Stephanie Joyce
June 24, 2026 marks four years since the Supreme Court eliminated the constitutional right to abortion. This is not a political argument. It is a documented record of what happened next.
The Blueprint: How Mississippi Lit the Fuse
It began in a state with the highest poverty rate in the nation, the worst infant mortality rate, and the only abortion clinic left standing.
In March 2018, Mississippi Governor Phil Bryant signed the Gestational Age Act into law — a bill banning nearly all abortions after 15 weeks of pregnancy, well before the viability threshold established by nearly 50 years of Supreme Court precedent. The law's architects knew it was unconstitutional under existing case law. That was the point. On the very day the bill was signed, the Center for Reproductive Rights filed suit on behalf of Jackson Women's Health Organization, the last abortion clinic in the state, and a federal judge issued a temporary restraining order the following morning.
But Mississippi had something it hadn't had before: a Supreme Court that looked different. By the time the case reached the nation's highest court, three of its nine justices had been appointed by President Donald Trump — Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. The Court agreed to hear Dobbs v. Jackson Women's Health Organization in May 2021.
On June 24, 2022, in a 5-1-3 decision, the Court handed down its ruling. Justice Samuel Alito wrote the majority opinion, joined by Justices Thomas, Gorsuch, Kavanaugh, and Barrett. Their conclusion was blunt: the Constitution “makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.” The majority declared that Roe v. Wade had been “egregiously wrong” and that the authority to regulate abortion belonged to “the people and their elected representatives.” In doing so, the Court did something it had never done before in its history: it took away a fundamental right that Americans had held for five decades.
Chief Justice John Roberts concurred in the judgment but not the sweeping reach of the ruling, arguing his colleagues had gone further than necessary and violated “a simple yet fundamental principle of judicial restraint.” Justices Breyer, Kagan, and Sotomayor filed a joint dissent, warning that the ruling undermined the Fourteenth Amendment's protection of bodily autonomy and liberty, and that for the first time in history, the Court had stripped citizens of an established constitutional right.
That dissent proved prophetic.
Amber Nicole Thurman, 28
Stockbridge, Georgia — Died August 19, 2022
In the summer of 2022, Amber Thurman was building a life. She had recently moved into a new apartment with her six-year-old son, Messiah, and applied to nursing school. When she discovered she was pregnant with twins, she worried about how she would manage. Georgia's six-week abortion ban — the Living Infants and Fairness Equality Act, or “LIFE Act” — had just gone into effect following the Dobbs ruling.
She drove to North Carolina, which still permitted abortion care. But when traffic made her late, the clinic — overwhelmed with patients traveling from states where bans had taken effect — could not keep her appointment slot. A clinic employee gave her FDA-approved abortion pills to take instead. The regimen is safe and used in over half of U.S. abortions.
A rare complication followed. Thurman experienced severe cramping and bleeding, signs that fetal tissue had not fully expelled — a situation requiring a routine procedure called a dilation and curettage, or D&C, to clear the uterus and prevent infection. Her boyfriend called 911. She was taken to Piedmont Henry Hospital in Stockbridge, Georgia, just before 7 p.m. on August 18.
What happened next is documented in a report by Georgia's maternal mortality review committee, obtained by ProPublica investigative reporter Kavitha Surana: doctors waited nineteen hours before performing the D&C. During that time, Thurman's condition deteriorated by the hour. During surgery, her heart stopped. She died on August 19, 2022. She was 28. Messiah was left asking why his best friend was gone.
Georgia's maternal mortality review committee concluded unanimously that her death was preventable, and that the delay in care had a “large” impact on the outcome. Many doctors in states with restrictive bans have publicly stated that they fear criminal prosecution or loss of their medical licenses if they perform procedures that could be construed as unlawful abortions — even when a patient's life is at risk. No one has publicly explained why Thurman's physicians waited nearly a full day to act.
A U.S. Senator later raised the question of whether the hospital violated the Emergency Medical Treatment and Labor Act, which requires hospitals accepting Medicare funding to stabilize patients in emergencies, regardless of state abortion laws. Attorney Ben Crump filed suit on behalf of Thurman's family. A Georgia judge later struck down the six-week ban as violating the state constitution. As her sister put it: “It's like getting a death row pardon two years too late.”
