On June 24th, 2022, the United States Supreme Court ruled 6-3 in favor of a Mississippi state health officer. With the decision of Dobbs v. Jackson Women’s Health Organization, decades of constitutional protection for abortion rights vanished.
Since 1973, Roe v. Wade had established the right for women to have an abortion based on the right to privacy. This Supreme Court decision reshaped reproductive health by opening access to millions of women, dramatically reducing the practice of unsafe procedures, and supporting the growth of reproductive healthcare clinics. Dobbs reversed this protection by handing the power to regulate reproductive care access to the states. This ruling, however, restricts not just abortion but broader reproductive care as well.
Although Dobbs was passed under the Biden Administration, the verdict was spearheaded by three judges appointed in Donald Trump’s first term: Justices Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. Following this judicial decision, twelve states have actively enforced total abortion bans with minimal exceptions. Other areas of reproductive health have also been restricted as a result of Trump’s direct executive action.
Gretchen Raffa, Chief Policy and Advocacy Officer at Planned Parenthood Votes Connecticut, told The Politic: “There have been non-stop attacks on reproductive, sexual, and reproductive health rights since this President took office.”
In Trump’s first 100 days of his second term, he froze Title X funding, removing critical financial support from numerous federally funded family planning organizations. Enacted in 1970, Title X has supported approximately 4,000 clinics, and in 2023 alone, helped provide care for 2.8 million people seeking birth control, cancer screenings, and STI testing.
Raffa emphasized the gravity of this decision: “The attack on Title X, the only federal family planning program—another essential public health program that funds preventative services for people who are uninsured or underinsured—is under attack.”
Freezes on funding create spill-over effects that extend far beyond abortion care. Dr. Megann Licskai, a lecturer in the History of Science, Medicine, and Public Health at Yale University, shared with The Politic: “I am very concerned about access to care, both abortion care, but also reproductive care more generally, because these things are very connected.”
Clinic closures not only limit the quality of care but also foster fear and uncertainty. “There are women who are just afraid to seek treatment for miscarriages because they are concerned this is going to be construed as an abortion,” added Dr. Lickskai.
Women are actively choosing to avoid medical attention altogether because of the fear of legal consequences. Reproductive care uncertainties have the potential to worsen the current state of public health in the United States.
“This is not something that we can fix overnight. The long-term impacts will be that patients lose access to care. That means they will have sexually transmitted infections that go untreated, cancers that go undetected, birth control that they cannot get,” said Raffa. The future implications of these policy changes are difficult to pinpoint, but long-lasting negative consequences are inevitable.
Additionally, Trump has pardoned 23 people who were convicted under the Freedom of Access to Clinic Entrances (FACE) Act, which prohibits the use or threat of force against individuals seeking or providing reproductive health services. These pardons weaken the Act’s significance, intimidating both patients and providers, and signal that protecting them from violence is not a priority.
His administration also removed ReproductiveRights.gov, a Biden-era resource that provided information about reproductive healthcare, patient rights, and abortions. These actions have resulted in fewer protections, fewer resources, and an increased threat to safe and accessible reproductive care. Following these developments, 41 Planned Parenthood locations have closed since the beginning of 2025.
With 64% of Planned Parenthood locations located in rural, medically underserved areas, or regions with health professional shortages, the organization is an invaluable resource. From mental health support and STD testing to prenatal and postpartum care, the organization is an invaluable resource for countless communities. Restricting funding means public health suffers across the board, a phenomenon seen in states such as Texas, Iowa, Indiana, Kansas, and Tennessee.
Indiana offers a revealing case study. After losing funding, a Planned Parenthood location in Scott County closed. This left the community without HIV testing and education. Soon after, the county saw one of the worst HIV outbreaks in state history, with 215 cases having since been attributed to it. Former Indiana Governor Mike Pence declared this outbreak a public health emergency.
The Scott County case is not the only example of the consequences of declining health care access. Sue Errington, Indiana House Representative who spent 17 years as the Public Policy Director for Planned Parenthood of Indiana and Kentucky, shared that “in 2024, [a near-total ban on abortion] was fully in effect. There were 146 abortions performed in Indiana, all in hospital settings. Now, to compare that to 2022, it was business as usual. There were 9,529 abortions performed in Indiana. So, we saw a 98% drop between 2022 and 2024.” This decrease does not suggest that women were not seeking abortion; it means that women were seeking healthcare services elsewhere.
In some cases, women have turned to Telehealth—the use of electronic information and telecommunication for long-distance healthcare. Telehealth has expanded its services far beyond its traditional applications, becoming a source for information on contraception, early pregnancy loss, abortion, and even self-removal of an IUD. Against physician recommendations, Telehealth has become the only viable option for women under restrictive circumstances.
