'Unthinkable' normalised two years after US abortion ruling

• Overturning of Roe v. Wade ruling leaves a nation divided
• Conservative states crack down with new restrictions
• Abortions up in 2023 in 'border' states
• Unthinkable normalised - is there more to come?    

RICHMOND, Virginia - Two years after a seismic U.S. decision to end a woman's constitutional right to an abortion, the fallout keeps on falling as Americans grapple with the day-to-day legacy of the Supreme Court ruling.

From medics to single mothers to abused minors, Americans from all walks of life have been affected by the landmark 2022 decision that paved the way for further restrictions on access to abortion.

Doctors say they now feel at risk of being criminalised. 

Women's lives have been endangered and victims of sex abuse have had to cross state lines to get the medical help denied them at home. 

Some states have even chosen to up the ante and crack down harder on reproductive rights, deepening a national schism.

"Things that were previously unthinkable are becoming more normalised," said Farah Diaz-Tello, who is senior counsel and legal director for the abortion rights legal group If/When/How.

Shortly after the 2022 ruling, Diaz-Tello recalled a social worker calling to say a supervisor had said clients seeking an abortion "had to be reported to law enforcement because abortion was illegal and they were a threat to the unborn child." 

"That is a misunderstanding of the law on so many levels it's staggering," Diaz-Tello said. "People who interact with someone who might have had a self-managed abortion have fear that they will be criminally liable."

Such perceptions and stigmas are just a few of the many lasting effects Americans are feeling ahead of the June 24 anniversary, advocates say.

Many of the effects have been life-changing. 

Women seeking abortions have been tracked down out of state. 

They've been airlifted from hospitals to other states for emergency care. And victims of sexual assault have been told they, too, would need to cross state lines in some cases if they didn't want to carry their child to term.  

'I wasn't dead enough for an abortion'

Women have been most directly affected in conservative states such as Texas, which not only had passed a "trigger ban" on abortion that kicked in shortly after the court decision but moved to impose penalties on people who tried to assist those seeking abortions out of state.

Lauren Miller became pregnant with twins in July 2022, only to be eventually told that one of them would not survive.

She said the medics would stop "mid-sentence...like they were afraid that they would be arrested just for saying the word 'abortion' out loud" - before one specialist tore off his gloves in frustration and told her she would need to leave the state.

"He was right – because just days later, I ended up back in the emergency room vomiting so severely that I feared the placenta would detach and I would bleed out," she told reporters on a recent conference call. 

"I was at risk of organ damage to my kidneys and brain – but I wasn't dead enough for an abortion in Texas."

In another case, a Texas man is pursuing a court order against an ex who traveled to Colorado to get an abortion, where it is legal, aiming for a wrongful death case under Texas law.

"In all polling, over 57% of Texans want abortion to be legal in all or most circumstances. And yet, Texas has an abortion ban that, if you violate it, you're facing 99 years in prison," said Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights.

Elsewhere, minors in Ohio who were subjected to sexual abuse were forced to travel out-of-state to get abortions.

Idaho's largest health system reported an uptick in the number of patients airlifted out of state for emergency abortions after the Supreme Court in January lifted a previous hold on the state's near-total abortion ban.

Anti-abortion advocates have defended the new restrictions and say there are ample laws in place to protect would-be mothers in a post-Roe world.

"Every single state allows for a pregnancy to be ended to save the life of the mother," said Kristan Hawkins, president of Students for Life of America. 

"Now, the ending of the pregnancy usually isn't killing the baby – you deliver the baby. Will that baby survive? Maybe not – but you don't kill the child."

Pressure on providers

Abortions actually increased in 2023 when compared to 2020 – with increases most pronounced in states such as Illinois, New Mexico and Virginia, which border states with a ban - according to the Guttmacher Institute, an abortion rights research group. 

Some Democratic-leaning states have passed "shield laws" protecting providers who take in patients from out of state, and abortion medication remains available by mail in many places.

The Supreme Court last week turned aside a challenge to the federal government's approval of mifepristone, a commonly used abortion medication, maintaining access to the drug for now.

"People need these services, and our movement has been incredibly successful in delivering these services," said Mini Timmaraju, president of the advocacy group Reproductive Freedom for All. 

"But the more successful we are at it, the more crazy the anti-abortion states have become in really pursuing and punishing and tracking and discouraging folks from accessing care."

Physicians are also feeling a chilling effect and are under tremendous pressure not to say or do the wrong thing, said Molly Meegan, general counsel for the American College of Obstetricians and Gynecologists (ACOG).

There are fewer applications to become OB-GYNs and ACOG members have left states with more restrictive laws, she said.

"These laws have really draconian civil and criminal penalties - doctors have never been asked to practice medicine in gray and nuanced areas when their decisions could result in loss of your profession, loss of freedom, loss of your income," Meegan said. "It's been unprecedented."

Advocates on both sides say they are steeling for a battle for the long haul, including at the federal level – either through additional protections or more uniform, national restrictions depending on the outcome of the 2024 elections.

"One of the things that I am more critical of our movement internally (for) has been having this view of looking at 2024," Hawkins said. "(Whereas) I'm waking up every day, the decisions that I'm making – I'm looking at 2044, understanding that this is going to be a long fight."

Miller of Texas said she is proof that real-world consequences are happening right now and that she wasn't sounding an alarm about some hypothetical future.

"I'm sounding the alarm about what has happened to me," she said. "The state of Texas and the Texas Supreme Court have declined to even clarify how dead is dead enough to get an abortion."

(Writing by David Sherfinski; Editing by Lyndsay Griffiths)