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Abortion rights activists react to the Dobbs v Jackson Women's Health Organization ruling in front of the U.S. Supreme Court on June 24, 2022 in Washington, DC. The Court's decision in Dobbs v Jackson Women's Health overturns the landmark 50-year-old Roe v Wade case and erases a federal right to an abortion.
(Photo: Brandon Bell/Getty Images)
End of Roe Will Have Far-Reaching Consequences
The court's ruling has done what reproductive rights advocates feared for decades: It has taken away the constitutional right to privacy that protected access to abortion.
Jun 24, 2022
After half a century, Americans' constitutional right to get an abortion has been overturned by the Supreme Court.
The ruling in Dobbs v. Jackson Women's Health Organization--handed down on June 24, 2022--has far-reaching consequences. The Conversation asked Nicole Huberfeld and Linda C. McClain, health law and constitutional law experts at Boston University, to explain what just happened, and what happens next.
What did the Supreme Court rule?
The Supreme Court decided by a 6-3 majority to uphold Mississippi's ban on abortion after 15 weeks of pregnancy. In doing so, the justices overturned two key decisions protecting access to abortion: 1973's Roe v. Wade and Planned Parenthood v. Casey, decided in 1992.
The court's opinion, written by Justice Samuel Alito, said that the Constitution does not mention abortion. Nor does the Constitution guarantee abortion rights via another right, the right to liberty.
The opinion rejected Roe's and Casey's argument that the constitutional right to liberty included an individual's right to privacy in choosing to have an abortion, in the same way that it protects other decisions concerning intimate sexual conduct, such as contraception and marriage. According to the opinion, abortion is "fundamentally different" because it destroys fetal life.
The court's narrow approach to the concept of constitutional liberty is at odds with the broader position it took in the earlier Casey ruling, as well as in a landmark marriage equality case, 2015's Obergefell v. Hodges. But the majority said that nothing in their opinion should affect the right of same-sex couples to marry.
Alito's opinion also rejected the legal principle of "stare decisis," or adhering to precedent. Supporters of the right to abortion argue that the Casey and Roe rulings should have been left in place as, in the words of the Casey ruling, reproductive rights allow women to "participate equally in the economic and social life of the Nation."
The ruling does not mean that abortion is banned throughout the U.S. Rather, arguments about the legality of abortion will now play out in state legislatures, where, Alito noted, women "are not without electoral or political power."
States will be allowed to regulate or prohibit abortion subject only to what is known as "rational basis" review--this is a weaker standard than Casey's "undue burden" test. Under Casey's undue burden test, states were prevented from enacting restrictions that placed substantial obstacles in the path of those seeking abortion. Now, abortion bans will be presumed to be legal as long as there is a "rational basis" for the legislature to believe the law serves legitimate state interests.
In a strenuous dissent, Justices Stephen Breyer, Elena Kagan and Sonia Sotomayor faulted the court's narrow approach to liberty and challenged its disregard both for stare decisis and for the impact of overruling Roe and Casey on the lives of women in the United States. The dissenters said the impact of the decision would be "the curtailment of women's rights, and of their status as free and equal citizens." They also expressed deep concern over the ruling's effect on poor women's ability to access abortion services in the U.S.
Where does this decision fit into the history of reproductive rights in the U.S.?
This is a huge moment. The court's ruling has done what reproductive rights advocates feared for decades: It has taken away the constitutional right to privacy that protected access to abortion.
This decision was decades in the making. Thirty years ago when Casey was being argued, many legal experts thought the court was poised to overrule Roe. Then, the court had eight justices appointed by Republican presidents, several of whom indicated readiness to overrule in dissenting opinions.
Instead, Republican appointees Anthony Kennedy, Sandra Day O'Connor and David Souter upheld Roe. They revised its framework to allow more state regulation throughout pregnancy and weakened the test for evaluating those laws. Under Roe's "strict scrutiny" test, any restriction on the right to privacy to access an abortion had to be "narrowly tailored" to further a "compelling" state interest. But Casey's "undue burden" test gave states wider latitude to regulate abortion.
Even before the Casey decision, abortion opponents in Congress had restricted access for poor women and members of the military greatly by limiting the use of federal funds to pay for abortion services.
