Last month, Louisiana became the first state to begin classifying misoprostol and mifepristone—the two pills used in medication abortion—as schedule IV controlled substances.

The move, driven by anti-abortion Republicans and unsupported by evidence, left the state’s doctors bracing for the worst—the pills also are used to manage miscarriages and treat postpartum hemorrhages, and the new law requires they be locked away with other narcotics, potentially wasting precious minutes in an emergency. Hundreds of Louisiana doctors opposed the law, and one of them, Dr. Veronica Gillispie-Bell, a board-certified OB-GYN in New Orleans, told me she feared other states would follow.

That fear may now come to pass: Pat Curry, a Republican lawmaker in Texas, pre-filed a bill in the state legislature this week that would classify the two drugs as schedule IV substances there. The next legislative session does not begin until January 14—if passed, the bill would take effect in September 2025. Curry did not immediately respond to a Facebook message from Mother Jones on Sunday, and appeared to block me from messaging him further after I inquired about the bill.

The news, which appears to have first been reported by the Louisiana Illuminator, is just the latest example of right-wing attacks on abortion pills. Project 2025, the extremist guidebook to a second Trump term, recommends that the Department of Justice invoke the 19th-century Comstock Act to prosecute providers of abortion pills, as I have previously reported. It also recommends that the Food and Drug Administration revoke its approval of abortion pills. Conservative attorneys general in three states are trying to revive a US Supreme Court case seeking to restrict access to mifepristone after the justices unanimously dismissed it earlier this year. And as the Guardian reported on Sunday, anti-abortion advocates hope to outlaw abortion pills nationwide during Trump’s next term.

There is no scientific or medical evidence base to support the notion that the pills are dangerous or should be regulated as controlled substances, which federal law describes as drugs that have “potential for abuse.” More than 100 studies have found that mifepristone and misoprostol are safe and effective methods to terminate a pregnancy, and research has shown abortion pills are just as safe and effective when prescribed via telemedicine and mailed to patients as when prescribed and dispensed in person. Post-Dobbs, Americans have taken to stockpiling abortion pills just in case they need them in the future; medication abortion provided via telehealth has also become an increasingly popular option in the face of rising abortion restrictions—it now accounts for approximately one in five abortions nationwide.

The Texas bill certainly has a shot. The legislature is solidly Republican and has historically been strongly anti-abortion, having passed SB 8, a six-week ban, then the nation’s most restrictive, in 2021. (As my colleague Nina Martin reported this summer, new research shows that a huge increase in infant deaths followed the implementation of SB 8, due in part to an increase of babies born with birth defects. After Dobbs, abortion became fully outlawed in Texas, with no exceptions for rape or incest—just the life or health of the mother.)

A spokesperson for Republican Gov. Greg Abbott—who, as I reported, falsely claimed Texas would “eliminate rape” as an attempt to justify passing SB 8—did not immediately respond to a request for comment Sunday asking if the governor would support the “controlled substances” bill.

When Texas lawmakers return to work in January, they will likely have to contend with protests from doctors and abortion rights advocates, who have evidence on their side. As Gillispie-Bell, the New Orleans doctor, told me: “It’s really a dangerous slippery slope when we have legislation that interferes with what we know to be evidence-based medicine.”

Last month, Louisiana became the first state to begin classifying misoprostol and mifepristone—the two pills used in medication abortion—as schedule IV controlled substances.

The move, driven by anti-abortion Republicans and unsupported by evidence, left the state’s doctors bracing for the worst—the pills also are used to manage miscarriages and treat postpartum hemorrhages, and the new law requires they be locked away with other narcotics, potentially wasting precious minutes in an emergency. Hundreds of Louisiana doctors opposed the law, and one of them, Dr. Veronica Gillispie-Bell, a board-certified OB-GYN in New Orleans, told me she feared other states would follow.

That fear may now come to pass: Pat Curry, a Republican lawmaker in Texas, pre-filed a bill in the state legislature this week that would classify the two drugs as schedule IV substances there. The next legislative session does not begin until January 14—if passed, the bill would take effect in September 2025. Curry did not immediately respond to a Facebook message from Mother Jones on Sunday, and appeared to block me from messaging him further after I inquired about the bill.

The news, which appears to have first been reported by the Louisiana Illuminator, is just the latest example of right-wing attacks on abortion pills. Project 2025, the extremist guidebook to a second Trump term, recommends that the Department of Justice invoke the 19th-century Comstock Act to prosecute providers of abortion pills, as I have previously reported. It also recommends that the Food and Drug Administration revoke its approval of abortion pills. Conservative attorneys general in three states are trying to revive a US Supreme Court case seeking to restrict access to mifepristone after the justices unanimously dismissed it earlier this year. And as the Guardian reported on Sunday, anti-abortion advocates hope to outlaw abortion pills nationwide during Trump’s next term.

There is no scientific or medical evidence base to support the notion that the pills are dangerous or should be regulated as controlled substances, which federal law describes as drugs that have “potential for abuse.” More than 100 studies have found that mifepristone and misoprostol are safe and effective methods to terminate a pregnancy, and research has shown abortion pills are just as safe and effective when prescribed via telemedicine and mailed to patients as when prescribed and dispensed in person. Post-Dobbs, Americans have taken to stockpiling abortion pills just in case they need them in the future; medication abortion provided via telehealth has also become an increasingly popular option in the face of rising abortion restrictions—it now accounts for approximately one in five abortions nationwide.

The Texas bill certainly has a shot. The legislature is solidly Republican and has historically been strongly anti-abortion, having passed SB 8, a six-week ban, then the nation’s most restrictive, in 2021. (As my colleague Nina Martin reported this summer, new research shows that a huge increase in infant deaths followed the implementation of SB 8, due in part to an increase of babies born with birth defects. After Dobbs, abortion became fully outlawed in Texas, with no exceptions for rape or incest—just the life or health of the mother.)

A spokesperson for Republican Gov. Greg Abbott—who, as I reported, falsely claimed Texas would “eliminate rape” as an attempt to justify passing SB 8—did not immediately respond to a request for comment Sunday asking if the governor would support the “controlled substances” bill.

When Texas lawmakers return to work in January, they will likely have to contend with protests from doctors and abortion rights advocates, who have evidence on their side. As Gillispie-Bell, the New Orleans doctor, told me: “It’s really a dangerous slippery slope when we have legislation that interferes with what we know to be evidence-based medicine.”

In the days before the election, when too many stories about deadlocked polls and undecided voters and the MAGAfication of young men began to wear on my soul, I turned to TikTok to see what women were thinking. Soon enough I was swimming in a sea of female excitement and angst. I watched videos of ordinary women of all ages and races—in deep blue districts and deep red ones—describing what this election meant to them. Women who had just voted, sitting in their cars and sobbing about what it would mean to elect the first female president, what it would mean to defeat a vitriolically sexist candidate who’s been found liable for sexually assaulting one woman and who stands accused by dozens more, whose campaign gleefully demeaned women as “trash” and “childless cat ladies.” What it would mean to elect someone who’d spent the last three months, and the two years before that, connecting reproductive freedom to economic concerns. What it would mean to elect someone taking the stress of caring for both kids and parents seriously, who recognizes the housing crisis is hurting all but the richest, who has more than a concept of a plan for how to address such problems.

I watched one young woman driving 10 hours to her home state because her absentee ballot never arrived, muttering “10 and 2, 10 and 2” as she stared out at the road ahead. I watched women flying across the country to vote. I watched women take part in the “They both reached for the gun” Chicago meme as they talked about canceling out the vote of their Trump-supporting father, brother, or husband. Or bragging on husbands or dads whose vote they didn’t have to cancel. One who said she wouldn’t have to cancel out her husband’s vote because he’d forget to do it if she didn’t remind him.

One woman told of breaking off her engagement when she found out her fiancé was for Trump. (“I can’t share my life with someone who is going to vote in that direction…Ladies, we need to stick together.”) I watched as young woman after young woman testified that they’d never, ever consider dating anyone who voted for Trump. I watched as women who were in middle or high school in 2016 reacted in horror at seeing, for the first time, Trump bragging on an Access Hollywood bus about grabbing women by the pussy and moving on them “like a bitch,” or stalking Hillary Clinton around a debate stage, or seeing the testimonies of the more than 25 women who have reported being sexually assaulted by him. “Dads voted for this?” read one incredulous caption.

There can be no doubt that there is fertile ground for those who find prominence and profit in nurturing resentment of women.

I was well aware that algorithmic offerings are not reality, particularly on TikTok, which serves you things akin to the things you’ve engaged with. But the videos seemed to be representative of a record gender divide, clocked by pollsters at about 30 points nationally at the time and even higher in key districts and among certain demographics. Would women, horrified by Trump’s and Vance’s statements and actions, furious that their reproductive rights were rolled back, foreclose another Trump term? Would enough white women finally cleave from white men, and vote for a woman who was also Black and Asian?

We know the answer now, and while conclusive demographic data will take months to emerge, exit polls in 10 historic battleground states indicate that women there favored Harris by 8 points overall—less than the margin for Hillary Clinton in 2016 or Joe Biden in 2020—resulting in an 11 point gender gap. (The exit polls’ ongoing inclusion of Florida, Ohio, and Texas might being warping our conclusions, but we don’t yet know.) Black women, Democrats’ most loyal constituency, voted for her in those states at a rate of 91 percent. Latinas, 60 percent. Young women, 61 percent. Other age groups, 49–54 percent. Harris won 57 percent of women with college degrees and 66 percent of women with even more education. But she lost white women with little or no college education by a mile. Only 35 percent of them supported her, and since those women constitute about one-fifth of the total electorate, they drove down her margins with women overall.

The questions that feel most burning right now—like what is up with those who voted against abortion bans but also for Trump, and which part of his gains can be attributed mostly to racism and/or sexism—are complex and will take more data and analysis to really understand. But it’s safe to say Trump’s margin of victory was powered by men, who, those same polls found, voted for him by 55 percent—a few points more than went for him in 2020. Trump looks to have made gains with almost every type of man, especially younger men and Latino men. (Despite a lot of pre-election angst, Black men overwhelmingly backed Harris, though Trump increased his margins there, too.) White men of all education levels went for Trump, but white men who didn’t go to college overwhelmingly so.

The Trump campaign knew that men were his ticket back to power, and it targeted them—pointedly young men, and men of color—with a sophisticated campaign of grievance and disinformation. And in that, they were massively aided by the manosphere and its billionaire mascot: Elon Musk.

Since he bought Twitter in 2022, Musk has been on a mission to turn it into an amplifier of toxicity. He allowed hate-mongers—including virulent misogynists such as Andrew Tate—back on the platform, now called X, and dismantled tools to help users fight harassment while making sure everyone was far more likely to see posts and replies from MAGA fans, foremost himself. He personally promoted disinformation of all kinds—about voting, about transgender kids (despite, or because of, having one), about Harris (his PAC literally called her a “c-word”), about science—to his more than 204 million followers. Who can forget his promise to impregnate Taylor Swift after she announced her support for Harris? His misleading election posts, including ones falsely claiming Democrats were “importing” millions of migrants to vote for Harris, were viewed 2 billion times according to the Center for Countering Digital Hate, which estimated his posts were worth $24 million to the Trump campaign. (Musk, who likes to claim he’s a defender of free speech, sued the center in 2023; a federal judge tossed the case, ruling it was an obvious attempt to both stifle criticism of X and bankrupt the organization.)

Musk gave, directly and through super-PACs, about $200 million to help Trump’s campaign in the final months, and mounted a parallel ground game in Pennsylvania, which Trump carried. He stumped for Trump, made the “brocast” rounds for Trump, and urged other tech billionaires to support Trump. He gave millions—possibly tens of millions—to Building America’s Future, a group focused on dividing communities of color and wooing Black men to vote for Trump.

Musk dismantled tools to help users fight harassment while making sure everyone was far more likely to see posts and replies from MAGA fans—foremost himself.

Musk’s efforts are both part of and indicative of the fact that more and more men are cocooned in a YouTube/podcast/Twitch information ecosystem that connects sports, gaming, and other male-dominated hobbies to politics. And in that space, algorithmic forces and concerted efforts by far-right influencers and adjacent grifters are normalizing disdain or hate for women, part of a conveyor belt of extremism. A good example of that came immediately after the election, when neo-Nazi Nick Fuentes (who famously dined with Trump at Mar-a-Lago) posted “Your body, my choice.” Soon that slogan was screamed at high school girls all over the country by their male classmates, many of whom had likely never heard of Fuentes himself. (Similarly, Black people, including kids at my son’s school, were subjected to a decentralized but nationwide campaign of racist texts.)

There can be no doubt that there is fertile ground for those who find prominence and profit in nurturing resentment of women. For decades, men have been losing ground relative to women, be it in education or job opportunities. Women are increasingly likely to be a household’s primary breadwinner or raise families by themselves. The MeToo movement was a massively needed corrective for sexual harassment and abuse, but the ferocity of it (and some occasional overreach) did destabilize many men. 

This has all happened before. Women in the 1940s were sent to the factories and then back to the kitchen. The feminist movement of the 1970s led to big gains—we finally got those credit cards, ladies!—and then to a backlash, as Susan Faludi famously chronicled. An “anti-PC” movement arose too. But eventually the pendulum swung back, and new waves of female empowerment began to swell. Hopefully this election will do the same, and figuring out how to reach young men before they calcify into hardened misogyny needs to be a big part of that.

After the 2016 election, I wrote that Trump’s victory was a “brutal affront to women” and “all who value kindness and tolerance.” His administration plumbed new depths of chaos, corruption, and cruelty, and while some voters are too young to fully remember, his 2024 campaign made sure that no one could say they didn’t get what he stands for. 

The women who voted for Harris know that—and they are not okay. About one-third of women now live in states with abortion bans, and anybody who believed that Trump won’t try for a national ban, or revive the Comstock Act to stop distribution of mifepristone or even contraception, is likely to be bitterly disappointed. Even if nationwide prohibitions don’t come to pass, women in red states, and their doctors, will be further surveilled to prevent abortions, and women trying to have children will continue to die in hospital parking lots because doctors are too afraid to provide lifesaving care. What else do the “pronatalist” policies that JD Vance and Elon Musk have been so eager to enact hold for women? 

Women are suspicious, guarded, and apoplectic, knowing that some in our families or neighborhoods voted us back into second-class status.

When I went back to TikTok after the election, I saw sorrow and disbelief and terror, but also incandescent rage. Women are furious—in a Greek mythology sort of way. Black women are especially flattened and yet unsurprised that white women didn’t break for Harris. Some young women began shaving their heads and embracing the South Korean feminist 4B movement, in which women swear off dating, sex, and childrearing. (“The good news is that men hate us, so there’s no point in catering to them,” posted one.) Not many are likely to go that far, but it was clear even before the outcome that this election could have far-reaching impacts on dating and marriage and divorce. Certainly sex: If women can’t get abortions and are prevented from obtaining contraception, young men will awake to a very different world, soon enough. “If his ballot was red, his balls stay blue,” posted one woman. (And guys? Project 2025 wants to come after porn, too.) 

Will the backlash, once the election’s consequences become fully apparent, help power a reckoning with misogyny and racism once more? Perhaps. But right now, so many of us fear for ourselves, fear for our daughters, fear for women whom we’ve never met, and all others with a target on their backs, and we are walking around, suspicious and guarded and apoplectic, knowing that some in our families or neighborhoods voted us back into second-class status, and wondering what else they’re ready to go along with.

