Indiana’s SB 1, enacted during the 2022 special session as Senate Enrolled Act 1, bans abortion in the state except in three narrow circumstances: when the pregnant patient faces death or serious, irreversible physical harm; when the fetus has a lethal anomaly; or when the pregnancy results from rape or incest and the patient is within ten weeks of fertilization.1Indiana General Assembly. Indiana Code 16-34-2-1 – Required Circumstances of Legal Abortion Even when an exception applies, the procedure must happen in a hospital or a hospital-owned surgical center, and a physician who performs an abortion outside the exceptions commits a Level 5 felony. The law took effect after the Indiana Supreme Court allowed it to stand, and a renewed challenge was turned away in May 2026.
The Three Legal Exceptions
Every abortion in Indiana is unlawful by default. A physician who performs one must be able to document, in writing, which of the three statutory exceptions applied and why.
Serious Health Risk or Life Endangerment
A physician may perform an abortion when, in their reasonable medical judgment, it is necessary to prevent the patient’s death or to avoid a serious risk of substantial and irreversible physical impairment of a major bodily function.2Indiana General Assembly. Indiana Code 16-18-2-327.9-b – Serious Health Risk The statute explicitly excludes psychological and emotional conditions and bars physicians from relying on any claim that the patient intends self-harm. This is one of the narrowest health exceptions in the country, and it leaves physicians to decide, often quickly, whether a given condition has crossed the statutory threshold.
Lethal Fetal Anomaly
An abortion is permitted when a fetus has been diagnosed with a lethal fetal anomaly, defined under Indiana law as a condition diagnosed before birth that, if the pregnancy results in a live birth, will with reasonable certainty cause the child’s death within three months.3Indiana General Assembly. Indiana Code Title 16 Health 16-25-4.5-2 The physician must formally diagnose the condition and record it in the patient’s medical file. This exception has no gestational time limit.
Rape or Incest
When a pregnancy results from rape or incest, an abortion is permitted only during the first ten weeks after fertilization.1Indiana General Assembly. Indiana Code 16-34-2-1 – Required Circumstances of Legal Abortion A police report is not required, but the physician must document the patient’s account in the medical record. After the ten-week window closes, this exception no longer applies regardless of the circumstances.
Where a Legal Abortion Can Take Place
SB 1 eliminated standalone abortion clinics as authorized facilities. A legal abortion must now be performed in either a hospital licensed under Indiana Code 16-21 or an ambulatory outpatient surgical center where a licensed hospital holds majority ownership.1Indiana General Assembly. Indiana Code 16-34-2-1 – Required Circumstances of Legal Abortion For procedures at or after twenty weeks of post-fertilization age, only a licensed hospital qualifies. The practical result is that the independent clinics that previously handled most abortions in Indiana are no longer part of the system.
Medication Abortion
Medication abortion is subject to the same ban and the same exceptions as surgical procedures, with additional restrictions on how the drugs are dispensed. A physician who prescribes an abortion-inducing drug must dispense it to the patient in person, and the patient must take the medication in the physician’s presence.1Indiana General Assembly. Indiana Code 16-34-2-1 – Required Circumstances of Legal Abortion Telehealth prescriptions and mail-order distribution are not permitted. The in-person requirement means a medication abortion has the same facility and visit requirements as any other legal abortion in the state.
Informed Consent and the Eighteen-Hour Wait
Before any legal abortion, a physician or qualified professional must deliver a set of disclosures to the patient, both orally and in writing, at least eighteen hours before the procedure.4Indiana General Assembly. Indiana Code Title 16 Health 16-34-2-1.1 The required content covers the nature of the procedure, medical risks, alternatives, the probable gestational age with developmental information and an image, the availability of medical assistance for prenatal and neonatal care, the father’s child support obligations, and adoption alternatives.
Several disclosures go beyond standard medical counseling. The physician must state that human physical life begins at fertilization and that scientific information indicates a fetus can feel pain at or before twenty weeks post-fertilization. For a medication abortion, the physician must provide a statement about the potential to reverse the effects of mifepristone if the second medication has not yet been taken, along with a reversal hotline number.4Indiana General Assembly. Indiana Code Title 16 Health 16-34-2-1.1 An ultrasound must be performed before the abortion, and the eighteen-hour clock runs from that appointment. A federal judge blocked the timing requirement in 2017, but the U.S. Supreme Court vacated that injunction in 2020, and the eighteen-hour ultrasound rule is now in effect.
Minors
A minor generally needs parental or guardian consent to obtain an abortion in Indiana, even when the procedure falls within one of the three exceptions. A minor who cannot or will not seek parental consent may ask a juvenile court for a judicial bypass by showing she is mature enough to make the decision on her own. The minor still has to meet one of the statutory exceptions in addition to clearing the consent requirement.
Who Faces Penalties
A physician who knowingly performs an abortion outside the legal exceptions commits a Level 5 felony.5Indiana General Assembly. Indiana Code 16-34-2-7 – Performance of Unlawful Abortion Offense A Level 5 felony carries a prison term of one to six years, with an advisory sentence of three years, and a fine of up to $10,000.6Indiana General Assembly. Indiana Code 35-50-2-6 – Class C Felony Level 5 Felony A violation can also trigger a report to the Medical Licensing Board of Indiana, which can impose a reprimand, probation, or revocation of the physician’s license.
The patient is not a target of the statute. Indiana law expressly provides that a pregnant person who receives an abortion in violation of the statute cannot be prosecuted for the offense or for conspiring to violate it.7Indiana General Assembly. Indiana Code 16-34-4-9 – Penalties for Performing a Prohibited Abortion Prohibition on Prosecuting a Woman on Whom a Prohibited Abortion Is Performed The legal risk falls on the physician and the facility.
Fetal Remains
Indiana requires that all fetal remains from an abortion or miscarriage be buried or cremated, and they cannot be disposed of as infectious waste.8Indiana Department of Health. Fetal Remains Disposition Letter Healthcare facilities must complete the burial or cremation, or preserve the remains for that purpose, within ten days. Simultaneous cremation of multiple fetal remains is allowed, and a Burial Transit Permit is required for transportation. The patient chooses the method and location, and bears the cost if she selects a location different from what the facility normally uses. Facilities must inform the patient of this right and document the decision in the record.
Emergency Care Under Federal Law
The federal Emergency Medical Treatment and Labor Act requires any hospital that accepts Medicare funds to provide stabilizing treatment to patients with emergency medical conditions. Since Dobbs, the open question has been whether EMTALA’s stabilization mandate overrides state abortion bans when a pregnant patient presents with an emergency that requires termination.
In July 2022, the Biden administration issued federal guidance reinforcing that EMTALA required emergency abortion access even in states with bans. In June 2025, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services rescinded that guidance. Around the same time, the U.S. Department of Justice dropped its EMTALA preemption challenge to Idaho’s similar abortion ban. No court has definitively resolved whether EMTALA preempts state abortion bans, and physicians in Indiana emergency departments now face a gap between what the federal law may require and what Indiana’s narrow health exception permits.
Current Legal Status
SB 1 was challenged almost immediately after passage. A trial court initially blocked it, but the Indiana Supreme Court allowed the law to take effect, finding that the challengers had not identified a specific health condition protected by the Indiana Constitution that the statute’s health exception did not already cover. On May 14, 2026, the Indiana Supreme Court declined to hear a renewed challenge in Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky, Inc. v. Members of the Medical Licensing Board of Indiana, leaving in place a Court of Appeals ruling that sided with the state. The providers had argued that the health exception was too narrow and the hospital-only requirement unconstitutionally burdened access. Neither argument prevailed, and the law stands as enacted.