Forty years after the U.S. Supreme Court struck down many state restrictions on abortion with Roe v. Wade, women who want to terminate a pregnancy face a growing number of roadblocks in many parts of the country.

Last year, 19 states enacted a total of 43 provisions limiting access to abortion, according to the Guttmacher Institute. That was half the number that went into effect the previous year, but still the second-highest number since 1985.

"The laws that have been passed, in the last couple of years especially, really make women walk through a gauntlet to get abortions, throughout the country," said Eric Ferrero, a spokesman for Planned Parenthood.

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Eight states now require women seeking abortion to have ultrasounds, after Virginia lawmakers passed a measure in 2012. Three states also enacted laws that require abortion providers to have admitting privileges at a local hospital, which can deny them for a variety of reasons.

Louisiana banned abortions after 20 weeks. Utah tripled its mandatory waiting period to 72 hours. A Montana ballot initiative mandated parent notification for abortions on minors under age 16.

In at least four states -- North Dakota, South Dakota, Arkansas, Mississippi -- there is only one clinic.

"When you're the only provider in a state, you become a target," Tammi Kromenaker, director of the Red River Women's Clinic in Fargo, N.D., recently told MSNBC's Rachel Maddow.

The fate of Mississippi's sole clinic, in Jackson, is up in the air. As of mid-January, it had not been able to comply with a new law requiring providers have hospital admitting privileges. If the clinic is shut down, Mississippi would become the first state where getting an abortion is impossible.

The erosion is happening as the rate of abortions has leveled off at about 15 per 1,000 women after a steady decline, according to the Centers for Disease Control. At the same time, public support for abortion rights appears to be stable or growing.

A new NBC News/Wall Street Journal poll found 54 percent of adults think abortion should be legal always or almost all of the time -- the biggest percentage since the question was first asked a decade ago. Seventy percent don't want Roe v. Wade to be overturned, the highest number since 1989.

But abortion opponents say there's another statistic worth noting: Most Americans don't want public funding of the procedure.

"A majority of Americans do not want their tax dollars being used to fund abortions," said Mallory Quigley, a spokeswoman for the Susan B. Anthony List, which is part of an effort to strip $60 million in women's-health funding from Planned Parenthood. 

U.S. law prohibits federal funding of most abortions, and only 17 states fund abortions for low-income women, most of them under court order. But abortion advocates argue that any government funding of Planned Parenthood for other health services -- from family planning to gynecology exams -- essentially frees up money it can use to provide abortions.

A scorecard put out by Quigley's group says officials in Arizona, Indiana, Kansas, New Hampshire, New Jersey, North Carolina, Tennessee, Texas and Wisconsin have moved to cut funds for the women's health group. 

Some state efforts are tied up in court; in others, Planned Parenthood was able to obtain direct federal grants to fill the gap. In Texas, the organization lost a court battle to hold onto funding until a trial.

Ultimately, though, Planned Parenthood believes it will prevail against state efforts to slash its programs, either through legal action or public pressure on lawmakers.

"What we've seen over the last two years is the public doesn’t want these preventive health services to be defunded and the courts won’t allow it," Ferrero said.

Related: NBC/WSJ poll: Majority, for first time, want abortion to be legal

A Planned Parenthood affiliate in New York is leaving the organization rather than comply with a policy that all affiliates must offer on-site abortions, fueling hopes among anti-abortion activists of a split within the abortion-rights movement. But the move is an isolated one that has nothing to do with political battles, officials of the family planning organization say, and the policy appears likely to take effect in the new year with little disruption.

The decision last week by Planned Parenthood of South Central New York to go independent comes as the Planned Parenthood Federation of America is fighting legislative attempts in several states to bar it from receiving state health funds because the organization provides abortions.

Planned Parenthood oversees 74 regional affiliates that operate about 800 offices and clinics across the country. The affiliates don't provide a standard menu of services, however, leading Planned Parenthood in late 2010 to issue a directive requiring them to offer a roster of core services — including cancer screenings and HIV testing in addition to on-site abortions — in at least one of their locations by 2013.

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Matt Yonke, a spokesman for the Pro-Life Action League, an anti-abortion group, said the decision by the New York affiliate highlighted that some Planned Parenthood workers were "deeply uncomfortable with what goes on inside their workplace" and were being backed into a corner.

