Content Warnings: This article discusses abortions, miscarriages, sexual assault/rape, violence, and/or death.
Four years. That’s how long it will be this upcoming June since the overturning of Roe v. Wade.
Over these past four years, millions of people have had to grapple with the grim reality of living in a post-Roe America. Yet, for many others, the various impacts of the ruling have been a lot less visible.
So, what does post-Roe America really look like today? Who and where does it impact? And what can the average person do about this increasingly difficult reality?
But first…
A (Brief) History of Roe v. Wade
In the early 1970s, abortion was banned in nearly every state, but in 1973, the Supreme Court decision on Roe v. Wade determined that one’s right to (not) continue a pregnancy was protected under the Fourteenth Amendment’s right to liberty. The ruling meant that states could no longer ban or criminalize abortions since they were constitutionally and federally protected, thus making abortions legal, safer, and more accessible across all states.
However, Roe was not an uncontroversial ruling, and for decades, anti-abortion and religious groups fought to overturn the decision.
Then, on May 3, 2022, Politico leaked a draft SCOTUS ruling on Dobbs v. Jackson, which stated the Court’s opinion that “the Constitution does not confer a right to abortion,” and that Roe was soon to be overturned. This SCOTUS ruling was not popularly shared, as a majority of Americans agreed that abortion should be legal — a public opinion that still holds today.
Roe was officially overturned on June 24, 2022, which eliminated the federal protection and constitutional right to abortion, thereby returning abortion access back to a state-level decision.
Post-Roe America: The Policies
But what exactly did this return to the state-level change in terms of abortion access in America?
According to the Center for Reproductive Rights, as of April 2026, 13 states have banned abortions completely, 13 states are hostile (threatening bans and not protecting access to abortion), and five states have no protections for abortions and/or have limited access to them. Of the remaining 25 states, only 11 have expanded their laws to create additional safeguards and care for those seeking abortions since the overturning of Roe.
The inequity of care between states with complete bans versus those with expanded laws that protect abortion is severe.
Take Texas, for example: following the Dobbs decision, in Aug, 2022, Texas’s comprehensive trigger ban on abortion officially went into effect. For comparison, just two years prior, in 2020, over 58,000 abortions were obtained in the state. Post-Roe, many Texans have been significantly harmed by the impacts of the ban, with numerous reports of women being forced to carry their non-viable pregnancies to term or facing deadly delays or denials in their pregnancy care.
Now, compare Texas’s abortion laws to California’s.
California was actually one of the few states that had legalized abortion before Roe v. Wade in 1969, enshrining strong state-level protections for abortion. Post-Roe, California has since introduced multiple shield laws that protect one’s right to abortion and contraceptives, as well as providing additional safeguards for medical practitioners, clinics, and patients. Currently, in 2026, California is ranked as one of the top 10 best states for reproductive rights.
Although these two states are only about 1,400 miles apart, the differences in their policies translate into dramatically different realities for those seeking abortion care.
Post-Roe America: Impacts on Healthcare
As a result of post-Roe bans and restrictive policies, healthcare has been made increasingly difficult for both patients and clinicians.
In a 2024 study, researchers identified abortion bans as a significant barrier to proper healthcare, citing “delayed provision of abortion care” as well as for “ectopic pregnancy…spontaneous pregnancy…and standard-of-care treatment due to the concern of causing an abortion regardless of whether the patient was pregnant or not.”
Some states have also begun to criminalize people for pregnancies that end in miscarriages or stillbirths for “failing to seek immediate medical treatment, not pursuing prenatal care, or disposing of the fetal remains in a way that law enforcement or prosecutors considered improper.” While an estimated 20% of pregnancies end in fetal loss for various reasons, more people are being investigated since the overturning of Roe, since new bans and restrictive policies automatically assume “suspicion that the woman didn’t want her baby or tried to end her pregnancy.”
This criminalization works hand-in-hand with new surveillance protocols, aimed at finding and subsequently investigating individuals suspected of obtaining an abortion through virtual or out-of-state means. Thankfully, some states like Washington and California have added new shield laws that protect your reproductive health data, even if you live out-of-state, helping to safeguard people from investigation.
Post-Roe America is also seeing an uptick in policies threatening and outright restricting birth control. For example, some states have opted to require parental consent or notification if a minor wants to obtain birth control, while others have significantly reduced the accessibility of birth control for low-income individuals and those on Medicaid. It may come as no surprise, then, that Gen Z has been in the news for having less sex than previous generations.
Patients aren’t the only ones facing issues either, as providers are also struggling with “moral distress at being forced to follow medically unsound practices” that harm their patients.
Specifically, bans have forced medical providers to practice a “new kind of defensive medicine” called “hesitant medicine” in which they are forced to find a balance between protecting themselves from criminal charges and providing life-saving care for their patients. Hesitant medicine is a result of the ambiguous policies and bans that often do not reflect medical-based decision-making.
It’s difficult to ignore how unsettling it would be to navigate a medical emergency when doctors have to debate what care they can legally provide you, instead of choosing what’s medically best for you. For some women, their healthcare experiences in post-Roe America have been deadly, perhaps a result of this new “hesitant medicine.”
