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Despite strong support for abortion rights on Election Day, the landscape of abortion access in the United States will not change immediately. And in President Donald Trump's second term, it remains highly fragmented — and vulnerable to future bans.
Voters in seven states – Arizona, Colorado, Maryland, Missouri, Montana, Nevada and New York – passed ballots this week in favor of abortion. About one-fifth of abortions in the U.S. — an average of about 19,000 each month — occur in those states, according to the Family Planning Society.
In most of those states — Colorado, Maryland, Montana, Nevada and New York — abortion is already legal, and ballot measures would preserve access by enshrining the right to abortion in the state constitution.
In only two states have voters approved measures to expand access to abortion: Arizona, which currently has a 15-week pregnancy limit, and Missouri, which currently bans abortion. The measures in both states allow the right to abortion to be regulated in the state constitutions until the fetus is viable, which doctors say is between 22 and 24 weeks of pregnancy.
It remains to be seen what practical changes these new methods will mean for women seeking abortions.
However, “adding constitutional protections does not automatically remove restrictions or limitations; Litigation is often necessary to overturn existing state laws; Guttmacher InstituteA research and policy organization focused on sexual and reproductive health that supports abortion rights.
On Wednesday, two providers of Planned Parenthood in Missouri They filed a lawsuit. To restore abortion in the state.
Still, it will take time to raise the resources to support broader access, experts say.
“We don't know how quickly clinics in the state will expand their services even after they get the legal green light to extend their limits,” said the University of San California professor. Dr. Ushma Upadhyay said. Advancing Francisco's New Standards in Reproductive Health.
Even before the Dobbs decision, there were no abortion providers in Missouri, so a new clinic had to be established. But greater access “could have a beneficial effect,” she said.
“Right now, our best estimate is that about 13,000 people in Missouri are getting abortions every year — through out-of-state trips or telehealth prescriptions,” said Upadhyay, who also co-led the #WeCount project. Family Planning Association, which tracks abortion trends in the US. “So there really is a lot of unmet need for abortion care in the state of Missouri.
The impact in Arizona may not be as big in terms of volume, but it's no less important, Upadhyay said. And expanding that reach by repealing the pregnancy limit would require time and resources to train more providers on second-trimester abortion.
More than 171,000 people traveled to a different state to get an abortion last year, according to Guttmacher data, and expanding access in Arizona and Missouri could help reduce barriers for women in other states. Most abortions provided in Arizona are provided to out-of-state patients, and Missouri borders several states with a ban.
Broad limitations remain
Even though ballot measures in Arizona and Missouri improved access in those states, 40% of women of reproductive age — more than 26 million women ages 15 to 44 — still live in states with abortion bans or restrictions.
And abortion measures failed to pass in three other states with bans: South Dakota, which currently has a total ban; Nebraska with a 12-week pregnancy limit; and Florida, where stricter policies have already echoed across the wider region and across the country.
It was Florida. A key abortion access point In the years since the United States Supreme Court's Dobbs decision struck down federal abortion rights in 2022 for the South. In the year By 2023, more than 1 in 10 abortions in the U.S. will occur in Florida, with thousands traveling from other states, Guttmacher estimates.
But when the state's more restrictive abortion policy went into effect in May — limiting abortions after six weeks of pregnancy, before most women know they're pregnant — abortions in Florida have been on a monthly basis. A reduction of more than 30% And the national abortion rate has also fallen.
Advocates had hoped Tuesday's ballot measure would help close some of the gaps that created a six-week moratorium, but the measure fell three percentage points short of the 60% support needed to pass.
“Like many Americans, Floridians are living under the ban on abortions they didn't ask for and don't want. As the majority of Florida voters made clear tonight, they want their reproductive freedoms back,” Nancy Northup, president and CEO of the Center for Reproductive Rights, a legal advocacy group, said in a statement Tuesday.
But because of the high 60% threshold and the state's disinformation campaign, fear, uncertainty and denial of care must continue to be fueled by a coup. There are also countless women in the southeastern US, which for now remains a virtual abortion desert.
Florida Physicians Oppose Amendment 4, Florida Ob-Gyns Group Votes Against the Ballot he said. The proposal's defeat did not have “maternal health and safety regulations,” which it called a “victory for women.”
Now we physicians can stay true to our Hippocratic principles of doing no harm to our patients,” says Dr. Cristina Pena, who practices in Miami and is a member of the team. press release
Florida's 6-week moratorium on the Tampa Bay Abortion Fund, which helps cover the costs of local abortions and those who have to travel, has led to an increase in the number of callers seeking help — a 26 percent jump. Average amount promised per caller.
“While we and abortion funds around the state are doing our best to fill the gaps, our needs are currently outstripping our resources,” Bree Wallace, director of case management for the Tampa Bay Abortion Fund, said in a statement this week. “Without funding, people can't afford their appointments or travel to them, forcing them to continue or risk pregnancies they don't want.”
It is unclear what the new Trump administration's strategy will be on abortion. Trump said during the campaign. Federal abortion ban But if selected His places The subject has changed many times over the years.
Despite bans and restrictions in more than 20 states in the years since Dobbs, the number of abortions in America has continued to rise. But the main reason for raising these numbers – the increase in medical abortions, especially those provided by telehealth – is probably the most vulnerable to change.
More than half of all abortions in the US are medical abortions, and about 1 in 5 women who have an abortion receive their pill in the mail. This spring, nearly half of all telehealth abortions — or about 1 in 10 abortions overall — were performed by women living in states with abortion restrictions or shield laws, according to #WeCount data. Shield laws provide certain legal protections for providers who practice in some states where abortion is legal, or who live in states with restrictions or bans, to order medication abortions via telehealth.
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Medical abortion has faced intense litigation, with the Supreme Court ruling this June to ban the abortion pill mifepristone. But there are a few ways that could change under the incoming administration.
For example, new leadership at the US Food and Drug Administration may implement regulations that limit access to the drugs. Or, the administration could enforce a different interpretation of the 19th-century Comstock Act, which prohibits the mailing or mailing of any abortion-related material as obscene.
“Donald Trump's re-election poses new and serious threats to the safety of those in need of reproductive health care. This result reflects a serious failure of science-based medical care in a country where many live in reproductive health deserts.” Dr. Daniel Grossman, ob-gyn and director of the University of California, San Francisco's New Standards in Reproductive Health, said in a statement.
“We've seen firsthand how previous Trump-era policies undermined patient care, leaving many without access to essential services that protect births, health and life. We need health decisions to prioritize science and patient safety over political agendas to make the future safer for everyone.