"No matter what conglomeration of services your Planned Parenthood affiliate provides, it had better provide abortion, or you're out because that's what Planned Parenthood does," he wrote last week on the group's website.

Calling the New York chapter "the latest affiliate to become independent because it won't comply with the rule," the anti-abortion group Susan B. Anthony List said in a statement that the policy was being resisted by local affiliates and was "the ultimate evidence that Planned Parenthood's chief concern is making money off abortion — not the health of vulnerable women and girls."

Interviews with affiliate officials, however, undermine the contention that Planned Parenthood is being torn apart from within.

The New York chapter, which will become Family Planning of South Central New York on March 1, is only the third known to have "disaffiliated" itself from Planned Parenthood because of the new policy in the two years since it was approved, and it said its reasons were financial, not philosophical.

Ingrid Husisian, a spokeswoman for the affiliate, which operates five clinics in the Binghamton and Oneonta region, said there were several providers of abortions in her operating area to whom the affiliate can refer clients, and "if we comply with the on-site mandate, we would be duplicating services already provided in the counties we serve."

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That raised the prospect of "creating competition that may financially hurt our local doctors," Husisian said, adding that the local group would "absolutely" offer on-site abortions if those other providers weren't nearby.

The two other affiliates known to have left specifically because of the policy also said their departures weren't political.

Tri-Rivers Planned Parenthood, based in Rolla, Mo., became Tri-Rivers Family Planning last year because "it was just not financially possible" to meet all of the new policy's requirements, said Lisa Davis, the organization's education director.

"We had no trouble with the list" Planned Parenthood mandated, Davis said.

Planned Parenthood of the Coastal Bend, based in Corpus Christi, Texas, left the national organization immediately when the policy was approved two years ago, becoming Family Planning of the Coastal Bend. Officials didn't respond to requests for comment this week, but when the group left, it said it didn't see a need to duplicate services already obtainable in the area.

Calling it old news, Planned Parenthood officials complained that the mandate had been "sensationalized" by anti-abortion activists spotlighting of the New York affiliate's announcement.

Lost in the polarized discussion, they said, was that the abortion requirement was only one part of a broader initiative covering many reproductive health services at every Planned Parenthood affiliate — some of which cover large regions in rural states where family planning services are in short supply.

Eric Ferrer, vice president of the Planned Parenthood Federation of America, acknowledged that one of those "core" services was on-site abortions, which about 10 percent of affiliates didn't previously offer. (Agency officials said nearly all of those affiliates, which currently refer clients to other local abortion providers, had already complied or were on track to do so.)

The other services have little to do with abortion, officials said, noting that the list also includes "well-woman" exams, cancer screenings, HIV and STD testing for both sexes and vaccination against the human pappilomavirus. Ferrer said the list was intended to reassure clients that they could count on "a consistent set of services at all health centers."

Davis, of Tri-Rivers Family Planning, stressed that her affiliate's move was a "business model decision; it wasn't a political thing. "We are still a pro-choice organization," she said. "We are totally aligned with Planned Parenthood."

Family Planning of South Central New York also "continues to support the mission of Planned Parenthood," Husisian said, adding: "We're going to do what we do great and let (other local abortion providers) do what they do great."

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A man who assaulted a protester outside a southern Oregon Planned Parenthood clinic on Tuesday ended up stabbed by the demonstrator, police said.

The incident occurred after Kailah L. Clair, 22, walked into the facility in Grants Pass, Ore. Witnesses told police that she kicked over protest signs, after which a demonstrator, named by police as Christopher R. Tolhurst, 54, pushed her.

The woman then returned with her father, Ted A. Clair, who pushed Tolhurst to the ground and punched him "numerous times" in the face, Lt. Dennis Ward told reporters.

That was when Tolhurst stabbed the elder Clair, The Associated Press quoted Ward as saying.

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Clair received seven stab wounds to the abdomen and neck, according to The Oregonian newspaper.

Kailah Clair received small cuts to her right hand, according to the paper.

Tolhurst received bruises and swelling to the left side of his face, police told the Oregonian.

Tolhurst and the younger Clair were treated and released from the hospital but Ted Clair, 48, remained hospitalized with serious injuries, police told reporters.

No arrests have been made over the incident.

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Abortions not performed at clinic
Tolhurst had been carrying signs denouncing abortion and Planned Parenthood, according to The Associated Press.

But spokeswoman Sarah Mosely of the Planned Parenthood for Southwestern Oregon told the AP that clinic only provides health services and does not perform abortions.

