Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Voters in the swing states (Arizona and Nevada), blue-leaning states (Colorado, Maryland and New York) and red-leaning states (Florida, Missouri, Montana, Nebraska and South Dakota) will have the ability to directly decide the future of abortion access this fall. Among the organizers who submitted signatures to qualify an abortion rights amendment for this year’s ballot, only those in Arkansas fell short.

These 10 initiatives will be the latest to pursue enshrining abortion access in a state’s constitution since the Supreme Court overturned Roe v. Wade in 2022.

Here is what the proposed amendments would do if passed — and how they would impact current abortion care laws in those states.

Arizona

The proposed constitutional amendment on the ballot in this crucial southwestern battleground would create a “fundamental right” to an abortion up until fetal viability, or about the 24th week of pregnancy. After that point, the measure would bar the state from restricting abortion in situations when the health or the life of the pregnant person is at risk, according to the treating health care professional.

Under current Arizona law, abortion is legal up until the 15th week of pregnancy, with an exception after that to save the woman’s life and no exceptions after that for rape or incest. If voters approve the proposed ballot measure in November, it would effectively undo the 15-week ban. It needs a simple majority of support to pass.

Colorado

The proposed amendment in Colorado would declare formally that “the right to abortion is hereby recognized” and that “government shall not deny, impede or discriminate against the exercise of that right.”

It also explicitly states that the government may not prohibit health insurance coverage for abortion, including insurance plans for public employees and publicly funded insurance plans. That provision would effectively undo a 1984 law that barred people from using their health insurance to pay for abortion care.

The ballot measure in Colorado — where there are no laws restricting abortion and no gestational limits at all for women seeking an abortion — is intended to formally enshrine those rights, a move organizers say is crucial to prevent lawmakers from having any future opportunity to undo them.

To pass in November, the measure requires the support of 55% of voters under state law, not just a simple majority.

Florida

The state’s ballot initiative would bar restrictions on abortion before fetal viability and would include exceptions past that point for “the patient’s health, as determined by the patient’s healthcare provider.”

Passage of the amendment would effectively undo the state’s six-week ban on abortion, which includes exceptions for rape, incest and the life of the woman.

Under Florida law, the measure must receive the support of 60% of voters in November, rather than a simple majority, to pass.

Maryland

Lawmakers, who control the amendment process in Maryland rather than citizens, voted to place a measure on the ballot that would enshrine abortion rights in the state constitution.

It would add language to guaranteeing the right to “to make and effectuate decisions to prevent, continue, or end one’s own pregnancy.”

Abortion is already legal in the state through fetal viability, with exceptions afterward when the woman’s life or health is at risk, or when a fetal anomaly is detected. A simple majority is needed for passage.

Missouri 

Missouri’s amendment would enshrine language in the state constitution to protect abortion rights up until fetal viability, with exceptions after that point for the life and health of the mother.

The amendment specifically states that the government “shall not deny or infringe upon a person’s fundamental right to reproductive freedom,” which the amendment defines as all decisions related to reproductive health care, explicitly including “birth control,” “abortion care” and “miscarriage care” — up until fetal viability. The proposal also deems any “denial, interference, delay or restriction” of such care as “invalid.”

After that point, the government may regulate abortion except in cases where a treating health care professional has judged the “life or physical or mental health” of the mother to be at risk.

At the same time, the amendment would allow lawmakers and state officials to restrict or limit abortion rights in situations in which doing so “is for the limited purpose and has the limited effect of improving or maintaining the health of a person seeking care, is consistent with widely accepted clinical standards of practice and evidence-based medicine, and does not infringe on that person’s autonomous decision-making.”

Missouri currently has one of the strictest abortion bans in the U.S. in place, with exceptions to protect the life of the mother and for medical emergencies. If the amendment were to pass, it would effectively undo that law. A simple majority is needed for passage.

Montana

The ballot measure in Montana would amend the state constitution to provide a right to “make and carry out decisions about one’s own pregnancy, including the right to abortion.” It would also “prohibit the government from denying or burdening the right to abortion before fetal viability,” and  “prohibit the government from denying or burdening access to an abortion when a treating healthcare professional determines it is medically indicated to protect the pregnant patient’s life or health.”

Abortion is currently legal in Montana until fetal viability, so enshrining abortion rights in the state constitution would serve to make it more difficult for lawmakers to undo current protections in the future. A simple majority is needed for passage.

Nebraska

In Nebraska, two dueling constitutional amendments will appear on the November ballot.

One of the ballot measures, known as “Protect the Right to Abortion,” would amend the state’s constitution to state that “all persons shall have a fundamental right to abortion until fetal viability, or when needed to protect the life or health of the pregnant patient.”

The other, called “Protect Women and Children,” bars abortions in the second and third trimesters, except in the case of a medical emergency or when the pregnancy is a result of sexual assault or incest.

Nebraska law currently bans abortion after 12 weeks of pregnancy, with exceptions for rape, incest and saving the mother’s life. The pro-abortion rights measure would effectively undo that law, while the other would basically codify the law in the state constitution.

For a ballot measure to pass in Nebraska, it needs to receive a majority of the vote and at least 35% of the total votes cast in the election in favor of it. If both amendments pass, the one with the most votes prevails.

Nevada

In Nevada, abortion is already legal until the 24th week of pregnancy. But fearing that such rights could be undone in the future, reproductive rights advocates succeeded in placing a constitutional amendment on the November ballot that would enshrine similar language, protecting abortion rights up until fetal viability.

Under state law, even if the measure passes in November, voters would need to approve it again in 2026 before the Nevada constitution is formally amended.

New York

As in Maryland, lawmakers, not citizens, control the amendment process in New York. State legislators voted to put a measure on the ballot that would enshrine abortion rights in the state constitution.

The Equal Protection of Law Amendment doesn’t actually explicitly mention abortion, but would enshrine rights in the state constitution designed to protect against anything the government does to affect a person’s “pregnancy, pregnancy outcomes, and reproductive healthcare and autonomy.”

In New York, abortion is legal up to around the 24th week of pregnancy. Passage of the proposal — which requires a simple majority — would effectively cement those projections constitutionally. 

South Dakota

The proposed constitutional amendment on the ballot in South Dakota would make abortion legal in all situations in the first trimester of pregnancy. It would allow “regulation” by the state of abortion in the second trimester of pregnancy, but such regulation “must be reasonably related to the physical health of the pregnant woman.” 

The amendment would allow “regulation or prohibition” by the state in the third trimester, except in cases when a physician has determined that the care would be necessary to “preserve the life or health” of the woman.

If it passes, the amendment would effectively undo the state’s near-total ban on abortion, which snapped back into effect after Roe v. Wade was struck down in 2022. The law, which abortion advocates say is among the harshest in the U.S., prohibits all abortions except when necessary to save the woman’s life.

The ballot measure will need to win a simple majority to pass.

This article first appeared on NBCNews.com. Read more from NBC News here:

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This story uses functionality that may not work in our app. Click here to open the story in your web browser.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

The findings, shared exclusively with NBC News, are the result of a monthslong investigation by Democrats on the House Committee on Energy and Commerce. They’re based on conversations with leaders and educators from 20 OB-GYN residency programs conducted from February to June. Half of those programs are in states that restrict abortion access.

The report highlights several worrisome effects of abortion restrictions instituted after Roe v. Wade was overturned, including fewer applicants to OB-GYN residency programs in states that restrict abortion, practicing OB-GYNs moving out of these states and new doctors being left unprepared to treat pregnant patients in life-threatening scenarios.

“I don’t think people realize how dire the situation has become so quickly,” said Rep. Frank Pallone Jr., of New Jersey, the committee’s ranking Democrat.

Several residency program directors interviewed for the report recalled dangerous, sometimes tragic, situations in states with abortion bans.

One director described a patient who died from sepsis after she wasn’t able to get an abortion. Another said their hospital had to hold off on providing an abortion for a patient whose amniotic sac had ruptured at 20 weeks, which creates a risk of infection.

The report also reinforces the conclusions of other prior research: that pregnant patients have to travel longer distances to obtain abortions or wind up visiting multiple hospitals before they can find one that will treat them for complex medical issues. The share of patients traveling to other states for abortions doubled from 2020 to 2023, according to the Guttmacher Institute, a research organization that supports abortion access.

“Those delays in care really can lead to downstream complications and preventable morbidity,” said Dr. Justin Lappen, chair of the Society for Maternal-Fetal Medicine’s Reproductive Health Committee, who wasn’t involved in the new report. 

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The report also highlights how little education some OB-GYN residents are receiving in how to provide an abortion. 

“It’s already happened in the restricted states that women who needed an emergency abortion were not able to get it because [doctors] were afraid to perform it. Now, on top of that, you layer the fact that even if the doctors wanted to do it, they don’t have the knowledge to do it,” Pallone said.

In the past, residency programs often partnered with abortion clinics to provide that training, but in states with abortion bans, those clinics have shut down. Some programs pay for residents to get such training out-of-state, but that often requires additional medical licenses and liability insurance and means residents must spend multiple weeks away from home. 

In states that restrict abortion, some OB-GYN residents have to rely on textbooks in lieu of observing an abortion firsthand or simulate the procedure using a piece of fruit. 

“You can tell who has done it and who has learned it from a book,” one residency director said in the report. “There is a gap in how they’d manage patients.”

Lappen said residents who don’t receive sufficient training might not develop expertise about how to manage situations like miscarriages or ectopic pregnancies, or lack the skills to quickly intervene in life-threatening emergencies, when an abortion is medically necessary. 

“Abortion care can be the fastest way to save someone’s life, and the easiest way to save someone’s life” in certain cases, he said. “That skill set is really, incredibly important and there are parts of the country where it currently is in significant shortage or may not exist.”

Applications to OB-GYN residency programs in states with abortion restrictions have declined since Dobbs, according to the report. Other research has found the same trend: The number of medical school graduates who applied to residencies in states with abortion bans fell 3% in the 2022-2023 application cycle compared to the previous year, then another 4% in the 2023-2024 cycle. 

Some states with strict abortion laws have also seen OB-GYNs move away, making it harder for residents to access reproductive care. Idaho, for instance, lost 22% of its practicing obstetricians from August 2022 to November 2023, according to one report.

Like many doctors and nurses in states that restrict abortion, OB-GYN residents fear being fined or held criminally liable for providing an abortion in an emergency, the new report says. They also lack clarity as to when the procedure is legally allowed to save a patient’s life. 

Some patients, doctors and advocates have begun to seek that clarity in court. In May, the Texas Supreme Court rejected a challenge to the state’s abortion ban from 20 women and two doctors who sought more information about what’s considered a “medical emergency” under state law. In June, the U.S. Supreme Court dismissed an appeal in a case about whether doctors in Idaho can perform abortions in emergencies. The decision allowed emergency abortions to continue in the state.

The problems outlined in the new report existed before Dobbs, several OB-GYNs said, since some states already had restrictions that made abortions difficult to obtain — but they said the issues have gotten worse in the last two years. 

The report suggests that reinstating a federal right to abortion is the way to keep these problems from escalating, and it calls on Congress to pass the Women’s Health Protection Act, a bill that would safeguard abortion access nationwide. 

This story first appeared on NBCNews.com. More from NBC News:

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On Thursday, Minnesota’s Democratic Lt. Gov. Peggy Flanagan toured the Whole Woman’s Health of Minnesota, a nonprofit abortion clinic in the city of Bloomington. She welcomed Iowa residents who were seeking abortions after the state’s new restrictions take effect.

Previously, abortion was legal up to 20 weeks of pregnancy in Iowa. Last July, the state’s Republican-controlled legislature passed a new ban on the procedure after six weeks of pregnancy, which is often before women know they are pregnant. There are limited exceptions in cases of rape, incest, fetal abnormality or when the life of the mother is in danger.

Sarah Traxler, an OB-GYN based in Minnesota and the chief medical officer of Planned Parenthood North Central States, said Iowa’s law could have ripple effects throughout the region.

“When the Dobbs decision came down, many of the patients coming to Iowa were from Missouri,” Traxler said in an interview with Minnesota Public Radio. “This is going to have resounding impacts on the region itself, especially the Midwest and the South.”

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The Iowa Supreme Court reiterated in June that there is no constitutional right to an abortion in the state and ordered a hold on the law to be lifted. The district court judge’s orders last week set July 29 as the first day of enforcement.

Across the country, the state of abortion access has being changing ever since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. Trigger laws immediately went into effect, new restrictions were passed, court battles put those on hold and in some places, there was expanded access.

In states with restrictions, the main abortion options are getting pills by mail or underground networks and traveling, vastly driving up demand in states with more access.

Whole Woman’s Health of Minnesota has served patients from South Dakota, Nebraska, Wisconsin, Indiana, Texas, Oklahoma, Tennessee, Florida and Arkansas over the past year. Amy Hagstrom Miller, founder and CEO of the clinic, said she expects to see an increase in patient demand after Iowa’s restrictions take effect.

Flanagan said Minnesota would remain committed to serving people traveling from other states seeking abortion care.

“If you’re afraid, come to Minnesota,” Flanagan said. “We’ve got you.”

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Democrats in several states hope similar measures mobilize supporters on Election Day.

Democrats have made abortion rights a central message since the U.S. Supreme Court overturned Roe v. Wade, the landmark 1973 court decision establishing a nationwide right to abortion. Nevada voters in 1990 made abortion legal up to 24 weeks, but a state law is easier to pass and more vulnerable to change than the constitutional protection organizers are seeking.

Several Republican-controlled states have tightened abortion restrictions or imposed outright bans. Fourteen states ban abortions at all stages of pregnancy, while 25 allow abortions up to 24 weeks or later, with limited exceptions.

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Most states with Democratic legislatures have laws or executive orders protecting access. Voters in California, Kansas, Kentucky, Michigan, Montana, Ohio and Vermont have sided with abortion rights supporters on ballot measures. Supporters of abortion rights have qualified measures for ballots in Colorado and South Dakota, and Nevada was among about nine other states where signature drives have been underway.

Nevadans for Reproductive Freedom, the political action committee that organized the ballot initiative, said last month that they submitted more than 200,000 signatures. Proponents needed 102,000 valid signatures by June 26 to qualify for the ballot.

The organization held a news conference Monday, which marked two years after the Dobbs decision overturned the national right to abortion, to promote the petition and unveil a letter signed by medical professionals in support.

“We can’t take anything for granted in a post-Dobbs world and that’s why we are really doubling down on the protections we have in statute currently,” said Lindsey Harmon, the group’s president.

