Updated on December 10, 2021:
This resource has been adjusted to indicate that the United States Supreme Court heard oral arguments on the constitutionality of Mississippi's 15-week abortion ban.
First published on November 22, 2021:
In January 1973, the U.S. Supreme Court ruling in Roe v. Wade affirmed the constitutional right to abortion. Since then, Roe has been used as shorthand for federal protections of abortion rights.
Today, the abortion policy landscape in the United States is shifting in major ways.
Whether you’ve been covering abortion policy for years or are new to the issue, here are 15 key ideas to consider as you write about the future of abortion rights in the United States.
1. At the end of 2021, the Supreme Court heard oral arguments in a case that could roll back generations of abortion rights in the United States.
- On December 1, 2021, the US Supreme Court heard oral arguments in Dobbs v. Jackson Women’s Health Organization, a case on the constitutionality of Mississippi’s 15-week abortion ban that will address whether a state can ban abortion before viability (generally 24–26 weeks of pregnancy).
- The fact that the Supreme Court is taking this case at all represents a stunning development, but the state of Mississippi has gone even further and asked the Court to overturn Roe v. Wade, the 1973 case that affirmed a constitutional right to abortion.
- It is not a foregone conclusion that the Court will cast aside five decades of precedent to overturn Roe and allow states to ban abortion. However, by even accepting the case, the Court has signaled that it is willing to revisit the legality of abortion.
- Furthermore, the Court’s decision to repeadly decline to block an unconstitutional six-week abortion ban in Texas (S.B. 8) may indicate the Court’s intent.
2. Today, abortion is a widely shared experience in the United States.
- People of all different ages, races and religions have abortions in the United States.
- In 2017, about 860,000 abortions were provided in clinical settings in the United States.
- Guttmacher analysis shows that abortion restrictions were not the main driver of recent abortion declines. Rather, births fell as well, indicating that declines in pregnancy were the main factor.
- Even as the overall number of abortions nationally has declined, use of medication abortion via pills has been rapidly increasing.
- The number of medication abortions increased 73% between 2008 and 2017.
- In 2017, medication abortion accounted for 39% of all abortions in the United States and 60% of all abortions that occurred before 10 weeks’ gestation.
- Beyond its exceptionally safe and effective track record, what makes the abortion pill particularly significant is how convenient and private it can be—and how radically it could expand access to abortion care if freed from politically motivated restrictions. This includes people self-managing their abortion.
3. Even with Roe v. Wade in place, many people are already unable to obtain abortion care.
- People currently face a number of barriers to obtaining abortions, from insurance coverage bans like the Hyde Amendment to forced waiting periods. Overcoming these restrictions, especially when they are layered on top of each other, can be impossible for many people, especially those with the fewest resources.
- In addition, if there are few abortion providers in a state, if abortions are unaffordable or if various logistical barriers make it too difficult to reach a provider or schedule an appointment, then the fact that abortion is “legal” means it is a right in theory but not in practice for many people.
- Today, there are five states with only one remaining abortion provider: Mississippi, Missouri, North Dakota, South Dakota and West Virginia.
4. Six in 10 U.S. women of reproductive age live in states that are hostile to abortion rights.
- Today, in the United States, 29 states have policies that demonstrate hostility to abortion rights and five states are considered middle-ground. At the same time, 16 states demonstrate support for abortion rights.
- Currently, nearly 40 million U.S. women aged 13–44 (58% of the total number in the country) live in states that have demonstrated hostility to abortion rights.
- In contrast, 26million women of reproductive age (almost 38% of the US total) live in states that have demonstrate support for abortion rights, while 2.5 million women of reproductive age (nearly 4% of the total) live in middle-ground states.
- Access to abortion also varies by geographic region. Many of the most hostile states are clustered in the Midwest, the South and the Plains, so a person may not be able to get the care they need even if they travel to a neighboring state.
5. Nearly 50 years of escalating anti-abortion campaigns and policies set the stage for the situation we are in today.
- Between 1973 and October 2021, over 1,300 abortion restrictions were enacted in states.
