The End of Roe v. Wade: What You Need to Know About Abortion Access

Answers to questions about what comes next for reproductive rights from The New Yorker’s writers.
Activist with “My Body My Choice” written on their stomach.
Photograph by Timothy A. Clary / AFP / Getty

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In a decision in the case of Dobbs v. Jackson Women’s Health Organization, the Supreme Court has overturned Roe v. Wade, which established a constitutional right to abortion, in 1973. The majority opinion, written by Justice Samuel Alito, echoed a draft that was leaked at the beginning of May.

The ruling is expected to create a stark divide within the country, with residents of more liberal states retaining the right to abortion and those in conservative states largely losing it. Abortion will be immediately illegal or severely restricted in as many as twenty states, affecting an estimated twenty-five million women of childbearing age. Twenty states—along with the District of Columbia—where roughly twenty-six million women of reproductive age reside, will continue to protect abortion rights.

The ruling is also expected to profoundly affect public perceptions of the Supreme Court. Opinion polls show that a majority of Americans oppose the overturning of Roe. It will also spark an intense political battle, as Democrats push to make the decision a central issue in the midterm elections. The decision could also kick off further political activism from the right. The ruling marks “the culmination of a half-century-long legal campaign singularly focussed on that outcome,” the law professor and New Yorker contributor Jeannie Suk Gersen writes. “And there are signs that, far from being an end in itself, it would launch even more ambitious agendas.”

What will the future of reproductive rights in the United States look like, and what will the political impact of the decision be? Our writers offer answers to urgent questions following today’s ruling.

How will people in states where abortion is outlawed seek care?

Even before the end of Roe, people have been forced to travel significant distances to obtain care. Stephania Taladrid follows the arduous and expensive journey of a fourteen-year-old girl named Laura, who, because of the Texas Heartbeat Act, is forced to travel seven hundred miles with her family from Dallas to New Mexico, to visit what is likely to become among the last remaining abortion clinics in the Southwest. In a dispatch from Illinois, which has been a safe harbor for abortion, Peter Slevin writes about health centers rushing to accomodate a growing number of medical migrants, or “abortion refugees.” And although abortion pills, which can be prescribed by phone or video, offer a path for people who can’t travel, several states have already imposed restrictions on them.

What will conservative activists target next?

Jeannie Suk Gersen writes that the overturning of Roe will “almost certainly fuel the broader fight to get fundamental moral issues out of the realm of federal constitutional rights and under the control of the states.” This effort might target same-sex marriage and other L.G.B.T.Q. rights, contraception, and more.

Why were Alito and his fellow-originalists unable to find any legal basis for abortion in the Constitution?

The “​​opinion rests almost exclusively on a bizarre and impoverished historical analysis,” Jill Lepore notes. It’s not just abortion that the Constitution fails to consider. “There is nothing in that document—or in the circumstances under which it was written—that suggests its authors imagined women as part of the political community embraced by the phrase ‘We the People,’ ” Lepore writes, and adds that, “to use a history of discrimination to deny people their constitutional rights is a perversion of logic and a betrayal of justice.”

How did the current conservative majority on the Supreme Court, including Justice Amy Coney Barrett, get to this point?

“Since originalists maintain that a right to abortion can’t be inferred from the Constitution, the goals of an originalist and an opponent of legal abortion often dovetail conveniently,” Margaret Talbot writes, in a profile of Justice Amy Coney Barrett, whose “personal views on abortion are no mystery.” In 2006, Barrett “signed her name to a newspaper ad that declared it ‘time to put an end to the barbaric legacy of Roe v. Wade and restore laws that protect the lives of unborn children.’ ” And in December, 2021, during oral hearings for Dobbs v. Jackson Women’s Health Organization, Barrett’s questioning focussed on whether abortion was necessary, given “safe haven” laws that allow a person who has just given birth to leave the baby at a fire station or another designated spot.

What are other possible collateral effects of the decision?

“Every year, there are about a million miscarriages in the United States. Under the doctrine of fetal personhood, these common, complicated, and profoundly intimate losses could become legally subject to surveillance and criminalization,” Jia Tolentino writes, about how overturning Roe may strengthen the fight by anti-abortion groups for fetal personhood on the state and federal levels.

Who will decide whether the “life of the mother” is threatened?

Twenty-six states are likely to criminalize abortion, and as many as twenty-two states are likely to enforce felony bans, Jessica Winter writes. These typically include a “life of the mother” exception, but the language of these exceptions varies, and questions such as “What constitutes an ‘emergency’? How does one define ‘substantial’ or ‘reasonable’?” are left unanswered. As one doctor says, “Do I have to watch the patient bleed to death? Do I have to call a lawyer before I save her life?”