Candi Miller, 41
Atlanta area, Georgia — Died November 12, 2022
Three months after Amber Thurman died, Candi Miller was found unresponsive at her home outside Atlanta. She was 41, the mother of three children, and had lived for years with serious chronic conditions — lupus, diabetes, and hypertension. Physicians had previously warned her that another pregnancy would pose grave health risks.
When she became pregnant in late 2022, she did not seek in-person medical care. According to her family, she feared both the legal consequences and the absence of safe options in Georgia's post-Dobbs landscape. She obtained abortion medication online and managed the process at home. The abortion was incomplete. Her autopsy documented retained fetal tissue and the presence of multiple pain medications, including fentanyl. The medical examiner was unable to determine the official manner of death — it could not be classified as accidental, suicide, homicide, or natural causes.
Georgia's maternal mortality review committee later evaluated her case and concluded unanimously that her death was preventable. Members determined that the state's abortion ban had contributed to the chain of events by shaping her decision not to seek medical care. She had concluded, correctly or not, that she had no safe legal options. She managed her own healthcare in secret, and she died alone.
Amanda Zurawski
Texas — 2022
In 2022, after roughly 18 months of fertility treatment, Amanda Zurawski and her husband were expecting their first child. At approximately 18 weeks, her membranes ruptured prematurely. Physicians told her the pregnancy could not result in a surviving infant. But they believed Texas law — which bans abortion at six weeks with a narrow medical exception — prevented them from ending the pregnancy until her condition became legally life-threatening enough to qualify.
She developed sepsis. She required intensive care. She lost the pregnancy. She has said the infection damaged her future fertility.
Zurawski became the lead plaintiff in Zurawski v. Texas, a landmark lawsuit arguing that uncertainty in the medical exception caused physicians to delay or deny necessary emergency care. In May 2024, the Texas Supreme Court rejected the challenge, ruling unanimously that existing law already permits abortions when necessary to prevent serious impairment — while acknowledging that what Zurawski experienced was not what the law intended to require. The gap between what the law intended and what physicians felt empowered to do had already cost her an incalculable amount.
She has since testified before the U.S. Senate and spoken at national advocacy events. Her account has become the most widely cited firsthand testimony about pregnancy emergency complications in the post-Dobbs era.
Kate Cox
Dallas, Texas — 2023
Kate Cox learned in late 2023 that her fetus had Trisomy 18, a chromosomal condition incompatible with survival. She had undergone prior cesarean deliveries, and her physicians warned that continuing the pregnancy risked serious harm to her future fertility.
Represented by the Center for Reproductive Rights, Cox sought a court order allowing her doctor to perform an abortion under Texas's existing medical exception. A state district judge initially granted the request. The Texas Supreme Court then reversed it, ruling that the legal standard had not been satisfied.
Cox traveled out of state to obtain care.
In 2024, she spoke publicly about her experience, including at the Democratic National Convention, where she announced she was pregnant again — and attributed that possibility to the care she had received outside of Texas, which her doctors said had helped preserve her fertility.
Her case represented the collision between law and medicine in its starkest form: a physician who believed a patient needed a procedure, a state Supreme Court that disagreed, and a woman forced to leave her home to receive care that could have been performed down the street.
The Numbers Behind the Names
These stories are not anomalies. They are part of a documented pattern.
Research published in 2025 and 2026 by Johns Hopkins Bloomberg School of Public Health found a possible 9.2 percent increase in pregnancy-associated deaths in states with abortion bans, amounting to an estimated 68 excess deaths by the end of 2023. A separate analysis by the Gender Equity Policy Institute found that women in ban states are twice as likely to die from pregnancy-related causes as those in states where abortion remains accessible.
In Texas specifically, the first year after the state's six-week ban took effect saw maternal mortality rise 56 percent overall and 95 percent among White women, along with a 50 percent increase in maternal sepsis. Infant mortality in Texas rose by approximately 13 percent over the same period, while the rest of the United States saw a 1.8 percent increase. Black infants in states with bans died at a rate 11 percent higher than would have been expected.