In recent years, states have adopted numerous restrictions on abortion that would not have survived Roe's tougher "strict scrutiny" test. Even so, many state restrictions have been struck down in federal courts under the undue burden test, including bans on abortions prior to fetal viability and so-called "TRAP"--targeted regulation of abortion provider--laws that made it harder to keep clinics open.
President Donald Trump's pledge to appoint "pro-life" justices to federal courts--and his appointment of three conservative Supreme Court justices--finally made possible the goal of opponents of legal abortion: overruling Roe and Casey.
What happens next?
Even before Dobbs, the ability to access abortion was limited by a patchwork of laws across the United States. Republican states have more restrictive laws than Democratic ones, with people living in the Midwest and South subject to the strongest limits.
Thirteen states have so-called "trigger laws," which greatly restrict access to abortion. These will soon go into effect now that the Supreme Court has overturned Roe and Casey, requiring only state attorney general certification or other action by a state official.
Nine states have pre-Roe laws never taken off the books that significantly restrict or ban access to abortion. Altogether, nearly half of states will restrict access to abortion through a variety of measures like banning abortion from six weeks of pregnancy--before many women know they are pregnant--and limiting the reasons abortions may be obtained, such as forbidding abortion in the case of fetal anomalies.
Meanwhile, 16 states and the District of Columbia protect access to abortion in a variety of ways, such as state statutes, constitutional amendments or state Supreme Court decisions.
None of the states that limit abortion access currently criminalize the pregnant person's action. Rather, they threaten health care providers with civil or criminal actions, including loss of their license to practice medicine.
Some states are creating "safe havens" where people can travel to access an abortion legally. People have already been traveling to states like Massachusetts from highly restrictive states.
The court's decision may drive federal action, too.
The House of Representatives passed the Women's Health Protection Act, which protects health care providers and pregnant people seeking abortion, but Senate Republicans have blocked the bill from coming up for a vote. Congress could also reconsider providing limited Medicaid payment for abortion, but such federal legislation also seems unlikely to succeed.
President Joe Biden could use executive power to instruct federal agencies to review existing regulations to ensure that access to abortion continues to occur in as many places as possible. Congressional Republicans could test the water on nationwide abortion bans. While such efforts are likely to fail, these efforts could cause confusion for people who are already vulnerable.
What does this mean for people in America seeking an abortion?
Unintended pregnancies and abortions are more common among poor women and women of color, both in the U.S. and around the world.
Research shows that people have abortions whether lawful or not, but in nations where access to abortion is limited or outlawed, women are more likely to suffer negative health outcomes, such as infection, excessive bleeding and uterine perforation. Those who must carry a pregnancy to full term are more likely to suffer pregnancy-related deaths.
The state-by-state access to abortion resulting from this decision means many people will have to travel farther to obtain an abortion. And distance will mean fewer people will get abortions, especially lower-income women--a fact the Supreme Court itself recognized in 2016.
But since 2020, medication abortion--a two-pill regimen of mifepristone and misoprostol--has been the most common method of ending pregnancy in the U.S. The coronavirus pandemic accelerated this shift, as it drove the Food and Drug Administration to make medication abortions more available by allowing doctors to prescribe the pills through telemedicine and permitting medication to be mailed without in-person consultation.
Many states that restrict access to abortion also are trying to prevent medication abortion. But stopping telehealth providers from mailing pills will be a challenge. Further, because the FDA approved this regimen, states will be contradicting federal law, setting up conflict that may lead to more litigation.
The Supreme Court's rolling back a right that has been recognized for 50 years puts the U.S. in the minority of nations, most of which are moving toward liberalization. Nevertheless, even though abortion is seen by many as essential health care, the cultural fight will surely continue.
Will Trump's Deeply Flawed Iran War Bring Down the US Empire?
The Suez crisis in 1957 was the end of the road for Britain’s 200-year role as a global rule-maker. From then on, it became a rule-taker. The recent political nostalgia for a different England pedalled by Brexiteers, that elegiac world of warm beer, sandwiches and Spitfires, was the world before Suez. The crisis was a monumental cock-up involving Britain, France and Israel, and a botched attack on Egypt to ensure European control over the critical Suez Canal. The fiasco resulted in the Egyptian nationalist leader, Gamal Nasser, having full authority over the canal.
