Voters in seven out of 10 states approved ballot measures protecting abortion rights this week. a hot button problem That helped get Americans to vote.
But President-elect Donald Trump's victory early Wednesday could make access to the procedure more vulnerable and unsure across the U.S., health policy experts warned, leaving the reproductive well-being of many ladies at stake.
Trump has waffled considerably about his position on abortion, most recently saying he would accomplish that not support a federal ban and would love to depart the matter to the states. But Trump and his federal appointees could further restrict federal abortion through methods that don’t require Congress to pass recent laws.
“The more restrictions on abortion are imposed over the next four years, the worse the health consequences will be. People are suffering and dying needlessly,” said Katie O’Connor, senior director of federal abortion policy on the National Women’s Law Center.
Abortion access within the U.S. has declined within the two years for the reason that Supreme Court's Roe v. Wade overturned and abolished the federal constitutional right to trial is already in flux – a choice Trump has taken credit for since reshaping the court. Since last 12 months greater than 25 million women PBS reported that girls ages 15 to 44 lived in states with stricter abortion restrictions than before the court's 2022 ruling.
Experts say further crackdown on abortion by the Trump administration could endanger the health of many patients, particularly those with lower incomes or coloured peopleendangered.
“As long as we have a government that is not fully committed to abortion access for all who seek it, there will be chaos and confusion on the ground about what is legal and what is available,” O'Connor said. “It will contribute to the ongoing crisis in health care access that we see with abortion.”
It is unclear what Trump's actions on this issue could be. There is little public support for Congress to pass nationwide abortion bans, a said Opinion poll conducted in June by The Associated Press-NORC Center for Public Affairs Research. At least 70% of Americans oppose a federal ban on abortion or a ban on the procedure after six weeks.
If Trump decides to limit access, experts say that might include restricting the usage of medication abortions, especially in the event that they are performed via telemedicine or delivered by mail.
Medication is essentially the most common approach to ending a pregnancy within the United States 63% of all abortions within the US last 12 months, in accordance with a March study by the Guttmacher Institute, a research organization that supports abortion access.
Trump's campaign didn’t immediately reply to a request for comment.
The decades-old Comstock Act
According to Julie Kay, co-founder and executive director of the Abortion Coalition for Telemedicine, a Trump administration could severely restrict or ban medication abortion by enforcing an interpretation of the long-defunct Comstock Act.
The law, passed in 1873, makes it a federal crime to send or receive drugs or other abortion-related materials by mail. It was not widely enforced for a long time.
Trump's administration could use the law to dam and stop doctors from shipping and distributing abortion pills and potentially all medical devices utilized in abortion procedures, resembling dilators and suction catheters, in accordance with Kelly Dittmar, director of research on the US hospital to perform abortions in hospitals Rutgers Center for American Women and Politics.
To pass it, Trump would need to appoint an anti-abortion attorney general, which might require Senate confirmation.
The Biden administration claims that the provisions of the Comstock Act are outdated. Trump said in August he had no plans to implement the Comstock Act.
But anti-abortion advocates and other people near Trump, including his vice presidential running mate, Vice President-elect JD Vance, did urged the contrary. Some of Trump's former advisers also support using the Comstock Act to limit abortion pills of their conservative policy proposal, Project 2025. This also applies to each major anti-abortion organization within the country.
There would likely be legal resistance to any try to implement it, O'Connor noted.
This issue could find yourself within the Supreme Court, whose justices have been open to the concept that the Comstock Act could ban abortions. Earlier this 12 months, Justices Samuel Alito and Clarence Thomas called many times of the Comstock Act during oral arguments in a medicine abortion case.
Appointing anti-abortion actors to key positions in government agencies
Trump could also appoint anti-abortion leaders to manage key federal agencies that might use executive power to severely restrict or ban the procedure within the US. These include the Department of Health and Human Services, the Food and Drug Administration, and the Department of Justice.
“These authorities have been instrumental in clarifying and protecting as much as possible when it comes to abortion rights in a post-Dobbs world,” said Kelly Baden, vice chairman of policy on the Guttmacher Institute, referring to the Supreme Court decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade.
Trump and his political appointees on the FDA could direct that agency to sharply restrict or possibly eliminate access to mifepristone, considered one of two drugs utilized in a standard medication abortion regimen.
In 2023, abortion opponents clashed with the FDA in a legal dispute over the agency's greater than two-decade-old approval of the drug. In June, the Supreme Court ruled unanimously dismissed challenged mifepristone and sided with the Biden administration, meaning the commonly used drugs could remain widely available.
But Trump's FDA appointees could push to reverse certain changes made out of 2016 to 2021 that expanded access to mifepristone. This could include reintroducing requirements that might require personal delivery of mifepristone, which could be the case effectively eliminate Access to the pill via telemedicine.
Telemedicine has change into an increasingly common strategy to access abortion bills, accounting for nearly one in five of them in the ultimate months of 2023, in accordance with data a research project published in May by the Society of Family Planning.
Restricting telemedicine as an option would have an “incredibly chilling effect” on abortion access, said Alina Salganicoff, senior vice chairman and director of ladies's health policy at KFF, a health policy research organization.
“We are likely to see more people having to travel to states where abortion is banned, more delays in seeking medical care, and the possibility that more of them will actually be denied that care because of it “It’s difficult to do the procedure in person,” she said.
New FDA leaders could also attempt to take a more extreme approach: revoking the approval of mifepristone altogether. Both strategies would ignore significant scientific research supporting the secure and effective use of mifepristone within the United States, experts said.
Trump vaguely hinted at in August that he wouldn’t rule out instructing the FDA to revoke access to mifepristone. Just just a few days later, Vance tried to return these comments.
Trump's comments seem like a departure from his stance in June, when the previous president said during a CNN debate that he would “not block” access to mifepristone.
Revive old rules, gut Biden's
At a minimum, Trump could reinstate a number of the policies implemented in his first term that made access to abortion harder and undo a number of the Biden administration's efforts to expand access.
Trump could reinstate a so-called “domestic gag rule” that he introduced in 2019 and that the Biden administration reversed in 2021.
The rule banned providers that were a part of the federally funded family program “Title Title
Guttmacher's Baden said the rule has “decimated” Title X's network of family planning clinics and limited its ability to serve low-income patients. She said those clinics are “still recovering from this.”
“I see no reason to believe he wouldn’t reinstate this rule in the first 100 days,” Baden said.
Baden said a Trump administration could also quickly roll back a few of Biden's executive orders, memoranda and other efforts geared toward protecting and expanding access to reproductive health services.
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