In her lifetime, nearly one out of three women will have an abortion. As Renee Bracey Sherman puts it, “Everyone loves someone who has had an abortion,” whether you know it or not. The statistics show the likelihood you love someone who has had an abortion are exponential. The US, for years, has decreased the availability of abortions for women, but the reality is that President Donald Trump’s second administration has already made changes to further restrict the opportunities for women to receive reproductive healthcare. Looking at the intentions of the Republicans, they seem to aim to restrict or even completely ban, abortion. As of December 2024, 12 states had total abortion bans and a further six had low gestational limits [between six and 12 weeks since the last menstrual period]. There is a harrowing truth here: The US already has severely restricted access to abortions and with further plans to revive and strengthen abortion regulations which already exist, women should be scared. 

The present vs. the past 

Newly appointed Health Secretary Robert F Kennedy has stated that his work on abortion and reproductive healthcare for women would fall in line with the Trump administration’s goals. Such goals are clearly aligned to the anti-abortion movement, with Vice President J.D. Vance making a commitment to fighting for the “unborn.” The Trump administration has also already removed ReproductiveRights.gov almost immediately after his inauguration. Although Trump changed his stance on abortion in the lead-up to the election, Trump changed his stance on abortion, it remains pretty clear that Trump is anti-abortion. He, himself, orchestrated three Supreme Court justices to deliver on his 2016 promise to overturn Roe v. Wade and expressed his desire to use the Dobbs v. Jackson decision to “monitor pregnancies and prosecute women for obtaining abortions.” 

In 1821, Connecticut is credited with the first codified ban on abortion. Since this point, the legal scope of abortion has changed dramatically, with big decisions, such as Roe v. Wade and Dobbs v. Jackson typically leading the narrative. There are innumerable cases and legal decisions, both nationally and on a state level, which scope the landscape of abortion today, but the discussion below mainly focuses on three methods by which abortion has already been restricted and the Trump administration could further restrict. Firstly, there are logistical issues, which limit physical access to abortion. Where can you get an abortion in the US and how has this been restricted? Closely linked are the financial restrictions placed on both healthcare providers and the women seeking abortions. What ties this all together is clearly the law and the legal ways in which both the logistical and financial restrictions are created and the larger legal landscape of abortion in the US.

The legal landscape 

Arguably the most important decision in the US abortion debate is the Roe v. Wade judgement in 1973. The Roe ruling found that the constitution’s 14th amendment, which includes the right to “liberty,” included the right to choose not to continue a pregnancy. Roe placed a federal and constitutional right to abortion across the US. Although, of course, it would be injudicious to suggest the judgement made abortion access easy, Roe did recognise a right to choose and solidified this in the constitution. 

In 2022, the Dobbs v. Jackson ruling essentially obliterated the ruling in Roe v. Wade. The ruling found that there was no constitutional right to abortion, which paved the way for states to regulate their own abortion laws and even completely ban access to abortion. Dobbs is a devastating blow to the pro-choice movement. Abortion should be a human right, let alone a constitutional one. A CNN poll in May 2024 found 69% of respondents disapproved of the overturning of Roe with a further 82% saying they strongly disagree and feel there should be laws ensuring national abortion access. 

Since the overturning of Roe, states have introduced various restrictions on abortion, with Texas indubitably fostering some of the strictest restrictions of the states. Senate Bill 8 (S.B.8), alternatively “The Heartbeat Act,” bans abortion once a heartbeat can be detected. Passed in 2021, controversially, although Roe was still the law, the Supreme Court refused to block the law. The enforcement of S.B.8 also cultivates some of the most stringent punishments for performing, inducing, aiding or abetting an abortion. In 2022, any violation of S.B.8 could be punished by life imprisonment. Texas also enforced a “bounty” style law, where private actors could stop abortions or collect bounties for those already performed. Medical professionals risked a life sentence for providing abortions that S.B.8 prohibited. For perspective, the sentence for attempted murder in Texas is a maximum of 20 years imprisonment. 