Separately, Republican organizers said they submitted nearly 180,000 signatures to get a measure on November’s ballot that would amend the state Constitution to require that voters show photo identification at the polls, said David Gibbs, of political action committee Repair the Vote. If counties verify just over 100,000 signatures, voters would have to pass the amendment in both 2024 and 2026 for it to take effect.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

The document suggests that a 6-3 ruling from the court will reinstate a lower court’s order to allow Idaho emergency rooms to provide abortions that save a woman’s health as the broader legal case plays out.

The Justice Department had sued Idaho over its abortion law, which allows a woman to get an abortion only when her life — not her health — is at risk. Idaho doctors say they were unable to provide the stabilizing treatment the federal law requires and that is typically standard of care, prompting them to airlift at least a half-dozen pregnant patients to other states since Idaho’s law took effect in January.

But attorneys for Idaho have said their state law allows for women in dire circumstances to get an abortion and is not in conflict with the federal law.

The federal law, called the Emergency Medical Treatment and Active Labor Act, or EMTALA, requires doctors to stabilize or treat any patient who shows up at an emergency room.

Here’s a look at the history of EMTALA, what rights it provides patients and how a Supreme Court ruling might change that.

What protections does EMTALA provide patients at an ER?

The law requires emergency rooms to offer a medical exam if you turn up at their facility. The law applies to nearly all emergency rooms — any that accept Medicare funding.

Those emergency rooms are required to stabilize patients if they do have a medical emergency before discharging or transferring them. And if the ER doesn’t have the resources or staff to properly treat that patient, staff members are required to arrange a medical transfer to another hospital, after they’ve confirmed the facility can accept the patient.

So, for example, if a pregnant woman shows up at an emergency room concerned that she is in labor but there is not an OB-GYN on staff who could deliver her baby, hospital staff cannot simply direct the woman to go elsewhere.

Why was this law created?

Look to Chicago in the early 1980s.

Doctors at the city’s public hospital were confronting a huge problem: Thousands of patients, many of them Black or Latino, were arriving in very bad condition — and they were sent there by private hospitals in the city that refused to treat them. Some were gunshot victims who hadn’t been stabilized. Most of them did not have health insurance.

Chicago wasn’t alone. Doctors working in public hospitals around the country reported similar issues. Media reports, including one of a pregnant woman who delivered a stillborn baby after being turned away by two hospitals because she didn’t have insurance, intensified public pressure on politicians to act.

Congress drafted legislation with Republican Sen. David Durenberger of Minnesota saying at the time, “Americans, rich or poor, deserve access to quality health care. This question of access should be the government’s responsibility at the federal, state, and local levels.”

Then-President Ronald Reagan, a Republican, signed the bill into law in 1986.

What happens if a hospital turns away a patient?

The hospital is investigated by the Centers for Medicare and Medicaid Services. If they find the hospital violated a patient’s right to care, they can lose their Medicare funding, a vital source of revenue needed for most hospitals to keep their doors open.

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Usually, however, the federal government issues fines when a hospital violates EMTALA. They can add up to hundreds of thousands of dollars.

Why did the Supreme Court look at the law?

Since the Supreme Court overturned the constitutional right to an abortion, President Joe Biden, a Democrat, has repeatedly reminded hospitals that his administration considers an abortion part of the stabilizing care that EMTALA requires facilities to provide.

The Biden administration argues that Idaho’s law prevents ER doctors from offering an abortion if a woman needs one in a medical emergency.

But Idaho’s attorney general has pointed out that EMTALA also requires hospitals to consider the health of the “unborn child” in its treatment, too. Attorneys for Idaho have also said that there’s no conflict between the state and federal law since Idaho allows doctors to perform an abortion if the woman’s life is at stake.

What are the advocates saying?

Anti-abortion advocates argue that state laws banning abortion can coexist with the federal law that requires hospitals to stabilize pregnant patients in an emergency.

The prominent anti-abortion group Susan B. Anthony Pro-Life America has called the lawsuit in Idaho a “PR stunt.”

“The EMTALA case is based on the false premise that pregnant women cannot receive emergency care under pro-life laws,” said Kelsey Pritchard, the group’s state public affairs director after the case was heard earlier this year. “It is a clear fact that pregnant women can receive miscarriage care, ectopic pregnancy care and treatment in a medical emergency in all 50 states.”

But many doctors say it’s not as clear cut as anti-abortion advocates claim.

In rare cases, a woman may risk sepsis, hemorrhaging or reproductive organ loss if a troubled pregnancy is not terminated. But Idaho’s state law forces a doctor to wait until the patient is close enough to death to end a pregnancy, doctors argue.

Doctors risk a minimum two-year imprisonment for providing an abortion if the woman’s life is not at risk.

“There’s nothing worse than feeling as a physician that you know what the patient needs and you can’t get it for them,” Dr. Jessica Kroll, the president of the Idaho American College of Emergency Physicians, told reporters during a press conference early this month.

The analysis out of Johns Hopkins University is the latest research to find higher infant mortality rates in states with abortion restrictions.

The researchers looked at how many infants died before their first birthday after Texas adopted its abortion ban in September 2021. They compared infant deaths in Texas to those in 28 states — some also with restrictions. The researchers calculated that there were 216 more deaths in Texas than expected between March and December the next year.

In Texas, the 2022 mortality rate for infants went up 8% to 5.75 per 1,000 births, compared to a 2% increase in the rest of the U.S., according to the study in the journal JAMA Pediatrics.

Among causes of deaths, birth defects showed a 23% increase, compared to a decrease of about 3% in the rest of the U.S. The Texas law blocks abortions after the detection of cardiac activity, usually five or six weeks into pregnancy, well before tests are done to detect fetal abnormalities.

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“I think these findings make clear the potentially devastating consequences that abortion bans can have,” said co-author Suzanne Bell, a fertility researcher.

Doctors have argued that the law is too restrictive toward women who face pregnancy complications, though the state’s Supreme Court last month rejected a case that sought to weaken it.

Infant deaths are relatively rare, Bell said, so the team was a bit surprised by the findings. Because of the small numbers, the researchers could not parse out the rates for different populations, for example, to see if rates were rising more for certain races or socioeconomic groups.

But the results did not come as a surprise to Tiffany Green, a University of Wisconsin-Madison economist and population health scientist who studies the consequences of racial inequities on reproductive health. She said the results were in line with earlier research on racial disparities in infant mortality rates due to state differences in Medicaid funding for abortions. Many of the people getting abortions are vulnerable to pregnancy complications, said Green, who was not part of the research.

Stephen Chasen, a maternal-fetal medicine specialist with Weill Cornell Medicine, said abortion restrictions have other consequences. Chasen, who had no role in the research, said people who carry out pregnancies with fetal anomalies need extra support, education and specialized medical care for the mother and newborn — all of which require resources

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The request has been ignored by the Republican lawmakers who have supermajority control in the Legislature and banned abortions in the state in 2022, shortly after the U.S. Supreme Court overturned a constitutional right to the procedure.

The petition, with more than 2,500 signatures, is essentially meaningless given the current makeup of the Legislature. But it illustrates the frustratingly limited options millions of Americans face in trying to re-establish abortion rights as the country marks the two-year anniversary since the Supreme Court’s ruling.

West Virginia is among the 25 states that do not allow citizen initiatives or constitutional amendments on a statewide ballot, an avenue of direct democracy that has allowed voters to circumvent their legislatures and preserve abortion and other reproductive rights in a number of states over the past two years.

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Republicans there have repeatedly dismissed the idea of placing an abortion-rights measure before voters, which in West Virginia is a step only lawmakers can take.

“It makes you wonder what they’re so afraid of,” said Democratic Del. Kayla Young, one of only 16 women in the West Virginia Legislature. “If they feel so strongly that this is what people believe, prove it.”

The court’s ruling to overturn Roe v. Wade was praised by abortion opponents as a decision that returned the question to the states. Former President Donald Trump, who named three of the justices who overturned Roe, has repeatedly claimed “the people” are now the ones deciding abortion access.

“The people are deciding,” he said during a recent interview with Fox News host Sean Hannity. “And in many ways, it’s a beautiful thing to watch.”

But that’s not true everywhere. In states allowing the citizen initiative and where abortion access has been on the ballot, voters have resoundingly affirmed the right to abortion.

Voters in seven states, including conservative ones such as Kentucky, Montana and Ohio, have either protected abortion rights or defeated attempts to curtail them in statewide votes over the past two years. Reproductive rights supporters are trying to put citizen initiatives on the ballot in several states this year.

But voters don’t have a direct say in about half the states.

This is particularly true for those living in the South. Republican-controlled legislatures, many of which have been heavily gerrymandered to give the GOP disproportionate power, have enacted some of the strictest abortion bans since the Supreme Court ruling while shunning efforts to expand direct democracy.

States began adopting the initiative process during the Progressive Era more than a century ago, giving citizens a way to make or repeal laws through a direct vote of the people. Between 1898 and 1918, nearly 20 states approved the citizen initiative. Since then, just five states have done so.

“It was a different time,” said John Matsusaka, professor of business and law at the University of Southern California. “There was a political movement across the whole country when people were trying to do what they saw as good government.”

Some lawmakers argue citizen initiatives bypass important checks and balances offered through the legislative process. In Tennessee, where Republicans have gerrymandered legislative districts to give them a supermajority in the statehouse, House Majority Leader William Lamberth likened ballot measures to polls rather than what he described as the legislature’s strict review of complicated policy-making.

“We evaluate bills every single year,” he said.

As in West Virginia, abortion-rights supporters or Democratic lawmakers have asked Republican-controlled legislatures in a handful of states to take the abortion question straight to voters, a tactic that hasn’t succeeded anywhere the GOP has a majority.

“This means you’re going to say, ‘Hey Legislature, would you like to give up some of your power? Would you like to give up your monopoly on policymaking?’” said Thad Kousser, professor of political science at the University of California, San Diego. “You need a political momentum and then have the process cooperate.”

In South Carolina, which bans nearly all abortions, a Democratic-backed resolution to put a state constitutional amendment on the ballot never got a hearing this year. Attempts to attach the proposal to other pieces of legislation were quickly shut down by Republicans.

“If you believe you are doing the right thing for all the people of South Carolina — men and women and babies — you should have no problem putting this to the people,” said Democratic Sen. Margie Bright Matthews, alleging that Republicans fear they would lose if the issue went directly to voters.

In Georgia, Democratic Rep. Shea Roberts said she frequently fields questions from her constituents asking how they can get involved in a citizen-led ballot measure. The interest exploded after voters in Kansas rejected an anti-abortion measure from the Legislature in 2022 and was rekindled last fall after Ohio voters overwhelmingly passed an amendment codifying abortion rights in the state’s constitution.

Yet when she has brought legislation to create a citizen initiative process in Georgia, the efforts have been ignored inside the Republican-controlled Legislature.

“Voters are constantly asking us why we can’t do this, and we’re constantly explaining that it’s not possible under our current constitution,” Roberts said. “If almost half of states have this process, why shouldn’t Georgians?”

The contrast is on stark display in two presidential swing states. Michigan voters used a citizen initiative to enshrine abortion rights in their state constitution in 2022. Voters in neighboring Wisconsin don’t have that ability.

Instead, Wisconsin Democrats, with a new liberal majority on the state Supreme Court, are working to overturn Republican-drawn legislative maps that are among the most gerrymandered in the country in the hope of eventually flipping the Legislature.

Analiese Eicher, director of communications at Planned Parenthood Advocates of Wisconsin, said a citizen-led ballot measure process would have been especially valuable for her cause.

“We should have legislators who represent their constituents,” she said. “And if they don’t, there should be another option.”

In West Virginia, Steve Williams acknowledges the petition he spearheaded didn’t change minds inside the Legislature.

But the Democratic mayor of Huntington, who is a longshot candidate for governor, said he thinks state Republicans have underestimated how strongly voters believe in restoring some kind of abortion access.

Republican leadership has pointed to a 2018 vote in which just under 52% of voters supported a constitutional amendment saying there is no right to abortion access in the state. But Williams said the vote also had to do with state funding of abortion, which someone could oppose without wanting access completely eliminated.

The vote was close, voter participation was low and it came before the Supreme Court’s decision that eliminated a nationwide right to abortion. Williams said West Virginia women weren’t facing the reality of a near-total ban.

“Let’s face it: Life in 2024 is a heck of a lot different for women than it was in 2018,” he said.

___

Associated Press writer Jeffrey Collins contributed to this report from Columbia, South Carolina. Kruesi reported from Nashville, Tennessee, and Fernando from Chicago.

___

The Associated Press receives support from several private foundations to enhance its explanatory coverage of elections and democracy. See more about AP’s democracy initiative here. The AP is solely responsible for all content.

Despite the ruling, women’s access to mifepristone still largely depends on a patchwork of state laws, with only about half of states allowing full access under terms approved by the federal government.

“It doesn’t change anything anywhere,” said David S. Cohen, a law professor at Drexel University. “Tomorrow’s the same as today, which is the same as yesterday, which is the same as before this case was filed.”

Here’s a look at what Thursday’s decision does and does not mean for abortion access.

What did the Supreme Court decide?

Essentially, the justices said the anti-abortion doctors who brought the case did not have the legal standing to sue the Food and Drug Administration over the drug’s safety or changes making it more widely available. The FDA approved the drug more than 20 years ago and has reiterated its safety and effectiveness.

The anti-abortion doctors, under the name the Alliance for Hippocratic Medicine, argued they might have to treat emergency room patients who experience serious injuries after taking mifepristone.

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While the decision keeps mifepristone available, legal experts say that other groups or individuals who believe they can show a stronger legal connection to the drug might try to sue along similar lines.

“It’s a win that the status quo is preserved but it doesn’t signal that these are now dead arguments that others aren’t going to try and pursue,” said Rachel Rebouche, a Temple University law professor.

What is mifepristone?

Mifepristone is prescribed to end pregnancies by dilating the cervix and blocking the hormone progesterone, which is needed to sustain a pregnancy. It is usually taken with a second drug, misprostol, that causes the uterus to cramp and contract. The two-drug regimen is used to end a pregnancy through 10 weeks.

What does the ruling mean for the status of mifepristone?

Mifepristone remains fully approved and available under the current FDA framework, which allows telehealth prescribing and mail delivery to patients. The FDA has also expanded availability to large pharmacy chains and allowed prescribing by nurses and other health professionals.

Those policies have increased the prescribing of mifepristone, which accounted for nearly two-thirds of all U.S. abortions last year.

How do state laws impact access to mifepristone?

Access to the pills is restricted across large swaths of the country because of state laws that ban abortion (including medication abortion) outright or impose separate restrictions on the drug’s use.

Access largely depends on the laws in the state where a patient lives and, in the case of states banning or restricting mifepristone, what steps they are willing to take to circumvent them.