Researchers at Johns Hopkins estimated that across the 14 states with complete or six-week bans, there were roughly 22,000 additional births above expectation by the end of 2023, 59 excess pregnancy-associated maternal deaths, and 478 excess infant deaths since Roe was overturned. One Johns Hopkins researcher, Dr. Suzanne Bell, put it plainly: “These findings suggest many preventable deaths have occurred in states that banned abortion.”
A review of federal emergency room investigations by the Associated Press found that more than 100 pregnant women in medical distress were turned away or treated negligently in emergency rooms since June 2022. In Missouri, Kansas, and Texas, federal investigations concluded that hospitals violated the Emergency Medical Treatment and Labor Act when they delayed or denied care to pregnant patients whose conditions required immediate intervention.
The Contradiction That Cannot Be Ignored
If this were genuinely about protecting life, one would expect to see the same legislative energy directed at the conditions that make pregnancy survivable — and childrearing possible. The record tells a different story.
On July 4, 2025, President Trump signed the “One Big Beautiful Bill Act” into law. The legislation cut nearly $1 trillion from Medicaid over ten years. The nonpartisan Congressional Budget Office estimated that the cuts would cause approximately 11.8 million people to lose health insurance directly, with millions more losing coverage through related marketplace changes. Medicaid currently covers 41 percent of all births in the United States and provides contraceptive care to 23 percent of American women, including 52 percent of women living below the poverty line.
The same bill eliminated Medicaid funding for services provided by Planned Parenthood affiliates, effectively defunding one of the nation's largest networks of reproductive healthcare providers. It also proposed eliminating the Title X Family Planning Program entirely — a move that, if enacted, would leave more than 19 million women already living in “contraceptive deserts” with even fewer options. Cuts to the Supplemental Nutrition Assistance Program put more than 7 million people at risk of losing food assistance, including 2 million children. Over 700 rural hospitals face potential closure as a result of the combined cuts.
The states that ban abortion also have, consistently and by measurable metrics, the worst records on child welfare. Mississippi banned abortion and ranks last in child well-being nationally. Louisiana has one of the strictest abortion bans and one of the highest maternal mortality rates in the country. Texas banned abortion and has declined to expand Medicaid, leaving hundreds of thousands of women and children without health coverage. These are not coincidences; they are a pattern.
The Trump administration also cut $1.81 billion from the National Institutes of Health, and eliminated all funding for the National Institute on Minority Health and Health Disparities — the very agency charged with tracking and closing the health gaps that disproportionately kill Black mothers and their infants. The CDC's Division of Reproductive Health, which monitors maternal mortality and contraceptive safety, lost significant staffing during the same period.
No paid family leave. No universal childcare. No meaningful expansion of maternal support programs. No requirement that the states demanding women carry pregnancies to term provide those women and their children with healthcare, nutrition, or housing after they do.
Analysis: How Different Groups Interpret This Record
The following section reflects the views of distinct groups as they have expressed them publicly. It is labeled opinion and argument, not fact.
Those who support abortion access argue that the evidence accumulated over four years is unambiguous: restricting abortion does not eliminate abortion, it relocates and endangers it. National abortion numbers actually rose above pre-Dobbs levels in the years after the ruling, according to Guttmacher Institute estimates, as patients traveled across state lines or accessed medication by mail from shield-law states. What bans do accomplish, supporters of access argue, is increase maternal mortality, force women to carry nonviable pregnancies, and deter physicians from providing emergency care even when a patient is septic. The simultaneous gutting of Medicaid, contraceptive access, and nutrition programs, they contend, exposes the movement's stated concern for life as selective at best.
Many physicians and medical organizations — including the American College of Obstetricians and Gynecologists — have argued that abortion ban exceptions are written in legal, not medical, language, and that they create a chilling effect in emergency rooms. Doctors do not know when they have crossed the legal threshold until after the fact. The result is what Amanda Zurawski, Amber Thurman, and Candi Miller each experienced in different ways: care withheld or delayed not because medicine demanded it, but because the law made physicians afraid.
