Since its collapse Roe v. WadeDemocratic lawmakers and reproductive rights advocates maintain a clear strategy: Win a more progressive Democratic trifecta in 2024, eliminate the Senate filibuster and pass comprehensive federal protections. When reporters asked about contingency plans — especially given polls that did not suggest full democratic control — such questions were dismissed, cast as premature or defeatist.
Now, with Donald Trump back in power and Republicans poised to control Congress, that strategy is drawing new questions. The GOP has signaled some openness to compromise: During the campaign, Trump said He supports abortion exceptions “In case of rape, molestation and protection of mother’s life” And he promised to make insurance coverage for in vitro fertilization (IVF) mandatory. Many Republican lawmakers have supported their own Fertility treatment Bill Rep. Mike Lawler (R-NY) Support for a democratically-led IVF measure and talks openly about Consider his family method. There is Sen. Joni Ernst (R-IA). push law To extend over-the-counter contraception.
But reproductive rights groups are skeptical. “We are not willing to compromise our ability to make decisions about our bodies, lives and futures,” Gretchen Borschelt of the National Women’s Law Center (NWLC) said in a press call the day after the election. “Would a compromise provide relief to the family of Amber Nicole Thurman who mourns her every day?” Added NWLC President Fatima Goss Graves, mentions To a patient dying of sepsis After denial of care.
Vox asked six major advocacy groups what they would consider pushing for new federal protections under a Republican-led Congress, whether for IVF, birth control or abortion. Most avoided answering directly, instead turning the conversation to Republican liability and the damage caused by abortion bans.
The position reflects a deeper calculation: Accepting anything less than what people deserve—meaning access to the full spectrum of reproductive health care for any reason—will legitimize restrictions and undermine the larger fight for bodily autonomy. Asked about pursuing partial protections for more Democrats, the group chose to wait.
“We’re really looking at this from a defensive position,” said Ryan Stitzlin, vice president of political and government relations for Reproductive Freedom for All, the group formerly known as NARAL. “As we read Project 2025, we are very familiar with the people in the leadership of the Republican Party … and preparing for them to launch an attack on reproductive freedom at all levels of government on the administrative side.”
Polling suggests that there may be political opportunities
Despite the surprising bipartisan agreements of the Biden era on thorny issues from gun control to climate change, there has never been a similar effort to compromise bipartisanship on reproductive rights. When a small group of Republican and Democratic senators introduced legislation in 2022 RoAbortion rights groups quickly rejected the idea, arguing in part that it didn’t go far enough. Even on issues like IVF and birth control, where Republican support seemed possible and anti-abortion groups held little sway, there was no serious effort to find common ground.
To be sure, while many Republicans have sought Reassure voters that they support IVFTheir voting record so far tells a different story. Many of the same lawmakers co-sponsored the Life at Conception Act, which would have severely limited fertility treatments by granting legal personhood from the moment of conception. Republicans basically are Democrats voted against IVF legislationWhile demanding they support narrow fertility treatment bills and criticizing Democrats for not being open to working on amendments.
Still, polling suggests potential political opportunities. about 80 percent Protecting contraceptive access is “deeply important” to voters, and 72 percent of Republican voters had a favorable view of birth control. IVF is more popular: 86 percent are American I think it should be valid. including 78 percent Self-identified “pro-life advocate” and 83 percent evangelical Christian. Americans’ support for abortion rights intensified Since its collapse RoAnd that reality has shaped the rhetoric of some Republicans on the campaign trail. Newly elected Pennsylvania Republican Sen. Dave McCormick ran onto a platform Fighting restrictions on fertility treatments and proposing a $15,000 tax credit for IVF.
Some policy strategists have suggested that, regardless of Republican fervor, Democrats and abortion rights groups could benefit from voting on new IVF and birth control bills, even if they offer limited protections or codify certain provisions that advocates oppose.
Such moves could either achieve new concrete protections or expose Republican resistance. But Democratic leadership and abortion rights groups are not interested in this approach for now, preferring to keep up the pressure to restore rights.
“We haven’t seen a real effort from Republicans to engage in this conversation,” Stitzlin said. “We have seen them propose face-saving bills in response Dobbs and the Alabama IVF Ruling.”
Should Democrats keep their red line on abortion exceptions?
The political math around abortion exceptions would seem straightforward. Trump clearly supports them. Most Americans, including many Republicans, believe abortion should be legal Rape, molestation, and threats Parents’ lives. And women are clearly affected by it Lack of effective exceptions to state prohibitions A recent study today estimated that more than 3 million women in the United States will experience pregnancy from rape in their lifetime.
