Amanda Zurawski, Josh Zurawski, Kaitlyn Joshua and Hadley Duvall speak at the Democratic National Convention in Chicago, Ill., on Aug. 19, 2024.  (Andrew Roth for Michigan Advance)

Galvanized by a pivotal election almost two years after the U.S. Supreme Court overturned federal abortion protections, patients, doctors, and activists in 2024 fought for renewed and expanded reproductive rights, while others pushed for more restrictions. These are some of the people and organizations that had an impact on reproductive health law and abortion access this year.

Women with wanted pregnancies affected by abortion bans

In state legislatures, before Congress, in court, in presidential campaign ads, and on stage at the Democratic National Convention, women all over the country have been reliving some of the worst moments of their lives in an effort to roll back abortion restrictions that have changed reproductive health care in America.

The year after Kentucky banned abortion, Hadley Duvall started talking publicly about how she was raped at 12 by her stepdad, who got her pregnant. She advocated for abortion rights in re-election campaign ads for Democratic Gov. Andy Beshear in 2023 and this year appeared in national campaign ads for Democrats.

Kaitlyn Joshua, of Baton Rouge, represented many Louisiana women at this year’s Democratic National Convention, telling what’s becoming an increasingly common story of not being able to access miscarriage treatment after the state passed a strict abortion ban. Louisiana Attorney General Liz Murrill subsequently challenged Joshua’s story on social media.

Kristin Lyerly, an OB-GYN from Wisconsin, is one of many doctors across the country who have sued over state abortion bans they say have changed medical practice. Lyerly this year participated in a civic engagement experiment in Madison, where strangers came together and shared the life experiences that inform their abortion views. Even when abortion rights were protected under Roe v. Wade, Lyerly said she was almost forced to give birth to a stillborn, in lieu of a less invasive abortion procedure. She also ran a reproductive-rights-focused campaign as a Democrat in a conservative-leaning congressional district, a race she lost.

Allie Phillips ran as a Democrat for a seat in the Tennessee legislature after the state’s abortion ban kept her from terminating a nonviable pregnancy in her home state, leading her to travel to New York City for care. She lost the race but said in November that she plans to continue fighting for reproductive rights, and announced her new pregnancy. Phillips is a plaintiff in an ongoing lawsuit with other affected women and physicians to clarify the state’s medical health exceptions. A three-judge panel ruled in October that doctors cannot be penalized for performing an emergency abortion to save a patient’s life.

Amanda Zurawski developed sepsis in Texas after her water broke at 18 weeks and doctors waited for days to terminate her pregnancy, fearing prosecution under the state’s strict abortion ban. She’s since become an outspoken abortion-rights advocate. She campaigned heavily for abortion-rights candidates this year and said she wants to continue working in politics.

The Charlotte Lozier Institute

The high-profile federal lawsuit over medication abortion was made possible in part by the Charlotte Lozier Institute, the research arm of the anti-abortion political powerhouse Susan B. Anthony Pro-Life America. Data from the institute featured prominently in the plaintiffs’ case for revoking the federal drug approval of mifepristone and was directly used as part of U.S. District Judge Matthew Kacsmaryk’s reasoning for granting the doctor-plaintiffs’ standing. The researchers found a significant jump in Medicaid-funded emergency room visits following a medication abortion over two decades, which also corresponds with an increase in access to medication abortion overtime. Public health experts told States Newsroom that the researchers inflated their findings, and appeared to conflate all emergency department visits with serious adverse events like sepsis. Their conclusions contradicted a large body of research showing a low rate of serious adverse events after taking mifepristone, prompting further scrutiny from curious scientists, as well as the academic publishing house that published it.

In February, Sage retracted three studies produced by Charlotte Lozier researchers and published in the journal Health Services Research and Managerial Epidemiology between 2019 and 2022, after a reader-prompted investigation found flaws in the studies’ methodology and data representation. The team behind the studies included Charlotte Lozier vice president and director of data analytics James Studnicki and longtime anti-abortion researchers, including the then-CEO of one of the plaintiff groups in the medication abortion lawsuit. They sued Sage, saying the retractions were unjustified and politically motivated.