Defenders of abortion restrictions argue that the medical exceptions in state laws are sufficient and that doctors should not delay care when the legal standard is met. Some argue that individual cases reflect medical malpractice or physician confusion rather than inherent flaws in the law itself. They maintain that life begins at conception and that the state has a compelling interest in protecting it from the earliest stages of pregnancy. They point to the democratic process: Dobbs returned the question to state legislatures, and voters in several states — including Ohio and Kentucky — have since passed ballot measures enshrining abortion rights, demonstrating that the system is working as intended.
Conservative legal scholars supporting the ruling argue that Roe was never constitutionally grounded to begin with — that the Court in 1973 invented a right not found in the text of the Constitution, and that correcting that error, however disruptive, was legally necessary. They dispute the framing that three Trump-appointed justices were “conservative judges” executing a political agenda, arguing instead that they applied a textualist and originalist reading of the Constitution that any intellectually honest jurist should reach.
These interpretations coexist. The documented deaths, the rising maternal mortality rates, and the cascading cuts to the healthcare safety net do not.
What Comes Next
Four years after Dobbs, 18 states enforce complete or near-total abortion bans. Roughly 62.7 million women and girls live under those bans. Physicians in ban states are leaving their practices or declining to specialize in obstetrics; medical residency programs report declining applications in ban states. Maternity care deserts are expanding. Clinics are closing. Medicaid cuts are beginning to ripple outward into rural hospitals, nutrition programs, and the contraceptive coverage that prevents the unintended pregnancies these laws were ostensibly designed to address.
Amber Thurman never got to go to nursing school. Candi Miller's three children no longer have their mother. Amanda Zurawski carries the physical consequences of a sepsis infection she did not need to survive. Kate Cox had to drive across a state line to preserve the possibility of having another child.
These are not abstractions. They are what the policy produced. And the policy is still in effect.
Sources: ProPublica, CBS News, Johns Hopkins Bloomberg School of Public Health, Gender Equity Policy Institute, Milbank Memorial Fund, Guttmacher Institute, Center for Reproductive Rights, Human Rights Watch, Urban Institute, Food Research & Action Center, American Psychological Association, Georgetown Center for Children and Families, and the Supreme Court of the United States.
June 24, 2026 marks four years since the Supreme Court eliminated the constitutional right to abortion. This is not a political argument. It is a documented record of what happened next.
The Blueprint: How Mississippi Lit the Fuse
It began in a state with the highest poverty rate in the nation, the worst infant mortality rate, and the only abortion clinic left standing.
In March 2018, Mississippi Governor Phil Bryant signed the Gestational Age Act into law — a bill banning nearly all abortions after 15 weeks of pregnancy, well before the viability threshold established by nearly 50 years of Supreme Court precedent. The law's architects knew it was unconstitutional under existing case law. That was the point. On the very day the bill was signed, the Center for Reproductive Rights filed suit on behalf of Jackson Women's Health Organization, the last abortion clinic in the state, and a federal judge issued a temporary restraining order the following morning.
But Mississippi had something it hadn't had before: a Supreme Court that looked different. By the time the case reached the nation's highest court, three of its nine justices had been appointed by President Donald Trump — Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. The Court agreed to hear Dobbs v. Jackson Women's Health Organization in May 2021.
On June 24, 2022, in a 5-1-3 decision, the Court handed down its ruling. Justice Samuel Alito wrote the majority opinion, joined by Justices Thomas, Gorsuch, Kavanaugh, and Barrett. Their conclusion was blunt: the Constitution “makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.” The majority declared that Roe v. Wade had been “egregiously wrong” and that the authority to regulate abortion belonged to “the people and their elected representatives.” In doing so, the Court did something it had never done before in its history: it took away a fundamental right that Americans had held for five decades.
Chief Justice John Roberts concurred in the judgment but not the sweeping reach of the ruling, arguing his colleagues had gone further than necessary and violated “a simple yet fundamental principle of judicial restraint.” Justices Breyer, Kagan, and Sotomayor filed a joint dissent, warning that the ruling undermined the Fourteenth Amendment's protection of bodily autonomy and liberty, and that for the first time in history, the Court had stripped citizens of an established constitutional right.
That dissent proved prophetic.