Yet when asked if they would consider seeking federal protections for abortion exceptions as a harm-reduction measure during Republican control, established advocacy groups showed no interest, pointing to patients like Kate Cox and Amanda Jurauski who are nearly lost their life or fertility Notwithstanding state prohibitions with exceptions.
“As we’re seeing across the country, exceptions often don’t work in practice, so people shouldn’t take comfort in them or rely on them,” said Rachna Desai Martin, chief government and external relations officer at the Center for Reproductive Rights. Vox.
This position stems from a core belief: that any engagement with exceptions will legitimize a broader framework of constraints. Some doctors on the ground in states with restrictive bans have lamented the lack of support they’ve received for carving out exceptions. “I worry that reproductive rights advocates may dig into the position of the disabled and fail to listen to those most affected by the current reality.” wrote a Maternal-Fetal Medicine Physicians in Tennessee.
On the question of codifying emergency medical care, the Planned Parenthood Action Fund stressed in an email that, “narrow health exceptions or focusing only on emergency situations are harmful to patients and their health care providers because every pregnancy is unique.”
In view of these the location is particularly noteworthy same group strong defense The Emergency Medical Treatment and Active Labor Act (EMTALA) in the Supreme Court this year. The groups argued that EMTALA — which requires hospitals to provide “stable treatment,” including emergency abortion care — represents an important federal protection for women in medical crisis. Yet when asked about codifying the Biden administration’s interpretation of EMTLA or similar protections into law, the parties hesitated.
Internationally, exceptions have served as imperfect stepping stones to broader rights. Colombia’s journey from a complete ban to full decriminalization began in 2006 with three abortion exceptions – for health risks, fatal fetal conditions and rape. For more than 16 years, advocates used these flawed systems to help set the legal precedent for expanding public support and access, which ultimately Criminalizing the process for up to 24 weeks In 2022.
India and Spain followed a similar path. India’s Medical Termination of Pregnancy Act of 1971 initially allowed abortion only in certain circumstances such as health risks and rape. Advocates gradually used this limited framework to build broader rights—first emphasizing public health arguments around unsafe abortion, then expanding to gender equality concerns. This incremental approach led to significant expansion In 2021 And 2022including increased gestational limits and greater access for unmarried women. Spain’s Path from the 1985 Restrictive Law Its 2010 validation Up to 14 weeks follows a similar pattern, especially with advocates Benefits of Spain’s mental health exception To create de facto broad access.
These tensions—between policy and pragmatism, between long-term strategies and immediate needs—have taken on new urgency as patients in the United States face restrictions on state-level abortion exceptions. In Louisiana, where there are exceptions to protect life, health and fatal fetal conditions, there are almost no legal abortions. has been reported Since its ban has come into effect. Doctors say vague laws and criminal penalties make them reluctant to test their rules.
But instead of following clear federal standards around exceptions, advocacy groups are betting on abortion rights becoming more prominent as restrictions continue.
“Americans will continue to wake up to the stories of women dying preventable deaths because they were denied access to essential health care, and voters will see the devastation these restrictions have wreaked on their families and communities,” declared a post-election strategy memo from Emily’s List, National Women’s. Saw Law Center Action Fund, Planned Parenthood Action Fund, and Reproductive Freedom for All. “With anti-abortion politicians in power, abortion rights will only become more important to voters in the next election.”
Even working with Republicans on limited protections could undercut the GOP’s narrative of extremism — a message advocacy groups see as critical to winning in 2026 and 2028.
A high stakes political stake
Although abortion rights proved less galvanizing in the most recent election than Democrats had hoped, reproductive rights groups are betting that voter attitudes will shift as the restrictions continue. Currently, 28 million women, plus many more trans and nonbinary people of reproductive age, live in states with abortion bans.
“We have no interest in narrowing our vision,” said Kimberly Inez McGuire, executive director of Unite for Reproductive and Gender Equity, “but the politicians who will soon govern a majority pro-abortion country would do well to expand them.”
In an interview with Vox, Democratic Sen. Tina Smith of Minnesota said she would work with anyone in Congress who wants to cooperate in good faith to protect abortion rights, but stressed that as Democrats move into the minority, “the onus is on Republicans” to come to the table and support them. To discuss with in a serious way. Asked about potential deal-breakers, Smith declined to discuss specific provisions in the abstract, saying he would wait to see the full proposals.
Smith’s view captures the current state of the movement: “We’ve been saying that for several years Dobbs The way to protect people’s access to abortion is to win elections for people willing to protect those rights. And that hasn’t happened, so there’s no magic solution.”