In the days before the election, when too many stories about deadlocked polls and undecided voters and the MAGAfication of young men began to wear on my soul, I turned to TikTok to see what women were thinking. Soon enough I was swimming in a sea of female excitement and angst. I watched videos of ordinary women of all ages and races—in deep blue districts and deep red ones—describing what this election meant to them. Women who had just voted, sitting in their cars and sobbing about what it would mean to elect the first female president, what it would mean to defeat a vitriolically sexist candidate who’s been found liable for sexually assaulting one woman and who stands accused by dozens more, whose campaign gleefully demeaned women as “trash” and “childless cat ladies.” What it would mean to elect someone who’d spent the last three months, and the two years before that, connecting reproductive freedom to economic concerns. What it would mean to elect someone taking the stress of caring for both kids and parents seriously, who recognizes the housing crisis is hurting all but the richest, who has more than a concept of a plan for how to address such problems.

I watched one young woman driving 10 hours to her home state because her absentee ballot never arrived, muttering “10 and 2, 10 and 2” as she stared out at the road ahead. I watched women flying across the country to vote. I watched women take part in the “They both reached for the gun” Chicago meme as they talked about canceling out the vote of their Trump-supporting father, brother, or husband. Or bragging on husbands or dads whose vote they didn’t have to cancel. One who said she wouldn’t have to cancel out her husband’s vote because he’d forget to do it if she didn’t remind him.

One woman told of breaking off her engagement when she found out her fiancé was for Trump. (“I can’t share my life with someone who is going to vote in that direction…Ladies, we need to stick together.”) I watched as young woman after young woman testified that they’d never, ever consider dating anyone who voted for Trump. I watched as women who were in middle or high school in 2016 reacted in horror at seeing, for the first time, Trump bragging on an Access Hollywood bus about grabbing women by the pussy and moving on them “like a bitch,” or stalking Hillary Clinton around a debate stage, or seeing the testimonies of the more than 25 women who have reported being sexually assaulted by him. “Dads voted for this?” read one incredulous caption.

There can be no doubt that there is fertile ground for those who find prominence and profit in nurturing resentment of women.

I was well aware that algorithmic offerings are not reality, particularly on TikTok, which serves you things akin to the things you’ve engaged with. But the videos seemed to be representative of a record gender divide, clocked by pollsters at about 30 points nationally at the time and even higher in key districts and among certain demographics. Would women, horrified by Trump’s and Vance’s statements and actions, furious that their reproductive rights were rolled back, foreclose another Trump term? Would enough white women finally cleave from white men, and vote for a woman who was also Black and Asian?

We know the answer now, and while conclusive demographic data will take months to emerge, exit polls in 10 historic battleground states indicate that women there favored Harris by 8 points overall—less than the margin for Hillary Clinton in 2016 or Joe Biden in 2020—resulting in an 11 point gender gap. (The exit polls’ ongoing inclusion of Florida, Ohio, and Texas might being warping our conclusions, but we don’t yet know.) Black women, Democrats’ most loyal constituency, voted for her in those states at a rate of 91 percent. Latinas, 60 percent. Young women, 61 percent. Other age groups, 49–54 percent. Harris won 57 percent of women with college degrees and 66 percent of women with even more education. But she lost white women with little or no college education by a mile. Only 35 percent of them supported her, and since those women constitute about one-fifth of the total electorate, they drove down her margins with women overall.

The questions that feel most burning right now—like what is up with those who voted against abortion bans but also for Trump, and which part of his gains can be attributed mostly to racism and/or sexism—are complex and will take more data and analysis to really understand. But it’s safe to say Trump’s margin of victory was powered by men, who, those same polls found, voted for him by 55 percent—a few points more than went for him in 2020. Trump looks to have made gains with almost every type of man, especially younger men and Latino men. (Despite a lot of pre-election angst, Black men overwhelmingly backed Harris, though Trump increased his margins there, too.) White men of all education levels went for Trump, but white men who didn’t go to college overwhelmingly so.

The Trump campaign knew that men were his ticket back to power, and it targeted them—pointedly young men, and men of color—with a sophisticated campaign of grievance and disinformation. And in that, they were massively aided by the manosphere and its billionaire mascot: Elon Musk.

Since he bought Twitter in 2022, Musk has been on a mission to turn it into an amplifier of toxicity. He allowed hate-mongers—including virulent misogynists such as Andrew Tate—back on the platform, now called X, and dismantled tools to help users fight harassment while making sure everyone was far more likely to see posts and replies from MAGA fans, foremost himself. He personally promoted disinformation of all kinds—about voting, about transgender kids (despite, or because of, having one), about Harris (his PAC literally called her a “c-word”), about science—to his more than 204 million followers. Who can forget his promise to impregnate Taylor Swift after she announced her support for Harris? His misleading election posts, including ones falsely claiming Democrats were “importing” millions of migrants to vote for Harris, were viewed 2 billion times according to the Center for Countering Digital Hate, which estimated his posts were worth $24 million to the Trump campaign. (Musk, who likes to claim he’s a defender of free speech, sued the center in 2023; a federal judge tossed the case, ruling it was an obvious attempt to both stifle criticism of X and bankrupt the organization.)

Musk gave, directly and through super-PACs, about $200 million to help Trump’s campaign in the final months, and mounted a parallel ground game in Pennsylvania, which Trump carried. He stumped for Trump, made the “brocast” rounds for Trump, and urged other tech billionaires to support Trump. He gave millions—possibly tens of millions—to Building America’s Future, a group focused on dividing communities of color and wooing Black men to vote for Trump.

Musk dismantled tools to help users fight harassment while making sure everyone was far more likely to see posts and replies from MAGA fans—foremost himself.

Musk’s efforts are both part of and indicative of the fact that more and more men are cocooned in a YouTube/podcast/Twitch information ecosystem that connects sports, gaming, and other male-dominated hobbies to politics. And in that space, algorithmic forces and concerted efforts by far-right influencers and adjacent grifters are normalizing disdain or hate for women, part of a conveyor belt of extremism. A good example of that came immediately after the election, when neo-Nazi Nick Fuentes (who famously dined with Trump at Mar-a-Lago) posted “Your body, my choice.” Soon that slogan was screamed at high school girls all over the country by their male classmates, many of whom had likely never heard of Fuentes himself. (Similarly, Black people, including kids at my son’s school, were subjected to a decentralized but nationwide campaign of racist texts.)

There can be no doubt that there is fertile ground for those who find prominence and profit in nurturing resentment of women. For decades, men have been losing ground relative to women, be it in education or job opportunities. Women are increasingly likely to be a household’s primary breadwinner or raise families by themselves. The MeToo movement was a massively needed corrective for sexual harassment and abuse, but the ferocity of it (and some occasional overreach) did destabilize many men. 

This has all happened before. Women in the 1940s were sent to the factories and then back to the kitchen. The feminist movement of the 1970s led to big gains—we finally got those credit cards, ladies!—and then to a backlash, as Susan Faludi famously chronicled. An “anti-PC” movement arose too. But eventually the pendulum swung back, and new waves of female empowerment began to swell. Hopefully this election will do the same, and figuring out how to reach young men before they calcify into hardened misogyny needs to be a big part of that.

After the 2016 election, I wrote that Trump’s victory was a “brutal affront to women” and “all who value kindness and tolerance.” His administration plumbed new depths of chaos, corruption, and cruelty, and while some voters are too young to fully remember, his 2024 campaign made sure that no one could say they didn’t get what he stands for. 

The women who voted for Harris know that—and they are not okay. About one-third of women now live in states with abortion bans, and anybody who believed that Trump won’t try for a national ban, or revive the Comstock Act to stop distribution of mifepristone or even contraception, is likely to be bitterly disappointed. Even if nationwide prohibitions don’t come to pass, women in red states, and their doctors, will be further surveilled to prevent abortions, and women trying to have children will continue to die in hospital parking lots because doctors are too afraid to provide lifesaving care. What else do the “pronatalist” policies that JD Vance and Elon Musk have been so eager to enact hold for women? 

Women are suspicious, guarded, and apoplectic, knowing that some in our families or neighborhoods voted us back into second-class status.

When I went back to TikTok after the election, I saw sorrow and disbelief and terror, but also incandescent rage. Women are furious—in a Greek mythology sort of way. Black women are especially flattened and yet unsurprised that white women didn’t break for Harris. Some young women began shaving their heads and embracing the South Korean feminist 4B movement, in which women swear off dating, sex, and childrearing. (“The good news is that men hate us, so there’s no point in catering to them,” posted one.) Not many are likely to go that far, but it was clear even before the outcome that this election could have far-reaching impacts on dating and marriage and divorce. Certainly sex: If women can’t get abortions and are prevented from obtaining contraception, young men will awake to a very different world, soon enough. “If his ballot was red, his balls stay blue,” posted one woman. (And guys? Project 2025 wants to come after porn, too.) 

Will the backlash, once the election’s consequences become fully apparent, help power a reckoning with misogyny and racism once more? Perhaps. But right now, so many of us fear for ourselves, fear for our daughters, fear for women whom we’ve never met, and all others with a target on their backs, and we are walking around, suspicious and guarded and apoplectic, knowing that some in our families or neighborhoods voted us back into second-class status, and wondering what else they’re ready to go along with.

Trump’s reelection has been described by advocates and experts as a final blow to reproductive rights.

These fears are not unfounded. Trump appointed three of the five conservative Supreme Court justices who overruled Roe v. Wade, ending the constitutional right to abortion and unleashing a health care apocalypse. Vulnerable women found themselves in even greater danger thanks to abortion bans in more than a dozen states that have enabled abusers and left doctors fearful of prosecution if they intervene in pregnancy-related emergencies that require abortion care. ProPublica reported such bans appeared to have led to the deaths of several women in Georgia and Texas who were unable to get necessary abortion care when faced with dire medical complications. Add to this, Project 2025—the 900-plus-page extremist guidebook to a second Trump term—recommends that various federal agencies take sweeping actions to roll back abortion access.

Trump’s convictions on abortion have been flexible throughout his career. During the presidential campaign, he tried to distance himself from Project 2025 and claimed he would leave abortion policy “to the states.” Immediately after the election, however, his acolytes admitted that “Project 2025 is the agenda.”

Given all this, reproductive rights experts and advocates agree that the future of abortion access is bleak. But there are several actions President Biden and his administration could take before Inauguration Day that could make it harder for the next administration to enact their absolutist anti-abortion agenda. “Some of [the ideas] are just throwing monkey wrenches into the gears,” says David Cohen, a law professor at Drexel University whose scholarly work focuses on abortion access, “and maybe with the chaotic Trump administration that helps delay some of the harm.”

“Some of [the ideas] are just throwing monkey wrenches into the gears, and maybe with the chaotic Trump administration, that helps delay some of the harm.”

While Vice President Kamala Harris campaigned on “restoring reproductive freedom,” it’s unclear if the Biden administration will prioritize these requests before the transition. The White House did not respond on the record to the specific proposals mentioned in this story, but pointed to the administration’s record of defending and expanding reproductive rights. But some say there’s more they can, and should, do. “If the administration was hesitant or holding off, now is the time, I think, to not hesitate,” Rachel Rebouché, reproductive rights legal scholar and dean of Temple Law School, says.

Here’s a look at some of what the administration could do to stymie the Trump administration’s anti-abortion agenda before he’s back in the White House.

Preemptively Pardon Providers of Abortion Pills

The Comstock Act is a 19th-century anti-obscenity law still on the books that anti-abortion Republicans argue should be used to “enforce federal law against providers and distributors of [abortion] pills.” In December 2022, Biden’s DOJ issued a memo arguing that the law cannot be used to prosecute abortion pill providers. Earlier this year, Democrats in Congress introduced legislation to repeal parts of the bill lawmakers say could be most relevant to abortion, but the measure has languished in House and the Senate committees.

Given that Project 2025 advises Trump’s DOJ to invoke the Comstock Act to prosecute providers of abortion pills, some advocates suggest that Biden preemptively pardon anyone who could be implicated for doing so. Cohen, from Drexel, notes that a preemptive pardon “would make it so that the people who have been mailing [abortion] pills, or mailing procedural instruments or supplies, are not at risk of being prosecuted.”

Jodi Jacobson, founder and executive director of the initiative Healthcare Across Borders, described the proposal as “a proactive thing that the Biden administration can do to automatically protect people over the five-year statute of limitations” for federal offenses. Jacobson oversees a coalition that comprises several reproductive health advocacy organizations that plan to ask the Biden administration to issue the blanket preemptive pardon. “This is a no-brainer—there is no reason not to do this,” she says, adding that it would “take off the table the immediate criminalization of folks who have been trying to save lives.”

Trump’s Food and Drug Administration, though, could still revoke its approval of abortion pills, as Project 2025 recommends—but the preemptive pardon would protect providers who could otherwise face prosecution. Experts concede that while there would likely be legal challenges, “pardon power is pretty plenary to the president,” Cohen says. President Gerald Ford preemptively pardoned his predecessor, President Richard Nixon, for instance, which allowed Nixon to avoid Watergate-related charges (but ignited a national outcry). The Department of Justice did not respond to questions about the proposal from Mother Jones.

Push to Fill Vacancies in the Federal Judiciary

Biden cannot shift the balance of the Supreme Court’s conservative supermajority before he leaves office, but the president and Senate Democrats do have the power to attempt to fill the 47 vacancies for open seats in the federal judiciary, mostly in federal district courts.

“We know the federal courts will continue to be central in the fight for reproductive freedom; the administration and Congress must be vigilant now in safeguarding our rights as much as possible,” Karen Stone, vice president of public policy and government relations at Planned Parenthood Action Fund, said in a statement provided to Mother Jones.

“We know the federal courts will continue to be central in the fight for reproductive freedom; the administration and Congress must be vigilant now in safeguarding our rights as much as possible.”

The significance of these lifetime appointments for the future of reproductive rights becomes apparent when you consider Matthew Kacsmaryk. He’s a Trump-appointed federal judge in Texas who issued an anti-science ruling last year that paved the way for anti-abortion activists to bring a case to the Supreme Court challenging the FDA’s approval of mifepristone, one of the two drugs used in a medication abortion. (The justices ultimately struck down the case, ruling that the anti-abortion plaintiffs lacked standing to bring the suit, as my colleague Nina Martin reported.)

Earlier this year, the Supreme Court sent the case on emergency abortion care back to the 9th Circuit Court of Appeals—a federal court in California with 10 Trump-appointed judges and jurisdiction over more than a dozen district courts in nine states. “The power of lower court federal judges is immense,” Cohen says, “because the Supreme Court only deals with such a limited number of cases.”

Once Biden makes a nomination, the Senate Judiciary Committee, currently chaired by Sen. Dick Durbin (D-Ill.), recommends whether to send nominees to a full floor vote, which is required for their confirmation. A spokesperson for Durbin’s office said that, as of Wednesday morning, there were 16 nominees ready for a floor vote, and eight more who have had committee hearings and are waiting for a committee vote. The spokesperson added that Durbin “aims to confirm every possible nominee before the end of this Congress.” Senate Majority Leader Chuck Schumer (D-N.Y.) said in a statement, “We are going to get as many done as we can.”

But that won’t necessarily be easy. Trump said in a social media post this weekend that “no Judges should be approved during this period of time because the Democrats are looking to ram through their Judges as the Republicans fight over Leadership.” Indeed, for Senate Democrats, time is of the essence. The next session of Congress begins January 3, just over two weeks before Trump takes office—so Biden’s nominees would need to be approved by after the New Year to make it onto the bench. Sen. Joe Manchin (I-W.Va.), whose vote is crucial in the tight Senate, may once again undermine Democrats’ plans. He told Politico in March he would not support any Biden-nominated judge unless they have at least one Republican supporter.