The U.S. Supreme Court unanimously rejected the abortion medication lawsuit this past summer — not on the merits of the case, but on the issue of the doctor-plaintiffs’ standing. Anti-abortion activists vowed to find a different plaintiff who could potentially persuade the court that abortion pills are too dangerous. After the Supreme Court remanded the case to the lower court, in October, intervening states Idaho, Kansas and Missouri amended their complaint, which no longer cites the retracted studies papers but instead cites a new paper from Studnicki and fellow Charlotte Lozier researchers, making similar claims.

The Alabama Supreme Court

A common fertility treatment, in vitro fertilization, was thrust into the national spotlight in February after the Alabama Supreme Court decided, 8-1, that frozen embryos should be considered children, in a wrongful death lawsuit over the embryos’ accidental destruction.

A lower court had dismissed the claim, ruling that embryos do not meet the legal definition of children. But in the majority opinion siding with the couples who sued the Mobile fertility clinic, Justice Jay Mitchell cited a 2018 state constitutional amendment ensuring “the protection of the rights of the unborn child.” He also cited an 1872 law allowing for civil lawsuits for the wrongful death of children, and argued that it does not explicitly include an exception for frozen embryos. Mitchell reasoned that the law “applies to all children, born and unborn, without limitation.” Chief Justice Tom Parker, an influential conservative Christian activist, cited biblical texts in his concurring opinion, writing, “even before birth, all human beings bear the image of God, and their lives cannot be destroyed without effacing his glory.”

Soon after, many IVF clinics in Alabama shut down until the state legislature passed a bill in March that extended criminal and civil immunity to IVF clinics for operations. This created major issues for families spending tens of thousands of dollars on a time-sensitive treatment. Alabama’s ruling also created a fear among families struggling to conceive in other states with abortion bans and showed that the fertility treatment is broadly supported by voters from both political parties. Republicans updated their national party platform to include support for IVF access. During his presidential campaign, President-elect Donald Trump promised: “your government will pay or your insurance company will be mandated to pay for all costs associated with I.V.F. treatment” — something he likely couldn’t do without congressional action. Meanwhile, GOP members of Congress have largely opposed IVF protections and access bills.

Mark Lee Dickson and Jonathan Mitchell

This year, attorney Jonathan Mitchell and pastor Mark Lee Dickson together experimented with ways to prevent out-of-state abortions, using their home state of Texas as the primary testing ground. Mitchell, a former solicitor general of Texas, used a little known state rule to depose abortion funds, doctors, and women who left the state for an abortion. As the Texas Tribune reported, the actions created fear and confusion but have not resulted in charges. Mitchell previously filed a wrongful death lawsuit against women who allegedly helped their friend obtain medication to terminate a pregnancy, which has since been dropped.

Through their Sanctuary Cities for the Unborn project, Dickson and Mitchell helped pass approximately 80 ordinances in cities and counties, mostly in Texas, but also in strategically located cities in abortion-access states, like Illinois and New Mexico. Some of the ordinances say a doctor in a state where abortion is legal cannot perform an abortion on a resident who lives in a town that has passed one of these laws. Some of the ordinances ban the use of that town’s highways to drive someone to an out-of-state abortion clinic. And some invoke a dormant federal anti-obscenity law known as the Comstock Act, which they say the federal government should enforce to mean that abortion pills cannot be transported through the mail.

Just like Texas’s 2021 six-week abortion ban that Mitchell and Dickson helped design, many of these ordinances are unenforceable by the governments that pass them, instead allowing for private citizens to sue other residents or medical professionals for “aiding and abetting” an abortion. The activists experienced a major loss on Election Day with the majority of voters in conservative Amarillo, Texas, voting down a ballot measure blocking abortion-related travel on its highly trafficked roads. But just before the end of the year, Texas Attorney General Ken Paxton sued a New York doctor for prescribing abortion drugs to a Texas resident, which Dickson told States Newsroom is a win for the anti-abortion movement. He said that in 2025 he plans to push for local anti-abortion ordinances in Arizona and Missouri, which reversed their abortion bans in November.

