Note: This explainer is an overview on the landscape of the Dobbs v. Jackson Supreme Court decision. As this legislation shifts on a daily basis, we will make every effort to keep this as current as possible with information and resources. For more regular updates as abortion legislation changes in states that are still vulnerable across the U.S., follow this interactive map at The New York Times. For how you can help your local abortion fund, stay updated at National Network of Abortion Funds here.
In a 5-4 decision on June 24, the United States Supreme Court overturned Roe v. Wade, the 49-year-old landmark case that established that the U.S. Constitution provides the right to privacy to anyone who wants to receive an abortion. The court’s decision on the Mississippi case Dobbs v. Jackson Women’s Health Organization held that the Constitution does not guarantee the right to an abortion, which overturned both Roe and Planned Parenthood v. Casey, the 1992 case that established the “essential holding” of Roe.
This decision officially turned over abortion access to the states; nearly half of the states in the U.S. have restrictions or trigger bans that automatically made abortion illegal. Despite Kansas’s victoy for abortion rights, by the time of the August 2 primary, 10 states had fully banned abortions, with Wyoming, West Virginia, Idaho, Tennessee, Arizona, and North Dakota with either impending or temporarily blocked bans.
On July 8, President Biden signed an executive order to safeguard some rights to abortion in the U.S. The executive order does the following, according to a statement from the White House:
“President Biden has made clear that the only way to secure a woman’s right to choose is for Congress to restore the protections of Roe as federal law. Until then, he has committed to doing everything in his power to defend reproductive rights and protect access to safe and legal abortion,” the statement reads.
Since June, abortion has been on the minds of voters across the U.S.—especially those whose states saw the overturn of Roe as the cue to further rollback abortion rights. And they should be concerned: According to the Society of Family Planning’s Oct. 28 #WeCount report of the nationwide abortions since SCOTUS’s decision, legal abortions in the U.S. have fallen by more than 10,000, or about 6 percent. Ahead of the midterm elections on November 8, and according to a Gallup poll, the issue ranked second as the most important on ballots this year, with the economy taking the lead.
Forty-two percent of voters said abortion was “extremely important,” compared to 49 percent of voters who ranked the economy in the same category. Gallup notes that four in 10 voters rank abortion and crime as having the same importance. Voters valued both issues ahead of both gun policy and immigration, which rank third and fourth on the list, respectively.
And, it turns out, abortion is what stopped the predicted “red wave” from sweeping at midterm elections on November 8. Per Politico, young voters of color came out in strong numbers to elect pro-choice leaders in key states. Voters also voted to expand abortion protections in Vermont, Michigan, and California.
“There are lessons here for 2024 that I hope the administration will take to heart,” Morgan Hopkins, the leader of All* Above All, an abortion-rights advocacy group, told Politico. “We showed up, especially young voters of color, in record numbers. Now, we need these elected officials to show up for us.”
After the Supreme Court decision, the effects were immediate across states with “trigger bans,” or laws that immediately outlawed abortion upon Roe’s demise. On June 26, two days after the Dobbs decision, a nurse named Ashley shared a tweet from her friend Lex, a fellow nurse, who shared her story of how pregnant people in states where abortion is banned are already in danger.
Lex shared that, after the trigger law went into effect in her state, she had a pregnant woman come in with an ectopic pregnancy, which means that the fertilized egg implants and grows outside the uterus, often in the fallopian tubes. A fetus does not survive this pregnancy. Lex said that, before her team could take action, they had to call legal counsel and make sure providing care would not cost them their medical licenses. By the time they could treat the woman, her fallopian tube had ruptured, she had dangerous amounts of blood in her abdomen, and almost died.
In Missouri, the first state to ban abortion upon the Dobbs decision, there is a medical exception to the total abortion ban. The state defines this emergency as “serious risk of substantial and irreversible physical impairment of a major bodily function.”
Dr. Jeannie Kelly, a Washington University OB-GYN, told St. Louis on the Air that the definition is not clear enough and could cause real problems for providers who are trying to save their patients’ lives.
“Medicine, in general, is not really black and white in many circumstances,” she said, before continuing. “There are many clinical situations that we are concerned [about]. The law is vague, and the law is not well defined [regarding] these trickier situations where we're not sure: ‘Is this a medical emergency? Does it qualify as an exception to this abortion ban? Or would we be risking our licenses and we'd be risking jail time if we perform the abortion in this circumstance?’”
