The Washington PostDemocracy Dies in Darkness

Roe’s demise marks new phase in state-by-state battle over abortion

The Supreme Court’s decision to strike down the landmark precedent will prompt immediate changes to the country’s abortion landscape

On June 24, the Supreme Court voted to overturn Roe v. Wade, leaving abortion decisions up to the states. Here’s what you need to know — and what comes next. (Video: Blair Guild/The Washington Post)

The tremors from Friday’s sweeping Supreme Court decision to strike down Roe v. Wade began rippling across the country immediately, with roughly half of all states poised to ban or drastically restrict abortion and some bans taking effect right away.

Thirteen states will outlaw abortion within 30 days with “trigger bans” that were designed to take effect as soon as Roe was overturned. These laws make an exception for cases where the mother’s life is in danger, but most do not include exceptions for rape or incest.

In some states, trigger bans activated as soon as officials certified the decision in the hours after the court ruling.

“I’ll be happy to see the butcher mill in Little Rock, Arkansas, shut down for good,” said Arkansas state Sen. Jason Rapert (R), who has championed much of his state’s antiabortion legislation, including the trigger ban that was certified Friday afternoon by the state’s attorney general.

In Missouri, Attorney General Eric Schmitt moved minutes after the court opinion was released to activate the state’s trigger ban, saying his office had “effectively ended abortion in Missouri.”

When the Supreme Court decision came down shortly after 10 a.m. Eastern time, many of the clinics in trigger-ban states were filled with patients scheduled to receive abortion care. Administrators had to confront busy waiting rooms and inform patients that they could no longer legally perform the procedure, distributing lists of out-of-state clinics hundreds of miles away, aware that many of their patients will not be able to travel that far.

Once all the trigger laws take effect, patients in Texas will have to drive an average of 542 miles to reach the nearest abortion clinic, according to the Guttmacher Institute, an abortion rights research organization. For patients in Louisiana, the one-way trip will be 666 miles. In Mississippi, 495 miles.

Empty clinics, no calls: The fallout of Oklahoma’s abortion ban

When Texas banned abortion after six weeks of pregnancy last fall, a large portion of patients were able to get out of the state, with support from a nationwide network of abortion rights advocates who helped them pay for gas, hotels and child care. But in the next few months, as funds dry up and clinics in Democratic-led states are overwhelmed, fewer patients will have access to that option, said Zack Gingrich-Gaylord, communications director of Trust Women, a network of clinics in Kansas and Oklahoma.

In a post-Roe America, he said, the typical patient “will be one who never shows up to any appointment, that never makes it to a clinic, never calls a clinic, never calls a fund.”

“Those are the people who are going to become emblematic of this next phase,” Gingrich-Gaylord said.

Before Roe v. Wade, hundreds of thousands of people obtained abortions illegally every year, with estimates ranging from 200,000 to 1.2 million. Experts estimate that hundreds of women died from complications annually.

Nearly 50 years later, many abortion rights advocates say abortions will be far easier — and safer — to obtain illegally. Aid Access, an Austrian-based organization run by Dutch physician Rebecca Gomperts, mails abortion pills to all 50 states, including over a dozen states that have banned abortion by mail. Their orders from Texas increased by over 1,000 percent when the state enacted its six-week ban.

More states are expected to ban or restrict abortion over the coming weeks and months. Five states without trigger bans have other recent laws on the books that would ban most abortions and have been blocked by the courts, which lawmakers will likely move to activate as soon as possible. While most state legislatures have adjourned for the year, several governors in Republican-led states have signaled their interest in reconvening to pass additional antiabortion legislation if the Supreme Court overturned Roe.

Across much of the country, the future of abortion access is uncertain. Midterm election results could affect whether abortion remains legal in Pennsylvania, Wisconsin and Michigan, states with Republican-led legislatures and Democratic governors who support abortion rights.

In Michigan, Gov. Gretchen Whitmer says she is “holding up the wall.”

“The only thing keeping Michigan a pro-choice state right now is the threat of my veto,” she said. “Had the outcome of the 2018 election been different, Michigan would have already gone the way of Texas.”

Planned Parenthood and other abortion clinics are doing what they can to accommodate as many patients as possible. In southern Illinois, where approximately 14,000 out-of-state patients are now expected to seek abortion care every year, the organization has created a flagship call center program that books appointments for traveling patients and helps them cover the cost of their trip.

Inside the plan to create an abortion refuge for a post-Roe era

Some abortion providers have already left states with trigger bans to provide abortion care elsewhere, while others are firming up plans to do the same.

In Fargo, N.D., Tammi Kromenaker has found a new location for Red River Women’s Clinic, the only abortion clinic in North Dakota, where a trigger ban will take effect within 30 days. The clinic will move across the river, to Moorhead, Minn., a state with abortion protections in place.

She hopes to make the move within a month so Red River never has to close.

Kromenaker has anticipated for years that she might have to make this move.

“It’s part of the reason we’re in Fargo,” she said.

Legislatures in Democratic-led states have been making their own preparations. Throughout the spring, Democratic lawmakers across the country passed sweeping legislation to protect access to the procedure and allow clinics in their states to expand to meet demand. Several states did away with laws that required physicians to perform abortions, allowing clinics to rely on nurse practitioners and nurse midwives, while others instituted additional legal protections for out-of-state patients.

Conn. lawmakers pass bill to be ‘place of refuge’ for abortion patients

With Roe gone, restricting out-of-state abortions is likely to become “the next frontier” for the antiabortion movement, said David Cohen, a Drexel University law professor who studies abortion legislation.

A Republican lawmaker in Missouri proposed legislation earlier this year that would allow private citizens to sue anyone who helps a Missouri resident access abortion outside the state, using the novel legal strategy behind the Texas abortion ban, which empowers private citizens to enforce the law through civil litigation.

“If your neighboring state doesn’t have pro-life protections, it minimizes the ability to protect the unborn in your state,” said Missouri state Rep. Mary Elizabeth Coleman (R), who introduced the bill.

With Roe overturned, Coleman said, she hopes to see abortion banned across the country.

Roe v. Wade and abortion access in America

Roe v. Wade overturned: The Supreme Court has struck down Roe v. Wade, which for nearly 50 years has protected the right to abortion. Read the full decision here.

What happens next?: The legality of abortion will be left to individual states. That likely will mean 52 percent of women of childbearing age would face new abortion limits. Thirteen states with “trigger bans” will ban abortion within 30 days. Several other states where recent antiabortion legislation has been blocked by the courts are expected to act next.

State legislation: As Republican-led states move to restrict abortion, The Post is tracking legislation across the country on 15-week bans, Texas-style bans, trigger laws and abortion pill bans, as well as Democratic-dominated states that are moving to protect abortion rights enshrined in Roe v. Wade.

How our readers feel: In the hours that followed the ruling in Dobbs v. Jackson Women’s Health Organization, Washington Post readers responded in droves to a callout asking how they felt — and why.