In the summer of 2019, as a crowded Democratic primary was picking up speed, Joe Biden was on the defensive, pummeled by abortion-rights groups and his opponents for his support of the Hyde Amendment, a measure that prohibits the use of federal funds for most abortions.

He reversed his position, but the episode underlined his wobbly standing in the eyes of abortion-rights activists as he faced off in 2020 against Donald Trump, who became a hero of the anti-abortion movement by using his presidency to appoint Supreme Court justices who appeared likely to overturn Roe v. Wade.

Now, in 2024, the tables have turned.

This week, it was Trump angering abortion opponents as he sought to wash his hands of the matter and leave it to the states, while President Biden depicted himself as a direct champion of the cause, releasing a stark TV ad and excoriating Trump as he sought to position the issue at the center of his re-election campaign.

“I am determined,” Biden said, “to restore the federal protections of Roe v. Wade.”

If you were going to invent two candidates for the first presidential election since the fall of Roe, neither side of the abortion divide would probably design the exact candidate they have. They are both white men. They are both old. And neither has always said what their respective side of the debate wants to hear, although Biden’s shift on the Hyde Amendment is not as stark a reversal as Trump’s flip over the years from “pro-choice” to “pro-life.”

So the week’s events, with the Arizona Supreme Court ruling on Tuesday upholding an 1864 law banning almost all abortions, offered a window into an uncanny moment that for both has been a long time coming.

It is now Biden, a Catholic who has openly expressed personal misgivings about the issue, making abortion more central to a presidential campaign than any major-party nominee in history, while Trump, a former president who is usually happy to take credit for rolling back abortion rights, is trying to skirt it.

And neither will be able to control where the issue, which will turn on court rulings, referendums and decisions by state legislatures, goes from here.

“The people who are driving the agenda and the headlines are not necessarily people in Biden world or Trump world,” said Mary Ziegler, a law professor at the University of California, Davis, who studies the history and politics of abortion. “They’re kind of prisoners of the moment.”

A flip on Roe, and a retreat from a national ban

The week began with a bout of wishful thinking from Trump. After appointing three of the Supreme Court justices who overturned Roe, sending the contentious debate over abortion back to the states and igniting a firestorm of abortion-related political fights all over the country, he sought to turn down the heat on the issue by, well, leaving the issue up to the states.

The Arizona ruling immediately revealed the political perils of that strategy. Republicans around the state, including the Senate candidate Kari Lake and at least two congressmen seeking re-election, slammed the ruling. The Biden campaign swiftly moved to depict Trump as responsible for removing the national abortion protections in Roe that had prevented old laws like that from taking effect.

“That will be straightened out,” Trump told reporters Wednesday as he arrived in Georgia before a fund-raiser. “I’m sure that the governor and everybody else are going to bring it back into reason.” (The Trump campaign did not return a request for comment.)

Trump’s allies on the religious right, meanwhile, were deeply disappointed with what they see as a flip-flop. Their alliance with Trump had always been uneasy — Trump called himself “pro-choice” in the late 1990s, but by 2011 had reversed his position entirely, calling himself “pro-life.” He won over evangelical support during his 2016 presidential race by promising to appoint anti-abortion judges.

“Scripture advises us, in Psalm 146 actually, to not place our trust in princes or kings or candidates for that matter,” said F. Brent Leatherwood, the president of the Ethics & Religious Liberty Commission, which is the policy wing of the Southern Baptist Convention. “These are people that are unreliable and inconsistent.”

Personal misgivings, but a long defense of Roe

It used to be Biden who was accused of modulating his position on abortion over politics, frustrating activists on both sides of the issue.

“Joe Biden moans a lot and then usually votes against us,” a top Planned Parenthood official told The Wall Street Journal in 1986. In the same piece, an official with National Right to Life complained he had “made a political judgment that he should be more pro-abortion.”

For much of his career, Biden supported the Hyde Amendment but also took votes in support of Roe. Over the years, he has spoken repeatedly of his discomfort with the procedure, including at a fund-raiser in February.

“I’m a practicing Catholic,” Biden said, according to a transcript provided by the White House. “I don’t want abortion on demand, but I thought Roe v. Wade had it right.”

Comments like that, as well as his well-documented reluctance to use the word “abortion,” have frustrated advocates who work on the issue.

“Whatever internal thoughts and feelings he might have on it personally, he’s the president of the United States,” said Kellie Copeland, the executive director of Pro-Choice Ohio. “People are suffering because they can’t access abortion. He should say that directly and plainly.”

Lauren Hitt, a spokeswoman for the Biden campaign, said that the president had long fought to protect abortion rights, and disputed the comparison between Trump and Biden. “For more than 50 years, Joe Biden has fought to protect Roe and women’s right to choose. As a senator, he voted repeatedly to protect Roe, and as president, he has used his full executive authority to fight back on extreme MAGA abortion bans,” Hitt said.

Biden’s leftward shift on abortion rights might lag behind some in his party — but it reflects decades of engagement with the issue, according to my colleague Lisa Lerer, who with Elizabeth Dias is writing an upcoming book on the fall of Roe.

Biden, Lisa said, has probably thought more deeply about abortion than any president in the modern era.

What Democrats learned in Alabama

News this week thrust abortion squarely into the middle of races around the country, and Democrats see the issue as advantageous to them in November. A recent victory in Alabama could offer them a blueprint for making reproductive rights central to their campaigns. I asked my colleague Maya King to tell us what she learned after a recent reporting trip to that district.

Marilyn Lands, 65, a licensed therapist in Huntsville, Ala., publicly shared her own abortion story from more than 20 years ago in the early weeks of her campaign in a special Statehouse election. But then, after Alabama’s Supreme Court ruled that embryos in test tubes were considered children, imperiling access to the procedure of in vitro fertilization, Lands decided to make her campaign entirely about reproductive rights.

Just 6,000 people turned out for the race, less than 15 percent of Huntsville’s electorate. But Lands flipped the Republican-held seat. Here are two takeaways from her victory:

• Moderate and conservative voters were important, but the Democratic base was crucial. Lands’s victory was bolstered by Democratic turnout in the heavily Black corners of her district in Huntsville. Their enthusiasm, the Alabama Democratic state party chair said, was a major factor in her 25-point win.
• First-person stories made a big difference. Lands did not share her abortion story during her first campaign in 2022, as she and her team felt the shock of the overturn of Roe v. Wade would be enough to move voters. But after sharing it publicly before the special election, it allowed her to reach voters who might not have otherwise had much interest in her race. Many, she said, were conservatives who felt the government had overextended its hand in its role in women’s health.

