The day the constitutional right to abortion ended in the US, Americans faced an unusual moment of regression. The current generation now has fewer constitutional rights than their parents and their grandparents.
What has happened since then has been almost unfathomable.
Many states have passed bans restricting access to abortion care. Most are full bans, which prevent abortion at any stage of pregnancy, with limited or no exceptions. In Georgia, abortion is banned after six weeks of pregnancy, when most people do not yet know they are pregnant. In some other states, abortion is severely restricted; Nebraska, Arizona, Florida, Utah, and North Carolina have bans that begin at 12, 15, 18 and 20 weeks of pregnancy, respectively.
Data suggests far fewer people have been able to get legal abortions since Roe was overturned, despite the need for abortion going up before 2022. WeCount, an effort to track abortion access post-Roe by the Society of Family Planning, calculated 66,000 fewer abortions took place in states that banned abortion between June last year and March this year. Although some states saw increased abortion rates, they did not offset the losses. As a recent WeCount report put it: “People in states with abortion bans were forced to delay their abortion, to travel to another state, to self-manage their abortion, or to continue a pregnancy they did not want.”
Preliminary data suggests many have managed their abortions through pills procured online. For others, in real terms, the loss of the constitutional right to abortion now means traveling hundreds of miles, across multiple state borders if they want an abortion. The existing inequalities along race and income lines in the US have only widened.
The impact of Roe being overturned will probably be felt worst among people of color, who are more likely to live in restrictive states and more likely to need abortions. Wealthier pregnant people can travel and get abortions, but those who can’t face worse economic outcomes.
“An already bad situation has gotten worse,” said Kelly Baden, a public policy expert at the Guttmacher Institute. “Accessing abortion in a state like Louisiana was already hard before the Dobbs decision. But now, abortion is banned in Louisiana and every state that touches its borders. That means having to cross one, two, three, four borders before accessing abortion safely for people from that state.”
Further, a huge national court case that could block access to mifepristone, a crucial pill used in more than half of all US abortions, is ongoing. Blocking access to that drug would be yet another win for the anti-abortion movement, making medication abortion hard to access all over the US, not just in states with bans.
In the majority opinion overturning Roe vs Wade, written by Justice Samuel Alito, he called Roe “egregiously wrong from the start”. Stating that the constitutional federal right to abortion had “enflamed debate and deepened division”, he ended with a call to leave abortion decisions up to the states.
“It is time to heed the constitution and return the issue of abortion to the people’s elected representatives,” Alito wrote.
The decision led to all-time low trust in the supreme court, whose approval rating dropped to below 40% by September 2022. Recent numbers suggest the court’s approval ratings have steadied once again, though the country remains changed.
Instead of returning the question of abortion to the states, battles – theoretical ones, at least for now – have ensued. Pro-choice and anti-abortion states are increasingly trying to extend the reach of where their authority lies.
Massachusetts, California, Colorado and New Jersey are some of the states that have enacted shield laws protecting people who travel to their states for abortions and providers who provide them; Vermont aims to protect medication abortion access, regardless of what happens in the national mifepristone case. Idaho, meanwhile, recently passed a law criminalizing anyone helping a minor travel out of state for abortion care, and Texas has threatened legal repercussions for companies that help people travel out of state for abortion.
Pregnant people continue to be jailed for their conduct during pregnancy, which was already happening long before Roe was overturned.
This week, Pregnancy Justice, a legal advocacy group that fights on behalf of women who are criminalized in pregnancy, released data suggesting at least 41 cases of women criminalized in their pregnancies since Roe was overturned. The cases were across 14 states, with more than half of them being in Alabama. The organization suspects those numbers are a huge undercount.
What stands out to Pregnancy Justice the most over the last year is how commonplace the language of pregnancy criminalization has been since Roe was overturned.
“Since Dobbs, we’ve seen increasingly alarming rhetoric in abortion-hostile states, lifting the veil on their true intentions: control and criminalization,” said Pregnancy Justice’s acting executive director, Dana Sussman. “The Alabama attorney general threatened to prosecute people for abortion under the chemical endangerment law. A South Carolina bill sought to make abortion punishable by death. And a Kentucky bill proposed homicide charges for having an abortion.
“Whether these bills pass or not is almost irrelevant because the confusion and fear still remain. And as we’ve long said, this is not just about abortion. Once you become pregnant, you become vulnerable to state control.”
The Dobbs decision has also had a seismic impact on the US healthcare system. Doctors have fled restrictive states, with lasting impact on maternal and other routine care. In Idaho, one hospital had to stop delivering babies completely, because the state’s total abortion ban has made it too hard to attract doctors. Dozens of abortion clinics have closed their doors; and hundreds of miles have opened up between patients and essential healthcare.
Despite medical exceptions allowing abortions in cases of rape, incest, medical emergencies and pregnancies incompatible with life in many states, there are still countless cases where pregnant people have been denied miscarriage care, life-saving care, and other vital health services – all of which continue to make headlines.
But there are also rays of hope. As a national election looms, the public are making it clear that they do not support abortion bans. In every state where the public has had a chance to directly vote on abortion restrictions since Roe was overturned – whether in states that are purple, blue or ruby red – people have voted to protect abortion.
“From Kansas, to the Wisconsin special election, to the midterm election, there’s a real recognition now, even among anti-abortion lawmakers, that perhaps they might experience some political blowback for this,” said Baden.
Legislators who have been clear on their abortion stances have seen repercussions at the ballot box. And as a result, the Republican party is having to soften its messaging.
That’s why Lindsey Graham has floated a 15-week abortion ban on the national stage, and why in places like North Carolina and Nebraska, 12-week bans have been floated as compromises.
“It’s this false idea that, really, what the American public wants is different kinds of abortion bans,” said Baden. “It is about politics and maintaining a shred of what they think will be credibility come next election season. And hopefully voters won’t fall for that.”
