Anti-abortion advocates press Trump for more restrictions
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Anti-abortion advocates press Trump for more restrictions

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Amanda Seitz
| Associated Press

Washington – Anti-abortion advocates say there is still work to be done to further restrict access to abortion when Republican Donald Trump returns to the White House next year.

They point to federal guidance released by Democratic President Joe Biden’s administration on emergency abortions, requiring hospitals to provide them for women whose health or life is at risk, and its easing of prescription restrictions on abortion pills that have allowed women to order medication online at the touch of a button.

“Now begins the work to dismantle the pro-abortion policies of the Biden-Harris administration,” Susan B. Anthony List, the powerful anti-abortion lobby, said in a statement Wednesday. “President Trump’s first-term lifetime achievements. are the baseline for his second term.”

The group declined to release details about what specifically it will seek to undo. But abortion rights advocates are bracing for further abortion restrictions once Trump takes office. And some women are also with online orders of abortion pills increasing in the days after Election Day.

Trump has said abortion is a matter for the states, not the federal government. Yet, during the campaign, he clearly noted that he was appointing justices to the Supreme Court who were in the majority when they struck down the national right to abortion. And there are things his administration can do, from selecting judges to issuing regulations, to advance an anti-abortion agenda.

Trump is unlikely to require emergency abortions from hospitals

The Trump administration is expected to roll back Biden’s controversial directive requiring emergency rooms to provide abortions when necessary to stabilize a woman’s health or life. The Biden administration had argued that the decades-old federal law, which requires hospitals to provide stabilizing treatment for patients in exchange for Medicare funding, also applies in cases where an abortion may be needed.

Reports of women being sent home or left untreated by hospitals in dangerous scenarios have spread across the United States since the Supreme Court struck down the national right to abortion in 2022. In some cases, hospitals said state abortion bans had prevented them from terminating a pregnancy.

“We see pregnant people’s lives being put at risk,” Fatima Goss Graves, president and CEO of the National Women’s Law Center, said Wednesday. “We see women who have become infertile, who have suffered sepsis. and we are now hearing reports of death.”

Even if a Trump administration abandons the guidance of the law, Goss Graves said advocacy groups like hers will continue a legal fight over the Biden administration’s interpretation of the law.

Some doctors and hospitals have also said the federal guidance offered protection for them to perform emergency abortions in states like Idaho and Texas, where the threat of prosecution for performing an abortion hangs over their decision-making.

Trump has said he supports exemptions for rape and incest cases, as well as when a woman’s life is in danger. But he has not gone so far as to support exceptions when a woman’s health is at stake.

Abortions may be necessary to prevent organ loss, significant bleeding, or dangerous infections for pregnant women in rare but serious scenarios. In cases such as ectopic pregnancy, premature rupture of membranes and placental abruption, a fetus may still be alive but continuing the pregnancy may be harmful. Doctors have argued that the legal gray area has locked them out.

In Idaho, for example, a hospital resorted to flying women out of the state after a strict abortion ban, which only allowed abortions to prevent a woman’s death, was enacted.

The Biden administration sued Idaho, arguing that its state law conflicts with federal law that requires hospitals to provide stabilizing treatment, which can include abortions, to patients. The state changed its law to allow abortions for ectopic pregnancy, but other dangerous scenarios still remain unknown. The Supreme Court declined to take up the issue earlier this year, issuing a limited order allowing hospitals to provide emergency abortions while the case worked its way through lower courts.

However, enforcement of the federal law is on hold in Texas, which called into question the Biden administration’s guidance on emergency abortions.

A patchwork of state laws governing abortion will remain under the Trump administration. Voters in Florida, Nebraska and South Dakota on Tuesday defeated constitutional amendments, leaving the ban in place.

In Missouri, however, voters approved a ballot measure Tuesday to reverse one of the nation’s strictest bans. Abortion rights amendments were also passed in Arizona, Colorado, Maryland and Montana. Nevada voters also approved an amendment, but they must approve it again in 2026 for it to take effect.

Challenges to access to abortion pills will continue under Trump

The ease with which women have been able to obtain abortion pills may also be up for reconsideration under Trump.

During the COVID-19 pandemic, the Food and Drug Administration made it easier to obtain abortion pills, including mifepristone, allowing women to access the medication via telehealth. The agency has approved the drug’s safety during 10 weeks of pregnancy and says side effects occur in 0.32% of patients.

Anti-abortion advocates have questioned that, arguing that the medications are not safe and at least not suitable for easy access without the personal supervision of a doctor.

Although the Supreme Court upheld access to the drug earlier this year, anti-abortion advocates and conservative states have renewed their challenge in lower courts.

Some women are worried. Telehealth company Wisp saw an immediate spike in abortion pill orders between Election Day and the following day, with a 600% increase. In states like Florida and Texas, where the drug cannot be shipped legally, the company saw a nearly 1,000% increase in orders for so-called “morning after” pills, also known as emergency contraception.

The company fills roughly tens of thousands of orders each month for reproductive products including birth control pills and abortion pills, CEO Monica Cepak told the Associated Press.

Right now, women usually take a two-step regimen of mifepristone and misoprostol to complete a medication abortion. Cepak said the company will keep a “close eye” on mifepristone under a Trump administration and is prepared to switch to a misoprostol-only regimen if the mifepristone restriction were to be implemented.

But Trump could be a wild card on the issue, said Mary Ziegler, a law professor at the University of California, Davis who is an expert on reproductive health issues. In the final months of the campaign, he backed away from a more rigid stance on abortion — even saying he wouldn’t sign a national abortion ban if it crossed his desk.

Although he has received firm support from anti-abortion groups, he is willing to break with allies whenever he wants.

“I don’t think we have a clear understanding from him of what he would do,” Ziegler said.

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Associated Press writer Lindsay Whitehurst contributed to this report.

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