Still, several advocates say they hope Senate Democrats make the necessary effort to get as many Biden-nominated judges approved as possible, considering the influence they’ll likely have on the future of reproductive rights. “If [getting judges approved] means working over Thanksgiving, working over Christmas, working over New Year’s—do it,” Cohen says. “This is not something that should be gifted to Trump.” One way they could speed circumvent Republican opposition is by dispensing with a tradition known as “blue slips,” in which senators weigh in on whether or not they support the federal court nominees for their state. There is precedent for this: Sen. Chuck Grassley (R-Iowa), former chair of the Senate Judiciary Committee, abandoned the tradition—to the ire of Democrats—to get two Trump-nominated judges confirmed despite opposition from their home states’ Democratic senators. With only two months until the next Congress, Senate Democrats may not want to buck this tradition, though; they may want to keep “blue slips” as a weapon in their own arsenal as they anticipate Trump’s nominees to the federal judiciary.

Finalize Pending Reproductive Health-Related Rules for Federal Agencies

The Biden administration made headlines last month when it announced a proposed rule to allow 52 million women with private health insurance to obtain over-the-counter contraception for free under the Affordable Care Act. (Trump, on the other hand, has said he wants to “replace” Obamacare. And while he claims he would not restrict contraception access, it will face myriad threats in his administration, as my colleague Madison Pauly recently reported.)

But the contraception rule has yet to be finalized, and its pathway to becoming a reality is less straightforward than the optimistic White House press release suggests. After the public comment period—which has, so far, only attracted 2 people—ends on December 27, officials will analyze the comments and then write the final rule, which could then not even take effect for another 30 days.

Unlike executive orders, which can be wiped out with the stroke of a pen, rules approved for federal agencies are typically harder to undo. That’s thanks to the Administrative Procedure Act, which outlines the process of how a proposed rule becomes a finalized regulation, and requires that federal agencies do not act in a way that is “arbitrary, capricious, [or] an abuse of discretion.” Rebouché, from Temple Law School, says the administration needs to aim to get the contraception rule—and any other similar ones—finalized as soon as possible. “Any rule that’s already in process, push forward,” she says.

Katie O’Connor, senior director of federal abortion policy at the National Women’s Law Center, would like to see the Consumer Financial Protection Bureau’s promise to launch a rule focused on ensuring “modern-day digital data brokers are not misusing or abusing our sensitive data” come to pass. An investigation by the office of Sen. Ron Wyden (D-Ore.) earlier this year found that a data broker tracked visits by individuals to 600 Planned Parenthood locations across the country and then sold the data for an anti-abortion ad campaign. Even though the rule was promised last year, a CFPB spokesperson says they did not have any update.

Even if the agency tried to ram it through, though, any rules that get finalized at this late stage of the administration are at risk of being overturned in the next session of the GOP-controlled Congress, thanks to the Congressional Review Act, notes Steven Balla, associate professor of political science at George Washington University and co-director of the school’s Regulatory Studies Center. During Trump’s first term, Congress used the legislation to overturn 16 rules issued at the end of the preceding Obama administration—the most of any administration, ever, Balla explains.

Complete Investigations Into Hospitals Accused of Violating Federal Law on Emergency Abortion Care

Earlier this year, the Supreme Court heard a case on whether hospitals must provide abortions to people whose lives or health are at risk, even in states with abortion bans, under the federal Emergency Medical Treatment and Labor Act, known as EMTALA. In a 6–3 decision—with Thomas, Alito, and Gorsuch dissenting—the court sent the case back to a lower court, refusing to rule on the merits of the Biden administration’s argument that EMTALA requires hospitals to provide emergency abortion care in states with post-Dobbs abortion bans that lack exceptions for a patient’s health. Project 2025 proposes an alternative approach: The guidebook says that “EMTALA requires no abortions” and that HHS should stop investigating hospitals that have failed to comply with its interpretation of the law.

Abortion rights advocates say Biden’s HHS should complete as many investigations as possible into hospitals that may have violated their interpretation of EMTALA by not providing stabilizing abortion care when needed. Otherwise, the Trump administration would inherit them, a spokesperson for the Center for Reproductive Rights points out.

That spokesperson added that the organization has also submitted three recent complaints to HHS, focused on hospitals in Texas and Arizona that allegedly violated EMTALA by failing to provide medically necessary abortions to women in need. A spokesperson for the Centers for Medicare and Medicaid Services at HHS said the agency does not comment on ongoing investigations.

But even if these investigations were undertaken and completed before the transition, reports suggest they would be unlikely to face penalties from the Biden administration. Investigations recently published by the Associated Press found that more than 100 pregnant women were turned away from emergency rooms while they were in medical distress over the past two years, and that none of those hospitals were fined. Last year, HHS announced it was investigating two unnamed hospitals for allegedly violating the law by failing to offer a woman with a nonviable pregnancy the abortion care she needed. The National Women’s Law Center said it filed the complaint on behalf of Mylissa Farmer and identified the hospitals as Freeman Hospital West in Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas. A spokesperson for the Centers for Medicare and Medicaid Services told Mother Jones Wednesday, “Both hospitals are back in compliance,” but did not clarify whether they had faced monetary penalties.

One thing that both advocates and officials agree on? Elections have consequences, and there’s a limit to what Biden administration can actually do to mitigate the decades-long damage the Trump administration could do to reproductive rights once he takes office. “The electorate was confused or didn’t really care about abortion,” Cohen says, “and we’re reaping the reality of it.”

The city of Amarillo, in the Texas Panhandle, has emerged as one of the strongholds of the anti-abortion movement in that state and around the country, not least because its sole federal judge, a far-right Trump appointee, has been so willing to rubber-stamp conservative challenges to reproductive health options like the abortion pill and birth control for minors. So when far-right activists hatched a plan to put a local measure on the ballot that would have essentially prohibited anyone from using Amarillo roadways to travel for abortion, supporters assumed it would easily pass.

But on Tuesday, Amarillo voters surprised the prognosticators by resoundingly defeating the measure, Proposition A, 60 percent to 40 percent. It was a rare abortion-rights victory in one of the most abortion-restrictive states in the country—even as the overall results of the national elections were a disaster for the future of reproductive rights across the US, with Republicans now in control of the White House and Senate. The House of Representatives remains up for grabs. 

The outcome in Amarillo is especially surprising considering the city’s staunchly conservative record: In the two counties that Amarillo encompasses, more than 70 percent of voters cast ballots for Donald Trump in Tuesday’s election.

But apparently the ban was too expansive even for some of those voters. It would have applied to any person who drives an abortion patient to an appointment using the city’s roads, or who provides financial assistance to anyone passing through the city to access out-of-state abortion care. Even someone simply offering directions to the nearest out-of-state clinic could be held accountable.

“This vote proves that when you actually sit down with people across the aisle, even those who are pro-life, and explain what these bans actually do in practice, they realize how harmful they are.”

“We are so unbelievably thrilled—and relieved,” Courtney Brown, co-founder of the Amarillo Reproductive Freedom Alliance, told me shortly after the vote totals came in. “This proves that when you actually sit down with people across the aisle, even those who are pro-life, and explain what these bans actually do in practice, they realize how harmful they are.”

The travel ban was the brainchild of two influential anti-abortion strategists: East Texas activist and pastor Mark Lee Dickson and former Texas solicitor general Jonathan Mitchell. Dickson is the leader of the so-called “sanctuary for the unborn” movement, which so far has persuaded about 80 local governments in seven states to pass ordinances prohibiting abortions within their jurisdictions. Mitchell is the architect of the state’s 2021 Senate Bill 8, also known as the Heartbeat Act, which prohibited abortions after six weeks of pregnancy and included a “bounty hunter” provision putting enforcement in the hands of private citizens rather than governments. SB8 played a critical role in helping overturn Roe v. Wade in 2022, after which Texas imposed a total abortion ban. The current law makes it a crime to provide abortions, with penalties up to life in prison and no exceptions for rape, incest, or life-ending fetal abnormalities.

But even with those draconian laws, Texans have continued to obtain abortions, either by purchasing abortion pills from online providers—illegal in the state but difficult to enforce—or by traveling out of state. According to the Guttmacher Institute, since 2023 some 35,000 Texas patients have been forced to trek elsewhere for the procedure—mostly to New Mexico and Colorado, where abortion remains legal throughout pregnancy, or to Kansas, where it’s legal until 22 weeks. 

So Mitchell and Dickson mounted new attacks on several related fronts. They began pushing for local “abortion trafficking bans,” based on Dickson’s argument that “the unborn child is always taken against their will.” And they began looking for ways to revive the Comstock Act, an 1873 anti-vice statute that bars the “sending or receiving” of all abortion-related materials, including pills. The so-called “zombie law” couldn’t be enforced while Roe was in effect, but it was never repealed by Congress; resurrecting it would be tantamount to a national abortion ban. 

Amarillo, located in the mostly rural Panhandle area of Texas, was seen as a “trophy” for anti-abortion advocates due to its prime location on Interstate 40—an hour’s drive to New Mexico, where more than 14,000 Texans sought abortion care last year, and a throughway to Colorado. With its proximity to abortion-legal states, Dickson told me in August he considers Amarillo to be the “abortion trafficking hub” of Texas. 

Amarillo also happens to be the home of a federal court where Trump-appointed anti-abortion extremist Matthew J. Kacsmaryk is the sole judge—meaning that he decides any legal federal lawsuit filed there. Formerly an attorney for a Christian-right law firm, Kacsmaryk has a history of ruling against reproductive rights—helping propel a lawsuit against the FDA’s regulation of the abortion drug mifepristone to the Supreme Court; ruling that teenagers must have parental consent for prescription birth control; and calling the Victorian-era Comstock Act “important public policy” that should be interpreted “plainly.” Far-right litigants seeking to block Biden administration policies have come under fire for “judge shopping” in Kacsmaryk’s courtroom, knowing they can count on him to be on their side. 

The measure was stunningly broad, banning not just the transport of abortion-seekers , but any conduct that knowingly “aids or abets an elective abortion” on any Amarillo resident, no matter where the procedure takes place.

The 18-page measure crafted by Dickson and Mitchell was stunningly broad, banning not just the transport of abortion-seekers in or through the city, but any conduct that knowingly “aids or abets an elective abortion” on any Amarillo resident, no matter where the procedure takes place. Borrowing from SB 8’s “bounty hunter” provision, the ordinance allows almost anyone to file a civil lawsuit to enforce the ban, with a potential payout of $10,000 in damages per violation, encouraging Texans to turn on each other. 

Also tucked into the ordinance is a prohibition against the “possession or distribution” of abortion pills under the Comstock Act. Mitchell—the brains behind numerous anti-abortion lawsuits and intimidation tactics against abortion supporters—hoped that the ordinance could provide standing for the city to sue the FDA over its regulation of mifepristone after the Supreme Court threw out a case brought by anti-abortion doctors this past June. 

First, Dickson and his allies tried to persuade Amarillo’s self-proclaimed “pro-life” City Council to pass the ordinance but failed by a 4-1 vote in June, with local leaders citing their lack of authority to regulate interstate travel. Anti-abortion activists then successfully moved to petition to add the ordinance to the November ballot, forcing the decision upon voters. 

When Brown and five friends learned the abortion travel ban would be coming to their community, they immediately sprung into action, creating the grassroots Amarillo Reproductive Freedom Alliance in 2023. They spent the next year organizing in the community to convince conservative voters that the ban would not only infringe on bodily rights—but many other constitutional rights as well.

Dickson blames a “misinformation campaign” led by the group—and even the city’s conservative mayor—for the ban’s defeat and vowed not to give up. “Amarillo truly is the new Alamo for the pro-life movement in Texas,” he said in a statement. “The fight is far from over in the city of Amarillo.”

Meanwhile, Brown suspects Dickson and Mitchell will continue to push travel bans in towns near Amarillo and possibly elsewhere. “We are staying vigilant to protect the rights of other citizens around us, too,” she says. “We continue to be prepared to fight.”

The first state to ban abortion after the fall of Roe v. Wade just became the first state to have a near-total abortion ban reversed by popular vote.

The people of Missouri voted on Tuesday to create a constitutional right to “reproductive freedom”—defined as the ability to make and carry out one’s own decisions about abortion, birth control, and health care during pregnancy—approving Amendment 3 by almost 54 percent of the vote as of 11:30 p.m. Central Time, according to the Associated Press.

Amendment 3 was part of a nationwide effort by reproductive rights groups to use ballot initiatives to restore abortion rights state by state after the Supreme Court wiped out the national right to abortion. On Election Day this year, 10 states voted on abortion rights ballot measures.

In deep-red Missouri, where the state government is controlled by avowed abortion foes, even getting this initiative before voters was a feat. Republican state officials repeatedly threw up barriers to the process of certifying the ballot language and gathering signatures, leading to a series of bitter legal battles that all, ultimately, were decided in favor of abortion rights advocates. As Mother Jones reported last week:

Amendment 3’s proponents, a coalition known as Missourians for Constitutional Freedom, have traveled a rocky road just to get the measure before voters. They’ve overcome blatant obstruction by top state GOP officials, multiple legal challenges, and deep internal divisions over whether the initiative should allow the state to ban abortions after fetal viability. The final text protects abortion rights until viability, and permits later abortions if needed to protect the life or health of the pregnant person.

The new constitutional amendment now sets up a legal challenge to Missouri’s abortion ban as well as to the constellation of restrictions that made getting an abortion almost impossible in the state even before the fall of Roe. As I wrote last year:

The reality is that, even before Dobbs, abortion access in Missouri was close to nil. The legislature had passed too many burdensome and medically unnecessary rules designed to be impossible for abortion clinics to comply with. In the years prior to Dobbs, the only clinic still offering abortions was a Planned Parenthood location in St. Louis, which performed about 100 abortions annually. “Many, many Missourians for years now have gone to Kansas or Illinois to access care, because the states had fewer restrictions,” explains Emily Wales, CEO of Planned Parenthood Great Plains, which stopped offering abortions at its Missouri locations in 2018. 

In this environment, the success of the initiative shows the enduring power of abortion rights as a motivation for voters—and their enduring anger against deadly laws that curb pregnant people’s power to control their bodies and their futures.

The first state to ban abortion after the fall of Roe v. Wade just became the first state to have a near-total abortion ban reversed by popular vote.

The people of Missouri voted on Tuesday to create a constitutional right to “reproductive freedom”—defined as the ability to make and carry out one’s own decisions about abortion, birth control, and health care during pregnancy—approving Amendment 3 by almost 54 percent of the vote as of 11:30 p.m. Central Time, according to the Associated Press.

Amendment 3 was part of a nationwide effort by reproductive rights groups to use ballot initiatives to restore abortion rights state by state after the Supreme Court wiped out the national right to abortion. On Election Day this year, 10 states voted on abortion rights ballot measures.

In deep-red Missouri, where the state government is controlled by avowed abortion foes, even getting this initiative before voters was a feat. Republican state officials repeatedly threw up barriers to the process of certifying the ballot language and gathering signatures, leading to a series of bitter legal battles that all, ultimately, were decided in favor of abortion rights advocates. As Mother Jones reported last week:

Amendment 3’s proponents, a coalition known as Missourians for Constitutional Freedom, have traveled a rocky road just to get the measure before voters. They’ve overcome blatant obstruction by top state GOP officials, multiple legal challenges, and deep internal divisions over whether the initiative should allow the state to ban abortions after fetal viability. The final text protects abortion rights until viability, and permits later abortions if needed to protect the life or health of the pregnant person.