“A lot of people have sort of tuned out. And I think maybe now they’re going to tune back in because they see that it can happen,” Lands told me of her victory in an interview in her home in Huntsville last week. “We have caught a moment.”

—Maya King

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A woman whose fetus was unlikely to survive called more than a dozen abortion clinics before finding one that would take her, only to be put on weekslong waiting lists. A teen waited seven weeks for an abortion because it took her mother that long to get her an appointment. Others seeking the procedure faced waits because they struggled to travel hundreds of miles for care.

Such obstacles have grown more common since Roe v. Wade was overturned in June 2022, doctors and researchers say, causing delays that can lead to abortions that are more complex, costly and in some cases riskier — especially as pregnancies get further along.

About half of U.S. states now have laws that ban or restrict access to abortion. Because of that, many clinics don’t offer the procedure, which has increased demand for appointments at the remaining providers.

At various points since Roe, waits in several states stretched for two or three weeks, and some clinics had no available appointments, according to results of a periodic survey spearheaded by Middlebury College economics professor Caitlin Myers and recently provided to The Associated Press. Doctors and researchers say even as wait times have lessened, people still encounter other challenges, like planning and paying for travel, taking time off work and finding child care.

“All of those things can contribute to delays, and then it kind of becomes like this vicious circle,” said Dr. Daniel Grossman, an OB-GYN at the University of California, San Francisco, who co-authored a research report earlier this year that compiled anecdotes from health care providers after Roe was overturned.

People may miss the window for medication abortions, which are not generally offered past 10 to 11 weeks gestation. A dwindling number of clinics provide abortions as people move through the second trimester, which begins at 13 or 14 weeks. Costs for the procedure change, too, from up to $800 in the first trimester to $2,000 or more in the second trimester.

“While abortion is safe at all points in pregnancy,” with an overall complication rate of 2%, it “does get more complicated as the pregnancy continues,” said Dr. Colleen McNicholas, chief medical officer at Planned Parenthood of the St. Louis Region. “It does carry additional risks.”

Rising demand pushes up waits

At least 66 clinics in 15 states stopped providing abortions in the 100 days after Roe was overturned, according to an analysis last year by the Guttmacher Institute, a research group that supports abortion rights.

The necessity for people to travel out of state is at the root of abortion delays.

Clinics run by Planned Parenthood of the Rocky Mountains, which operates in Colorado, New Mexico and southern Nevada, saw out-of-state patients more than double after Roe. And Planned Parenthood of the St. Louis Region’s health center in Fairview Heights, Illinois, saw a 715% increase in patients from outside of Illinois or Missouri in the year after Roe.

“We know that abortion bans have caused a ripple effect and increased wait times even in states where access is protected,” McNicholas said.

The ongoing Myers Abortion Appointment Availability Survey called more than 700 facilities across the United States. Its latest survey, conducted in September, found that 11 states had median appointment wait times of more than five business days and four states had waits of at least eight business days, not counting weekends or holidays. The longest wait was in Iowa: 12 business days.

A year earlier, the survey found Iowa had a median wait of 13 business days, and six other states had waits between 12 and 15 business days.

Planned Parenthood of the Rocky Mountains told the AP that wait times peaked at 28 days shortly after the U.S. Supreme Court decision, though it later fell. Before June 2022, waits in the region’s Planned Parenthood clinics averaged 17 days, reflecting restrictions in Texas that were put into place in 2021.

In the report from Grossman’s team, a health care worker described how it took one mom seven weeks to get an appointment for her pregnant teen, who was about 17 weeks along by then. Another patient described in the report was also that far along by the time she got an abortion after struggling for six weeks to find an appointment. She drove 10 hours to a different state for care.

The latest statistics from the U.S. Centers for Disease Control and Prevention are from 2021 and show that about 7% of abortions took place at 14 weeks or later.

While there’s no way to know definitively whether delays have pushed more abortions into the second trimester, several providers said they’ve seen the number rise in their own clinics. The St. Louis region’s Planned Parenthood, for instance, tracked a 35% increase in the number of patients getting abortions at 14 weeks or later at the Southern Illinois health center in the year after the Supreme Court decision.

Dr. Rebecca Cohen, an OB-GYN at a hospital-affiliated clinic in Colorado, said her team has cared for an increasing number of patients seeking abortions later in pregnancy, some of whom “have experienced several weeks of delays” trying to find care.

Jillaine St.Michel struggled to find somewhere to have an abortion late last year after learning that her 20-week fetus had multiple genetic and developmental problems and probably wouldn’t survive. She lives in Idaho, which has a ban on abortions, so St.Michel and her husband called about 15 out-of-state clinics, finally getting on a three-week waiting list in Denver and a two-week waiting list in Seattle.

St.Michel, 37, said she worried about passing abortion time limits: Colorado allows abortion at all stages of pregnancy, while Washington state allows the procedure up to viability, the point a fetus may survive outside the womb. Some babies can survive with medical help at 22 or 23 weeks.

A chance cancellation opened up a spot in Seattle four days after she called to get on the list. Still, she said, “we absolutely felt the time crunch.”

Dealing with a deluge

Clinics have taken numerous steps to reduce waits, such as adding more telehealth appointments for medication abortions, staying open longer and adding more staff. That’s generally brought appointment wait times down and also helped people obtain other types of reproductive care at the clinics in a timely fashion.

“If someone’s sexually active and they don’t want to become pregnant, we want to get them on birth control,” said Adrienne Mansanares, president and CEO of Planned Parenthood of the Rocky Mountains. “If they are experiencing symptoms of a sexually transmitted infection … we want to get them treated.”

But streamlining appointments is only part of the answer to reducing abortion delays, providers said. Individual issues like child care problems, canceled flights and financial concerns can be tough to overcome — even when clinics try to help by connecting patients to abortion funds, for instance.

This is especially difficult as travel distances grow longer. Research by Myers and colleagues found the average driving distance to the nearest clinic rose substantially in some states after Roe. From March 2022 to September 2023, it shot up from 34 to 160 miles in Alabama and from 43 to 499 miles in Texas.

The clinic where St.Michel, a chiropractor, had an abortion is about 500 miles from her home. She and her husband quickly came up with about $4,000 for airplane tickets, a rental car, three nights of lodging and the procedure, since the clinic was out of network for her insurance. The couple decided not to turn to an abortion fund because they thought others needed it more, instead taking it out of their savings.

