Kamala Harris has been the presumptive Democratic nominee for US president for less than a fortnight, but some key themes are becoming clear from her campaign. One of those is abortion, about which she has spoken frequently since Joe Biden declared her his preferred successor.
Just over two years ago, the US Supreme Court overruled the 49-year-old precedent of Roe v Wade and withdrew constitutional protection for the choice to terminate a pregnancy. In the June 2022 majority judgment in the case of Dobbs v Women’s Health Organization – the case that overturned Roe v Wade – Supreme Court Justice Samuel Alito wrote that Roe v Wade had been “egregiously wrong from the start”. He concluded that: “Its reasoning was exceptionally weak, and the decision has had damaging consequences.”
Under the guise of undoing this wrong, the Supreme Court returned the issue of abortion law to state jurisdiction. Americans have been watching the consequences unfold ever since, as various states have passed laws restricting or banning women from being able to terminate pregnancies.
Harris led the Biden administration’s response to this decision, visiting an abortion clinic and speaking out about reproductive freedom. Even before she took on the presidential candidacy, campaign rallies and adverts from the Democratic campaign were focused on the decision restrict women’s reproductive freedom.
The results of the 2022 midterm elections suggest this could be a useful strategy. The Democrats did significantly better than expected – and abortion was considered a major factor. Certainly successful ballot initiatives in California, Michigan and Ohio (which added constitutional protections) and defeats for abortion restriction measures in Kansas, Kentucky and Montana suggested an increased turnout of Democrat voters.
This November, a possible 11 states could have abortion-related initiatives on the ballot, including Arizona, a key swing state in this election. In such a tight race, parties are looking for any possible advantage.
Possibly mindful of this – and of the fact that most Americans continue to support some access to abortion – the Republican party recently softened its official stance, removing language calling for a federal abortion ban which appeared in both 2016 and 2020. Some Republican state legislators have urged caution about strict abortion bans that may alienate potential voters.
Widespread impact
Speaking regularly about reproductive rights also helps keep in voters’ minds the widespread consequences of the Dobbs decision on abortion and how it affects pregnant women and medical professionals across much of the country.
Only half of states protect abortion, at least until the point of foetal viability. These states – particularly those which border two or more states with abortion bans such as Illinois and Ohio – have become centres for those seeking abortion care and who are able to travel.
Fourteen states have outright bans on abortion access. Some have exceptions for cases of rape, incest, or to save the life of the pregnant women, but many do not. Another 11 states have gestational limits that are earlier than the previous 24-week limit. Some are so early that most pregnant women don’t even yet know they are pregnant.
More than half of states have other restrictions: waiting time requirements, mandated counselling, required ultrasounds, multiple visits to the doctor, spousal or parental consent laws and others.
The most recent estimates suggest 48% of women now live in states with some form of abortion restrictions. That figure rises to 57% for black women and higher for Native American women. The Guttmacher Institute, a pro-choice research organisation, estimates that almost one in five pregnant women now have to travel out of state for abortion access.
Indirect attacks on access
By speaking out on abortion, the Harris campaign is also seeking to galvanise pro-choice voters by reminding them that the threats come in many forms.
In June, an attempt to undermine access to the abortion pill, mifepristone, was rejected by the Supreme Court. The case was, in effect, a back door attempt to further restrict abortion access.
EPA-EFE/Etienne Laurent
And, although interstate travel is constitutionally protected in the US, some localities in Texas have been trying to prevent use of their roads by those seeking to leave the state to access abortion care.
Two University of Texas at Austin professors sought the legal right to academically fail students who take time off for abortion care, while Idaho academics were warned they could no longer advise students about anything relating to abortion.
And, as the New Republic reported, anti-abortion laws are increasingly being used by domestic abusers to threaten and harass partners.
Healthcare consequences
As anti-abortion advocates continue to press for greater restrictions across the US, data from the Guttmacher Institute show that they continue to fail to achieve their aim of reducing abortion rates. In 2023, abortion rates were higher across the country than in previous years.
But, as many doctors are pointing out, the restrictions are regularly putting the lives of pregnant women at risk. Mimi Zieman, an obstetrician from Georgia wrote: “If I were finishing my training today and choosing somewhere to practice, I would not come to this state or anywhere with these restrictions on practice.”
Many agree with her. Recent studies suggest as many as 70% of gynaecology students in the US are less likely to consider residency in a state with abortion restrictions.
This risks leaving pregnant women without both abortion access and good, reliable, accessible reproductive healthcare. In a country that already has the highest maternal mortality rate among developed nations, this suggests further declines.
Testimony from practitioners overwhelmingly indicates that threats to medical licences and risk of prison terms are deterring doctors from undertaking vital healthcare provision.
And pregnant women are suffering as a result. Stories now abound of women like Kate Cox, who was forced to travel outside of Texas for an abortion when the state refused to determine that her case was sufficiently life threatening to qualify under their exemption. Or that of Nicole Miller, airlifted to a nearby state because the abortion she required to medically stabilise her was unavailable in her home state of Idaho.
Harris and the Democrats want voters to remember these stories as they go to the polls in November. And they want voters to remember that it was Trump, and his Supreme Court appointees, who made it possible.
