Abortion: How the US has fared since Roe v. Wade reversal

One year ago, in June 2022, the Supreme Court overturned a landmark ruling on abortion. Since then, many abortion clinics have had to close. Those seeking safe abortions are now left to travel hundreds of miles.

The landmark Roe v. Wade ruling of 1973 gave pregnant people in the US the right to decide themselves whether to have an abortion up to the 24th week of pregnancy.

But in June 2022, the Supreme Court, which since Donald Trump's presidency has a conservative majority on the bench, overturned the decision. The highest court in the land gave back jurisdiction in this issue to the 50 federal states — a shock for all those who in principle are in favor of the right to abortion. And, according to surveys, those people make up a constant majority of Americans.

It is true that even before this reversal, there had been a decades-long "culture war," with US states interpreting Roe v. Wade according to whether they had liberal or conservative governments — something that led to a patchwork of different abortion rules. But the removal of the basic right to terminate a pregnancy has caused an even higher degree of polarization, and made it possible to introduce yet stricter restrictions on abortion, or absolute bans.

A country drifting apart

Nicole Huberfeld, a professor of health law at Boston University who is also co-director of a reproductive justice program there, says that "[t]he difference was that states always had to be mindful of the line of viability, the time at which a fetus would potentially be viable outside of the womb, outside of a pregnant person's uterus. [...] And if the state law outlawed abortion before 24 weeks, approximately, of pregnancy, then the federal court would say: 'Well, this is a pre-viability law. We're going to strike it down,' and that law would have no effect."

She says that this "guardrail" was really important, including for the legal security of doctors who carry out abortion. But, she says: "Now that guardrail does not exist anymore."

The US Guttmacher Institute, which does a lot of research on the issue of abortion, has drawn up a map showing, in seven gradations, how restrictive or liberal the rules on abortion are in the individual states. Of the 50 in total, 13 are dark red and thus highly restrictive. In these states, abortions are more or less forbidden.

Conservative, highly religious states such as Texas, Tennessee or Mississippi already had strict rules for those with unwanted pregnancies and people providing the relevant medical services. They and the other states marked dark red on the map had prepared "trigger laws" — laws banning abortion that would automatically go into force if there were a new ruling at the federal level, which came in 2022.

Long trips for those seeking abortions

One person who knows from personal experience how difficult the additional hurdles to getting an abortion can be is Sarah King. In 2006, at the age of 17, she had an abortion in Alabama.

"The guy I had been seeing broke up with me, told me it wasn't his baby," she says. "It was a very difficult decision. Basically, I would have been stuck in the small town that I was in. I would end up having to give up my scholarships because I wouldn't be able to start [to study at university] immediately."

At the time, abortions were, in principle, still possible in Alabama. But there were still restrictions, such as requiring people to go to an abortion clinic first for information before coming back 24 hours later to have the procedure carried out — something that is no trivial matter when there are so few abortion clinics and people have to travel long distances to get to them. King says that at the time there were three in the entire state, meaning that she spent the night at the clinic in Montgomery where she had the abortion done.

Far-reaching consequences

The complete bans on abortion in some states makes the problems caused by the lack of adequate medical care in parts of the US even worse, says Huberfeld.

"What we're starting to see is that physicians are actually moving to abortion-protective states," she says. Huberfeld believes that "[w]e may start to see some real shifts in terms where access to care generally exists in the United States."

There is some comfort for those who defend the right to abortion: Some Democrat-ruled states have stepped up their efforts in the opposite direction as a kind of countereffect. For example, they have enshrined in their constitutions the individual freedom to decide whether to have an abortion, or now provide more financial assistance for terminations of pregnancy. California, Michigan, Minnesota, New York and Oregon, for instance, even reimburse people for travel costs if they come to look for abortion clinics.

The reversal of Roe v. Wade has exacerbated the conflict between liberal and conservative states and caused great instability and confusion, says Huberfeld.

"There's also conflict between the states and the federal government over things like the Emergency Medical Treatment and Labor Act. That makes it so that hospitals have to provide emergency care regardless of the state law," she says.

Loss of physical autonomy

Sarah Kind says that the overturning of Roe v. Wade made her extremely angry and that she has taken part in pro-choice demonstrations as well as spoken at them herself.

"It's really scary because I feel like as a woman, I don't even have control over my own body ... It's OK that your religion or spirituality guides you through life. But it should not dictate what is done to other people," she says.

The ruling last summer also attracted great international attention and met with criticism from many countries and governments. But some countries, such as Poland, saw it as validating its own restrictive abortion rules.

Christina Rosero, the senior legal adviser for Latin America and the Caribbean to the NGO Center for Reproductive Rights, has been closely following events in the US.

"What happens in the United States is always a global reference, but a year after this event we can say that the historic legal guarantees we have achieved for access to abortion in Latin America are still in place," she says. "It should not lead us to think, from a colonialist vision, that the advances achieved in the Global South are vulnerable because of what happens in the North."

However, she also says that "[w]hat happened in the US tells us that we cannot simply take for granted the rights we have won. It is a warning that should encourage us to keep up the historical legal and political struggles."

Moira Donegan writing for The Guardian says  "Women experiencing miscarriages now wait around in emergency rooms and parking lots, unable to receive treatment until they sicken to the point where sufficiently brutal health outcomes (life-ending or life-altering, depending on the state) become a certainty. Other women, and no small number of girls, now gestate and give birth to infants conceived by their rapists – their coaches, abusive boyfriends, acquaintances, priests, fathers."

"Public opinion polls show the public supports legal abortion. The Dobbs decision has been cited as a major reason for Republicans' underperformance in the 2022 congressional elections, when the Democrats won the Senate and lost fewer seats in the House of Representatives than expected," a Reuters report states.

In an article entitled "One year, 61 Clinics", The New York Times has put together a list of abortion clinics across the United States that had to either move or permanently shut shop. The report demonstrates the changing landscape of the country through a photo-gallery of these abortion centres.

"In Milwaukee, this former clinic is for sale for $1 million. The real estate agent says he’s had a hard time finding buyers. Elsewhere, patients still show up, knocking on closed doors. CeeJ, 20, who asked to be identified only by her first name, recently stopped by a shuttered Montgomery, Ala., clinic because she could not afford $50 for emergency contraception at Walmart," the report states.

With inputs from DW