Donald Trump stated during his campaign that he would not implement a national abortion ban, but experts predict he will still significantly curtail access to abortion and contraception.
The future president of the United States has been largely inconsistent in his approach to abortion access – in a March interview, he signalled support for a nationwide ban on abortion after 15 weeks, in his previous term he supported a bill that would have banned abortion after 20 weeks. As president, he appointed three Supreme Court Justices with the specific goal of overturning Roe vs Wade, which was achieved in 2022. However, his most recent stance is to let states decide for themselves.
So, if not a national ban, then what? Experts suggest that future federal action to restrict access to medical abortion is still plausible, just through a different route. Medical abortions account for 63% of all abortions and involve two pills: mifepristone and misoprostol. Via his appointees to the FDA, Trump could reinstate the requirement for mifepristone to be dispensed in person. This move would end access to mail-order abortion pills, cutting off abortion access entirely in 14 states where clinic-based abortions are already banned. Trump’s appointee could even go a step further and rescind mifepristone’s licensing, taking it off the market entirely. This could force women to rely solely on misoprostol, which is less effective and carries higher risks.
The repercussions extend beyond abortion – access to contraception is increasingly under threat. One year after Dobbs vs. Jackson Women’s Health Organisation (a decision made by the US Supreme Court that determined that the Constitution of the United States does not guarantee a right to abortion), states with the most restrictive laws saw a 65% dip in prescriptions filled for emergency contraceptives.
Some state laws define pregnancy as beginning at fertilisation, jeopardising the legality of IUDs and emergency contraception. These methods aim to prevent fertilisation but can also prevent fertilised eggs from implanting in the uterus, meaning they could be characterised as abortions under this definition.
The ripple effects of these policies are profound. Maternity care ‘deserts’ – areas without a single birthing facility or obstetric clinician – are expanding as physicians flee restrictive states, leaving fewer women with access to life-saving obstetric care. The patchwork of state laws that emerged after Dobbs has created confusion and uncertainty; a situation likely to worsen under Trump. As doctors face the threat of legal and professional risks for providing reproductive care, these deserts will continue to expand, deepening healthcare inequalities and putting the lives of millions of women in jeopardy.
The US has become a country where safe pregnancies and reproductive autonomy are viewed as privileges, not rights. If Trump pursues these policies, he will likely deepen the divide, exacerbating maternal mortality rates, worsening healthcare disparities, and undermining decades of progress in women’s reproductive health.
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