"It just appears to be a tragic situation," she told the AP. "Our thoughts are with the people who have been injured and their loved ones."

Local resident Charlotte Cook said Tolhurst accosted people coming and going through the area.

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"It was an accident looking for a place to happen," she told the AP.

Cherie Adams told the news agency that the protester would shout obscenities at her when she passed by him, which has led her to change he route to work.

“He's been out there for months," she told the AP.

"He's screaming at people. I had a feeling something like this would happen,” the AP quoted her as saying.

The Associated Press contributed to this report.

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A federal appeals court has upheld a portion of a 2005 South Dakota law that requires a doctor to tell a woman seeking an abortion that she faces an increased risk of suicide.

In a 7-4 opinion on Tuesday, the 8th Circuit Court of Appeals said medical research has shown that the risk of suicide is higher for women who abort compared with women who don’t.

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“The statute does not require the physician to disclose that a causal link between abortion and suicide has been proved.  The disclosure is truthful, as evidenced by a multitude of studies published in peer-reviewed medical journals that found an increased risk of suicide for women who had received abortions compared to women who gave birth, miscarried, or never became pregnant,” the opinion said.

“Various studies found this correlation to hold even when controlling for the effects  of other  potential  causal factors  for  suicide,  including  pre-existing depression, anxiety, suicide ideation, childhood sexual abuse, physical abuse, child neuroticism, and low self-esteem.”

The appeals court said the suicide advisory is “non-misleading” and “relevant to the patient’s decision to have an abortion.”

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The ruling came in a lawsuit filed by Planned Parenthood Minnesota, North Dakota, South Dakota against former South Dakota Gov. Mike Rounds and Attorney General Marty J. Jackley.

The full appellate panel agreed to rehear the case after a three-judge panel upheld U.S. District Judge Karen Schreier's decision to overturn the requirement, The Associated Press reported. The decision by the full 11-member court vacates the permanent injunction against enforcing the provision, according to the AP.

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"On its face, the suicide advisory presents neither an undue burden on abortion rights nor a violation of physicians’ free speech rights," the decision said.  

Planned Parenthood Minnesota, North Dakota, South Dakota took issue with the appeals court decision, saying it "allows the greatest intrusion by the government into the patient doctor relationship to date."

"The bottom line is that women don’t turn to politicians for advice about mammograms, prenatal care, or cancer treatments. Politicians should not be involved in a woman’s personal medical decisions about her pregnancy," Planned Parenthood said in a statement.

Leslee Unruh of the Alpha Center pregnancy counseling center in Sioux Falls, which seeks to persuade women not to seek abortions, called the decision a victory for South Dakota women.

“We are thrilled. This has been a long time working from 2005. It’s a long, long haul. We are so excited for the women of South Dakota that they have this victory,” she told the AP.

The suicide advisory was part of a larger 2005 law requiring South Dakota doctors to provide women with certain information before an abortion can be voluntary.

Still entangled in the courts are two sections of a separate 2011-12 law dealing with a 72-hour waiting period for abortions and requirements for "pregnancy help centers," Jackley said.

The Associated Press contributed to this story.

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Tennessee teachers can no longer condone so-called "gateway sexual activity" such as touching genitals under a new law that critics say is too vague and could hamper discussion about safe sexual behavior.

Gov. Bill Haslam's office Friday confirmed to Reuters that Haslam had signed the bill, which stirred up controversy nationwide and even was lampooned by comedian Stephen Colbert.

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"Kissing and hugging are the last stop before reaching Groin Central Station, so it's important to ban all the things that lead to the things that lead to sex," he said on the "Colbert Report" television show.

But proponents say the new law helps define the existing abstinence-only sex-education policy.

Under the law, Tennessee teachers could be disciplined and speakers from outside groups like Planned Parenthood could face fines of up to $500 for promoting or condoning "gateway sexual activities."

Parents could sue outside sexual education instructors, according to the Tennessean newspaper, while school district employees would be exempt from prosecution.

David Fowler, president of the Family Action Council of Tennessee, which pushed the bill, told Reuters the law does not ban kissing or holding hands from discussion in sex education classes. But he said it addresses the touching of certain "gateway body parts," including genitals, buttocks, breasts and the inner thigh.

