Fernando Vergara

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AP

Some countries have taken unprecedented steps to expand access to abortion in recent years, but international rights groups have long warned that overturning Roe v. Wade could weaken abortion rights around the world, potentially leading some nations to adopt new restrictive laws.

As NPR's Ayana Archie and Joe Hernandez report:

Many countries are expanding abortion access

Ireland legalized abortion in 2019, Argentina legalized it in 2020 and Mexico's Supreme Court voted to decriminalize abortion last year. In February, Colombia's highest court legalized abortion until 24 weeks of pregnancy.

Human Rights Watch, Amnesty International and the Global Justice Center said in a joint brief that 60% of women of reproductive age live in countries where abortion is available.

"Only 26 countries, representing 5% of women of reproductive age, ban or prohibit abortion altogether," they wrote.

The brief adds that 34 of the 36 countries that the United Nations classifies as "economically developed" — including the U.S. — make abortions accessible. Poland and Malta were the lone exceptions.

The groups also note that the U.S. has signed several international treaties (including the U.N.'s International Covenant on Civil and Political Rights) that include the right to nondiscrimination; the right to be free from torture and other cruel, inhumane, or degrading treatment or punishment; the right to privacy; and the right to life.

By restricting access to abortions, the organizations argue, people will be forced to seek out unsafe and unsanitary procedures — therefore jeopardizing their right to life.

Read more here.

But those looking to crack down on abortion could use the U.S. as an example

Human rights advocates say the reversal of Roe not only would damage the perception of the U.S. on the world stage, but also could lead some countries to adopt more restrictive laws of their own.

Licha Nyiendo, chief legal officer of the group Human Rights First, wrote in a statement after the draft opinion leak that such a move constituted a "step in a very dangerous direction for everyone in the United States and a frightening signal to authoritarians around the world that they can strip long-established rights from their countries' people."

Tarah Demant, Amnesty International's interim national director for programs, advocacy and government affairs, told NPR that other countries could point to the U.S. to legitimize their own restrictive policies.

Take Poland for example, she said: The country has faced criticism from the European Union for severely limiting abortion, but soon could argue that the bloc's close ally has done nearly the same thing.

"You're looking at an emboldened anti-rights movement," Demant said.

Read more here.

The Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization clears the way for states to reshape abortion law in the U.S., nearly 50 years after the court enshrined abortion rights at the federal level in the Roe v Wade decision.

The Dobbs case came to the high court from Mississippi, where the Jackson Women’s Health Organization has long been the only abortion provider. In 2018, the state enacted a law that bans abortion after 15 weeks, allowing exceptions only for medical emergencies or severe fetal abnormalities — and not for cases involving rape or incest.

The "Dobbs" in the case title refers to Thomas Dobbs, an infectious diseases doctor who became Mississippi’s top health officer the same year the state enacted the new abortion restriction. The Jackson clinic and one of its doctors sued Mississippi officials in federal court, saying the state’s law was unconstitutional.

A federal district court and the Fifth Circuit Court of Appeals ruled in favor of the clinic, blocking Mississippi’s law. But the state then appealed to the Supreme Court, which put the case on its docket two years ago.

When the Supreme Court granted the state’s request to hear the case, it limited itself to one question: “Whether all pre-viability prohibitions on elective abortions are unconstitutional.”

The notion of viability is crucial to the case. As Priscilla J. Smith, a Yale Law professor and a supporter of abortion rights, told NPR late last year, “The central tenet of Roe is the availability of abortions up to viability.”

Mississippi’s petition to the Supreme Court called that standard “unsatisfactory.” It also noted that fetal viability has changed over time, thanks to advances in obstetrics and medical technology.

“Tomorrow, development of an artificial womb will inevitably move the ‘viability’ line to the moment of conception,” the state wrote in its petition.

But attorneys for Jackson Women’s Health Organization said the central question of viability was already settled — by Roe v. Wade in 1973 and by Planned Parenthood of Southeastern Pennsylvania v. Casey in 1992.

The clinic wanted the Supreme Court to affirm the Fifth Circuit’s decision, citing “nearly fifty years of precedent.” But a majority of justices ruled that Roe had been wrongly decided, returning control of abortions to states.

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AFP

In its ruling overturning Roe v. Wade, the Supreme Court produced a sea change in U.S. abortion law.

“The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives,” the court stated in a syllabus included with its lengthy decision.

Justice Samuel Alito wrote the majority opinion, joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett.

Two concurring opinions were also filed — one by Chief Justice John Roberts, and one by Justices Thomas and Kavanaugh.

