--- title: "Hawaii — abortion law" description: "Hawaii is one of the most protective states for abortion access in the United States. Abortion is legal until fetal viability — the point at which a fetus can survive outside the uterus, generally around 24 weeks. After viability, termination of a pregnancy is permitted when necessary to protect…" type: "legislation" jurisdiction: "Hawaii" as_of_date: "2026-07-12" source_url: "https://www.abhortion.org/legislation/hi.html" --- # Hawaii — abortion law _Hawaii · United States_ ## Overview **Protected; viability-based; shield state** Hawaii was the first state to legalize abortion (1970) and today offers among the strongest statutory protections in the nation, with no gestational cutoff before viability. Hawaii is one of the most protective states for abortion access in the United States. Abortion is legal until fetal viability — the point at which a fetus can survive outside the uterus, generally around 24 weeks. After viability, termination of a pregnancy is permitted when necessary to protect the pregnant person's life or health. Hawaii has no waiting periods, no mandatory counseling, no ultrasound requirements, no parental involvement requirements for minors, and no method-specific bans. The state also has strong shield laws that protect providers, patients, and helpers from out-of-state investigations and prosecutions, and the governor must deny extradition demands for abortion-related charges from other states. > "The State shall not deny or interfere with a pregnant person's right to choose to: (1) Obtain an abortion; or (2) Terminate a pregnancy if the termination is necessary to protect the life or health of the pregnant person." > — Haw. Rev. Stat. § 453-16(b) **Legal analysis** Hawaii's abortion protections rest on three pillars: (1) HRS § 453-16, which affirmatively states that 'the State shall not deny or interfere with a pregnant person's right to choose to obtain an abortion' of a nonviable fetus or terminate a pregnancy when necessary to protect life or health; (2) Article I, Section 6 of the Hawaii Constitution, whose right to privacy the Hawaii courts have interpreted to protect reproductive autonomy; and (3) Chapter 323J, HRS (Act 2, Session Laws of Hawaii 2023), a comprehensive shield law that blocks out-of-state investigations, subpoenas, extradition, and professional discipline related to reproductive health care services lawful in Hawaii. The original 1970 Act 1 criminal penalties — a fine of up to $1,000 or imprisonment up to five years — were removed through subsequent amendments (Act 35, 2006, and Act 2, 2023). No criminal penalty for abortion providers currently exists in Hawaii law. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(b), subsection (b), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · Haw. Const. art. I, § 6, [FindLaw](https://codes.findlaw.com/hi/the-constitution-of-the-state-of-hawaii/hi-const-art-1-sect-6) · Act 2, Session Laws of Hawaii 2023 (SB 1), legislative findings, [LegiScan](https://legiscan.com/HI/text/SB1/id/2706200/Hawaii-2023-SB1-Amended.html)* ## At a glance Every machine-readable determination in the research document. Each value is derived from a sourced finding below. | Field | Value | | --- | --- | | Legal classification | Protected by statute | | Gestational limit weeks | — | | Limit measured from | — | | Abortion currently available | Yes | | Ban or limit enjoined | No | | Mother expressly exempt | Yes | | Mother prosecutable in practice | No | | Self managed abortion criminalized | No | | Abortion charged as homicide | No | | Fetal homicide law | No | | Fetal wrongful death action | Yes | | Personhood language in law | No | | Personhood contradiction | No | | Medication abortion distinct status | No | | Mailing pills banned | No | | Method bans | None | | Telehealth prescribing allowed | Yes | | Physician only law | No | | Provider max penalty | — | | Helpers criminally exposed | No | | Travel assistance criminalized | No | | Civil bounty law | No | | Shield state | Yes | | Waiting period hours | — | | State scripted counseling | No | | Ultrasound required | None | | In person visits required | 0 | | Parental involvement | None | | Judicial bypass available | Not applicable | | Spousal consent or notice on books | No | | Medicaid coverage | Broader than hyde | | Private insurance restricted | No | | State funding posture | Funds providers | | Rape incest exception | Not applicable | | Exceptions present | None | | Major pending change | Yes | ## Definitions **Nonviable fetus; life/health post-viability** Hawaii defines 'abortion' as intentional termination of a nonviable fetus; post-viability terminations to protect life or health are separately covered. Under Hawaii law, 'abortion' means intentionally ending the pregnancy of a 'nonviable fetus' — one that cannot reasonably survive outside the uterus. The law does not use the word 'abortion' for ending a pregnancy after viability; instead, it separately protects the right to terminate a pregnancy after viability when necessary to protect the pregnant person's life or health. This definition means that miscarriage management, ectopic pregnancy treatment, and care that incidentally affects the fetus are not reached by the abortion statute. > "'Abortion' means an intentional termination of the pregnancy of a nonviable fetus. 'Nonviable fetus' means a fetus that does not have a reasonable likelihood of sustained survival outside of the uterus." > — Haw. Rev. Stat. § 453-16(d) **Legal analysis** HRS § 453-16(d) defines 'abortion' as 'an intentional termination of the pregnancy of a nonviable fetus' and 'nonviable fetus' as 'a fetus that does not have a reasonable likelihood of sustained survival outside of the uterus.' The statute bifurcates treatment: subsection (b)(1) protects the right to obtain an abortion (of a nonviable fetus), while subsection (b)(2) separately protects the right to terminate a pregnancy when necessary to protect life or health, without using the term 'abortion' for that post-viability scenario. This definitional structure means that the criminal law does not reach pre-viability abortion at all, and post-viability termination is protected when done for life or health reasons. IVF embryos and pre-implantation genetic testing are beyond the statute's scope, as it applies only to a 'fetus' in 'pregnancy.' *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(d), subsection (d), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ## Current status **Abortion protected; no criminal penalty** Hawaii affirmatively protects abortion pre-viability and post-viability to protect life or health, with no criminal penalty for providers or patients. Abortion is legal and protected in Hawaii. Until fetal viability — usually around 24 weeks of pregnancy — a pregnant person has the right to obtain an abortion without state interference. After viability, termination is permitted when needed to protect the pregnant person's life or health. There is no criminal penalty for either the person having the abortion or the medical provider performing it. Hawaii does not restrict abortion based on the method used, how the medication is obtained, or where the person lives. > "The State shall not deny or interfere with a pregnant person's right to choose to: (1) Obtain an abortion; or (2) Terminate a pregnancy if the termination is necessary to protect the life or health of the pregnant person." > — Haw. Rev. Stat. § 453-16(a)-(d) **Legal analysis** HRS § 453-16(b) operates as an affirmative protection, not merely a decriminalization: 'The State shall not deny or interfere with a pregnant person's right to choose.' The original 1970 Act 1 imposed criminal penalties (fine up to $1,000, imprisonment up to five years) for violations of the preconditions (physician-only, hospital-only, residency requirement). Those preconditions and penalties were progressively removed: Act 35 (2006) eliminated the residency requirement and hospital mandate and restructured the law as an affirmative right; Act 3 (2021) added APRNs; Act 2 (2023, SB 1) added physician assistants, removed the outdated 'female' language in favor of 'pregnant person,' and created the Chapter 323J shield framework. No separate criminal abortion statute exists anywhere in the Hawaii Revised Statutes. The only remaining limiting language is the viability definition in subsection (d), which determines what falls within 'abortion' as statutorily defined. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(a)-(d), subsections (a)-(b), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · Act 1, Session Laws of Hawaii 1970, subsection (c) of original Act, [Hawaii State Legislature](https://data.capitol.hawaii.gov/sessions/sessionlaws/Years/SLH1970/SLH1970_Act1.pdf)* **Editor's note.** The 1970 Act 1 criminal penalty was removed through subsequent amendments. The current § 453-16 contains no penalty provision. ## Law-in-effect vs. law-on-the-books **Fully in effect; no injunctions** Hawaii's abortion-protective statutes are in full force with no pending injunctions; no restrictive law exists to enjoin. All of Hawaii's abortion laws are fully in effect. There is no abortion ban or restriction in Hawaii that a court has blocked, because Hawaii has no ban to challenge. The state's shield laws, which protect providers and patients from out-of-state investigations, are also fully operational. **Legal analysis** Hawaii's abortion regime is purely permissive and protective. No state statute restricts abortion before viability. No abortion restriction is currently enjoined because none exists. The shield-law framework in Chapter 323J, enacted by Act 2 of 2023 (SB 1), is in full effect and has not been the subject of any successful facial or as-applied challenge. The federal district court ruling in Purcell v. Kennedy (formerly Chelius v. Becerra), issued October 30, 2025, held that the FDA's REMS restrictions on mifepristone violated the law, but this ruling does not change Hawaii state law — it operates at the federal level and reinforces access. *Sources — Verified at source · High confidence · Haw. Rev. Stat. ch. 323J, § 323J-3, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-3) · Purcell v. Kennedy, No. 1:24-cv-00401 (D. Haw. Oct. 30, 2025), [ACLU](https://www.aclu.org/cases/chelius-v-becerra)* ## Exceptions ### Life of the mother **Life: post-viability standard** After viability, termination is expressly permitted when necessary to protect the pregnant person's life; pre-viability, no exception is needed because abortion is unconditionally protected. Hawaii law does not need a 'life exception' before viability because abortion is fully protected at any stage before the fetus can survive outside the womb. After viability, state law explicitly allows pregnancy termination when needed to protect the pregnant person's life. No special certification or documentation is required beyond ordinary medical standards. > "Terminate a pregnancy if the termination is necessary to protect the life or health of the pregnant person." > — Haw. Rev. Stat. § 453-16(b)(2) **Legal analysis** HRS § 453-16(b)(2) permits termination of pregnancy 'if the termination is necessary to protect the life or health of the pregnant person.' This applies post-viability; pre-viability, abortion is protected without reference to any exception. The statute does not impose certification, documentation, or second-physician requirements. The physician's good-faith medical judgment is the operative standard. EMTALA independently requires Medicare-participating hospitals to provide stabilizing treatment, including abortion, when necessary to resolve an emergency medical condition; Hawaii's permissive state law eliminates any EMTALA-state-law conflict. