What could abortion access look like under Trump?

While celebrating the passage of abortion ballot initiatives in seven states, abortion rights advocates are warning that a second Donald Trump presidency threatens access to abortion care nationwide.

“An abortion access crisis that’s already devastating is going to get worse,” Kelly Baden, policy chair of the Guttmacher Institute, told ABC News.

“The 13 states that ban abortion today — that has real consequences including death. Women are dying because of these abortion bans,” Baden said.

Trump may have convinced voters that there would be no federal ban on abortion, but experts warn that nationwide access could be at risk.

“I don’t think people know that a federal ban on abortion would preempt state constitutional protections. There could also be a sense of, ‘I’m going to vote yes on this amendment, and that means my state is OK,'” Elisabeth Smith. , state policy director for the Center for Reproductive Rights, told ABC News.

“A federal ban on abortion — if upheld by the U.S. Supreme Court — would preempt a state’s policy of making abortion legal and accessible,” Smith said. “We don’t know which party controls the House (of Representatives) yet, but that’s a possibility.”

Regulation by federal agencies can also affect access to abortion care. Medication abortion It could be under fire if the Food and Drug Administration — under a Trump presidency — restricts access to mifepristone, one of the pills used in the abortion regimen, or withdraws its approval, as anti-abortion groups have tried to do. .

The Trump administration could try, too Misusing the Comstock Act to try to prevent access to abortion medication, Smith warned.

The 150-year-old law is an anti-obscenity law that “makes it an offense to send anything by mail that is ‘indecent, lewd or lascivious’ or ‘intended to induce abortion'”. to the ACLU.

Voting initiatives

Missouri became the first state to enact a near-total abortion ban after the US Supreme Court ruled in Roe v. Since overturning Wade, ending federal protections for abortion rights.

If the ban is repealed as expected, Missouri could make access to abortion care easier for Southern women. The state borders four states that have abandoned nearly all abortion services: Kentucky, Tennessee, Arkansas, and Oklahoma.

But currently, there is not a single brick-and-mortar abortion clinic in Missouri, which means that even when the law is repealed, it would take time to restore access to care, according to Baden.

“So we’re going to continue to see doctors have to leave the state for abortion care or to find another way to get care in the interim,” Baden said.

Legal proceedings to overturn the state’s ban under the new constitutional amendment could also take months or years, according to Baden.

Battleground states Arizona and Nevada were also among the top 10 abortion states in Tuesday’s vote. Some strategists hypothesized that this would boost turnout among the majority of voters who support legal abortion, helping Democratic candidates in the process.

But exit polls showed some abortion supporters still elected Trump in the battlefields.

Advocates warn that while ballot initiatives have been effective, they are not a universal solution.

“They’re just one tool in the toolbox. They’re clearly not our silver bullet, either, because structurally they can’t be. Not every state supports these kinds of ballot measures either, they’re expensive, and they’re also not an immediate solution. .. a series of lawsuits has to happen.”

Advocates for protections related to abortion care say they will continue to work to restore and protect access to abortion care under the incoming administration.

“Our job is to hold this incoming administration to its word, that we will no longer work to restrict or ban abortion and insist that they invest in care,” National Women’s Law President Fatima Goss Graves. Center Action Fund, he told reporters at a press conference on Wednesday.