About half of U.S. states allows online prescribing and mail delivery of mifepristone, conforming to FDA’s drug label.

Currently, 14 states are enforcing bans on abortion at all stages of pregnancy, including with mifepristone. More than a dozen other states have laws specifically limiting how it can be prescribed, such as requiring an in-person visit with a physician or separate counseling about the potential risks and downsides of the drug.

Those steps are not supported by major medical societies, including the American Medical Association.

How safe and effective is mifepristone?

The FDA and the Biden administration filed multiple legal challenges reiterating the drug’s safety and effectiveness.

Mifepristone results in a completed abortion 97.4% of the time, according to the FDA label. Like all drugs, the abortion pill is not 100% effective and in 2.6% of cases, a surgical intervention was needed to complete the abortion. Less than 1% of the time, the pregnancy continued.

In rare cases, mifepristone can cause serious complications including excessive bleeding, infections and other emergency problems. Those occur in far less than a fraction of 1% of all patients using the drug, according to the FDA label.

How are medication abortions increasing despite restrictions?

Despite state laws targeting mifepristone, statistics show women in those states continue to receive the drug through the mail because state authorities have little visibility into deliveries by the U.S. Postal Service.

A survey earlier this year found about about 8,000 women a month in states that restrict abortion or place limits on prescribing were getting the pills by mail at the end of 2023, according to the Society of Family Planning.

What’s next for legal challenges to mifepristone?

Legal experts say other parties could bring new lawsuits.

Idaho, Kansas and Missouri sought to join the case against the FDA, which the Supreme Court rejected — though a conservative Texas judge who initially ruled against the FDA allowed them to intervene in his district. The three states, all led by Republican attorneys general, could try to revive the case at the lower court, according to legal experts.

“They are not physicians who have to show that they actually have some relationship to abortion care,” Rebouche said. “They’re claiming a state interest in the regulation of medicine, so I think that’s the vehicle in which you could see a lawsuit come forward.”

___

Geoff Mulvihill contributed to this story from Cherry Hill, New Jersey

The test vote won a 51-39 majority, but that was well short of the 60 votes to move ahead on the legislation.

It came as the Senate has abandoned hopes of doing serious bipartisan legislation before the election. Senate Majority Leader Chuck Schumer and his Democrats are trying to instead spotlight issues they believe can help them win the presidency and keep the Senate in November. A similar vote on ensuring nationwide access to in vitro fertilization is expected next week.

That bill is expected to similarly stall in the Senate, where Democrats need 60 votes to move forward on legislation. Schumer said Tuesday that Democrats will “put reproductive freedoms front and center before this chamber, so that the American people can see for themselves who will stand up to defend their fundamental liberties.”

The effort comes as Democrats worry that reproductive rights will be further threatened after the Supreme Court overturned the nationwide right to an abortion two years ago and as they continue to see that access as one of their most potent election-year issues. President Joe Biden’s campaign has embraced reproductive rights as a key to winning undecided voters, especially women.

“Contraception is health care, essential health care, that millions of people rely on,” said Hawaii Sen. Mazie Hirono, a Democrat. She said the court’s decision overturning Roe v. Wade “foretold more chaos to come.”

President Joe Biden called the Republican opposition to the bill “unacceptable.”

“We will continue to urge Congress to restore the protections of Roe v. Wade in federal law and safeguard the right to contraception once and for all,” Biden said.

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Minority Republicans have scoffed at the votes, saying the political messaging votes were unserious distractions from legislation they would like to vote on. “I expect we will see a lot more show votes this summer,” said South Dakota Sen. John Thune, the No. 2 Senate Republican, on Tuesday.

Maine Sen. Susan Collins, one of two Republicans to vote with Democrats to move forward on the bill, said Monday that she would want the legislation to be amended to include more religious liberty protections. “It is clearly a messaging attempt and not a serious attempt in itself,” she said.

Alaska Sen. Lisa Murkowski, who along with Collins supports abortion rights, also voted to move forward on the legislation.

Many Republicans who voted against consideration of the bill said they support access to contraception but believe the legislation is unnecessary.

“The Democrats are using their power to push an alarmist and false narrative that there is a problem accessing contraception,” said Louisiana Sen. Bill Cassidy, the top Republican on the Senate Health, Labor, Education and Pensions Committee.

The Senate push on reproductive access this year differs from bipartisan legislation passed in 2022 that would protect same-sex marriage amid concerns that the court could go after the Obergefell v. Hodges decision that legalized gay marriage nationwide. A vote on that bill was delayed until after that year’s midterm elections to try and avoid political complications, and 12 Republicans eventually supported it, sending it to Biden’s desk.

Since Republicans took the House majority last year, though, Congress has moved on few legislative items that were not immediately urgent or that did not face deadlines for expiration. Schumer has said repeatedly that he would like to move on bills to improve rail safety, lower the cost of prescription drugs and improve online safety for children, among other bipartisan legislation. But most of those bills have stalled in the divided Congress as some Republicans and Democrats have been less willing to work together in an election year.

Instead, Schumer has focused the Senate on judicial nominations and political messaging bills, including a repeat vote last month on a border security bill that Republicans had already rejected in February after months of bipartisan negotiations. Democrats who have faced intense criticism over the border issue have hoped that they can blunt that issue somewhat by highlighting that legislation. But Republicans have said it did not go far enough.

Democrats seized on the contraception issue after former President Donald Trump, the presumptive GOP nominee, said in an interview last month that he was open to supporting restrictions on birth control. He quickly reversed course and said that he “has never and never will” advocate to restrict that access.

Contraception has been increasingly entangled in the abortion debate in some conservative states, however. In Missouri, a women’s health care bill was stalled for months over concerns about expanding insurance coverage for birth control after some lawmakers falsely conflated birth control with medication abortion. In Arizona, Republicans unanimously blocked a Democratic effort to protect the right to contraception access. Tennessee Republicans blocked a bill that would have clarified that the state’s abortion ban would not affect contraceptive care or fertility treatments.

And in Virginia, Republican Gov. Glenn Youngkin vetoed bills from the Democratic-controlled Legislature that would have protected the right to contraception earlier this year. He said he supports the right to birth control but that “we cannot trample on the religious freedoms of Virginians.”

The Senate bill would make it federal law that an individual has the right to obtain contraceptives and to “engage in contraception,” and that health providers can provide them.

In the GOP-led House, Democratic Rep. Kathy Manning of North Carolina is leading a longshot effort to get enough signatures to discharge a similar version of the Senate’s contraception bill from committee and put it on the floor — a tactic used when leadership won’t bring up legislation for a vote.

Schumer said that the legislation designed to protect IVF access will come up in the Senate next week.

That bill comes after Alabama’s Supreme Court ruled frozen embryos can be considered children under state law earlier this year, causing several clinics to suspend IVF treatments. The state later enacted a law providing legal protections for IVF clinics, but Democrats have argued that Congress should act to guarantee nationwide access to reproductive care to try and prevent courts from making those decisions.

“Democrats will act to safeguard and strengthen IVF access for all Americans, so that everyone has a chance to start a family,” Schumer said.

Southwest argues flight attendant Charlene Carter was fired because she violated company rules requiring civility in the workplace by sending “hostile and graphic” anti-abortion messages to a fellow employee, who also was president of the local union.

Carter called the union leader “despicable” for attending the 2017 Women’s March in Washington, D.C., where participants protested the inauguration of then-President Donald Trump and called for protecting abortion rights.

Carter’s attorneys argue in briefs that she made clear to management she sent the material “because she was a pro-life Christian, and as a Christian she believes she must get the word out to anyone who touches the issue of abortion.”

They argued firing her violated federal law shielding employees from religious-based discrimination and that Southwest management and the union, which complained about Carr’s messages, should be held liable for her firing.

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After the trial, U.S. District Judge Brantley Starr, a Trump nominee who joined the bench in 2019, ordered the airline to tell flight attendants that under federal law, it “may not discriminate against Southwest flight attendants for their religious practices and beliefs.”

Instead, the Dallas-based airline told employees that it “does not discriminate,” and told flight attendants to follow the airline policy that it cited in firing Carter.

Starr found Southwest in contempt in August for the way it explained the case to flight attendants. He ordered Southwest to pay Carter’s most recent legal costs and he dictated a statement for Southwest to relay to employees.

He also ordered three Southwest lawyers to complete at least eight hours of religious liberty training from the Alliance Defending Freedom, which offers training on compliance with federal law prohibiting religious discrimination in the workplace.

The conservative group has played a high-profile role in multiple legal fights. They include defending a baker and a website designer who didn’t want to work on same-sex marriage projects, efforts to limit transgender rights and a challenge to longstanding federal approval of a medication used in the most common way to end a pregnancy.

Lawyers for Carter said in briefs that the type of training ordered “is a commonplace civil contempt sanction” and denied that it impinges on the airline’s free speech rights.

The initial monetary award against Southwest and the union was $5.1 million, the bulk to be paid by Southwest. The judge, citing federal limits on punitive damages, later reduced it to about $800,000, including $450,000 in damages and back pay from Southwest, $300,000 in damages from the union and about $60,000 in interest.

California’s law is meant to circumvent an Arizona law — first passed in 1864 — that bans nearly all abortions in that state. The Arizona Supreme Court had ruled that law can take effect next month.

“I’m grateful for the California Legislative Women’s Caucus and all our partners for moving quickly to provide this backstop,” Newsom said. “California stands ready to protect reproductive freedom.”

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The Arizona Legislature responded by repealing that law earlier this month. But the repeal won’t take effect until later this year.

The Newsom administration said California’s law is “a critical stopgap for Arizona patients and providers.”

California’s law says Arizona doctors who are licensed in that state can come to California to perform abortions. The law will expire on Nov. 30.

Licensed Arizona doctors would have to apply to the Medical Board of California or the Osteopathic Medical Board of California. The law requires California regulators to approve those requests within five days.

Since the Supreme Court’s overturning of Roe v. Wade in 2022, more than 20 states began enforcing abortion bans of varying degrees.

Supporters of the reclassification of mifepristone and misoprostol, commonly known as “abortion pills,” say it would protect expectant mothers from coerced abortions. Numerous doctors, meanwhile, have said it will make it harder for them to prescribe the medicines that they use for other important reproductive health care needs, and could delay treatment.

Passage of the bill comes as both abortion rights advocates and abortion opponents await a final decision from the U.S. Supreme Court on an effort to restrict access to mifepristone. The justices did not appear ready to limit access to the drug on the day they heard arguments.

The GOP-dominated Legislature’s push to reclassify mifepristone and misoprostol could possibly open the door for other Republican states with abortion bans that are seeking tighter restrictions on the drugs. Louisiana currently has a near-total abortion ban in place, applying both to surgical and medical abortions.

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Current Louisiana law already requires a prescription for both drugs and makes it a crime to use them to induce an abortion in most cases. The bill would make it harder to obtain the pills by placing it on the list of Schedule IV drugs under the state’s Uniform Controlled Dangerous Substances Law.

The classification would require doctors to have a specific license to prescribe the drugs, which would be stored in certain facilities that in some cases could end up being located far from rural clinics. Knowingly possessing the drugs without a valid prescription would carry a punishment including hefty fines and jail time.

More than 200 doctors in the state signed a letter to lawmakers warning that it could produce a “barrier to physicians’ ease of prescribing appropriate treatment” and cause unnecessary fear and confusion among both patients and doctors. The physicians warn that any delay to obtaining the drugs could lead to worsening outcomes in a state that has one of the highest maternal mortality rates in the country.

“This goes too far. We have not properly vetted this with the health care community and I believe it’s going to lead to further harm down the road,” said state Sen. Royce Duplessis, a Democrat who opposes the measure. “There’s a reason we rank at the bottom in terms of maternal health outcomes, and this is why.”

Supporters say people would be prevented from unlawfully using the pills, though language in the bill appears to carve out protections for pregnant woman who obtain the drug without a prescription for their own consumption.

The reclassification of the two drugs in Louisiana is an amendment to a bill originating in the Senate that would create the crime of “coerced criminal abortion by means of fraud.” The sister of Republican state Sen. Thomas Pressly, who authored the bill, has shared her own story, of her husband slipping her abortion-inducing drugs without her knowledge or consent.

“The purpose of bringing this legislation is certainly not to prevent these drugs from being used for legitimate health care purposes,” Senator Pressley said. “I am simply trying to put safeguards and guardrails in place to keep bad actors from getting these medications.”

The Senate voted 29-7, mainly along party lines, to pass the legislation. In the 39-person Senate there are only five women, all of whom voted in favor of the bill.

In addition to inducing abortions, mifepristone and misoprostol have other common uses, such as treating miscarriages, inducing labor and stopping hemorrhaging.

Mifepristone was approved by the U.S. Food and Drug Administration in 2000 after federal regulators deemed it safe and effective for ending early pregnancies. It’s used in combination with misoprostol, which the FDA has separately approved to treat stomach ulcers.

The drugs are not classified as controlled substances by the federal government because regulators do not view them as carrying a significant risk of misuse. The federal Controlled Substances Act restricts the use and distribution of prescription medications such as opioids, amphetamines, sleeping aids and other drugs that carry the risk of addiction and overdose.

Abortion opponents and conservative Republicans both inside and outside the state have applauded the Louisiana bill. Conversely, the move has been strongly criticized by Democrats, including Vice President Kamala Harris, who in a social media post described it as “absolutely unconscionable.”

The Louisiana legislation now heads to the desk of conservative Republican Gov. Jeff Landry. The governor, who was backed by former President Donald Trump during last year’s gubernatorial election, has indicated his support for the measure, remarking in a recent post on X, “You know you’re doing something right when @KamalaHarris criticizes you.”

Landry’s office did not respond to an emailed request for comment.

A recent survey found that thousands of women in states with abortion bans or restrictions are receiving abortion pills in the mail from states that have laws protecting prescribers. The survey did not specify how many of those cases were in Louisiana.

Louisiana has a near-total abortion ban in place, which applies both to medical and surgical abortions. The only exceptions to the ban are if there is substantial risk of death or impairment to the mother if she continues the pregnancy or in the case of “medically futile” pregnancies, when the fetus has a fatal abnormality.

Currently, 14 states are enforcing bans on abortion at all stages of pregnancy, with limited exceptions.

The measure, which has drawn support from anti-abortion groups and alarm from medical professionals and reproductive rights advocates, would add the medications mifepristone and misoprostol to Schedule IV of the state’s Uniform Controlled Dangerous Substances Law. Abortion — both medical and surgical — is illegal in Louisiana, so it is already illegal to prescribe the medications to terminate a pregnancy, except in very limited circumstances.