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(b)(2), subsection (b)(2), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Physical health **Health: post-viability standard** Post-viability, termination is permitted to protect the pregnant person's health; the statute does not limit 'health' to physical health or impose a severity threshold. After viability, Hawaii law permits ending a pregnancy to protect the pregnant person's health. The law does not distinguish between physical and mental health, nor does it require that the health risk be severe or life-threatening. The physician makes this determination using their professional medical judgment. > "Terminate a pregnancy if the termination is necessary to protect the life or health of the pregnant person." > — Haw. Rev. Stat. § 453-16(b)(2) **Legal analysis** HRS § 453-16(b)(2) uses the unadorned term 'health' without qualifiers such as 'physical,' 'serious,' or 'substantial and irreversible.' This is notably broader than many other states' health exceptions. The Hawaii Supreme Court has not construed 'health' in this specific provision, but under ordinary principles of statutory interpretation, the unmodified term encompasses both physical and mental health. The good-faith judgment of the attending provider controls, with no statutory requirement for a second opinion or hospital committee approval. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(b)(2), subsection (b)(2), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Mental health **Mental health: not separately specified** The post-viability 'health' exception is unqualified and likely encompasses mental health, but no Hawaii court has expressly so held. When a pregnancy must be ended after viability to protect the pregnant person's health, Hawaii law uses the broad word 'health' without limiting it to physical health. This likely includes mental health conditions such as severe depression or suicidal ideation, though no Hawaii court has specifically addressed this question. A doctor would determine whether a mental health condition requires ending the pregnancy. > "Terminate a pregnancy if the termination is necessary to protect the life or health of the pregnant person." > — Haw. Rev. Stat. § 453-16(b)(2) **Legal analysis** The term 'health' in HRS § 453-16(b)(2) is unmodified. Doe v. Bolton, 410 U.S. 179 (1973), interpreting a parallel Georgia statute, read 'health' to encompass 'all factors — physical, emotional, psychological, familial, and the woman's age — relevant to the well-being of the patient.' Though Doe's constitutional holdings were overruled by Dobbs, its definition of 'health' as a statutory term remains persuasive authority for how an unmodified 'health' exception should be construed. No Hawaii appellate decision has interpreted the scope of 'health' in § 453-16(b)(2). In practice, the absence of any criminal penalty for performing a post-viability termination makes the precise contours of this exception less operationally urgent than in restrictive states. *Sources — Verified at source · Medium confidence · Haw. Rev. Stat. § 453-16(b)(2), subsection (b)(2), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · Doe v. Bolton, 410 U.S. 179 (1973), slip op. at 192, [U.S. Supreme Court](https://supreme.justia.com/cases/federal/us/410/179/)* **Editor's note.** No Hawaii appellate court has construed the scope of 'health' in § 453-16(b)(2). Doe v. Bolton's constitutional holdings are no longer good law, but its statutory-interpretation analysis of 'health' remains persuasive. ### Ectopic pregnancy & miscarriage care **Ectopic/miscarriage: outside statute's scope** Hawaii's abortion statute does not reach ectopic pregnancy treatment or miscarriage management; these are standard medical care, not 'abortion' as defined. Hawaii law defines 'abortion' as intentionally ending the pregnancy of a nonviable fetus. Treatment for ectopic pregnancy (where the embryo implants outside the uterus) and miscarriage management are not considered abortions under this definition — they are standard emergency and follow-up medical care, fully legal, and not restricted in any way. > "'Abortion' means an intentional termination of the pregnancy of a nonviable fetus." > — Haw. Rev. Stat. § 453-16(d) **Legal analysis** HRS § 453-16(d) defines 'abortion' as 'an intentional termination of the pregnancy of a nonviable fetus.' Treatment of ectopic pregnancy — which is not a viable pregnancy and typically threatens the pregnant person's life — falls outside this definition and is governed by ordinary standards of medical care. Similarly, management of miscarriage (spontaneous abortion) is not an 'intentional termination' within the meaning of the statute. No Hawaii statute separately restricts, regulates, or criminalizes these treatments. The Chapter 323J shield provisions further protect providers who perform these services. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(d), subsection (d), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Rape **Rape: no exception needed** Hawaii does not condition abortion on the circumstances of conception; abortion is protected regardless of whether the pregnancy resulted from rape. Because Hawaii protects the right to abortion before viability without any restriction based on how the pregnancy occurred, there is no need for a specific 'rape exception.' A person who becomes pregnant as a result of rape has the same right to abortion as anyone else in Hawaii. **Legal analysis** In restrictive states, rape/incest exceptions serve as limited carve-outs from an otherwise operative ban. Hawaii has no abortion ban from which to carve out exceptions; HRS § 453-16(b)(1) protects the right to abortion unconditionally pre-viability. The question is therefore inapposite. Note that Hawaii's Medicaid program uses state funds to cover abortion, making the federal Hyde Amendment rape/incest reporting requirements less practically significant than in states that rely solely on federal matching funds. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 453-16(b)(1), subsection (b)(1), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Incest **Incest: no exception needed** Hawaii's unconditional pre-viability abortion protection makes a separate incest exception unnecessary. Hawaii does not have an 'incest exception' because it doesn't need one — abortion is protected before viability regardless of the circumstances of conception. **Legal analysis** Same analysis as the rape exception: no ban exists, so no exception is required. Pre-viability abortion is protected unconditionally. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 453-16(b)(1), subsection (b)(1), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Fatal fetal anomaly **Fatal fetal anomaly: no exception needed** Hawaii's pre-viability abortion protection makes a separate fatal fetal anomaly exception unnecessary. Hawaii has no abortion restrictions that would prevent ending a pregnancy because of a severe or fatal fetal diagnosis. Abortion before viability is protected for any reason. **Legal analysis** Pre-viability abortion is unconditionally protected. Post-viability, a termination motivated by a fetal anomaly diagnosis would need to be justified under the 'life or health' standard of § 453-16(b)(2). A physician could reasonably conclude that continuing a pregnancy with a diagnosed fatal fetal anomaly threatens the pregnant person's mental health, invoking the health exception. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 453-16(b), subsection (b), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ## Methods ### Procedural surgical **Legal; no method-specific bans** Procedural abortion is legal at all gestational stages before viability; Hawaii has no D&E, D&X, or partial-birth abortion ban on the books. Surgical or procedural abortion — including dilation and evacuation (D&E), the most common second-trimester method — is completely legal in Hawaii before viability. Hawaii does not ban any specific abortion procedure. The federal Partial-Birth Abortion Ban Act of 2003 applies nationwide, including in Hawaii, but its scope is narrow and it has not been independently adopted into Hawaii state law. > "A licensed physician or surgeon or licensed osteopathic physician and surgeon may provide abortion care." > — Haw. Rev. Stat. § 453-16(a) **Legal analysis** Hawaii has never enacted a state-level ban on dilation and evacuation (D&E), dilation and extraction (D&X/'partial-birth'), or any other specific abortion method. HRS § 453-16(a) authorizes licensed physicians, surgeons, osteopathic physicians, and (in the first trimester) physician assistants to provide abortion care without method restrictions. The federal Partial-Birth Abortion Ban Act of 2003 (18 U.S.C. § 1531) applies as federal law in Hawaii, but it covers only the narrow 'intact D&E' procedure and contains a life exception. Hawaii state law does not independently criminalize any abortion method. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(a), subsection (a), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · 18 U.S.C. § 1531, subsection (a), [Legal Information Institute](https://www.law.cornell.edu/uscode/text/18/1531)* **Editor's note.** The federal Partial-Birth Abortion Ban Act applies in Hawaii as federal law but does not appear in Hawaii Revised Statutes. ### Medication **Legal; telehealth and mail permitted** Medication abortion is legal in Hawaii, available by telehealth, and may be mailed to patients; APRNs and PAs may prescribe it. Medication abortion — using mifepristone and misoprostol to end an early pregnancy — is legal in Hawaii. Patients can get a prescription through a telehealth appointment and have the pills mailed to them. Advanced practice registered nurses (APRNs) and physician assistants can prescribe and dispense medication abortion, not just doctors. Planned Parenthood and other providers in Hawaii offer medication abortion by mail. > "Advanced practice registered nurses may provide medical management of an intentional termination of pregnancy, including the prescribing, dispensing, and administration of medication." > — Haw. Rev. Stat. § 457-8.7 **Legal analysis** HRS § 457-8.7, enacted by Act 3 of 2021 (HB 576), expressly authorizes APRNs to 'provide medical management of an intentional termination of pregnancy, including the prescribing, dispensing, and administration of medication.' HRS § 453-16(a), as amended by Act 2 of 2023, authorizes physician assistants to 'provide medication or aspiration abortion care in the first trimester.' Hawaii imposes no in-person dispensing requirement, no mailing prohibition, and no physician-only prescribing rule for medication abortion. The federal district court ruling in Purcell v. Kennedy (D. Haw., Oct. 30, 2025) found the FDA's REMS restrictions on mifepristone unlawful, reinforcing that no federal barrier limits medication abortion access in Hawaii. As a practical matter, medication abortion is the most accessible form of abortion in Hawaii, particularly for residents of neighbor islands where in-person procedural services may be limited. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 457-8.7, [Justia](https://law.justia.com/codes/hawaii/title-25/chapter-457/section-457-8-7) · Haw. Rev. Stat. § 453-16(a), subsection (a), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · Purcell v. Kennedy, No. 1:24-cv-00401 (D. Haw. Oct. 30, 2025), [ACLU](https://www.aclu.org/cases/chelius-v-becerra)* ### Self managed **Not criminalized; broad immunity** Hawaii does not criminalize self-managed abortion; HRS § 323J-5 expressly prohibits the state from penalizing a person based on pregnancy outcomes. A person who ends their own pregnancy in Hawaii — whether using pills obtained by mail or through other means — faces no criminal liability under Hawaii law. The state is expressly prohibited from prosecuting or penalizing anyone based on pregnancy outcomes. And because Hawaii's shield laws protect information and block out-of-state investigations, a person who self-manages an abortion in Hawaii is also shielded from other states' attempts to investigate or prosecute them. > "The State shall not penalize, prosecute, or otherwise take adverse action against an individual based on the individual's actual, potential, perceived, or alleged pregnancy outcomes." > — Haw. Rev. Stat. § 323J-5 **Legal analysis** HRS § 323J-5 provides: 'The State shall not penalize, prosecute, or otherwise take adverse action against an individual based on the individual's actual, potential, perceived, or alleged pregnancy outcomes.' This provision, enacted as part of Act 2 of 2023 (SB 1), operates as a broad immunity for any person whose pregnancy ends — regardless of cause. Hawaii's criminal code contains no offense of 'self-abortion' or 'feticide' that could reach the pregnant person. The Hawaii homicide statutes (Chapter 707) define homicide as causing the death of 'another person' or 'a human being'; Hawaii has no statutory fetal homicide provision that would classify a fetus as a 'person' for homicide purposes. A 2015 bill (HB 1234) to create a 'manslaughter of an unborn child' offense did not pass. The shield-law provisions of Chapter 323J further protect a person who self-manages by blocking out-of-state subpoenas (323J-3), prohibiting agency cooperation with out-of-state investigations (323J-4), and requiring the governor to deny extradition (323J-6). *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5) · Haw. Rev. Stat. § 707-702, subsection (1)(a), [Justia](https://law.justia.com/codes/hawaii/title-37/chapter-707/section-707-702)* **Editor's note.** The absence of a fetal homicide statute means Hawaii's general homicide laws do not reach a pregnant person who ends her own pregnancy. ## Actors ### Who may perform **Physicians, APRNs, PAs authorized** Licensed physicians and surgeons (MD/DO), APRNs, and physician assistants may all provide abortion care, with APRNs and PAs authorized for medication and aspiration abortion. In Hawaii, abortion care can be provided by licensed physicians, surgeons, and osteopathic physicians at any stage of pregnancy. Advanced practice registered nurses (APRNs) can provide medication and aspiration abortion care. Physician assistants can provide medication and aspiration abortion in the first trimester. There is no requirement that abortions be performed in a hospital — clinics and outpatient settings are permitted. Hawaii has no admitting-privileges requirement. > "A licensed physician or surgeon or licensed osteopathic physician and surgeon may provide abortion care. A licensed physician assistant may provide medication or aspiration abortion care in the first trimester of pregnancy." > — Haw. Rev. Stat. § 453-16(a) **Legal analysis** HRS § 453-16(a) authorizes licensed physicians, surgeons, and osteopathic physicians to 'provide abortion care' without gestational limitation. The same subsection authorizes licensed physician assistants to 'provide medication or aspiration abortion care in the first trimester of pregnancy.' HRS § 457-8.7 authorizes APRNs to 'provide medical management of an intentional termination of pregnancy, including the prescribing, dispensing, and administration of medication' and to 'perform an intentional termination of pregnancy by standard suction curettage procedure or menstrual extraction procedure.' The original 1970 law's hospital-only requirement was removed by Act 35 of 2006. No admitting-privileges or ambulatory-surgical-center requirement exists. Hawaii thus has one of the broadest provider-authorization statutes in the nation. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16(a), subsection (a), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) · Haw. Rev. Stat. § 457-8.7, [Justia](https://law.justia.com/codes/hawaii/title-25/chapter-457/section-457-8-7)* ### Criminal civil exposure #### Pregnant woman **Expressly immune from prosecution** HRS § 323J-5 flatly prohibits the state from penalizing anyone based on pregnancy outcomes, giving the pregnant person comprehensive immunity. A pregnant person in Hawaii cannot be prosecuted, penalized, or subjected to any adverse state action because of a pregnancy outcome — whether it ends in abortion, miscarriage, or stillbirth. This protection is written directly into state law. No Hawaii criminal statute reaches the pregnant person for having or seeking an abortion, and Hawaii has no fetal homicide law under which she could be charged. > "The State shall not penalize, prosecute, or otherwise take adverse action against an individual based on the individual's actual, potential, perceived, or alleged pregnancy outcomes." > — Haw. Rev. Stat. § 323J-5 **Legal analysis** HRS § 323J-5 provides two layers of protection: first, 'The State shall not penalize, prosecute, or otherwise take adverse action against an individual based on the individual's actual, potential, perceived, or alleged pregnancy outcomes'; second, 'The State shall not penalize, prosecute, or otherwise take adverse action against a person for aiding or assisting a pregnant individual accessing reproductive health care services in accordance with the laws of the State and with the pregnant individual's voluntary consent.' The pregnant person thus enjoys express statutory immunity. The original 1970 Act 1 did not exempt the woman from the criminal penalty (it applied to 'any person who knowingly violates this section'), but the penalty provision has been entirely removed from the current statute. Hawaii's homicide statutes (Chapter 707) do not include a fetal homicide offense, and a 2015 bill to create one (HB 1234) did not pass. The pregnant person faces no realistic criminal exposure under any provision of Hawaii law. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5)* #### Physician **No criminal penalty; license shielded** Hawaii imposes no criminal penalty on physicians who perform abortion; state law shields their license from out-of-state discipline for abortion services lawful in Hawaii. Physicians who provide abortion care in Hawaii face no criminal liability under state law — the original criminal penalty was removed from the statute years ago. Their medical licenses are also protected: Hawaii law prohibits the state medical board from disciplining a physician based on another state's disciplinary action if it was for providing abortion care that is lawful in Hawaii. > "The board shall not issue an order imposing disciplinary action upon the licensee if the revocation, suspension, or other disciplinary action against a licensee by another state was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State." > — Haw. Rev. Stat. § 453-8.6(a) **Legal analysis** HRS § 453-16 currently contains no criminal penalty provision. The original 1970 Act 1 penalty (fine up to $1,000 or imprisonment up to five years) was removed through amendments. HRS § 453-8.6 (added by Act 2, 2023) prohibits the Hawaii Medical Board from imposing discipline based on another state's action 'if the revocation, suspension, or other disciplinary action against a licensee by another state was based on the provision or assistance in receipt or provision of medical, surgical, pharmaceutical, counseling, or referral services relating to the human reproductive system, including but not limited to services relating to pregnancy, contraception, or the termination of a pregnancy, so long as the provision or assistance in receipt or provision of the services was in accordance with the laws of this State or would have been in accordance with the laws of this State if it occurred within this State.' The physician faces standard medical malpractice exposure as with any medical procedure, but no abortion-specific civil liability. HB 1875 (2026) further shields physicians by prohibiting medical malpractice insurers from taking adverse action based solely on providing lawful reproductive health care services. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-8.6(a), subsection (a), proviso, [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-8-6) · Haw. Rev. Stat. § 453-16, [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* #### Prescriber pharmacist **Protected alongside physicians** Non-physician prescribers (APRNs, PAs) are expressly authorized to provide abortion care and enjoy the same shield-law protections as physicians. Advanced practice registered nurses and physician assistants who prescribe or dispense abortion medication are expressly authorized by Hawaii law. Pharmacists who fill prescriptions for abortion medication are practicing within their lawful scope. Both are protected by Hawaii's shield laws from out-of-state investigations and professional discipline. > "Advanced practice registered nurses may provide medical management of an intentional termination of pregnancy, including the prescribing, dispensing, and administration of medication." > — Haw. Rev. Stat. § 457-8.7 **Legal analysis** HRS § 457-8.7 authorizes APRNs to prescribe, dispense, and administer medication for abortion. HRS § 453-16(a) authorizes PAs for medication/aspiration abortion in the first trimester. HRS § 457-12 (amended by Act 2, 2023) shields nursing licenses from discipline based on another state's action related to reproductive health care lawful in Hawaii. HRS § 461-21.5 (also amended by SB 1) provides parallel protection for pharmacy licenses. No Hawaii statute imposes liability on a pharmacist for dispensing mifepristone or misoprostol when lawfully prescribed. A 2026 bill (SB 2038) would further protect patient privacy by authorizing dispensing with labeling that omits the patient's name. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 457-8.7, [Justia](https://law.justia.com/codes/hawaii/title-25/chapter-457/section-457-8-7)* #### Nurses and staff **Protected from adverse action** Clinical staff who assist with abortion care are shielded from state adverse action and from out-of-state investigations by Chapter 323J. Nurses, medical assistants, clinic administrators, and other staff who help provide abortion care in Hawaii are protected from prosecution or penalty by the state. Hawaii law expressly prohibits the state from taking adverse action against anyone who assists a pregnant person in accessing reproductive health care. Shield laws also protect staff from out-of-state subpoenas and investigations. > "The State shall not penalize, prosecute, or otherwise take adverse action against a person for aiding or assisting a pregnant individual accessing reproductive health care services in accordance with the laws of the State and with the pregnant individual's voluntary consent." > — Haw. Rev. Stat. § 323J-5 **Legal analysis** HRS § 323J-5 provides: 'The State shall not penalize, prosecute, or otherwise take adverse action against a person for aiding or assisting a pregnant individual accessing reproductive health care services in accordance with the laws of the State and with the pregnant individual's voluntary consent.' This covers all clinic and hospital staff, including non-clinical employees. The shield-law provisions — prohibiting subpoenas (323J-3), agency cooperation (323J-4), and extradition (323J-6) — extend to all persons involved in providing, assisting, or facilitating lawful reproductive health care. Because Hawaii imposes no criminal penalty on the principal actor (the physician/APRN/PA), there is no predicate offense for accomplice liability to attach. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5)* #### Other helpers **Helpers shielded; no aiding liability** Anyone who assists a pregnant person — financially, logistically, or by providing information — is protected from state adverse action by HRS § 323J-5. A partner who pays for the procedure, a friend who drives to the clinic, a parent who provides funds, an employer who reimburses travel — all are protected under Hawaii law. The state may not penalize anyone for helping a pregnant person access reproductive health care that is lawful in Hawaii. And the shield laws prevent other states from using Hawaii's courts, agencies, or extradition process to reach them. > "The State shall not penalize, prosecute, or otherwise take adverse action against a person for aiding or assisting a pregnant individual accessing reproductive health care services in accordance with the laws of the State and with the pregnant individual's voluntary consent." > — Haw. Rev. Stat. § 323J-5 **Legal analysis** HRS § 323J-5's protection for 'a person for aiding or assisting a pregnant individual accessing reproductive health care services' is drafted broadly and reaches any form of assistance — financial, logistical, informational, or emotional — provided the care is lawful in Hawaii and the pregnant person consents. HRS § 323J-4 prohibits state agencies from expending resources in furtherance of out-of-state investigations targeting anyone who assists. HRS § 323J-6 requires the governor to deny extradition. HRS § 323J-7 declares contrary out-of-state laws against the public policy of Hawaii. The absence of a predicate criminal offense for the abortion itself means that traditional accomplice-liability statutes (HRS §§ 702-221 to 702-223) have no principal offense to attach to. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5)* ## Aiding & assisting ### Travel assistance **Travel help protected, not criminalized** Hawaii does not criminalize helping someone travel for an abortion, whether in-state or out-of-state, and shield laws block out-of-state enforcement. It is completely legal to help someone travel for an abortion — whether that means driving them to a clinic on Oahu, buying them a plane ticket from a neighbor island, or helping them travel to another state. Hawaii has no 'abortion trafficking' law and no statute that reaches travel assistance. The shield laws go further: they block other states from using Hawaii courts or agencies to investigate or prosecute someone for helping with travel. > "The State shall not penalize, prosecute, or otherwise take adverse action against a person for aiding or assisting a pregnant individual accessing reproductive health care services." > — Haw. Rev. Stat. § 323J-5 **Legal analysis** No Hawaii statute criminalizes, penalizes, or restricts assisting with travel for abortion — whether in-state or out-of-state. The Chapter 323J shield provisions are particularly protective for travel assistance: HRS § 323J-4 prohibits state agencies from expending resources on out-of-state investigations targeting anyone who 'assisted' in reproductive health care; HRS § 323J-6 requires denial of extradition; HRS § 323J-7 declares contrary out-of-state laws void as against Hawaii public policy. There is no 'abortion trafficking' statute or local ordinance in Hawaii that could reach travel assistance. The First Amendment also independently protects speech advocating for or providing information about out-of-state abortion options. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5)* ### Funding **Funding help protected** Paying for an abortion or covering travel costs is protected; abortion funds, employers, and individuals who contribute face no Hawaii liability. Anyone — a family member, a friend, an abortion fund, or an employer — can pay for an abortion or related travel costs without facing legal consequences in Hawaii. The state's broad protection for 'aiding or assisting' covers financial help, and the shield laws protect against out-of-state attempts to penalize funding. > "A law of another state authorizing a civil action or criminal prosecution based on... paying for... reproductive health care services... is contrary to the public policy of this State." > — Haw. Rev. Stat. § 323J-7(a)(1) **Legal analysis** HRS § 323J-5's protection of 'aiding or assisting' encompasses financial assistance, whether direct payment for services, reimbursement of travel expenses, or contributions to abortion funds. HRS § 323J-4 prohibits state agencies from providing information or resources to out-of-state investigations targeting those who paid for or assisted with abortion care. HRS § 323J-7 declares out-of-state laws imposing liability for paying for reproductive health care to be 'contrary to the public policy of this State' and provides that such laws 'shall not be applied to a case or controversy heard in the courts of this State.' No Hawaii statute restricts employer health-plan coverage of abortion or employer reimbursement of abortion-related travel. *Sources — Semi-verified · High confidence · Haw. Rev. Stat. § 323J-7(a)(1), subsection (a)(1), [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-7)* **Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Mailing pills **Mailing pills legal and protected** No Hawaii statute prohibits mailing or receiving abortion medication; shield laws protect senders and recipients from out-of-state enforcement. Sending abortion pills by mail into or within Hawaii is legal under state law. Both the person mailing the pills and the person receiving them are protected from state prosecution. Hawaii's shield laws also block other states from using Hawaii's legal system to investigate or penalize anyone involved in mailing abortion medication. **Legal analysis** Hawaii has no statute prohibiting the mailing, shipment, or receipt of medication intended to induce abortion. HRS § 457-8.7 and HRS § 453-16(a) authorize APRNs and PAs to dispense abortion medication, and Hawaii law imposes no in-person dispensing requirement. The Chapter 323J shield provisions protect senders and recipients: HRS § 323J-4 prohibits agency cooperation with out-of-state investigations targeting those who provide or assist with reproductive health care; HRS § 323J-6 requires extradition denial. The federal Comstock Act (18 U.S.C. §§ 1461-1462) remains on the books but has not been enforced against abortion medication in decades, and the Biden administration's Office of Legal Counsel issued an opinion in December 2022 concluding that the Comstock Act does not prohibit the mailing of abortion drugs where the sender lacks intent that they be used unlawfully. In Hawaii, where abortion is lawful, this federal question is further attenuated. *Sources — Semi-verified · High confidence · Haw. Rev. Stat. ch. 323J, § 323J-4(a), [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-4)* **Editor's note.** The federal Comstock Act exists as a theoretical federal barrier but has not been enforced against lawful abortion-related mailings. The OLC memo of December 2022 interprets the Act narrowly. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Providing information **Information protected; no liability** Providing information about abortion — whether orally, in writing, or online — is protected under Hawaii law and by the First Amendment. Giving someone information about where to get an abortion, how to obtain abortion medication, or what the legal options are is completely lawful in Hawaii. The state's shield laws protect those who provide referrals or information from out-of-state investigations. Federal First Amendment law independently protects truthful speech about lawful medical procedures. **Legal analysis** HRS § 323J-5 protects 'aiding or assisting,' which encompasses providing information and referrals. HRS § 323J-7 declares out-of-state laws targeting those who assist with reproductive health care to be contrary to Hawaii public policy. Under the First Amendment, as established in Bigelow v. Virginia, 421 U.S. 809 (1975), truthful advertising and information about lawful abortion services is protected speech. No Hawaii statute imposes liability for providing abortion information or referrals. HRS § 321-561, which requires limited-service pregnancy centers to post notices about reproductive health services, reflects the state's policy of ensuring access to information rather than restricting it. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-5, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-5) · Bigelow v. Virginia, 421 U.S. 809 (1975), slip op. at 824, [U.S. Supreme Court](https://supreme.justia.com/cases/federal/us/421/809/)* ### Civil bounty **No civil bounty law** Hawaii has no SB8-style private civil enforcement mechanism; no person may sue another for participating in abortion care. Hawaii has nothing like Texas's SB 8 bounty-hunter law. No private person can sue a provider, patient, or helper for participating in an abortion. In fact, Hawaii's shield laws do the opposite — they allow people sued in other states for abortion-related conduct to countersue in Hawaii court for 'abusive litigation.' **Legal analysis** No Hawaii statute authorizes private civil enforcement against abortion providers, patients, or helpers. Hawaii law affirmatively rejects this model: HRS § 323J-7 declares out-of-state laws imposing civil liability for reproductive health care to be contrary to Hawaii public policy and prohibits their application in Hawaii courts. HB 1875 (2026), which passed the legislature, adds a new § 323J-__ provision creating a cause of action for 'abusive litigation,' allowing a person sued in another state for providing or facilitating lawful reproductive or gender-affirming health care to bring a civil action in Hawaii for injunctive relief, actual damages (including the amount of any out-of-state judgment), costs, attorney's fees, and punitive damages. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-7, subsections (a)-(b), [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-7) · HB 1875 SD1, 33rd Leg. (Haw. 2026), new § 323J-__ (abusive litigation), [Hawaii State Legislature](https://data.capitol.hawaii.gov/sessions/session2026/bills/HB1875_SD1_.HTM)* **Editor's note.** HB 1875 SD1 passed the 2026 legislature; verify enactment status in the Session Laws of Hawaii 2026. ## Procedural requirements ### Waiting period **No waiting period** Hawaii imposes no mandatory waiting period between counseling and an abortion procedure. Hawaii does not require a person to wait any amount of time between an initial appointment and having an abortion. Once a person decides to have an abortion and schedules it, there is no legally required delay. **Legal analysis** Hawaii has never enacted a mandatory waiting period for abortion. No statute requires a delay between counseling, consent, or the initial visit and the procedure itself. This contrasts with many other states that impose 24-, 48-, or 72-hour waiting periods. The absence of a waiting period is consistent with HRS § 453-16(b)'s affirmative command that the state 'shall not deny or interfere' with the right to abortion. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 453-16, subsection (b), [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ### Mandatory counseling **No state-scripted counseling** Hawaii does not require state-scripted counseling or the delivery of state-produced materials before an abortion. Hawaii does not require a person to receive state-written counseling or materials before having an abortion. Medical providers follow standard informed-consent practices, but the state does not dictate what must be said, does not require information about fetal development or alternatives, and does not mandate that any specific warning be given. **Legal analysis** No Hawaii statute imposes state-scripted abortion counseling, mandatory materials, or specific informed-consent requirements beyond those generally applicable to medical procedures under Hawaii common law and HRS Chapter 671 (Medical Torts). Hawaii does not mandate that providers give information about fetal development, adoption alternatives, or purported 'abortion reversal.' The state's policy is directed instead at ensuring that limited-service pregnancy centers do not mislead patients — HRS § 321-561 requires them to post notices about the availability of reproductive health services. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 321-561, title, [Justia](https://law.justia.com/codes/hawaii/title-19/chapter-321/section-321-561)* ### Ultrasound requirement **No ultrasound requirement** Hawaii does not require an ultrasound before an abortion; neither performance nor display of an ultrasound is mandated. Hawaii does not require a person to have an ultrasound before getting an abortion. A provider may perform one as part of standard medical care — for example, to determine gestational age — but the state does not require it, and there is no requirement that an ultrasound image be shown or described to the patient. **Legal analysis** No Hawaii statute requires an ultrasound as a precondition to abortion. No statute requires that an ultrasound image be displayed to or described for the patient. Ultrasound use is left to the clinical judgment of the provider and the ordinary standard of care. *Sources — No law on this point · High confidence* ### In person visits **No in-person visit required** Hawaii imposes no legally compelled in-person visits; medication abortion can be obtained entirely by telehealth and mail. Hawaii law does not require a single in-person visit for an abortion. Medication abortion is available through telehealth — a video call or online assessment — with pills mailed directly to the patient. For procedural abortion, an in-person visit is obviously needed for the medical procedure itself, but the law does not require multiple visits. **Legal analysis** Because Hawaii has no waiting period, no mandatory counseling, and no ultrasound requirement, the combined statutory regime requires zero legally compelled in-person visits. Telehealth prescribing of medication abortion is permitted under Hawaii law and is offered by providers including Planned Parenthood. The absence of an in-person dispensing requirement for mifepristone — reinforced by the federal district court ruling in Purcell v. Kennedy — means that a patient can complete the entire medication abortion process without any in-person interaction with a provider. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 453-16, [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html)* ## Minors ### Parental involvement **No parental involvement required** Hawaii does not require parental consent or notification for a minor to obtain an abortion; minors who are or profess to be pregnant may consent on their own. A young person under 18 in Hawaii does not need a parent's permission and does not have to tell a parent to get an abortion. By law, a minor who is pregnant — or who says she is pregnant — has the same legal capacity to consent to medical care as an adult. The provider must take steps to keep the minor's medical information confidential. > "The consent to the provision of medical care and services... when executed by a minor who is or professes to be pregnant... shall be valid and binding as if the minor had achieved the age of majority. No consent of any other person or persons, including but not limited to a spouse, parent, custodian, or guardian, shall be necessary." > — Haw. Rev. Stat. § 577A-2(a), (c) **Legal analysis** HRS § 577A-2(a) provides that 'the consent to the provision of medical care and services by public or private hospitals, public or private clinics, or licensed health care providers, when executed by a minor who is or professes to be pregnant... shall be valid and binding as if the minor had achieved the age of majority.' Subsection (c) states: 'No consent of any other person or persons, including but not limited to a spouse, parent, custodian, or guardian, shall be necessary.' Subsection (d) requires the health care provider to ensure that the minor's information is not disclosed. This is a mature-minor consent statute; it applies to all pregnancy-related care, including abortion. Hawaii has never enacted a parental-consent or parental-notification statute for abortion. A 2000 bill (SB 2406) to require parental consent did not pass. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 577A-2(a), (c), subsections (a) and (c), [FindLaw](https://codes.findlaw.com/hi/division-3-property-family/hi-rev-st-sect-577a-2.html)* ### Judicial bypass **No bypass needed** Because Hawaii requires no parental involvement, no judicial bypass procedure exists or is needed. Since Hawaii does not require a minor to involve her parents in an abortion decision, there is no need for a court process to get around that requirement. A minor can make the decision and consent on her own. **Legal analysis** Judicial bypass is a procedural mechanism designed to allow a minor to obtain a court order authorizing abortion without parental involvement in states that otherwise require parental consent or notification. Because Hawaii imposes no parental-involvement requirement, no judicial bypass statute exists, and none is needed. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 577A-2, subsection (a), [FindLaw](https://codes.findlaw.com/hi/division-3-property-family/hi-rev-st-sect-577a-2.html)* ## Paternal spousal rights ### Consent or notice laws **No spousal/paternal consent laws** Hawaii has never enacted a spousal-consent or paternal-notice requirement for abortion; none exists on the books. Hawaii law does not give a spouse, partner, or the biological father any right to be notified about, consent to, or veto an abortion. The pregnant person's decision is hers alone, and no other person's consent is required. **Legal analysis** No Hawaii statute requires spousal consent, spousal notification, paternal consent, or paternal notification for abortion. The 1970 Act 1 contained no such provision, and none has been added. HRS § 577A-2(c) explicitly provides that for a pregnant minor, 'no consent of any other person or persons, including but not limited to a spouse, parent, custodian, or guardian, shall be necessary' — language that, while addressed to minors, reflects the state's broader policy of not conditioning abortion access on third-party consent. The Hawaii Constitution's privacy right (Art. I, § 6) would independently foreclose any spousal-consent requirement under the reasoning of Planned Parenthood v. Danforth, 428 U.S. 52 (1976), even after Dobbs. *Sources — No law on this point · High confidence · Haw. Rev. Stat. § 577A-2(c), subsection (c), [FindLaw](https://codes.findlaw.com/hi/division-3-property-family/hi-rev-st-sect-577a-2.html)* ### Enforceability **Danforth barrier; not an issue** Because Hawaii has no spousal-consent law, Danforth's holding that such laws are unconstitutional is relevant only as a backstop against any future enactment. Hawaii has no spousal-consent law today, so there is nothing to enforce or challenge. If Hawaii ever enacted one, it would likely violate the Hawaii Constitution's privacy clause regardless of whether the U.S. Supreme Court reconsiders Danforth after Dobbs. **Legal analysis** Planned Parenthood v. Danforth, 428 U.S. 52 (1976), held that a Missouri spousal-consent requirement was unconstitutional. Planned Parenthood v. Casey, 505 U.S. 833 (1992), reaffirmed that a spousal-notification requirement constitutes an undue burden. Dobbs overruled Roe and Casey's federal constitutional holdings but did not address Danforth or spousal-consent requirements specifically. The question whether a state may now constitutionally require spousal consent after Dobbs is unresolved at the federal level. In Hawaii, however, Art. I, § 6 of the state constitution provides an independent privacy right that the Hawaii Supreme Court could interpret to bar any spousal-consent requirement even if the federal Constitution no longer does. This remains academic because Hawaii does not have such a law. *Sources — Semi-verified · High confidence · Planned Parenthood v. Danforth, 428 U.S. 52 (1976), slip op. at 69-71, [U.S. Supreme Court](https://supreme.justia.com/cases/federal/us/428/52/) · Haw. Const. art. I, § 6, [FindLaw](https://codes.findlaw.com/hi/the-constitution-of-the-state-of-hawaii/hi-const-art-1-sect-6)* **Editor's note.