The consequences of ending Americans’ right to abortion

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FOR NEARLY half a century, since the Supreme Court ruled in Roe v Wade in 1973, women in America have had a legal right to abortion—even if lawmakers in many conservative states have done their best to prevent them from exercising it. On May 2nd came the clearest sign yet that the right could soon disappear altogether, with the publication of a leaked draft majority opinion for the overturning of Roe when the Supreme Court rules on an abortion case from Mississippi, Dobbs v Jackson Women’s Health Organisation.

The opinion, published in Politico, a politics website, and written by Samuel Alito, a conservative justice, describes Roe as “egregiously wrong from the start” and says it “must be overruled”. The opinion is dated February and it is not known whether it has changed since then or whether it may yet change. Leaking a draft opinion is an unprecedented breach of Supreme Court protocol and could signal some discord between the conservative justices, or their staffs, about how to rule on Dobbs. (It may alternatively reflect liberal outrage.) The chief justice, John Roberts, called the leak itself “egregious” and has ordered an investigation. He also stressed that the draft decision is not final. The definitive ruling is expected in the next two months.

News of the opinion was greeted with jubilation and horror by activists on either side of America’s long-running abortion war. “Today is a day for courage and hope”, tweeted Americans United for Life, an anti-abortion organisation. Within hours abortion-rights protesters had gathered outside the Supreme Court. Some wept; others swore through a megaphone at Justice Alito. Nancy Northup, the president of the Centre for Reproductive Rights, said overturning Roe would be “the most damaging setback to the rights of women in the history of our country”.

Yet it would not come as a shock. Since Donald Trump assured pro-life voters during his 2016 presidential campaign that Roe would be overturned if he picked “two or perhaps three” pro-life justices—and then went on to appoint three, giving the nine-justice court a conservative supermajority—the end of Roe has looked increasingly likely. The first clear sign of that came in May 2021, when the justices said they would consider Dobbs. It concerns a law, blocked by a lower court, which bans abortion after 15 weeks. Because Roe protects the right to abortion until a fetus is viable, around 24 weeks, upholding Mississippi's law would mean overturning or substantially weakening Roe. Since then, the court’s repeated failure to block a law in Texas that bans abortions from around six weeks of pregnancy, without exceptions for rape or incest, has indicated that the conservative justices do not consider Roe worth upholding.

The repercussions will be momentous. If Roe goes it will be up to the states to legislate abortion, just as it was before 1973. At least 13 states have “trigger laws” that would click into effect the moment Roe is undone; a further 12 are expected to dust off pre-Roe bans or make new ones. That means abortion would become illegal in half of America’s states. Congress is unlikely to pass a law to protect abortion rights. House Democrats have passed a bill that would guarantee them, but it has little chance in the Senate. President Joe Biden suggested as much in a statement on May 3rd in which he urged voters to elect more abortion-rights supporters to Congress.

For women in conservative states, the effects will be dreadful. Restrictions designed to make it hard for abortion clinics to operate already mean many women have to travel across state lines to terminate a pregnancy. That number will grow. It is difficult to predict by how much because new clinics could open near the borders of states that ban abortion, and no one knows how many women will access abortion medication—which enables women to have abortions at home, without the involvement of clinics or doctors. Although at least 22 states have introduced bills restricting the use of medication abortion and, if Roe is overturned more will doubtless follow, it is hard to enforce such laws. Abortion-rights groups are working to inform women that such medication is available, even when it is illegal, and that it is safe and effective.

But this medication can be used only in the first 11 weeks of pregnancy. And some women will continue to need in-clinic abortions. Since clinics in Texas stopped performing most abortions on September 1st, clinics in nearby states say they have been flooded with patients from America’s second-most populous state. Doctors in clinics as far away as Maryland and Washington, DC, say they have seen patients from Texas.

Poorer women will bear the brunt of all this. Federal funds cannot be used for abortion. Planned Parenthood, the biggest provider of abortions in America, says that 75% of patients are on low incomes. Some obstetricians worry that ditching Roe could push up America’s maternal- and infant-mortality rates. Little wonder that within hours of the leak, Women’s March, which in 2017 organised the biggest political protest in American history, had called for supporters to show up in court houses and town halls across America.