State of Abortion on 51st Anniversary of Roe v. Wade - Reproductive Freedom for All

Formerly NARAL Pro-Choice America


State of Abortion on 51st Anniversary of Roe v. Wade

Fifty-one years after the U.S. Supreme Court decided Roe v. Wade, Americans are being forced to reckon with the nightmarish state of abortion access in the United States with twenty-one states having eliminated or restricted access because of abortion bans, and the very real, and often life-threatening, consequences of bans and restrictions across the country. Since Roe was overturned in 2022, anti-abortion extremists and their Republican allies have engaged in a race to the bottom, clambering to pass cruel bans in the face of near-constant reports of the harm these bans cause to pregnant people and families. Regardless of claims of “moderation,” exceptions, or compromise, Republicans and anti-abortion extremists are working in lockstep to pass a national ban. This extreme agenda to ban all abortion is made worse by the fact that it is fundamentally out of step with what the vast majority of Americans want, including most Republicans.

The Irony of Exceptions 

Republicans continue to make attempt after attempt at covering up the very real and dangerous impact of their bans. The reality is that their abortion bans with or without so-called exceptions—which we know are in name only—do exactly what they were intended to do: stop women and pregnant people from accessing the care they need, regardless of the horrific, and often deadly, impacts on their bodies, families, and futures.

Any supposed exceptions inserted into these extreme abortion bans were never intended to account for the life-threatening emergencies pregnant people face– they were meant to earn support from lawmakers and lull voters into thinking that, if they really needed an abortion, they could get one.

But horror story after horror story since Roe fell has exposed the truth. And the response from Republicans? Further challenges in court to make sure they can deny necessary, life-saving exceptions and continue to put pregnant people at risk of death. After a judge granted a Texas woman, Kate Cox, an exception to the state’s abortion law, which was essential to protect her life and health due to a lethal fetal condition, Texas Attorney General Ken Paxton said he would still prosecute any doctor in the state who performed an abortion. Paxton went even further to make sure Cox would not get the care she needed and sent a letter threatening the hospitals and their staff with legal action if they provided Cox abortion care.

When Roe was first overturned in June 2022, the U.S. Department of Health and Human Services (HHS) issued guidance to hospitals that under the Emergency Medical Treatment and Active Labor Act (EMTALA), emergency care protected under the act included abortion care. The guidance reiterated that health care providers at hospital emergency rooms must provide abortions when they are necessary to stabilize a patient because federal law overrides state abortion bans when they conflict. Despite attorneys for the federal government arguing that EMTALA protects the right to abortion in these life-saving situations, even in states with strict laws around the procedure, conservative judges have rejected these arguments, setting up a crucial battle for reproductive freedom at the Supreme Court. Republicans and their unaccountable, unelected allies on the bench continue to fight against providing life-saving care for countless patients.

GOP Consensus: Criminalization over compassion

Staring down the reality that abortion bans are backed by only nine percent of Americans, Republicans continue to falsely claim that they’re in search of a “reasonable compromise.” Still, when it comes to the policies they’re passing and the steps they’re taking to enforce them, it’s crystal clear that they are more extreme than ever.

Republicans have stacked the courts with judges who believe–and rule accordingly– that pregnant people should die rather than access fundamental reproductive health care. Desperate and out of step with the vast majority of Americans, they are increasingly relying on those judges to reaffirm that belief and circumvent the will of the people. Attorney General Paxton notably fought to make it clear that the so-called exceptions included in Texas’ abortion ban would not apply in cases like Kate Cox’s, forcing her to travel out of state for abortion care after her non-viable pregnancy continued to threaten her life.

These extreme efforts to criminalize abortion don’t stop at doctors and medical providers. Anti-abortion extremists are going out of their way to punish pregnant people for pregnancy outcomes–even those outcomes caused by their very own policies. Take the case of Brittany Watts in Ohio.

Watts was arrested in October 2023 after she miscarried a nonviable fetus at her home. Watts was initially admitted to a religiously affiliated hospital in Ohio when she had severe complications and faced significant risk of death, sepsis, and other life-threatening issues. During that first visit, Watts decided to leave after waiting eight hours for a hospital ethics panel to determine if they could intervene without facing legal repercussions due to Ohio’s extreme abortion restrictions. She returned the next day with the same symptoms and again was forced to leave without receiving treatment, later miscarrying at home. The hospital provided follow up care but then reported Watts to the police. Watts was charged under a decades-old law for “abuse of a corpse” by the prosecutor’s office, but the grand jury ultimately decided not to charge her. This one particularly horrific case is indicative of a larger appetite from Republicans to criminalize pregnant people and their health care providers. The cruelty is the point.

Voters At Odds Republican Politicians

Poll after poll and election after election has shown that voters–across party lines and geography–overwhelmingly support reproductive freedom and access to abortion care. But Republicans have stacked the courts–all the way up to the Supreme Court–with extremist judges whose rulings have flown in the face of public opinion. Now, the nation’s highest court will hear a case that could impact access to medication abortion and another case that could affirm a state’s right to allow pregnant people to die by permitting states to deny life-saving abortion care.

Republican politicians and their activist judges are poised to wreak even more havoc on reproductive freedom in 2024. In December 2023, the Supreme Court agreed to take up a case brought by anti-abortion extremists over medication abortion, the most common method of abortion in the United States. This case has the potential to impact 64.5 million women of reproductive age if the Supreme Court sides with extremists and reinstates medically unnecessary restrictions that would roll back access, even in states where abortion is legal. This would have devastating effects in a landscape where Republicans are working overtime to push abortion care further out of reach.

In January 2024, the Supreme Court allowed Idaho to enforce its strict abortion ban after the Biden administration gave guidance in 2022 that reiterates federal requirements for emergency room doctors to provide care to stabilize patients, even in states where abortion is banned. The guidance is being challenged by several states, including at the Supreme Court by Republicans in Idaho who want to continue enforcing a law that makes it a crime to perform an abortion unless a doctor can show the patient’s life is at stake. Idaho Republicans are fighting to ensure doctors can’t perform abortions in cases where the patient’s health is in “serious jeopardy” or faces other serious complications, in conflict with federal law. This also creates a culture of fear around providing abortion care, exacerbating the problem further. If these Republican extremists and their allies on the bench get their way, pregnant people facing emergencies won’t have access to potentially life-saving abortion care.


Republican politicians don’t want to admit it, but their actions make their endgame clear: they want to ban all abortion, everywhere, for any reason–even if it means that you will die as a result. With the Supreme Court set to decide two cases of incredible consequence in the coming months, the potential harm from abortion bans and extreme enforcement is incalculable.

We can, and we will, fight back. There are small actions each and every one of us can take to protect and expand access to abortion care in our communities and beyond: registering to vote, talking to our families and friends about what’s at stake, and sharing information from trusted sources on our social platforms to activate the power of our networks. That’s how we change the state of abortion care in America to fulfill the promise of Roe and restore our rights.