A study conducted in Colorado, which neighbours Texas and boasts legal abortions throughout pregnancy, has concluded that since the introduction of S.B.8, the number of Texans seeking an abortion in the state has increased from 1.2% of abortions to 17.7%. The movement of women seeking an abortion has sparked a new wave of legal barriers to the procedure with the introduction of “abortion trafficking” laws. Texas has already implied intentions to make the transport of women seeking abortion or even abortion medication across state lines a criminal offence. In Idaho, a state which enacts a complete abortion ban, the 9th Circuit Court of Appeals has upheld their law which prohibits the transportation of a minor for an abortion without parental consent. 

The introduction of so-called “abortion trafficking” laws raises a plethora of questions. Where does the monitoring of pregnant women stop? If pregnant women want to leave the state, is this then restricted? There are major questions regarding the logistics of these laws. How do these states plan on monitoring the state lines and highways? Texas’s bounty punishment is equally applied to anyone helping women gain an abortion, including traveling to a different state. The Contraception article already highlights that the laws have not stopped women from traveling, so how is this enforced? Principally and most importantly, how does this affect the rights of pregnant women to freedom? 

The logistics of abortion

Logistically, there have already been ways Trump has tightened abortion restrictions in the US. Although Trump had distanced himself from Project 2025 in the build-up to the elections, the executive orders Trump has already enforced are clearly reflective of, and some taken straight out of, the Project 2025 presidential playbook. Part of the playbook involves a resurrection of the Comstock Act, a backdoor way of using a 150-year-old law to ban abortion nationwide. Jonathan Mitchell, Trump’s attorney and the author of S.B.8, has already expressed his desire to revive the 1873 Act, which criminalises the mailing of abortion medication and equipment. Ideally for the Heritage Foundation, the thought process here is that the law means Congress would not have to pass a federal abortion ban, as one already exists and just needs to be enforced. 

This logic is legally flawed. The Comstock Act only criminalised unlawful abortion medication to be mailed and despite Congress being aware of this legal caveat, they have, up to now, chosen not to change the wording of the law despite many opportunities to do so. This view, that the law only prosecuted unlawful abortions, has been backed up by the Post Office, who agreed to this interpretation in 1970, and the Department of Justice enforced this view again in the post-Roe era in December 2022. 

However, if Congress did decide to revisit the specific wording of this law, this could have massive legal implications for the pro-choice movement. The law currently prohibits the mailing of abortion medication and equipment, which would not mean just for self-managed abortions, but would have implications on how medical centres, abortion clinics and hospitals receive such medication. The implications of the criminalization of posting these medications and equipment would mean centres who offer abortion would need to find alternate methods of receiving banned products. This, in turn, would have both a financial and a logistical impact on the ease of access to abortion centres, clinics and hospitals to provide abortions. There is clear intention from the Heritage Foundation to implement this law, which seeks to further logistically restrict access to abortion in the US. 

One way in which the US has already limited abortion access, logistically, is through the Targeted Regulations of Abortion Providers (TRAP) laws. TRAP laws originated in Texas and constitute a series of regulations that providers of abortion must meet to continue providing this service. As of August 2023, 23 states had active and enforced TRAP laws. While the claim is that these laws ensure that abortions are safe, largely, the requirements established in the laws have little to no medical impact. Abortion itself is one of the safest medical procedures in the US, with only 2% of women who receive abortions experiencing any complications. It is widely agreed that many of the restrictions within TRAP laws, which include the decoration of procedure rooms and the width of corridors, are significantly more rigorous than is medically required. Although there is clearly a requirement for medical procedures to be controlled in order to remain safe, the frankly draconian measures of the TRAP laws are far more restrictive than those of similar procedures. 

In 2015, a study was conducted in North Carolina, who have strict TRAP laws enforced, on the implications of these regulations on providers. Within the study, Mercier, Buchbinder and Bryant found that the TRAP laws placed an overwhelming burden on healthcare, so much so that clinics have been forced to close and the laws have even prevented the opening of new clinics. Interviews with various providers found that many clinics did not have the money or time to implement these changes to already under-resourced and over-burdened clinics. Overarchingly, the study found that the TRAP laws, despite all their aims, only served to delay abortion care and consequently make the procedure more dangerous. A consensus among the providers’ interviews was clearly that the laws implemented barriers which they had to work with but had no impact on patients or quality of care. It is easy to suggest that the sole purpose of TRAP laws is to limit access to abortion, not to make an already safe procedure “safe.”

