Judges, state legislators and voters are deciding the future of abortion in the United States Two years after the Supreme Court shook up the legal status quo with a ruling overturning Roe v. Wade.
He ruling of June 24, 2022 in the case Dobbs v. Jackson Women’s Health Organization sparked legislative action, protests, and numerous lawsuits, placing the issue of women’s access to abortion at the center of politics across the country.
Abortion is now prohibited at all stages of pregnancywith limited exceptions, in 14 states controlled by Republicans. In three other states, it is banned after the first six weeks, which is before many know they are pregnant. Most Democratic-led states have taken steps to protect abortion rights and have become sanctuaries for out-of-state patients seeking care.
That has changed the landscape of abortion access, turning it into a logistical and financial ordeal for many women, adolescents and girls in conservative states. But has not reduced the total number of procedures performed each month throughout the United States.
The states with total abortion bans at any stage of pregnancy are: Idaho, North Dakota, South Dakota, Missouri, Texas, Oklahoma, Arkansas, Louisiana, Indiana, Kentucky, West Virginia, Tennessee, Mississippi and Alabama. In North Carolina, the restriction is up to 12 weeks, as in South Carolina and Georgia.
Here’s what you need to know about the current state of the right to abortion in the United States.
Limited abortion access prompts more travel outside red states
Bans in Republican-led states have led many people seeking abortions to travel to receive safe medical care.
That translates into higher costs for gasoline or plane tickets, hotels and meals; more logistics to sort out, including childcare; and more days of sick leave.
A new study by the Guttmacher Institute, which advocates for abortion access, found that of just over a million abortions performed in clinics, hospitals and doctors’ offices, more than 161,000, or 16 percent, were for people who crossed state lines to obtain them.
More than two-thirds of the abortions performed in Kansas and New Mexico were for people from other states, particularly Texans.
Since Florida’s six-week abortion ban went into effect in May, many people have had to travel further than before, as across the Southeast, most states have bans.
Low-income patients and those without legal permission to be in the country are more likely to be unable to travel. There may be lasting costs for those who do so.
In Alabama, the Yellowhammer Fund, which previously helped residents pay for the procedure, has stopped doing so since facing threats of litigation from the state.
Jenice Fountain, CEO of Yellowhammer, said she recently met a woman who traveled from Alabama to neighboring Georgia to get an abortion, but found she couldn’t get one there because she was too far along in her pregnancy. She so she went to Virginia. The trip drained her rent money and she needed help staying housed.
“We’re making people use every penny they have to leave the state, or use every penny they have to have another child,” Fountain said.
Abortion pills only: The only option for most procedures
Nearly two-thirds of known abortions last year were performed with pills instead of medical procedures.
One report found that the pills are prescribed via telehealth and mailed to about 6,000 people a month who live in states with abortion bans. They are sent by medical providers in states with laws intended to protect them from prosecution for those prescriptions. Laws in Colorado, Massachusetts, New York, Vermont and Washington specifically protect medical providers who prescribe the pills to patients in prohibitionist states.
The growing prominence of the pills, which were used in about half of all abortions just before the Dobbs ruling, is a frontier in the latest chapter of the legal fight.
The U.S. Supreme Court this month unanimously rejected an effort by abortion opponents seeking to overturn or reverse the U.S. Food and Drug Administration’s approval of the mifepristone, one of two drugs usually used together for medical abortions. The problem is likely to return.
Abortion is on the 2024 ballot
In this presidential election year, abortion is a key issue.
Protecting access to abortion has become a key campaign issue for Democrats, including President Joe Biden in his re-election bid. Former President Donald Trump, the presumptive Republican nominee, has said that states should be the ones to decide whether to restrict abortions. He also suggested that states could limit contraceptive use, but changed his tone on the matter.
“We recognize that this could be the last Dobbs anniversary that we celebrate,” Kelsey Pritchard, a spokesperson for Susan B. Anthony Pro-Life America, said in an interview, noting that if Democrats win the presidency and regain control of both houses of Congress , The right to abortion could be enshrined in law.
The issue will also be presented directly to voters in at least four states. Colorado, Florida, Maryland and South Dakota have ballot measures this year asking voters to approve state constitutional amendments that protect or expand access to abortion. A New York measure would prohibit discrimination against someone who undergoes an abortion. There are attempts to put questions about abortion access on the ballot this year in Arkansas, Missouri, Montana, Nebraska and Nevada.
There is also push for a ballot measure in Arizona, where the state Supreme Court ruled this year that an 1864 abortion ban could be enforced. With the help of some Republicans, Democrats in the Legislature were able to repeal that law.
Abortion rights typically expand when voters are deciding. In all seven state votes related to abortion policy since 2022, voters have sided with abortion rights advocates in every case.
It is still up to the courts, including the Supreme Court
The Dobbs ruling and its aftermath gave rise to a series of legal questions and lawsuits that challenged almost all prohibitions and restrictions.
Many of those questions have to do with how the exceptions, which come into play much more often when abortion is prohibited early in pregnancy, should be applied. The issue is often raised by those who wanted to get pregnant but experienced life-threatening complications.
A group of women who had serious pregnancy complications but were denied abortions in Texas have filed a lawsuit, alleging that the state’s ban is vague about what exceptions are allowed. The all-Republican Texas Supreme Court disagreed in a May ruling.
The Supreme Court also heard arguments in April on the federal government’s lawsuit against Idahowhich says its ban on abortions at all stages of pregnancy can extend to women in medical emergencies. The Biden administration says that violates federal law. A ruling can be made on that case at any time.
Meanwhile, judges in Iowa, Montana, Utah and Wyoming have suspended the bans.