Hoping to help other families, she joined a lawsuit filed by the Center for Reproductive Rights, an organization of lawyers and advocates that supports abortion rights. The suit asks state courts in Idaho and Tennessee to place holds on abortion laws.

“I personally can’t imagine that most people would be able to make this work,” said St.Michel, who is pregnant again. “This is not how we should have to seek health care.”

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Donald Trump “flip-flipped” on abortion, overreached in response to COVID-19 and failed to uphold his campaign pledge to get Mexico to pay for a wall on the southern U.S. border, Florida Gov. Ron DeSantis said Tuesday in Iowa.

DeSantis, who is in a distant second place behind Trump in most national polls in the battle for the 2024 Republican presidential nomination, stepped up his case against the former president during a CNN town hall in Des Moines five weeks before the state’s first-in-the-nation caucuses.

He zeroed in on abortion in a state where evangelical voters form the backbone of the GOP, contrasting Trump’s recent skepticism about strict anti-abortion laws with his earlier comments about protecting the sanctity of life.

“You should be consistent in your beliefs, especially on something that’s very fundamental, and he has not been consistent,” DeSantis said. “And there’s a lot of voters in Iowa who really care about this, who need to know how he’s changed his position.”

DeSantis last month picked up the endorsement of Bob Vander Plaats, a prominent Iowa evangelical leader who has also questioned Trump’s commitment to the anti-abortion movement. Trump has responded by emphasizing his support from more than 150 pastors around the state.

Abortion has become a flashpoint in U.S. politics since a Supreme Court majority shaped by Trump’s three appointments eliminated the constitutional right to abortion, helping to power unexpectedly strong Democratic performances in the 2022 midterms. Trump has not backed a national abortion ban and has criticized the way many Republican politicians talk about the issue. He has implied that a Florida law DeSantis signed, which outlaws abortions after about six weeks of pregnancy, is “ too harsh.”

Asked about the case of Kate Cox, a Texas woman who sought an abortion when her health deteriorated as she carried a fetus with a fatal condition, DeSantis was vague. He said “these are very difficult issues” and pointed to the Florida law’s exceptions allowing abortions when the mother’s life is in danger, though in Cox’s case, the Texas Supreme Court ruled that her pregnancy complications did not constitute the kind of medical emergency under which abortions are allowed.

DeSantis has staked his campaign on a strong showing in Iowa’s leadoff caucuses on Jan. 15, but he’s struggled to break out of a distant second place. Like most of his rivals, he has largely treated the front-runner gingerly, avoiding direct criticism of Trump, who remains popular with GOP primary voters.

But sprinkled through the CNN town hall was a case to Trump-supporting voters that it’s time to move on. Trump, he said, is no longer the colorful “America First” advocate whom Republicans embraced in 2016.

“Now a lot of it’s about him,” DeSantis said.

And he worked to pierce rosy memories of Trump’s tenure in the White House. He said Trump erred in his response to COVID-19, an issue that helped catapult DeSantis to GOP prominence when he refused to go along with strict lockdowns that most other governors imposed early in the pandemic.

“The first three years of the Trump administration, the economy’s better than it has been, but that last year with COVID, I think was mishandled dramatically,” DeSantis said. “Shutting down the country was a huge mistake. Printing trillions and trillions of dollars was a huge mistake.”

DeSantis also took aim at one of the defining themes of Trump’s first run for the White House: his promise to build a wall along the U.S.-Mexico border and have the Mexican government pay for it.

“That didn’t happen,” DeSantis said. “And why didn’t it happen? Well, one, I think he got distracted, and he didn’t do it on day one. But, two, he didn’t utilize the levers of power that he had.”

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NAIROBI, Kenya (AP) — The graves at the edge of the orphanage tell a story of despair. The rough planks in the cracked earth are painted with the names of children, most of them dead in the 1990s. That was before the HIV drugs arrived.

Today, the orphanage in Kenya’s capital is a happier, more hopeful place for children with HIV. But a political fight taking place in the United States is threatening the program that helps to keep them and millions of others around the world alive.

The reason for the threat? Abortion.

The AIDS epidemic has killed more than 40 million people since the first recorded cases in 1981, tripling child mortality and carving decades off life expectancy in the hardest-hit areas of Africa, where the cost of treatment put it out of reach. Horrified, then-President George W. Bush and the U.S. Congress two decades ago created what is described as the largest commitment by any nation to combat a single disease.

The program, known as the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, partners with nonprofit groups to provide HIV/AIDS medication to millions around the world. It strengthens local and national health care systems, cares for children orphaned by AIDS and provides job training for people at risk.

Now, a few Republican lawmakers are endangering the stability of the program, which officials say has saved 25 million lives in 55 countries from Ukraine to Brazil to Indonesia. That includes the lives of 5.5 million infants born HIV-free.

At the Catholic-run Nairobi orphanage, program manager Paul Mulongo has a message for Washington.

“Let them know that the lives of these children we are taking care of are purely in their hands,” Mulongo says.

The issue of abortion has been a sensitive one since PEPFAR’s inception in 2003. But each time the program came up for renewal in Congress, Republicans and Democrats were able to put aside partisan politics to support a program that’s long been seen as the vanguard of global aid.

“Most eras in countries are measured by loss of life in war and famine and pandemic,” said Tom Hart, president of the ONE Campaign, a nonpartisan organization that worked with Bush, a Republican, to create the program. “This era has been measured in lives saved.” The campaign has published a letter from dozens of faith leaders to Congress calling PEPFAR “a story of medical miracles and mercy.”

But the bipartisan support is cracking as the program is set to expire at the end of September. The trouble began in the spring, when the Heritage Foundation, an influential conservative Washington think tank, accused the Biden administration of using PEPFAR “to promote its domestic radical social agenda overseas.”

The group pointed to new State Department language that called for PEPFAR to partner with organizations that advocate for “institutional reforms in law and policy regarding sexual, reproductive and economic rights of women.” Conservatives argued that’s code for trying to integrate abortion with HIV/AIDS prevention, a claim the administration has denied.

In language echoing the early, harsh years of the epidemic, Heritage called HIV/AIDS a “lifestyle disease” that should be suppressed by “education, moral suasion and legal sanctions.” It recommended halving U.S. funding for PEPFAR, saying poor countries should bear more of the costs.

Shortly after that, U.S. Rep. Chris Smith, a longtime supporter of PEPFAR who wrote the bill reauthorizing it in 2018, said he would not move forward with reauthorization this time unless it barred nongovernmental organizations that used any funding to provide or promote abortion services. He said he came to this decision after having extensive conversations with stakeholders involved.

