The Abortion Law: Overturned Or Still Standing?

On June 24, 2022, the US Supreme Court overturned Roe v. Wade, the landmark legislation that made abortion a federal right in the United States. The decision ended nearly 50 years of legal protection and paved the way for individual states to curtail or ban abortion rights. The Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization, a case involving a challenge to Mississippi's 15-week ban on abortion, overturned Roe v. Wade and ended the federal constitutional right to abortion in the United States.

The impact of overturning Roe v. Wade

On June 24, 2022, the United States Supreme Court overturned Roe v. Wade, the 1973 Supreme Court decision that had guaranteed a constitutional right to abortion. The overturning of Roe v. Wade has had a significant impact on abortion access and reproductive rights in the United States, with wide-ranging consequences for women's health and well-being, particularly for midlife women and women of colour.

Impact on Women's Health and Well-being

The overturning of Roe v. Wade has had a significant impact on women's health and well-being, particularly for midlife women. Midlife women are defined as those between 40 and 65 years of age, and they face unique challenges when it comes to unintended pregnancies and access to reproductive health services. Even before the overturning of Roe v. Wade, a 1995 survey revealed that 51% of pregnancies among women aged 40 and older were unintended. With the loss of Roe v. Wade, midlife women in states with restrictive abortion laws may face critical access issues, and their health and well-being may be at risk.

Disproportionate Impact on Women of Colour

The overturning of Roe v. Wade has also had a disproportionate impact on women of colour, particularly Black and Hispanic women. Historically, women of colour have faced greater barriers to accessing healthcare and have been subjected to racist practices and systemic racism within the healthcare system. With the loss of Roe v. Wade, women of colour are now facing even greater obstacles to obtaining abortions and reproductive health services. They are also more likely to face financial and social challenges when trying to access abortion care, as they often have more limited financial resources and transportation options.

Criminalization of Pregnancy-Related Conduct

In the year following the overturning of Roe v. Wade, there was a significant increase in pregnancy-related prosecutions in the United States. A report by the advocacy group Pregnancy Justice found that at least 200 people were prosecuted for conduct relating to their pregnancies between June 2022 and June 2023. This included allegations of substance use during pregnancy and child abuse, neglect, or endangerment, with embryos and fetuses being treated as persons with legal rights. The criminalization of pregnancy-related conduct has had a disproportionate impact on low-income women and women of colour, further exacerbating existing inequalities and injustices.

State-by-State Differences in Abortion Laws

Following the overturning of Roe v. Wade, abortion laws are now being decided at the state level, leading to a patchwork of different laws and access to abortion across the country. As of June 2022, 26 US states had multiple abortion bans in place, with 13 of these being "trigger laws" that automatically took effect when Roe v. Wade was revoked. This has resulted in significant differences in abortion access depending on where a person lives, with one in three women now living in states where abortion is not accessible.

State-by-state reproductive rights

On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, the 1973 ruling that had guaranteed a constitutional right to abortion. The decision has given individual states the power to restrict or prohibit abortion.

States with Expanded Access

In some states, the right to abortion is protected by state statutes or state constitutions, and additional laws and policies have been enacted to create further access to abortion care. These states include:

• Alaska
• Arizona
• California
• Colorado
• Florida
• Kansas
• Massachusetts
• Minnesota
• Montana
• New Jersey
• New Mexico

States with Protected Access

In these states, the right to abortion is protected by state law, but there are limitations on access to care.

States with No Protection

Abortion may continue to be accessible in these states, but it is not protected by state or territory law. It is unclear whether the legislatures in these states will enact a ban, but concern is warranted.

Hostile States

These states have expressed a desire to prohibit abortion entirely and are extremely vulnerable to the revival of old abortion bans or the enactment of new ones. None of these states have legal protections for abortion:

• Georgia
• South Carolina
• Iowa

Illegal States

States that ban abortion entirely and enforce those bans through criminal penalties are characterized as "illegal". As of October 2024, 14 states have made abortion illegal.

The legality of third-trimester abortions

Third-trimester abortions are substantially more expensive, difficult to obtain, and stigmatized than first-trimester abortions in the US. They are also rare, with only 1% of abortions taking place at or after 21 weeks after the first day of the pregnant person's last menstrual period.

There are two main pathways to needing a third-trimester abortion: new information and barriers to abortion before the third trimester. In the first pathway, a pregnant person learns new information about the pregnancy, such as a serious fetal health issue or that they are pregnant, that makes them realize they no longer want to continue the pregnancy. In the second pathway, a pregnant person decides they want an abortion before the third trimester but faces barriers such as financial obstacles, difficulty finding a provider, and stigmatization that delay the procedure until the third trimester.

The circumstances that lead to someone needing a third-trimester abortion may overlap with the pathways to abortion at other gestational ages. For example, people may seek a third-trimester abortion due to medical concerns such as fetal anomalies or maternal life endangerment, as well as barriers to care that cause delays in obtaining an abortion.