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Tabitha Crowe’s first child was due in February 2025, but she had a miscarriage in August. (Courtesy of Tabitha Crowe) 

Editor’s Note: This is the sixth installment of an occasional States Newsroom series called When and Where: Abortion Access in America, profiling individuals who have needed abortion care in the U.S. before and after Dobbs. The first installment can be found here, the second installment is here, the third is here, the fourth is here, and the fifth is here.

By Sofia Resnick

Tabitha Crowe said she woke up around 4 a.m. one Thursday in August covered in blood. She was visiting her parents in southern Louisiana when she started miscarrying her first pregnancy. She said her mom and dad drove her to a nearby hospital while she fought dizziness from the blood loss in their back seat.
“I didn’t even know I could bleed that much,” Crowe told States Newsroom.

Over the course of the next few days, Crowe said she passed baseball-sized blood clots and experienced extreme pain and dizziness in two different hospitals, while never being offered a common miscarriage procedure, even after she requested it.

An estimated 10 to 20% of known pregnancies in the U.S. end in miscarriage. In about 80% of miscarriages, women are able to expel the pregnancy tissue naturally over a period of one to eight weeks, according to the American College of Obstetricians and Gynecologists. When intervention is necessary in the first trimester, ACOG recommends abortion medications or procedures such as vacuum aspiration or dilation and curettage (D&C). Later in pregnancy, recommended termination procedures include dilation and evacuation (D&E), which has a high safety record but is condemned by anti-abortion groups and banned in some states.

But increasingly, women say they are being denied routine miscarriage care in states like Louisiana, where doctors face imprisonment if they perform an abortion unless a woman is at risk of dying, and where common miscarriage drugs are now more difficult to access. Doctors in Louisiana and Texas have also reported a rise in patients whose pregnancies are no longer viable receiving more risky and invasive terminations, such as Cesarean sections and inductions, in lieu of abortion procedures. It’s a change in practice some doctors involved in the anti-abortion movement endorse.

And in cases like Crowe’s — where death might not be imminent but failing to intervene could increase the risk for infection or other issues — some doctors are telling patients to finish their miscarriages at home.

“I think they were waiting for me to get in bad enough health,” said Crowe, who attributes her experience to Louisiana’s abortion ban, though she said no medical staff mentioned the law or responded to her requests for a D&C.

But waiting for patients’ conditions to worsen can sometimes be fatal, according to an ongoing investigation by ProPublica, which has reported on five deaths linked to abortion bans, most recently a young mom in Texas who spent hours in the ER but was never offered a D&C that could have saved her life.

As stories emerge linking abortion bans to adverse health effects, some state health departments are working to make these stories harder to learn about.

In Georgia, officials recently dismissed all 32 members of the state’s Maternal Mortality Review Committee following ProPublica’s reporting that the committee linked two women’s deaths to Georgia’s six-week abortion ban. The state said it would reset the committee through a new application process and is considering measures to ensure patient confidentiality.

In Texas, ProPublica reported that at least three women have died because of delays in care caused by the state’s abortion bans. Despite these reported deaths, Texas’ Maternal Mortality and Morbidity Review Committee said it wouldn’t examine any pregnancy-related deaths from 2022 and 2023, the first two years after the state’s near-total abortion ban took effect, according to the Washington Post.

Idaho, shortly after banning abortion, disbanded its Maternal Mortality Review Committee in 2023 after members recommended expanding Medicaid. The recently re-established committee is now backlogged and focused on publishing 2023 data in January before tackling 2022 data. The committee’s last report, based on 2021 data, showed the state’s maternal mortality rate had doubled in recent years and most of the deaths were preventable.

Crowe said her experience has moved her to speak out for better reproductive health care.

“For me to have a miscarriage for the first time, it’s already a very scary process,” said Crowe, who said she eventually got the care she needed outside of Louisiana. “You go to a hospital, you expect care, you expect some type of answers on what’s going on. And I didn’t get that.”

‘I had a sense it was because of the abortion laws’

Crowe and her husband, Noah Holesha, live on the Eglin Air Force Base in the Florida Panhandle. Crowe said her husband is in the Army and she was medically discharged from the military in 2023 and now works as a caretaker. The two married in 2022 and were expecting their first baby in February.

