Judges, state lawmakers, and voters are currently shaping the future of abortion in the U.S. two years after a landmark Supreme Court ruling that overturned Roe v. Wade.
The decision in Dobbs v. Jackson Women’s Health Organization on June 24, 2022, triggered significant legislative actions, protests, and numerous legal battles, placing abortion at the forefront of national politics.
Abortion is now prohibited at all stages of pregnancy, with limited exceptions, in 14 states controlled by Republicans. In three other states, abortion is banned after about six weeks, catching many women unaware of their pregnancies. Most states led by Democrats have taken measures to protect abortion rights and serve as safe havens for out-of-state patients seeking care.
This changing landscape of abortion access has made it more logistically and financially challenging for many in conservative states. Despite this, there has been no overall decline in the number of monthly abortion procedures performed in the U.S.
Here is an update on the current state of abortion rights in the U.S.
Limited access leads to increased out-of-state travel
The bans in Republican-governed states have forced many individuals seeking abortions to travel elsewhere for care.
This has resulted in additional expenses for travel, accommodation, meals, childcare arrangements, and missed workdays. According to a study by the Guttmacher Institute, out of over a million abortions provided in clinics, hospitals, and doctors’ offices, more than 161,000 were sought by individuals crossing state lines.
Over two-thirds of abortions in Kansas and New Mexico were for out-of-state residents, with Texans being a significant portion of them.
Following the implementation of Florida’s six-week abortion ban in May, many individuals had to travel farther than before due to bans in most Southeastern states.
Individuals with low incomes and those lacking legal authorization to be in the country are more likely to face barriers to travel, resulting in long-lasting consequences for them.
The Yellowhammer Fund in Alabama, which previously assisted residents with abortion costs, had to suspend its services due to threats of legal action from the state.
Jenice Fountain, the executive director of Yellowhammer, shared a story of a woman from Alabama who traveled to Georgia for an abortion but was unable to get one there as she was slightly past the permissible gestational age. She then had to journey to Virginia, depleting her rent money and requiring assistance to retain housing.
Preference for pills over procedures
Almost two-thirds of known abortions last year were carried out using pills rather than traditional procedures.
A significant number of medical providers in states with abortion restrictions prescribe abortion pills via telehealth and mail them to about 6,000 individuals per month. These providers are protected by state laws in Colorado, Massachusetts, New York, Vermont, and Washington that shield them from prosecution for these prescriptions.
The rising popularity of abortion pills, which were utilized in around half of all abortions before the Dobbs ruling, is a key area in the ongoing legal battle.
Recently, the U.S. Supreme Court rejected a challenge by abortion opponents seeking to overturn the FDA approval of mifepristone, one of the drugs commonly used in medication abortions. The issue is expected to resurface in the future.
Abortion in the upcoming elections
Abortion has become a central issue in the current presidential election cycle.
Democrats, including President Joe Biden, have focused on protecting abortion access in their campaigns. Former President Donald Trump, the likely Republican nominee, has advocated for states to have the authority to regulate abortion. He initially suggested restrictions on contraception but subsequently revised his stance.
Kelsey Pritchard, a spokesperson for Susan B. Anthony Pro-Life America, expressed concerns about the potential implications of the upcoming election, suggesting that a Democratic victory could lead to the enshrinement of abortion rights in the law.
Several states, including Colorado, Florida, Maryland, and South Dakota, have ballot measures this year seeking to protect or expand access to abortion through state constitutional amendments. Efforts are also underway in other states to address abortion access through ballot measures or legal challenges.
Generally, voters have supported abortion rights in statewide policy-related votes since 2022.
Legal challenges and the role of the courts
The aftermath of the Dobbs ruling has generated numerous legal challenges and lawsuits contesting various abortion bans and restrictions.
Many of these legal questions revolve around exceptions, particularly in cases of life-threatening complications for individuals denied abortions due to earlier gestational bans.
In Texas, a group of women who faced severe pregnancy complications but were denied abortions due to the state’s ban filed a lawsuit alleging vague exceptions. However, the Texas Supreme Court, comprised entirely of Republicans, ruled against them in May.
The Supreme Court heard arguments in April in a lawsuit brought by the federal government against Idaho, challenging the state’s ban on abortions at all stages of pregnancy. The Biden administration argues that this ban violates federal law, and a ruling is pending.
Meanwhile, bans in Iowa, Montana, Utah, and Wyoming have been halted by judicial orders.