MARY LOUISE KELLY, HOST:
Nearly two years after the Supreme Court overturned Roe v. Wade, a lot has happened with abortion access. State laws have been changing constantly. New bans have taken effect. There's been a slew of lawsuits and ballot measures. All this week, we are going to take a look at how this issue is motivating voters. And here to give us the state of play on that are NPR's Elissa Nadworny, who covers reproductive rights, and NPR's Selena Simmons-Duffin, who covers health policy for us. Hey to you both.
ELISSA NADWORNY, BYLINE: Hi, Mary Louise.
SELENA SIMMONS-DUFFIN, BYLINE: Hello.
KELLY: Elissa, kick us off. As I say, it has been changing so fast. Where do things stand big picture if we're just trying to picture the map of abortion access in the country right now?
NADWORNY: So there are total bans on abortion with very limited exceptions in 14 states. A few more states have six-week bans. And so often that's so early in a pregnancy, most don't know they're pregnant.
KELLY: Yeah.
NADWORNY: Florida was the most recent place for this to take effect. There are states like Nebraska that ban abortion after 12 weeks. In Arizona, it's 15 weeks. More than half of the states have restrictions. And in those states, the number of abortions has dropped drastically.
SIMMONS-DUFFIN: And I just want to point out that those laws aren't just affecting the number of abortions happening in these states. They're having a broad impact on how the health care system is working overall.
KELLY: Explain. What does that mean?
SIMMONS-DUFFIN: OK, so Idaho is an extreme case of how this is playing out. Doctors are leaving the state. Three maternity wards have closed since the abortion ban there took effect. And I talked to Dr. Sarah Thomson. She's an OB-GYN in Boise.
SARA THOMSON: We lost 58 obstetricians either to moving out of state or retiring. And in that same time period, only two OB-GYNs moved into Idaho. So that is not really a sustainable loss-to-gain ratio.
SIMMONS-DUFFIN: And it's not just Idaho. A lot of hospital systems in states with abortion bans are having recruiting problems.
KELLY: OK, so how should we square what you both are telling me, though, with something I just heard you reporting on, Elissa - that despite all this, abortions are actually increasing nationally?
NADWORNY: That's right. And it's because more than half of abortions are done with medication. So with the rise of telehealth, patients don't have to take off fork and go to a clinic. They can connect with a provider via text message, phone call or video, no matter where they live. Lauren, who is 33 and lives in Utah - she used a telehealth appointment to access abortion medication last month. She was on birth control. She's already a mother, which is a demographic most likely to have an abortion. We're not using her last name because she's worried about professional repercussions.
LAUREN: In my situation, I felt more at ease than I would in a physician's office and more comfortable, to be honest. Especially with a provider within the state of Utah, I feel like there's always a judgmental, like, indication or undertone.
SIMMONS-DUFFIN: So in Utah, where Lauren lives, abortions are allowed up to 18 weeks, but access to them is severely restricted. So as of January, only hospitals can perform abortions. The state also essentially bans the use of telehealth abortions by requiring an in-person visit to receive a medication abortion. So Lauren used an online company that connected her with a doctor in another state that has protections for doctors and clinics known as shield laws.
KELLY: Well, I have to ask. Is that legal - what Lauren is doing in the doctors who are helping her?
SIMMONS-DUFFIN: So it's kind of a legal gray area. States with abortion bans or restrictions hold the provider at fault, not the patient. But there's not a lot of legal precedent on this. I talked with John Seago, who is the president of Texas Right to Life. He's concerned with the rise of online pills and the shield laws. He told me his group is currently working on how to bring criminal and civil challenges to tamp down on the number of abortions happening.
JOHN SEAGO: I'm afraid that we are going to wake up in 20 years and just kind of realize that we won in Dobbs and then we've been losing ever since.
SIMMONS-DUFFIN: He says he sees the rise of overall abortion access as very worrisome.
KELLY: Selena, let me change gears because I want to look at the other side of this. We're paying a lot of attention, as we should, to states that have banned abortion. But some other states are going in the other direction. They're moving to make access easier. Where does that stand?
SIMMONS-DUFFIN: Yeah. So abortion was heavily regulated for years, even while Roe was the law of the land. Some states like Michigan, Colorado, Minnesota, California and others have made moves to undo some of those regulations. So to give you an idea, they're getting rid of things like waiting periods and gestational limits. They're allowing more types of providers like nurse practitioners, for instance, to provide abortions. They're training more providers on abortions. Some states have stockpiled mifepristone, one of the medicines that can be used for abortion, in case access is curtailed in the future. And in some places, like New York City, they've made abortion hubs part of the health department. So you can call a number and find out where to get an abortion and how to get funding to cover the costs.
KELLY: OK. Let's go to how all this may play out in the election. Where is abortion actually on the ballot this year?
SIMMONS-DUFFIN: So far, voters will be weighing in on the right to an abortion in four states - Colorado, Florida, Maryland and South Dakota. More states are in the process of getting it on the ballot, including Arizona and Missouri.
KELLY: OK. And for the states where it is on the ballot or may be on the ballot, Elissa, what are the prospects? How likely are these measures to succeed?
NADWORNY: Well, nationally, polling shows 6 in 10 Americans say abortion should be legal in all or most cases, but that can vary by state. But since Dobbs, voters in six states have weighed in on constitutional amendments on abortion. Voters chose access to abortion each time.
KELLY: And, Selena, to wind us back to where we began, in the Supreme Court, they are not done with this. There are two major decisions on abortion pending right now before the Supreme Court that's going to come out next month. What's the latest?
SIMMONS-DUFFIN: Right. So the first case is about the abortion pill mifepristone. The court could restrict this drug for the whole country and change access to medication abortion through telemedicine. Court watchers reading the tea leaves think it won't go that way, but obviously, no one knows for sure. The second case is about abortion in emergency situations, and it centers on Idaho's medical exception. It's a fight over whether federal or state law should have priority. The oral arguments left analysts really unsure about how this one will go. But the takeaway, as you say, is that both of these decisions will be coming down in early summer, just a few months before the election. So regardless of what the justices decide, it's going to catapult abortion back into the headlines at a key time for voters.
KELLY: That's NPR's Selena Simmons-Duffin - thanks to you...
SIMMONS-DUFFIN: Thank you.
KELLY: ...And Elissa Nadworny. Thank you.
NADWORNY: Thank you.
KELLY: And work by activists who identify as pro-life is also continuing post-Dobbs. We're going to hear what some of them are pushing for and where they disagree. That's on the show tomorrow.
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