The best way to predict the success of pro-life political strategies in a particular state is to look at that state’s church attendance rate.
In 10 of the 11 states where 40 percent or more of the population goes to church at least once a month, abortion is almost entirely illegal. The lone exception is heavily Mormon Utah, where the state government has adopted an abortion ban, but the courts have blocked it.
On the other hand, in all but two of the 17 states with monthly church attendance rates below 30 percent, abortion is fully legal, with most of these states offering state Medicaid funding for the procedure.
This is true even in conservative states with low church attendance rates. Alaska, for instance, has voted Republican in every presidential election for the last 60 years, but as a state with a church attendance rate below 30 percent, its policies are strongly pro-choice. The state’s Medicaid program not only covers elective abortions but in some cases also reimburses recipients for travel to an abortion clinic.
But the largest contingent of states falls somewhere between these extremes. With church attendance rates above 30 percent but below 40 percent, the 22 states in this middle group generally lean pro-choice, with only a few exceptions. About two thirds of these states reliably vote Republican. But the vast majority also allow most or all abortions. Only a few ban abortion before 12 weeks, and most allow nearly unrestricted abortion during most or all of the first two trimesters of pregnancy.
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What can pro-lifers do in these largely unchurched states where support for the Republican Party might be strong but few voters want to restrict abortion?
When pro-lifers have tried to ban abortion against the will of their state’s majority, they have failed. In Ohio, a Republican state where only 32 percent of the population attends church even once a month, citizens voted in 2023 by a margin of 57 to 43 percent to make abortion constitutionally protected up to the point of viability.
Pro-lifers in Ohio have now gone back to the drawing board and proposed modest restrictions on abortion that might win political support in the Republican-controlled legislature. One bill would require a 24-hour waiting period for abortion. Another would require abortion providers to give women a document outlining the risks of an abortion.
Yet to really bring down abortion rates in states like Ohio, pro-life advocates will need to cut off sources of state funding for abortion. Multiple studies have shown that mandatory waiting periods have little, if any, effect on abortion rates. At the same time, studies suggest that Medicaid funding for abortion substantially affects abortion rates.
In Illinois, a study found the introduction of state Medicaid coverage for abortion in 2018 increased the number of abortions in the state by 18 percent, which amounted to more than 6,000 per year. Conversely, when government funding for abortion is cut, abortion rates drop and Planned Parenthood clinics close. In 2025, three Planned Parenthood clinics in Ohio closed because of cuts in Medicaid funding.
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What is happening in Ohio holds lessons for the nation, because when it comes to abortion, the national Republican Party now reflects sentiment in states with modest church attendance rates far more than in the highly churched states of the Bible Belt. President Donald Trump and Republican political leaders in Washington have shown scant interest in pushing for national restrictions on abortion. Instead, Trump even floated the idea in January of compromising on the Hyde Amendment, which restricts federal funding for abortions.
But Republicans in Washington listened to pro-lifers when they insisted that the Hyde Amendment was nonnegotiable. In doing so, pro-lifers probably saved unborn lives, because if the Hyde Amendment were removed, abortion rates would almost certainly increase.
In an ideal world, this type of lobbying would not be necessary because a national culture of church participation would result in a societal consensus in favor of protecting the unborn. Ultimately, if pro-life Christians can share the gospel and increase the number of churchgoers in their regions, they might be able to do more lasting good for the pro-life cause than any purely political strategy could accomplish.
But in the meantime, pro-life Christians who want to engage in political battles on this issue have to face the reality that church attendance rates in most states are low enough that even Republican politicians are afraid of abortion prohibitions. Yet in such a climate, pro-lifers can still win modest victories and save lives by focusing their efforts on the one area where they have a chance of success—restrictions in abortion funding. Cutting off state or federal Medicaid funds for abortion is not the same as protecting the unborn in public law, but it can still save some.
Daniel K. Williams is an associate professor of history at Ashland University and the author of Abortion and America’s Churches.