The new constitutional amendment now sets up a legal challenge to Missouri’s abortion ban as well as to the constellation of restrictions that made getting an abortion almost impossible in the state even before the fall of Roe. As I wrote last year:

The reality is that, even before Dobbs, abortion access in Missouri was close to nil. The legislature had passed too many burdensome and medically unnecessary rules designed to be impossible for abortion clinics to comply with. In the years prior to Dobbs, the only clinic still offering abortions was a Planned Parenthood location in St. Louis, which performed about 100 abortions annually. “Many, many Missourians for years now have gone to Kansas or Illinois to access care, because the states had fewer restrictions,” explains Emily Wales, CEO of Planned Parenthood Great Plains, which stopped offering abortions at its Missouri locations in 2018. 

In this environment, the success of the initiative shows the enduring power of abortion rights as a motivation for voters—and their enduring anger against deadly laws that curb pregnant people’s power to control their bodies and their futures.

Florida’s six-week abortion ban will remain the law of the land, as an abortion rights constitutional amendment failed Tuesday night.

With 91 percent of the vote tallied as of 9:20 p.m., support for Florida’s Amendment 4 hovered around 57 percent, according to Associated Press projections—shy of the 60 percent threshold required to pass. The amendment would have protected the right to an abortion until fetal viability, or until about 24 weeks’ gestation, and after viability if a medical provider determined that the procedure is necessary to preserve a patient’s health.

The amendment’s failure isn’t just a loss to the political momentum following the Dobbs v. Jackson Women’s Health Organization decision in 2022; it’s a major win for Republican Gov. Ron DeSantis, who wielded the power of his office to defeat the measure. “A bipartisan group of voters today sent a clear message to the Florida legislature,” a representative from Floridians Protecting Freedom, the campaign behind the amendment, said in a Tuesday night livestream. That message to lawmakers? “End the ban.”

DeSantis proclaimed victory within minutes of the final polls closing at 8 p.m. “Amendment 4 has failed,” he wrote in a post on X. More than a million more Floridians voted for Amendment 4 than voted for DeSantis in 2022.

Abortion rights supporters spent more in Florida—over $75 million—than in any other state with similar measures on the ballot. Despite popular support for abortion rights in the state, the ballot measure faced an uphill battle to victory, in more ways than one.

Most obviously, it needed to garner 60 percent support—more than the simple majorities that were needed to pass abortion protections in red states like Ohio, Kansas, and Kentucky. But DeSantis’ administration also challenged the measure in unprecedented ways, including by threatening television stations that ran pro-amendment advertisements, releasing a massive report weeks before the election accusing Floridians Protecting Freedom of “widespread election fraud,” and using a state agency website as a virtual billboard to oppose the amendment.

Since coming into effect in May, Florida’s six-week abortion ban has upended access to the procedure across the South. Tennessee, Alabama, Arkansas, Mississippi, and Kentucky all have near-total abortion bans, and Georgia and South Carolina have six-week bans. The number of abortions in Florida plummeted by 30 percent in the first two months of the ban, according to the Guttmacher Institute.

Amendment 4’s defeat marks the first failure of a state abortion rights amendment since Dobbs. Voters in seven states have passed abortion protections, and voters in nine other states have similar measures on their ballots.

The first time I met Kamala Harris, in 2007, I was a reporter profiling her for San Francisco magazine. She was in a basement near City Hall, trying to persuade a roomful of low-level ex–drug dealers to find time in their lives for a little self-care. “I have a job that’s just crazy,” she told the crowd of 100 or so young men and women, sounding more like a motivational speaker than the San Francisco district attorney and possible future president of the United States. “I get calls day and night. That’s a lot of stress.” What helped her stay sane, she explained, was waking up early every morning, jumping on the treadmill, and tuning the TV to something upbeat. “My life is like the news, and I don’t need to watch the news. So I watch MTV and VH1. I know every song!” 

Her audience—participants in a program Harris created for young, nonviolent ex-offenders called Back on Track—was there because, if they fulfilled all the program’s requirements and stayed out of trouble, their criminal records would be wiped clean. Harris knew that for these mostly Black and brown young people, the keys to their eventual success included educational opportunities, decent jobs, stable housing, and affordable childcare. Helping them move toward economic security was Back on Track’s—and Harris’—primary mission. 

But taking care of their bodies and their emotional health was also important. Instead of self-medicating with booze and drugs, she wanted to help them develop the mental habits that could help them persevere when they felt worn down by the world—a mindset for believing they did have the power to determine the course of their futures. Going to the gym wasn’t the point, she told them— though she had wrangled free passes to 24-Hour Fitness for anyone who wanted one. “It’s about being happy and healthy and figuring out ways to cope.” Scanning the room, I could see that many of her listeners seemed … baffled. Since when did the city’s top law enforcement official care about how a bunch of former drug dealers felt?

Scanning the room, I could see that many of her listeners seemed … baffled. Since when did the city’s top law enforcement official care about how a bunch of former drug dealers felt?

Flash forward almost two decades: The Democratic presidential nominee who has spent the past 107 days running an ultramarathon on a tightrope in designer pantsuits and high heels seems light years away from that earnest young DA preaching about the healing power of cardio. Consider Harris’ urgent closing message on the Ellipse a week before the election, flanked by a parade of flags and 75,000 people who were terrified by the prospects of a second Trump presidency. Donald Trump is a “petty tyrant,” the vice president declared—“unstable, obsessed with revenge, consumed with grievance and out for unchecked power.” America is better than he is, she insisted, “America is the greatest idea humanity ever devised, a nation big enough to encompass all our dreams, strong enough to withstand any fracture or fissure between us, and fearless enough to imagine a future of possibilities.”

The 2024 election feels like a second chance, if not the last chance, for the nation, a back-on-track moment. In much the same way that she was encouraging young offenders to seize control of their lives decades ago, Harris spent a good chunk of her speech trying to convince her listeners that they can control the fate of a democracy threatened by bullies, demagogues, and oligarchs. “Each of you has the power,” she told the cheering but jittery crowd, “to turn the page and start writing the next chapter in the most extraordinary story ever told.” 

For me, the most striking moment in her speech came when Harris talked about her adored mother, Shyamala Gopalan Harris, who died from colon cancer in 2009 at the age of 70. “I took care of my mother when she got sick, cooking foods that she had a taste for, finding clothes that would not irritate her skin,” Harris told her audience, describing intimate acts of love and kindness that public figures, much less politicians, rarely discuss. Harris the candidate was touting her plan to expand Medicare coverage to include home health care for seniors: “Currently, if you need home care and you don’t have some money to hire someone, you and your family need to deplete your savings to qualify for help. That’s just not right.” Harris the daughter was speaking from a personal place that she has often tried to guard. “Caregiving is about dignity,” she said. “It is about dignity.” 

It was a profoundly empathetic moment. And I wondered if her capacity to communicate empathy might just end up saving democracy.

As Americans reach the finish line of the most stomach-wrenching, soul-sucking, exhausting, consequential presidential campaign in memory, many factors will help determine whether Harris will be able to beat back Trump and pull America from the brink. 

If she wins, pundits will point to the innumerable GOP mistakes. Abortion bans transforming health care for women (and families) across the US, infuriating not just the tens of millions of people capable of getting pregnant but also their mothers and grandmothers old enough to remember the coat-hanger-abortion era before Roe v. Wade. Then there is the far-right’s embrace of Project 2025 and other extreme policies that would catapult the country back to the 19th century. The grotesque, proto-fascist spectacle at Madison Square Garden. Trump’s rapidly degenerating mental capacity, his accelerating physical decline, his unapologetic embrace of corrupt dictators, his incessant lies. His vice presidential pick, Ohio Sen. JD Vance’s repulsive views about women, especially unmarried ones with no children. Elon Musk’s full-on transformation into a Marvel supervillain, one who turns out to be clueless about politics even as he spends hundreds of millions of dollars trying to disrupt a democracy that helped make him the richest person on the planet. 

“Considering they had such little time, some say this is a minor miracle. But it isn’t—it is the result of the right people and the right candidate. It will be a case study for future political scientists.”

Then there’s the Harris campaign, which people who pay close attention to these things are calling one of the best Democrats have ever run. “Considering they had such little time, some say this is a minor miracle,” the Washington Post’s Jennifer Rubin posted on Twitter. “But it isn’t—it is the result of the right people and the right candidate. It will be a case study for future political scientists.” Harris, who spent four years being dismissed as a DEI lightweight, has been a revelation since President Joe Biden bowed out of the race in July, even to her longtime supporters. “It seems to us that something happened to you,” Oprah Winfrey marveled in September, as if “a veil or something dropped… and you just stepped into your power.” Harris responded by (of course) laughing, then added, “You know, we each have those moments in our lives where it’s time to step up.” In the weeks since that virtual rally, despite a schedule that has sometimes seemed to require her to be in 12 places at once, Harris has seemed to gain in strength and clarity of purpose. Through it all, her sunny stamina has been one of her greatest attributes.

But for me, another quality that distinguishes Harris and may even be a determinative superpower in this race is empathy. Obviously, empathy can be a double-edged sword for women politicians, making them seem “soft” and “weak,” their feminine/maternal instincts writ inappropriately large in an arena requiring steely strength. At least that’s what Trump and Vance and Musk and their ilk seem to think—people who at minimum lack any semblance of emotional intelligence and at worst, seem to have learned their social skills on 4chan. It’s not what Democratic strategists have emphasized when they’ve framed her candidacy; she’s the tough-talking prosecutor who recognizes in Trump the type of criminal and predator she spent much of her career trying to put in jail. But scratch the surface of her prosecutorial rigor and consider the policy ideas she’s been talking about on the campaign trail—health care, reproductive care, child care, elder care.

Empathy can be a double-edged sword for women politicians, making them seem “soft” and “weak,” their feminine/maternal instincts writ inappropriately large in an arena requiring steely strength. At least that’s what Trump and Vance and Musk and their ilk seem to think.

Of course, those are perennially Democratic issues, embraced with special fervor by female candidates and their voters. It’s hardly surprising that Harris—who was raised by a single mother and focused on victims of violence and crime for much of her career—would espouse a public policy agenda that is fundamentally about treating people with dignity and kindness.

But you can support empathic policies and still be a terrible person. What’s notable is how many people have a story about her kindness out of the public eye, going back decades. A young woman named Tanene recently went viral on TikTok, talking about how, when she was a homeless teenager in the early 2000s, Harris—not yet a politician—plucked her from the San Francisco streets, deciding “she was going to love me and guide me and cheer me on for literally my entire life.” Twenty years later, she considers Harris her “big sister Auntie mentor friend.”

Lateefah Simon, a MacArthur fellow who ran Harris’s Back on Track program for a few years in the mid-2000s, recalls how, soon after she’d been hired, she showed up to work wearing a hoodie and sweats, like the kids she would be meeting with that day. Harris was not amused. “Why would you ever disrespect your people?” Harris demanded, sending her home to change. “You work for this office. You work for the state, so you represent. Would you go to Pacific Heights”—one of the city’s whitest and wealthiest neighborhoods— “wearing that?” But the next day, Harris presented Simon with a brand-new suit, the very first she ever owned. (Today, Simon is expected to be elected to replace Representative Barbara Lee, representing Berkeley and Oakland in Congress.)

Some of these stories can edge into a kind of Frank Capra sentimentality—except they happen to be true. One of them comes from her former boss, one-time San Francisco city attorney Louise Renne. One day Harris—then a young lawyer heading their division on children and families—arrived in Renne’s office with an armful of stuffed toys for kids whose adoptions were being finalized. “She said, Louise, it’s Adoption Day, we’re going to hand out teddy bears to the children so they can remember this day.” Renne recalled. “So off we went, teddy bears in arms, over to the courthouse. Well, that had never been done before. And I just thought, what an insightful thing to do.” 

Now, 25 years later, what Renne remains struck by is Harris’s unusual alchemy of toughness and kindness. “Nobody should ever mistake her for not being tough enough,” Renne told me recently. But Harris also cares about people and consequences, Renne says: “What’s going on in the real world? What is the impact here? Who’s it hurting most? How do we solve the problem to get around the hurt?”

Imagine JD Vance handing out teddy bears. As Adam Serwer famously wrote about the first Trump presidency, “The cruelty is the point.” Four years later, that cruelty continues to be manifest in hideous, even jaw-dropping ways—were we still able to be shocked—but especially in Trump and Vance’s ugly rhetoric about immigrants and in their callous reactions to stories about women who have died and nearly died because of restrictions on abortion care.

Harris, meanwhile, has reached out to Republicans in part by acknowledging their misgivings about voting for a Democrat. The quality of empathy helps explain why she and her vice presidential running mate Minnesota Gov. Tim Walz—the football coach who helped launch his high school’s Gay/Straight Alliance club, the governor who supported free meals and tampons for school kids, the proud dad of a special-needs son—seem to genuinely connect. Theirs is not the Bill Clinton-esque “I feel your pain” schtick that often seems performative. 

Empathy has likewise been at the heart of Harris’s messaging on abortion. Where she really catches fire is when she talks about how abortion bans have brutalized the lives of women and families.

Empathy has likewise been at the heart of Harris’s messaging on abortion. From the moment that the Dobbs decision was announced and Biden gave her the responsibility to lobby for reproductive rights in ways he never did, she has offered a full-throated defense of reproductive freedom the likes of which we have never before heard from a sitting vice president or a presidential candidate. She’s been exceptional in her attacks on Trump and his allies overturning Roe v. Wade, passing extreme abortion bans, threatening access to birth control and IVF, and stripping away the ability of women and girls to make decisions about their own bodies. Admittedly, on the what-she-plans-to-do-about-it side, Harris is more circumspect. During the debate, for example, when asked if there were any limits to abortion care that she would support, she replied that she wanted to “restore Roe.” She knows how limited her powers are likely to be on that front, especially if she lacks majorities in the House and/or Senate. 

Harris really catches fire when she talks about how abortion bans have brutalized the lives of women and families, like the young Georgia woman, Amber Thurman, whose 2022 death from delayed abortion care left her six-year-old son without a mother. Or what happens to victims of rape or incest or domestic violence: “The idea that a woman who survives a crime of a violation to her body should not have the authority to make a decision about what happens to her body next—that is immoral,” Harris declared in her speech on the Ellipse. “That is immoral.” 

So now it’s Election Day and the polls continue to forecast a tight race, though with some unexpected, late-breaking reasons for optimism for Democrats. If Harris wins, it will be because she has managed to break through the Trump–Musk–Fox News chaos machine and convince millions of people who knew hardly anything about her three months ago to support her and her vision of America’s future. Voters have myriad choices this election, with down-ballot races and ballot measures. But at the top of the ticket, if voters don’t choose empathy, that future will be cruel indeed.

J. Ann Selzer has earned several nicknames throughout her 37-year-long stint leading the Des Moines Register’s Iowa Poll. She’s called the “Outlier Queen” when she breaks from what appears to be the consensus of political polls. And when her final pre-election polls paint a complicated picture for otherwise favored candidates, political insiders refer to her as the “Harbinger of Doom.”

Now, as the Election Day countdown timer inches toward zero, Selzer’s latest polling may be the specter that has worried some Republicans—the rageful spirit of Iowa women who lost abortion access this past summer. Contrary to every other poll, this poll of 808 likely Iowa voters shows that Kamala Harris has a 3-point lead over Donald Trump in one of the reddest red states. It’s within the poll’s margin of error but a far cry from Selzer’s previous tallies: In September, Trump enjoyed a 4-point lead over Harris, and in June, he was 18 points ahead of President Joe Biden.

“Nobody in their right mind would predict it,” Selzer said on the self-described “Never Trump” podcast The Bulwark. “Our methodology is to make no assumptions, and we made no assumptions.”

“Nobody in their right mind would predict it. Our methodology is to make no assumptions, and we made no assumptions.”

