Tennessee Abortion Laws: What’s Legal and What’s Restricted
An overview of how Tennessee regulates abortion access through legal exceptions, procedural rules, and enforcement mechanisms.
Tennessee’s abortion laws have shifted significantly, particularly after the Supreme Court overturned Roe v. Wade in 2022, leading to uncertainty about legal access and potential consequences.
Understanding the state’s current framework is crucial for residents and observers of evolving reproductive rights policies. This article outlines the key aspects of Tennessee’s abortion regulations.
Permitted Circumstances
Following the Dobbs decision, Tennessee enacted the “Human Life Protection Act,” found in Tennessee Code Annotated Section 39-15-213, establishing a near-total ban on abortion from fertilization.1Justia Law. Tennessee Code § 39-15-213 (2024) – Criminal Abortion – Affirmative Defense The law defines abortion broadly but excludes treatments for ectopic pregnancies, molar pregnancies, or miscarriages after fetal cardiac activity has ceased.
The only legal path for an abortion in Tennessee is a narrow medical exception. Section 39-15-213(c) permits an abortion if a licensed physician, using “reasonable medical judgment,” determines it is necessary to “prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function.” This exception explicitly excludes mental health reasons or potential self-harm. The law provides no exceptions for pregnancies resulting from rape or incest.
The application of this exception faced a legal challenge in Phillips, et al., v. State of Tennessee, et al. (formerly Blackmon v. State of Tennessee), which argued the standard was unconstitutionally vague. In October 2024, a state court panel issued a temporary injunction.2Center for Reproductive Rights. Ruling Temporarily Blocking Tennessee’s Abortion Ban While not invalidating the law, the ruling clarified that certain conditions—like pre-viability membrane rupture (PPROM), inevitable abortion scenarios, or fatal fetal diagnoses causing severe maternal health risks (such as preeclampsia or infection)—would likely qualify under the exception. This provides temporary protection from disciplinary action for the physicians involved in the lawsuit when treating these specific conditions, but it does not change the statewide statute itself.
Parental Involvement Requirements
Even within the extremely limited scope of legal abortion, Tennessee law mandates parental involvement for minors seeking the procedure.
Notification Laws
State law generally requires a physician to notify a parent or legal guardian of an unemancipated minor at least 48 hours before performing an abortion, as outlined in Tennessee Code Annotated Section 37-10-303. Notice must be given in person or by phone, and documentation is required. This waiting period allows time for parental consultation.
Consent Requirements
Beyond notification, Section 37-10-303(a) requires the physician to obtain written consent from one parent or legal guardian before performing an abortion on a minor. Notification alone is insufficient; affirmative written permission is needed unless a medical emergency exists or a court grants authorization.
Judicial Bypass
Tennessee provides a judicial bypass process under Section 37-10-304, allowing a minor to seek court approval for an abortion without parental notification or consent. The minor can file a confidential petition, receive court-appointed counsel, and must have a hearing within 48 hours. A judge can grant the waiver if the minor is deemed mature enough to decide independently or if bypassing parental involvement is in the minor’s best interest. Denials can be appealed confidentially and quickly.
Provider Licensing Rules
Performing a legally permissible abortion in Tennessee is restricted to licensed physicians, as mandated by Section 39-15-213(c)(1). The Tennessee Board of Medical Examiners oversees physician licensing and enforces practice standards.3Tennessee Secretary of State. Tennessee Board of Medical Examiners Rules (Nov 2023)
Physicians must exercise “reasonable medical judgment” when applying the medical exception. Failure to meet this standard could lead to disciplinary action by the Board, separate from criminal charges. The temporary injunction in the Phillips case currently shields the plaintiff physicians from Board discipline for abortions performed under the specific emergency conditions outlined by the court, but this protection is limited to those physicians and does not alter the Board’s general authority.