Following a dressing down by new kid on the block the US, Britain and France withdrew with their tails between their imperialist legs. In the story of the global fight against colonialism, Suez was a famed victory for the colonised. It constituted the ultimate asymmetric war story where, like Iran and the Straits of Hormuz today, possession is nine-tenths of the law. Geography was on the Egyptian side.
Suez changed the global view of Britain for good. From then on, the risk of being associated with or adjacent to Britain in everything from geopolitics to finance increased. For more than 100 years, the UK had been a sure thing: the City of London was the epicentre of global finance; sterling was the world’s reserve currency; and the interest rates on UK gilts—the interest at which the UK government borrowed—was regarded as the global risk-free rate of return.
This meant that whatever else happened in the world, the UK government was seen as always good for its money, and would never default. With sterling pre-eminent, investors could shove their money into UK gilts and go on holiday, safe in the knowledge that it was a risk-free bet. In short, the UK manufactured sterling assets and the rest of world bought them, without question.
In finance, this extraordinary privilege is called credibility. After Suez, UK credibility gradually eroded, politically and financially—not overnight, but slowly and surely.
Could something similar happen to the US following Donald Trump’s war on Iran?
Let’s focus on finance.
Over the past few decades, despite all this talk of trade wars and the US’s inability to manufacture merchandise that the world wants, there is one product, made in the US, which the world wants in huge quantities: the American dollar. The Americans know the rest of the world wants American assets – stocks, bonds, companies and real estate. All of these are priced in dollars, so the Yanks are simply printing dollars and the world is buying those greenbacks. The process works like a resource find.
Other countries find oil that the rest of the world wants. The Americans have dollars, which they print for free and the world buys. Manufacturing these dollars is similar to turning on an oil spigot. Foreign money buys dollars to buy US assets, in the same way as foreign money flows into Saudi Arabia to buy oil. US government debt is above $31 trillion (€26.5 trillion), and foreigners hold about $9.5 trillion of US Treasuries. In order to get their hands on these American assets, foreigners must keep dollars handy, and therefore the US dollar still makes up 56.77 per cent of all official reserves all over the world.
After Suez, UK credibility gradually eroded, politically and financially—not overnight, but slowly and surely. Could something similar happen to the US following Donald Trump’s war on Iran?
Over a few decades, this process has led the dollar to be higher in value than it would otherwise be, plus it means the returns to US financial assets and its adjacent industries rise relative to other American industries. In time, finance elbows out manufacturing at home, while the expensive dollar makes it profitable for corporate America to relocate its industry overseas to cheaper and more tax-friendly locations, such as Ireland. Everyone wins—from the finance bros to the corporate leaders, the shareholders, and the real estate owners in urban America where the finance industry is based. Everyone, that is, but the blue-collar workers made redundant in the hollowed-out rust belt cities. They reacted slowly, but when they did a new political movement was born.
MAGA was birthed by the death of American manufacturing, itself destroyed by the expensive dollar, itself the result of foreigners’ insatiable demand for particular American assets and successive US administrations preferring to bet on things rather than make things. The US swapped manufacturing stuff for manufacturing dollars. The end result is that the US is both strong and weak, robust and fragile, stable and unstable, at the same time. A huge amount of the world’s capital is now over-concentrated in the US, as it used to be in Britain, and it remains there based on the assumption that American credibility will remain unimpeached.
The world has bet big time on the US. But as anyone who knows the form will attest, when you get an overconcentration of bets on one horse, your risk increases exponentially, while your potential return also diminishes significantly.
All this money flowing into the US, and all that buying of American dollars has led to the unsustainable situation whereby the US accounts for about 60 per cent of global listed equities, about half of private capital and 40 per cent of global bond markets. Yet it represents only about 4 per cent of the world’s population, 2 per cent of the global population under the age of 18, about 9 per cent of global growth, 13 per cent of world trade and one-sixth of world GDP. Something must give.