And the threat from the New Jersey Republican comes with weight: He chairs the U.S. House Foreign Affairs subcommittee with jurisdiction over the program’s funding.

Because that proposal faces stiff opposition from congressional Democrats, Smith, with support from prominent anti-abortion groups, wants to cut PEPFAR’s usual five-year funding to one year if that ban is not included. He said that way the program would remain funded at its highest level — $6.7 billion — while allowing lawmakers to annually to revisit contracts with partners they believe may support or provide abortion services.

The proposal would also include a measure that requires at least 10% of funds to be directed to NGOs like the Nairobi orphanage, which targets orphans and vulnerable children affected by HIV/AIDS.

“It’s a false narrative that says that you can’t do (the program) year by year as we try to protect the unborn child,” Smith told The Associated Press.

But supporters of the program say that under existing U.S. law, partners are already prohibited from using its funding for abortion services. The head of PEPFAR, John Nkengasong, told the AP he knew of no instance of the program’s money going directly or indirectly to fund abortion services.

He warned that any instability in the flow of U.S. funding for PEPFAR could have dangerous implications for health globally, including in the United States. The key to controlling AIDS, he said, is the assurance that infected people have a pill to take each day.

Without that, the virus could come back, ”and about 20 million lives might be lost in the coming years,” he said. “The fragile gains that we’ve achieved will be lost.”

In Africa, many PEPFAR partners and recipients in largely conservative countries don’t support abortion either because of religious beliefs. But the idea that the program reliant on the steady supply of HIV drugs could be subject to political winds is a cause for alarm.

“If PEPFAR goes, who is going to meet that cost?” asked Josephine Kaleebi, who leads an organization in Uganda that helped the program’s first-ever recipient of HIV treatment medication.

“We are proud to say that the first recipient is alive,” Kaleebi said.

The group, Reach Out Mbuya Community Health Initiative, was founded by members of Uganda’s Catholic Church, which is against abortion. In the reception area, portraits of priests line the walls.

But Reach Out helps anyone who walks in needing HIV drugs, Kaleebi said. About 6,000 people are served, many of them “the extremely most vulnerable” from one of the poorest areas of the capital, Kampala.

Mark Dybul, who helped create and lead PEPFAR under Bush, warned that weakening PEPFAR would also hurt the diplomatic goodwill the U.S. has created in developing regions.

“It’s no secret that we are in a geopolitical struggle for influence in Africa with Russia and China,” he said. “And our biggest influence in many ways, visible and most impactful, is PEPFAR.” A spokesperson for former president Bush declined comment.

In neighboring Kenya, Bernard Mwololo believes he is alive because of the drugs that PEPFAR provides. “Sometimes it’s so crazy when you hear people saying that these HIV drugs should be bought by the local government,” he said. “I am telling you, they can’t manage it.”

The 36-year-old, now an HIV activist, has lived most of his life at the Nairobi orphanage after his parents died of AIDS. He recalled arriving and learning that he could have hope. He was enrolled in a better school, was given a bicycle and ate balanced meals.

The number of children in sub-Saharan Africa newly orphaned by AIDS reached a peak of 1.6 million in 2004, the year that PEPFAR began its rollout of HIV drugs, researchers wrote in a defense of the program published by The Lancet medical journal last month. In 2021, the number of new orphans had dropped to 382,000.

Deaths of infants and young children from AIDS in the region have dropped by 80%.

Now the orphanage is transformed. Children dart around playing soccer or swing in the colorful play area. Some are among the 1.4 million children and adults living with HIV in Kenya, according to UNAIDS. More than 1 million have received free HIV drugs because of PEPFAR.

Stopping PEPFAR would be like committing “global genocide,” said Mulongo, the orphanage program manager.

He recalled how helpless he felt watching children die before HIV drugs were readily available. Almost two decades ago, they would lose at least 30 children a month to AIDS.

Elsewhere in Nairobi, 16-year-old Idah Musimbi is part of a generation that has grown up without the fear that an HIV diagnosis was a likely death sentence.

She displayed the pills that have given her a sense of normalcy. She contracted HIV at birth.

“I don’t think I would live for long if these drugs stopped coming. My grandparents cannot afford to buy food every day, let alone these ARVs,” she said.

Her grandfather David Shitika, a pastor, said he owes the lives of his granddaughter and her mother to PEPFAR. His daughter was diagnosed with HIV in 1995, when many people were dying.

“It was called the slimming killer disease,” he said. “Nobody wanted to live with an infected person, and those who died were wrapped in nylon bags before burial” for fear of infection.

Now he hopes that the Republicans’ threat to PEPFAR will fade, and that his granddaughter will go on to study law and achieve her dream of becoming a judge.

“I want to tell the American people, God bless you,” Shitika said. “I do not know why you decided to help us.”

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WASHINGTON (AP) — Confidence in the Supreme Court sank to its lowest point in at least 50 years in 2022 in the wake of the Dobbs decision that led to state bans and other restrictions on abortion, a major trends survey shows.

The divide between Democrats and Republicans over support for abortion rights also was the largest ever in 2022, according to the General Social Survey. The long-running and widely respected survey conducted by NORC at the University of Chicago has been measuring confidence in the court since 1973, the same year that Roe v. Wade legalized abortion nationwide.

In the 2022 survey, just 18% of Americans said they have a great deal of confidence in the court, down from 26% in 2021, and 36% said they had hardly any, up from 21%. Another 46% said they have “only some” confidence in the most recent survey.

The drastic change was concentrated among women, Democrats and those who say a woman should be able to get an abortion if she wants one “for any reason,” the survey shows.

Just 12% of women said they have a great deal of confidence in the court in 2022, down from 22% a year earlier and from 32% in 2018. Confidence among Democrats fell to 8% in 2022 from 25% a year earlier. And among those who think abortion should be available to a woman who wants one for any reason, confidence in the court dropped from 25% to 12%.

Even among Republicans, though, confidence has slipped somewhat over the past several years in a court dominated by Republican-appointed conservative justices. Twenty-six percent said they have a great deal of confidence in the court, down from 31% in 2021 and from 37% in 2018.

The survey is conducted using in-person and online interviews over the course of several months. Most interviews were conducted after the court’s conservative majority issued its Dobbs decision in late June that overturned Roe and all were conducted after a draft of the decision was leaked seven weeks earlier.