The finances of abortion

Just three days after his inauguration, Trump enacted Executive Order 14182, which set out to enforce the Hyde Amendment. At its core, the Hyde Amendment bans the use of federal funding for abortions in the US. This includes limiting provisions of Medicaid and Medicare to women seeking abortions. The only exceptions to Hyde are the endangerment to life of the mother or pregnancies that are the result of rape or incest. Trump claims that the amendment has been ignored by the previous administration, which is, to an extent, true on both sides of the debate. 17 states allowed the use of state funds for abortions provided to women insured by Medicaid. Conversely, some states do not allow federal funds to be used when the Hyde conditions are met. For example, South Dakota would only allow abortion in the case of life endangerment and not for cases of rape and incest which are covered by the amendment. 

The impact of enforcing the Hyde Amendment is huge. Currently, 35% of women aged 15-49 are covered by Medicaid in states where abortion is legal. A further 21% of women in this age category are covered by Medicaid in states where abortion is banned and furthermore, the ban extends to block funding for out-of-state abortions. There is a clear implication that the amendment seeks to limit access to abortion, even in the 35 states that currently still allow the procedure. In Louisiana, a post-Dobbs study found that 29% of Medicaid-eligible pregnant women in the state would have had an abortion if the procedure had been covered by their insurance. 

The first Trump administration already took steps to limit abortion through financial restrictions. The administration took fire at Title X in 2019, using a gag rule that made it illegal for Title X providers to offer advice regarding the safe and legal access to abortion to pregnant patients. Title X, originally established under the Richard Nixon administration, seeks to provide affordable birth control and reproductive healthcare to women who otherwise would not be able to afford such care. The program currently covers four million women in the US. Four million women are now, again, unable to receive information on abortion through this provider in the US. 

Abortion as a human right

Possibly the most ironic statistics in this discussion are simple. Since Dobbs, the rate of abortions in the US has increased. The biggest debate within the abortion argument is the perception of the beginning of life, but there is just medically no answer to this question. Meanwhile, most women who find themselves not wanting to continue their pregnancies are eager to terminate as soon as they are able to. The restrictions and legislation introduced have actually seen the number of abortions after the first trimester (13 weeks+) increase. While some of these abortions are performed for medical reasons, relating to both the pregnant person and fetus, there are also a number of them that are necessary because of the financial and logistical restrictions on abortions. Some women are only in the position to meet the required criteria after their first trimester, and this is disproportionately the case in states that have complete abortion bans.

The World Health Organisation (WHO) published in May 2024 that restricting access to abortion does not reduce the number of abortions. The harrowing statistic that almost 50% of abortions are unsafe is terrifying when viewing the numerous, uncompromising and confiding restrictions placed on abortions in the US. The WHO noted, among other factors, that geographic and financial barriers to abortion increased the probability of women turning to unsafe abortion as a final resort. As of July 2023, the number of women attempting to induce their own abortion has risen from 5% before the overturning of Roe to 7%. Abortion restrictions, clearly, do not restrict abortions; they only serve to limit access to safe procedures. 

Although the above has a clear focus on abortion rights in the US, this administration should scare women globally. Trump has already re-joined the Geneva Consensus Declaration, which aims to defend the unborn and acts as a global anti-abortion coalition that seeks to question a woman’s right to abortion. The signature count for this coalition stands at forty signatories globally. Trump has already published on the White House website, whitehouse.gov, that “there is no international right to abortion.” In 2020, the WHO recognised that abortions are critical and vital healthcare. A woman’s right to choose should be vehemently defended in the US and on an international level. Safe, timely, affordable and respectful abortion is a human right. Now is the time to fight for reproductive justice, to fight for the right to choose and to defend our human rights to all healthcare. For me, it is this simple. Abortion is healthcare and is an international right; if you are against abortion, don’t have one.

The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.