It is not that the finance world will turn on the US, but any risk assessment suggests that not having all your eggs in one basket is a good idea. Even before the Iran war, the supportive reasons for betting big on the US were beginning to wane. For years, the country was supported by falling interest rates, lower taxes, quantitative easing and falling wages relative to profits. All these factors made the US a place to park money. Profits rose and valuations soared, attracting in yet more capital. All this drove the return on US equities above US GDP, seducing foreign investors. In the years since 2008, foreigners have tripled down on US stocks, investing about $20 trillion in US companies. As the dollar rose on foreign exchanges, profits from the US expressed in foreign currencies exploded.
At the same time as foreigners increased their bets on the US in general, the country increased its bets on a particular domestic sector: tech. We have seen a doubling concentration of global risk in a few companies. Since the end of the pandemic, just seven companies account for more than half of total US stock market returns. The top 10 stocks now make up 40 per cent of the index.
One of the central assumptions underlying all this movement of money into the US was that the people who are making the big decisions about where the US is going are sensible, rational and informed. They wouldn’t start an unwinnable war without clear objectives or an extra strategy. They wouldn’t be accused of insider trading, betting personally on the timing of an airstrike that they were about to order. They wouldn’t risk the US’s military reputation by being seen to do another country’s dirty work. When they start a war, surely they’d win it? And if they didn’t, would they blame their staunchest allies, against whom they have already started a trade war?
When such questions are being asked, with so much foreign capital overinvested in America, the US’s credibility begins to erode. Once this starts, as the UK experienced after Suez, it’s almost impossible to recover.
This work is licensed under a Creative Commons Attribution 4.0 International License
Linda C. Mcclain
Linda C. McClain is a Professor of Law at Boston University.
Nicole Huberfeld
Nicole Huberfeld is a Professor of Law at Boston University.
mifepristoneus supreme courtabortion pillsroe v. wadereproductive rightsabortion rightsplanned parenthoodrepublican party
After half a century, Americans' constitutional right to get an abortion has been overturned by the Supreme Court.
The ruling in Dobbs v. Jackson Women's Health Organization--handed down on June 24, 2022--has far-reaching consequences. The Conversation asked Nicole Huberfeld and Linda C. McClain, health law and constitutional law experts at Boston University, to explain what just happened, and what happens next.
What did the Supreme Court rule?
The Supreme Court decided by a 6-3 majority to uphold Mississippi's ban on abortion after 15 weeks of pregnancy. In doing so, the justices overturned two key decisions protecting access to abortion: 1973's Roe v. Wade and Planned Parenthood v. Casey, decided in 1992.
The court's opinion, written by Justice Samuel Alito, said that the Constitution does not mention abortion. Nor does the Constitution guarantee abortion rights via another right, the right to liberty.
The opinion rejected Roe's and Casey's argument that the constitutional right to liberty included an individual's right to privacy in choosing to have an abortion, in the same way that it protects other decisions concerning intimate sexual conduct, such as contraception and marriage. According to the opinion, abortion is "fundamentally different" because it destroys fetal life.
The court's narrow approach to the concept of constitutional liberty is at odds with the broader position it took in the earlier Casey ruling, as well as in a landmark marriage equality case, 2015's Obergefell v. Hodges. But the majority said that nothing in their opinion should affect the right of same-sex couples to marry.
Alito's opinion also rejected the legal principle of "stare decisis," or adhering to precedent. Supporters of the right to abortion argue that the Casey and Roe rulings should have been left in place as, in the words of the Casey ruling, reproductive rights allow women to "participate equally in the economic and social life of the Nation."
The ruling does not mean that abortion is banned throughout the U.S. Rather, arguments about the legality of abortion will now play out in state legislatures, where, Alito noted, women "are not without electoral or political power."
States will be allowed to regulate or prohibit abortion subject only to what is known as "rational basis" review--this is a weaker standard than Casey's "undue burden" test. Under Casey's undue burden test, states were prevented from enacting restrictions that placed substantial obstacles in the path of those seeking abortion. Now, abortion bans will be presumed to be legal as long as there is a "rational basis" for the legislature to believe the law serves legitimate state interests.