The Roe decision was “egregiously wrong and on a collision course with the Constitution from the day it was decided,” the court’s syllabus states.

In his opinion, Alito writes that the 1973 ruling ended a political process in which states crafted their own stances on abortion. “It imposed the same highly restrictive regime on the entire Nation, and it effectively struck down the abortion laws of every single State,” Alito wrote.

When the Supreme Court granted Mississippi’s request to hear the case, it limited itself to one question: “Whether all pre-viability prohibitions on elective abortions are unconstitutional.”

Alito says the court looked at several issues in deciding the case, “including whether a right to obtain an abortion is part of a broader entrenched right that is supported by other precedents.”

He wrote that the Roe decision “was remarkably loose in its treatment of the constitutional text. It held that the abortion right, which is not mentioned in the Constitution, is part of a right to privacy, which is also not mentioned.”

A state’s law regulating abortion “must be sustained if there is a rational basis on which the legislature could have thought that it would serve legitimate state interests,” Alito wrote. Those interests include “respect for and preservation of prenatal life at all stages of development,” he added, along with protecting “maternal health and safety” and other issues, such as preserving “the integrity of the medical profession” and the “mitigation of fetal pain.”

“These legitimate interests justify Mississippi’s Gestational Age Act,” Alito wrote.

Alito's opinion includes two appendices — one that lists "statutes criminalizing abortion at all stages of pregnancy in the States existing in 1868," and another that lists similar statutes from territories that became states and the District of Columbia.

Since the Supreme Court's 1973 Roe v. Wade decision ruled that women have a constitutional right to end their pregnancies, proponents and opponents of abortion rights have worked to own the conversation over the issue.

In 2019, the Centers for Disease Control and Prevention reported that 629,898 legal induced abortions were reported across the United States.

Lingering claims circulate about abortion, including about its safety, the kinds of people who get abortions and even who supports or opposes access to abortion.

Below, seven popular claims surrounding abortion get fact-checked. Click expand for details, and read the full story here.

Claim: There is big support for ending Roe in America.

According to the Pew Research Center's polls, 37% of Americans want abortion illegal in all or most cases.

But an even bigger fraction — around 6 in 10 Americans — think abortion should be legal in all or most cases.

Claim: After Roe, abortions skyrocketed.

While the rate of abortions increased significantly in the decade after Roe v. Wade, it has since decreased to below the 1973 level.

Current abortion rates are lower than what they were in 1973 and are now less than half what they were at their peak in the early 1980s, according to the Guttmacher Institute, a reproductive health research organization that supports abortion rights.

In 2017, pregnancy rates for females age 24 or below hit their lowest recorded levels, reflecting a long-term decline in pregnancy rates among females 24 or below.

Overall, in 2017, pregnancy rates for females of reproductive age hit their lowest recorded levels, with 87 pregnancies per 1,000 females ages 15 to 44, according to the Guttmacher Institute.

Claim: Abortion is dangerous.

Pregnancy and childbirth are far more dangerous than getting an abortion, according to data from the CDC.

The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973, according to the CDC.

An analysis of data from 2013 to 2018 showed the national case-fatality rate for legal induced abortion was 0.41 deaths per 100,000 legal induced abortions, lower than in the previous five years.

The World Health Organization said people obtaining unsafe abortions are at a higher risk of death. Annually, 4.7% to 13.2% "of maternal deaths can be attributed to unsafe abortion," the WHO said. In developing regions of the world, there are 220 deaths per 100,000 unsafe abortions.

Claim: The only people getting abortions are straight, cisgender women.

The Guttmacher Institute estimates in 2017, an estimated 462 to 530 transgender or nonbinary individuals in the U.S. had abortions. That same year, the CDC said, 609,095 total abortions were carried out in the country.

The Abortion Out Loud campaign has collected stories from thousands of people who have had an abortion. Included are stories from trans and nonbinary people who have had an abortion — such as Jae, who spoke their experience.

Claim: A lot of people are getting abortions late in pregnancy.

Over 90% of abortions happen in the first trimester (by 13 weeks).

"Most abortions in 2019 took place early in gestation," according to the CDC. Nearly 93% of abortions were performed at less than 13 weeks' gestation.

Abortion pills, which typically can be used up to 10 weeks into a pregnancy, made up 54% of abortions in 2020. These pills were the primary choice in the U.S. for the first time since the Food and Drug Administration approved the abortion drug mifepristone more than 20 years ago.

Claim: Fetuses feel pain early in a pregnancy.