- Nearly 600 restrictions have been enacted since 2011, showing how the pace of attacks has picked up. In other words, it took nearly 40 years to accrue 56% of the restrictions and only about a decade for the other 44%.
- In fact, over 100 abortion restrictions have been enacted in 2021 alone. This surpasses the count from 2011, previously the worst year on record, when 89 restrictions were enacted.
6. The people most affected by these 1,300+ abortion restrictions are those already facing overlapping systems of oppression.
- Restrictions disproportionately impact those who have limited resources to overcome financial and logistic barriers. This includes young people, people with disabilities, LGBTQ+ people, people with low incomes and those in rural areas, as well as Black, Indigenous and other people of color.
- It’s critical to remember that the majority of people who get an abortion are already struggling to make ends meet: Some 75% of abortion patients have low incomes and the majority are already parents.
- In 2014, Black patients accounted for 28% of abortion patients, Hispanic patients for 25%, White patients accounted for 39%, and patients of other races and ethnicities accounted for 9%. This means the majority of people who have abortions are also facing structural racism that is exacerbated by every logistic hurdle.
7. Abortion restrictions are political tools designed to make abortion harder to access and are not focused on helping people or improving medical standards of care.
- Any one restriction on abortion can pose an undue burden and require patients to jump through hoops and navigate barriers to receive care.
- But rarely is there only one restriction. In 2021, 90% of the enacted restrictions were adopted in states already considered to be hostile toward abortion rights.
- Many states layer restrictions on top of one another, creating a labyrinth of obstacles that research shows creates a compounding effect and negative consequences for pregnant people seeking care.
8. Anti-abortion laws block patients from getting care by intentionally targeting people where they are most vulnerable: finances and logistics.
- Abortion restrictions are typically designed to make it too expensive or logistically challenging for an abortion provider to provide care, or for a patient to obtain an abortion. Other restrictions override providers' medical judgment or intentionally make the experience demeaning or harmful to patients.
- The average cost of an abortion at 10 weeks is around $550, and that cost goes up significantly later in pregnancy. This creates a vicious cycle in which someone might have to delay getting an abortion to raise the needed funds, only to have the cost increase.
- The Hyde Amendment prohibits federal funding for abortion, preventing people enrolled in Medicaid and other public programs in most states from using their health insurance to cover abortion care.
- In addition, 11 states have restrictions that keep people from using their private health insurance to pay for an abortion, and 25 states restrict abortion coverage in plans offered through the Affordable Care Act’s health insurance exchanges.
- If a person has to travel a long way to get an abortion, they may have to arrange for time off work, find and pay for transportation and child care, and pay for food and lodging.
- And in 13 states, the combination of in-person counseling requirements and a waiting period means patients have to make two separate trips to a clinic.
9. Many states supportive of reproductive rights have laws on the books that maintain or expand the right to abortion with or without Roe.
- As states hostile to abortion have become more hostile over the past 20 years, other states have stepped up to support abortion rights and access. State lawmakers can—and must—shore up abortion access in their own states.
- 14 states and the District of Columbia have laws that protect the right to abortion.
- 2 states and the District of Columbia have codified the right to abortion throughout pregnancy without state interference.
- 12 states explicitly permit abortion prior to viability or when necessary to protect the life or health of the pregnant person.
10. The 6-3 anti-abortion majority on the US Supreme Court has signaled that it is ready to strike a blow against abortion rights.
- The record onslaught of new state abortion restrictions in 2021 has been motivated by a recent shift to a much more conservative federal judiciary and a Supreme Court majority that conservatives hope is willing to gut Roe v. Wade or overturn it completely.
- In just four years, then-President Trump appointed more than 200 federal judges—nearly three in 10 of all active federal judges in the United States—and three of the nine justices on the Supreme Court.
- State policymakers are testing the limits of what the new Supreme Court majority might allow and laying the groundwork for a day when federal constitutional protections for abortion are weakened or eliminated.
