The Biden administration has reversed a ban on abortion referrals by family planning clinics, lifting a Trump-era restriction as battles over abortion grow sharper from Texas to the US Supreme Court.

The Department of Health and Human Services said its new regulation will restore the federal family planning programme to the way it ran under the Obama administration, when clinics were able to refer women seeking abortions to a provider.

Groups representing the clinics said they hope the Biden administration action will lead hundreds of service providers that left in protest over Mr Trump’s policies to return, helping to stabilise a longstanding programme that has been shaken by the coronavirus pandemic on top of ideological battles.

Known as Title X, the taxpayer-funded programme makes available more than 250 million dollars a year to clinics to provide birth control and basic healthcare services mainly to low-income women.

Under former president Donald Trump, clinics were barred from referring patients for abortions, prompting a mass exit by service providers affiliated with Planned Parenthood, as well as several states and other independent organisations.

Women’s groups labelled the Trump policy a “gag rule,” and medical organisations called it a violation of the clinician-patient relationship.

But religious and social conservatives praised the policy for imposing a strict separation between family planning services and abortion. Under federal law, clinics could not use federal money to pay for abortions.

In 2018, the family planning clinics served about 3.9 million clients, but HHS estimates that number fell by nearly 40% after the Trump policy. The upheaval may have led to more than 180,000 unintended pregnancies, the agency said.

Mr Biden campaigned on a promise to overturn the restrictions on family planning clinics, but abortion was not a central issue in the 2020 presidential race. It may become one in the 2022 midterm elections to determine who controls Congress.

Restrictive state laws in Texas, Mississippi and elsewhere have prompted a mobilisation by abortion rights supporters, who fear a conservative-leaning Supreme Court will overturn the 1973 Roe v Wade decision that legalised abortion nationally.

Hundreds of abortion-themed protests were held around the country on Saturday, including one that brought thousands of abortion rights supporters to the steps of the court.

The Supreme Court has allowed the Texas law to take effect, but has not ruled on the substantive legal questions behind that statute, which bans most abortions in the state. The justices will hear arguments on December 1 on the Mississippi law, which bans most abortions after 15 weeks of pregnancy.

The court now tilts decidedly to the right after Mr Trump appointed three conservative justices. Twelve states have passed laws that would ban abortion entirely if Roe is overturned.

The new abortion referral policy for family planning clinics will take effect on November 8.