After 49 years Roe v. Wade, Americans had the right to obtain an abortion if they became pregnant. Then, two years ago, with Dobbs v. Jackson Women’s Health OrganizationThe Supreme Court put an end to it.
The Biden administration and some blue states — backed by a network of nonprofits focused on reproductive care — aggressively sought to provide compensation, while many red states enacted near-total bans on abortion.
but Dobbs Despite this, it has a devastating effect on pregnant women in large parts of the country.
While the number of abortions across the country actually rose last year — thanks in large part to increasingly cheap and readily available medical abortions — that hasn’t changed the underlying realities of the latter.Dobbs America. Large reproductive care deserts have emerged where there are no abortion providers for hundreds of miles. Pregnant women are denied medical care they need because their doctors fear legal repercussions for providing it. All this has exacerbated chronic inequality.
Both Abortion is prohibited and attack Breeding the right Widely unpopular, and elections in subsequent years Dobbs shows that abortion rights are a strong motivating factor for voters. But in this year’s matchup between President Joe Biden and former President Donald Trump — both of whom have been reluctant messengers of their parties’ positions on abortion — there is a question of whether the issue will inspire American voters.
It’s not too late to make a difference for their vote reproductive access. It may seem like the worst has already happened for the abortion rights movement: Although once protected by the constitution nationally, access now increasingly depends on where you live or whether you can travel to get the care you need. But Republicans have also made it clear they have no intention of stopping there.
How the legal landscape has changed
On the eve of Dobbs13 states implemented immediately “Trigger” Prohibition On abortion, others wanted to enforce abortion restrictions that were previously on the books Roe v. Wade It was even decided in 1973 or moved to quickly pass a new ban on abortion. Within months a new patchwork of abortion laws had been established in the United States. There are total 14 states An almost total ban on abortion has been imposed.
Many of these prohibitions involve narrow medical exceptions where abortions may be performed if the mother’s health or life is at risk. But these exceptions have proven exceptionally difficult — in some states, almost impossible — to qualify for.
Kate was a woman from Cox, Texas significantly denied An abortion though her fetus was diagnosed with a rare and terminal genetic condition and was forced to travel out of state to get one. Other women have been Obliged to carry the term Fetal doctors know that a fetus will, or will, die soon after birth Denied abortion care even after experiencing a miscarriage Which puts them in medical crisis. The Texas Supreme Court also ruled against a group of 20 women who claimed they were Denied medically necessary abortions.
The Republicans aren’t stopping now that they’ve flipped Ro. They continue to advocate for one side National abortion banTrump, however, has indicated he won’t sign it, and has opened new attacks Contraception And In vitro fertilization.
If Trump wins the election, he could also order the FDA to withdraw approval of the abortion drug mifepristone after the Supreme Court’s recent ruling left open the possibility of upholding access to the drug.
In short: the dust hasn’t settled yet post-DobbsBut it’s clear that abortion was only the Republicans’ first target in the larger war on reproductive freedom.
What this means for people seeking abortions
Despite new restrictions on abortion in many parts of the country, the number of abortions performed nationally actually increased slightly. Dobbs. But it would be wrong to look at those statistics and say that everyone has improved access to abortion equally across the US.
“While the number has increased slightly nationally, in some states virtually no abortions are occurring,” said Usha Ranji, associate director of women’s health policy, health policy research, at KFF, at least in a formal health care setting. news agency.
The use of medicinal abortions, which can terminate a pregnancy during the first trimester, has increased in particular. Although this was already the most common method of obtaining an abortion-Dobbs, it is now cheaper and easier to obtain quickly, especially through telemedicine. That’s because, amid the pandemic, the FDA suspended the requirement to dispense mifepristone in person, leading to an explosion of telemedicine abortion services.
however, 19 states Telemedicine prohibits abortion: five expressly do so, and another 14 require a prescribing clinician to be physically present with patients. Some states also require counseling or an ultrasound before an abortion can be performed, which can rule out the possibility of obtaining a medication abortion via telemedicine.
This has led some patients to turn to community networks or websites that sell abortion pills without contacting a doctor or pharmacy.
All of these reflect monumental efforts without restrictions to increase care in these states, as well A flood of donations Abortion Fund After-Dobbs. such as New Mexico, Dedicated $10 million To build a new abortion clinic that opened last year on the border with Texas, which bans abortion with limited exceptions.