But on the way to LSU Health Lallie Kemp Medical Center in Independence, Louisiana, on Aug. 8, Crowe said she felt she would never get to meet this baby. Two weeks earlier, her 10-week-old fetus only measured 6 weeks. Now in the emergency room, Crowe said medical staff gave her pain medicine, cleared her blood clots, and discharged her to finish miscarrying naturally.

Two days later at her parents’ house, Crowe said she woke up with 10 out of 10 pain.

“I was in excruciating pain again, like screaming and crying pain,” she said.

She said her parents took her back to Lallie Kemp, where they transferred her to St. Tammany Parish Hospital Emergency Department in Covington, about a 45-minute drive, because it was the nearest hospital with a dedicated OB-GYN unit.

“Lallie Kemp Medical Center complies with federal patient privacy laws and therefore cannot discuss specific patients’ care,”  Dr. Matloob Rehman, the hospital’s medical director, said in an email. “Lallie Kemp is a small, rural hospital without a full complement of specialists, including obstetrical surgery. If a patient is in need of such care, it is Lallie Kemp’s practice to refer or transfer the patient to a hospital that can provide such services.”

At St. Tammany, Crowe said she spent the day receiving pain medicine and transvaginal ultrasounds and having her vaginal canal cleared of clots. Medical records Crowe shared with States Newsroom indicate she was given misoprostol to evacuate her uterus, which Crowe said she was not aware of. She said the ultrasounds were still showing she had not completed the miscarriage. Crowe’s cousin had recently miscarried, so she and her family knew to ask for a D&C.

“They did ultrasounds and all that, but they didn’t help make sure that the miscarriage was completing,” Crowe said. “We kept telling them, ‘Hey, can y’all just do this D&C, so like we can be done with this pain?’ They wouldn’t answer.”

Crowe’s sister, a nurse in Texas, where abortion is also banned, suggested in a text that maybe it was because of Louisiana’s abortion ban that she wasn’t being offered a D&C.

“I had a sense it was because of the abortion laws, because by the time they did the canal sweep of blood clots, they didn’t even want to listen that I was in pain anymore. They were like, brushing it off, like, you’ll be fine,” Crowe said. “Even if them not doing it was wasn’t because of the abortion laws, I still didn’t get the treatment that I needed.”

Crowe said she was still dizzy and in pain when St. Tammany released her late on Aug. 10. Her St. Tammany hospital medical records say her miscarriage was completed at St. Tammany, which Crowe disputes. Medical records from the hospital in Florida, where she received the D&C, say the patient had an “incomplete miscarriage with evidence of retained POC [products of conception] on TVUS [transvaginal ultrasound], continued bleeding and anemia.”

The St. Tammany Health System Communications Department declined to comment on Crowe’s account, citing patient confidentiality, and said in a statement: “At St. Tammany Health System, we place our patients and their families’ wellbeing first. Patient privacy rights are established by the Federal Health Insurance Portability and Accountability Act (HIPAA). In compliance with this act, we are not at liberty to provide information or comment.”

Crowe decided to drive the four hours back to Florida. She said her pain had ebbed, but soon after she got home, her husband rushed her to Eglin Air Force Base emergency department, where she said she received a D&C the following day.

The Eglin hospital did not respond to requests for comment.

Crowe said she was still dizzy in the weeks following, and she was confused and angry, believing — without confirmation — that she was denied health care she needed because of a new abortion law. She said she started reaching out to malpractice attorneys, reproductive rights groups, even President-elect Donald Trump.

“I sent everybody emails.” Crowe said. “I reached out to Congress. I reached out to the office of Trump. I reached out to lawyers. It wasn’t anger that I’ve lost the child — because I had a feeling I was going to lose the child — but it was the anger of they didn’t give their 100% care. I was getting in bad shape, health-wise, because of it.”

Louisiana abortion laws affect miscarriage care

Louisiana was one of the first states to ban abortion after the U.S. Supreme Court overturned Roe v. Wade in 2022. And it’s the first, followed by Texas, to reclassify two abortion and miscarriage medications — mifepristone and misoprostol — as controlled substances, even though they haven’t been shown to cause addiction or dependence. In late October, health care workers sued the state, arguing that the new law is unconstitutional and has added barriers to emergency care.

