The Supreme Court could be on the verge of striking down the landmark Roe v. Wade decision that established a right to abortion, upending decades of policy and fully returning the issue to the states.
The court's watershed decision in Roe, and subsequent rulings upholding it, have granted the right to first-trimester abortion for Americans since 1973 — but the reality of that right varies dramatically from state to state.
Since Roe became the law of the land, individual state legislatures have enacted dozens of restrictions and regulations to make it as difficult as possible for patients to actually access abortion, in addition to outright bans that violate the constitution.
From strict regulations on clinics and bans on abortion after a certain number of weeks, to requiring patients to receive counseling and undergo waiting periods, these laws have tested the limits of Roe.
In 2021, Texas became the first state to successfully enact a "heartbeat" bill that effectively bans abortion after six weeks of pregnancy, before many patients know they're pregnant. The law's unusual design outsources the enforcement of the ban to private citizens, enabling them to sue abortion providers and those who "aid and abet" in abortion procedures and receive up to $10,000 in damages.
These seven charts and maps illustrate what abortion access in America actually looks like today, and what could happen if Roe fell.
The latest stage of pregnancy at which a patient can obtain an abortion by state in 2021 varies from 20 weeks to no limit.
Forty-three states limit abortions after a certain point in pregnancy (either defined as weeks post-fertilization or from the last menstrual pregnancy), with exceptions to save the life of the pregnant person.
Many other states also carve out exceptions for the physical and general health of the patient, fetal abnormalities, and rape or incest.
If the court strikes Roe down, 23 states have laws on the books that could outright ban or severely limit access to abortion, and 16 states and DC have passed laws that would explicitly protect the right to abortion.
If the Supreme Court does overturn Roe, it wouldn't result in abortion being banned nationwide.
Instead, the issue of abortion would go back to the jurisdiction of the states, as was the case before the Roe decision.
Every state would have much freer reign to permit or restrict abortion access, and over 30 states have passed laws or decrees that spell out how they'd treat abortion in the absence of Roe, according to research from the Guttmacher Institute.
Currently, 13 states have passed "trigger" laws that are explicitly designed to ban all or most abortions if Roe were struck down.
Nine states have passed post-Roe abortion restrictions, like "heartbeat" bills and first-trimester abortion bans, that have been blocked by courts but could go back into effect with a court order if Roe fell.
Another group of nine states still have their pre-Roe abortion bans, which are currently unenforceable, on the books.
Those laws, importantly, wouldn't automatically be revived if Roe were struck down, but would have to be put back into effect by a state legislature or order from a state attorney general, Guttmacher told Insider in 2019.
And lawmakers in seven states have passed decrees, which do not hold the force of law, expressing their intent to ban abortion to the greatest extent possible if Roe falls.
Four states have also passed constitutional amendments establishing that there is no right to an abortion under the state's constitution.
On the other hand, 16 Democratic-controlled states and the District of Columbia have passed laws that ensure abortion will remain legal within their borders if Roe falls.
The number of abortion clinics varies significantly per state, and more have shut down in the South and Midwest over the last decade.
In the decades since Roe, individual states have enacted a slew of restrictions to make it as difficult as possible for abortion clinics to operate, such that several states only have one remaining clinic.
Targeted Restrictions on Abortion Providers, or TRAP laws, impose very specific regulations on clinics. Oftentimes, these restrictions are so expensive that the costs of implementing them cause many clinics to close down altogether.
These include requirements on the width of corridors, the size and equipment of procedure rooms, and mandating that clinics have admission privileges at local hospitals, even though less than 0.5% of abortions result in complications.
In 2017, 89% of US counties had no known abortion providers, with 38% of US women ages 15-44 living in those counties.
The Supreme Court struck down one of the most extreme TRAP laws, Texas' HB2, in a 5-3 vote in 2016. But despite that, over 20 states still have such laws on their books.
By causing clinics to close down, TRAP laws have the consequence of making patients further and further to get to a clinic, especially in states that require patients to make multiple trips to the clinic and undergo a 24-to-72-hour "waiting periods."
According to another study from the Guttmacher Institute, patients travel an average of 34 miles each way to access abortion, and one in five American women have to travel at least 50 miles to reach their closest abortion provider.
Here's how the phases of pregnancy and fetal development line up with abortion bans. The Second Trimester starts at week 14.
Shayanne Gal/Insider
Before Texas' successful six-week abortion ban, states made many attempts to restrict patients from getting abortions after a certain number of weeks — oftentimes before a woman even knows she's pregnant.
In 2019, the Governors of Arkansas, Alabama, Georgia, Mississippi, Louisiana, Kentucky, Ohio, and Missouri signed bills to either severely restrict abortion with so-called "heartbeat bills" or, in Alabama's case, ban the procedure altogether.
Other states have tried to ban dilation & evacuation (D&E), the method commonly used to perform abortions after 14 weeks.
The surgical procedure is usually used in late-term miscarriages and abortions to remove the fetal tissue as safely as possible, and accounts for less than 0.5% of all abortions.
Prohibiting D&E abortions is effectively a ban on all second-trimester abortions, landing such prohibitions in murky legal territory.
Most US adults still favor protecting the legal right to abortion.
While the last decade has seen a huge increase in state-level abortion restrictions, Americans as a whole haven't become more anti-abortion in the past 20 years, according to survey data from Pew Research Center.
Currently, 59% of adults say abortion should be legal in all or most cases, while 39% say it should be illegal in all or most cases. Those numbers are almost exactly the same as they were back in 1995.
A supermajority of Democrats support keeping abortion legal, while conservative Republicans favor making it illegal. Moderates are more split.
Abortion has long been a hot-button partisan issue, with support for the procedure in all or most cases being highest among liberal Democrats and lowest among conservative Republicans.
Just under a quarter of those who identify as conservative Republicans now believe abortion should be legal in all or most cases, according to Pew Research.
And while state legislatures have passed draconian abortion restrictions for the purpose of starting litigation they hope will overturn Roe v. Wade, support for the landmark decision remains high.
A number of polls conducted prior to the 2020 election by organizations including Quinnipiac University, ABC News/Washington Post, Fox News, and Kaiser Family Foundation, found that between 61% and 69% of Americans support Roe, with 24% to 28% saying they want the decision overturned, CNN recently reported.
