“I felt pretty vulnerable. I was so broke, homeless, in debt … I had worked so hard at my education and coming from my background … I knew I wanted to be an artist and I knew that if I had a baby on my own, I felt that I had zero chance of that happening. It seemed ironic that now after all my education and fighting … that I was going to end up being a single mother … And I just thought, I can’t bring a baby into the world with all this …”

These are the words of Tracey Emin reflecting on her two abortions from the early 1990s. They highlight the reality endured by so many women around the world. Emin has been making highly political work for decades. Through painting, textiles, films and more, she unveils the rawness and truths of life. Abortion is an issue she has constantly explored, yet its importance in her work has too often been dismissed.

In 1996, for her film How It Feels, shot outside the clinic where she underwent the procedure, she speaks frankly about her experience with a male doctor who performed one of her abortions: “He told me it was too late.” She continues: “He showed me a picture of his child … and he told me what a wonderful mother I would make.” He then “refused to sign the papers for me to have an abortion”.

This doctor saw Emin solely as a child-bearing woman, with no other aspirations than to be a mother. By doing so, and by delaying the procedure, she was forced to live with her foetus for six weeks longer than she should have. This underlines how dangerous it is to have such people in positions of power, people who have not had any experience themselves, offering up advice or inflicting their own ideology on those in vulnerable positions – especially when they do not understand the emotional and physical implications. As Emin recounts in the film: “He shouldn’t have had beliefs for me.”

To help those facing a similar situation, in 2002 Emin constructed The Last of the Gold, a quilted blanket emblazoned with the “A to Z of abortion”. This is something, the artist told me recently, she would have “100%” wanted when she was younger. “I am sure it’s very much out of date now,” she added, “but the fundamental principle is that there is very little information or advice to give women in that situation. So at the time I thought, ‘Why not put it across the gallery wall?’”

Some suggestions are practical: “Insist on having an abortion as soon as possible – if you have the money (300 pounds) you can be treated within 24 hours – if you go through the NHS you may have to wait up to six weeks depending on availability, but then they may say no.” Others are emotional: “You may feel in a state of euphoria from the relief, be careful as depression may follow.”

Although made 20 years ago, The Last of the Gold is, sadly, still relevant, especially now that the US supreme court has overturned Roe v Wade, leaving it up to individual state leaders to decide whether or not abortion laws should come into effect. Currently, abortion is banned in 13 states. In Georgia, abortion is banned after six weeks, a point when most women do not even realise they are pregnant.

In tomorrow’s midterm elections, abortion will be, for many, a deciding factor. In the swing state of Michigan – where Democrat Elissa Slotkin is hoping to be re-elected over the “100% pro-life, no exceptions” Republican candidate Tom Barrett – the issue is on a par with inflation. For a while, Barrett and Slotkin were neck and neck. However, since September, the votes have risen in her favour, in part due to Republican-voting women in Michigan fearing the overturning of Roe v Wade.

“I’ve never seen anything like it,” Slotkin recently told the Guardian. “Everywhere I go, Democrats, Independents and Republicans are talking about this issue. They’re talking about how scared they are of a 1931 abortion ban coming back in Michigan. They don’t want it.”

Emin’s raw accounts expose, on a human level, the precariousness of women’s situation. “I lived it,” Emin told me. “And I know what it was like to make that choice. When I make work about that subject, it’s not a fake idea or a fake notion or just a political statement. It’s a heartfelt, gut-felt, heartbreaking decision that I had to make.”

Her blanket concludes with this advice: “And most important, if you do decide you want to have the baby, don’t listen to anyone, just listen to your heart.” Depending on how the elections pan out this week, many women in America may need Emin’s work more than ever.