In a strenuous dissent, Justices Stephen Breyer, Elena Kagan and Sonia Sotomayor faulted the court's narrow approach to liberty and challenged its disregard both for stare decisis and for the impact of overruling Roe and Casey on the lives of women in the United States. The dissenters said the impact of the decision would be "the curtailment of women's rights, and of their status as free and equal citizens." They also expressed deep concern over the ruling's effect on poor women's ability to access abortion services in the U.S.
Where does this decision fit into the history of reproductive rights in the U.S.?
This is a huge moment. The court's ruling has done what reproductive rights advocates feared for decades: It has taken away the constitutional right to privacy that protected access to abortion.
This decision was decades in the making. Thirty years ago when Casey was being argued, many legal experts thought the court was poised to overrule Roe. Then, the court had eight justices appointed by Republican presidents, several of whom indicated readiness to overrule in dissenting opinions.
Instead, Republican appointees Anthony Kennedy, Sandra Day O'Connor and David Souter upheld Roe. They revised its framework to allow more state regulation throughout pregnancy and weakened the test for evaluating those laws. Under Roe's "strict scrutiny" test, any restriction on the right to privacy to access an abortion had to be "narrowly tailored" to further a "compelling" state interest. But Casey's "undue burden" test gave states wider latitude to regulate abortion.
Even before the Casey decision, abortion opponents in Congress had restricted access for poor women and members of the military greatly by limiting the use of federal funds to pay for abortion services.
In recent years, states have adopted numerous restrictions on abortion that would not have survived Roe's tougher "strict scrutiny" test. Even so, many state restrictions have been struck down in federal courts under the undue burden test, including bans on abortions prior to fetal viability and so-called "TRAP"--targeted regulation of abortion provider--laws that made it harder to keep clinics open.
President Donald Trump's pledge to appoint "pro-life" justices to federal courts--and his appointment of three conservative Supreme Court justices--finally made possible the goal of opponents of legal abortion: overruling Roe and Casey.
What happens next?
Even before Dobbs, the ability to access abortion was limited by a patchwork of laws across the United States. Republican states have more restrictive laws than Democratic ones, with people living in the Midwest and South subject to the strongest limits.
Thirteen states have so-called "trigger laws," which greatly restrict access to abortion. These will soon go into effect now that the Supreme Court has overturned Roe and Casey, requiring only state attorney general certification or other action by a state official.
Nine states have pre-Roe laws never taken off the books that significantly restrict or ban access to abortion. Altogether, nearly half of states will restrict access to abortion through a variety of measures like banning abortion from six weeks of pregnancy--before many women know they are pregnant--and limiting the reasons abortions may be obtained, such as forbidding abortion in the case of fetal anomalies.
Meanwhile, 16 states and the District of Columbia protect access to abortion in a variety of ways, such as state statutes, constitutional amendments or state Supreme Court decisions.
None of the states that limit abortion access currently criminalize the pregnant person's action. Rather, they threaten health care providers with civil or criminal actions, including loss of their license to practice medicine.
Some states are creating "safe havens" where people can travel to access an abortion legally. People have already been traveling to states like Massachusetts from highly restrictive states.
The court's decision may drive federal action, too.
The House of Representatives passed the Women's Health Protection Act, which protects health care providers and pregnant people seeking abortion, but Senate Republicans have blocked the bill from coming up for a vote. Congress could also reconsider providing limited Medicaid payment for abortion, but such federal legislation also seems unlikely to succeed.
President Joe Biden could use executive power to instruct federal agencies to review existing regulations to ensure that access to abortion continues to occur in as many places as possible. Congressional Republicans could test the water on nationwide abortion bans. While such efforts are likely to fail, these efforts could cause confusion for people who are already vulnerable.
What does this mean for people in America seeking an abortion?
Unintended pregnancies and abortions are more common among poor women and women of color, both in the U.S. and around the world.
Research shows that people have abortions whether lawful or not, but in nations where access to abortion is limited or outlawed, women are more likely to suffer negative health outcomes, such as infection, excessive bleeding and uterine perforation. Those who must carry a pregnancy to full term are more likely to suffer pregnancy-related deaths.
The state-by-state access to abortion resulting from this decision means many people will have to travel farther to obtain an abortion. And distance will mean fewer people will get abortions, especially lower-income women--a fact the Supreme Court itself recognized in 2016.