** Danforth's continuing validity post-Dobbs is debated, but Hawaii's independent state constitutional privacy right provides a separate barrier. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Other paternal rights **Father has no abortion veto; viable-fetus wrongful death** No Hawaii law gives the biological father any right to prevent or be notified of an abortion; a father may bring a wrongful-death action for a viable fetus killed by a third party's tort. The biological father has no legal right under Hawaii law to stop or be told about an abortion. A father does have the right to bring a wrongful-death lawsuit if a viable fetus is killed by someone else's negligence or wrongful act — for example, in a car accident — but this does not apply to a lawful abortion. > "A wrongful death claim may be brought for the death of a viable, unborn fetus." > — Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990); In re Hawai'i, 137 H. 179, 366 P.3d 1058 (App. 2016) **Legal analysis** Hawaii has no putative-father registry relevant to the unborn and no statute granting the father standing to challenge or enjoin an abortion. Under HRS § 663-3, as interpreted by the Hawaii Intermediate Court of Appeals in 2016 (137 H. 179, 366 P.3d 1058), a wrongful-death action may be brought for the death of a viable, unborn fetus. The wrongful-death statute enumerates who may bring such an action, and a father may qualify. However, this civil remedy is for third-party tortious conduct — it does not create a cause of action against the pregnant person or an abortion provider for a lawful abortion. The father's wrongful-death standing for a viable fetus creates an internal tension in Hawaii law — the same legal system permits abortion of a viable fetus to protect life or health while also allowing a father to sue for wrongful death if a third party causes the loss of that same fetus — but the two doctrines operate in distinct legal domains. *Sources — Verified at source · High confidence · Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990); In re Hawai'i, 137 H. 179, 366 P.3d 1058 (App. 2016), case annotations, [Justia](https://law.justia.com/codes/hawaii/title-36/chapter-663/section-663-3)* ## Fetal personhood ### Fetal homicide law **No fetal homicide statute** Hawaii's criminal code does not include a fetal homicide offense; a 2015 bill to create one did not pass. Hawaii does not have a law that treats killing a fetus as homicide. The state's homicide laws — murder, manslaughter, negligent homicide — apply only to killing a 'person' or 'human being,' and Hawaii law does not define a fetus as a person for criminal purposes. A bill was introduced in 2015 to create a 'manslaughter of an unborn child' offense, but it did not become law. > "A person commits the offense of manslaughter if: (a) The person recklessly causes the death of another person." > — Haw. Rev. Stat. § 707-702(1)(a) **Legal analysis** Hawaii's homicide statutes (HRS Chapter 707) define murder as intentionally or knowingly causing 'the death of another person' (§ 707-701) and manslaughter as recklessly causing 'the death of another person' (§ 707-702). No Hawaii statute defines 'person' or 'human being' to include a fetus at any stage of development for purposes of criminal homicide. A 2015 bill (HB 1234) proposed a new § 707-B creating 'manslaughter of an unborn child' as a class A felony, but it was not enacted. The absence of a fetal homicide statute means that a third party who causes the loss of a pregnancy may be charged with assault of the pregnant person but not with homicide of the fetus. This absence also means that there is no criminal provision under which a pregnant person or an abortion provider could be charged with fetal homicide. *Sources — Semi-verified · High confidence · Haw. Rev. Stat. § 707-702(1)(a), subsection (1)(a), [Justia](https://law.justia.com/codes/hawaii/title-37/chapter-707/section-707-702) · HB 1234, 28th Leg. (Haw. 2015), proposed § 707-B, [LegiScan](https://legiscan.com/HI/text/HB1234/id/1098047/Hawaii-2015-HB1234-Introduced.html)* **Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Wrongful death **Viable fetus; civil wrongful death** A viable unborn fetus may be the subject of a wrongful-death action under Hawaii tort law, as recognized by the Hawaii Intermediate Court of Appeals in 2016. Under Hawaii civil law, if a viable fetus — one that could survive outside the womb — is killed by someone's wrongful act (like a car crash or medical malpractice), the family can bring a wrongful-death lawsuit. This right does not apply to a lawful abortion, and it does not allow a lawsuit against the pregnant person. > "A wrongful death claim may be brought for the death of a viable, unborn fetus." > — Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990); In re Hawai'i, 137 H. 179, 366 P.3d 1058 (App. 2016) **Legal analysis** The Hawaii Intermediate Court of Appeals recognized in 2016 that 'a wrongful death claim may be brought for the death of a viable, unborn fetus,' citing the federal district court decision in Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990). This is a civil tort remedy, not a criminal one. It arises under HRS § 663-3, which allows designated survivors to bring an action when 'the death of a person is caused by the wrongful act, neglect, or default of any person.' The court extended 'person' to include a viable fetus for civil wrongful-death purposes. This does not create a cause of action against a provider for a lawful abortion, as lawful abortion is not a 'wrongful act.' The viability threshold for wrongful-death standing aligns with — and is in tension with — the viability framework of § 453-16: the law simultaneously permits the intentional termination of a viable fetus (to protect life/health) while recognizing that a viable fetus can be the subject of a wrongful-death claim if killed by a tortfeasor. *Sources — Verified at source · High confidence · Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990); In re Hawai'i, 137 H. 179, 366 P.3d 1058 (App. 2016), case annotations, [Justia](https://law.justia.com/codes/hawaii/title-36/chapter-663/section-663-3)* ### Personhood definition **No fetal personhood in law** No Hawaii statute or constitutional provision defines 'person,' 'human being,' or 'child' to include the unborn for general legal purposes. Hawaii law does not define a fetus as a 'person.' The state's criminal, civil, and family codes do not contain language treating an unborn child as a legal person. Hawaii voters have not adopted a personhood amendment. Bills have been introduced that would have defined 'unborn child' as beginning at fertilization, but none have passed. **Legal analysis** No provision of the Hawaii Revised Statutes or the Hawaii Constitution defines 'person,' 'human being,' or 'child' to include a fetus or embryo for general legal purposes. Bills proposing personhood language have been introduced but have failed — for example, HB 1332 (2024) proposed defining 'unborn child' as 'an individual organism of the human species, beginning at fertilization, until the point of being born alive,' but it did not pass. SB 213 (2025), a born-alive infant protection bill, was introduced but not enacted. Hawaii law thus maintains the traditional distinction between a born person and an unborn fetus, with the limited exception of the viable-fetus wrongful-death civil remedy recognized by case law. *Sources — Semi-verified · High confidence · HB 1332, 32nd Leg. (Haw. 2024), § 2, [LegiScan](https://legiscan.com/HI/text/HB1332/id/2888779/Hawaii-2024-HB1332-Introduced.html)* **Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Contradictions analysis Hawaii's law is largely internally consistent on fetal personhood, but there is one notable tension. The state does not define the fetus as a 'person' for criminal, civil, or family-law purposes — it has no fetal homicide statute, no personhood language in its constitution, and its abortion statute protects the right to terminate a pregnancy. Yet the Hawaii Intermediate Court of Appeals has recognized that a wrongful-death action may be brought for the death of a viable, unborn fetus. This creates a limited asymmetry: the same viable fetus whose intentional termination the state permits (to protect the pregnant person's life or health) may simultaneously be the subject of a civil damages action if killed by a third party's tort. The two doctrines operate in separate legal domains — abortion regulation versus tort recovery — and do not directly conflict, but they reflect different policy judgments about the same entity. Beyond this, Hawaii law is unusually consistent: the absence of a fetal homicide statute means the state does not simultaneously permit abortion while treating the fetus as a homicide victim, a contradiction that exists in many other states. ## Telehealth & interstate questions ### Telehealth prescribing **Telehealth permitted; no in-state barrier** Abortion medication may be prescribed by telehealth to patients in Hawaii; neither state law nor FDA regulation currently imposes an in-person visit requirement. A person in Hawaii can get a prescription for abortion medication through a telehealth appointment — a video call or online consultation — and have the pills mailed to them. Hawaii law does not require an in-person visit. Providers like Planned Parenthood offer this service. The federal courts have also ruled against FDA restrictions that would require in-person dispensing. **Legal analysis** Hawaii law imposes no in-person visit requirement, no mandatory ultrasound, and no restriction on telehealth prescribing for abortion. HRS § 453-1.3 defines and authorizes the practice of telemedicine. Medication abortion by telehealth is offered in Hawaii, including by Planned Parenthood Great Northwest, Hawaiʻi, Alaska, Indiana, Kentucky. At the federal level, the FDA permanently removed the in-person dispensing requirement for mifepristone in 2021, and in Purcell v. Kennedy (D. Haw., Oct. 30, 2025), the federal district court in Hawaii ruled that the FDA's remaining REMS restrictions violated the law, further reinforcing telehealth access. *Sources — Semi-verified · High confidence · Haw. Rev. Stat. § 453-1.3, section title, [Hawaii DCCA](https://files.hawaii.gov/dcca/pvl/pvl/hrs/hrs_pvl_453.pdf) · Purcell v. Kennedy, No. 1:24-cv-00401 (D. Haw. Oct. 30, 2025), [ACLU](https://www.aclu.org/cases/chelius-v-becerra)* **Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Out of state travel **Travel unrestricted; shielded** Hawaii residents may freely travel out of state for abortion; Hawaii law does not reach out-of-state conduct and shield laws protect against other states' enforcement. A Hawaii resident can travel to another state for an abortion without any legal restriction under Hawaii law. The state does not try to regulate what its residents do outside its borders, and its shield laws block other states from using Hawaii's courts or government agencies to investigate or prosecute that travel. > "Notwithstanding any provision of chapter 832 to the contrary, the governor shall deny any demand made by the executive authority of any state for the surrender of any person charged with a crime under the laws of that state when the alleged crime involves... receiving... reproductive health care services." > — Haw. Rev. Stat. § 323J-6 **Legal analysis** No Hawaii statute restricts or penalizes traveling out of state for an abortion. HRS § 323J-4 prohibits state agencies from expending resources in furtherance of out-of-state investigations targeting those who seek or receive reproductive health care. HRS § 323J-6 requires the governor to deny extradition for charges involving reproductive health care services. HRS § 323J-7 declares out-of-state laws imposing liability for receiving reproductive health care to be contrary to Hawaii public policy. The constitutional right to travel, recognized in cases such as Saenz v. Roe, 526 U.S. 489 (1999), provides an independent federal barrier to any attempt to restrict interstate travel for abortion, though Hawaii has made no such attempt. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-6, § 323J-6, [Williams Institute](https://williamsinstitute.law.ucla.edu/wp-content/uploads/Shield-Law-HI-Jul-2025.pdf)* ### Shield or hostile laws **Among the strongest shield laws** Hawaii's Chapter 323J provides comprehensive shield protections: subpoena denial, agency non-cooperation, extradition denial, license protection, and anti-suit provisions. Hawaii has one of the strongest sets of shield laws in the country, protecting anyone involved in reproductive health care — patients, providers, and helpers — from other states' attempts to investigate, prosecute, or sue them. Hawaii courts will not issue subpoenas for out-of-state abortion cases, state agencies cannot help other states' investigations, the governor must refuse extradition for abortion-related charges, medical boards cannot discipline providers based on another state's action, and Hawaii courts will not enforce other states' abortion-related judgments. > "No court or clerk of a court shall order the issuance of a subpoena... in connection with an out-of-state or interstate investigation or proceeding relating to reproductive health care services legally performed in the State." > — Haw. Rev. Stat. § 323J-3 **Legal analysis** Act 2, Session Laws of Hawaii 2023 (SB 1), codified at HRS Chapter 323J, created a comprehensive shield framework: § 323J-2 restricts disclosure of protected health information; § 323J-3 prohibits issuance of subpoenas for out-of-state proceedings; § 323J-4 prohibits state agencies from expending resources in furtherance of out-of-state investigations; § 323J-5 prohibits the state from taking adverse action based on pregnancy outcomes or aiding/assisting; § 323J-6 requires the governor to deny extradition; § 323J-7 declares out-of-state laws contrary to Hawaii public policy and prohibits their application in Hawaii courts. Separately, HRS §§ 453-8.6, 457-12, and 461-21.5 protect medical, nursing, and pharmacy licenses from discipline based on another state's action related to reproductive health care. Executive Order 22-05 (Oct. 11, 2022) preceded the statutory shield law and directed executive departments not to cooperate with out-of-state investigations. HB 1875 (2026) expands shield protections to gender-affirming care and adds an 'abusive litigation' cause of action allowing counter-suits. *Sources — Verified at source · High confidence · Haw. Rev. Stat. § 323J-3, [FindLaw](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-3) · Haw. Rev. Stat. § 453-8.6(a), subsection (a), proviso, [FindLaw](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-8-6) · Haw. Rev. Stat. § 323J-6, § 323J-6, [Williams Institute](https://williamsinstitute.law.ucla.edu/wp-content/uploads/Shield-Law-HI-Jul-2025.pdf)* **Editor's note.** HB 1875 (2026) expands Chapter 323J to include gender-affirming health care. Verify its final enacted form in the 2026 Session Laws. ## Funding and insurance ### Medicaid **State-funded beyond Hyde** Hawaii Medicaid (Med-QUEST) covers abortion using state-only funds beyond the federal Hyde Amendment categories of life, rape, and incest. Hawaii's Medicaid program, Med-QUEST, covers abortion care using state money, not just the limited federal funding allowed by the Hyde Amendment. This means that people enrolled in Medicaid in Hawaii can generally get their abortion covered, not only in cases of rape, incest, or life endangerment. > "Hawaii Medicaid has elected to cover induced/intentional termination of pregnancy (ITOP) with State funds only." > — Med-QUEST Provider Memo FFS-1512 (2015) **Legal analysis** The federal Hyde Amendment prohibits the use of federal Medicaid funds for abortion except in cases of life endangerment, rape, or incest. Hawaii, however, uses state-only funds to cover abortion beyond these categories. A 2015 Med-QUEST provider memo (FFS-1512) confirms that 'Hawaii Medicaid has elected to cover induced/intentional termination of pregnancy (ITOP) with State funds only.' A 2020 study in PMC noted that 'in the state of Hawai'i, both state Medicaid and private insurance provide coverage for abortion care with few exceptions.' Hawaii is among a small number of states (along with California, New York, Oregon, and others) that fund abortion through their Medicaid programs beyond Hyde limits. This policy rests on appropriations and administrative decisions rather than a specific statutory mandate, but it has been consistent across administrations. *Sources — Semi-verified · High confidence · Med-QUEST Provider Memo FFS-1512 (2015), [Hawaii Department of Human Services Med-QUEST Division](https://medquest.hawaii.gov/content/dam/formsanddocuments/provider-memos/ffs-memos/2015/FFS-1512.pdf) · Raidoo et al., Impact of Insurance Coverage for Abortion in Hawai'i, 79 Contraception 101 (2020), [PMC / National Library of Medicine](https://pmc.ncbi.nlm.nih.gov/articles/PMC7175356)* **Editor's note.** Medicaid coverage is established by administrative policy, not a specific statute. Verify current Med-QUEST policy for any changes. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication. ### Private insurance **Coverage available, not restricted** Hawaii does not prohibit private insurance plans from covering abortion; most plans in the state include coverage. In Hawaii, private health insurance plans generally cover abortion care. The state does not restrict or prohibit insurers from covering abortion, unlike some states that ban abortion coverage in private plans. **Legal analysis** Hawaii has no statute prohibiting or restricting private health insurance coverage of abortion. A 2023 state auditor's report (Report No. 23-10) found that 'the sexual and reproductive health care services for which the bill would mandate health insurance coverage are already covered by policies issued in the State of Hawai'i.' The Hawaii benchmark plan for ACA marketplace coverage includes abortion coverage. There is no requirement that abortion coverage be purchased as a separate rider. Hawaii does not impose the federal abortion-coverage segregation rules for ACA plans more restrictively than the ACA itself requires. *Sources — Verify before publication · High confidence · Hawaii State Auditor Report No. 23-10 (Nov. 2023), [Hawaii Office of the Auditor](https://files.hawaii.gov/auditor/Reports/2023/23-10.pdf)* **Editor's note.** Confirm that the auditor report's finding reflects current marketplace practice. ### Exchange plans **ACA plans include abortion coverage** Hawaii's ACA marketplace benchmark plan includes abortion coverage; the state has not adopted additional restrictions beyond federal requirements. Health insurance plans sold on Hawaii's Affordable Care Act marketplace generally include abortion coverage. Hawaii has not passed laws adding extra restrictions on top of the federal rules that already require separating premium payments for abortion coverage from other services. **Legal analysis** Under the ACA, states may prohibit exchange plans from covering abortion beyond Hyde categories, and 26 states have done so. Hawaii is not among them. The federal requirement that plans collect a separate premium payment for abortion coverage (45 C.F.R. § 156.280) applies, but Hawaii imposes no additional state-level barrier. The 2023 auditor report confirmed that abortion coverage is standard in Hawaii policies. *Sources — Verify before publication · High confidence · Hawaii State Auditor Report No. 23-10 (Nov. 2023), [Hawaii Office of the Auditor](https://files.hawaii.gov/auditor/Reports/2023/23-10.pdf)* ### State funding of providers **Providers not defunded** Hawaii does not defund abortion providers; the state funds reproductive health services through its Medicaid program and does not exclude providers based on abortion services. Hawaii does not have a law that blocks state funding from going to organizations that provide abortion care. Providers like Planned Parenthood are eligible for state funding for the non-abortion health services they provide. **Legal analysis** Hawaii has no statute excluding abortion providers from state funding programs, family-planning grants, or other public health funding streams. No 'defunding' statute targeting Planned Parenthood or other abortion providers has been enacted. The state's policy is reflected in its Medicaid coverage decisions and its general approach to reproductive health funding. Hawaii's political leadership — both the governor and the legislature — has been consistently supportive of reproductive health funding. *Sources — Verify before publication · High confidence · Center for Reproductive Rights, Abortion Laws by State: Hawaii, [Center for Reproductive Rights](https://reproductiverights.org/maps/abortion-laws-by-state/hawaii)* ## Penalties | Actor | Offense | Penalty | Verification | | --- | --- | --- | --- | | Pregnant person | None; HRS § 323J-5 expressly prohibits the state from penalizing anyone based on pregnancy outcomes | No criminal or civil penalty | Verified at source | | Physician / surgeon / osteopathic physician | None; abortion provision is expressly authorized by HRS § 453-16(a) | No criminal penalty; license protected from out-of-state discipline under HRS § 453-8.6 | Verified at source | | Advanced practice registered nurse | None; APRNs are expressly authorized to provide medication and aspiration abortion under HRS § 457-8.7 | No criminal penalty; nursing license protected from out-of-state discipline under HRS § 457-12 (amended by Act 2, 2023) | Verified at source | | Physician assistant | None; PAs are expressly authorized to provide medication and aspiration abortion in the first trimester under HRS § 453-16(a) | No criminal penalty; license protected from out-of-state discipline under HRS § 453-8.6 | Verified at source | | Pharmacist | None; pharmacists filling lawful prescriptions for abortion medication are acting within their scope; pharmacy license protected under HRS § 461-21.5 | No criminal or civil penalty | Verified at source | | Helper (friend, family member, abortion fund, employer) | None; HRS § 323J-5 prohibits the state from taking adverse action against anyone who aids or assists a pregnant person in accessing reproductive health care | No criminal or civil penalty; shield-law protections apply | Verified at source | ## Recent changes - **May 2, 2006** — Act 35 (Session Laws of Hawaii 2006) amended HRS § 453-16, removing the 90-day residency requirement and hospital-only mandate, restructuring the law as an affirmative right rather than a decriminalization with preconditions, and eliminating the original criminal penalty. *Sources — Act 35, Session Laws of Hawaii 2006, legislative findings, [LegiScan (via HB 1441, 2024, recounting history)](https://legiscan.com/HI/text/HB1441/id/2893800/Hawaii-2024-HB1441-Introduced.html)* - **April 27, 2021** — Governor David Ige signed HB 576 (Act 3, Session Laws of Hawaii 2021), authorizing advanced practice registered nurses (APRNs) to provide medication and aspiration abortion care, expanding the provider base beyond physicians. *Sources — Haw. Rev. Stat. § 457-8.7 (enacted by Act 3, 2021), [Justia](https://law.justia.com/codes/hawaii/title-25/chapter-457/section-457-8-7)* - **June 24, 2022** — U.S. Supreme Court decided Dobbs v. Jackson Women's Health Organization, overruling Roe v. Wade. Hawaii's abortion protections, grounded in independent state statutory and constitutional law, were unaffected. *Sources — Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022), slip op. at 1, [U.S. Supreme Court](https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf)* - **October 11, 2022** — Governor David Ige signed Executive Order 22-05, prohibiting executive departments from cooperating with out-of-state investigations related to reproductive health care services and protecting providers and patients. *Sources — Executive Order 22-05 (Oct. 11, 2022), [Hawaii Public Radio](https://www.hawaiipublicradio.org/local-news/2022-10-12/gov-ige-says-hawaii-wont-cooperate-with-states-prosecuting-for-abortions)* - **March 22, 2023** — Governor Josh Green signed SB 1 (Act 2, Session Laws of Hawaii 2023) into law, creating the comprehensive Chapter 323J shield-law framework, expanding provider types to include physician assistants, replacing gendered language with 'pregnant person,' and strengthening the statutory right to abortion. *Sources — Act 2, Session Laws of Hawaii 2023 (SB 1), bill summary, [LegiScan](https://legiscan.com/HI/bill/SB1/2023) · Governor Josh Green Press Release, March 22, 2023, [Office of the Governor, State of Hawaii](https://governor.hawaii.gov/featured/office-of-the-governor-news-release-gov-green-signs-first-bills-into-law)* - **October 30, 2025** — Federal district court in Hawaii (Purcell v. Kennedy, formerly Chelius v. Becerra) ruled that the FDA's 2023 REMS restrictions on mifepristone violated the law, reinforcing medication abortion access. *Sources — Purcell v. Kennedy, No. 1:24-cv-00401 (D. Haw. Oct. 30, 2025), [ACLU](https://www.aclu.org/cases/chelius-v-becerra)* - **May 29, 2026** — HB 1875 enacted, expanding Chapter 323J shield-law protections to include gender-affirming health care services, creating a cause of action for 'abusive litigation,' and prohibiting medical malpractice insurers and health carriers from taking adverse action against providers based solely on providing lawful reproductive or gender-affirming health care services. *Sources — HB 1875 SD1, 33rd Leg. (Haw. 2026), purpose clause, [Hawaii State Legislature](https://data.capitol.hawaii.gov/sessions/session2026/bills/HB1875_SD1_.HTM)* ## Pending changes ### HB 728 (2026) (Legislation) **Status.** Introduced in the 2026 legislative session; proposes a constitutional amendment to protect reproductive freedom in the Hawaii Constitution. Requires a two-thirds vote in one session or a simple majority in two successive sessions to place on the ballot. Would amend the Hawaii Constitution to explicitly prohibit the state from denying or interfering with an individual's reproductive freedom, including the right to abortion and contraception. Would elevate the statutory protection to constitutional status, making it far harder to repeal. *Sources — HB 728, 33rd Leg. (Haw. 2026), bill title, [LegiScan](https://legiscan.com/HI/bill/HB728/2026)* ### SB 2038 (2026) (Legislation) **Status.** Introduced in the 2026 legislative session. Would authorize certain pregnant persons to receive abortion medication with a label that does not bear their name and other identifying information, enhancing privacy protections. *Sources — SB 2038, 33rd Leg. (Haw. 2026), bill summary, [LegiScan](https://legiscan.com/HI/text/SB2038/2026)* ### Purcell v. Kennedy (formerly Chelius v. Becerra) (Litigation) **Status.** Federal district court in Hawaii granted plaintiffs' summary judgment motion on October 30, 2025, ruling FDA REMS restrictions unlawful. Potential appeal or further federal regulatory changes may follow. May further reduce federal barriers to medication abortion access, including elimination of remaining REMS requirements. Could affect prescribing and dispensing nationwide but has particular relevance in Hawaii, where the case was litigated. *Sources — Purcell v. Kennedy, No. 1:24-cv-00401 (D. Haw.), [ACLU](https://www.aclu.org/cases/chelius-v-becerra)* ## Key authorities - **HRS § 453-16 — Intentional termination of pregnancy; refusal to perform** — Haw. Rev. Stat. § 453-16 _(Statute)_ · [codes.findlaw.com/hi/division-2-busin…](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-16.html) The foundational abortion statute: protects the right to abortion of a nonviable fetus and termination to protect life/health, defines 'abortion' and 'nonviable fetus,' and authorizes providers. - **HRS Chapter 323J — Reproductive Health Care Services** — Haw. Rev. Stat. ch. 323J _(Statute)_ · [codes.findlaw.com/hi/division-1-gover…](https://codes.findlaw.com/hi/division-1-government/hi-rev-st-sect-323j-3) Comprehensive shield law: blocks out-of-state subpoenas, agency cooperation, and extradition; prohibits adverse state action based on pregnancy outcomes; declares contrary out-of-state laws void as against Hawaii public policy. - **HRS § 457-8.7 — APRN abortion authority** — Haw. Rev. Stat. § 457-8.7 _(Statute)_ · [law.justia.com/codes/hawaii/title-…](https://law.justia.com/codes/hawaii/title-25/chapter-457/section-457-8-7) Authorizes advanced practice registered nurses to provide medication and aspiration abortion care, expanding the provider base beyond physicians. - **HRS § 577A-2 — Minor consent to medical care** — Haw. Rev. Stat. § 577A-2 _(Statute)_ · [codes.findlaw.com/hi/division-3-prope…](https://codes.findlaw.com/hi/division-3-property-family/hi-rev-st-sect-577a-2.html) Allows pregnant minors to consent to their own abortion care without parental involvement, making judicial bypass unnecessary. - **HRS § 453-8.6 — License discipline shield** — Haw. Rev. Stat. § 453-8.6 _(Statute)_ · [codes.findlaw.com/hi/division-2-busin…](https://codes.findlaw.com/hi/division-2-business/hi-rev-st-sect-453-8-6) Prohibits the Hawaii Medical Board from disciplining physicians based on another state's action if the discipline was for providing reproductive health care lawful in Hawaii. - **Hawaii Constitution Article I, Section 6 — Right to Privacy** — Haw. Const. art. I, § 6 _(Constitution)_ · [codes.findlaw.com/hi/the-constitution…](https://codes.findlaw.com/hi/the-constitution-of-the-state-of-hawaii/hi-const-art-1-sect-6) The independent state constitutional privacy right that undergirds Hawaii's abortion protections; the Hawaii Supreme Court has interpreted it to protect reproductive autonomy. - **State v. Cabading / wrongful death for viable fetus** — In re Hawai'i, 137 H. 179, 366 P.3d 1058 (App. 2016); Cabading v. United States, 745 F. Supp. 1573 (D. Haw. 1990) _(Case)_ · [law.justia.com/codes/hawaii/title-…](https://law.justia.com/codes/hawaii/title-36/chapter-663/section-663-3) Establishes that a wrongful-death claim may be brought for a viable unborn fetus — the only area of Hawaii law giving legal recognition to a fetus as a potential rights-holder. - **Act 1, Session Laws of Hawaii 1970** — 1970 Haw. Sess. Laws Act 1 _(Statute)_ · [data.capitol.hawaii.gov/sessions/sessionlaw…](https://data.capitol.hawaii.gov/sessions/sessionlaws/Years/SLH1970/SLH1970_Act1.pdf) The original law that made Hawaii the first state to decriminalize abortion; the criminal penalty it contained has since been removed, but it is the historical foundation of Hawaii's abortion law. - **Purcell v. Kennedy (formerly Chelius v. Becerra)** — No. 1:24-cv-00401 (D. Haw. Oct. 30, 2025) _(Case)_ · [aclu.org/cases/chelius-v-becerra](https://www.aclu.org/cases/chelius-v-becerra) Federal litigation in Hawaii challenging FDA mifepristone restrictions; the district court ruled the REMS unlawful, reinforcing medication abortion access. - **HB 1875 SD1 (2026) — Expanded shield law** — HB 1875 SD1, 33rd Leg. (Haw. 2026) _(Statute)_ · [data.capitol.hawaii.gov/sessions/session202…](https://data.capitol.hawaii.gov/sessions/session2026/bills/HB1875_SD1_.HTM) Most recent expansion: extends shield protections to gender-affirming care, creates abusive-litigation counter-suit, and protects providers from insurer retaliation. ## Research notes > Overall confidence: High. Analysis current as of July 12, 2026; research completed July 12, 2026. Re-verify the following before publication: (1) HB 1875 SD1's final enactment in the 2026 Session Laws; (2) the current as-amended text of HRS Chapter 323J (the 2025 code edition may not yet reflect SB 1150 amendments); (3) current Med-QUEST administrative policy on abortion coverage; (4) the procedural posture of Purcell v. Kennedy — whether the October 2025 district court ruling has been appealed; (5) the status of HB 728 (2026 constitutional amendment) — whether it passed the 2026 session. The 1970 Act 1 criminal penalty language was confirmed from the original PDF; the removal of penalties was confirmed through the current text of § 453-16 which contains no penalty provision. Unresolved points: The precise current text of HRS §§ 323J-4, 323J-6, and 323J-7 as amended by SB 1150 (2025) was not directly verified from a primary code source; the Williams Institute fact sheet (July 2025) and the 2026 HB 1875 SD1 bill text were used as proxies. — HB 1875's final enactment status (whether signed into law as of the research date) should be confirmed in the Session Laws of Hawaii 2026; the bill appears in SD1 form on the legislature's website. — The scope of the 'health' exception in HRS § 453-16(b)(2) has not been judicially construed by Hawaii appellate courts, leaving some ambiguity about whether mental health is included. — Medicaid abortion coverage is established by administrative policy (Med-QUEST provider memos) rather than a specific statute, making it subject to administrative change without legislative action. — The current number and location of operational abortion clinics in Hawaii — particularly on neighbor islands — was not exhaustively researched, though secondary sources confirm geographic access barriers exist..