Medication abortions accounted for 63% of all abortions in 2023, according to the reproductive rights think tank the Guttmacher Institute.

The bill passed Tuesday in a vote in the state’s GOP-controlled House of Representatives, 64-29.

The measure will now go back to the Senate, and if approved, will then be sent to the governor to sign into law.

The legislation would make possession of the medications without a valid prescription or an order from a medical professional punishable by up to five years in prison. Pregnant people who obtain the medications for their own consumption would not be subject to prosecution, according to the legislation.

Medical professionals have spoken out against the measure, saying the medications have critical uses outside of abortion care, including aiding in labor and delivery, miscarriage treatment, and the prevention of gastrointestinal ulcers.

Schedule IV substances include some narcotics; medications within the category of depressants, such as Xanax and Valium; muscle relaxants; sleep aids; and stimulants that can be used to treat ADHD and weight loss.

The bill, Senate Bill 276, would also criminalize “coerced criminal abortion by means of fraud,” which would prohibit someone from knowingly using the medications to cause or attempt to cause an abortion without the consent of the pregnant person. That would be punishable by up to 10 years, or up to 20 years if the pregnant person was three months or more into a pregnancy. 

Republican state Sen. Thomas Pressly, who introduced the bill, has said the issue is personal to him and his sister, Catherine Herring. Herring’s estranged husband was accused of slipping abortion medication into her drinks when she was pregnant with their third child. Mason Herring pleaded guilty to the allegations in February and was sentenced to 180 days in jail. 

But doctors and reproductive rights advocates have expressed alarm at the bill, which would make Louisiana the only state to categorize the two medications as controlled dangerous substances. 

“They are safe and effective and they are not dangerous drugs of abuse to be on a schedule of a controlled dangerous substance list,” Dr. Jennifer Avegno, an emergency medicine physician and the director of the New Orleans Health Department, told NBC News on Tuesday. “From a medical standpoint, healthcare providers think this is bad science, and not well informed.” 

“This is not about abortion. This is about using these drugs, routinely for many, many other things. Mainly, number one to facilitate safe childbirth, number two miscarriage management,” she said.

Avegno is one of more than 250 doctors who wrote in a letter to Pressly that reclassifying the medications would create “the false perception that these are dangerous drugs that require additional regulation” and said that the proposal was “not scientifically based.”

“Given its historically poor maternal health outcomes, Louisiana should prioritize safe and evidence-based care for pregnant women,” the doctors said.

Pressly told NBC News on Tuesday that the goal of the bill “certainly is to not provide an additional challenge to our medical providers, but it is to ensure that these drugs are being used appropriately and effectively for legitimate medical reasons which are outside of abortion. As stated previously, abortion is already illegal in Louisiana.”

After it was introduced in the House Tuesday afternoon, State Rep. Mandie Landry, a Democrat, called for a motion to recommit the bill to the legislature’s Health and Welfare Committee because of the amendment that would recategorize the medications as controlled dangerous substances.

“This amendment is about rescheduling drugs that are used every single day to induce labor, to manage miscarriages, to manage post-hemorrhage issues with a pregnancy,” she said.

Landry said the recategorization would require certain storage facilities to store the drugs, which could potentially hurt the ability of rural clinics to access them and provide them to patients.

“I think it’s horrible how this good bill was hijacked by outsiders who are not doctors, and aren’t even legislators,” she said. 

Landry’s motion was voted down, 66-30.

Rep. Julie Emerson, a Republican who introduced the bill for the House vote, said that the amendment “does not mean the doctors cannot prescribe this and administer this. This doesn’t mean they can’t prescribe it, and that people can’t go pick it up and still use this medication.”

Abortion is banned in Louisiana with limited exceptions, which include to save a pregnant person’s life, to prevent “serious risk” to their health and if the fetus is not expected to survive pregnancy. Earlier this month, a Louisiana legislative committee rejected a bill that would have added cases of rape and incest to the exceptions. 

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Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

The lawsuit led by Tennessee and Arkansas comes since finalized federal regulations were published on Monday to provide guidance for employers and workers on how to implement the Pregnant Workers Fairness Act. The language means workers can ask for time off to obtain an abortion and recover from the procedure.

The rules, which the Equal Employment Opportunity Commission adopted on a 3-2 vote along party lines, will go into effect June 18. The lawsuit filed in federal court in Arkansas argues the regulations go beyond the scope of the 2022 law that passed with bipartisan support.

“This is yet another attempt by the Biden administration to force through administrative fiat what it cannot get passed through Congress,” Arkansas Attorney General Tim Griffin said in a statement. “Under this radical interpretation of the PWFA, business owners will face federal lawsuits if they don’t accommodate employees’ abortions, even if those abortions are illegal under state law.”

An EEOC spokesperson referred questions to the Justice Department, which did not immediately respond to a request for comment.

A Better Balance, one of the most vocal advocates for the Pregnant Workers Fairness Act, called the lawsuit a baseless attack on the law’s protections.

“This lawsuit represents a bad faith effort to politicize what is a vital protection for the health and economic security of millions of families, and a continuation of the alarming attacks on women’s health and reproductive choice,” Dina Bakst, the group’s co-president, said in a statement. “We are committed to fighting to defend workers’ rights under the Pregnant Workers Fairness Act.”

The EEOC has said the new law does not obligate employers or employer-sponsored health plans to cover abortion-related costs, and that the type of accommodation that most likely will be sought under the Pregnant Workers Fairness Act regarding an abortion is time off to attend a medical appointment or for recovery, which does not have to be paid.

The other states joining the lawsuit are Alabama, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Utah and West Virginia.

After a dizzying course of votes throughout the afternoon, three state House Republicans joined Democrats in approving a repeal of the Civil War-era law that made abortion a felony punishable by two to five years in prison for anyone who performs one or helps a woman obtain one.

Members of the state Senate, where Republicans also hold a narrow majority, voted last week in favor of a motion to introduce a bill that would repeal the abortion ban. Two Republicans joined every Democrat in the chamber on that vote.

The state Senate could vote on the repeal as early as next Wednesday, after the bill comes on the floor for a “third reading,” as is required under chamber rules.

The state Senate is likely to pass a repeal of the law, a source in Arizona familiar with the situation told NBC News. Once that happens, Democratic Gov. Katie Hobbs is certain to sign the repeal quickly.

Abortion rights supporters and Democrats — all the way up to the White House — praised Arizona lawmakers for their passage of the repeal.

“That’s a good thing,” White House Press Secretary Karine Jean-Pierre said of the vote. “We’re moving forward in the right direction.”

The Biden campaign blamed Donald Trump for the turmoil, saying that the former president “is responsible for Arizona’s abortion ban” after appointing three of the U.S. Supreme Court justices who overturned Roe v. Wade.

“If he retakes power, the chaos and cruelty he has created will only get worse in all 50 states,” Biden 2024 campaign manager Julie Chavez Rodriguez said in a statement.

The state House’s vote to repeal came on the chamber’s third attempt since the state Supreme Court ruled earlier this month to uphold the 160-year-old near-total ban.

Following that ruling, Republicans across the U.S. — including Trump, who has said he wants to let states make their own decisions on abortion policies — called on legislators in the state to repeal the ban amid a broader political blowback against the GOP on the issue of reproductive rights in the nearly two years since the U.S. Supreme Court struck down Roe v. Wade.

But Republicans in the Arizona state House, where the party holds a narrow majority, had remained steadfast in not allowing a repeal bill to advance.

But on Wednesday, amid mounting pressure, Republicans in the chamber appeared to finally relent, with three GOP lawmakers — state Reps. Matt Gress, Tim Dunn and Justin Wilmeth — joining the 29 Democrats in the chamber to pass the repeal.

Republican opponents of the repeal pleaded with their colleagues to reject the bill for a third time during remarks they were allowed to make while voting.

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Abortion Apr 10

Arizona Republicans distance themselves from state Supreme Court ruling on abortion

Arizona Apr 9

Arizona Supreme Court upholds near-total ban on abortions

“We should not have rushed this bill through the legislative process,” Republican state House Speaker Ben Toma said. “Instead today we are rushing to judgment.”

“It breaks my heart that you’re here to witness this,” said House Speaker Pro Tempore Travis Grantham, before casting a “no” vote. “I’m proud of my Republican caucus that has fought this off as long as it has,” added Grantham, who accused Democrats of having used the issue as a political cudgel.

“To see how this has been turned against one party and used as a weaponization of the issue is disgusting,” he said. At the end of Wednesday’s hearing, Grantham said the vote was an “awful, disgusting situation” and stripped Gress, as well as Democratic Assistant Minority Leader Oscar De Los Santos, of their committee assignments.

Just last week, during the state House’s prior session, Democrats in the chamber introduced a bill to repeal the 160-year-old abortion ban and filed a motion to Republican House leaders requesting an immediate vote. The vote failed, prompting Democrats to move again to force a vote, which also fell short.

Republicans were more easily able to kill that vote because it came under a procedural vote to suspend state House rules. Under Arizona House rules, a majority of the chamber that includes the speaker is required to vote to suspend the rules to hold an immediate vote. Such obstacles didn’t exist on Wednesday because the vote came amid normal House order.

Wednesday’s proceedings marked the latest chapter in the fight over abortion rights in the crucial battleground following the Arizona Supreme Court’s bombshell ruling earlier this month.

The law the conservative-leaning court ruled was enforceable makes abortion a felony punishable by two to five years in prison for anyone who performs one or helps a woman obtain one. The law was codified in 1901 — and again in 1913, after Arizona gained statehood — and outlaws abortion from the moment of conception but includes an exception to save the woman’s life.

The law is set to go into effect as early as June 8, though Democratic Attorney General Kris Mayes has said her office is working to find ways to delay that date. The ban is likely to go into effect for a short period of time — even if the Senate passes it next week and Hobbs signs it shortly thereafter — because under Arizona law, repeals don’t go into effect until 90 days after a legislative session concludes. Last year’s session ended in late July.

“We may still be looking at a period of time when the 1864 [ban] could potentially take effect,” Mayes said in a statement.

A successful repeal of the 1864 ban would likely result in state policy reverting to a 15-week ban on abortions that makes exceptions for medical emergencies but not for rape or incest. 

Some prominent anti-abortion groups called on Republicans to unite behind that law, which was enacted in 2022, following Wednesday’s vote.

“After months of confusion, the people of Arizona will soon have clarity on the state’s abortion laws: a 15-week protection for the unborn,” Susan B. Anthony Pro-Life America President Marjorie Dannenfelser said in a statement. “Kari Lake and all GOP candidates and elected officials must bring clarity to Arizona voters by campaigning vigorously in support of Arizona’s 15-week protection with exceptions.”

Despite the continued repeal efforts, voters are likely to have the power this November to decide on the future of abortion rights in the state themselves.

Organizers in the state are likely to succeed in placing a proposed constitutional amendment on the November ballot that would create a “fundamental right” to receive abortion care up until fetal viability, or about the 24th week of pregnancy. If voters approve the ballot measure, it would effectively undo the 1864 ban, which now remains law in the state.

It would also bar the state from restricting abortion care in situations in which the health or life of the pregnant person is at risk after the point of viability, according to the treating health care professional.

But the state Supreme Court decision prompted Republicans to also discuss a series of possible contingencies to upend that effort, including pushing alternative ballot measures to compete with the pro-abortion rights proposed amendment, according to a leaked strategy document circulated among Arizona Republicans.

During a brief state House Rules committee hearing Wednesday, Republicans voted to advance three resolutions — without explaining what they were — that Democrats and abortion rights supporters said were likely the GOP-backed ballot measures.

“I can’t tell you what the subject matter will be,” Grantham, the House Speaker Pro Tempore who led the hearing, said.

Chris Love, a spokesperson for Arizona for Abortion Access, called the resolutions “three dishonest placeholder bills” that served as “the first step toward referring up to three anti-abortion measures to the November ballot aimed at confusing and deceiving voters in hopes of pulling votes from the Arizona Abortion Access Act.”

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The case marks the first time the Supreme Court has considered the implications of a state ban since the nationwide right to abortion was overturned. It comes from Idaho, which is among 14 states that now ban abortion at all stages of pregnancy with very limited exceptions.

While members of the high court’s conservative majority expressed concern about pregnant patients’ ability to get emergency care in the state, it was unclear whether any were swayed by the Biden administration’s argument.

The Justice Department says abortion care must be allowed in emergencies that seriously threaten a woman’s health under a federal health care law that requires hospitals accepting Medicare to provide emergency care regardless of patients’ ability to pay.

“How can you impose restrictions on what Idaho can criminalize, simply because hospitals in Idaho have chosen to participate in Medicare?” said Justice Samuel Alito, who wrote the decision overturning Roe v. Wade.

Justices on the high court’s liberal minority, meanwhile, raised sharp questions about whether Idaho’s law was putting women’s health at risk.

“Within these rare cases, there’s a significant number where the woman’s life is not in peril, but she’s going to lose her reproductive organs. She’s going to lose the ability to have children in the future unless an abortion takes place,” said Justice Elena Kagan.

The Biden administration argues that even in states where abortion is banned, federal health care law says hospitals must be allowed to terminate pregnancies in rare emergencies where a patient’s life or health is at serious risk.

Idaho contends its ban has exceptions for life-saving abortions but allowing it in more medical emergencies would turn hospitals into “abortion enclaves.” The state argues the administration is misusing a health care law that is meant to ensure patients aren’t turned away based on their ability to pay.

The Supreme Court has allowed the Idaho law to go into effect, even during emergencies, as the case played out. It makes performing an abortion a felony punishable by up to five years in prison.

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Abortion Apr 12

More young people choosing permanent sterilization after abortion restrictions

Dueling protests were taking shape outside the court before the start of arguments on Wednesday. “Abortion saves lives,” read signs displayed by abortion rights supporters. Opponents displayed a sign that read, “Emergency rooms are not abortion clinics.”

Doctors have said Idaho’s abortion ban has already affected emergency care. More women whose conditions are typically treated with abortions must now be flown out of state for care, since doctors must wait until they are close to death to provide abortions within the bounds of state law.

Meanwhile, complaints of pregnant women being turned away from U.S. emergency rooms spiked after the Supreme Court overturned Roe v. Wade, according to federal documents obtained by The Associated Press.

Anti-abortion groups blame doctors for mishandling maternal emergency cases. Idaho argues the Biden administration overstates health care woes to undermine state abortion laws.

The justices also heard another abortion case this term seeking to restrict access to abortion medication. It remains pending, though the justices overall seemed skeptical of the push.