Support for widely available abortion did not change substantially between 2021 and 2022, but the poll shows support for widely available abortion has increased since 2016, when just 46% said that abortion should be available if a woman wants one for any reason and 54% said it should not. In the new survey, slightly more said it should be available than that it should not be, 53% to 47%.

The difference is driven by skyrocketing support for abortion rights among Democrats, while Republican levels of support are at or near a 50-year low. The 77%-28% split between Democrat and Republicans in their backing for abortion rights is the largest-ever partisan divide on the question.

Large majorities of Americans said they think a woman should be able to have an abortion if her own health is at risk, if there is a strong change of a serious defect in the baby or if the pregnancy was the result of rape.

Multiple states now ban abortion with no exception in cases of rape or incest. Mississippi’s ban has an exception for rape but not incest.

The General Social Survey has been conducted since 1972 by NORC at the University of Chicago. Sample sizes for each year’s survey vary from about 1,500 to about 4,000 adults, with margins of error falling between plus or minus 2 percentage points and plus or minus 3.1 percentage points. The most recent survey was conducted May 5, 2022, through Dec. 20, 2022, and includes interviews with 3,544 American adults. Results for the full sample have a margin of error of plus or minus 3 percentage points.

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RALEIGH, N.C. (AP) — Legislation banning most abortions after 12 weeks of pregnancy will become law in North Carolina after the state’s Republican-controlled General Assembly successfully overrode the Democratic governor’s veto late Tuesday.

The House completed the second and final part of the override vote Tuesday night after a similar three-fifths majority voted for the override earlier Tuesday in the Senate. The outcome represents a major victory for Republican legislative leaders who needed every GOP member on board to enact the law over Gov. Roy Cooper’s opposition.

Cooper vetoed the measure over the weekend after spending last week traveling around the state to convince at least one Republican to uphold his expected veto.

Republicans have pitched the measure as a middle-ground change to state law, which currently bans nearly all abortions after 20 weeks of pregnancy, without exceptions for rape or incest.

The vote came as abortion rights in the U.S. faced another tectonic shift with lawmakers considering sharply limiting abortion both in North Carolina and South Carolina, two of the few remaining Southern states with relatively easy access.

Nebraska joined the two states in debating abortion restrictions Tuesday that are possible because the U.S. Supreme Court last year struck down the landmark 1973 Roe v. Wade ruling, which established a nationwide right to abortion.

Under another bill up for a vote Tuesday in the South Carolina House, abortion access would be almost entirely banned after about six weeks of pregnancy — before women often know they’re pregnant. The South Carolina state Senate previously rejected a proposal to nearly outlaw abortions.

Abortion is banned or severely restricted in much of the South and is now banned throughout pregnancy in Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee, Texas and West Virginia. In Georgia, it’s allowed only in the first six weeks.

The Carolinas, Florida and Virginia are now the main destinations in the region for those seeking legal abortions. Florida has a ban that kicks in 15 weeks into pregnancy. Under a recent law, that would tighten to six weeks pending a court ruling. Further west, women often travel to Illinois, Kansas, New Mexico or Colorado.

Nationally, bans on abortion throughout pregnancy are in effect in 14 states.

If both the North and South Carolina bans become law, combined with Florida’s recent ban, “it would be just devastating for abortion access in the South,” Jamie Lockhart, executive director of Planned Parenthood Advocates of Virginia, said Tuesday.

During the North Carolina Senate debate, Republicans said Cooper ignored $160 million within the measure that would boost funding to increase contraceptive services, reduce infant and maternal mortality and provide paid maternity leave for state employees and teachers.

“North Carolinians watching this debate, you are bearing witness to exaggerated and extremist objections from some Democrats,” Republican Sen. Vickie Sawyer of Iredell County said. “Their anger is that this bill is mainstream and a common-sense approach to a very difficult topic.”

Democrats focused on details of the abortion rules, which they said would place barriers between women and their doctors, leaving those who are pregnant in danger.

And the 12-week cutoff means that young women will have potentially only a couple of weeks to decide whether an abortion is the right decision, leading them to continue with unwanted pregnancies, Democratic Sen. Natasha Marcus of Mecklenburg County said.

“This bill is a slap in the face. It is a muzzle over our mouths, and it is a straitjacket on our bodies,” Marcus said. After the Senate vote, loud chants of “Shame!” could be heard outside the chamber doors.

Anti-abortion protesters who arrived hours before the vote packed the North Carolina Senate gallery, with about 150 supporters of the proposed ban holding identical “Vote Pro-Life” signs.

“So many Republicans have just keeled over from pressure from all the groups who are just filled with hate and are pushing things that are going against God,” said Sharon Dooley, 63, of Garner, North Carolina.

In South Carolina, the impasse dates back to a special session last fall when House lawmakers demanding a near-total ban did not meet to negotiate with their Senate counterparts pushing for a ban around six weeks.

The stalemate persisted even after the state Supreme Court in January struck down a previous law banning abortions once cardiac activity is detected.

That decision left abortion legal through 22 weeks of pregnancy. A sharp increase in abortions since then has rankled Republicans.

The House was weighing a Senate bill similar to the one they denied last year. The measure would ban abortion when an ultrasound detects cardiac activity, around six weeks.

A late night is expected even after Republicans invoked rules to limit debate. House Speaker Murrell Smith has said the chamber will not adjourn until the measure gets approval. Democrats slowed the process Tuesday by speaking for all three allotted minutes on each of their hundreds of amendments and forcing other procedural votes.

Lawmakers in Nebraska were debating a proposal that would ban abortion at 12 weeks of pregnancy. The proposal comes after lawmakers rejected a bill last month that would have banned abortion after cardiac activity is detected.

This latest proposal is tacked onto a bill that would ban gender-affirming care for transgender minors. Conservatives in Nebraska’s unique single-chamber, officially nonpartisan Legislature will need 33 out of 49 votes for these proposals to advance.

In Montana, Republican Gov. Greg Gianforte’s office announced Tuesday that he had signed into law a bill that makes performing the abortion method most commonly used after 15 weeks of gestation a felony. Planned Parenthood of Montana asked a judge to temporarily block the ban on dilation and evacuation abortions.

A separate challenge to abortion access will be considered Wednesday, when a federal appeals court hears arguments on whether the Food and Drug Administration’s approval of the widely used abortion drug mifepristone should be overturned. A three-judge panel of the 5th U.S. Circuit Court of Appeals will review a ruling last month by a federal judge in Texas who ordered a hold on approval of mifepristone, a decision that overruled two decades of scientific approval of the drug. That ruling was stayed while the appeal is pending.

