Last week’s March for Life in Washington, D.C., was a great success. As always, it was a great opportunity to reconnect with friends, listen to inspiring speakers, and protest an indefensible Supreme Court decision that has resulted in the tragic deaths of tens of millions of unborn children. This year in particular, there was a renewed sense of optimism. During his time in office, President Donald Trump appointed three justices to the U.S. Supreme Court, who are widely thought to disagree with the Court’s abortion jurisprudence. Additionally, this past December, the Court heard oral arguments in Dobbs v. Jackson Women’s Health Organization, considering the constitutionality of a Mississippi 15-week abortion ban.
This is the first time since Roe v. Wade that the Court considered the constitutionality of a law that would protect preborn children after a certain stage of pregnancy. Many in the pro-life movement believe that the Court will use this case to overturn Roe. There is a strong possibility that, by this time next year, states will be able to pass laws protecting preborn children. But as pro-lifers return home from the March, we should remember that a post-Roe world will include both new opportunities and new challenges, including likely increases in chemical abortions, increased travel to states with permissive abortion laws, and the difficulty of enforcing pro-life laws.
Chemical abortions
Regardless of how the Court rules in Dobbs, the continuing increase in chemical abortions across the country will continue to pose challenges for the pro-life movement. According to data from the Guttmacher Institute, the share of all abortions that were chemical abortions increased from 5 percent to 39 percent between 2001 and 2017. Furthermore, the Biden administration has pursued an expansion of chemical abortions prescribed via telehealth rather than in person. In December, the Food and Drug Administration permanently waived the in-person dispensing requirement for chemical-abortion drugs, making it possible for women to obtain these pills through the mail without an in-person medical examination.
In a post-Roe world, pro-lifers will need to place legal limits on obtaining chemical abortion pills by telehealth and by mail from states where chemical abortion remains legal. Pro-lifers would also need to invest in educational efforts about the health risks involved in obtaining a chemical abortion without an in-person medical exam. If a woman obtains a chemical abortion via telehealth but unknowingly has an ectopic pregnancy, that could be fatal for her. Additionally, if a woman is further along in pregnancy than she realizes, which is certainly possible without a medical examination, a chemical abortion could pose additional serious health risks.
Out-of-state abortions
If Roe is overturned, some women living in pro-life states will attempt to obtain abortions in states where laws continue to permit abortion. But, of course, not every woman will pursue that option. A Journal of Health Economics study analyzing abortion data between 1971 and 1972 found a positive correlation between the state abortion rate and the closeness of the state to New York, where abortion was legal and there was no residency requirement. Unsurprisingly, women who lived far away from New York were considerably less likely to obtain abortions in New York than women who lived in nearby states.
It should also be noted that, during the past 50 years, pro-lifers have developed a strong and extensive network of pregnancy help centers. There are more 2,700 pregnancy help organizations across the country providing various kinds of assistance to pregnant women, including shelter, health care, and counseling. In a post-Roe world, pro-lifers will need to continue to expand the reach of these centers and make additional efforts to advertise them to abortion-minded women.
Enforcement of pro-life laws
In pro-life states, attorneys general are likely to take reasonable steps to ensure that pro-life laws are enforced. But there are some right-leaning states that sometimes elect Democrats to statewide office, including attorney-general positions. In these states, Democrats may choose not to enforce pro-life laws; the attorney general of Wisconsin has already admitted he plans not to do so. Additionally, many conservative states have liberal cities where local law enforcement may not prioritize enforcing pro-life laws. Pro-lifers will need to make the enforcement of pro-life laws a salient campaign issue in right-leaning states. Furthermore, depending on the outcome of ongoing litigation involving the Texas heartbeat law, pro-lifers may need to consider alternative enforcement mechanisms for laws protecting the preborn in places where state officials will decline to enforce the law.
I have consistently argued that the pro-life movement has been more effective over the past 40 years than many realize. Between 1980 and 2017, the U.S. abortion rate declined by 53 percent. What is especially impressive about the decline is that it occurred in the absence of substantial changes in public policy. A reversal of Roe would allow pro-lifers to build on these impressive gains.
But the movement needs to realize that mail-order abortion drugs, out-of-state travel, and lax enforcement of pro-life legislation will enable abortion supporters to circumvent laws protecting the unborn. Pro-lifers should remain clear-eyed about these challenges without becoming pessimistic. Pro-life creativity and resilience has helped us overcome many obstacles over the past several decades. We will doubtless overcome these challenges as well.