The Justice Department originally brought the case against Idaho, arguing the state’s abortion law conflicts with the 1986 Emergency Medical Treatment and Active Labor Act, known as EMTALA. It requires hospitals that accept Medicare to provide emergency care to any patient regardless of their ability to pay. Nearly all hospitals accept Medicare.

A federal judge initially sided with the administration and ruled that abortions were legal in medical emergencies. After the state appealed, the Supreme Court allowed the law to go fully into effect in January.

The Supreme Court is expected to rule by the end of June.

The paper, published Friday in JAMA Health Forum, is the first to focus specifically on the contraception choices of women and men ages 18 to 30 after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization ended the constitutional right to abortion. 

Studying this age group is important because they are “much more likely to have an abortion and … to experience sterilization regret relative to their older counterparts,” said co-author Jacqueline Ellison, an assistant professor at the University of Pittsburgh School of Public Health.

A vasectomy is a routine procedure in men that blocks sperm from reaching semen. Tubal ligation or sterilization involves cutting, tying or removing the fallopian tubes to prevent sperm from reaching the eggs. 

It’s difficult to prove the Dobbs decision caused a rise in women and men undergoing permanent birth control. But the new study used a particular statistical approach that, Ellison said, strongly suggested the increase in sterilization procedures flowed from the Supreme Court’s decision and the subsequent actions in 21 states to ban or further restrict access to abortion.

Ellison and her fellow researchers analyzed medical record data from academic medical centers and affiliated clinics nationally from two periods: Jan. 1, 2019, to May 31, 2022, before Dobbs, and from June 1, 2022, to Sept. 30, 2023, after Dobbs.

They found that there were roughly 58 more tubal ligations per 100,000 outpatient visits after Dobbs and 27 more vasectomies per 100,000 visits. 

“There was a lot of fear and anxiety … around whether people were going to be able to get an abortion that they needed or wanted and even fears about being able to access contraception down the road,” she said.

Young women may have felt a greater urgency to act than their male partners in the wake of policy changes because pregnancy disproportionately affects them, said Dr. Angela Liang, a clinical assistant professor of obstetrics and gynecology at the University of Michigan who was not involved in the new study. There are medical risks during pregnancy and during delivery, “such as postpartum hemorrhage and the need for a cesarean section,” Liang said, adding that much of the burden after pregnancy also falls on women.

Abortion Apr 10

Arizona Republicans distance themselves from state Supreme Court ruling on abortion

Arizona Apr 9

Arizona Supreme Court upholds near-total ban on abortions

The new study had limitations. For one thing, the data was not broken down by state, which can reveal a more detailed response to policy changes.

In Michigan, for example, the Supreme Court’s decision allowed a 1931 law making all abortions a felony to be enforced. Two and a half months later, a permanent injunction blocked the law, and, two months after that, Michigan voters passed an amendment to the state constitution that established an individual right to reproductive freedom.

Liang and several colleagues analyzed electronic health records at one health care institution in Michigan and found that requests for tubal sterilizations surged in the months after the Dobbs decision and then returned to baseline.

“The decrease back to baseline after 6 months may have been due to the demand being met, a decreased sense of urgency after abortion access was temporarily protected, or crisis fatigue,” they wrote in JAMA last year. 

Using medical records to analyze contraception decisions captures the decisions of only patients and not those who have not sought medical care during the time period studied. 

In a recent study, Megan Kavanaugh, the principal research scientist at the Guttmacher Institute, and a colleague analyzed survey data of reproductive-age women in four states, finding an increase in condom use but no significant changes in permanent contraception methods. The report from Guttmacher, a research and policy organization that supports abortion rights, was published in a medical journal in February.

This broader population of women “may not necessarily have very strong attitudes about pregnancy prevention,” said Kavanaugh, who was not involved in the new study.

A more complete examination of contraception choices in the United States will be available at the end of the year when the federally sponsored National Survey of Family Growth releases data from January 2022 through December 2023, Kavanaugh said. The pandemic interrupted the survey, and the latest available data is from 2019.

“It is the gold standard for much of the data we track around sexual and reproductive health care and their outcomes,” she said.

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Republicans in the state issued a wave of statements in opposition to Tuesday’s ruling, which came a day after former President Donald Trump said that abortion laws should be decided by states.

Arizona Senate candidate Kari Lake, who two years ago called the 1864 statute “a great law,” said Tuesday that it was “out of step with Arizonans.”

“I oppose today’s ruling,” she said, while also adding, “I wholeheartedly agree with President Trump — this is a very personal issue that should be determined by each individual state and her people.”

Trump has frequently boasted that he is responsible for the U.S. Supreme Court’s overturning Roe v. Wade in 2022. More than a dozen states have imposed abortion bans or no longer have facilities where abortions can be obtained since the Supreme Court eliminated federal protections in 2022.

Rep. David Schweikert, R-Ariz., who in 2021 co-sponsored the Life at Conception Act, which declared the right to life at “the moment of fertilization,” also voiced disapproval of the ruling, saying abortion “should be decided by Arizonans, not legislated from the bench.”

In 2022, Schweikert wrote on X that he was “pleased” with the fall of Roe v. Wade.

Fellow Arizona Republican Rep. Juan Ciscomani said that Tuesday’s ruling was “a disaster for women and providers” and that the Civil War-era law was “archaic.”

Schweikert and Ciscomani are locked in competitive races for re-election that the nonpartisan Cook Political Report has labeled Republican toss-ups.

The campaign arm of House Democrats said Schweikert and Ciscomani “are hell-bent on controlling women and bringing this country backwards.”

“Voters know that Juan Ciscomani and David Schweikert have been working overtime to restrict access to abortion care,” Lauryn Fanguen, a spokesperson for the Democratic Congressional Campaign Committee, said in a statement Tuesday. “Whether it’s voting to restrict medication abortion or co-sponsoring a nationwide abortion ban, time and time again Ciscomani and Schweikert have made it clear that they will side with anti-abortion zealots over Arizona women.”

Republican legislators also blasted the high court’s ruling.State Rep. T.J. Shope called the ruling “disappointing to say the least,” adding that he would work to repeal the law in favor of a 15-week abortion law then-Gov. Doug Ducey signed two years ago.

Ducey, a Republican, said the ruling was “not the outcome I would have preferred.”

The law upheld by the state Supreme Court outlaws abortion from the moment of conception but includes an exception to save the woman’s life. The ruling effectively undoes a lower court’s ruling that the recent 15-week ban from 2022 superseded the 1864 law.

State Rep. Matt Gress, who also backed a 15-week abortion ban, condemned the ruling, saying it “cannot stand.”

“I cannot and will not condemn women, especially the victims of rape and incest, to be forced to carry their pregnancy to term,” Gress said, calling on Arizona Senate President Warren Petersen and House Speaker Ben Toma to bring a measure to the floor to repeal the ban “and restore modern-day protections for Arizona women.”

Petersen and Toma — both Republicans — said in a joint statement that they were looking over the court’s ruling.

“We will be closely reviewing the court’s ruling, talking to our members, and listening to our constituents to determine the best course of action for the legislature,” the statement said.

Reached for comment, a spokesperson for Arizona Senate Republicans did not say whether they would take up a repeal effort.

Adam Edelman and Alex Tabet contributed.

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In a four-and-half-minute video released on his Truth Social media platform, Trump falsely claimed that “we have abortion where everybody wanted it from a legal standpoint” in the wake of the Supreme Court’s 2022 Dobbs decision, NBC News reported. A majority of Americans have consistently said in polling that they favor the Roe vs. Wade protections that the court dismantled.

“My view is, now that we have abortion where everybody wanted it from a legal standpoint, the states will determine by vote or legislation, or perhaps both, and whatever they decide must be the law of the land,” Trump said.

In doing so, he refused to take a position on the national ban that has been promoted by some of his staunchest allies, including Sen. Lindsey Graham, R-S.C., and former White House aide Kellyanne Conway. In the past, Trump had hinted that he might embrace a national ban, referring to a 15- or 16-week threshold as a consensus position.

Trump did not say what he would do if he won the presidency and Congress sent him a national ban.

Trump’s silence on the matter upset at least one prominent anti-abortion group in Washington. Susan B. Anthony Pro Life America President Marjorie Dannenfelser, who has pushed Republicans to adopt a weeks-based ban at the national level, said she is “deeply disappointed in President Trump’s position” on the matter.

“Saying the issue is ‘back to the states’ cedes the national debate to the Democrats who are working relentlessly to enact legislation mandating abortion throughout all nine months of pregnancy,” she said. “If successful, they will wipe out states’ rights.”

Graham also criticized Trump’s stance, saying in a statement, “Dobbs does not require that conclusion legally and the pro-life movement has always been about the wellbeing of the unborn child — not geography.”

Democrats in Congress have signed onto a bill that would limit states’ ability to restrict abortion rights. No Democrat in Congress has proposed “mandating abortion.” Unless either party can control the House and 60 votes in the Senate at the same time, the prospects for legislation limiting or expanding abortion rights are dim. It is unlikely that Trump would be presented with an abortion-ban bill.

Over the last quarter of a century, and even since he became a candidate for office in 2015, Trump has been all over the map on how to handle the abortion issue. Since the 2024 campaign began, he’s offered few specifics about which policies he’d back in the post-Roe v. Wade era should he win the White House.

Trump, a Florida resident, hasn’t said where he stands on Florida’s new six-week ban. When he’s teased support for a nationwide ban, his words often appear to contradict formal statements put out by his campaign.

Trump has said he supports exceptions in cases of rape, incest and to protect the life of the mother, a position he reiterated in Monday’s video. But the president does not determine how states make their laws.

Trump has frequently gloated over being responsible for the reversal of Roe v. Wade, which dismantled reproductive rights protections. But he also blamed GOP losses in 2022 on the issue and has said Republicans need to learn how to talk about abortion in a way that doesn’t turn off potential voters. 

Last September, more than a year after abortion protections were reversed, he made a vague overture in an interview with NBC News’ “Meet the Press” that he would be a voice of consensus on abortion — but didn’t specify how.

“Let me just tell you what I’d do,” he said. “I’m going to come together with all groups, and we’re going to have something that’s acceptable.”

At the time, he said he wouldn’t sign a federal abortion ban at 15 weeks.

In recent months, however, Trump moved in the direction of a federal abortion ban even as some of his statements were at odds with his campaign. After reports surfaced that he told allies he was mulling a federal abortion ban at 16 weeks, his campaign dismissed it as “fake news.” Soon after, Republican South Carolina Sen. Lindsey Graham told NBC News that “Trump is warming up to 16 weeks.” And then Trump himself in an interview suggested he’d support a 15-week ban. 

The prospect of the top of the GOP ticket backing a federal abortion ban at a time when Democrats are elevating the issue as a central point of attack could put swing-state Republicans in a trick box, after some have attempted to moderate their positions. Statements from Trump’s campaign, however, seem to be leaning toward states’ rights and not a federal ban.

“President Trump supports preserving life but has also made clear that he supports states’ rights because he supports the voters’ right to make decisions for themselves,” Brian Hughes, a Trump senior adviser, said in a statement. He added: “President Trump thinks voters should have the last word.”

After offering little clarity, this week, at a campaign rally in Grand Rapids, Mich., Trump said his campaign would be “making a statement next week on abortion” after he was asked if he supported a six-week abortion ban that the Florida Supreme Court just upheld.

President Joe Biden’s campaign has seized on Trump’s varying remarks on abortion, particularly his past boasts of having a hand in overturning Roe v. Wade. 

“Donald Trump doesn’t trust women,” Biden says in a new ad. “I do.” 

Biden continued that theme after Trump’s video remarks on Monday, saying in a statement released by his campaign, “Donald Trump made it clear once again today that he is — more than anyone in America — the person responsible for ending Roe v. Wade. He is — more than anyone in America — responsible for creating the cruelty and the chaos that has enveloped America since the Dobbs decision.”

“Trump is scrambling,” Biden added. “He’s worried that since he’s the one responsible for overturning Roe the voters will hold him accountable in 2024. Well, I have news for Donald. They will.”

This story first appeared on NBCNews.com. More from NBC News:

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Amanda Zurawski and Kaitlyn Joshua will travel to North Carolina and Wisconsin over the next two weeks to meet with doctors, local officials and voters. The Biden campaign sees their stories as potent firsthand accounts of the growing medical peril for many women as abortion restrictions pushed by Republicans complicate health care.

“The abortion topic is a very heavy topic, and I understand that, said Joshua, 31, of Baton Rouge, Louisiana. ”But I also understand and believe that the Biden and Harris administration is the only administration that could do anything remotely close to addressing the abortion bans … and then also doing a deeper dive into research and understanding women’s health in general.”

Biden and Democrats see reproductive health as a major driver for the 2024 election as the president and his proxies blame Republican Donald Trump, whose judicial nominations paved the way for the Supreme Court’s conservative majority decision in 2022 that overturned abortion rights codified by Roe v. Wade.

Republicans, including Trump, are struggling to figure out how to talk about the issue, if at all. Trump has both taken credit for the overturning of Roe and suggested abortion should be legal until 15 weeks, and has promised to make a statement outlining his policies this week.

Since the high court’s ruling, voters have approved a number of statewide ballot initiatives to preserve or expand the right to abortion. Support for abortion access drove women to the polls during the 2022 midterm elections, delivering Democrats unexpected success.

About two-thirds of Americans say abortion should generally be legal, according to polling by The Associated Press-NORC Center for Public Affairs Research. Only about one-quarter say abortion should always be legal and only about 1 in 10 say it should always be illegal.

Joshua and her husband were excited to be having a second baby. But she started to experience bleeding and serious pain at about 11 weeks. She suspected she was miscarrying.

At an emergency room in Baton Rouge, doctors examined her but wouldn’t confirm she was miscarrying or discuss medical options, she said. She was sent home to wait. The bleeding worsened, and she went to a second hospital where again, doctors sent her home and told her to contact her doctor in a few days. A midwife eventually confirmed that Joshua had miscarried.

“Something that sounds as simple as dealing with a miscarriage can’t even be met with a true diagnosis anymore,” Joshua said. “It’s kind of wild, right? And it’s really frightening.”

Joshua and Zurawski will be in Raleigh, Durham and Charlotte, North Carolina, on Wednesday, a state Biden hopes to flip. The state has enacted a law banning most abortions after 12 weeks, overriding a veto from the Democratic governor.

The week after that, they will visit Milwaukee, Eau Claire and Madison, Wisconsin, a state Biden won in 2020. Republicans in the state Assembly tried to set up a statewide referendum on the April ballot banning abortion after 14 weeks of pregnancy — more restrictive than current law — but the legislative session ended without a state Senate vote.

Both women said they felt compelled to get into politics after their own experiences.

