Two years after the Supreme Court decision that overturned Roe v. Wade, the national picture on abortion access is inconsistent, disjointed and teetering on the precipice of the coming election.
In several states, ballot measures will, if passed, change state constitutions to enshrine abortion access as a fundamental right. Measures are in the works in Pennsylvania and Nebraska that would change the states' constitutions to ban or further restrict abortion access.
"The Dobbs decision ushered in a new era of American politics," said Rachel O'Leary Carmona, the executive director of Women's March. "It changed for women ... but it also changed for democracy."
The Center for Reproductive Rights tracked changes to state law since the high court ruled on the case known as Dobbs v. Jackson Women's Health Organization. They found 17 states currently have total bans on abortion or bans after six weeks of pregnancy, before many women know they're pregnant. Another eight states restrict it earlier than viability.
On the other hand, 22 states expanded or protected abortion access since the Dobbs decision. In 17 states, providers can care for patients living out of state.
The patchwork makes for an uncertain environment for pregnant people. Kate Cox, a Texas woman who sued the state over abortion after learning her pregnancy was nonviable, is pregnant again. Now, she says, "If I have an emergency, my first call would be my lawyer, and my second call would be my doctor."
This fall, four states will have ballot initiatives that would amend their state constitution to enshrine the right to abortion. Another six are gathering or have submitted signatures to do the same.
In some cases, the measures are part of citizen-led ballot initiatives, a process that puts issues on the ballot with the requisite citizen signatures. That process doesn't exist in half of U.S. states.
The argument against it says it's a potentially dangerous form of direct democracy: Citizens are bypassing their elected representatives to enact or repeal laws.
The concept started in South Dakota in 1898. Just 20 years later, 21 other states had adopted similar measures. Not much has changed since.
Today, in states without a citizen initiative process, the majority isn't always getting what it wants.
In Texas, a state with one of the most restrictive abortion bans in the country, a poll this year from the Texas Politics Project found most Texans think abortion should be legal in many circumstances. In Louisiana, where abortion is almost entirely illegal, a poll last year found 53% of people opposed the law.
In states that have a citizen ballot initiative process, people are organizing to try to get what they want. Take Florida, where abortions are currently banned after six weeks except in limited cases. Citizens organized to put a measure on the ballot this fall that will enshrine abortion access in the state's constitution if it passes. In Nebraska, where a 12-week ban is in effect, citizens are collecting signatures to get three constitutional amendments on the ballot: One to enshrine abortion rights, one to ban abortion in the second and third trimesters, and one to establish fetal personhood.
Trying to realize citizen initiatives in states where they're not currently allowed can be an uphill climb.
In West Virginia, a mayor started a petition to get a ballot initiative process, but it never gained traction in the Republican-controlled legislature. In Tennessee, the Republican House Majority Leader spoke to The Associated Press and, "likened ballot measures to polls rather than what he described as the legislature's strict review of complicated policy-making," the outlet reported.
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