Selzer has gone against the polling consensus before—and has been proven right. She was one of the few pollsters who predicted Trump’s significant lead over Hillary Clinton in 2016, and she broke from the crowd in 2008 when her poll predicted Barack Obama’s 2008 win in the Iowa Democratic caucuses. The driving force behind the latest shift? Selzer says it’s women—particularly older and independent women—incensed by the Iowa Supreme Court’s decision to allow a six-week abortion ban to go into effect. 

The state Supreme Court’s June decision overruling a lower court’s block on the six-week ban may have come as a surprise, considering previous court decisions. In 2018, four years before the Dobbs v. Jackson Women’s Health Organization decision overturned Roe v. Wade, the Iowa court upheld the fundamental right to abortion, striking down a 72-hour waiting period and dooming the six-week ban, which was then the most restrictive abortion law in the United States. 

But this past summer’s opinion wasn’t a fluke; as I reported in July, it was the desired result of a yearslong scheme to rig Iowa’s courts against abortion. The GOP, which holds every statewide office and controls both legislative chambers, used its unencumbered power to overhaul the judicial selection process, giving Republican Gov. Kim Reynolds majority control over the committee that nominates justices. Her conservative appointees changed the makeup of the court. When lawmakers passed another six-week ban last year, the justices delivered on the Republican promise to restrict abortion—despite Iowans repeatedly signaling their support for abortion rights. The shift of a significant number of Iowa voters toward supporting Harris represents more than just anguish at the fall of abortion rights; it’s a strong rebuke to the GOP for its manipulation of the court.

The court’s opinion has likely produced what Selzer called a “jaw-dropping” result: Women age 65 and older, a typically Republican group, favor Harris over Trump 63 percent to 28 percent. Women overall favor Harris by 20 points, while Trump has a 4-point lead among men. “You need to win with women more than you lose with men,” Selzer said, “and we’re seeing that in these data.”

For his part, Trump dismissed the poll as “heavily skewed.” But Iowa House Democratic Leader Jennifer Konfrst says the results reflect what Democrats have been seeing on the ground. “They are sick and tired of politicians interfering in their doctor’s offices and are looking for people up and down the ballot who are going to actually fight for their freedoms,” Konfrst told the Des Moines Register. “And this issue is salient and real, and the fact that Vice President Harris all the way down to candidates for the Iowa House are talking about the same rights and freedoms shows that this is what Iowans are looking for.”

The contrast between the intentions of former President Donald Trump and Vice President Kamala Harris on reproductive rights could not be clearer—no matter how much Trump tries to suggest otherwise.

Trump appointed three of the five Supreme Court justices who overruled Roe v. Wade and has famously flip-flopped on his stances on abortion. Back in 2016, for example, he briefly floated the idea of punishing women who get abortions, but then, following public outcry even from some anti-abortion groups, his campaign walked that back. At his debate with Vice President Kamala Harris last month, he twice refused to say whether or not he would veto a federal abortion ban if Congress passed one—and then claimed earlier this month that he would. And in August, Trump appeared to suggest he would vote to expand abortion rights on the ballot measure in Florida, where he maintains his Mar-a-Lago estate and where abortion is currently banned at six weeks’ gestation; just a day later, he reversed course following backlash from the anti-abortion crowd.

Harris, on the other hand, has consistently campaigned as a vocal supporter of abortion rights. She has highlighted the fallout of the overruling of Roe for women in need of abortion care, and warned about the likelihood of Republicans’ passing a national abortion ban if Trump is reelected. In her presidential campaign, she has promised voters her administration would pass a law that would “restore reproductive freedom.”

But there’s a problem, even should she win. Any hope for such a law depends on Democrats winning control of Congress, which looks unlikely. (When confronted about this, Harris has called for ending the filibuster to make it easier for such legislation to pass.) For some advocates, the promises Harris makes also lack any details of what protections she would support and how her policies would move beyond Roe—if at all.

Roe was “the ultimate floor, and not the ceiling, of what we need for making abortion affordable and accessible for all who need it,” Nourbese Flint, president of the advocacy group All* Above All, told me. Under Roe, states were still permitted to restrict abortion access after the point of so-called fetal viability, and it did not protect women from criminalization over their pregnancy outcomes, including when they used abortion pills to end their pregnancies without supervision from a doctor.

Even if Republicans do win Congress, as president, Harris would still have options to protect and expand abortion access—options that appear on a reproductive freedom wish list supported by hundreds of advocates. Several told me that they are still waiting to see more specific details on abortion access and justice policies Harris would support—and they are hoping those details would go beyond restoring Roe. “That is not a useful campaign slogan, to say we’re going to restore the bare minimum,” said Renee Bracey Sherman, author of the new book Liberating Abortion.

(A spokesperson for the Harris campaign did not respond to questions from Mother Jones for this story.)

Despite President Joe Biden’s reluctance as a devout Catholic to express full-throated support for abortion rights, legal experts say his administration has gotten behind measures that have prevented some of the most extreme Republican efforts to further criminalize abortion. Biden’s Department of Justice, for example, issued guidance in December 2022 saying that the Comstock Act—a 19th-century anti-obscenity law—cannot be marshaled to ban the mailing of abortion pills, as Project 2025 and anti-abortion Republicans argue it can.

Rachel Rebouché, Dean of Temple University’s law school and an expert in reproductive rights laws, notes that if right-wing judges—including those on the Supreme Court—ruled that Comstock should be applied to criminalize the mailing of medication abortion, a Harris-run DOJ could simply refuse to prosecute such cases. This is a place, she says, where Harris potentially “has the most power.” Meanwhile, Project 2025 explicitly recommends that the DOJ prosecute those who provide and distribute the pills under a Trump presidency.

Her administration could also continue, and even strengthen, Biden’s Department of Health and Human Services attempts to require hospitals—even in states with bans—to provide emergency abortion care when necessary to save the parent’s life or protect their health. Legal challenges took that case to the Supreme Court earlier this year, where the justices ultimately punted on interpreting the federal law’s applicability to abortion care in emergency situations. Project 2025, on the other hand, claims that “EMTALA requires no abortions” and says HHS should stop investigating hospitals that have failed to comply with its interpretation of the law.

Under Biden, the Food and Drug Administration made the two pills used in medication abortion—mifepristone and misoprostol—easier to access by repealing restrictions that required them to be picked up in person. They now can be ordered online and delivered by mail. (As I have reported, this method now accounts for about 1 in 5 abortions nationwide). Under Harris, the FDA could remove even more restrictions that remain on medication abortion—including limits on who can prescribe them—according to Elisa Wells, co-founder of Plan C, a resource that provides information on how to access abortion pills. “All of them need to go,” Wells told me.

While anti-abortion Republicans have baselessly alleged the pills are dangerous, more than 100 scientific studies have confirmed they are overwhelmingly safe and effective—including when they are prescribed virtually and mailed. The FDA, Wells said, should “update the approval to reflect science and not politics.” Project 2025 recommends the exact opposite: It says the FDA should immediately re-instate the in-person requirement to access the pills and in the longer term should revoke approval of the drugs entirely. But the FDA and HHS would likely face continued legal challenges if they did try to enact these protections—and the Supreme Court’s decision in Loper Bright Enterprises v. Raimondo earlier this year, in which the justices vastly limited the power of federal agencies, could make it harder for those agencies to enact regulations protecting abortion rights, as my colleague Nina Martin has reported.

Perhaps the biggest challenge facing abortion access is the repeal of the Hyde Amendment, which prohibits federal funding for abortion with minimal exceptions, leaving millions of low-income people on Medicaid without insurance coverage for abortion. (Paying for an abortion out of pocket can cost upwards of $500, or far more in the second trimester, according to KFF.) This year and since 2016, the Democratic Party platform has called for the repeal of Hyde, and it was one of the campaign promises Harris made the first time she ran for the presidency in 2020. Biden, too, has repeatedly excluded Hyde from his proposed federal budgets over the last few years, but it has always reappeared in the finalized budget passed by Congress. Still, Rebouché says, Harris “could refuse to sign the budget until Hyde is gone.” Conversely, Project 2025 calls for strengthening Hyde and codifying it into law.

Flint, from All* Above All, which has campaigned to overturn Hyde, said the policy shows the ways that abortion can be inaccessible even if it’s technically legalized, as it was under Roe. “If we do not figure out how to get government funding,” she told me, “we are on the precipice of another crisis, where there’s going to be a lot of folks not being able to get abortions, regardless of whether it’s legal or not.”

“We are on the precipice of another crisis, where there’s going to be a lot of folks not being able to get abortions, regardless of whether it’s legal.”

Perhaps one of the most significant ways in which a Harris presidency could alter the reproductive rights landscape is one of the most obvious. “She could shape a Supreme Court that is not the Dobbs court,” Rebouché notes. Three of the current justices—including two conservatives, Clarence Thomas and Samuel Alito—are in their 70s, and could potentially retire during the next president’s term. As Rebouché sees it, it’s likely that a future liberal-leaning court shaped by Harris could one day undo Dobbs. “We should continue to talk about Dobbs just the way Alito described Roe: ‘Egregiously wrong’ and ‘erroneously’ decided.” The significance of Harris’ ability to pave the way for undoing Dobbs becomes all the more clear when one, again, looks at Project 2025’s plans: “The Dobbs decision,” it says, “is just the beginning.”

This summer, more than 380 reproductive rights and justice organizations and activists—including Flint’s All* Above All—signed onto a 17-page memo called “Abortion Justice, Now: Protecting Abortion At the Federal Level.” The brief primarily calls for passing federal legislation that abolishes the so-called viability line established in Roe and Planned Parenthood v. Casey. “We know that viability is directly connected to fetal personhood, which is directly connected to the criminalization of pregnancy,” Jenni Villavicencio, a practicing OB-GYN and one of the primary authors of the brief, told me. “We really want to call attention to anybody making policy, including a possible future Harris administration, that is unacceptable to enshrine any sort of limit” for abortion access.

Two pieces of legislation—both introduced last year—are highlighted as model policies that could help expand access. The first is the Abortion Justice Act, sponsored by Rep. Ayanna Pressley (D-Mass.), which would establish a federal right to abortion without limits, provide $350 million in annual grant funding to support abortion access, and increase the number of abortion-providing facilities. The EACH Act, introduced by Sen. Tammy Duckworth (D-Ill.) would effectively repeal Hyde. Spokespeople for both politicians said that they, or their colleagues, plan to re-introduce some version of the legislation in the next session of Congress.

Major medical groups also support abolishing gestational limits from abortion policy, and in August, more than 400 physicians also signed onto a letter, spearheaded by the group Physicians for Reproductive Rights, asking Biden and Harris to support “moving beyond the legal framework created by Roe,” in part by supporting abortion access later in pregnancy. But the issue of gestational limits has long divided the reproductive rights movement, which has struggled to balance where to compromise in its quest for broad abortion rights, as my colleague Madison Pauly has reported. Notably absent from the signatories of the memo, for example, are some of the largest abortion rights groups, including Planned Parenthood Action Fund and Reproductive Freedom For All. (Spokespeople for those groups did not respond to requests for comment.)

For Democrats, this has long been a tough needle to thread. The anti-abortion right has argued that Democrats support abortions later in pregnancy or, as Trump has insisted without basis, “even after birth.” But more than 90 percent of abortions nationwide take place within the first trimester, according to CDC data, and many Democrats, including Harris, have said they support the viability limit that existed under Roe, with later-term exceptions for emergency complications. Harris reiterated that at her debate with Trump, when he repeated his lies about Democrats supporting infanticide.

As Bracey Sherman, author of Liberating Abortion, points out, many of the tragic cases the Harris campaign has highlighted—in which people with wanted pregnancies had miscarriages, nonviable pregnancies, or other health emergencies requiring abortion—may not have had different outcomes under Roe. “There is no evidence that those people would be helped because they would still be stuck with the same viability line and the exception line,” she said. “We need to be pushing for abortion access at any time, for any reason, for anyone, anywhere in this country.”

Villavicencio, for her part, says she recognizes the necessity of compromise in policymaking. “What we patently reject,” she adds, “is compromise when it is for people who are the most marginalized”—specifically the young, low-income people, and people of color, many of whom struggled to access abortion care under Roe. Under Harris, she and other advocates see a possibility for a fresh start. As Flint, of All* Above All, says, “We have an incredible opportunity in the ashes of Roe v. Wade to build the thing that our community needs.”

But that all depends on who wins on Tuesday.

Update, Nov. 1: This story has been updated to clarify the Biden administration’s interpretation that EMTALA requires hospitals to provide abortion care to protect patients’ health—not just their lives.

Earlier this month, Louisiana became the first state in the country to classify the two most common drugs used in medication abortions, mifepristone and misoprostol, as Schedule IV controlled substances, creating stiff penalties for their unauthorized use. Medical providers sounded alarms when the GOP-controlled legislature passed the law: Abortion is already banned in the state in nearly all cases, and the new classification would delay lifesaving care for people experiencing miscarriages and health conditions unrelated to pregnancy. 

Now, in a just-filed lawsuit, doulas, medical providers, and women denied care under the state’s abortion law argue that the new classification of mifepristone and misoprostol runs afoul of Louisiana’s constitution. By separating the drugs from others with similar risk profiles, the suit contends, the new law discriminates against people on the basis of their physical conditions, ones that are treated with mifepristone and misoprostol.

In Louisiana, controlled substances fall into five categories depending on their medical indications and risk for abuse—Schedule I being the highest risk, and Schedule V the lowest risk. The current list of Schedule IV drugs includes opioids, barbiturates, and benzodiazepines, all drugs with high potential for addiction. The classification of mifepristone and misoprostol as dangerous drugs subjects them to tight regulations. But they’re not dangerous drugs, nor do they have abuse potential like their Schedule IV counterparts; more than 100 studies have shown them to be safe and effective in ending pregnancy. Contrary to their current classification in Louisiana as having addictive potential, the Food and Drug Administration—which approved the drugs decades ago—has never found the medications to lead to physical or psychological dependence. 

Misoprostol and mifepristone have proven to be effective in a variety of contexts. Both are used in miscarriage care, mifepristone is used to treat ovarian cancer, and misoprostol is crucial to managing postpartum hemorrhages. Under Louisiana’s law, anyone in possession of either drug—except for pregnant women—is subject to five years in prison and a $5,000 fine. 

The classification, the lawsuit argues, subjects the drugs to a “highly regulated legal scheme” that delays care. Previously, misoprostol was commonly stored in obstetric hemorrhage carts or in staff’s pockets. But under its new status, only a provider licensed to administer controlled substances can retrieve the drug from locked cabinets where other scheduled substances, like narcotics, are stored. As a New Orleans OB-GYN told my colleague Julianne McShane, in a medical emergency, time is of the essence, and even a delay of several minutes can have disastrous consequences.

Pregnant women were already being denied care before the medications were reclassified. One of the plaintiffs, Kaitlyn Joshua, was denied miscarriage care by two hospitals because of the state’s abortion ban. “Now lawmakers have passed yet another law making it harder to get care during a miscarriage, and they did it without following the requirements of the State’s constitution,” Joshua said in a news release.

Earlier this month, Louisiana became the first state in the country to classify the two most common drugs used in medication abortions, mifepristone and misoprostol, as Schedule IV controlled substances, creating stiff penalties for their unauthorized use. Medical providers sounded alarms when the GOP-controlled legislature passed the law: Abortion is already banned in the state in nearly all cases, and the new classification would delay lifesaving care for people experiencing miscarriages and health conditions unrelated to pregnancy. 