“People don’t get how bad it is, and they don’t get how bleak it is,” Zurawski said. “And so the more we continue to share our stories. … I think it’s really important to spread awareness and paint this picture.”

Zurawski, 37, of Austin sued Texas last year after she and other women could not get medical care because of the state’s abortion laws. She had been in her second trimester, after 18 months of fertility treatments, when she went into early labor and was told the baby would not survive. Doctors said they could not intervene to provide an abortion because Zurawski wasn’t in enough medical danger.

Zurawski had to wait. Three days later, her condition rapidly worsened and she developed sepsis, a dangerous medical condition in which the body responds improperly to an infection. She stabilized long enough to deliver a stillborn girl, whom she named Willow. Zurawski then spent days in intensive care.

She recently returned from a family trip to Disney World and said, “I thought I’d be coming home from that trip with a 1-year-old and be putting her down for a nap.”

“But instead I’m doing this interview to help campaign for Biden,” Zurawski said. “It’s just the complete opposite world than I ever would have seen myself in.”

Democratic Sen. Eva Burch of Mesa told fellow lawmakers in a floor speech Monday that she was going to get an abortion because her pregnancy is no longer viable. The first-term lawmaker, who previously worked as a nurse practitioner at a women’s health clinic, described a “rough journey” with fertility and recounted a miscarriage she had suffered.

Burch, 43, also criticized restrictions in Arizona as being out of touch, saying the state law requires an ultrasound that her doctor didn’t order and that she was given what she regards as disinformation about alternatives to abortion.

“It was an opportunity for me to highlight what we’re experiencing here in Arizona and how the laws that we pass in Arizona actually do impact people in practice and not just in theory,” Burch said Tuesday in an interview with The Associated Press in her legislative office.

The abortion that Burch is planning wouldn’t be her first. While running for office in 2022, Burch said she had an abortion because that pregnancy wasn’t viable and even mentioned on the campaign trail that she had undergone the procedure.

Abortion Mar 4

France becomes the only country to explicitly guarantee abortion as a constitutional right

Abortion Jan 24

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Burch, who previously gave birth to two sons, said she understands why women who have abortions keep that information private. But she said she wants the public to know that the struggles she has experienced are common.

Burch, who is running for re-election this year, also acknowledged that she wanted to shine light on a proposed ballot measure that would create a constitutional right to abortion.

“If the Arizona Legislature is not going to operate in reality, then the people of Arizona need to have an opportunity to be able to take control of some of those decisions for themselves,” Burch said.

Two abortion bills proposed this year by Democrats haven’t received committee hearings, including one that would repeal a pre-statehood law that criminalizes nearly all abortions.

The Arizona Supreme Court is considering the fate of the 1864 law. In a 2022 ruling, a lower court concluded doctors can’t be charged for performing an abortion in the first 15 weeks of pregnancy because other Arizona laws over the years have allowed them to provide abortions.

Apart from their efforts at the Arizona Legislature, abortion rights advocates began a push last summer to ask voters to create a constitutional right to abortion. If proponents collect enough signatures, Arizona would become the latest state to put the question directly to voters.

The proposed constitutional amendment would guarantee abortion rights until a fetus could survive outside the womb, typically around 24 weeks of pregnancy. It also would allow later abortions to save the mother’s life or to protect her physical or mental health.

Organizers of the effort will have to collect 384,000 signatures from registered voters by July to put the question on the November ballot.

France is the first country to explicitly guarantee abortion rights in the national charter.

While abortion is a deeply divisive issue in the United States, it’s legal in nearly all of Europe and overwhelmingly supported in France, where it’s seen more as a question of public health and not politics. French legislators approved the constitutional amendment on Monday in a 780-72 vote that was backed by many far-right lawmakers.

Friday’s ceremony, held on the cobblestones of Vendome Plaza in Paris, is a key event on a day focused on advancing women’s rights globally. Marches, protests and conferences are being held from Jakarta, Indonesia, to Mexico City and beyond.

The French constitutional amendment has been hailed by women’s rights advocates around the world, including places where women struggle to access birth control or maternal health care. French President Emmanuel Macron called it a direct result of the U.S. Supreme Court ruling in 2022 rescinding long-held abortion rights.

Macron’s critics questioned why he pursued the measure in a country with no obvious threat to abortion rights but where women face a multitude of other problems.

Abortion Mar 4

France becomes the only country to explicitly guarantee abortion as a constitutional right

Women's History Mar 6

What is International Women's Day and why does it fall on March 8?

France has a persistently high rate of women killed by their partners and challenges remain in prosecuting sexual abuse against women by powerful celebrities and other men. French women also see lower pay and pensions — especially women who are not white.

Macron’s government said the abortion amendment was important to avoid a U.S.-like scenario for women in France, as hard-right groups are gaining ground and seeking to turn back the clock on freedoms around Europe.

Macron will preside over the constitutional ceremony. Justice Minister Eric Dupond-Moretti will use a 100-kilogram (220-pound) press from 1810 to imprint the amendment in France’s 1958 constitution.

It will include the phrase saying, “the freedom of women to have recourse to an abortion, which is guaranteed.” The ceremony will be held outdoors with the public invited, in another first.

France follows in the footsteps of the former Yugoslavia, whose 1974 constitution included the phrase: “A person is free to decide on having children.” Yugoslavia’s successor states retained similar language in their constitutions, though they did not spell out guaranteed abortion rights.

In Ireland, voters will decide on Friday whether to change the constitution to remove passages referring to women’s domestic duties and broadening the definition of the family.

Protesters in Istanbul plan to call attention to violence against women, and rallies are expected in many cities. Protests are often political and, at times, violent, rooted in women’s efforts to improve their rights as workers. This year’s global theme is “Inspire Inclusion.”

Indonesian demonstrators demanded adoption of the International Labor Organization’s Conventions concerning gender equality and eliminating workplace violence and harassment. Labor rights groups in Thailand marched to the Government House to petition for better work conditions, and activists marching against violence in the Philippine capital were stopped by police near the presidential palace, sparking a brief scuffle.

India’s government cut the price of cooking gas cylinders by 100 rupees ($1.20) with Prime Minister Narendra Modi posted on social media that the move was “in line with our commitment to empowering women.”

Officially recognized by the United Nations in 1977, International Women’s Day is a national holiday in some 20 countries including Russia, Ukraine and Afghanistan.

___

Associated Press journalists around the world contributed to this report.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Both chains have received certification to dispense the drug in stores under guidelines the Food and Drug Administration issued last year and expect to begin dispensing the pills within a month.

“Walgreens has completed the FDA certification process to dispense mifepristone and expects to begin dispensing within a week, consistent with federal and state laws. We are beginning a phased rollout in select locations to allow us to ensure quality, safety, and privacy for our patients, providers, and team members,” spokesman Marty Maloney said in a statement to NBC News.

CVS told NBC News, “We’ve received certification to dispense mifepristone at CVS Pharmacy and plan to fill prescriptions for this medication in states where legally permissible.”

“We’re working with manufacturers and suppliers to secure the medication and are not yet dispensing it in any of our pharmacies. We’ll begin filling prescriptions for the medication in Massachusetts and Rhode Island in the weeks ahead and will expand to additional states, where allowed by law, on a rolling basis.”

Mifepristone is used in combination with another pill, misoprostol, in a majority of abortions nationwide. It is approved for use up to around 10 weeks of pregnancy.

The certifications are expected to give more people access to the drug at a time when access to abortion services is being hotly debated in statehouses across the country and has become a central focus of the 2024 presidential race.

The Supreme Court is also slated to hear oral arguments on how patients can access mifepristone on March 26 in a case brought by the conservative group Alliance for Hippocratic Medicine challenging policies expanding access to mifepristone. 

Abortion Feb 21

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President Joe Biden praised the certification in a statement.

“Today is an important milestone in ensuring access to mifepristone, a drug that has been approved by the Food and Drug Administration as safe and effective for more than 20 years. With major retail pharmacy chains newly certified to dispense medication abortion, many women will soon have the option to pick up their prescription at a local, certified pharmacy — just as they would for any other medication. I encourage all pharmacies that want to pursue this option to seek certification.”

“The stakes could not be higher for women across America,” the statement continued. “In the face of relentless attacks on reproductive freedom by Republican elected officials, Vice President Harris and I will continue to fight to ensure that women can get the health care they need, to defend the Food and Drug Administration’s independent and evidence-based approval and regulation of mifepristone, and to restore the protections of Roe v. Wade in federal law.”

Data compiled by the Idaho Physician Well-Being Action Collaborative also shows that only two obstetricians moved to the state to practice in the last 15 months, the Idaho Statesman reported on Tuesday. Obstetricians provide health care during pregnancy and childbirth.

The number of obstetricians in Idaho decreased from 227 in 2022 to about 176 in 2023, a decline of 51 doctors, the report said. The Idaho Physician Well-Being Action Collaborative was created in 2018 by local doctors to address problems affecting physicians and patients in Idaho communities, according to its website.

The numbers “should concern every person living in or considering a move to Idaho,” the Idaho Coalition for Safe Healthcare said this week in a news release. The coalition is the parent group of the Idaho Physician Well-Being Action Collaborative.

Additionally, the report said two hospital obstetrics programs — at West Bonner General Health in Sandpoint and at Valor Health in Emmett — have closed since Idaho’s law banning abortion took effect, the report said.

Feb 8

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Abortion Jan 24

64,000 women and girls became pregnant due to rape in states with abortion bans, study estimates

A third hospital obstetrics program is in “serious jeopardy” of closing, the report also said.

Only 22 of 44 counties in Idaho have access to any practicing obstetricians, the report said. About 85% of obstetricians and gynecologists in Idaho practice in the seven most populous counties.

Idaho banned nearly all abortions after the U.S. Supreme Court overturned Roe v. Wade in 2022. Idaho makes it a crime with a prison term of up to five years for anyone who performs or assists in an abortion.

Post-Roe, many maternal care doctors in restrictive states are deciding whether to stay or go. They weigh tough questions about medical ethics, their families and whether they can provide the best care without risking their careers or prison time.

Dr. Kylie Cooper, a maternal-fetal specialist, left Idaho last year. She told The Associated Press at the time that it was a very difficult decision but that she and her family needed to be where they felt reproductive health care was protected and safe.

Data also shows Idaho is at the 10th percentile of maternal mortality outcomes, meaning 90% of the country has better maternal and pregnancy outcomes than Idaho.

“In a time when we should be building our physician workforce to meet the needs of a growing Idaho population and address increasing risks of pregnancy and childbirth, Idaho laws that criminalize the private decisions between doctor and patient have plunged our state into a care crisis that unchecked will affect generations of Idaho families to come,” Dr. Caitlin Gustafson, an OB-GYN and the board president of the Idaho Coalition for Safe Healthcare Foundation, said in the news release.

The loss of obstetricians further strains a health system that was already experiencing a physician shortage, the release said. The national average of live births a year per obstetrician is 94 compared to 107 in Idaho, the news release said.

The research letter, published by JAMA Internal Medicine and headed up by the medical director at Planned Parenthood of Montana, estimated that nearly 520,000 rapes were associated with 64,565 pregnancies across 14 states, most of which had no exceptions that allowed for terminations of pregnancies that occurred as a result of rape.

Texas topped the list, with about 45% of the rape-related pregnancies occurring within the state, researchers estimated. Ninety-one percent of the estimated rape-related pregnancies took place in states without exceptions for rape, according to the researchers.

"Few (if any)" of the women and girls who became pregnant due to rape "obtained in-state abortions legally, suggesting that rape exceptions fail to provide reasonable access to abortion for survivors," the research letter said.

Abortion rape exceptions can be rendered “virtually meaningless” because of rape reporting requirements, said Dr. David Himmelstein, who co-authored the research and teaches at the School of Urban Public Health at Hunter College.

The researchers used data from the Centers for Disease Control and Prevention, the Bureau of Justice Statistics and the FBI to create their estimates.

Read the full story on NBCNews.com.

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It’s one of numerous cases involving abortion restrictions that have played out in state and federal courts after the U.S. Supreme Court ended abortion rights in 2022. The administration issued guidance that year saying hospitals “must” provide abortion services if there’s a risk to the mother’s life, citing the Emergency Medical Treatment and Labor Act of 1986, which requires emergency rooms to provide stabilizing treatment for anyone who arrives at the emergency room.

Abortion opponents have challenged the guidance in multiple jurisdictions. In Texas, the state joined abortion opponents in a lawsuit to stop the guidance from taking effect and won at the district court level. The Biden administration appealed to the 5th U.S. Circuit Court of Appeals, which has jurisdiction in Texas, Louisiana and Mississippi. But a unanimous three-judge panel rejected the appeal in Tuesday’s ruling.

The ruling said the guidance could not be used to require emergency care abortions in Texas or by members of two anti-abortion groups that filed suit — the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations. The California-based 9th Circuit has allowed the use of the guidance to continue in an Idaho case, which is pending at the U.S. Supreme Court.

Opponents of the guidance said Texas law already allows abortions to save the life of the mother but that the federal guidance went too far, calling for abortions when an emergency condition is not present and eliminating obligations to treat the unborn child.

The 5th Circuit panel sided with Texas. The opinion said language in the 1986 emergency care law requires hospitals to stabilize the pregnant woman and her fetus.

“We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child especially when EMTALA imposes equal stabilization obligations,” said the opinion written by Judge Kurt Engelhardt.

In the appellate hearing last November, a U.S. Justice Department attorney arguing for the administration said the guidance provides needed safeguards for women and that the district court order blocking the use of the guidance was an error with “potentially devastating consequences for pregnant women within the state of Texas.”

The panel that ruled Tuesday included Engelhardt and Cory Wilson, nominated to the court by former President Donald Trump, and Leslie Southwick, nominated by former President George W. Bush.

Texas Abortion Law

Dec 8, 2023

Texas Supreme Court pauses lower court's order allowing pregnant woman to have an abortion

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Oral arguments were scheduled for Wednesday in Santa Fe. At least four state supreme courts are grappling with abortion litigation this week in the aftermath of the U.S. Supreme Court’s decision last year to rescind the constitutional right to abortion.

In New Mexico’s Lea and Roosevelt counties and the cities of Hobbs and Clovis, where opposition to abortion runs deep, officials argue that local governments have the right to back federal abortion restrictions under a 19th century U.S. law that prohibits the shipping of abortion medication and supplies. They say the local abortion ordinances can’t be struck down until federal courts rule on the meaning of provision within the “anti-vice” law known as the Comstock Act.

Attorney General Raúl Torrez has argued that the recently enacted local laws violate state constitutional guarantees — including New Mexico’s equal rights amendment that prohibits discrimination based on sex or being pregnant.

