIRH, told me. “There is a real new awakening to the importance of state and local advocacy, politics, and health care access.”

Here is a snapshot from the three months after Dobbs:

• Four states and at least 11 localities tackled financial barriers to abortion, both in places where abortion is banned or restricted and in places where it remains legal. Atlanta; Chicago; Columbus, Ohio; Fresno, Calif.; Nashville and Davidson County, Tenn.; New York City; and Seattle directed state or municipal funding to abortion access. Cuyahoga County, Ohio; and St. Louis, Mo., directed funding from the American Rescue Protection Act to abortion access. While the Hyde Amendment has banned most federal funding of abortion for more than 40 years, the ban didn’t apply to ARPA funds. New York City became the first city to directly fund abortions in 2019.
• Four states and at least 12 localities moved to protect against abortion-related prosecution. In California, Massachusetts, Delaware, and New Jersey, where abortion remains legal, legislatures passed laws to protect abortion providers and/or patients from legal threats coming from outside the state, including extradition to states where abortion is banned. Localities in states that have banned or heavily restricted abortion, including Athens–Clarke County and Atlanta, Ga.; Austin, Dallas, Denton, and Travis County, Tex.; and New Orleans passed measures like the one Porterfield introduced in Nashville to say that abortion-related prosecution should be law enforcement’s lowest priority.
• One state and several municipalities secured reproductive health information. Athens–Clarke County and Atlanta, Ga.; Boise, Idaho; Austin, Dallas, San Antonio, Denton, and Travis County, Tex.; and New Orleans banned the use of city and/or county funds to conduct surveillance or collect information to determine if someone has had an abortion. The metropolitan council in Nashville banned law enforcement from using license plate readers to enforce abortion laws. California, which has become a destination for abortion seekers, passed laws to prevent law enforcement from cooperating with out-of-state legal processes investigating a lawful abortion and banned health care providers and employers from releasing information on people seeking an abortion in response to a subpoena from out of state.
• Sacramento and Seattle authorized buffer zones outside of clinics.
• Pittsburgh; Seattle; and Cambridge, Mass. banned deceptive advertising by anti-abortion pregnancy centers. New York City established an advertising campaign to counteract the misleading information issued by these centers.
• Three states—California, Delaware, and Washington—expanded the scope of who can provide abortions to include physician assistants and nurse practitioners.
• Governors and attorneys general in 14 states issued orders to protect abortion access.

That’s just a sampling. Meanwhile, for those keeping track at home, the grand total of measures passed by Congress to restore the nationwide right to legal abortion is zero.

Of course, the policies to expand abortion access don’t yet outweigh the devastating impact of measures to restrict abortion. In the first 100 days after the decision, 66 clinics across 15 states stopped offering abortions, according to the Guttmacher Institute. At least a dozen states ban abortion today. But even within restrictive states, city and county governments have managed to make a tangible difference in creative ways. In Austin, Tex., the city council banned employment discrimination based on a person’s reproductive health care decisions. Atlanta passed measures to deprioritize abortion-related investigations, protect reproductive health information, and donate $300,000 to the abortion fund ARC Southeast.

“Democracy is only fully functional and representative when it functions to its full potential at all levels of government,” Atlanta city councilwoman Liliana Bakhtiari told me. “I would argue that city government hasn’t been doing all that it could be doing to protect the safety and lives of its constituents for quite some time.”

The Dobbs decision, combined with a lack of action from Congress, has forced abortion rights supporters into a long-overdue recognition of the power of local and state policy-making—a domain that has long been claimed by abortion opponents. Last year, state legislatures enacted a record 108 abortion restrictions across 19 states. These state laws chipping away at abortion access date back decades—as do efforts to restrict abortion through city ordinances. Just five years after Roe v. Wade, the city of Akron, Ohio, passed an ordinance with a lengthy list of abortion restrictions; the Supreme Court struck it down in 1983.

More recently, Mark Lee Dickson, a pastor and director of Right to Life of East Texas, has convinced some 60 cities to ban abortion within city lines by declaring themselves sanctuary cities for the unborn. While most of these cities didn’t have an abortion clinic, the Planned Parenthood in Lubbock was forced to stop offering abortions after the city passed one of Dickson’s ordinances. Most of the “sanctuary cities for the unborn” are in Texas, where Dickson and legal mastermind Jonathan Mitchell used the ordinances to debut a private citizen enforcement mechanism that later allowed a six-week abortion ban to take effect in Texas before Roe fell.

Dickson has now shifted his attention to cities in states like New Mexico and Colorado where abortion remains legal and where abortion clinics might try to relocate from hostile states. In November, the city of Hobbs along the New Mexico–Texas border passed a version of Dickson’s ordinance that invokes federal law to claim that mailing abortion pills or instruments used to perform abortion is illegal. Dickson has called the ordinance a “de facto” ban. During a recent appearance in Pueblo, Colo., where city officials are considering a version of his ordinance, Dickson urged city leaders to take action in the wake of Dobbs.

“The strongest body of government outside of the local church…is the local government,” Dickson said. “You can get things accomplished here at the local level that you can’t get accomplished at the state capital.”

It seems policy-makers who support abortion rights are finally starting to agree.