The impact on doctors and medical staff

On June 24, 2022, the US Supreme Court overturned Roe v. Wade, eliminating the federal constitutional right to abortion. The decision has had a profound impact on doctors and medical staff across the country, particularly in states with restrictive abortion laws.

Confusion and Fear

In states with restrictive abortion laws, such as Texas, doctors report confusion and fear about the legal implications of providing abortion care. Many doctors are uncertain about when they are legally permitted to intervene to perform an abortion, even in cases of medical necessity. This confusion is exacerbated by the fear of criminal prosecution, with 60% of OB-GYNs in Texas expressing fear of legal repercussions. As a result, doctors may be less likely to provide abortion care, even when it is legally permitted, out of concern for their own legal risk.

Impact on Patient Care

The overturning of Roe v. Wade has had a direct impact on the quality of patient care provided by doctors and medical staff. With restrictions on abortion access, doctors are prohibited from providing the full range of evidence-based care options to their patients. This can result in delays in treatment and negative health outcomes for patients. In some cases, doctors may be forced to deny medically necessary care due to the fear of legal consequences.

Workforce Shortages

The restrictive abortion laws have also led to workforce shortages, particularly in the field of obstetrics and gynecology. In Texas, for example, more than 70% of practicing OB-GYNs feel that the state's abortion ban has negatively impacted their work. The laws have also led to a decrease in applications for obstetrics and gynecology residencies, with medical students opting to train in states with less restrictive abortion laws. This could have long-term implications for the availability and quality of women's healthcare in these states.

Ethical Dilemmas

Doctors and medical staff may also face ethical dilemmas as a result of the overturning of Roe v. Wade. They may be forced to choose between adhering to their own personal and professional ethics and complying with restrictive state laws. This can cause moral distress and conflict, particularly for those who believe that abortion is a necessary component of comprehensive healthcare.

Impact on Research and Education

The impact of the abortion law overturn is also felt in the areas of research and education. Doctors and medical staff who are involved in abortion research may face challenges in continuing their work, particularly in states with restrictive laws. Additionally, medical schools and residency programs in these states may struggle to attract students and trainees, as future doctors may be concerned about the impact of these laws on their ability to provide comprehensive care.

The future of other rights

The overturning of Roe v. Wade in 2022 has had a profound impact on reproductive rights in the United States, with abortion policies and access now determined at the state level. This shift has far-reaching implications for other rights and freedoms, and the future of these rights remains uncertain. Here are some key areas of concern:

Access to Safe and Legal Abortion

With Roe v. Wade overturned, abortion rights are now decided at the state level, and many states have moved to restrict or ban abortion altogether. As a result, millions of people are forced to travel great distances to access legal abortion services, and those who cannot afford to do so may resort to unsafe methods. This situation highlights the deep inequalities that exist in the United States, as people from marginalized communities, including people of color, LGBTQ+ individuals, and people with low incomes, are disproportionately affected by these restrictions. The future of abortion access remains uncertain, with ongoing legal battles and a patchwork of state-by-state policies.

Reproductive Justice and Bodily Autonomy

The concept of reproductive justice goes beyond abortion access and encompasses issues such as population control, bodily self-determination, immigrants' rights, economic and environmental justice, and criminal injustices. The overturning of Roe v. Wade has empowered those who seek to control women's bodies and limit their reproductive rights. The future of reproductive justice is closely tied to broader social, economic, and political inequalities, and the ability of marginalized communities to exercise their sexual and reproductive rights remains at risk.

LGBTQ+ Rights

The Christian conservative group Alliance Defending Freedom (ADF), which played a key role in overturning Roe v. Wade, has set its sights on restricting LGBTQ+ rights. ADF has been working to undermine marriage equality, erase trans adults from public life, require gender conformity for children, and control family building. The group's long-term goal appears to be to establish a legal framework that would give parents the authority to demand that their children only interact with cisgender individuals and to make it financially ruinous to be a trans adult. The future of LGBTQ+ rights in the United States is uncertain, with ongoing legal battles and a growing conservative movement to restrict these rights.

Separation of Church and State

ADF and other conservative groups are working to blur the lines between church and state, seeking to increase the influence of religious organizations in public life. This includes efforts to secure religious exemptions from anti-discrimination laws, influence education and healthcare policies, and redirect public funds to religious schools. The future of the separation of church and state is at stake, with potential implications for religious freedom and the establishment of a secular society.

Right to Privacy and Freedom of Speech

The right to privacy, which forms the basis for many other rights, including reproductive rights and freedom of speech, is under threat. The overturning of Roe v. Wade has emboldened conservative groups to challenge established precedents and seek greater control over personal decisions and expressions of identity. The future of privacy rights and freedom of speech hangs in the balance, with technology giants like Meta and TikTok already removing information about abortion, further restricting access to vital information.

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