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On Thursday, State Rep. Jon Lundberg told NBC station WCYB-TV that a focus on abstinence is needed because Tennessee has the seventh-highest teen birth rate in the nation and the 11th-highest HIV infection rate in the nation.

"The shift is that the main core needs to be an abstinence-based approach. Not, 'hey, I know everybody's having sex, so when you have sex do this, do this, [and] do this.’ That's not it,'" Lundberg told the station.

The bill sailed through the legislative session, passing the Senate 28-1 and the House 68-23.

Opponents, which include Planned Parenthood of Middle and East Tennessee and the state teachers' union, say that before they can begin fighting the new law, they have to be able to figure it out. They worry that discussion of sexual behavior could be interpreted as condoning it.

"The very ambiguous language in this bill certainly puts teachers in a very difficult situation" when it comes to knowing what to teach, said Jerry Winters, spokesman for the Tennessee Education Association.

Fowler said the new law was authored in part because of incidents in which teachers were instructing about alternate sexual practices as ways to have gratification without risking pregnancy.

He said one such incident involved a Nashville high school teacher who was encouraging girls to give boys oral sex in order to get a condom on them.

Fowler also pointed to a Planned Parenthood-organized program at a school in Knoxville, where students were directed to a web site "that actually lists as possible methods of birth control things like oral sex and anal sex play that I think most Tennesseans would find inappropriate."

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Lyndsey Godwin, manager of education and training for Planned Parenthood, told Reuters the idea that her group was encouraging such behavior was "utterly false." She said that while Planned Parenthood educators may answer a student's question by agreeing that anal and oral sex don't lead to pregnancy, they also emphasize the disease risks.

Godwin said Planned Parenthood supports the state's abstinence-centered policy, but the reality is not everyone can be abstinent. She said that being able to address issues of condom use and contraception and answer questions about sexual behaviors to educate students are essential to her group's role.

Winters of the Tennessee Education Association said that already existing sex-education policy was "quite adequate."

"It does focus on abstinence, but in this modern world to say that ‘just say no' is the answer to teenage pregnancy is putting your head in the sand," Winters said.

Reuters contributed to this report.

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AUSTIN, Texas - A U.S. appeals court judge on Tuesday issued an emergency stay of a ruling that prevented the state from excluding Planned Parenthood from a health program for low-income women because the organization performs abortions.

The stay, issued by Judge Jerry Smith of the 5th U.S. Circuit Court of Appeals, reversed a lower court ruling Monday in favor of the family planning organization. The decision means the state is free for now to enforce a new rule banning Planned Parenthood from the Texas Women's Health Program, state officials said.

The Associated Press reported that Smith gave eight Planned Parenthood organizations involved in a lawsuit until 5 p.m. Tuesday to present arguments.

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"At this point, Planned Parenthood is not an eligible provider in the Women's Health Program," Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, said Tuesday.

The Women's Health Program, which is part of the federal-state Medicaid program, provides cancer screenings, birth control and other health services to more than 100,000 low-income women.

It does not pay for abortions or allow abortion providers to participate in the program. The new state rule bans program money from going to affiliates of abortion providers. State law has included that ban on affiliates since the program began in 2007, but the state did not enforce it.

Judge: Texas can't ban Planned Parenthood from health program

The Planned Parenthood groups sued, and on Monday, U.S. District Judge Lee Yeakel temporarily blocked the state rule pending trial, citing "the potential for immediate loss of access to necessary medical services by several thousand Texas women."

Planned Parenthood had told Yeakel that the health care of 40,000 women would be disrupted unless he blocked the rule.

But lawyers for the state said that Planned Parenthood's mission was contrary to a program goal of reducing abortions and that the program would end if Planned Parenthood remains in it.

Texas notified the federal government last year of its intent to begin enforcing the ban, effectively excluding Planned Parenthood from the program.

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President Barack Obama's administration has said it will not renew funding for the Texas program because the state was violating federal law by restricting the freedom to choose providers.

The state is suing over that decision. The federal government pays 90 percent of the $33-million-a-year program.

Msnbc.com staff contributed to this report.

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A federal judge on Monday blocked a Texas rule that would have excluded Planned Parenthood from participating in the state's women's health program.

In a win for Planned Parenthood, U.S. District Judge Lee Yeakel ruled Monday there was sufficient evidence the state rule barring Planned Parenthood is unconstitutional. He imposed a temporary injunction against enforcing it until he can hear full arguments.

