Two Years After the End of “Roe”: The Struggle for Reproductive Justice and Bodily Autonomy

The struggle for reproductive justice is about more than legal rights — it’s about bodily autonomy and access to care. Two years after the Supreme Court decision Dobbs v. Jackson Women’s Health Organization ended federal protections for the legal right to abortion, the number of people traveling across state lines to access abortions has more than doubled. Dobbs, which was the first case to fully overturn the precedent set by Roe v. Wade in 1973, was the culmination of a long and complex conservative political strategy.

Impact on Abortion Access and Public Health

The Dobbs decision transformed the abortion access landscape, putting extreme strain on a system of abortion providers, clinic workers and abortion funds that was already highly over-taxed due to the significant gaps in access that Roe v. Wade never prevented. The following data highlights the scale of these changes:

• Increased travel: The number of people traveling across state lines to access abortions has more than doubled.
• Self-managed care: Within the six-month period immediately after the decision, an estimated 27,838 more people accessed abortion outside the formal medical system than would have been expected before the Dobbs decision.
• Continued pregnancies: Based on the first six months of 2023, researchers estimated over 30,000 people per year since the landmark decision who would have accessed abortion instead continued their pregnancies.

Assuming the estimate to be accurate, the reproductive lives of over 30,000 people per year were fundamentally different as a result of the Dobbs decision and these individuals were put at higher risk of various harmful outcomes, including increased financial instability and physical health problems, than they would have been if they had been able to access wanted abortions.

Historical Stigma and Systemic Barriers

Abortion has been stigmatized and exceptionalized from the rest of health care since the advent of the modern medical system in the United States. In the 19th century, the physicians of the newly formed American Medical Association campaigned alongside politicians to make abortion an issue of morality in U.S. society in order to consolidate their power and control who could practice medicine. Their efforts included attempts to push midwives, in particular Black Southern midwives, out of practice through the simultaneous introduction of medical practice licensure requirements and criminal penalties for providing abortion care, a service provided primarily by midwives.

These criminalization campaigns across history have relied on xenophobic and racist ideas that have been cyclically embraced in the context of rising immigration and the popularity of eugenicist ideologies. In the endeavor to secure social and economic power for physicians, these individuals transformed the general public’s perception of abortion and opened the door to the criminalization of abortion that we are facing today.

The Current Legal Landscape

The gaps in care included legislation intended to induce clinic closures and make access more difficult through waiting periods and other unnecessary barriers like the Hyde Amendment, which bars federal funds from being used for abortions. Today, the entities orchestrating the anti-abortion project in the United States — including politicians, judges, and religious and political organizations — have since shifted their efforts toward increasing criminal penalties for those who have abortions in states with bans; banning or restricting abortion pill access; and working toward a national abortion ban. For example, Louisiana Banned Abortion Pills even as it also faces a maternal mortality crisis.

The anti-abortion movement has employed multiple legal avenues, including influencing legal and judicial education and appointments and funding election campaigns of anti-abortion candidates. Instead of addressing sky-high rates of pregnancy-related death, lawmakers in certain states have prioritized criminalizing medical care.