Abortion Dec 11, 2023

Texas Supreme Court rules against Dallas woman who sought abortion; her attorneys say she left state to get procedure

Dec 8, 2023

Texas Supreme Court pauses lower court's order allowing pregnant woman to have an abortion

Since the court case began, additional local ordinances have been adopted to restrict abortion near Albuquerque and along the state line with Texas.

New Mexico is among seven states that allow abortions up until birth, and it has become a major destination for people from other states with bans, especially Texas, who are seeking procedures.

A pregnant Texas woman whose fetus has a fatal condition left the state to get an abortion elsewhere before the state Supreme Court on Monday rejected her unprecedented challenge of one of the most restrictive bans in the U.S.

In 2021, the New Mexico Legislature repealed a dormant 1969 statute that outlawed most abortion procedures as felonies, ensuring access to abortion even after the U.S. Supreme Court rolled back guarantees last year.

Earlier this year, New Mexico Gov. Michelle Lujan Grisham signed a bill that overrides local ordinances aimed at limiting abortion access and enacted a shield law that protects abortion providers from investigations by other states.

On Tuesday, the Arizona Supreme Court grilled lawyers about a pre-statehood ban in 1864 on nearly all abortions and whether it has been limited or made moot by other statutes enacted over the past 50 years.

Arizona’s high court is reviewing a lower-court decision that said doctors couldn’t be charged for performing the procedure in the first 15 weeks of pregnancy because other, more recent laws have allowed them to provide abortions.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

The Justice Department filed a statement of its position in consolidated lawsuits against Alabama Attorney General Steve Marshall, arguing that such prosecutions would be unconstitutional. The lawsuits, filed by an abortion fund and former providers, seek a court ruling clarifying the state can’t use conspiracy statutes to prosecute people who help Alabama women travel elsewhere to obtain an abortion. Marshall has not prosecuted anyone for providing such assistance, but he has made statements saying that his office would “look at” groups that provide abortion help.

The Justice Department argued in the filing that the U.S. Constitution protects the right to travel. The department said that just as Marshall cannot stop women from crossing state lines to obtain a legal abortion, “neither can he seek to achieve the same result by threatening to prosecute anyone who assists that individual in their travel.”

Alabama is one of several states where abortion is almost entirely illegal after the U.S. Supreme Court, in a decision known as Dobbs, handed authority on abortion law to the states. Alabama bans abortion at any stage of pregnancy with no exceptions for rape and incest. The only exemption is if it’s needed because pregnancy seriously threatens the pregnant patient’s health.

“As I said the day Dobbs was decided, bedrock constitutional principles dictate that women who reside in states that have banned access to comprehensive reproductive care must remain free to seek that care in states where it is legal,” Attorney General Merrick B. Garland said in a statement.

The Justice Department asked a federal judge to consider its view as he decides the issue. Marshall indicated he welcomed the fight.

“Attorney General Marshall is prepared to defend our pro-life laws against this most recent challenge by the Biden Administration and, as always, welcomes the opportunity,” Marshall’s office said in a statement Thursday evening.

The legal dispute in Alabama comes as several Texas counties have enacted ordinances, which would be enforced through private lawsuits, seeking to block travel on local roads to get to where abortion is legal. The measures would not punish women who are seeking an abortion but would present legal risks to people who help transport them to get the procedure.

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The two Alabama lawsuits seek a ruling clarifying that people and groups can assist women leaving the state for an abortion. One lawsuit was filed by the Yellowhammer Fund, a group that stopped providing financial assistance to low-income abortion patients because of prosecution concerns. The other was filed by an obstetrician and two former abortion clinics that continue to provide contraception and other health services.

Speaking at a legislative hearing on funding requests for the upcoming budget cycle, Bob Anderson, who leads the Mississippi Department of Human Services, said the upward trend in voucher enrollment means the agency might “hit a wall with state and federal money,” forcing parents to undergo a waiting period for child care assistance.

The department counted 31,532 families receiving those vouchers as of this month, up from 24,500 last October.

“That is on track with what we were told to expect when Dobbs happened,” Anderson said, referring to Dobbs v. Jackson Women’s Health Organization, the Mississippi case in which the U.S. Supreme Court overturned the five-decade-old protection of abortion rights established by Roe v. Wade.

After Dobbs, a Mississippi law went into effect banning abortion only if the woman’s life is in danger or if a pregnancy is caused by a rape that has been reported to law enforcement.

Voucher enrollment further accelerated in May after Gov. Tate Reeves, a Republican, approved a recommendation from a council of early childhood administrators to do away with a 19-year-old policy that had forced single parents and guardians to seek child support from the other parent to be eligible for assistance through the Child Care Payment Program, which offers help to low-income parents.

Advocates had sought to change that policy for years, saying it deterred many single mothers from applying for assistance because, among other reasons, they feared identifying their former partners would lead to abuse. They also said that when parents couldn’t find child care, it prevented them from getting back to work.

Lt. Gov. Delbert Hosemann, also a Republican, disputed the idea that the abortion ban has had an impact on child care voucher enrollment. He said the increase cannot be tied to Dobbs because “we actually have less live births than we did before,” and the spike results instead from the May policy change.

“It’s clear to me it’s not the Dobbs decision. It’s the fact that we made this policy decision that’s been approved by the governor and that you’re seeing thousands of people become eligible because of that,” Hosemann said. “And the other side of that coin has to be that you will see less fathers responsible because they’re not being disclosed by an individual.”

Anderson said more children are being born in Mississippi than there would have been had abortion still been legal, leading to increased demand for services.

“Whether that’s a direct corollary from Dobbs, I don’t know. We can debate that,” Anderson said.

In a statement, Reeves’ office said the May decision was made because the governor “is always looking for more ways to make state government more effective and efficient.”

“He listened to the experts and made the decision based on their recommendation that a change in this policy would allow more mothers to enter the workforce without being penalized,” said Cory Custer, the governor’s deputy chief of staff. “If it is determined that the previous policy is a better path to prosperity, we will be happy to return.”

___

Michael Goldberg is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow him at @mikergoldberg.

New details behind the 2022 arson at Wellspring Health Access in Casper, delaying the clinic’s opening by almost a year, emerged as Lorna Roxanne Green, 22, was sentenced to five years in prison and three years probation.

In addition, Green will have to pay “very, very substantial” restitution that is yet to be determined but will be “well over $280,000,” U.S. District Judge Alan Johnson said.

Green said little at the hearing but through her attorney, Ryan Semerad, told the court she acted alone, accepted responsibility and didn’t intend to cause fear or make a political statement but failed to handle her strong emotions about the clinic.

“You are a talented and gifted person,” Johnson told her. “You are entitled to your opinions, whatever they may be, but those opinions do not justify in any respect the terror that was caused.”

Prosecutors and Green’s attorney said in the hearing they agreed to the mandatory minimum sentence.

As many as 20 supporters of Green turned out for the hearing. Green looked to them with a slight smile after entering the courtroom but neither she nor they reacted emotionally during the proceedings. Two women and a man who sat among Green’s supporters during the proceedings said her family had no comment.

Johnson said he received a “remarkable” outpouring of letters in support of Green from family, friends and community members.

Green faced up to 20 years in prison and a $250,000 fine after pleading guilty in July. At her plea hearing, she said she was sorry for what she did.

Green told investigators she opposed abortion and that anxiety and nightmares about the clinic caused her to burn it. Johnson urged Green to get treatment for her obsessive-compulsive disorder, anxiety and depression described in a “lengthy report” from a psychologist.

“You are a complex person,” Johnson told her.

The judge related details from pre-sentencing reports about her now-distant relationship with “helicopter” parents after a childhood in which she was regularly spanked up to age 18. Her mother once struck and gave her sister a bloody nose, Johnson said, referring to the documents.

Green experienced “emotional and physical abuse” and “control and manipulation by her parents” who “talked down” to her, Johnson said.

The pre-sentencing reports have not been made available to the public. Green’s parents, who had no listed number, did not return a phone message left through Semerad’s office seeking comment on the allegations.

The fire happened weeks before the clinic was to open. Extensive damage to the building being remodeled for the clinic kept it from opening for almost a year.

Green admitted to breaking in, pouring gasoline around the inside of the building and lighting it on fire, according to court documents.

The Casper College mechanical engineering student showed no sign of anti-abortion views on social media but told investigators she opposed abortion.

She told a U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives agent she bought gas cans and aluminum pans the day before the fire, drove to Casper, and carried the cans and pans to the clinic in a bag, matching security video and a witness account, according to a court filing.

She admitted using a rock to break glass in a door to enter and pouring gasoline into the pans in several rooms and on the floor before lighting it, according to the document.

Investigators said they made little progress finding who started the fire until a reward was increased to $15,000 in March, leading several tipsters to identify Green.

The arson was one of hundreds against abortion clinics in the U.S. since the 1970s, Wellspring founder and President Julie Burkhart said in the hearing.

Burkhart said she had a daughter about Green’s age, however, and felt sorry that she had derailed her life by burning the clinic.

“In a way, my heart breaks for the defendant. She made a terrible choice and committed a heinous crime,” Burkhart said.

Burkhart once worked closely with Dr. George Tiller, a Wichita, Kansas, abortion doctor who was assassinated at church in 2009. Four years after his murder, Burkhart helped to reopen Tiller’s clinic.

The clinic, which opened in April, provides surgical and pill abortions, making it the first of its kind in the state in at least a decade. Only one other clinic in Wyoming — in Jackson, some 250 miles (400 kilometers) away — provides abortions, and only by pill.

Laws passed in Wyoming in 2022 and 2023 sought to make abortion in the state illegal but a judge has kept abortion legal while a lawsuit challenging the new laws proceeds. One of the new Wyoming laws to ban any drug used to cause an abortion would be the nation’s first explicit ban on abortion pills.

Teton County District Judge Melissa Owens has expressed sympathy with arguments that a 2012 state constitutional amendment guaranteeing Wyoming residents’ right to make their own health care decisions conflicted with the bans.

Though abortion in Wyoming has remained legal, women in the rural state often go to nearby states, including Colorado, for abortions.

Jessica Burgess, 42, pleaded guilty in July to tampering with human remains, false reporting and providing an abortion after at least 20 weeks of gestation, which is illegal in Nebraska. Madison County District Judge Mark Johnson sentenced her Friday to one year in prison for each count, with the first two to run concurrently. The sentence for the abortion count was ordered to run after the first two, amounting to a two-year sentence.

Her attorney, Brad Ewalt of Norfolk, sought probation, but the judge balked at that request. He said Burgess demonstrated that she knew she was breaking the state’s abortion law by initially lying to investigators about it and by going to “extraordinary means” to obtain the pills online instead of through a Nebraska medical provider, according to the Norfolk Daily News.

“I shudder to think, Ms. Burgess, that you have such disrespect for a — call it a human fetus, call it a stillborn child — that you would treat it like yesterday’s trash and not give it some respect in its treatment and disposal,” the judge said. “Our society expects more; it demands more.”

Burgess, of Norfolk, Nebraska, admitted at her plea hearing to helping her then-17-year-old daughter end her pregnancy. As part of her plea, charges of concealing the death of another person and abortion by someone other than a licensed physician were dismissed.

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Her daughter, Celeste Burgess, who is now 19, was sentenced in July to 90 days in jail and two years of probation for burning and burying the fetus. She was released from jail on Sept. 11.

Both Jessica Burgess and her daughter, who was in the courtroom Friday, wept as the elder woman was taken away in handcuffs to begin serving her sentence, the Daily News reported. She will be eligible for release after about a year.

The abortion, well into the teen’s third trimester, violated Nebraska law at the time that banned abortion after 20 weeks of gestation. Officials have said Jessica Burgess ordered abortion pills online and gave them to her daughter in the spring of 2022.

Norfolk police opened an investigation into the abortion following a tip, according to an arrest affidavit. Police secured a search warrant to gain access to Facebook messages between the two, where prosecutors say the women discussed terminating the pregnancy and destroying the evidence. Police then found the burned fetal remains buried in a field north of Norfolk.

In one of the Facebook messages, Jessica Burgess instructed her daughter on how to take the pills to end the pregnancy, according to court records.

During the legislative session that ended in June, Nebraska lawmakers who opposed Republicans’ efforts to severely restrict abortion access repeatedly cited the Norfolk case, saying it shows state prosecutors would target women who seek abortions for criminal prosecution.

Republicans in the officially nonpartisan Nebraska Legislature failed this year to enact a six-week ban on abortions, but later passed a 12-week ban after adding it as an amendment to another bill limiting gender-affirming care for transgender youth. The American Civil Liberties Union has sued to overturn the abortion ban and transgender care bill, citing a Nebraska constitutional requirement that legislative bills stick to a single subject.

Both the legislative action and the sentencings in the Norfolk case came in the wake of the U.S. Supreme Court’s decision last year to overturn Roe v. Wade, which for 50 years had established a constitutional right to abortion.

A special International Profile in Courage Award will honor South Korean President Yoon Suk Yeol and Japanese Prime Minister Fumio Kishida for working to improve relations between their countries despite domestic opposition.

During the filibuster the senators – Republicans Katrina Shealy, Sandy Senn, and Penry Gustafson, Democrat Margie Bright Matthews, and independent Mia McLeod — took turns “describing the complexities of pregnancy and the reproductive system, the dangers of lack of access to contraception, and inadequate privacy laws,” award officials said in written release.

Officials noted that members of the coalition, who became known as the “sister senators,” were heckled by anti-abortion activists and the three Republicans were also met with strong opposition from their own party – including censures and promises of primary challenges in 2024.

Despite the filibuster, the South Carolina Legislature was later able to approve the measure that would ban most abortions after around six weeks of pregnancy — before most people know they are pregnant.

“We in the South Carolina Legislature are not God. We do not know what’s going on in somebody else’s life. We do not have the right to make decisions for someone else,” Shealy said at the time, urging other members of her party to adopt a 12-week abortion ban instead.

U.S. Ambassador to Australia Caroline Kennedy said the goal of the Profile in Courage awards is to honor leaders who took stands of conscience and risked their careers by putting the public interest ahead of their own political standing.

“The women of the South Carolina Senate set an example for those seeking justice and individual freedom at all levels of government,” she said in a statement. “President Yoon and PM Kishida are doing the hard work of reconciliation in pursuit of a more peaceful world.”

Kennedy and her children Jack Schlossberg and Tatiana Schlossberg, members of the Profile in Courage Award Committee, will present the awards on Oct. 29 at the John F. Kennedy Presidential Library in Boston.

President Kennedy’s book, “Profiles in Courage,” recounts the stories of eight U.S. senators who risked their careers by taking principled stands for unpopular positions. The award was created by the John F. Kennedy Library Foundation in 1989.