The procedure must also occur in a licensed hospital or ambulatory surgical treatment center (ASTC), regulated by the Tennessee Department of Health’s Board for Licensing Health Care Facilities. These facilities must meet state operational and safety standards. Given the current ban, any legal abortions are most likely to occur in hospitals equipped for complex medical emergencies.
Potential Criminal Penalties
Performing or attempting an abortion outside the narrow medical exception is a Class C felony under Tennessee’s “Human Life Protection Act” (Section 39-15-213).
A Class C felony conviction carries a potential prison sentence of three to fifteen years and a fine up to $10,000, according to Tennessee Code Annotated Section 40-35-111.
These criminal penalties apply specifically to the person performing the abortion, typically the physician. Section 39-15-213(e) explicitly protects the pregnant woman from criminal conviction or penalty under this statute.
Civil Enforcement Measures
While the primary enforcement mechanism for the abortion ban is criminal prosecution of the provider, some civil measures exist. Tennessee’s main ban does not authorize private citizens to sue abortion providers, unlike laws in some other states.
State administrative bodies can impose civil penalties. The Tennessee Board of Medical Examiners can discipline physicians, including suspending or revoking licenses, for violating abortion laws (Section 63-6-214(b)(6)). This administrative enforcement is separate from criminal proceedings. The temporary injunction in the Phillips case currently limits the Board’s ability to discipline the plaintiff physicians under specific circumstances.
The Board for Licensing Health Care Facilities oversees hospitals and ASTCs. Facilities failing to post required signage about unlawful coercion (mandated by Section 39-15-202(i)) can face civil penalties of $2,500 per day if an abortion occurred during the violation.4FindLaw. Tennessee Code § 39-15-202 – Coercion Prohibited Similarly, the Board of Medical Examiners can assess a $1,000 civil penalty against a physician for related signage violations in their office. These penalties are in addition to other potential remedies.
A 2024 law (Public Chapter 1032) created civil liability for “abortion trafficking of a minor,” defined as intentionally recruiting, harboring, or transporting a minor for an abortion without parental consent.5Tennessee Secretary of State. Tennessee Public Chapter 1032 (2024) – Abortion Trafficking of a Minor Section 39-15-221(e) allows the minor’s parent, guardian, or the father (unless culpable) to sue the violator for wrongful death, seeking economic, non-economic, and punitive damages, plus attorney fees. Enforcement of this specific law was temporarily blocked by a federal court in Welty v. Dunaway in September 2024, pending further litigation.
Reporting Protocols
Tennessee requires detailed documentation and reporting for any abortion performed legally. Section 39-15-203 mandates that physicians maintain records of each procedure, including the method used for disposing of fetal tissue.6Justia Law. Tennessee Code § 39-15-203 (2024) – Records and Reports of Abortions
Physicians must submit a formal report to the Tennessee Department of Health’s Office of Vital Records within ten days, as required by Section 68-3-505.7Justia Law. Tennessee Code § 68-3-505 (2024) – Reports of Abortions – Information to be Included If the procedure occurs in a licensed facility, the facility administrator ensures filing; otherwise, the attending physician is responsible.
The report uses a unique patient identifier instead of a name to protect confidentiality (Sections 39-15-203(d) and 68-3-505(b)). It includes patient demographics (age, marital status, residence), date and location of the procedure, procedure type, and gestational age. The report must also state if an ultrasound was performed and if fetal cardiac activity was detected (Section 39-15-203(b)(3)).
Details about the disposition of fetal tissue must be included, specifying the method (consistent with Section 39-15-219, generally requiring interment or cremation) and identifying any third party involved. An exception exists for medication abortions where tissue expulsion occurs outside the facility (Section 39-15-203(a)). The Department of Health keeps these reports confidential but uses them to compile aggregate data, reported quarterly to the Governor and legislative leaders, including judiciary committee chairs as of a 2025 update (Section 39-15-203(e)). Separate reporting rules apply to fetal deaths at or after 20 weeks gestation under Section 68-3-504.