Now, in a just-filed lawsuit, doulas, medical providers, and women denied care under the state’s abortion law argue that the new classification of mifepristone and misoprostol runs afoul of Louisiana’s constitution. By separating the drugs from others with similar risk profiles, the suit contends, the new law discriminates against people on the basis of their physical conditions, ones that are treated with mifepristone and misoprostol.

In Louisiana, controlled substances fall into five categories depending on their medical indications and risk for abuse—Schedule I being the highest risk, and Schedule V the lowest risk. The current list of Schedule IV drugs includes opioids, barbiturates, and benzodiazepines, all drugs with high potential for addiction. The classification of mifepristone and misoprostol as dangerous drugs subjects them to tight regulations. But they’re not dangerous drugs, nor do they have abuse potential like their Schedule IV counterparts; more than 100 studies have shown them to be safe and effective in ending pregnancy. Contrary to their current classification in Louisiana as having addictive potential, the Food and Drug Administration—which approved the drugs decades ago—has never found the medications to lead to physical or psychological dependence. 

Misoprostol and mifepristone have proven to be effective in a variety of contexts. Both are used in miscarriage care, mifepristone is used to treat ovarian cancer, and misoprostol is crucial to managing postpartum hemorrhages. Under Louisiana’s law, anyone in possession of either drug—except for pregnant women—is subject to five years in prison and a $5,000 fine. 

The classification, the lawsuit argues, subjects the drugs to a “highly regulated legal scheme” that delays care. Previously, misoprostol was commonly stored in obstetric hemorrhage carts or in staff’s pockets. But under its new status, only a provider licensed to administer controlled substances can retrieve the drug from locked cabinets where other scheduled substances, like narcotics, are stored. As a New Orleans OB-GYN told my colleague Julianne McShane, in a medical emergency, time is of the essence, and even a delay of several minutes can have disastrous consequences.

Pregnant women were already being denied care before the medications were reclassified. One of the plaintiffs, Kaitlyn Joshua, was denied miscarriage care by two hospitals because of the state’s abortion ban. “Now lawmakers have passed yet another law making it harder to get care during a miscarriage, and they did it without following the requirements of the State’s constitution,” Joshua said in a news release.

Two years after the US Supreme Court ended the federal right to abortion, tens of millions of Americans will go to the polls this November hoping to protect access to the procedure—whether their lawmakers like it or not. Ten states— some already with robust protections, others with near-total bans—have measures on their ballots to enshrine abortion rights in their constitutions. The expected outpouring of voters, including in key swing states, could help determine control of the White House, Congress, state legislatures, and state supreme courts.

Reproductive freedom has proved to be one of the strongest currents shaping the outcome of American elections since 2022. So far, voters in seven states have reacted to the end of Roe v. Wade by passing ballot measures aimed at restoring, and even expanding, Roe’s protections. In a few of those states, the voter-initiative process empowered the public to bypass GOP-dominated legislatures and supersede decades-old restrictions. Reproductive rights organizers are hoping to continue that winning streak on November 5. 

But faced with the broad appeal of abortion initiatives in GOP-led states such as Ohio, Republican officials have gone to sometimes extreme lengths to undermine the latest measures. In Florida, for example, Gov. Ron DeSantis has waged a multifront war on Amendment 4, threatening television stations that air ads favoring the measure and issuing a 348-page report accusing the Floridians Protecting Freedom campaign of “widespread petition fraud.” 

While most of this year’s measures have a common objective—protecting reproductive access—they take very different approaches to reaching that goal. Here is a rundown of what’s on the November ballot, which we will update as election results become available. 

Arizona

In anticipation of the end of Roe, Arizona Republicans passed a 15-week abortion ban in early 2022. But they also left in place an 1864 statute that outlawed nearly all abortions and threatened providers with jail time—a “zombie” law that was moot as long as Roe was in effect. This past April, the Arizona Supreme Court revived that Civil-War era ban by a 4–2 vote. The GOP-controlled legislature quickly repealed the old law, but many Arizonans were outraged at what the court had done, and the campaign to put Proposition 139 on the November ballot exploded. Prop 139 would enshrine a fundamental right to abortion in the Arizona Constitution and prohibit the state from restricting or banning abortion until the point of fetal viability—about 24 weeks. Abortions would be allowed later in pregnancy to save the mother’s life or to protect her physical or mental health. The amendment would also protect anyone who helps another person obtain an abortion.

A coalition of reproductive rights groups certified more than 575,000 signatures this past summer—the most ever validated for a citizens initiative in the state’s history, supporters said. In a New York Times/Siena College poll in late September, Prop 139 was ahead among likely voters by a resounding 58 percent. If it passes, Prop 139 could be used to challenge almost 40 abortion laws on Arizona’s books, including the existing 15-week ban, a prohibition on telehealth abortions, and a parental consent requirement for teenagers.

Colorado

Long before the Dobbs decision, Colorado legislators passed numerous laws safeguarding access to abortion. But after Dobbs, reproductive health advocates in the state concluded that even the strongest statutes weren’t strong enough—Colorado needed to enshrine those protections in its constitution. The measure they put on the November ballot, Amendment 79, wouldn’t just establish a right to abortion; it would repeal a 40-year-old constitutional provision that prohibited the use of state dollars to fund abortion. Sponsored by a coalition called Coloradans for Protecting Reproductive Freedom, the measure needs 55 percent of votes to pass. 

Surrounded by states with bans or heavily restrictive laws, Colorado is a crucial abortion access point for the West. With no gestational limits, the state is also a haven for anyone seeking an abortion later in pregnancy, as it is home to one of four clinics in the US that offer third-trimester procedures. Repealing the ban on state funding would allow Colorado to use its state Medicaid dollars to pay for abortions, making the procedure more accessible for low-income patients.

Florida

Florida’s Amendment 4 would enshrine in the state’s constitution the freedom to seek an abortion before fetal viability, and after viability if a medical provider determines that the procedure is necessary to preserve a patient’s health.

Gov. DeSantis and his GOP administration have done everything they can to sabotage the amendment—including sending “election police” to the homes of people who signed the petitions.

If the measure passes, it would dramatically improve access to reproductive care in Florida, which since May has banned abortions after six weeks of pregnancy. Before that, the state permitted abortions up to 15 weeks, and before Dobbs, until 24 weeks. The impact of the Florida vote will be felt throughout the Southeast: Tennessee, Alabama, Arkansas, Mississippi, and Kentucky all have near-total abortion bans; Georgia and South Carolina have six-week bans, and North Carolina’s 12-week ban is made more burdensome by a 72-hour waiting period. 

The stakes for passage are high, and so are the barriers. Over the last several election cycles, Florida has turned out more conservative voters than liberal ones. While reproductive rights are popular across the political spectrum, the state has a 60 percent threshold to approve constitutional amendments; the other red states that have passed abortion-protective measures since Dobbs—Kansas, Kentucky, Ohio—only required simple majorities. Meanwhile, Gov. DeSantis and his GOP administration have done everything they can to sabotage the amendment—including sending “election police” to the homes of people who signed the petitions, ostensibly to root out fraud. If the measure passes, DeSantis and his allies are widely expected to fight just as hard to overturn the results.

Maryland

Maryland’s Question 1, which was placed on the November ballot by the state legislature, does not mention “abortion”—much to the chagrin of supporters and opponents alike. Instead, the amendment broadly establishes the constitutional right to “reproductive freedom,” including the freedom to decide whether to continue or end a pregnancy. It needs a simple majority to pass.

Maryland already has some of the least restrictive abortion laws in the country: There is no gestational limit, state Medicaid covers the procedure, and a shield law protects patients who travel from states with abortion bans. This has made the state a critical access point for abortion seekers further along in pregnancy, as well as people traveling from the South. Abortion protections are widely popular in the state; in a recent poll by the University of Maryland, Baltimore County, 69 percent of respondents said they plan to vote for Question 1.

Missouri

Missouri’s near-total abortion ban took effect mere minutes after the Supreme Court overturned Roe v. Wade in 2022—making it the first state in the nation to broadly prohibit abortion. Abortion-rights advocates soon set about crafting a ballot initiative to end the ban, inspired by wins in other states. Now, with Amendment 3, voters will decide whether they want the right to “reproductive freedom”—defined as the ability to make and carry out one’s own decisions about contraception, abortion, and healthcare during pregnancy. If approved by a simple majority, the amendment would set up a legal battle to overturn the current ban and challenge the many other Missouri laws that regulated abortion providers nearly out of existence even when Roe was still in effect.

Amendment 3’s proponents, a coalition known as Missourians for Constitutional Freedom, have traveled a rocky road just to get the measure before voters. They’ve overcome blatant obstruction by top state GOP officials, multiple legal challenges, and deep internal divisions over whether the initiative should allow the state to ban abortions after fetal viability. The final text protects abortion rights until viability, and permits later abortions if needed to protect the life or health of the pregnant person.

Montana

Constitutional Initiative 128 establishes the right to make and carry out decisions about one’s own pregnancy, including abortion. If passed, it would allow the state to regulate abortion after fetal viability, so long as those restrictions don’t prevent abortions that health care providers deem medically necessary. The amendment, which requires more than 50 percent of the vote, would also prevent the government from criminalizing patients and anyone who helps a person exercise her abortion rights.

If top Republican state officials had it their way, the measure would not even be on the ballot. State courts intervened at multiple points; the Montana Supreme Court overruled Attorney General Austin Knudsen’s initial rejection of the proposed amendment, nixed Knudsen’s drafted ballot language saying the amendment “may increase the number of taxpayer-funded abortions,” and threatened Secretary of State Christi Jacobsen with a contempt charge because she refused to hand over the sample ballot petition to the campaign behind the amendment, Montanans Securing Reproductive Rights. After abortion rights supporters submitted nearly double the required 60,000 signatures, Jacobsen even tried changing the rules to throw out the signatures of inactive registered voters, until a district court ordered her to stop.

Thanks to the state supreme court, abortion is currently legal in Montana until fetal viability, despite the best efforts of Republican state legislators to restrict access. Montanans have already brushed off one GOP attempt to stigmatize abortion; in November 2022, 52 percent of voters rejected a legislature-initiated statute that would have made it a felony for doctors to not provide care to infants born alive after induced labor, a cesarean section or an “attempted abortion.” (The law wasn’t necessary since Montana, like every other state, already makes infanticide a crime.)

Nebraska

Nebraska voters will see dueling abortion amendments on their November ballots. Initiative 434 restricts abortion rights, banning the procedure after 12 weeks of pregnancy with limited exceptions. That’s essentially the same law already on the state’s books—but the measure would enshrine it as a constitutional amendment, making it much harder to repeal. And because the amendment doesn’t protect abortion before the 12-week mark, state politicians could always go further and pass a complete ban, as Republican Gov. Jim Pillen has pledged to do.

By contrast, Initiative 439 expands abortion rights, creating a “fundamental right to abortion until fetal viability, or when needed to protect the life or health of the pregnant patient.” In practice, the amendment would roughly double the length of time for pregnant people in Nebraska to get an abortion. Crucially, it would block lawmakers from passing a total ban.

If the double initiatives sound confusing, well, that’s the point. Anti-abortion activists have repeatedly tried to muddy the waters about which ballot initiative is which, as Rachel Cohen at Vox has reported. They’ve also tried to get the pro-abortion initiative thrown off the ballot on a technicality, but the Nebraska Supreme Court shot them down.

Given the confusion, it is possible that both measures could pass. In that case, the one with the most votes wins.

Nevada

Nevada, one of the swingiest states in the 2024 election, has its own version of the Equal Rights Amendment, passed by voters in 2022. But it didn’t explicitly mention protections for abortion. Question 6 constitutionally enshrines the right to abortion until fetal viability or for the health or life of the mother, as determined on a case-by-case basis by health care providers. Any pre-viability restrictions must be directly related to promoting the health of the pregnant person and “consistent with accepted clinical standards of practice.” This year’s vote is just the first step in a multiyear process; assuming a simple majority of voters approve it, the measure must be passed again in 2026 to become part of the constitution.

Thanks to a law passed in 1973, abortion has been legal in Nevada until 24 weeks. Because voters passed a referendum on that law in 1990, it can only be changed by a direct ballot measure. Protections for abortion are very popular in Nevada; a University of Maryland poll conducted over the summer found that about 70 percent of state voters oppose criminalizing abortion at any stage of pregnancy. The campaign behind the amendment, Nevadans for Reproductive Freedom, has raised nearly $10 million since January, according to campaign finance reports; the Coalition for Parents and Children PAC, which successfully sued to block an initial version of the amendment that covered reproductive healthcare more broadly, hasn’t raised or spent any money.

New York

New York’s Proposal 1 may not include the word “abortion,” but it would create first-in-the-nation protections for the rights of pregnant people.

The proposal is a broad version of the Equal Rights Amendment, the long-running feminist effort to guarantee women’s rights in state and federal constitutions. Right now, New York’s constitution only forbids government discrimination on the basis of race and religion. Prop 1 adds more protected categories to that list: disability, age, ethnicity, national origin, and sex, including sexual orientation, gender identity, and gender expression. Those types of discrimination are already banned under state law, but by enshrining protections in the constitution, Prop 1 would make them harder for legislators to attack in the future—for example, if New York politics keep trending rightward.

Here’s where abortion comes in: The amendment also bans discrimination based on “pregnancy status, pregnancy outcomes, and reproductive health care and autonomy.” Not only does that definition go farther than any other state, it leaves little room for judges to interpret in ways that might limit abortion access, according to Katharine Bodde, of the New York Civil Liberties Union.

Yet while New York Democrats initially viewed Prop 1 as a surefire way to boost voter turnout, their right-wing opponents have seized on transphobic messaging to great effect—making this blue-state fight unexpectedly close.

South Dakota

South Dakota’s current abortion ban is one of the most extreme in the country, with all abortions banned except when needed to save a pregnant person’s life. Amendment G, backed by a group called Dakotans for Health, would replace that law with a trimester-based system allowing increasing restrictions on abortion as a pregnancy progresses.  

In the first trimester, the state would be banned from interfering with “a woman’s abortion decision and its effectuation.” In the second trimester, the state could restrict abortion in ways “reasonably related to the physical health of the pregnant woman.” Third-trimester abortions could be banned, except when necessary to preserve a pregnant person’s life or health. The amendment needs a simple majority to pass.

Planned Parenthood and other abortion-rights groups aren’t supporting Amendment G, which they’ve said doesn’t go far enough. But the conservative Republicans who dominate state politics are still so terrified of the measure that they passed an emergency law to let voters revoke their petition signatures—then opponents of the measure led a phone banking effort to dupe signers into pulling their support. Why are state Republicans spooked? “If you can do it in South Dakota, it will strike fear into the hearts of every red-state legislature in the country,” Dakotans for Health co-founder Adam Weiland told the American Prospect.

Madison Pauly, Abby Vesoulis, Julianne McShane, and Nina Martin contributed reporting. This is a developing story. Check back for updates.

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Top image photo credits: Octavio Jones/AFP/Getty; RJ Sangosti/The Denver Post/Getty; William Campbell/Getty; Rachel Aston/Las Vegas Review-Journal/Getty; Getty(3)

Every Monday morning, the staff of the Abortion Fund of Ohio’s intake line starts fresh, answering calls, following up on voicemails, and doling out cash to people who can’t afford to go to their abortion appointments. The team of three fields as many financial requests as they can until the money allotted for the week runs out. Lately, that’s been by Tuesday. Sometimes they can stretch the funds until Wednesday.

The Ohio Fund, one of the largest abortion funds in the United States, didn’t always operate this way. When I first spoke with the fund in August 2023, it didn’t even have monthly caps on the amount of money it gave callers. Back then, even though the wave of “rage donations” that followed the end of Roe v. Wade had receded, there was still enough money to pay for patients’ medical costs, travel, and child care.

