NARAL Pro-Choice America Foundation launched its 21st annual roundup of abortion-related laws late last week. The results are staggering: In 2011, states enacted 69* pieces of anti-choice legislation–the second highest number since the organization began tracking these laws in 1995.

Because Roe v. Wade prevents them from outlawing abortion outright, ultraconservative mostly male, white and Republican legislators used a range of tactics to harass women, limit their access to reproductive health services and effectively shut down abortion providers. According to the "Who Decides?" report:

• Three states passed laws that deny state funding for organizations that counsel or refer women for abortions.
• Six states passed laws forcing women to undergo blatantly biased and very often misleading counseling before having an abortion.
• Three enacted laws that forbid private insurers to cover abortions, which cost about $350 to $500 within six to 10 weeks of gestation. Eight blocked abortion coverage in state insurance exchanges and four prohibited coverage for state employees.
• Five states enacted TRAP (Targeted Regulation of Abortion Providers) laws that force providers to adhere to onerous construction and licensing requirements.
• Fourteen states considered so-called personhood provisions; none took effect.

Arizona, Florida and Kansas passed the highest number of anti-choice measures in 2011, five each. Arizona, which earned a D grade from NARAL for its record on choice, also has the dubious distinction of being the first state in the nation to criminalize doctors who perform an abortion with the knowledge that a patient wants the procedure because of the race or gender of the fetus. Coming from a state that literally requires law enforcement to practice racial profiling via SB1070, this is hypocritical as hell.

"The bottom line is that elections matter," NARAL president Nancy Keenan told reporters at a press briefing. "When you have a change of anti-choice politicians sitting in the statehouse, it affects women’s lives. We have to make sure our voices are heard."

Speaking of elections, on Friday the Obama administration earned the goodwill of reproductive health activists–and the ire of the Catholic Church–when it refused to weaken new rules for co-pay free birth control coverage. Faith-based institutions whose primary purpose isn’t religious–such as hospitals, colleges and charities–won’t be able to use so-called conscience clauses to deny their employees these health benefits. They have a one-year grace period to comply with the coverage rules.

"I have friends who have been struggling because our school is Catholic and the insurance doesn’t cover birth control," says Tanisha Humphrey, a 22-year-old senior at Georgetown University, who serves as outreach coordinator for H*yas for Choice and a campus organizer for Advocates for Youth. "I think this was the right decision because this is a health issue. To ignore the needs of so many women was just wrong."

Given the legislative hostility to women’s reproductive health care and choices, the Obama decision is a courageous one. Let’s hope it’s the first step in turning this rip tide.

*The report cites only 67 laws because two passed after it went to print.