But since 2020, medication abortion--a two-pill regimen of mifepristone and misoprostol--has been the most common method of ending pregnancy in the U.S. The coronavirus pandemic accelerated this shift, as it drove the Food and Drug Administration to make medication abortions more available by allowing doctors to prescribe the pills through telemedicine and permitting medication to be mailed without in-person consultation.
Many states that restrict access to abortion also are trying to prevent medication abortion. But stopping telehealth providers from mailing pills will be a challenge. Further, because the FDA approved this regimen, states will be contradicting federal law, setting up conflict that may lead to more litigation.
The Supreme Court's rolling back a right that has been recognized for 50 years puts the U.S. in the minority of nations, most of which are moving toward liberalization. Nevertheless, even though abortion is seen by many as essential health care, the cultural fight will surely continue.
Linda C. Mcclain
Linda C. McClain is a Professor of Law at Boston University.
Nicole Huberfeld
Nicole Huberfeld is a Professor of Law at Boston University.
After half a century, Americans' constitutional right to get an abortion has been overturned by the Supreme Court.
The ruling in Dobbs v. Jackson Women's Health Organization--handed down on June 24, 2022--has far-reaching consequences. The Conversation asked Nicole Huberfeld and Linda C. McClain, health law and constitutional law experts at Boston University, to explain what just happened, and what happens next.
What did the Supreme Court rule?
The Supreme Court decided by a 6-3 majority to uphold Mississippi's ban on abortion after 15 weeks of pregnancy. In doing so, the justices overturned two key decisions protecting access to abortion: 1973's Roe v. Wade and Planned Parenthood v. Casey, decided in 1992.
The court's opinion, written by Justice Samuel Alito, said that the Constitution does not mention abortion. Nor does the Constitution guarantee abortion rights via another right, the right to liberty.
The opinion rejected Roe's and Casey's argument that the constitutional right to liberty included an individual's right to privacy in choosing to have an abortion, in the same way that it protects other decisions concerning intimate sexual conduct, such as contraception and marriage. According to the opinion, abortion is "fundamentally different" because it destroys fetal life.
The court's narrow approach to the concept of constitutional liberty is at odds with the broader position it took in the earlier Casey ruling, as well as in a landmark marriage equality case, 2015's Obergefell v. Hodges. But the majority said that nothing in their opinion should affect the right of same-sex couples to marry.
Alito's opinion also rejected the legal principle of "stare decisis," or adhering to precedent. Supporters of the right to abortion argue that the Casey and Roe rulings should have been left in place as, in the words of the Casey ruling, reproductive rights allow women to "participate equally in the economic and social life of the Nation."
The ruling does not mean that abortion is banned throughout the U.S. Rather, arguments about the legality of abortion will now play out in state legislatures, where, Alito noted, women "are not without electoral or political power."
States will be allowed to regulate or prohibit abortion subject only to what is known as "rational basis" review--this is a weaker standard than Casey's "undue burden" test. Under Casey's undue burden test, states were prevented from enacting restrictions that placed substantial obstacles in the path of those seeking abortion. Now, abortion bans will be presumed to be legal as long as there is a "rational basis" for the legislature to believe the law serves legitimate state interests.
In a strenuous dissent, Justices Stephen Breyer, Elena Kagan and Sonia Sotomayor faulted the court's narrow approach to liberty and challenged its disregard both for stare decisis and for the impact of overruling Roe and Casey on the lives of women in the United States. The dissenters said the impact of the decision would be "the curtailment of women's rights, and of their status as free and equal citizens." They also expressed deep concern over the ruling's effect on poor women's ability to access abortion services in the U.S.
Where does this decision fit into the history of reproductive rights in the U.S.?
This is a huge moment. The court's ruling has done what reproductive rights advocates feared for decades: It has taken away the constitutional right to privacy that protected access to abortion.
This decision was decades in the making. Thirty years ago when Casey was being argued, many legal experts thought the court was poised to overrule Roe. Then, the court had eight justices appointed by Republican presidents, several of whom indicated readiness to overrule in dissenting opinions.
