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Dozens of bills are advancing through statehouses nationwide that would put an array of new obstacles -- legal, financial and psychological -- in the paths of women seeking abortions.
The tactics vary: mandatory sonograms and anti-abortion counseling, sweeping limits on insurance coverage, bans on abortions after 20 weeks of pregnancy. To abortion-rights activists, they add up to the biggest political threat since the Roe v. Wade decision of 1973 that legalized abortion nationwide.
"It's just this total onslaught," said Elizabeth Nash, who tracks state legislation for the Guttmacher Institute, a reproductive-health research organization that supports abortion rights.
What's different this year is not the raw number of anti-abortion bills, but the fact that many of the toughest, most substantive measures have a good chance of passage due to gains by conservative Republicans in last year's legislative and gubernatorial elections. On Tuesday, South Dakota Gov. Dennis Daugaard signed into law a bill that would impose a longest-in-the-nation waiting period of three days before women could have an abortion -- and also require them to undergo counseling at pregnancy help centers that discourage abortions.
"We're seeing an unprecedented level of bills that would have a serious impact on women's access to abortion services that very possibly could become law," said Rachel Sussman, senior policy analyst for the Planned Parenthood Federation of America.
On the other side, anti-abortion strategists such as Mary Spaulding Balch of the National Right to Life Committee have been scrambling to keep up with legislative developments: "Until the bills get on the governors' desks, it's premature to claim victory. But it's moving faster than it has in previous years. ... We're very pleased with the progress thus far."
In a number of states, lawmakers are considering bills that would ban elective abortions after 20 or 21 weeks of pregnancy. These measures are modeled after a law approved last year in Nebraska that was based on the disputed premise that a fetus can feel pain after 20 weeks.
The Idaho Senate approved one such bill Wednesday, sending it to the House, while a similar bill won final legislative approval in the Kansas Senate. The same type of measure is pending in Oklahoma and Alabama.
In Ohio, there's been a hearing on an even tougher measure that would outlaw abortions after the first medically detectable heartbeat -- as early as six weeks into a pregnancy. At that hearing, two pregnant women underwent ultrasounds so lawmakers could see and hear the fetal hearts.
The Ohio bill and the bans on abortions after 20 weeks are direct challenges to the legal status quo, based on Supreme Court rulings that permit abortions up to the point of a fetus' viability -- approximately 24 weeks -- and allow states to impose restrictions for abortions after that stage.
In Texas, a bill passed by the House would require that pregnant women have an opportunity to view a sonogram image, hear the fetal heartbeat and listen to a doctor describe the fetus. While the doctor would be obligated to provide the information, the woman could close her eyes or cover her ears, according to the bill, which doesn't exempt victims of rape or incest.
"We don't believe these bills will dissuade women who've already made their decisions," said Donna Crane of NARAL Pro-Choice America. "What we think they will do is harass and intimidate women who don't deserve it."
Balch disagreed, insisting that the South Dakota bill and the sonogram measures in several states were not coercive.
"When a woman is pregnant and doesn't want to be, the more information she has, the better," Balch said. "That's what these laws are trying to do -- give a thoughtful pause so the mother can understand the options that are out there."
In more than 20 states, bills have been introduced to restrict insurance coverage of abortion. In Utah, one such measures -- affecting both private and public plans -- has cleared both legislative chambers and been sent to Gov. Gary Herbert.
Of the various types of bills, the insurance bans could have the broadest impact, according to some abortion-rights activists.
"You could have nearly half the states where you couldn't buy regular insurance coverage for abortion even with your own money," Crane said. "This is having a transformational effect on the insurance industry and the way abortion is viewed."
While routine first-trimester abortions generally cost $400 to $700, later and more complicated abortions can run into the thousands of dollars, especially if hospitalization is needed.
"A lot of these bills have an edge to them that really discounts the complications that can occur in pregnancy," said Planned Parenthood's Sussman. "There's a disregard for women's health."
Florida is a prime battleground. With a new Republican governor, Rick Scott, who touts his anti-abortion beliefs, conservative lawmakers have introduced at least 18 bills on the topic -- including proposals to require ultrasound and to ban most insurance coverage of abortion.
"That could result in tens of thousands of women losing coverage," said Stephanie Kunkel, executive director of the Florida Association of Planned Parenthood Affiliates.
A different tactic is being tried in Virginia, where lawmakers last month passed a bill requiring abortion clinics to be regulated on the same basis as hospitals. Abortion-rights group said this could entail higher costs and force several clinics to close.
Many of the states where anti-abortion bills are advancing have new Republican governors who made campaign pledges to support such efforts.
For example, Kansas Gov. Sam Brownback urged legislators to create a "culture of life" and is considered likely to sign the pending bill that would tighten restrictions on abortion after the 21st week of pregnancy.
The sponsor of the Idaho bill to impose a similar ban after 20 weeks, Sen. Chuck Winder, summoned out-of-state medical and legal experts to tell colleagues that a fetus at that point will suffer pain during an abortion. It's a disputed assertion; the American Congress of Obstetricians and Gynecologists says it knows of no legitimate evidence showing a fetus can ever experience pain.
Thus far, the year-old Nebraska law banning most abortions after 20 weeks has not been challenged in court. That has emboldening abortion foes to promote versions of it in other states this year even though the nationwide norm is to allow elective abortions up to roughly 24 weeks.
Jill June of Planned Parenthood of the Heartland, which operates in Nebraska and Iowa, said she expected the 20-week ban to be challenged at some point -- either in Nebraska or some other state that passes such a law.
She cited the case of Danielle Deaver, a Nebraska woman who -- under the new law -- was denied the option of terminating a pregnancy at 22 weeks after she learned the baby was nonviable.
Deaver ended up going into natural pre-term labor and gave birth to a girl who died after 15 minutes. She later told her story to local media, expressing hope that other legislators would consider the ramifications as they contemplated such bans.
"There will be more women like her who will be harmed if these laws continue to be passed in other states," June said.