The three judges who will hear the case each have a history of supporting restrictions on abortion. A ruling is not expected immediately.

___

Lavoie reported from Richmond, Virginia. Associated Press writers James Pollard and Jeffrey Collins in Columbia, South Carolina, Geoff Mulvihill in Cherry Hill, New Jersey, Amy Beth Hanson in Helena, Montana and Sarah Rankin in Richmond, Virginia contributed to this report. Schoenbaum and Pollard are corps members for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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LOS ANGELES (AP) — California has joined with law firms and advocacy groups to create a hotline that provides access to information and pro bono services for people who need legal help related to abortion, as the state seeks to become a safe haven for reproductive rights since Roe v. Wade was overturned.

State Attorney General Rob Bonta and officials with the Southern California Legal Alliance for Reproductive Justice made the announcement Tuesday, one year since the U.S. Supreme Court draft decision reversing Roe was leaked.

Calling it a “dark anniversary,” Bonta said that in the ensuing year the national legal landscape surrounding abortion has become “confusing, and frankly, scary.”

He said the new coalition seeks to put patients and care providers at ease by providing a wide range of legal services to people in places where abortion is restricted — including pro bono representation for anyone facing civil or criminal penalties for seeking, providing or assisting in reproductive care.

“They aren’t alone. We’re here. We have support. We have resources. We have guidance, we have counsel for you,” Bonta said at a news conference.

In addition, legal experts will offer guidance about compliance amid shifting restrictions in various states, advice about protecting sensitive health data and support for amicus briefs to advance reproductive rights.

“Unforgiving abortion bans and the devastating health consequences that follow are galvanizing advocates, providers and law firms,” said Lara Stemple, director of the Legal Alliance for Reproductive Justice.

Threats of jail time, fines or protracted legal battles have already caused providers to deny critical care and forced patients to turn to unsafe measures, officials said.

The state and the legal alliance will get support from groups including Planned Parenthood, Access Reproductive Justice, the National Women’s Law Center and the University of California, Los Angeles, Law Center on Reproductive Health, Law, and Policy.

The California coalition will align with the Abortion Defense Network, a national nonprofit that provides similar advice, representation and funding to help pay legal expenses related to abortion care, Stemple said.

“So the network is vast and growing,” she said. “I’m confident that we would be able to connect any abortion provider in any place in the United States with lawyers who would be willing to help.”

Last June, the Supreme Court overturned Roe v. Wade, the 1973 decision that had provided a constitutional right to abortion. The ruling has led to abortion bans in roughly half the states.

In anticipation of the decision, California and other states led by Democrats have taken steps to protect abortion access. The high court’s decision also set up the potential for legal fights between the states over whether providers and those who help women obtain abortions can be sued or prosecuted.

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DAVENPORT, Iowa (AP) — No elected Republican has done more to restrict abortion rights in the U.S. than Donald Trump.

But in the early days of the 2024 presidential contest, no Republican has worked harder to avoid the issue than the former president. Far more than his GOP rivals, Trump is sidestepping the issue just nine months after he and his party celebrated the Supreme Court’s decision to strip away women’s constitutional right to abortion.

Look no further than Trump’s trip to Iowa last week for evidence of his delicate balancing act.

Moments after he stepped off his plane just outside Davenport, Trump repeatedly refused to say whether he would support a federal law restricting abortion in every state, a move that anti-abortion activists are demanding of the GOP’s presidential contenders.

“We’re looking at a lot of different things,” Trump said when asked twice by The Associated Press whether he supports a federal abortion ban.

The former president quickly shifted the conversation to immigration, the economy and “radical-left lunatics.” And in the hours that followed, he didn’t mention the word “abortion” even once as he chatted with Iowans in a diner, delivered an hourlong speech and took almost a dozen questions from voters.

Trump enters the opening stretch of the GOP primary in a strong position. But he faces a host of challenges in the coming weeks, especially as legal investigations surrounding the former president intensify. In a social media post this weekend, Trump said he expected to be arrested this week as a New York grand jury investigates hush money payments to women who alleged sexual encounters with the former president. Manhattan prosecutors, however, have not been in direct touch with Trump, leaving the timeline of potential charges unclear.

But the ultra-cautious approach on abortion reflects a new political reality for Republicans this presidential season.

Party leaders concede that the GOP’s stunning success in persuading Trump’s remade Supreme Court to overturn Roe v Wade last June ultimately triggered a fierce backlash that boosted Democrats in November’s midterms. And while the 2024 political landscape is far from settled, leaders in both parties acknowledge that few issues may be more significant in the election of the next president than abortion.

Meanwhile, abortion access is disappearing across America.

Since the Supreme Court overturned Roe just nine months ago, 24 states have banned abortion outright or are likely to do so, according to the Guttmacher Institute. Other states with Republican-controlled legislatures, including Florida, are moving toward restrictive laws that would ban abortion as soon as six weeks of pregnancy.

The next step, according to anti-abortion leaders already playing a vocal role in the GOP’s 2024 presidential primary, is to adopt a federal law that would force abortion restrictions upon every state.

Majorie Dannenfelser, who leads the socially conservative organization Susan B. Anthony Pro-Life America, is pushing for a law banning abortions nationwide at 15 weeks of gestation — if not sooner. She said she has spoken privately with most of the GOP’s prospective field, including Florida Gov. Ron DeSantis, and believes they would all embrace such a federal ban.

And while she’s generally pleased by her conversations with the 2024 field so far, she has noticed Trump’s lack of public commitment to continued abortion restrictions in recent weeks.

“No one gets a pass,” Dannenfelser said, acknowledging that Roe would have not been overturned without Trump’s three Supreme Court appointments. “With Trump, this is his legacy. It’s something that I believe he will get right, but he’s clearly doing some soul searching right now.”

Meanwhile, Trump’s rivals in the nascent presidential primary field have not shied away from their aggressive abortion plans as they court primary voters.

In Florida, a DeSantis-backed measure to ban abortion after six weeks of pregnancy — before many women realize they’re pregnant — is moving through the Republican-controlled state legislature. Democrats there admit there’s nothing they can do to prevent the bill from becoming law, which DeSantis is using to strengthen his conservative bona bides ahead of a formal presidential announcement expected in the coming months.

Former Vice President Mike Pence, another likely 2024 contender who has long promoted religious conservatism, has been one of the GOP’s most aggressive anti-abortion voices since the Supreme Court’s ruling. On the campaign trail in recent weeks, he highlighted his commitment to go further.

