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In June 2022, the United States Supreme Court issued a ruling in Dobbs v. Jackson Women’s Health Organization which ended the legal right to abortion nationwide.
CNN
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Two years ago, the United States Supreme Court overturned Roe v. Wade, ending the constitutional right to abortion and sparking a fierce fight for reproductive rights at the state level.
Abortion has become a key issue in the 2024 elections, and as access narrows in many states, reproductive freedom advocates are working to get measures preserving reproductive rights on the November ballot to allow voters to weigh in.
Two years after Roe v. Wade was overthrown, 14 states have completely or mostly banned abortion, including Alabama, Texas, Idaho and Tennessee.
Despite an increase in restrictive policies, the number and rate of abortions in 2023 reached their highest level in more than a decade, according to a report from the Guttmacher Institute, a nonprofit research and policy organization. who advocates for sexual and reproductive health rights.
The organization estimates that there were more than 1 million abortions in America’s formal health care system last year, an 11% increase from 2020. States without total abortion bans experienced a 26% increase compared to 2020, according to the report.
The loss of access to abortion in banned states, the authors noted, was countered by “efforts by clinics, abortion funds, and logistical support organizations to help people…to access to care”.
Nearly two-thirds of all abortions in 2023, or about 642,700, were medication abortions – not including self-managed medication abortions outside of the care setting, the report said. The authors note a steady increase since 2001, when medical abortions accounted for less than 10% of all procedures.
Over the years, the U.S. Food and Drug Administration has relaxed some restrictions on the use of the abortion pill and access to the medication has increased. In 2016, the agency ruled that the abortion pill was safe to use up to 10 weeks of pregnancy, instead of seven, and expanded the pool of providers who could prescribe it. After the Covid-19 pandemic began, the FDA authorized distribution of the pill through certified pharmacies and by mail, rather than only to health care settings.
Abortion policies have changed rapidly in many states since the Supreme Court’s decision to overturn Roe. Four states, California, Michigan, Vermont and Ohio, have since enshrined the right to reproductive freedom in their constitutions, while New York and other states have implemented policies aimed at to protect abortion patients and providers.
More than a dozen states passed abortion “trigger laws” before the court’s ruling, meant to take effect almost immediately in the event Roe was overturned, and at least seven states without trigger laws followed suit the step with restrictive reproductive health policies which, according to critics. endanger patients and expose providers to risks of civil and criminal liability.
Patients and providers have struggled to navigate a patchwork of sometimes hastily implemented abortion policies, which include mandatory waiting periods to obtain an abortion in states like Arizona and Georgia, limits on Medicaid coverage for abortion in states like South Dakota, and vague language around medical emergencies. Exceptions to abortion bans in states, including Texas. Lower courts have been asked to take up abortion issues in multiple legal challenges across the states.
These policies have already had concrete effects. For example, a Texas woman sued the state for access to an abortion for a pregnancy that threatened her future fertility. Another Texas woman was illegally charged with murder for using abortion drugs to induce an abortion herself and spent two nights in jail before the charges were dropped. Providers say patients in states that ban abortion have been forced to carry a pregnancy against their will, compromising fertility and having other life-threatening consequences.
Last month, Florida replaced its 15-week abortion ban with a six-week ban, which falls before many women know they are pregnant. The ruling was a blow to reproductive access in the South, where Florida was a key access point for people seeking abortions. Providers and advocates say restrictive policies have created a reproductive care “desert” in the region.
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Some reproductive care providers say the South has become a desert for abortion services.
More than 171,000 patients traveled for abortions in 2023, according to the Guttmacher Institute.
Many people who traveled to get an abortion before Roe was overturned were traveling to states that now have total abortion bans, meaning people now travel greater distances – sometimes crossing multiple state lines – to access care, the organization recently noted.
In the first half of 2023 alone, nearly one in five people who had an abortion — or more than 92,000 people — crossed state lines to get an abortion, according to a December 2023 analysis from the institute.
As the abortion care landscape becomes more restrictive, Alexandra Mandado, president of Planned Parenthood in South, East and North Florida, says the remaining abortion clinics will struggle to absorb the increase in the number of out-of-state patients.
The Supreme Court recently rejected a challenge to access to the abortion pill mifepristone, maintaining widespread access to medical abortion in a ruling that will allow the pills to continue being sent to patients without an in-person doctor’s visit. Experts say access to the abortion pill could face new legal challenges in the future.
The court is considering another case this summer involving emergency medical exceptions to the abortion ban. In that case, the Biden administration sued the state of Idaho, where exemptions to its abortion ban are limited to life-threatening situations, arguing that federal law requires hospitals receiving funding of Medicare provide stabilizing care, including abortions, when a pregnant person’s health is poor. in danger.
Evelyn Hockstein/Reuters
The abortion pill has become a major access point to abortion amid increasing restrictions since the fall of Roe v. Wade.
In February, the Alabama Supreme Court ruled that frozen embryos are considered human and those who destroy them can be held liable for wrongful death, leading fertility clinics across the state to interrupt in vitro fertilization (IVF) treatments for fear of legal action.
As families across the state lost access to IVF treatments, they scrambled to meet widespread demand for a solution. In March, the state passed a law aimed at protecting IVF patients and providers from the legal liability imposed on them by the state court ruling. Although some services have resumed, at least one of the state’s few IVF providers announced it would stop its services completely by the end of the year, citing litigation concerns.
Experts worry that other reproductive care services, like contraception, are also at stake amid a wave of misinformation that some say will soon intentionally create panic, as others confuse contraception emergency and abortion, for example.
Most abortion policies implemented after the Supreme Court overturned Roe were either directly triggered by that decision or issued by participating courts or state courts. In an effort to restore the issue of access to reproductive health, organizers across the country worked to secure measures to enshrine reproductive health rights in state constitutions on November ballots.
Colorado, Florida, Maryland and South Dakota got these measures on their state ballots, and New York and Nevada are likely to follow suit. Organizers in at least seven other states are working to do the same.
In addition to making it harder to challenge access to abortion services, organizers hope the measures will allow voters to send a message to politicians about what they want.