11. A recent Guttmacher analysis shows that if Roe v Wade is weakened or overturned, there are 26 states that are certain or likely to quickly ban abortion to the fullest possible extent.
- 21 states have laws or constitutional amendments already in place that would make them certain to attempt to ban abortion as quickly as possible. Anti-abortion policymakers in several of these states have also indicated that they will introduce legislation modeled after the Texas six-week abortion ban.
- An additional five states have political composition, history and other indicators—such as recent actions to limit access to abortion—that show they are likely to ban abortion as soon as possible if federal protections are no longer in place.
- In this scenario, there are 36 million women of reproductive age who live in those 26 states, and any who need an abortion would have to travel significantly longer to get out-of-state care.
12. For years, anti-abortion activists have been teeing up blatantly unconstitutional state laws to lie in wait for a day when Roe is gone or drastically undermined.
- With the potential for the Supreme Court to severely roll back abortion rights, anti-abortion policymakers have been enacting a wide range of restrictions in the hopes that these laws will be allowed to go into effect.
- Twelve states have provisions to ban all or nearly all abortions that would be triggered if Roe were overturned: Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas and Utah.
- In addition, four states have passed a constitutional amendment explicitly declaring that their state constitution does not secure or protect the right to abortion or allow use of public funds for abortion: Alabama, Louisiana, Tennessee and West Virginia.
- Eighteen states have passed laws in an attempt to ban abortion at or before 20 weeks: Alabama, Arkansas, Arizona, Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee and Utah. Most of these bans have been challenged in court and are not in effect.
13. Research shows that pregnant people are harmed in many different ways when they don’t have access to abortion care.
- A significant body of scientific literature shows that the adverse consequences of withholding abortion coverage are serious and long-lasting.
- Forcing someone who wants an abortion to continue a pregnancy is tantamount to requiring them, against their wishes, to accept the risks of pregnancy- and labor-related complications, including preeclampsia, infections and death.
- These risks fall much heavier on some communities than others. The United States has the highest maternal mortality rate among developed countries, with dramatic but preventable racial inequities caused by systemic racism and provider bias. Black and Indigenous women’s maternal mortality rates are 2–3 times the rate for White women, and 4–5 times as high among women aged 30–39 than among younger women.
- The risks of serious consequences do not end with a safe delivery. The Turnaway Study by researchers at UCSF found that denying wanted abortion care can have adverse consequences for people’s health, safety and economic well-being.
- For example, among women experiencing intimate partner violence, being forced to carry an unwanted pregnancy to term can delay separation from the partner, resulting in ongoing exposure to violence. In addition, compared with women who get the abortion they seek, women who do not obtain a wanted abortion have four times greater odds of subsequently living in poverty.
- People who are unable to get the abortion they want also have three times greater odds of being unemployed, and they are less likely to be able to have the financial resources for basic needs such as food and housing.
14. Abortion funds and practical support networks already exist and are incredibly important.
- Each time an egregious anti-abortion law makes national news, folks less involved in the abortion-rights movement are quick to propose new support networks (often on social media) for pregnant people who may need an abortion.
- But in doing so, they can actually cause harm and confusion by diverting funds from more than 80 organizations called Abortion funds that already serve at least 50,000 patients annually who need assistance obtaining an abortion.
- In the event that Roe were weakened or overturned, the abortion funds already supporting their communities are best positioned to help patients navigate local and regional barriers.
15. Congress has the tools to put an end to discriminatory state restrictions and let people get the abortion care they need.
- The Women’s Health Protection Act would protect pregnant people’s access to abortion—whether someone lives in California, Texas, Indiana or Maine—by establishing federal statutory rights for providers to offer, and patients to receive, abortion care free from medically unnecessary restrictions and bans.
- The Equal Access to Abortion Coverage in Health Insurance (EACH) Act would lift the discriminatory Hyde Amendment and restore insurance coverage of abortion for people enrolled in Medicaid and other federal programs. This bill is the result of long-standing efforts led by women of color to counter the injustice and discrimination of the Hyde Amendment.