Instead, Republican appointees Anthony Kennedy, Sandra Day O'Connor and David Souter upheld Roe. They revised its framework to allow more state regulation throughout pregnancy and weakened the test for evaluating those laws. Under Roe's "strict scrutiny" test, any restriction on the right to privacy to access an abortion had to be "narrowly tailored" to further a "compelling" state interest. But Casey's "undue burden" test gave states wider latitude to regulate abortion.
Even before the Casey decision, abortion opponents in Congress had restricted access for poor women and members of the military greatly by limiting the use of federal funds to pay for abortion services.
In recent years, states have adopted numerous restrictions on abortion that would not have survived Roe's tougher "strict scrutiny" test. Even so, many state restrictions have been struck down in federal courts under the undue burden test, including bans on abortions prior to fetal viability and so-called "TRAP"--targeted regulation of abortion provider--laws that made it harder to keep clinics open.
President Donald Trump's pledge to appoint "pro-life" justices to federal courts--and his appointment of three conservative Supreme Court justices--finally made possible the goal of opponents of legal abortion: overruling Roe and Casey.
What happens next?
Even before Dobbs, the ability to access abortion was limited by a patchwork of laws across the United States. Republican states have more restrictive laws than Democratic ones, with people living in the Midwest and South subject to the strongest limits.
Thirteen states have so-called "trigger laws," which greatly restrict access to abortion. These will soon go into effect now that the Supreme Court has overturned Roe and Casey, requiring only state attorney general certification or other action by a state official.
Nine states have pre-Roe laws never taken off the books that significantly restrict or ban access to abortion. Altogether, nearly half of states will restrict access to abortion through a variety of measures like banning abortion from six weeks of pregnancy--before many women know they are pregnant--and limiting the reasons abortions may be obtained, such as forbidding abortion in the case of fetal anomalies.
Meanwhile, 16 states and the District of Columbia protect access to abortion in a variety of ways, such as state statutes, constitutional amendments or state Supreme Court decisions.
None of the states that limit abortion access currently criminalize the pregnant person's action. Rather, they threaten health care providers with civil or criminal actions, including loss of their license to practice medicine.
Some states are creating "safe havens" where people can travel to access an abortion legally. People have already been traveling to states like Massachusetts from highly restrictive states.
The court's decision may drive federal action, too.
The House of Representatives passed the Women's Health Protection Act, which protects health care providers and pregnant people seeking abortion, but Senate Republicans have blocked the bill from coming up for a vote. Congress could also reconsider providing limited Medicaid payment for abortion, but such federal legislation also seems unlikely to succeed.
President Joe Biden could use executive power to instruct federal agencies to review existing regulations to ensure that access to abortion continues to occur in as many places as possible. Congressional Republicans could test the water on nationwide abortion bans. While such efforts are likely to fail, these efforts could cause confusion for people who are already vulnerable.
What does this mean for people in America seeking an abortion?
Unintended pregnancies and abortions are more common among poor women and women of color, both in the U.S. and around the world.
Research shows that people have abortions whether lawful or not, but in nations where access to abortion is limited or outlawed, women are more likely to suffer negative health outcomes, such as infection, excessive bleeding and uterine perforation. Those who must carry a pregnancy to full term are more likely to suffer pregnancy-related deaths.
The state-by-state access to abortion resulting from this decision means many people will have to travel farther to obtain an abortion. And distance will mean fewer people will get abortions, especially lower-income women--a fact the Supreme Court itself recognized in 2016.
But since 2020, medication abortion--a two-pill regimen of mifepristone and misoprostol--has been the most common method of ending pregnancy in the U.S. The coronavirus pandemic accelerated this shift, as it drove the Food and Drug Administration to make medication abortions more available by allowing doctors to prescribe the pills through telemedicine and permitting medication to be mailed without in-person consultation.
Many states that restrict access to abortion also are trying to prevent medication abortion. But stopping telehealth providers from mailing pills will be a challenge. Further, because the FDA approved this regimen, states will be contradicting federal law, setting up conflict that may lead to more litigation.
The Supreme Court's rolling back a right that has been recognized for 50 years puts the U.S. in the minority of nations, most of which are moving toward liberalization. Nevertheless, even though abortion is seen by many as essential health care, the cultural fight will surely continue.
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