Last month in New Hampshire, a state long known for protecting abortion rights, Pence openly vowed to support a federal abortion ban if elected.

“If I was in the Congress of the United States or in a job at the other end of Pennsylvania Avenue, and they put a policy in front of me to limit abortions in the country, I’d certainly support it,” Pence said in a radio interview. He added that the issue would likely be decided by each individual state, however.

Nikki Haley, who launched her Republican presidential bid a month ago, also believes the issue will be resolved at the state level, despite her personal wishes.

She discussed the possibility of a 15-week federal ban during a February interview on the “Today” show. In a New Hampshire radio interview earlier this month, she reminded voters that she signed into law a 20-week ban while South Carolina governor.

“I can tell you that if it were up to me, every single state would be pro-life,” Haley said. “But I think the people need to decide that.”

South Carolina Sen. Tim Scott, another likely Republican 2024 prospect, celebrated the Supreme Court’s Roe reversal last summer with his party. Last fall, he headlined a gala for Susan B. Anthony Pro-Life America, which is fighting for a federal ban.

Democrats are closely tracking the Republican White House hopefuls, knowing that aggressive anti-abortion rhetoric and policies will likely alienate key groups of voters — especially swing voters in the suburbs — in the 2024 general election.

“Republicans are not going to be able to hide from their extremist anti-abortion rights agendas in the 2024 presidential election,” said Alexandra De Luca of American Bridge, a pro-Democrat super PAC. “American Bridge and the Democratic Party will hammer Republican presidential candidates early and often, making it impossible for whoever emerges to walk back their extremist views during the general election.”

More than his Republican opponents, Trump seems acutely aware of such political risks.

Before the 2022 midterms, he tried to persuade some of his preferred candidates to back off hard-line abortion positions — especially those that opposed exceptions in cases of rape, incest or life of the mother.

In distancing himself from aggressive anti-abortion policies, however, Trump opens himself up to a new set of challenges with religious conservatives.

Already, some evangelical leaders have withheld their endorsement. Trump said such moves are “a sign of disloyalty” in an interview with David Brody of the Christian Broadcasting Network. And he accused anti-abortion leaders of failing to do enough to help GOP candidates in the midterms, which hasn’t sat well with some evangelicals.

Bob Vander Plaats, the president of Iowa’s Family Leader, said that abortion remains “a character-defining issue” that helps voters determine whether they can trust candidates or not.

So far, he said, it’s unclear whether evangelicals can trust Trump in 2024.

“While we’re thrilled that he gave us justices to overturn Roe v. Wade, and we’re thrilled he did other things on abortion, frankly I think there’s a big question mark out there,” Vander Plaats said. “Where is he on the sanctity of life? Does he really believe what he says he believes? When he’s pivoting and when he doesn’t want to talk about it and when he throws the pro-life community under the bus, those are all indicators that give us more cause for pause.”

Trump’s campaign pushed back against such concerns.

Campaign spokesman Steven Cheung listed Trump’s “unmatched” record on abortion, highlighting Trump’s Supreme Court nominations, his moves to block taxpayer-funded abortion and his decision to reinstate the “Mexico City” policy that required nongovernmental organizations as a condition of funding not to promote abortion as a family planning method in other countries.

“There has been no bigger advocate for the movement than President Trump,” he said.

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WASHINGTON (AP) — A federal judge heard arguments Wednesday in a lawsuit that poses a threat to the nationwide availability of a leading abortion medication. The hearing comes as a conservative Christian group seeks to reverse federal approval of the drug mifepristone.

A two-pill combination of mifepristone and another drug is the most common form of abortion in the U.S. and the ruling would affect states where abortion is legal as well as those that outlaw it. The case has raised concerns about court transparency and so-called judge shopping.

Here’s a look at some of the legal issues surrounding the case:

HOW DID THE ABORTION PILL CHALLENGE START?

Abortion opponents who helped overturn Roe v. Wade filed a lawsuit in November, asking a judge in Texas to reverse the approval of mifepristone.

Research shows that medication-induced abortions are safe and effective, and they were approved by the Food and Drug Administration more than 20 years ago.

But the group, Alliance Defending Freedom, argued in the lawsuit that the FDA process was flawed for mifepristone. It also took aim at more recent changes that have eased access to the drug.

The suit was filed in Amarillo, Texas, which meant that it was assigned to U.S. District Judge Matthew Kacsmaryk, a former attorney at a Christian law firm who previously wrote critically about Roe. He was appointed by former President Donald Trump and confirmed over fierce opposition from Democrats.

WHY IS IT IMPORTANT?

Medication is the most common form of abortion in the U.S., according to the Guttmacher Institute, a research group that supports abortion rights. It’s become more available as the FDA allowed it to be prescribed online and sent through the mail. Demand continued as states began banning abortion after Roe was overturned and more women traveled for access, or sought medication online.

If Kacsmaryk reverses the approval of mifepristone, it could restrict access nationwide. Such a ruling would be an unprecedented challenge to the FDA, which approved mifepristone in combination with a second pill, misoprostol, as a safe and effective method for ending a pregnancy in 2000.

That would be “nothing short of catastrophic,” a group of 22 Democratic-led states said in court documents filed in the case. Another group of 22 Republican states filed briefs supporting the reversal. They argue the ability to order pills by mail undermines their laws banning abortion.

WHY IS THIS IN THE HANDS OF ONE TEXAS JUDGE?

Kacsmaryk is a federal judge and one of the major tasks of the U.S. court system has always been deciding whether laws and policy are constitutional. That means any judge weighing a case challenging a federal law or policy could make a decision that has ripple effects across the nation.

Lawyers on either side of a case can appeal a ruling, however, and federal appeals courts can block or overturn a decision. In this case, an appeal would go to the 5th Circuit Court of Appeals, which also leans conservative. It upheld Kacsmaryk’s decision in another high-profile case requiring the Biden administration to continue the “Remain in Mexico” immigration policy implemented by Trump. The ruling was later overturned by the Supreme Court.

The case has also raised concerns about judge shopping, a term for litigants seeking to file cases in front of judges they consider sympathetic to their cause. It’s a tactic that’s been utilized by groups across the ideological spectrum, but the volume of cases filed before Kacsmaryk and other Texas judges has raised concerns among experts.

WHAT SET OFF TRANSPARENCY ALARM BELLS?

Kacsmaryk set the first hearing in the closely watched case on a conference call with attorneys. He also asked them to for the “courtesy” of not publicizing the upcoming arguments, according to a court transcript.

