Tennessee’s abortion laws changed significantly after the 2022 U.S. Supreme Court decision overturning Roe v. Wade. These changes make Tennessee one of the states with the most restrictive abortion policies, affecting both patients and healthcare providers. The state’s laws now include strict limitations and significant penalties.
Key Prohibitions
After the Roe v. Wade reversal, Tennessee’s Human Life Protection Act, a trigger law from 2019, took effect on August 25, 2022.1Tennessee Attorney General. Human Life Protection Act to Take Effect August 25, 2022 This law, Tennessee Code Annotated 39-15-213, prohibits performing or attempting an abortion from fertilization, making it illegal in nearly all circumstances.2Justia Law. Tennessee Code § 39-15-213: Criminal Abortion – Affirmative Defense (2024)
This ban replaces previous gestational age limits and prohibitions on abortions based on reasons like race, sex, or a Down syndrome diagnosis. Performing or attempting an abortion is a criminal offense for the provider, but the law does not penalize the pregnant individual.
The legal definition of abortion in Tennessee does not include certain medical procedures. For example, removing an ectopic or molar pregnancy, or treating an incomplete miscarriage where there is no embryonic or fetal cardiac activity, are not considered abortions. Medical treatment for a pregnant person that unintentionally harms or causes the death of the unborn child is also not a violation. The state also prohibits intact D&E (dilation and evacuation) procedures.
Consent and Notice Requirements
Tennessee has laws for consent and notification for medical procedures, including those that would end a pregnancy, detailed in the Woman’s Right to Know Act (Tennessee Code Annotated 39-15-202).3Justia Law. Tennessee Code § 39-15-202: Woman’s Right to Know Act (Consent and Waiting Period) (2024) While the state’s broad abortion ban greatly limits when these rules apply, the laws are still in place.
Previously, these laws required physicians to give specific information to the pregnant individual, including medical risks, gestational age, and alternatives like adoption, followed by a mandatory 48-hour waiting period. This waiting period could only be waived for certain medical emergencies.
For unemancipated minors, the law requires written consent from one parent or legal guardian for an abortion.4Justia Law. Tennessee Code § 37-10-303: Parental Consent for Minor’s Abortion and Judicial Waiver (2021) A minor can ask a court for permission without parental consent through a judicial bypass procedure if she is found to be mature and well-informed, or if the abortion is in her best interest. These court proceedings are confidential and handled quickly.5Tennessee Administrative Office of the Courts. Rule 24: Rules of Procedure for Petitions for Waiver of Parental Consent for Abortions by Minors
Exceptions
Tennessee’s abortion ban has a narrow exception. An abortion is allowed if it’s necessary to save the pregnant person’s life or prevent a serious risk of substantial and irreversible harm to a major bodily function. This is an affirmative defense, meaning a physician charged with performing an illegal abortion must prove the procedure met these strict conditions.
This defense cannot be used based on claims that the pregnant person might self-harm or for mental health reasons. When using this defense, the physician must also try to give the unborn child the best chance of survival, unless doing so would create a greater risk to the pregnant person.
The medical community has expressed concerns that this medical emergency exception is unclear. An October 2024 Tennessee Chancery Court ruling in Blackmon v. Tennessee temporarily stopped disciplinary actions against physicians for abortions in cases of specific dangerous pregnancy complications and lethal fetal diagnoses.6WPLN News. Davidson County Chancery Court Order in Blackmon v. Tennessee (Oct. 17, 2024) The court found the existing exception “demonstrably unclear” and noted that conditions like PPROM, inevitable abortion, and certain fatal fetal diagnoses causing severe maternal health problems could qualify as medical necessities.
There have been legislative efforts to clarify which medical conditions qualify for this defense, such as severe preeclampsia and infections that threaten fertility, while confirming that mental health conditions do not qualify. The federal Emergency Medical Treatment and Labor Act (EMTALA) also plays a role. Federal guidance suggests EMTALA requires hospitals to provide stabilizing treatment, which could include an abortion if a physician believes it’s necessary for an emergency medical condition.7Centers for Medicare & Medicaid Services. HHS Guidance: Emergency Medical Care Includes Abortion Services Under EMTALA
Penal Consequences
Under Tennessee’s Human Life Protection Act, performing or attempting to perform an abortion is a Class C felony. This can result in a prison sentence of three to fifteen years and a fine of up to $10,000.8Justia Law. Tennessee Code § 40-35-112: Felony Sentence Ranges (2024) The pregnant individual does not face criminal penalties.
In addition to criminal charges, physicians who violate the ban can lose their medical license. A court can review whether an abortion met the narrow affirmative defense criteria, examining the physician’s medical judgment after the procedure.
Violating parts of the Woman’s Right to Know Act, such as informed consent rules (if applicable), can be a Class E felony, with penalties of one to six years in prison and a fine up to $3,000. Failing to post required notices, like those about coerced abortion, can lead to civil fines, such as $1,000 per day.
Providing drugs for a medication abortion without an in-person physician visit is also a Class E felony, carrying a fine up to $50,000. A 2024 law, which is currently being challenged in court, makes it illegal to recruit, harbor, or transport a minor within Tennessee for an abortion without parental consent. Penalties for this range from a Class A misdemeanor to a Class C felony.
Provider Eligibility
Tennessee law requires that any abortion must be performed by a physician licensed in the state. Other healthcare professionals, such as physician assistants or nurse practitioners, cannot perform abortions.
A physician is defined as someone with an active, unrestricted license from the Tennessee Board of Medical Examiners or the Tennessee Board of Osteopathic Examination.
Physicians performing abortions, even under the narrow affirmative defense, must follow accepted medical standards. Medical boards oversee physician conduct and ensure compliance with state laws.
Enforcement Mechanisms
Tennessee’s abortion laws are enforced through criminal charges and administrative actions. District Attorneys General in each judicial district usually handle criminal charges for unlawful abortions. The Tennessee Attorney General’s Office might get involved in cases with statewide importance.
Administrative oversight comes from the Tennessee Department of Health through its professional licensing boards, like the Board of Medical Examiners and the Board of Osteopathic Examination.9Tennessee Department of Health. Tennessee Board of Medical Examiners These boards regulate physicians and can investigate complaints about violations of abortion laws.
Medical board investigations can include gathering evidence, conducting interviews, and reviewing records. If a violation is found, disciplinary actions can be taken, separate from any criminal charges. Courts handle criminal trials and review decisions from administrative bodies.