Previous winners have included Presidents Barack Obama, Gerald Ford and George H.W. Bush.

Last year, Ukrainian President Volodymyr Zelenskyy was among five people named as recipients of the award for his efforts to protect democracy.

The court filing from the Justice Department sets the stage for a possible final resolution to a contentious legal fight mounted by abortion rights opponents over federal approval of the drug mifepristone. The dispute lands at the Supreme Court in time for the justices to potentially take it up, hear oral arguments and issue a decision by next summer.

In urging the Supreme Court to intervene, Solicitor General Elizabeth Prelogar wrote that the case marked the first time a court has ever second-guessed the “expert judgment” of the FDA in approving a drug.

If lower court rulings were left in place, they “would impose grave harms on the government, mifepristone’s sponsors, women seeking medication abortions, and the public,” Prelogar added. Among other things, access to the pill by mail — which the FDA formally approved in 2021 — would be curtailed.

Danco — the maker of Mifeprex, the brand version of mifepristone — filed a similar appeal Friday.

For more on this story, go to NBC News.

That earlier ruling had set off a grinding process of decriminalizing abortion state by state. Last week, the central state of Aguascalientes became the 12th state to decriminalize the procedure. Judges in states that still criminalize abortion will have to take account of the top court’s ruling.

The Supreme Court wrote on X, the platform formerly known as Twitter, that it had decided that “the legal system that criminalized abortion in the Federal Penal Code is unconstitutional, (because) it violates the human rights of women and people with the ability to gestate.”

The court’s sweeping decision Wednesday comes amid a trend in Latin America of loosening restrictions on abortion, even as access has been limited in parts of the United States. Some American women were already seeking the help of Mexican abortion activists to obtain the pills used to end their pregnancies.

Mexico City was the first Mexican jurisdiction to decriminalize abortion 15 years ago.

The Information Group for Chosen Reproduction, known by its Spanish initials as GIRE, said the court decided that the portion of the federal penal code that criminalized abortion no longer has any effect.

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“No woman or pregnant person, nor any health worker will be able to be punished for abortion,” the non-governmental organization said in a statement.

The impact also means that the federal public health service and any federal health institution must offer abortion to anyone who requests it, GIRE said. The court ordered that the crime of abortion be removed from the federal penal code.

Across Latin America, countries have made moves to lift abortion restrictions in recent years, often referred to as a “green wave.”

After decades of work by feminist activists across the region, the wave picked up speed in Argentina, which in 2020 legalized the procedure. In 2022, Colombia, a highly conservative country, also decriminalized abortion.

Many organizers worry, however, that the lifting of restrictions may not translate to expanded access in highly conservative and religious countries.

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Hadley Duvall says in voiceover that she’s never slept a full night in her life — her stepfather first started abusing her when she was five years old, and impregnated her when she was 12. As she speaks, images of Duvall as a child flash on the screen. The soundtrack of the ad is a song by Billie Eilish, who endorsed the vice president on Tuesday.

“I just remember thinking I have to get out of my skin. I can’t be me right now. Like, this can’t be it,” Duvall says. “I didn’t know what to do. I was a child. I didn’t know what it meant to be pregnant, at all. But I had options.”

The ad is part of a continued push by the Harris campaign to highlight the growing consequences of the fall of Roe, including that some states have abortion restrictions with no exceptions for rape or incest. Women in some states are suffering increasingly perilous medical care and the first reported instance of a woman dying from delayed reproductive care surfaced this week. Harris lays the blame squarely on Republican nominee Donald Trump, who appointed three of the conservatives to the U.S. Supreme Court who helped overturn the constitutional right to abortion.

Duvall blames Trump, too.

“Because Donald Trump overturned Roe v. Wade, girls and women all over the country have lost the right to choose, even for rape or incest,” she says in the ad. “Donald Trump did this. He took away our freedom.”

During the presidential debate on Sept. 10, Trump repeatedly took credit for appointing the three Supreme Court justices and leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban.

“I’m not signing a ban,” he said, adding that “there is no reason to sign the ban.”

But he also repeatedly declined to say whether he would veto such a ban if he were elected again — a question that has lingered as the Republican nominee has shifted his stances on the crucial election issue.

Duvall of Owensboro, Kentucky, first told her story publicly last fall in a campaign ad for the governor’s race in her home state supporting Democratic Gov. Andy Beshear. Duvall’s stepfather was convicted of rape and is in prison; she miscarried.

Beshear won reelection, and Democrats have said Duvall’s ad was a strong motivator, particularly for rural, male voters who had previously voted for Trump.

Duvall is also touring the country to campaign for Harris along with other women who have been telling their personal stories since the fall of Roe, joining Pennsylvania Gov. Josh Shapiro last week.

Some of the division among the candidates has come over whether there should be a national ban on the practice — and after how many weeks — now that the justices have returned specific debate over abortion legality to the states.

A look at how the issue of abortion is playing out among Republican and Democratic candidates:

Donald Trump

The former president, the current GOP front-runner, has often sidestepped the issue of abortion, even as Republicans across the country have celebrated the Supreme Court’s decision.

In April, a major anti-abortion group assailed Trump on the issue, saying his contention that abortion restrictions should be left up to individual states, not the federal government, is a “morally indefensible position for a self-proclaimed pro-life presidential candidate.”

The Susan B. Anthony Pro-Life America group has said it would not support any White House candidate who did not at a minimum support a 15-week federal abortion ban.

Trump, who has referred to himself as “the most pro-life president in American history, has pointed to his successful nomination of three conservatives justices, a move that tilted the court to the conservative majority that overturned Roe v. Wade. Earlier this year, he characterized as “too harsh” a measure signed into law by fellow contender Gov. Ron DeSantis that would ban abortions in Florida after six weeks of pregnancy.

Ron DeSantis

While DeSantis has been governor, Florida passed an abortion ban after six weeks of pregnancy. But DeSantis, who says he is “pro-life,” has suggested that individual states should decide the issue, adding in a recent interview that he is “running on doing things that I know I can accomplish.”

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, criticized DeSantis for not supporting a national ban on the procedure, calling DeSantis’ position “unacceptable” as he runs for president.

Mike Pence

The former vice president supports a federal ban on abortion at six weeks, before many women even know they’re pregnant.

And he has advocated pulling from the market one of two widely used abortion pills — a medication with a better safety record than Viagra and penicillin. Sensing that such a position may be viewed as too extreme in a general election, no other major presidential candidate has joined his calls.

In a recent Associated Press interview, Pence went even further, saying abortion should be banned, even when a pregnancy is deemed nonviable. Such a standard would force women to carry pregnancies to term even when doctors have determined there is no chance a baby will survive outside the womb.

Earlier this month while touring the Iowa State Fair, Pence said he was expecting to use the debate as an opportunity to call out Trump and DeSantis for not insisting on a national abortion ban.

Tim Scott

The South Carolina senator has long voiced his opposition to abortion, pledging that as president “I would sign the most conservative pro-life legislation you can bring to my desk.”

He has signaled support for a federal ban on the practice for as early as 12 weeks and also support for a bill sponsored by Sen. Lindsey Graham, R-S.C., that would ban abortions nationally after 15 weeks.

In 2021, Scott also co-sponsored legislation that would have established a constitutional right to life from “the moment of fertilization.”

Nikki Haley

Haley, the sole woman in the GOP field, pledged in May that she would sign a federal abortion ban if elected president.

But Haley has not specified a time frame for after how many weeks she feels abortion should be outlawed, noting that passing such a measure would be highly unlikely without more Republicans in Congress, and advocating for “consensus” around the issue. She’s said she would “absolutely” sign a 15-week federal ban.

The former South Carolina governor and U.S. ambassador to the United Nations said “no one has been honest” about how difficult a ban could be to achieve, in a closely divided federal government.

Haley campaign spokesman Ken Farnaso said in June that she would “sign pro-life legislation that includes exceptions for rape, incest, and for the life of the mother,” suggesting she may be opposed to an exception for non-viable pregnancies — but declining to clarify.

As governor, Haley signed an abortion ban after about 20 weeks. That law is still in effect while a six-week ban, passed by state lawmakers, is held up in the courts.

Vivek Ramaswamy

The wealthy biotech entrepreneur and author of “Woke, Inc.” has said he would not support a federal ban on abortion because ”the federal government should stay out of it.” He has voiced support for states that have passed six-week bans.

Like some other hopefuls, he has pushed for more policies that encourage adoption and better child care.

Chris Christie

The former two-term New Jersey governor has argued that the issue of abortion should be carried out in the states, not at the federal level.

In a CNN town hall, Christie said that “the federal government should not be involved unless and until there’s a consensus around the country from the 50 states making their own decisions about what it should be.”

Seeking local office in the 1990s, Christie identified himself as “pro-choice,” saying he changed his position after hearing his daughter’s heartbeat at 13 weeks.

As governor, he vetoed millions in state funding for Planned Parenthood and other family planning clinics. Before the Supreme Court’s decision that overturned Roe, Christie joined Dannenfelser in meetings other GOP governors to discuss the issue and how it might play out at the state level.

Asa Hutchinson

The former two-term Arkansas governor has said the issue of abortion should stay in the states without a Republican supermajority in Congress.

As governor in 2021, Hutchinson signed a near-total ban on abortions that did not include rape and incest exceptions.

Doug Burgum

In April, the two-term North Dakota governor signed one of the strictest anti-abortion laws in the country. The measure would allow abortions up to six weeks’ gestation in cases of rape or incest, or medical emergencies. After that marker, no exceptions aside from some medical emergencies, such as ectopic pregnancies, are allowed at any stage of pregnancy.

Burgum has mostly said the issue of abortion should be left to the states and has indicated he would not support a federal ban.

Larry Elder

The conservative talk radio host opposes abortion but has said he would not support a federal ban.

Perry Johnson

The businessman describes himself as “pro-life.” When he ran for Michigan governor in 2022, Johnson told reporters “two wrongs don’t make a right” when asked if he would rule out banning abortion in cases of sexual assault.

Francis Suarez

The Miami mayor has said that he would support a national ban on abortions after 15 weeks of pregnancy, with some exceptions, including rape, incest and the mother’s health.

Will Hurd

The former Texas congressman has said he would sign a 15-week federal abortion ban, although he has said that he doesn’t see it as realistic that Congress would pass such a measure.

While in the House, Hurd twice voted in favor of a 20-week ban.

Joe Biden

The president supports abortion access and has said he would veto a national ban on the practice. As a senator, Biden supported abortion restrictions like the 1976 Hyde Amendment — which states that Medicaid won’t pay for abortions unless the woman’s life is in danger or the pregnancy is the result of rape or incest — but said during the 2020 campaign he had shifted course.

The aftermath of last year’s Supreme Court ruling has framed much of Biden’s presidency on abortion. He signed an executive order designed to strengthen and promote access to contraception.

Mounting a rallying cry to 2022 midterms voters to seat more Democratic lawmakers who could possibly codify abortion access nationally, Biden has also directed his administration to take steps to protect access to abortion care. This includes making mifepristone — one of two pills used in medication abortions — easier to obtain, and ensuring members of the military can access reproductive health care.

Robert F. Kennedy Jr.

The author and environmental lawyer has spoken in favor of “bodily autonomy” and describes himself as “pro-choice.”

A nephew of President John F. Kennedy and son of Attorney General Robert F. Kennedy, he has also said “it’s a woman’s choice, and it’s solely up to the woman” in terms of how a pregnancy should be handled in its first trimester.

Marianne Williamson

The self-help author’s campaign website describes her as “one hundred percent pro-choice.” Williamson has also noted that she believes the decision to have an abortion or not “lies solely with a pregnant woman, according to the dictates of her conscience and in communion with the God of her understanding.”

Levonorgestrel, often called Plan B, is the most widely available type of emergency contraception. It works by preventing or delaying ovulation.

Scientists estimate that it is about 95% effective when taken within a day after unprotected sex, dropping to 58% or lower within three days. The new study, published by the medical journal Lancet, suggests levonorgestrel can remain highly effective up to three days after unprotected sex when it is taken with piroxicam, an anti-inflammatory pain medication typically prescribed for arthritis.

“It’s really exciting and very timely that we could have a more effective emergency contraceptive option,” said Kelly Cleland, executive director for the American Society for Emergency Contraception, who was not part of the Lancet study.

Scientists tracked 836 women at a Hong Kong clinic between 2018 and 2022 who had unprotected sex and requested emergency contraception within three days. Half the women received a dose of levonorgestrel and piroxicam while the other half got the contraceptive pill plus a placebo.

Doctors calculated that 95% of pregnancies among the women who got the combination with piroxicam were prevented, compared with 63% of those who got the placebo combination.

The most common side effects in both groups were fatigue, nausea, abdominal pain, dizziness and headache. No funding was provided for the study. The researchers used a Hong Kong brand of the contraceptive that it is sold over-the-counter in the U.S. under several names, including Plan B One-Step.

The authors acknowledged that because the research was done in mostly Asian women weighing less than 70 kilograms (154 pounds), it was unclear if the results could be extrapolated to other populations. There is some evidence levonorgestrel doesn’t work as well in heavier women.

Piroxicam is in the same class of anti-inflammatories as ibuprofen and paracetamol. It requires a prescription in many countries, including the U.S. and the U.K.

“It’s fascinating that they found this already existing medication really increases the efficacy of Plan B,” said Dr. Beverly Gray, a Duke University associate professor of obstetrics and gynecology who was not part of the new study. “But any medication that requires a prescription is going to be one more barrier, so what we really need is an over-the-counter medication that people can use in conjunction with Plan B.”

Dr. Kristina Gemzell Danielsson, head of Women and Children’s Health at Sweden’s Karolinska Institute and one of the Lancet study authors, said similar anti-inflammatory drugs could have the same effect. She said there would be no risk to women who took over-the-counter ibuprofen with Plan B, though it might not prove as effective as longer-acting piroxicam.

Piroxicam can cause bleeding in the stomach or severe skin reactions and increases the risk of heart or kidney disease in people susceptible to those conditions. Still, experts said using the drug once would be less likely to cause harm, particularly for the mostly younger women who would be most likely to use emergency contraception.

Gemzell-Danielsson said further studies could examine whether anti-inflammatories boost the effectiveness of the other main emergency contraceptive pill, ellaOne.

She recommended that women keep some form of emergency contraception at home, especially in places with highly restrictive abortion policies.

“It is a simple, effective and really smart solution to have,” Gemzell-Danielsson said. “You don’t buy (Band-Aids) because you plan to cut yourself, but you have it because you think it might happen.”

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