Amber Nicole Thurman, 28
Stockbridge, Georgia — Died August 19, 2022
In the summer of 2022, Amber Thurman was building a life. She had recently moved into a new apartment with her six-year-old son, Messiah, and applied to nursing school. When she discovered she was pregnant with twins, she worried about how she would manage. Georgia's six-week abortion ban — the Living Infants and Fairness Equality Act, or “LIFE Act” — had just gone into effect following the Dobbs ruling.
She drove to North Carolina, which still permitted abortion care. But when traffic made her late, the clinic — overwhelmed with patients traveling from states where bans had taken effect — could not keep her appointment slot. A clinic employee gave her FDA-approved abortion pills to take instead. The regimen is safe and used in over half of U.S. abortions.
A rare complication followed. Thurman experienced severe cramping and bleeding, signs that fetal tissue had not fully expelled — a situation requiring a routine procedure called a dilation and curettage, or D&C, to clear the uterus and prevent infection. Her boyfriend called 911. She was taken to Piedmont Henry Hospital in Stockbridge, Georgia, just before 7 p.m. on August 18.
What happened next is documented in a report by Georgia's maternal mortality review committee, obtained by ProPublica investigative reporter Kavitha Surana: doctors waited nineteen hours before performing the D&C. During that time, Thurman's condition deteriorated by the hour. During surgery, her heart stopped. She died on August 19, 2022. She was 28. Messiah was left asking why his best friend was gone.
Georgia's maternal mortality review committee concluded unanimously that her death was preventable, and that the delay in care had a “large” impact on the outcome. Many doctors in states with restrictive bans have publicly stated that they fear criminal prosecution or loss of their medical licenses if they perform procedures that could be construed as unlawful abortions — even when a patient's life is at risk. No one has publicly explained why Thurman's physicians waited nearly a full day to act.
A U.S. Senator later raised the question of whether the hospital violated the Emergency Medical Treatment and Labor Act, which requires hospitals accepting Medicare funding to stabilize patients in emergencies, regardless of state abortion laws. Attorney Ben Crump filed suit on behalf of Thurman's family. A Georgia judge later struck down the six-week ban as violating the state constitution. As her sister put it: “It's like getting a death row pardon two years too late.”
Candi Miller, 41
Atlanta area, Georgia — Died November 12, 2022
Three months after Amber Thurman died, Candi Miller was found unresponsive at her home outside Atlanta. She was 41, the mother of three children, and had lived for years with serious chronic conditions — lupus, diabetes, and hypertension. Physicians had previously warned her that another pregnancy would pose grave health risks.
When she became pregnant in late 2022, she did not seek in-person medical care. According to her family, she feared both the legal consequences and the absence of safe options in Georgia's post-Dobbs landscape. She obtained abortion medication online and managed the process at home. The abortion was incomplete. Her autopsy documented retained fetal tissue and the presence of multiple pain medications, including fentanyl. The medical examiner was unable to determine the official manner of death — it could not be classified as accidental, suicide, homicide, or natural causes.
Georgia's maternal mortality review committee later evaluated her case and concluded unanimously that her death was preventable. Members determined that the state's abortion ban had contributed to the chain of events by shaping her decision not to seek medical care. She had concluded, correctly or not, that she had no safe legal options. She managed her own healthcare in secret, and she died alone.
Amanda Zurawski
Texas — 2022
In 2022, after roughly 18 months of fertility treatment, Amanda Zurawski and her husband were expecting their first child. At approximately 18 weeks, her membranes ruptured prematurely. Physicians told her the pregnancy could not result in a surviving infant. But they believed Texas law — which bans abortion at six weeks with a narrow medical exception — prevented them from ending the pregnancy until her condition became legally life-threatening enough to qualify.
She developed sepsis. She required intensive care. She lost the pregnancy. She has said the infection damaged her future fertility.
Zurawski became the lead plaintiff in Zurawski v. Texas, a landmark lawsuit arguing that uncertainty in the medical exception caused physicians to delay or deny necessary emergency care. In May 2024, the Texas Supreme Court rejected the challenge, ruling unanimously that existing law already permits abortions when necessary to prevent serious impairment — while acknowledging that what Zurawski experienced was not what the law intended to require. The gap between what the law intended and what physicians felt empowered to do had already cost her an incalculable amount.