One of the legal advocacy groups representing plaintiffs in that case, Lift Louisiana, co-published a report with Physicians for Human Rights with detailed interviews from patients, doctors and clinicians of how the state’s abortion ban has changed reproductive health care in Louisiana. The report found that some OB-GYN practices are now deferring prenatal care until beyond the first trimester, when miscarriage care is more common. Some clinicians reported an increase in patient referrals from rural hospitals for routine care.

“To avoid the risk of criminal penalties under the bans, nearly every clinician relayed an account

in which they and/or their colleagues delayed abortion care until complications worsened to

the point where the patient’s life was irrefutably at risk,” the report reads.

Crowe said she was grateful she was able to get treated, not a given in Florida, which has a six-week abortion ban and where patients have also reported being denied miscarriage treatment. But she lives on a military base, under federal jurisdiction. With a soon-to-be GOP majority in Washington, D.C., anti-abortion activists are pushing Trump to restrict pregnancy termination at military hospitals.

Though she personally disagrees with abortion after the first trimester, Crowe said she now believes in abortion rights.

“Growing up, I was always pro-life, because I always wanted to have a kid and all that,” Crowe said. “I was also the type that’s like, I’m not going to judge you if you do. Now I’m like … the choice to have an abortion is important because some women … we need this procedure done to save our lives, too. My child was already lost; it lost its life. Because of the abortion laws, you’re keeping me from having my life. … I couldn’t grieve because I was in so much pain.”

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Donald Trump spoke at the March for Life rally in January 2019 during his first term as president. (Mark Wilson | Getty Images)

The 2024 election results created complicated new realities for reproductive rights in the U.S., with Americans even in a few red states overwhelmingly voting to protect the right to have an abortion while also overwhelmingly electing anti-abortion representatives in state houses, courts, Congress and the White House.

With a Republican trifecta coming to the nation’s capital in January, anti-abortion activist groups are planning for the first potentially friendly presidential administration since the 2022 Dobbs v. Jackson Women’s Health Organization decision overturned Roe v. Wade and eliminated a 50-year federal right to terminate a pregnancy. They aim to end other federal and state protections while vastly expanding restrictions on reproductive health care.

Though many anti-abortion leaders are skeptical of President-elect Donald Trump’s commitment to their cause, they say they are willing to compromise to maintain influence in his administration. Some groups are strategizing how to end-run Trump’s campaign pledge not to enact any federal abortion bans — by heavily restricting medication abortion or trying to ban a common abortion procedure.

“I don’t think we have a champion here for pro-life causes,” said longtime anti-abortion organizer Rev. Patrick Mahoney. “What we have here is someone who will not work against us and try to crush us. We will not see pro-choice federal judges.”

The director of the Christian Defense Coalition and the chief strategy officer of Stanton Public Policy Center told States Newsroom that he is not a supporter of Trump and disagrees with his rhetoric on immigrants. But Mahoney said he is happy Democratic presidential nominee Kamala Harris lost. The vice president had vowed to try to restore federal abortion rights and throughout her career has advocated for reproductive rights. As California attorney general, she prosecuted anti-abortion activists charged with illegally recording abortion providers about a decade ago.

“We can have an opportunity now to begin the second phase after Roe was overturned,” Mahoney said. “We knew overturning Roe was only a starting line, not a finishing line.”

Live Action president Lila Rose was one of the few prominent anti-abortion leaders who called out Trump before the election, after he criticized Florida’s six-week abortion ban and vowed to veto a federal ban. In late August, Rose told Politico she would write in a presidential candidate and would encourage her millions of followers to do the same if Trump did not change course. On her podcast, the millennial activist recently revealed that she met with Trump and asked him to say he would vote against Florida’s abortion-rights amendment, which he did. Days before the election, Rose endorsed Trump on X.

Live Action did not respond to an interview request.

Nationally, three out of 10 abortion-rights measures failed: Florida’s proposed amendment had the highest threshold to clear, but got 57% out of the required 60% of the vote. It would have reversed the ban that reproductive rights advocates say has decimated abortion access in the Southeast.