There has already been a report that OBGYNs in the state are being told to observe patients with ectopic pregnancy but wait to take action until they have “a documented falling hemoglobin or unstable vital signs.”
This week, a 10-year-old abuse survivor in Ohio had to travel to Indiana to receive an abortion because she was six weeks and three days pregnant. Following the Supreme Court’s decision on June 24, Ohio’s law banning abortion after six weeks took effect immediately.
The 10-year-old was referred by a child abuse doctor in Ohio to Dr. Caitlin Bernard, who was able to provide her with care in Indiana. Bernard told the Cincinnati Enquirer that though she was able to help this week, she knows her window to do so is closing.
“It’s hard to imagine that in just a few short weeks we will have no ability to provide that care,” she said, referring to the Indiana legislature’s plan to call a special session in late July to further restrict abortion beyond its current 22-week ban.
These stories are examples of difficulties healthcare providers and pregnant people faced in the first 10 days since Roe was overturned.
In the days, weeks, and months following the Supreme Court’s decision, Americans will and should expect to see more restrictions on abortion at the state level. By the first full week of July, there were eight states—Michigan, Iowa, Kentucky, North Carolina, Georgia, Louisiana, Arizona, and Nevada—where abortion bans had been blocked by the court, which means they remained vulnerable to any future legislation. Michigan voters voted to make abortion rights part of the state constitution, preventing a 1931 law, that would have banned abortion with no exemptions for rape or incest from going into effect. Mississippi’s trigger law went into effect on July 7. Judges in Wyoming and North Dakota’s have temporarily blocked trigger bans.
Politico’s map gives state-by-state updates here.
Although it’s clear that things will get worse on the state level across the country, state leadership in key blue states are working to expand abortion access. In New York, for example, the Reproductive Health Act, which was enacted in January of 2019, expanded and decriminilized abortion, and eliminated several restrictions of state law.
Ahead of the Dobbs decision, the state fortified laws when Gov. Kathy Hochul signed a package of bills that would help to protect those providing and seeking abortions in the state from out-of-state legal action.
“We’ve already seen the threats of anti-abortion violence, and the climate out there is just getting more extreme every single day, and it’s only going to get worse,” Hochul said upon signing the protections, per Politico. “So we need to be ready for that as well. So that’s what we do here in New York. We don’t talk. We act. We don’t follow. We lead. We don’t wait. We get to work.”
On June 24, the governors of Washington, California, and Oregon issued a multi-state statement in which they committed the West Coast to being a “safe haven for all people seeking abortions and other reproductive health care services.”
On July 5, Maine’s governor, Janet Mills, signed an executive order to further protect abortion access in the state. The Order does the following, according to the website for the office of the governor:
These are just examples of current leaders who are making moves to safeguard access in their states for anyone seeking abortion care. Republican governors in four blue states—Massachusetts, Maryland, New Hampshire, and Vermont—have also said they will uphold abortion rights in their states.
Stay posted on your state’s legislation, your midterm voting registration deadlines, and where you can contact your state representatives to express your concerns.
OBGYN Colleague in Missouri “We are now observing patients with ectopic pregnancy and hemoperitoneum until they have a documented falling hemoglobin or unstable vital signs”
— Jane van Dis MD (@janevandis) June 28, 2022
1:50 pregnancies is ectopic pic.twitter.com/HwYEMz67su
On August 25, trigger laws took effect in Tennesse and Texas that banned abortions with no exceptions for rape and incest. On August 24, one day before a total aboriton ban was supposed to take effect in Idaho, Judge B. Lynn Winmill, a federal judge, enacted a preliminary injunction on part of the ban.
Winmill ruled that providers could not be criminalized for protecting the health of the pregnant person, which is required by the Emergency Medical Treatment and Labor Act. The rest of the trigger law, which put a near-total ban on abortion, reamains in effect. This follows the Justice Department’s lawsuit of the state over its strict law and is a small win for the Biden administration’s efforts to protect pregnant people and abortion providers.
“It’s not about the bygone constitutional right to an abortion,” Winmill wrote. “The court is called upon to address a far more modest issue—whether Idaho’s criminal abortion statute conflicts with a small but important corner of federal legislation. It does.” Per The New York Times, the pause on criminalizing providers will stay in effect until the DOJ lawsuit challenging the law is settled.