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The rule forbids state agencies from providing funds to an organization affiliated with abortion providers. It was set to go into effect on Tuesday.

In response to the new rule, eight Planned Parenthood clinics that don't provide abortions sued the state. The clinics say the law unconstitutionally restricts their freedom of speech and association.

In granting the preliminary injunction, Planned Parenthood can continue to serve women, and getting reimbursed by the state, according to the Austin Statesman.

"The court is particularly influenced by the potential for immediate loss of access to necessary medical services by several thousand Texas women," Yeakel said in a 24-page ruling.

The preliminary injunction is a big win for Planned Parenthood, which has been under siege in several states by abortion opponents. In the past year alone, states including Wisconsin, North Carolina, Tennessee and Indiana, in addition to Texas, have all moved to block Planned Parenthood from receiving taxpayer money.

"For many women, we are the only doctor's visit they will have this year," Cecile Richards, president of Planned Parenthood Federation of America, said in a statement. "This ruling affirms what women have known all along: politics simply doesn't have a place in women's health."

The state Health and Human Services Commission will comply with the order and will work with the state attorney general to determine its next steps, spokeswoman Stephanie Goodman said.

"We remain confident that federal law gives states the right to establish criteria for Medicaid providers," Goodman said.

Texas Governor Rick Perry and some Republican lawmakers have said they would rather eliminate the women's healthcare program entirely than direct money to Planned Parenthood clinics.

The Texas program, which is part of the federal-state Medicaid program, provides cancer screenings, birth control and other health services to more than 100,000 low-income women.

The program does not pay for abortions or allow abortion providers to participate in the program. The new Texas state rule would ban program money from going to affiliates of abortion providers.

State law has included that ban on affiliates since the program began in 2007, but the state did not enforce it. Texas notified the federal government last year that it intended to begin enforcing the ban, effectively excluding Planned Parenthood from the program.
According to Planned Parenthood, about 49 percent of the women who received services through the program in 2010 obtained some services through a Planned Parenthood provider. Planned Parenthood said it would lose about $13.5 million of annual funding for preventive care and family planning if the rule is applied, forcing it to close clinics and lay off staff.

Texas has already made deep cuts in other family-planning programs. As a result, state subsidies that once provided low-cost birth control to 220,000 women a year now cover fewer than 60,000 women a year.

The federal government pays for 90 percent of the cost of the Texas Women's Health Program, which serves low-income women of reproductive age who do not qualify for regular Medicaid coverage. Texas puts up just $4 million a year.

Critics object to Planned Parenthood receiving taxpayer money, which cannot be used to provide abortions, arguing that a steady stream of government grants provide an indirect subsidy by helping pay utility bills and keep doctors on staff.

Planned Parenthood is the nation's largest abortion provider, terminating about 330,000 pregnancies a year.

It gets about a third of its revenue -- $360 million in 2009 -- from government grants to provide birth control, gynecological exams and care for sexually transmitted diseases to low-income women.

The Associated Press and Reuters contributed to this report.

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A bill passed by Mississippi lawmakers putting new restrictions on doctors performing abortions moves the state one step closer to becoming “abortion free.”

There is only one abortion clinic in the state, and the owner, Diane Derzis, has said the bill’s requirements could force it to shut down.

“It looks dire for them,” said Leola Reis, vice president for external affairs for Planned Parenthood Southeast.

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The bill, which passed the state Senate on Wednesday, would require doctors performing abortions to be board-certified OB-GYNs and to have admitting privileges at a local hospital in case a woman undergoing an abortion needs to be immediately hospitalized. The House previously passed the bill, and after a comment period it goes to Republican Gov. Phil Bryant for his expected signature.

Derzis, owner of the Jackson Women’s Health Organization in Jackson, told The Associated Press that while all doctors on her staff are certified OB-GYNs, only one of them has admitting privileges to a local hospital. The clinic's doctors live out of state and hospitals usually don't grant such privileges to non-Mississippi physicians, she said.

Derzis has previously said that she would go to court to challenge the bill if it becomes law.“We're not going to leave the women of Mississippi high and dry,” she told Reuters on Tuesday.

Supporters of the bill have made it no secret they would like to see the state’s sole provider of abortions shut down.

“These are strong, common-sense pro-life bills that will not only end abortion in Mississippi but will enhance efforts to protect children from abuse,” Lt. Gov. Tate Reeves said in a statement Wednesday.