Another anti-abortion leader willing to compromise with the incoming president and Congress is Steven Aden, general counsel at Americans United for Life, the policy shop behind many state and federal abortion restrictions. Aden said he was disappointed the Republican Party removed from its platform a previous commitment to a federal ban.

However, he said his group was still able to inject critical language into the current platform that effectively supports states establishing fetal personhood through the U.S. Constitution’s 14th Amendment, which grants equal protection under the law. The platform also says Republicans “will oppose Late Term Abortion,” a political term used to refer to abortions in the second and third trimesters, the rarest but most restricted types of abortions in the U.S.

“We had direct input into the Trump campaign and framing the pro-life language in the party platform,” Aden told States Newsroom. “The platform language was much pared down, but we believe that the pro-life language preserves the essence of the party’s position on the pro-life issue, and we’re proud of that, and look forward to continuing to work with the incoming Trump administration.”

Federal reproductive rights protections in question

Early into his term, Democratic President Joe Biden began reversing blocks on federal funding domestically and globally for reproductive health organizations that also provide or refer for abortions. Leading up to and following the Dobbs decision, the Biden administration loosened restrictions to the medication abortion regimen, a combination of mifepristone and misoprostol, which has become the most common way of terminating pregnancy in the U.S. during the first trimester. The U.S. Food and Drug Administration allowed abortion medication to be obtained via telemedicine and dispensed directly at pharmacies.

Nearly half the country has partially or fully banned abortions. But abortion numbers have risen since before Dobbs, researchers have reported, attributing the increase in part to expanded access to telemedicine abortion and to more people using online abortion clinics that mail abortion drugs from states with so-called shield laws to those with bans.

Anti-abortion groups Susan B. Anthony Pro-Life America and Students for Life of America recently unveiled memos asking the Trump administration to pull regulatory levers that especially target abortion drugs.

Under the U.S. Department of Health and Human Services, regulations could include:

• The FDA reinstating medication abortion restrictions, such as requiring multiple in-person appointments and revoking telemedicine. Or altogether revoking the 2000 approval of mifepristone.

• Reversing guidelines that under the federal Emergency Medical Treatment and Labor Act, emergency departments at hospitals enrolled in Medicare — even in states with abortion bans — must offer pregnant patients the medical treatment necessary to stabilize an “emergency medical condition.” This law is the subject of an ongoing lawsuit deferred by the U.S. Supreme Court earlier this year. In sharp contrast to the mainstream medical community, anti-abortion advocates argue these guidelines are unnecessary and would allow doctors to broadly interpret a health emergency to mean anything.

When asked about stories of alleged denied care, maternal deaths, and doctor confusion related to state abortion bans, Aden chalked up the problem to a misinterpretation of state laws, which he said should be clarified to address these problems, while noting several times, “I’m not a doctor.” Americans United for Life’s recommended health-exception language in part says abortion should be allowed “to preserve the life of a pregnant woman or to address a serious risk of substantial and irreversible impairment of a major bodily function.”

“That’s a health exception with teeth,” Aden said. “It doesn’t allow for a free-ranging, quote unquote, ‘mental health’ exception that would swallow the rule.”

• Funding a study on the potential health effects of abortion pills in the water system from patients miscarrying in their toilets after taking medication abortion drugs. Anti-abortion leaders like Mahoney said they were disappointed with Trump’s pick for HHS secretary, Robert F. Kennedy Jr., who has previously said he supports abortion rights. But Mahoney said he’s hoping to appeal to Kennedy’s skepticism of FDA drug approvals. “How do chemical abortions being flushed down the drain affect our water supply? We’re definitely going to push hard on that,” Mahoney said.

• Revoking a rule requiring health clinics that receive federal family planning Title X grants to offer referrals for abortion clinics, which is also the subject of an ongoing federal lawsuit. It is already prohibited to use federal funds for abortions unless the pregnancy is the result of rape or incest, or has become fatal. Activists also want to defund Planned Parenthood, the largest reproductive health center network, and extend tax credits to anti-abortion pregnancy centers.

Trump’s pick to lead the Centers for Medicare and Medicaid Services, which manages the country’s largest health programs, is Dr. Mehmet Oz, who opposes abortion.