Medical researchers agree a fetus is not capable of experiencing pain until the third trimester, somewhere between 29 or 30 weeks. Despite this, 16 states have passed abortion bans based on the notion that fetuses experience pain at or around 22 weeks.

State legislatures moved to adopt 20-week abortion bans, with abortion opponents claiming fetuses can feel pain at that point. Roughly a third of states have implemented an abortion ban around 20 weeks.

But this contradicts widely accepted medical research from 2005. This study, published in the Journal of the American Medical Association, concluded that a fetus is not capable of experiencing pain until somewhere between 29 or 30 weeks.

Researchers wrote that fetal awareness of pain requires "functional thalamocortical connections." Those thalamocortical fibers begin appearing between 23 and 30 weeks' gestational age, but the capacity for pain perception comes later.

Claim: People who are religious don’t get abortions.

The argument against abortion has frequently been based on religion, but data shows that more than 60% of people who get an abortion have some sort of religious affiliation, according to the most recent Guttmacher Institute data, from 2014.

The Pew Research Center also shows that attitudes on whether abortion should be legal vary among evangelical Protestants, mainline Protestants and Catholics.

Most abortions are or will soon be banned across the Gulf South now that Roe v. Wade has been overturned. Here’s the legal landscape for each state:

Alabama: In May 2019, Gov. Kay Ivey signed a bill into law that banned nearly all abortions at any stage of a pregnancy, unless a woman's life is threatened or there is a lethal fetal anomaly. The ban, however, was blocked by a federal judge. With Roe overturned, though, state officials say they would move quickly to challenge the federal judge’s ruling.

Currently, Alabama does not allow abortion past the 20th week of gestation unless a doctor has determined either that the fetus is unviable or that carrying the fetus to term would cause death or severe and irreversible impairment to the woman.

The state also has a pre-Roe ban on abortion that was never repealed. State lawmakers have also passed an amendment to the state constitution that recognizes the rights of the unborn. Some believe this amendment could open the door to outlaw abortion completely now that Roe v. Wade has been overturned.

Louisiana: Louisiana is one of three states with a trigger law that goes into effect immediately without further action by the state Legislature. The law, passed in 2006, bans abortions completely.

On Tuesday, Gov. John Bel Edwards signed Senate Bill 342 into law, which updated the law to include exceptions for medically futile and ectopic pregnancies. No exceptions for victims of rape or incest are included. The new bill also stiffens the criminal penalties for abortion providers already outlined in state law, doubling the maximum sentences to 10 and 15 years, depending on when an abortion is performed during a pregnancy.

Mississippi: Mississippi also has a trigger law in place, but unlike Louisiana, it will require certification from state Attorney General Lynn Fitch before going into effect — one of seven states in this situation.

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In 2019, the Missouri General Assembly passed House Bill 126, which contains a so-called “trigger ban” prohibiting nearly all abortions in the state.

As KCUR’s Dan Margolies reports, that ban goes into effect as soon as the governor or attorney general certifies that Roe has been overturned, or the legislature enacts a resolution to the same effect.

Head to KCUR.org for more

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Getty Images

Texas is one of 26 states that has laws in place now that would ban abortions, according to a study by the Guttmacher Institute, a nonprofit research organization on reproductive health. Surrounding states Oklahoma, Arkansas and Louisiana also have near-total bans in place now that Roe is overturned.

Texas already banned abortions around six weeks back in September 2021 when SB 8 went into effect, which also allowed private citizens to sue anyone helping a person access abortion care. Thousands of Texans went out of state to get abortions since then, with clinicians in Texas helping to connect patients with services. The Supreme Court decision in Dobbs v. Jackson Women’s Health Organization means all Texans seeking abortions will have to travel hundreds of miles to neighboring states like New Mexico.

Follow KERA for updates

Sarah A. Miller

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Idaho Statesman/Tribune News Service via Getty Images

Nearly all abortions in Idaho are poised to be outlawed in 30 days after the U.S. Supreme Court Friday gave individual states the right to prohibit abortion.

Doctors found violating Idaho's law would face between two and five years in prison under a felony charge. Their medical license would be suspended for six months after the first offense, and it would be permanently revoked for any following offenses.

Adopted in 2020, Idaho’s trigger law will only allow abortions in cases of rape, incest and if the mother’s life is at-risk. But there are caveats to those exceptions.

Read more from Boise State Public Radio

Sue Ogrocki

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AP

Access to legal abortion could soon end for more than 100 million Americans, including those living in nearly every Southern state and large swaths of the Midwest.