Bryant, the Republican governor who prides himself as a backer of “traditional values,” also hailed the Senate passage.

"This legislation is an important step in strengthening abortion regulations and protecting the health and safety of women. As governor, I will continue to work to make Mississippi abortion-free," he said in a separate statement.

Dr. Beverly McMillan of Jackson, a retired OB-GYN who in 1975 opened the first abortion clinic in the state but later came to oppose abortions, says anyone performing an abortion should have admitting privileges at a nearby hospital. (Admitting privileges are an arrangement whereby doctors can refer patients to a hospital if further treatment is warranted).

"If you're going to do outpatient surgery that has the possibility of injuries, you should have a quick route to get those patients into a hospital,” McMillan, who is now an officer of the Christian organization Pro-Life Mississippi, was quoted as saying Tuesday at the state Capitol by the AP. “And if you're a decent doctor, you'll be the doctor that admits them and takes care of their complication."

Critics say the bill is misguided and endangers the health and safety of pregnant women rather than ensuring it.

Reis, of Planned Parenthood Southeast, noted Mississippians last year rejected a statewide “personhood” referendum that would have defined a fertilized egg as a person. “Mississippians believe that this is a level of government intrusion that is completely inappropriate,” she told msnbc.com.

"It's obvious the intention of supporters is that they would like Mississippi to be an abortion-free state. Their goal in passing this legislation is to end abortion in Mississippi," said Jordan Goldberg, state advocacy counsel with the Center for Reproductive Rights.

She told msnbc.com that singling out physicians who perform abortions "raises serious constitutional questions." The center has represented the Mississippi clinic in previous legal matters but Goldberg wouldn't comment on whether it would go to court to try to quash the new bill.

If the state’s sole abortion clinic shuts down, women would have to go to another state to get a legal abortion.

“It really punishes poor women. The cost of travel, the cost of child care, missing work in order to leave the state, really punishes the most vulnerable Mississippians,” Reis said.

Derzis said the bill is misguided and a waste of Mississippi taxpayer dollars. “I think it’s very sad when Mississippi has the ranking that it does as one of the poorest states in the nation, if not the poorest, highest in maternal mortality, that we are worried about passing laws that have no bearing on women’s health,” Derzis was quoted as saying by Mississippi Public Broadcasting.

According to the Guttmacher Institute, a think-tank that works to advance reproductive rights including abortion rights, Mississippi is among fewer than a handful of states that have just one abortion clinic. In 2008, the latest year for which complete figures are available, about 2,770 abortions were performed in Mississippi, out of roughly 1.2 million procedures nationwide.

"Mississippi stands as one of the most restrictive states in the nation with regard to abortion, along with state such as Kansas and South Dakota," said Elizabeth Nash, state issues manager with the Guttmacher Institute.

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AUSTIN, Texas -- The federal government will withdraw funding for a Texas program providing more than 100,000 poor women with birth control and other health services because Planned Parenthood clinics are not allowed to participate, a U.S. Health and Human Services spokeswoman said on Friday.

Health and Human Services Secretary Kathleen Sebelius announced the decision in Houston on Friday, prompting a furious response from Texas Governor Rick Perry, who called it an "egregious federal overreach."

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At the heart of the dispute between the administration of President Barack Obama and Texas is the divisive issue of abortion.

Texas begins enforcing strict anti-abortion sonogram law

The Texas legislature last year voted to cut off funding for Planned Parenthood because the network of women's health clinics performs abortions. The federal government says that this violates rules of Medicaid, the health program for the poor.

Some 130,000 low-income Texas women who get free exams and contraceptives through Medicaid could lose those benefits as a result of the dispute.

The program provides free birth control and annual exams to women of reproductive age who do not qualify for the regular Medicaid program for the poor. The federal government pays 90 percent of the cost and Texas puts up about $4 million a year.

Wisconsin, North Carolina, Tennessee and Indiana all have joined Texas trying to block Planned Parenthood from receiving taxpayer money in the last year. Several other states, including Ohio, Oklahoma and New Hampshire, are considering similar moves.

'Politically motivated'
While public funds do not pay for abortions, critics of Planned Parenthood argue that hiring the organization to provide family planning to poor women helps the organization stay afloat and thus indirectly supports abortion services.

The Texas funding cut prompted Planned Parenthood to shut down 11 clinics in the state.

