abortion rights rally

An abortion rights rally in Washington, D.C. in June 2022.

The overturn of Roe v. Wade on Friday marks an inflection point in our country’s trajectory. It’s the beginning of the end. But not for who you think. It’s the beginning of the end of the anti-abortion movement. 

With Dobbs v. Jackson — in which the Court held that because the Constitution makes no mention of abortion it does not confer a right to one — the Supreme Court went too far. The majority’s decision moved beyond the parameters of the case to completely overturn Roe v. Wade and Casey v. Planned Parenthood. From a legal point of view, the decision blows past any semblance of legal conservatism and reveals the current court for what it is: a radical, activist court pushing a political agenda. 

In itself, this might not immediately imperil the decision, but the public health ramifications of this decision spell doom for the movement as a whole. Friday’s decision opens the door for states not just to restrict abortion but also to trigger existing laws that begin restricting birth control, access to emergency contraceptive pills and effectively criminalizing miscarriage.

Remember, Roe vs. Wade comes in the middle of a line of legal thinking that starts with access to birth control for married couples (Griswold v. Connecticut, 1965), and ends most recently with the right for same-sex couples to marry (Obergefell v. Hodges, 2015). If the legal principles that upheld Roe v. Wade over the past 50 years are so easily thrown away by this current court, the rights that have enabled Americans to care for their health, live their lives and care for their families by deciding when and how to bring new life into the world are similarly up grabs. 

About half of the U.S. states are expected to either fully ban or highly restrict abortion in the coming months. In states where abortion is already banned — as of this writing, seven states have done so; eight states will quickly follow and three are expected to ban abortion 30 days from today — this is having immediate repercussions that will dominate the news cycle for the months to come.

In the meantime, there are a whole host of people for whom the depth and breadth of this decision’s impact cannot yet be anticipated. As clinics close, out-of-state clinics prepare for the influx of new patients, state surveillance of pregnancy, miscarriage and stillbirth increases and access to emergency contraceptive pills disappears, Dobbs will touch the lives of far more people in far more negative and invasive ways than Roe v. Wade did. 

COVID-19 showed us how overloaded health care systems struggle to respond to dramatic increases in need. We can expect that even for residents in states where abortion is not illegal, access to in-clinic care will decrease or take longer if appointments fill up with people from out of state.

Suddenly, a procedure like removing a life-threatening ectopic pregnancy might be delayed at clinics that are overloaded with patients. States like California, Maryland and Connecticut have passed laws allowing additional advanced practice clinicians, like nurse practitioners and physicians assistants, to provide abortion care to help prepare for this surplus. But these three states reside on the coastal sides of the country, leaving the middle of America stranded without access to increased abortion care in states protecting access. 

Likewise, the coming increase in use of medication abortion will exacerbate the trend toward medical and police surveillance of women who miscarry and have stillbirths. Since the pandemic, the availability of medication abortion through telehealth has played a huge role in people being able to safely end pregnancies in a timely manner when they can’t seek treatment in-person. For many women this will make access to abortion more convenient and accessible. 

But the unparalleled access by law enforcement to people’s online searches, period tracking data and other forms of infoveillance means that longer term, technology will become a double-edged sword: While it may expand access and convenience for people already in states that support abortion healthcare, the data created by people’s online activity can be used against them in states where it is banned. This will most heavily affect those who are already under increased scrutiny and surveillance due to their race or socioeconomic status, and this will also reach into the lives of families and individuals who previously felt buffered from the dramatic shifts in reproductive law over the past decade.

Many people over the coming months will claim this is “just the beginning” as states begin to carve away at access to medication abortion, birth control and emergency contraceptive pills. They are right. It will be the beginning of the end of the anti-abortion movement.

We’ve seen the extreme impact abortion bans can cause in other countries. In Ireland, Savita Halappanavar lost her life from septicemia — an infection caused by being denied an abortion after a miscarriage. More recently in Poland, Izabela Sajbor died after her doctors refused to give her an abortion. Their deaths led to calls for reform in their countries. Restrictive regimes like those in Ireland and Poland that leave people vulnerable to such tragedies are already the reality for many black and brown women in the U.S. whose states have de facto banned abortion by so thoroughly reducing access. Dobbs just made this a reality for millions more Americans. 

But the Supreme Court went further and opened the door to a slew of restrictions that touch on both the extreme and mundane aspects of reproduction for wide swaths of America. It will be impossible not to see how important it is that women and pregnant people are in control of their reproductive decisions. The Supreme Court made a decision that will directly impact every American. As clinics across the country begin to close their doors starting this week, there will be no turning back. 

Today is the day the tides will change. Today is the day the anti-abortion movement goes on the defensive. 

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Lindsay Parham, PhD, JD, is executive director of the Wallace Center for Maternal, Child and Adolescent Health at UC Berkeley. Emma Anderson is a graduate student in the UC Berkeley School of Public Health.