But as costs of care—and daily life—have risen, so, too, has demand for the fund’s services. Ohio’s relatively new constitutional protections for abortion—the result of a ballot measure approved last year—have made it a destination for needy patients from nearby states where onerous restrictions remain in place. When national abortion rights organizations suddenly announced this summer that they would be slashing the amount of money they devote to defraying patients’ medical costs, the financial problems escalated. 

To put all this in perspective: In July 2023, the Ohio Fund spent about $100,000 helping 300 or so people get abortions. This past July, they fulfilled twice as many requests for help with half as much money—and the number of calls has continued to rise. People who might once have been able to pay for their own abortions are now begging for assistance, and people who always would have needed financial assistance are begging for more. 

“The first word that comes to my mind is helpless,” says Taren Holliman, the Ohio Fund’s program manager. “It feels very helpless when you are not able to fully bridge the gap, or help bridge the gap, in a way that actually allows a person to access the health care that they deserve.”

It’s not just the Ohio Fund that is struggling to meet callers’ needs. Every abortion fund I spoke with, from the East Coast to the Great Plains to the Deep South, is in varying stages of crisis, with many taking unprecedented measures to ward off looming disaster. As the abortion issue dominates the 2024 elections, from Kamala Harris’ campaign to the battle for the Senate to ballot measures in a record 10 states, the frontline groups that have taken on the lion’s share of the post-Dobbs burden—the clinics that provide abortions, and the funds that get people to their appointments—are barely able to keep their doors open and phones on the hook.

“What I’m seeing looks like the collapse of the abortion care system.”

Just days after the state’s voter-approved constitutional amendment officially took effect in December 2023, the Ohio Fund closed shop until February due to a lack of money. That was despite a record-breaking year for the fund, during which it almost doubled the money it doled out, to $1.5 million, and nearly quadrupled the number of abortion seekers it helped. 

As Ohio’s courts begin implementing the ballot measure, the financial strains are likely to grow. With its six-week ban permanently struck down, and its 24-hour waiting period and restrictions on medication abortion temporarily blocked, the state is poised to become an even more vital access point for abortion patients from neighboring states with near-total bans, including Kentucky, West Virginia, and Indiana.

Ohio’s abortion-rights measure has been a model for many of the ones on the ballot. But the nationwide lack of abortion funding infrastructure presents a stark reminder of the post-November reality, even if Harris wins: Protecting the right to abortion is very different from ensuring that patients, particularly low-income ones, can access abortion care. Draconian laws, stigma, and a lack of buy-in from large donors and local and state governments have produced a funding catastrophe that has been decades in the making—and is unlikely to be solved anytime soon. Dr. Diane Horvath, director of an independent abortion clinic in Maryland, a state with robust abortion laws and an abortion-rights amendment on the November ballot, put it bluntly: “What I’m seeing looks like the collapse of the abortion care system.”

For low-income women in particular, access to abortion has long depended on the benevolence of donors. For nearly 50 years, the Hyde Amendment has prohibited federal funds from going toward abortions except when a woman’s life is threatened or in cases involving rape or incest. Many states implemented their own versions of Hyde, barring state Medicaid funds from being used for abortions; some states also passed laws banning private insurers from covering abortions in their states.

Despite the promises of Roe, abortion remained far from accessible—and unnecessary regulations on abortion providers and mandatory waiting periods that delayed care only exacerbated the access problem. Grassroots funds, mostly funded by small, individual donations, cropped up in communities across the country to offer financial assistance and, crucially, stigma-free emotional support to people seeking abortion care. 

In 1993, an alliance of 22 local organizations in 14 states established the National Network of Abortion Funds to better connect abortion seekers to help and advocate for abortion rights. Now made up of almost 100 funds, the network gave out more than $18 million in grants last year, tax filings show. The fall of Roe produced a swell of “rage donations” to national organizations and local funds alike, enabling some funds to expand their staff, service areas, and funding amounts. But those donations have since dried up.

For years, and especially since Dobbs, local abortion funds and the people they serve have relied on two big national organizations to help defray the medical costs of procedures for patients who meet financial eligibility requirements: Planned Parenthood and the National Abortion Federation. Planned Parenthood funds abortions at its own clinics, and NAF funds abortions at NAF-member independent clinics. 

Local abortion funds fill in the gaps, helping pay for things like plane fares, motels, and babysitters; many, like the Ohio Fund, do not have income limits or other eligibility requirements that cut some pregnant people off from national assistance. Although NAF has a limited fund for non-appointment expenses like travel and child care, the overwhelming burden of practical support falls on the shoulders of local organizations. 

Immediately after the US Supreme Court overturned the federal right to abortion, NAF and Planned Parenthood committed to funding up to half of patient medical costs, and NAF offered additional assistance to patients in emergencies. Before the Dobbs decision, NAF spent, on average, $50,000 a month to defray abortion costs, president and CEO Brittany Fonteno says. In the two years after Dobbs, it spent $6 million a month. 

But this past July 1, NAF cut its abortion funding in half; going forward, it would only cover 30 percent of qualifying patients’ appointment costs. Fonteno says the decision was difficult but necessary to ensure the organization’s future. “Our funding has not been able to keep pace with the need,” Fonteno tells me. “We were set to run out of funds by fall if we had continued to fund at the pace that we were funding at previously.”

Planned Parenthood, meanwhile, joined a campaign called Abortion Access Now that aims to pass federal abortion protections in the next decade. On the two-year anniversary of the Dobbs decision, the campaign launched with $100 million from national groups including the ACLU, National Women’s Law Center, and the Center for Reproductive Rights. A week later, Planned Parenthood’s patient appointment funding cuts, which mirror NAF’s, went into effect. Planned Parenthood did not provide comment by publication time.

“It is disheartening to be engaged in this work and, in moments of political crisis, to witness groups that should be our partners in the fight—uplifting, investing in, and centering our expertise and critical role—fail us, too.”

Local organizations like the Ohio Fund felt the impact immediately; they were inundated with more patients needing more money, even as their own donations were drying up. “It actually feels repulsive to offer someone $200 who has a $1,500 appointment cost and says that they can’t afford to eat or pay their rent,” says Lexis Dotson-Dufault, the Ohio Fund’s executive director. “What do we do? Because if we cover your whole appointment cost, that’s our budget for the day.”

And big institutional donors, like foundations, haven’t stepped in to help. Dotson-Dufault pointed out to me that when large donors decide to fund reproductive rights, they usually pour their money into national organizations. Planned Parenthood, for instance, which has over $330 million in net assets (despite losing nearly $68 million last year), received a $275 million donation in 2022 from billionaire MacKenzie Scott, the ex-wife of Amazon founder Jeff Bezos, to increase abortion access nationwide.

More than 30 local abortion funds went public with their frustrations in an open letter published in August in The Nation. “Abortion funds exist because governmental and political systems have failed our communities—primarily Black, Indigenous and Native, immigrant, rural, and low-income—and abandoned us in times of need,” the letter reads. “It is disheartening to be engaged in this work and, in moments of political crisis, to witness groups that should be our partners in the fight—uplifting, investing in, and centering our expertise and critical role—fail us, too.”

The leaders behind national groups counter that local abortion funds are partly to blame for the low cash flow. An anonymous organization leader working on abortion ballot campaigns in multiple states told Vox in September that local funds’ visions for the future—for example, making abortion (and all health care) free and eliminating parental consent laws—alienate more mainstream would-be donors. “If you’re only communicating in very extreme messaging about abortion access, you’re not broadening your base of donors, you’re just talking to the 12 people who already agree with you,” the anonymous source said. “A lot of people who would love to donate to funds and probably don’t understand the need are turned off before they even get in the door by the language and behavior.”

Dotson-Dufault offers a different perspective. She attributes the lack of institutional funding to deeply rooted stigma around abortions, which large donors share and are continuing to perpetuate. “I think a lot of people want to say that they’re supporting abortion,” she tells me, “but not go as far as paying for the abortion itself.”

The thing about abortion is that it is inherently time-sensitive. And with each week that passes, the procedure gets significantly more expensive.

In Ohio, the cheapest option—medication abortion—costs about $650, and it’s only available until 12 weeks’ gestation. Costs for an in-clinic procedure, which is legal until 22 weeks, range from $735 to over $1,600, depending on how far along the pregnancy is. Just delaying care for a week—for example, to secure money from an abortion fund—raises the cost by several hundred dollars. That’s because patients having later-term abortions require more complex care; what can be completed in one appointment in the first trimester requires multiple days and pricey anesthesia in the second or third trimester. 

And for nearly all people whose pregnancies are beyond the point of viability, getting an abortion requires travel and a lot of time. There are just four clinics in the US that offer third-trimester abortions, and three of them are in the DC metropolitan area. The Brigid Alliance, which helps cover travel costs for patients beyond 15 weeks’ gestation, spends an average of $2,300 per client on non-medical expenses. Between plane tickets, childcare and multiple-day hotel stays,  the costs for some clients can approach $10,000, says The Brigid Alliance’s Sarah Moeller. That’s on top of costs for the procedure itself, which can exceed $15,000 in the third trimester.

Abortion patients have always relied on local funds to fill the funding gap, especially low-wage patients who can’t afford to take time off from work, much less pay for travel and child care. But those gaps are increasingly urgent—and nearly insurmountable. “Something that’s become more common is people are coming to us with these gaps the day before or the day of their appointment,” says Alisha Dingus, development director at the DC Abortion Fund. Patients are calling the fund needing as much as $10,000, sometimes from inside the clinic waiting room. In the months after Dobbs, such last-minute requests were something the DC Fund, one of the most well-resourced local funds in the country, used to be able to cover without a second thought. Not anymore. 

Now, it’s not unusual for the DC Fund to put out emergency requests for donations on social media. It’s not a policy change that came lightly; the DC team had decided against such callouts before. “We don’t want to create this sense of panic across our community, because we are such a critical fund,” Dingus says. “The other funds say, ‘Oh, if DCAF is in trouble, then what’s going to happen to callers who need care after 28 weeks?’”

We have two callers with appointments on Tuesday with a $8,300 gap. We are calling on this community to dig deep & show up to close this gap. We have seen y’all do it before & we hope you can again We keep us safe! https://t.co/IWBAHrRgG3

— DC Abortion Fund (@DCAbortionFund) August 29, 2024

The answer, increasingly, is that the independent providers who offer the costliest and least accessible abortion care are operating at a loss so as not to turn patients away. Even in states like Maryland, which has no gestational limits on abortion, Planned Parenthood does not offer third-trimester abortions. So later-pregnancy abortion care falls to a handful of independent clinics, many of which don’t have years of savings to dip into when patients come in crisis. 

The DuPont Clinic in DC, for example, spent about $100,000 to offset patients’ funding gaps in the first two months after the NAF cuts, Karishma Oza, the clinic’s care coordination director, says. DuPont is often a clinic of last resort; by the time someone ends up there, they’ve likely been turned away from other providers that can’t afford to subsidize their medical care. “Every week, our case management team has to reassure patients to come to their appointments despite not having all their funding together,” Oza tells me.

“We are in a position where, if things don’t change, if we’re not able to find alternative sources of funding, then we will have to close.”

It’s a similar situation at Partners in Abortion Care, a clinic in Maryland that provides abortions up to 34 weeks’ gestation. Since opening after Dobbs, Dr. Diane Horvath, its medical director and co-founder, says the clinic has always helped cover medical costs for patients. But since NAF slashed direct patient subsidies, women are coming in with significantly greater funding gaps. Partners in Abortion Care, like many independent clinics, relies on block grants from NAF to offer emergency financial help. With its own grant cut in half, the clinic now shoulders the bulk of patient medical costs.

“We’re operating at a loss,” Horvath told me in September. She and the clinic staff want to give people the care they need, “but we are in a position where, if things don’t change, if we’re not able to find alternative sources of funding, then we will have to close.”

Even in states with strong abortion protections, abortion providers and funds don’t often receive local or state government support. Horvath’s clinic receives no grant from Maryland, for instance. Many abortion funds told me they rely on small donations from community members for the bulk of their money supply. As costs rise, and demand for funds’ help alongside it, small donations aren’t enough.

Faced with increased need and a declining cushion of cash, the DuPont Clinic in DC has formed The Lavender Fund to beef up its emergency reserve of money for patients who can’t afford their appointments. Meanwhile, many funds, like Ohio’s, have implemented monthly or weekly funding caps or have slashed limits already in place. It’s not just money funds are worried about; they are trying to balance a drastic rise in demand with their workers’ and volunteers’ emotional wellbeing. 

Many of the people who volunteer or work at abortion funds—especially those who staff call lines—have themselves had abortions. The Ohio Fund’s Holliman, for instance, became involved in reproductive justice after facing barriers to her own abortion care while in college. It’s not just passion that drives the people who operate local abortion funds; it’s the intimate knowledge of everything that impedes care, from appointment fees to confusion about laws to a lack of support—and what it means if a fund cannot make up a person’s outstanding cost.

“You’re literally looking at a crossroads of two completely different futures in front of you,” Holliman says. “As much as I hate to say it, there are going to be people who are not able to access the care that they need.”

When the US Supreme Court overturned the federal right to an abortion in its 2022 Dobbs decision, one argument the justices made was that it was not banning abortion across the country, but rather granting states, and their voters, the opportunity to regulate the procedure. Since then, seven states have voted on their local abortion laws through ballot measures. From the liberal paradises of Vermont and California to redder states like Ohio and Kansas, all seven voted to protect abortion. In November, 10 more states are using ballot measures to address the topic, too.

Among them is Florida. Until 2022, the state allowed abortions until the third trimester. But since Dobbs, the state first enacted a ban on abortions after 15- weeks gestation, and subsequently a ban on abortions after six weeks, which took effect in May.

Floridians Protecting Freedom (FPF) is trying to change that with Amendment 4, which the reproductive rights group added to Florida’s November ballots by collecting more than 900,000 signatures. If enough Floridians vote “yes” on the ballot measure (official summary shown below), the referendum will theoretically enshrine in the Florida Constitution the right to abortion access up until fetal viability—which is generally around 23 to 24 weeks. As the referendum states:

No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider. This amendment does not change the Legislature’s constitutional authority to require notification to a parent or guardian before a minor has an abortion.

More than half of Florida voters support expanding abortion rights, according to polling by both Florida Atlantic University and the Hill/Emerson College. But whether this support ultimately alters the abortion landscape in the state is a different question.

That’s because Republican Gov. Ron DeSantis is using the power of his administration to threaten the initiative. He’s appointed people to the Financial Impact Estimating Conference—a panel responsible for gauging potential costs of ballot measures—that required the amendment be accompanied by language stating, without evidence, that access to abortion may cost taxpayer dollars. State law enforcement has also been sent to question Floridians who signed the petition for Amendment 4 to appear on the ballot. He’s enlisted a state agency to create a misleading website about abortions in Florida. Local television channels playing an advertisement supporting Amendment 4 have also been threatened with prosecution over the alleged violation of Florida’s sanitary nuisance law, which is generally used to combat health risks like the improper disposal of human waste or dead animals.

On Friday, DeSantis further escalated his intimidation campaign when his state department released a 348-page preliminary report alleging FPF may have committed “widespread petition fraud” to reach the 891,000 signature Florida statute requires to advance ballot measures. In a statement, FPF says its campaign has been “run above board and followed state law at every turn.” Further, the state deadline to challenge amendment signatures has already passed.