Perry said the decision by the Obama administration was "politically motivated," and said it was an affront that Sebelius had not informed the state of Texas before announcing the move to the press.

After touring a hospital in Houston Friday, Sebelius said the state law violates federal Medicaid regulations that require women be allowed to choose where they go for health care. Federal funds flowed to Texas under a waiver, but "we plan to let Texas know that that waiver will not be extended," Sebelius said.

The money will be phased out so women have time to find alternative care, she said.

The state was warned that implementing the law would jeopardize federal funding, and Texas chose not to immediately enforce it when it was passed, Sebelius added.

"They knew ... they are not allowed to deny women the right to choose," Sebelius said. "Women would be losing their doctor, their medical home, their choice."

Stephanie Goodman, spokeswoman for the Texas Department of Health and Human Services, said money to pay for the program would be diverted from others that are under budget - though she didn't offer specifics. If that doesn't cover the costs, she said, the state would increase its deficit to pay for the services because officials believe that if low-income women don't have access to birth control, the birth rate would rise and cost the state another $57 million in maternity bills.

The abortion fight is the latest of a string of disputes between Obama's Democratic administration and the Republican-dominated Texas state government. The two sparred last year over disaster aid for Texas after devastating wildfires and environmental regulations Texas opposes.

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Reuters and The Associated Press contributed to this report.

There's an agenda behind those cookies the Girl Scouts sell, one bent on promoting communism, lesbianism and subverting "traditional American family values," according to an Indiana lawmaker.

That's the reason Rep. Bob Morris, a Republican representing Fort Wayne, insists he won't go along with a resolution meant to honor the Girls Scouts on the organization's 100th anniversary. 

Morris owns a chain of nutrition stores, but it's not the fat and sugar in Girl Scout cookies that have him riled up.

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"After talking to some well-informed constituents, I did a small amount of Web-based research, and what I found is disturbing," Morris wrote Saturday to Republican House colleagues in a letter obtained by the Fort Wayne Journal Gazette.

Morris alleged that the Girl Scouts of the  United States of America and the World Association of Girl Guides and Girl Scouts "have entered into a close strategic affiliation with Planned Parenthood," which he claimed is trying to "sexualiz(e) young girls through the Girl Scouts."

Even worse, he wrote, only three of the 50 role models promoted by the Girl Scouts have even "a briefly-mentioned religious background."

"All the rest are feminists, lesbians, or Communists," he wrote.

As proof, Morris notes that the "radically pro-abortion" Michelle Obama is honorary president of Girl Scouts of America, which "should give each of us reason to pause before our individual or collective endorsement of the organization."

After learning all this, he wrote, he pulled his two daughters out of the Girl Scouts and instead put them in American Heritage Girls Little Flowers, a parent-run group best described as a center for recovering Girl Scouts.

Michelle Tompkins, a spokeswoman for the Girl Scouts, responded to Morris' assertions by telling NBC station WISE of Fort Wayne, "Not only is Rep. Morris off the mark on his claims, it's also unfortunate in his limited research that he failed to discover that, since 1917, every first lady has served as the honorary leader of Girl Scouts, including Nancy Reagan, Barbara Bush and Laura Bush."

"We believe that leadership is about hearing from all sides of an issue before making up one's mind," Tompkins said. "We only wish we had the chance to speak with the freshman representative before he distributed his letter."

For its part, Planned Parenthood of Indiana called Morris' comments "inflammatory, misleading, woefully inaccurate and harmful," saying he'd insulted not only it but also the Girl Scouts and Obama.

"Planned Parenthood currently has no formal partnership with the Girl Scouts, but supports their mission and recognizes their century of contributions to our society," the organization said in a statement to NBC station WTHR of Indianapolis.

NBC stations WISE of Fort Wayne, Ind., and WTHR of Indianapolis contributed to this report by M. Alex Johnson of msnbc.com. Follow M. Alex Johnson on Twitter and Facebook.

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Fewer abortions? Better-informed patients? Insulted women? The impact of a controversial new Texas law that requires women to have a sonogram – and listen to a description of the fetus as well as its heartbeat – at least 24 hours before they can get an abortion is far from clear.

Texas state health officials began enforcing the sonogram provision – which critics say is the most extreme sonogram-related law in the nation – on Tuesday.

Reaction has been decidedly mixed.

Msnbc.com was unable to contact women who have undergone the sonogram this week, but Texas abortion providers say many of their patients felt insulted.