The Supreme Court’s decision is already having an effect on lawmakers who are using the momentum of this event to pass restrictive laws.
On August 5, Indiana became the first state to pass a ban on abortion that was not triggered by the overturn of Roe v. Wade. Other states, such as Missouri, banned abortion based on laws that would automatically overturn the right to abortion based on the outlaw of Roe.
The Indiana law will take effect on September 15 and has exceptions for rape and incest and lethal fetal anomalies, as well as if the pregnant person’s life is at “serious risk.” As providers have pointed out in the past few months, language in laws like this can prove to be too vague and puts them in a vulnerable position during emergencies.
After Roe was eradicated, Republican Gov. Eric Holcomb said he would support legislation that would “protect innocent life” but did not detail the steps he would take to do so. In early August the Indiana state House passed the bill 62-38 earlier, and the Senate 28-19.
“Following the overturning of Roe, I stated clearly that I would be willing to support legislation that made progress in protecting life,” Holcomb said in a statement, per The Indianapolis Star. “In my view, [the bill] accomplishes this goal following its passage in both chambers of the Indiana General Assembly with a solid majority of support. These actions followed long days of hearings filled with sobering and personal testimony from citizens and elected representatives on this emotional and complex topic.”
In a statement following the passage of the bill, White House Press Secretary Karine Jean Pierre wrote, in part:
“Yesterday’s vote, which institutes a near-total abortion ban in Indiana, should be a signal to Americans across the country to make their voices heard. Congress should also act immediately to pass a law restoring the protections of Roe — the only way to secure a woman’s right to choose nationally. Until then, President Biden is committed to taking action to protect women’s reproductive rights and freedom, and access to care they are afforded under Federal law.”
Indiana providers are now at greater risk as a result of this new law. Caitlin Bernard, who spoke out about providing the abortion for the 10-year-old girl from Ohio, told The New York Times.
“Physicians who provide abortion have been harassed, they have been murdered,” Bernard said. “And for too long, I think, because of that, they’ve had to be silent to protect their families, and it’s created an idea that we’re doing something wrong or something illegal. And we’re not. And I feel compelled to say that.”
Bernard added that she takes the biggest risk outside of the hospital, when she is advocating for abortion rights publicly.
To help people in Indiana who need abortions, you can support the Hoosier Abortion Fund, which is open to all residents of Indiana, “regardless of age, income, insurance, or immigration status.”
For some states, the restrictions don’t stop post-Roe trigger bans. On August 27, an Oklahoma law that would charge abortion providers with up to 10 years in prison or fines up to $100,000 went into effect. Before this, Oklahom’s trigger law had already banned abortion at the point of conception.
In the wake of Roe’s demise, the majority of American voters have made it known that they are not aligned with the Supreme Court’s decision. In a May 2022 survey from the Pew Research Center, 61% of Americans polled said that abortions should be legal in all circumstances. In further affirmation of this data, a July Kaiser Family Foundation poll found that 73% of American women between the ages of 18 to 49 say abortion is “very important.” In February of this year, 59% of the same group answered “very important.” The foundation also notes that six in 10 women voters between the ages of 18 and 49 also said they were “more motivated” to vote because of the Supreme Court’s June 24 decision to overturn Roe.
As a real-life reflection of this poll, on August 2, voters in Kansas voted overwhelmingly to preserve abortion rights in their state’s constitution. This follows misinformation associated with the proposed "Value Them Both" amendment, which abortion advocates argued would have paved the way for a total ban on abortion in the state, whose neighbor to the East, Missouri, was the first trigger state to ban abortion upon the overturn of Roe.
“The voters in Kansas have spoken loud and clear: We will not tolerate extreme bans on abortion,” Rachel Sweet, the campaign manager for Kansans for Constitutional Freedom, told The New York Times.
In addition to voting and advocating for pro-choice candidates in your state and at your local level, you can:
Hilary Weaver is a writer and editor based in New England. Her work has been published in The Cut, ELLE, Vanity Fair, Refinery29, Esquire, Cosmopolitan, The Nation, and more. She has covered reproductive rights both as a writer and as a fact-checker and researcher since 2015.