The U.S. Department of Justice could:

• Enforce part of the 19th century Comstock Act to prohibit the mailing of abortion-inducing drugs. Aden said enforcing this law would likely mean cracking down on online abortion clinics like Aid Access.

• Revoke or refuse to enforce the federal Freedom of Access to Clinic Entrances Act,  enacted because of the sometimes-violent anti-abortion protests of the 1980s and 1990s. One of several activists sentenced to prison for staging a clinic blockade in Washington, D.C., Lauren Handy was also involved in obtaining aborted fetuses outside the same clinic. Trump had indicated he would potentially pardon Handy and fellow blockaders. Activists have said they will also ask the DOJ to investigate the doctor at the abortion clinic from where Handy obtained the fetuses, of whom she and other activists have accused, without evidence, of infanticide.

The U.S. Departments of Defense and Veterans Affairs could:

• Revoke policies that expanded abortion access for veterans and members of the Military.

The U.S. Agency for International Development could:

• Reinstate the so-called Mexico City Policy, which barred federally funding international organizations that provide or refer for abortions.

As they brace for the potential impact of Dobbs without a federal safety net, reproductive justice activists are working to expand access and fight anti-abortion laws, while also protecting new state wins. The election results did not change the fact that most people want abortion access, said Fatima Goss Graves, president and CEO of the National Women’s Law Center, during a recent media press briefing organized by the progressive Robert Wood Johnson Foundation.

“Donald Trump won the election, but so did abortion, and people need to hold this incoming administration to its word that it would not restrict abortion,” Graves said. “We have to square the idea that millions of people in the United States voted for reproductive freedom … but they also will be experiencing a situation that will become even more dire, and that people will feel scared and hopeless in this period.”

Arguments for a national abortion ban

Aden said AUL would support a federal “dismemberment” bill, referring to a proposed ban on a common second-trimester abortion procedure known as dilation and evacuation, or D&E. This procedure involves dilating the cervix and removing the contents of the uterus, typically performed beginning around 12 weeks. It would be a way to effectively get a 12- or 15-week ban without calling it that.

Despite its safety and efficacy record, the D&E procedure has been banned in several states, over the objection of the American Medical Association and the American College of Obstetricians and Gynecologists. It’s part of an old anti-abortion playbook, which under Republican President George W. Bush resulted in a federal ban on another later abortion procedure — dilation and extraction, or D&X — by reframing it as “partial-birth” abortion, which the U.S. Supreme Court upheld in 2007’s Gonzales v. Carhart decision.

Abortion foes describe D&Es as a gruesome procedure, or as Aden puts it, “tearing 13-week-old humans apart limb from limb.” Anti-abortion doctors recommend more risky and invasive procedures like C-sections, even when the abortion is medically indicated.

If D&Es are banned, there would be fewer options for later abortions, which are sometimes necessary, said reproductive-health legal expert Rachel Rebouché, dean of Temple University School of Law in Philadelphia. She noted that some of the U.S. Supreme Court justices have indicated support for abortion restrictions for reasons of preserving fetal dignity rather than preserving maternal health.

“That litigation, from the anti-abortion perspective, depends on saying the fetus is a person with rights that attach at a certain point, if not from conception,” Rebouché told States Newsroom. “Dobbs opens the door wide open for those kinds of regulations. … But the question is, is there a role for the federal government to enact a nationwide ban that would curtail the rights of states that have not gone the way of Idaho or Texas or others?”

Aden said that for now AUL will be more focused on the incremental approach to abortion restrictions, as well as calling for expanded child and prenatal tax credits and other social supports. The attorney, who was 11 when Roe was decided in 1973, is expecting another half-century of litigation over abortion with the hopes that one day the U.S. Constitution gives personhood rights to the unborn, regardless of the stage of that pregnancy. Aden said a so-called Human Life Amendment is likely impossible in the near term, needing approval from two-thirds of both houses of Congress. He said U.S. culture is not there yet.

“It would require a cultural sea change in the way that the majority of Americans view human life in the womb,” Aden said. “That’s our second generational goal. Having won our first generational goal of overturning Roe, we’d love to see the day when every life is welcomed and protected in law. And if that’s through a constitutional amendment, then we’re here for that.”

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