Anna Hochkammer, the executive director of the Florida Women’s Freedom Coalition, says the administration is “using the resources of the state to suppress the purest form of democracy, which in this case is necessary because an entrenched unrepresentative cabal of elected officials refuses to legislate in accordance with the overwhelming preferences of the citizens…Despite all of that, we are unbowed and unbroken.”

“An entrenched unrepresentative cabal of elected officials refuses to legislate in accordance with the overwhelming preferences of the citizens…Despite all of that, we are unbowed and unbroken.”

But the report could provide basis for a new, albeit insincere, legal argument against the ballot measure—and it seems it already has. On Wednesday, anti-abortion advocates filed a lawsuit citing the state missive, alleging that, “When all fictitious, forged, illegally obtained, or otherwise invalid signatures are removed from consideration, Amendment 4 failed to reach the constitutionally required number of signatures for ballot placement.” Accordingly, the lawsuit against FPF says, “The invalid petitions must be stricken and Amendment 4 removed from the 2024 General Election.”

DeSantis didn’t personally wage the lawsuit, but he did tee it up for the petitioners who did. Such tactics should not be surprising. Other GOP leaders, such as Ohio Secretary of State Frank LaRose and state lawmakers in Missouri, respectively tried to thwart similar initiatives through politically motivated lawsuits, exaggerated cost estimates, disinformation, and more.

As my colleague Ari Berman points out in his recent magazine story, this is particularly concerning because ballot measures are the only method in which majority rule by a plurality of a state’s citizens can supersede the minority rule of increasingly and disproportionately powerful GOP state lawmakers who have re-drawn districts to benefit them staying in power.

In hyper-gerrymandered states like Ohio, the only way to ensure that the will of the majority is followed is to override representative democracy and go directly to the people. This strategy has taken on renewed urgency in response to recent US Supreme Court decisions taking away fundamental rights, from the gutting of the Voting Rights Act to the overturning of Roe v. Wade. These initiatives can garner support across party lines in a way that is otherwise impossible in a highly polarized partisan political climate.

The Supreme Court explicitly noted that the solution to abortion access is not—in the majority’s opinion—protected by the US Constitution. Instead, as Justice Brett Kavanaugh wrote in his concurring opinion, the 2022 Dobbs decision “properly returns the Court to a position of neutrality and restores the people’s authority to address the issue of abortion through the processes of democratic self-government.”

In other words, the court said, abortion is an issue that should be regulated through voting: either for political candidates whose reproductive rights views align with those of the voters or, even more directly, for ballot measures.

This is also—in theory—the party line of the GOP. In his presidential campaign, former President Donald Trump has emphasized this point. “It’s all about the states, it’s about state rights. States’ rights,” Trump told Time magazine in April. “States are going to make their own determinations.”

Even without DeSantis putting his thumb on the scale, Florida already had a high bar for passing referenda: As of 2006, 60 percent of voters are required to amend the state’s constitution. Among conservative-leaning states—Kansas, Kentucky, Ohio—that have voted on abortion ballot measures, none have had to hit that high a mark. (Kansas was closest, at 59 percent).

Organizers of Amendment 4 say they believe Florida could be the first state to do so, but it’s a harder task when the DeSantis administration is engaging in what Hochkammer calls “asshole politics,” which values “power and posturing over good policy.”

For example, both the proponents and opponents of Amendment 4 have television advertisements in Florida. A pro-Amendment 4 ad depicts a woman describing how a pre-ban abortion saved her life when she found out she had a brain tumor while also pregnant with her second child. “The doctors knew that if I did not end my pregnancy, I would lose my baby. I would lose my life. And my daughter would lose her mom,” the mom says in the 30-second clip. “Florida has now banned abortion even in cases like mine.”

Florida’s Department of Health alleged the advertisement was false in cease-and-desist letters, citing Florida’s “exception” to save the life of a mother. But many physicians, who risk fines and prison time, argue that life-or-death scenarios are extremely complicated and often do not conform to the vague language of abortion-ban exceptions.

In the case of the woman who had a brain tumor, her diagnosis was terminal. According to a lawsuit filed in federal court by Floridians Protecting Freedom on Wednesday, the woman would not have met the requirements for an exception because an abortion only would have “extend[ed]” her life, not saved it. There are post-ban examples, too.

In another case, a 15-week pregnant woman was leaking amniotic fluid for an hour in a Broward County, Florida, hospital waiting room. Her ultrasound showed she had no amniotic fluid around her fetus, a condition that can quickly lead to serious infection and death. She was discharged and miscarried in a public restroom later that day, at which point was rushed to another hospital and put on a ventilator. She stayed in the hospital for six days.

“When you don’t want to talk about the fact that your state has an abortion ban that’s forced rape survivors to go out of state for care, that’s led to women almost losing their lives,” FPF campaign director Lauren Brenzel recently told Mother Jones, “you create distractions because you don’t want to talk about the harmful policy that you’ve implemented.” She added, “It’s not shocking. It’s the national playbook.”

When the US Supreme Court overturned the federal right to an abortion in its 2022 Dobbs decision, one argument the justices made was that it was not banning abortion across the country, but rather granting states, and their voters, the opportunity to regulate the procedure. Since then, seven states have voted on their local abortion laws through ballot measures. From the liberal paradises of Vermont and California to redder states like Ohio and Kansas, all seven voted to protect abortion. In November, 10 more states are using ballot measures to address the topic, too.

Among them is Florida. Until 2022, the state allowed abortions until the third trimester. But since Dobbs, the state first enacted a ban on abortions after 15- weeks gestation, and subsequently a ban on abortions after six weeks, which took effect in May.

Floridians Protecting Freedom (FPF) is trying to change that with Amendment 4, which the reproductive rights group added to Florida’s November ballots by collecting more than 900,000 signatures. If enough Floridians vote “yes” on the ballot measure (official summary shown below), the referendum will theoretically enshrine in the Florida Constitution the right to abortion access up until fetal viability—which is generally around 23 to 24 weeks. As the referendum states:

No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider. This amendment does not change the Legislature’s constitutional authority to require notification to a parent or guardian before a minor has an abortion.

More than half of Florida voters support expanding abortion rights, according to polling by both Florida Atlantic University and the Hill/Emerson College. But whether this support ultimately alters the abortion landscape in the state is a different question.

That’s because Republican Gov. Ron DeSantis is using the power of his administration to threaten the initiative. He’s appointed people to the Financial Impact Estimating Conference—a panel responsible for gauging potential costs of ballot measures—that required the amendment be accompanied by language stating, without evidence, that access to abortion may cost taxpayer dollars. State law enforcement has also been sent to question Floridians who signed the petition for Amendment 4 to appear on the ballot. He’s enlisted a state agency to create a misleading website about abortions in Florida. Local television channels playing an advertisement supporting Amendment 4 have also been threatened with prosecution over the alleged violation of Florida’s sanitary nuisance law, which is generally used to combat health risks like the improper disposal of human waste or dead animals.

On Friday, DeSantis further escalated his intimidation campaign when his state department released a 348-page preliminary report alleging FPF may have committed “widespread petition fraud” to reach the 891,000 signature Florida statute requires to advance ballot measures. In a statement, FPF says its campaign has been “run above board and followed state law at every turn.” Further, the state deadline to challenge amendment signatures has already passed.

Anna Hochkammer, the executive director of the Florida Women’s Freedom Coalition, says the administration is “using the resources of the state to suppress the purest form of democracy, which in this case is necessary because an entrenched unrepresentative cabal of elected officials refuses to legislate in accordance with the overwhelming preferences of the citizens…Despite all of that, we are unbowed and unbroken.”

“An entrenched unrepresentative cabal of elected officials refuses to legislate in accordance with the overwhelming preferences of the citizens…Despite all of that, we are unbowed and unbroken.”

But the report could provide basis for a new, albeit insincere, legal argument against the ballot measure—and it seems it already has. On Wednesday, anti-abortion advocates filed a lawsuit citing the state missive, alleging that, “When all fictitious, forged, illegally obtained, or otherwise invalid signatures are removed from consideration, Amendment 4 failed to reach the constitutionally required number of signatures for ballot placement.” Accordingly, the lawsuit against FPF says, “The invalid petitions must be stricken and Amendment 4 removed from the 2024 General Election.”

DeSantis didn’t personally wage the lawsuit, but he did tee it up for the petitioners who did. Such tactics should not be surprising. Other GOP leaders, such as Ohio Secretary of State Frank LaRose and state lawmakers in Missouri, respectively tried to thwart similar initiatives through politically motivated lawsuits, exaggerated cost estimates, disinformation, and more.

As my colleague Ari Berman points out in his recent magazine story, this is particularly concerning because ballot measures are the only method in which majority rule by a plurality of a state’s citizens can supersede the minority rule of increasingly and disproportionately powerful GOP state lawmakers who have re-drawn districts to benefit them staying in power.

In hyper-gerrymandered states like Ohio, the only way to ensure that the will of the majority is followed is to override representative democracy and go directly to the people. This strategy has taken on renewed urgency in response to recent US Supreme Court decisions taking away fundamental rights, from the gutting of the Voting Rights Act to the overturning of Roe v. Wade. These initiatives can garner support across party lines in a way that is otherwise impossible in a highly polarized partisan political climate.

The Supreme Court explicitly noted that the solution to abortion access is not—in the majority’s opinion—protected by the US Constitution. Instead, as Justice Brett Kavanaugh wrote in his concurring opinion, the 2022 Dobbs decision “properly returns the Court to a position of neutrality and restores the people’s authority to address the issue of abortion through the processes of democratic self-government.”

In other words, the court said, abortion is an issue that should be regulated through voting: either for political candidates whose reproductive rights views align with those of the voters or, even more directly, for ballot measures.

This is also—in theory—the party line of the GOP. In his presidential campaign, former President Donald Trump has emphasized this point. “It’s all about the states, it’s about state rights. States’ rights,” Trump told Time magazine in April. “States are going to make their own determinations.”

Even without DeSantis putting his thumb on the scale, Florida already had a high bar for passing referenda: As of 2006, 60 percent of voters are required to amend the state’s constitution. Among conservative-leaning states—Kansas, Kentucky, Ohio—that have voted on abortion ballot measures, none have had to hit that high a mark. (Kansas was closest, at 59 percent).

Organizers of Amendment 4 say they believe Florida could be the first state to do so, but it’s a harder task when the DeSantis administration is engaging in what Hochkammer calls “asshole politics,” which values “power and posturing over good policy.”

For example, both the proponents and opponents of Amendment 4 have television advertisements in Florida. A pro-Amendment 4 ad depicts a woman describing how a pre-ban abortion saved her life when she found out she had a brain tumor while also pregnant with her second child. “The doctors knew that if I did not end my pregnancy, I would lose my baby. I would lose my life. And my daughter would lose her mom,” the mom says in the 30-second clip. “Florida has now banned abortion even in cases like mine.”

Florida’s Department of Health alleged the advertisement was false in cease-and-desist letters, citing Florida’s “exception” to save the life of a mother. But many physicians, who risk fines and prison time, argue that life-or-death scenarios are extremely complicated and often do not conform to the vague language of abortion-ban exceptions.

In the case of the woman who had a brain tumor, her diagnosis was terminal. According to a lawsuit filed in federal court by Floridians Protecting Freedom on Wednesday, the woman would not have met the requirements for an exception because an abortion only would have “extend[ed]” her life, not saved it. There are post-ban examples, too.

In another case, a 15-week pregnant woman was leaking amniotic fluid for an hour in a Broward County, Florida, hospital waiting room. Her ultrasound showed she had no amniotic fluid around her fetus, a condition that can quickly lead to serious infection and death. She was discharged and miscarried in a public restroom later that day, at which point was rushed to another hospital and put on a ventilator. She stayed in the hospital for six days.

“When you don’t want to talk about the fact that your state has an abortion ban that’s forced rape survivors to go out of state for care, that’s led to women almost losing their lives,” FPF campaign director Lauren Brenzel recently told Mother Jones, “you create distractions because you don’t want to talk about the harmful policy that you’ve implemented.” She added, “It’s not shocking. It’s the national playbook.”

Former President Donald Trump on Tuesday greeted what may have been his dream audience: a roomful of seemingly adoring women.

The squeals and claps seem confounding when you consider Trump’s history with—and impacts on—women: He has been found liable of sexual assault against a woman; he was found guilty of 34 felony counts related to buying a porn star’s silence, after he allegedly cheated on his wife with her; and he appointed three of the five Supreme Court justices who overruled Roe v. Wade, which has subsequently created a health care apocalypse and endangered vulnerable women.

But his presence at the all-women Georgia town hall, hosted by Fox News’ Harris Faulkner, makes sense when you recognize that Trump (understandably) has a major problem with women voters: A national poll from NBC News released this weekend found that Harris has a 14 point lead among them. (Trump seems to be aware of the problem; see, for example, a late-night, all-caps meltdown he had on Truth Social last month, in which he essentially—and implausibly—promised to make women great again if reelected.)

As attendees to the Georgia town hall, which was taped Tuesday, made clear, Trump’s women problem has a lot to do with his role in restricting abortion access nationwide, and the ripple effects that have flowed from that—including threats to accessing IVF, which often involves the discarding of embryos.

As audience members confronted him over these impacts—which became clear in Alabama earlier this year—Trump reiterated his usual spiel of reproductive rights-related falsehoods, which included claiming that “every legal scholar” wanted Roe overruled (easily debunked) and that Republicans are “the party of IVF”—despite the fact that Republicans have twice blocked a vote on a bill that would protect IVF access nationwide, as I have covered. (The GOP said that it supports IVF and that the bill was unnecessary.)

But Trump also debuted a new lie at the town hall: He claimed he’s the “father of IVF.”

“I want to talk about IVF,” Trump said in the lead-up to a question about how abortion bans could impact fertility treatments. “I’m the father of IVF, so I want to hear this question.” (He then proceeded to call Sen. Katie Britt (R-Ala.)—who he said taught him what IVF is—”fantastically attractive.”)

"We really are the Party of IVF."

President Trump pledges FULL SUPPORT for fertility treatments at a town hall in Georgia. pic.twitter.com/swgf7bUUsx

— Trump War Room (@TrumpWarRoom) October 16, 2024

If you are wondering what on Earth he could have possibly meant, you are not alone. Trump is certainly not the creator of the reproductive technology (that was a British doctor, named Robert Edwards, in 1978). And Trump has never suggested any of his five children were born through IVF. In a statement provided to Mother Jones, Karoline Leavitt, national press secretary for the Trump campaign, dismissed the comment as “a joke President Trump made in jest when he was enthusiastically answering a question about IVF as he strongly supports widespread access to fertility treatments for women and families.” She did not respond to questions about whether Trump supported the Democratic-led bill on IVF that Republicans twice blocked, or how his proposal to force the government or private insurance companies to fund IVF would actually work (estimates say it could cost around $8 billion).

Harris promptly clapped back, telling reporters Trump’s comments were “quite bizarre,” adding, “if what he meant is taking responsibility, then yeah, he should take responsibility for the fact that one in three women in America lives in a Trump abortion ban state.”

Jenny Lawson, executive director of Planned Parenthood Votes, said in a statement that Trump’s claim was “disturbing,” adding, “He can try pandering (or whatever that was) to women on issues like IVF but he only cares about himself.” Women voters, on the other hand, care a lot about reproductive rights: While the NBC poll found Trump and Harris in a dead heat overall, polling at 48 percent each, voters said abortion was a top motivator for them—and that they prefer Harris to Trump on the issue, 53 percent to 34 percent.

But Trump seems to be living in an alternate reality—one in which he is the best candidate for reproductive rights. “We want fertilization, and it’s all the way, and the Democrats tried to attack us on it and we’re out there on IVF even more than them,” he said at the town hall. “So we’re totally in favor of it.”