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“The emotions range from confusion to anger to being quite emotionally upset by it. Having to hear the position described of fetal development is not something they are wanting to endure,”  said Rochelle Tafolla, spokesperson for Planned Parenthood Gulf Coast, which has three centers that provide abortions.

“We haven’t heard of any women who, after going through these steps, are saying, ‘No, I’m changing my mind.’”

The law requires doctors who perform abortions to conduct a sonogram 24 hours before the procedure, display the images of the fetus and make the heartbeat audible. The woman can decline to view the images and listen to the heartbeat. The doctor must also verbally describe the sonogram result – even if the woman doesn’t want to hear it.

Read details of Texas sonogram law

Although the sonogram law technically went into effect last fall, the state didn’t begin enforcing its requirements until Tuesday, when the Texas Department of State Health Services posted guidelines for abortion providers. Facilities that fail to comply face penalties of up to $1,000 per violation per day.

Department spokeswoman Carrie Williams said Wednesday that the state agency has received “a couple of technical questions” about the law’s requirements since its implementation but hasn’t gotten any significant feedback yet from abortion providers or pregnant women.

Effect uncertain at this point
It’s too soon to track the impact of the sonogram law on the number of abortions performed in Texas, which has 39 licensed abortion providers, Williams added.

About 75,000 abortions were performed in Texas in 2010, the latest year for which statistics are available, according to State Health Services.

Elizabeth Graham, director of Texas Right to Life, says anecdotal reports she’s received “from our friends who counsel outside of abortion clinics tell us 70 to 80 percent of women will choose life after seeing a sonogram.”

As for the long-term impact, ”If the clinics are following the law according to its legislative intent, then we think the law could reduce the number of abortions in Texas by at least 30 percent,” she said.

Tafolla said Planned Parenthood Gulf Coast clinics have not seen a drop-off in the number of abortions performed since the sonogram law went into effect Oct. 1.

About 15 percent to 17 percent of pregnant women who undergo the ultrasound at Planned Parenthood don’t come back for the abortion, Tafolla says, but that could be for a number of reasons.

“What we knew by fact is statistically the majority of women who are having abortion are already mothers.  They fully understand what a pregnancy is, so they’re making a very informed decision,” she says.

'Most extreme ultrasound-related law'
Julie Rikelman, an attorney with the New York-based Center for Reproductive Rights, which sued unsuccessfully to block the Texas legislation, calls it “the most extreme ultrasound-related law that is being enforced in the United States.”

(Oklahoma and North Carolina have similar laws, but their enforcement has been held up because sonogram requirements were blocked by the courts, Rikelman says.)

“I think the experience of providers has been that women just find it offensive because the presumption of the law is somehow women don’t know what they’re doing and need to be forced to consider information even if it’s not relevant to them. It’s very demeaning to them,” she says.

But Lori DeVillez, executive director of the Austin Pregnancy Resource Center, which provides support services and abortion alternatives to pregnant women, says the sonogram law is “a healthy law.”

Like any other major medical procedure, she says, patients deserve to know beforehand what an abortion entails before they decide whether to undergo it.

Devillez doesn’t know whether the law will eventually lower the number of abortions performed in Texas. But she hopes it does. “I hope giving women the opportunity to get the information they need will help them understand decisions they are making for themselves and their babies,” she says.

Logistical headache for clinics
Perhaps one of the most significant practical impacts of the Texas law to date is logistics, says Amy Hagstrom Miller, founder of Whole Woman’s Health clinics in Texas. The law’s requirements have caused scheduling headaches because doctors who perform abortions now must also perform a sonogram – on a separate day. They can’t delegate that latter task to, say, an ultrasound technician.

And they can’t have another doctor do the abortion if they're busy.

As for patients, many are already mothers and must make separate doctor's visits, often taking an additional day or two off work, Hagstrom Miller said.

“We’ve had a lot of frustration, a lot of, ‘Why do I have to do this? I know what I want to do,’” she said.

The five Whole Woman’s Health clinics began complying with the sonogram law in mid-January. Out of the several hundred women who were offered a chance to listen to the fetal heartbeat, only two opted to do so, Hagstrom Miller says.

Likewise, most women are declining to see their sonogram image, she said.

“I am not aware of anyone saying, ‘Oh my goodness, I didn’t know what the ultrasound looked like and I’m going to change my pregnancy,'” Hagstrom Miller added.

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