Dr. Theresa Rohr-Kirchgraber, former president of the American Medical Women’s Association, highlighted order-by-mail birth control services like Pandia Health. Dr. Rohr-Kirchgraber mentions that Telehealth is “an option, but it’s only an option for birth control pills.” She adds, “You cannot put in a Mirena by telehealth… [So] Telehealth is okay, but it is for a small percentage of women who will be very receptive to the use of oral contraceptives, and not forget the pill.” Telehealth also has its own barriers to access that are not available to all: a capable device, digital literacy, and a reliable internet connection.
But the repercussions of Trump’s decisions may completely alter the future of women’s health within the medical profession. Dr. Rohr-Kirchgraber shared that, “the applications in those states with strict abortion laws have gone down. You have fewer people training to be an OB/GYN in your area, and we know that doctors typically stay around the place they do their residency.”
In states with strict abortion bans, OB/GYNs face increased ethical conflicts and legal risks compared to physicians in states that protect access to abortion, disincentivizing them from practicing locally. Thus, states that limit reproductive care access will have fewer and fewer women’s health professionals. In the long run, this could give rise to and exacerbate medically underserved areas and healthcare deserts.
The concern not only lies in the future of OB/GYNs’ careers, but also in their current state. Dr. Rohr-Kirchgraber mentioned that OB/GYNs are currently leaving their practices.
“Who wants to get thrown in jail because you provided the appropriate care for our patient? You know, none of us,” she said. This dilemma leads to an increase in health deserts, as physicians who are facing these consequences are often located in the same states. “In some states, currently, I would not be able to offer a woman the appropriate medication for her cancer because she’s pregnant, because it could cause her to lose the baby, and she doesn’t have the right to say let me have a termination,” said Dr. Rohr-Kirchgraber.
In some states, a woman’s health and quality of life are being pushed aside, and future health implications are being ignored. Dr. Rohr-Kirchgraber labels moments like this as a “travesty” and “bringing in some legislator into [the] exam room.” She emphasizes, “It’s up to you and your physician what you decide to do, because every situation is different.” Every case is different and calls for unique action, but taking power away from the patient and the physician limits the decisions they can make.
The economic costs of these restrictions are just as daunting. Representative Errington shared that, “being forced to carry a pregnancy to term is not something that affects you for a year or a few months. It’s a lifetime, and it throws women, especially if they are not married, into the welfare system, and that has implications for the children.”
She added that, “it affects our whole economy, because the more people that are utilizing Medicaid and food stamps, the state has to pay for that. They get money from the federal government, but it’s causing a lot of problems at the state level.” This affects not only women living in poverty, but also women from rural communities who lack access to abortion, leading to a greater likelihood of them not receiving the care they need, thus causing them to be in a situation where they rely on money from the federal government.
The Institute for Women’s Policy Research estimates that restrictions on abortion have cost the United States an average of 173 billion dollars per year. Furthermore, the widespread bans on abortion disproportionately affect women in poverty. Around half of the people who get an abortion are living below the federal poverty level, yet rates of sexual activity are almost identical across income groups. Socioeconomic status greatly affects the level of education received surrounding reproduction and contraception, leading to an increased need for abortion access.
Finding a path forward is an arduous balancing act of deeply held and often opposing perspectives. Dr. Lickskai emphasized that abortion “can mean so many different things to so many different people, and these are things that people feel very strongly about.” While views on abortion are polarized, finding a middle ground that expands access is crucial, not only for individual health but also for broader economic and social well-being.
Representative Errington reminds us that ultimately, “the person who is affected should decide with whoever she wants to involve. Usually, the doctor, for sure, but also other friends or family members. She is the one who has to live with the consequences of the decision, whether she makes it or somebody else.” The task of reestablishing full reproductive care access provides many challenges, but policies that respect both autonomy and equity offer the best chance of building a healthy future.
In an effort to create equitable and effective policy, Raffa stressed the importance of continued advocacy: “Anyone who believes that healthcare is a human right needs to talk to people in power,” adding, “it is so important for people to share their story.”
To create a more equitable policy, Dr. Rohr-Kirchgraber emphasized that “you have to get to where people are and understand where they’re coming from, and then try to find some common ground.” The topic of abortion pulls on moral, ethical, and religious beliefs, so it is increasingly important to enter conversations with an open mind, while still advocating for your stance.
Similarly, Dr. Licskai recommended “leaning into the mess.” With so many viewpoints and opinions coming from both sides of the argument, it is important to try to understand the perspectives of others, even if you disagree. Creating a well-rounded argument sets you up for success compared to an argument that does not consider both sides.
Representative Errington urges advocates of accessible abortion policy, “Don’t give up.” If you feel strongly about extending access, speak up, reach out to those in power, and have the hard conversations.