Twenty-two states are poised to immediately ban or acutely curtail access to abortions with the Supreme Court's decision to overturn Roe v. Wade, according to the Guttmacher Institute, a research group in favor of abortion rights. The landmark 1973 decision had guaranteed women's right to seek an abortion for nearly 50 years.

So-called "trigger laws" are taking effect and will automatically ban or curtail abortion in 13 states. Most were enacted during the Trump administration, after conservatives Neil Gorsuch and Brett Kavanaugh were confirmed to the Supreme Court.

In another nine states, pre-Roe abortion bans can once again become enforceable, or more recent bans that had been blocked by courts can now take effect.

In effect, abortions could soon be illegal or next to impossible to access in these 21 states, with a combined population of more than 135 million people — a major change from today's environment, where all 50 states have at least one operating abortion clinic.

In response, many Democratic-led states have enacted laws to shore up abortion rights at the state level.

Sixteen states and Washington, D.C., have laws protecting access to abortion, according to Guttmacher. Four states and D.C. "have codified the right to abortion throughout pregnancy without state interference," the group notes, while 12 others "explicitly permit abortion prior to viability or when necessary to protect the life or health of the pregnant person."

California, Oregon and Washington state also recently moved to expand financial support for abortion access.

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AP

As the Supreme Court prepared to issue its decision overturning Roe, NPR spent weeks speaking to experts and activists about what will likely happen after the ruling. Here's some suggested reading.

What will this mean for health care and access to services?

Kristyn Brandi, an OB-GYN and family planning doctor who is also the board chair for Physicians for Reproductive Health, and NPR health policy correspondent Selena Simmons-Duffin answered some of your most common questions here.

Here are insights from two reproductive health care providers about the options available to pregnant people in anti-abortion states, and how to find a safe clinic.

Medical and legal experts say the decision could have implications for other types of care, including birth control and fertility treatments. Plus, read up on how medication abortion works and what the end of Roe could mean for it.

And it's important to remember that this decision doesn't just affect cisgender women.

What about possible legal implications?

Dozens of states already passed trigger laws that could end access to legal abortions for many Americans. Here's what enforcement could look like. Also, the removal of federal abortion protections could spark new legal fights between states.

Liberal politicians and activists have publicly speculated that other landmark Supreme Court rulings, like those legalizing same-sex marriage and birth control, could be on shaky ground. Since the release of the draft ruling Democrats have sought to make the abortion debate about more than just abortion, hoping to jolt voters into action as the November midterms approach.

What will daily life look like?

As NPR's Joe Hernandez has reported, here's what a future without Roe could mean:

• More than two dozen states have laws that could restrict or ban abortion soon after the Supreme Court overturns Roe, according to Guttmacher. One type of statute, called a "trigger law," is designed to take effect after a Supreme Court ruling to overturn Roe. Some states also still have pre-Roe abortion bans on the books that they could begin enforcing again. Other laws express the intent of states to crack down on abortion if permitted by the Supreme Court.
• States that continue to allow abortion could see an influx of patients seeking care. For example, after Texas enacted its roughly six-week ban on abortion last year, some residents began to get abortions out of state. In the final four months of last year, Planned Parenthood clinics in states near Texas reported a nearly 800% increase in abortion patients from Texas compared to the same period in the prior year.
• Women of color will bear the brunt of further abortion restrictions. According to The Associated Press, Black and Hispanic women get abortions at higher rates than their peers. Women of color also experience higher poverty rates and could have a harder time traveling out of state for an abortion, the AP said.
• Limits on abortion access can lead to negative long-term health effects. A major study from the University of California, San Francisco found that women are harmed by being denied abortions. The women surveyed who gave birth had economic hardships that lasted for several years, were more likely to raise the child alone, and were at higher risk of developing serious health problems than those who were able to have abortions.
• Some blue states already are taking steps to enshrine the right to abortion in state law. From Colorado to New Jersey, Democratic governors have signed laws protecting reproductive rights and announced their intention to be able to provide abortion services to people who live in states where the procedure is restricted.

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The U.S. Supreme Court has overturned the constitutional right to an abortion, reversing Roe v. Wade, the court’s five-decade-old decision that guaranteed a woman’s right to obtain an abortion.

“The Constitution does not prohibit the citizens of each State from regulating or prohibiting abortion. Roe and Casey arrogated that authority,” the court’s conservatives wrote in their majority opinion. The Court overrules those decisions and returns that authority to the people and their elected representatives.”

The three liberals dissented.