He said he planned to delay making the hearing public until the evening before, making it difficult for many to attend because Amarillo is hours away from major cities. Such a delay is highly unusual in the American judicial system, where hearing notices are typically quickly made public and often scheduled weeks or months in advance.

After news reports about the call, the hearing was placed on the public docket a day and a half before it was scheduled.

WHAT HAPPENS NEXT?

A ruling in the case could come any time after the arguments conclude. A decision against the FDA would almost certainly be swiftly appealed by the Justice Department.

A ruling reversing approval 20 years later is all but unprecedented, so it’s not clear exactly what would happen next or how quickly access might be curtailed. If mifepristone is sidelined, clinics and doctors that prescribe the combination say they would switch to using only misoprostol, the other drug in the two-drug combination, an approach that is slightly less effective.

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Anti-abortion activists will have multiple reasons to celebrate — and some reasons for unease — when they gather Friday in Washington for the annual March for Life.

The march, which includes a rally drawing abortion opponents from across the nation, has been held annually since January 1974 — a year after the U.S. Supreme Court’s Roe v. Wade decision established a nationwide right to abortion.

This year’s gathering — 50 years after that decision — will be the first since the high court struck down Roe in a momentous ruling last June.

Since then, 12 Republican-governed states have implemented sweeping bans on abortion, and several others seek to do the same. But those moves have been offset by other developments. Abortion opponents were defeated in votes on ballot measures in Kansas, Michigan and Kentucky. State courts have blocked several bans from taking effect. And myriad efforts are underway to help women in abortion-ban states either get abortions out of state or use the abortion pill for self-managed abortions.

“It’s almost like the old wild, wild West … everything is still shaking out,” said Carol Tobias, president of the National Right to Life Committee.

With numerous Democratic-governed states taking steps to protect and expand abortion access, Tobias likened the current situation to the pre-Civil War era when the nation was closely divided between free states and slave states.

“I will not be surprised if we have something like that for a few years,” she said. “But I do know that pro-lifers are not going to give up — it’s a civil rights issue for us.”

The theme for this year’s March for Life is “Next Steps: Marching Forward into a Post-Roe America.” Scheduled speakers include Hall of Fame football coach Tony Dungy and Mississippi Attorney General Lynn Fitch, who won the Supreme Court case that overturned Roe.

The president of March for Life, Jeanne Mancini, depicted the June ruling as “a massive victory for the pro-life movement.”

“But the battle to build a culture of life is far from over,” she said. “March for Life will continue to advocate for the unborn and policies that protect them until abortion becomes unthinkable.”

Prospects for any federal legislation restricting abortion nationwide are negligible for now, given that any such measures emerging from the Republican-led House would face rejection in the Democratic-led Senate. The main battlegrounds will be in the states.

Since June, near-total bans on abortion have been implemented in Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas and West Virginia. Legal challenges are pending against several of those bans.

Elective abortions also are unavailable in Wisconsin, due to legal uncertainties faced by abortion clinics, and in North Dakota, where the lone clinic relocated to Minnesota.

Bans passed by lawmakers in Ohio, Indiana and Wyoming have been blocked by state courts while legal challenges are pending. And in South Carolina, the state Supreme Court on Jan. 5 struck down a ban on abortion after six weeks, ruling the restriction violates a state constitutional right to privacy.

The Guttmacher Institute, a research group which supports abortion rights, says the overall result is “a chaotic legal landscape that is disruptive for providers trying to offer care and patients trying to obtain it.”

“When people do not have access to abortion care in their state, they are forced to make the difficult decision to travel long distances for care, self-manage an abortion or carry an unwanted pregnancy to term,” Guttmacher staffers Elizabeth Nash and Isabel Guarnieri wrote last week.

Looking ahead, some anti-abortion leaders hope the Republicans nominate a 2024 presidential candidate who will aggressively push for nationwide abortion restrictions, rather than keep it as a state-by-state matter.

“The approach to winning on abortion in federal races, proven for a decade, is this: state clearly the ambitious consensus pro-life position and contrast that with the extreme view of Democrat opponents,” said Marjorie Dannenfelser, president of SBA Pro-Life America.

Dannenfelser says she’s not surprised by the divisive ups-and-downs that have unfolded since the June ruling.

“This is what it looks like when democracy is restored and we have a voice in the debate,” she said. “For 50 years, we had no voice because the judiciary was always going to shield public opinion from having an effect on the law.”

“We always knew it wouldn’t be a straight line (after Roe’s repeal),” she said, adding “we know neither side is going to lay down and die.”

Multiple public opinion polls since June have found that a majority of Americans support access to legal abortion. According to an Associated Press-NORC Center for Public Affairs Research poll conducted in July, 53% of U.S. adults said they disapproved of the Supreme Court’s repeal of Roe, while 30% approved.

Professor Kathleen Sprows Cummings, director of the University of Notre Dame’s Cushwa Center for the Study of American Catholicism, suggested the anti-abortion movement may suffer from a perception among many Americans that it’s more concerned with controlling women’s bodies than helping them cope with unintended pregnancies.

“It’s about consolidating their political power, more than about babies,” she said.

Some abortion opponents are trying to counter such perceptions. In Texas, for example, anti-abortion groups are urging lawmakers to spend more money on services for pregnant and parenting Texans, including expanding Medicaid coverage for mothers.

According to Texas Right to Life, the state’s new abortion ban has had a major impact — it says only 68 abortions were recorded by state health officials in July 2022, compared to 4,879 in July 2021.

The group noted the data does not include illegal, unreported abortions — which are widely believed to be increasing as women obtain abortion pills by mail from overseas or from Mexico suppliers.

Charles Camosy, a medical humanities professor at Creighton University School of Medicine who opposes abortion, has analyzed the high-profile election defeats suffered by the anti-abortion movement. Voters in Kansas and Kentucky rejected constitutional amendments that would have declared there is no right to abortion; Michigan voters approved an amendment enshrining the right to abortion in the state constitution.

“Pro-lifers have clearly and badly lost the PR battle since June and this has shaped how people are voting,” Camosy said via email. He said abortion-rights supporters were better organized and better funded, while many anti-abortion politicians either avoided the issue or sounded too extreme.

“There are obviously very good things that have happened, however,” added Camosy, citing the drop in abortions reported in states with bans.

“Pro-lifers also now relish the chance to actually debate the issues in a democratic, open context … as opposed to constantly running into the fiats of various courts,” he said. “We may lose some battles early on… but it is worth it to have the debates.”

___

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

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