She has since testified before the U.S. Senate and spoken at national advocacy events. Her account has become the most widely cited firsthand testimony about pregnancy emergency complications in the post-Dobbs era.
Kate Cox
Dallas, Texas — 2023
Kate Cox learned in late 2023 that her fetus had Trisomy 18, a chromosomal condition incompatible with survival. She had undergone prior cesarean deliveries, and her physicians warned that continuing the pregnancy risked serious harm to her future fertility.
Represented by the Center for Reproductive Rights, Cox sought a court order allowing her doctor to perform an abortion under Texas's existing medical exception. A state district judge initially granted the request. The Texas Supreme Court then reversed it, ruling that the legal standard had not been satisfied.
Cox traveled out of state to obtain care.
In 2024, she spoke publicly about her experience, including at the Democratic National Convention, where she announced she was pregnant again — and attributed that possibility to the care she had received outside of Texas, which her doctors said had helped preserve her fertility.
Her case represented the collision between law and medicine in its starkest form: a physician who believed a patient needed a procedure, a state Supreme Court that disagreed, and a woman forced to leave her home to receive care that could have been performed down the street.
The Numbers Behind the Names
These stories are not anomalies. They are part of a documented pattern.
Research published in 2025 and 2026 by Johns Hopkins Bloomberg School of Public Health found a possible 9.2 percent increase in pregnancy-associated deaths in states with abortion bans, amounting to an estimated 68 excess deaths by the end of 2023. A separate analysis by the Gender Equity Policy Institute found that women in ban states are twice as likely to die from pregnancy-related causes as those in states where abortion remains accessible.
In Texas specifically, the first year after the state's six-week ban took effect saw maternal mortality rise 56 percent overall and 95 percent among White women, along with a 50 percent increase in maternal sepsis. Infant mortality in Texas rose by approximately 13 percent over the same period, while the rest of the United States saw a 1.8 percent increase. Black infants in states with bans died at a rate 11 percent higher than would have been expected.
Researchers at Johns Hopkins estimated that across the 14 states with complete or six-week bans, there were roughly 22,000 additional births above expectation by the end of 2023, 59 excess pregnancy-associated maternal deaths, and 478 excess infant deaths since Roe was overturned. One Johns Hopkins researcher, Dr. Suzanne Bell, put it plainly: “These findings suggest many preventable deaths have occurred in states that banned abortion.”
A review of federal emergency room investigations by the Associated Press found that more than 100 pregnant women in medical distress were turned away or treated negligently in emergency rooms since June 2022. In Missouri, Kansas, and Texas, federal investigations concluded that hospitals violated the Emergency Medical Treatment and Labor Act when they delayed or denied care to pregnant patients whose conditions required immediate intervention.
The Contradiction That Cannot Be Ignored
If this were genuinely about protecting life, one would expect to see the same legislative energy directed at the conditions that make pregnancy survivable — and childrearing possible. The record tells a different story.
On July 4, 2025, President Trump signed the “One Big Beautiful Bill Act” into law. The legislation cut nearly $1 trillion from Medicaid over ten years. The nonpartisan Congressional Budget Office estimated that the cuts would cause approximately 11.8 million people to lose health insurance directly, with millions more losing coverage through related marketplace changes. Medicaid currently covers 41 percent of all births in the United States and provides contraceptive care to 23 percent of American women, including 52 percent of women living below the poverty line.
The same bill eliminated Medicaid funding for services provided by Planned Parenthood affiliates, effectively defunding one of the nation's largest networks of reproductive healthcare providers. It also proposed eliminating the Title X Family Planning Program entirely — a move that, if enacted, would leave more than 19 million women already living in “contraceptive deserts” with even fewer options. Cuts to the Supplemental Nutrition Assistance Program put more than 7 million people at risk of losing food assistance, including 2 million children. Over 700 rural hospitals face potential closure as a result of the combined cuts.