But the question is whether this patchwork solution is sustainable in the long term, especially given the funding it provides Bov. And it doesn’t fully mitigate the impact of abortion bans, which have created maternity care deserts across large swaths of the southern United States and the Midwest.
“There are still people who can’t get the abortions they want in part because not everyone can travel,” Ranji said.
Traveling can be difficult for both logistical and financial reasons. And poor women are disproportionately affected: those women (who live below 200 percent of the poverty line, which is $46,060 for a family of three in 2022); concentrated 14 states that have banned abortions and 11 states that have passed strict gestational limits on abortions. Although they may be candidates for medication abortion, they are less likely to know about it as an option—a messaging challenge that abortion activists are struggling to overcome.
There is growing evidence that Dobbs The decision has adversely affected maternal health outcomes, including maternal mortality. But only two years have passed since then Dobbs And the annual maternal mortality rate is very low (even if maternal mortality occurs Higher in the US than any other high-income country) to determine any trends that have yet to emerge.
So for now, the best information is based on statistical modeling. Researchers at the University of Colorado Boulder projected Based on 2020 data on maternal outcomes, if abortions were not done nationally, there would be an overall 24 percent increase in maternal mortality after one year. Black mothers will see the highest death rates.
“These communities that have historically been disadvantaged will bear the brunt of this abortion care crisis that we’re having,” said Candace Gibson, state policy director for Guttmacher, a nonprofit that researches abortion policy.
Anecdotally, physicians also reported concerns about their ability to provide adequate reproductive care Dobbs The decision has been made. A KFF National Survey Among OBGYNs, a significant proportion of respondents were concerned about their ability to administer a level of care consistent with the standards of the medical profession, their potential legal liability in states where abortion is prohibited, and the health outcomes for their patients. In states where abortion is banned or restricted, for example, six in 10 OBGYNs say their decision-making autonomy has worsened. Dobbs rule
“They’re at this point where they really have to think about whether they’re going to continue to provide care within that state, or whether they’re going to leave the state so they can actually practice medicine in a way that meets the standards of care,” Gibson said.
That’s what American politics means
Republicans’ opposition to abortion rights has proved a thorn in their side electorally Dobbs came down
In 2022, Democrats nearly jumped the table on abortion rights. Every ballot initiative aimed at limiting lost abortions, including Kansas, kentuckyAnd montana. Meanwhile, states with ballot initiatives have strengthened abortion rights Michigan, VermontAnd California And even outperformed Democratic candidates in some cases.
In 2023, ohio Also passed a ballot measure enshrining abortion rights in its state constitution. And Democrats were able to flip the Virginia House of Delegates and retain control of the state Senate after Republican Governor Glenn Yonkin. Committed to banning 15-week abortions.
Abortion proved a key motivating issue during these off-cycle years. The question is whether it can be the same force in a presidential election year.
That may be the case in a handful of states, especially when it comes to four upcoming the ballot measurement Aiming to expand abortion rights. In Florida, a six-week abortion ban that recently went into effect could be overridden by a ballot measure to protect abortions up to fetal viability, which is estimated around 24 weeks of pregnancy.
But at the top of the ticket, the potential impact of abortion is less clear when other issues, including the economy and immigration, dominate the national conversation. Critically, low-propensity voters — those who are running against Biden and who may decide this election because they stay home or lean toward Trump — don’t rank abortion rights among their top issues, despite being largely in favor. Abortion rights.
But voter turnout in this election is expected to be lower than in 2020 due to voter apathy about a rematch between Biden and Trump. something Commentators argue That’s less voters Might actually help Democrats, a change for recent American politics. But abortion could help boost voter turnout in a way that helps Biden, said Tom Bonnier, a Democratic political strategist and senior adviser at the data and polling firm TargetSmart.
But first, he must overcome a clear messaging problem: 17 percent of voters overall and 12 percent of Democrats blame President Biden. RoAccording to The New York Times/Siena College Poll and a Times/Philadelphia Inquirer/Siena Poll In a battleground state. Some less-engaged voters wrongly linked the reversal to Biden because he was president when the conservative-controlled Supreme Court issued the decision.
But it also shows that Biden — who as a Catholic has at times been an uncomfortable messenger for his party’s pro-abortion right position — has room to woo voters.
“Democratic campaigns, including presidential campaigns, have a task ahead of them [to] Spend time reaching out to these voters and making sure they understand the reality,” Bonier said. “I don’t think most voters are aware of what the Republicans are doing, unless they’re in the state where it’s happening. But I think these issues will have a substantial impact on the election as it communicates to more voters.”