The states that ban abortion also have, consistently and by measurable metrics, the worst records on child welfare. Mississippi banned abortion and ranks last in child well-being nationally. Louisiana has one of the strictest abortion bans and one of the highest maternal mortality rates in the country. Texas banned abortion and has declined to expand Medicaid, leaving hundreds of thousands of women and children without health coverage. These are not coincidences; they are a pattern.
The Trump administration also cut $1.81 billion from the National Institutes of Health, and eliminated all funding for the National Institute on Minority Health and Health Disparities — the very agency charged with tracking and closing the health gaps that disproportionately kill Black mothers and their infants. The CDC's Division of Reproductive Health, which monitors maternal mortality and contraceptive safety, lost significant staffing during the same period.
No paid family leave. No universal childcare. No meaningful expansion of maternal support programs. No requirement that the states demanding women carry pregnancies to term provide those women and their children with healthcare, nutrition, or housing after they do.
Analysis: How Different Groups Interpret This Record
The following section reflects the views of distinct groups as they have expressed them publicly. It is labeled opinion and argument, not fact.
Those who support abortion access argue that the evidence accumulated over four years is unambiguous: restricting abortion does not eliminate abortion, it relocates and endangers it. National abortion numbers actually rose above pre-Dobbs levels in the years after the ruling, according to Guttmacher Institute estimates, as patients traveled across state lines or accessed medication by mail from shield-law states. What bans do accomplish, supporters of access argue, is increase maternal mortality, force women to carry nonviable pregnancies, and deter physicians from providing emergency care even when a patient is septic. The simultaneous gutting of Medicaid, contraceptive access, and nutrition programs, they contend, exposes the movement's stated concern for life as selective at best.
Many physicians and medical organizations — including the American College of Obstetricians and Gynecologists — have argued that abortion ban exceptions are written in legal, not medical, language, and that they create a chilling effect in emergency rooms. Doctors do not know when they have crossed the legal threshold until after the fact. The result is what Amanda Zurawski, Amber Thurman, and Candi Miller each experienced in different ways: care withheld or delayed not because medicine demanded it, but because the law made physicians afraid.
Defenders of abortion restrictions argue that the medical exceptions in state laws are sufficient and that doctors should not delay care when the legal standard is met. Some argue that individual cases reflect medical malpractice or physician confusion rather than inherent flaws in the law itself. They maintain that life begins at conception and that the state has a compelling interest in protecting it from the earliest stages of pregnancy. They point to the democratic process: Dobbs returned the question to state legislatures, and voters in several states — including Ohio and Kentucky — have since passed ballot measures enshrining abortion rights, demonstrating that the system is working as intended.
Conservative legal scholars supporting the ruling argue that Roe was never constitutionally grounded to begin with — that the Court in 1973 invented a right not found in the text of the Constitution, and that correcting that error, however disruptive, was legally necessary. They dispute the framing that three Trump-appointed justices were “conservative judges” executing a political agenda, arguing instead that they applied a textualist and originalist reading of the Constitution that any intellectually honest jurist should reach.
These interpretations coexist. The documented deaths, the rising maternal mortality rates, and the cascading cuts to the healthcare safety net do not.
What Comes Next
Four years after Dobbs, 18 states enforce complete or near-total abortion bans. Roughly 62.7 million women and girls live under those bans. Physicians in ban states are leaving their practices or declining to specialize in obstetrics; medical residency programs report declining applications in ban states. Maternity care deserts are expanding. Clinics are closing. Medicaid cuts are beginning to ripple outward into rural hospitals, nutrition programs, and the contraceptive coverage that prevents the unintended pregnancies these laws were ostensibly designed to address.
Amber Thurman never got to go to nursing school. Candi Miller's three children no longer have their mother. Amanda Zurawski carries the physical consequences of a sepsis infection she did not need to survive. Kate Cox had to drive across a state line to preserve the possibility of having another child.
These are not abstractions. They are what the policy produced. And the policy is still in effect.
Sources: ProPublica, CBS News, Johns Hopkins Bloomberg School of Public Health, Gender Equity Policy Institute, Milbank Memorial Fund, Guttmacher Institute, Center for Reproductive Rights, Human Rights Watch, Urban Institute, Food Research & Action Center, American Psychological Association, Georgetown Center for Children and Families, and the Supreme Court of the United States.
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