A possible trickle-down effect of these bans obstructing proper healthcare is that women have become more unwilling to disclose their pregnancy status. And it’s understandable that trust in the healthcare system has been shaken for many patients navigating pregnancy-related care, considering these numerous ripple effects of overturning Roe.
Post-Roe America: Who Is Affected?
Even if not everyone feels it in the same way, the overturning of Roe has reshaped healthcare access, legal systems, and personal decision-making across the country.
However, some people are much more likely to be impacted personally and are more at risk in a post-Roe America due to various and intersecting factors, including but not limited to: one’s geography, economic status, race, immigration status, and whether they are a survivor of sexual assault/rape.
Geography
As discussed earlier, 25 states currently have complete bans or restrictions on abortions. Due to these policies, many individuals are unable to access abortion care within their state, resulting in a significant increase in the number of individuals who’ve had to travel out-of-state to receive abortion care.
Specifically, Guttmacher reports that about 142,000 individuals traveled out of state to seek abortion care in 2025 alone, with 62,000 being from states with total bans; those numbers are more than double those seen before the overturning of Roe. Even one year after the Dobbs decision, the proportion of out-of-state (versus in-state) care surged from 1 in 10 patients in 2020 to 1 in 5 in 2023.
Yet, for many individuals, crossing state lines for abortion care is not an option.
For example, as noted, Texans are banned from having in-state abortions. However, as of 2023, in nearly every single county in Texas, it would take you over 200 miles to access an abortion provider if you need the medical care. The data holds the same for other Southern states like Arkansas, Louisiana, and Mississippi, which are essentially landlocked by other states with complete bans.
Additionally, research finds that states with abortion bans have “higher rates of maternal deaths from any cause, cardiovascular disease, and violence than those with fewer restrictions.”
Taken together, these patterns make it clear that in post-Roe America, where you live can directly affect whether you’re able to access timely, potentially life-saving care.
Economic status
Another intersecting factor to abortion access and care is your economic status.
For individuals below the federal poverty line, unintended pregnancies are already 5 times more likely, and abortion rates are 6 times more likely than those above the poverty line. In states with abortion restrictions, it’s also much less likely that someone will graduate from secondary and undergraduate education, thereby reducing their lifetime earnings and leading to “poorer economic futures for [their potential] children.”
Moreover, as mentioned previously, many people who need an abortion must try to obtain one out-of-state. Before the Dobbs decision, those living below the poverty line were already at a disadvantage, having less time available to take off work and more difficulties in securing transportation or childcare than those with higher incomes. In post-Roe America, those challenges have only been intensified by state-level restrictions and complete bans.
Race
Race is another intersecting factor that significantly impacts abortion access and proper healthcare.
For example, in post-Roe America, Black women with lower incomes are more likely than their white counterparts to be pressured by healthcare providers to use contraceptives or to limit their childbearing overall. They are also more likely to experience contraceptive failures. Research also suggests Latina and Black women face more race-based discrimination when it comes to their healthcare than other races and ethnicities.
In post-Roe America, women of color are especially endangered by abortion restrictions and bans. Since the Dobbs decision, while overall maternal mortality rates doubled in states that banned abortion (while supportive state rates fell by 21%), Latina and Black mothers living in states with bans are 3 to 3.3 times (respectively) more likely than white women to die. Additionally, Black infants are more at risk of infant death in post-Roe America than non-Black infants.
Immigration status
Despite being a country where 15.4% of the population is made up of immigrants, post-Roe America is an especially dangerous place for immigrants seeking abortion care.
Many undocumented immigrant women — 1.9 million as of June 2024 — are concentrated in states with either complete bans or severe restrictions. While geography is one intersecting factor, immigrant women are also barred from Medicaid and restricted from purchasing health insurance that would help them obtain abortion care in-state, if legal, or out-of-state.
With the increase in deportations and ICE Detention Centers under the current Trump Administration, immigrant women — especially those who are detained by ICE — are also more at risk of sexual abuse and rape, in which abortion access would become even more crucial. More and more allegations of abuse in ICE Detention Centers are being uncovered, including in the nation’s 10 largest. Despite these numerous reports, the Department of Homeland Security continues to allow these facilities to stay open, even if they don’t meet ethical standards, further limiting access to abortion care for immigrant women.
Survivors
Due to bans and severe requirements for “eligibility” (aka gestational limits) in anti-abortion states, survivors of sexual assault/rape are more at risk in post-Roe America.
Specifically, as of Jan. 2024, only 5 out of 14 states that outlawed abortion allowed exceptions for rape-related pregnancies, also requiring individuals to report the rape, a significant barrier to many survivors, as rape is only reported to law enforcement 21% of the time.
Immediately following the overturning of Roe, reports estimate that 64,565 rape-related pregnancies occurred out of about 519,981 total survivors (equaling to about 12.4%), with an overwhelming 91% of those pregnancies occurring in states with zero rape exceptions.
Survivors already go through traumatic events, and the addition of anti-abortion bans and policies creates yet another devastating instance where they are stripped of their bodily autonomy.
Where Do We Go From Here?
Four years later, the realities of post-Roe America are no longer abstract: they’re showing up in our healthcare access, legal systems, and day-to-day experiences.
Losing the constitutional right to abortion at the federal level has exacerbated existing inequities and contributed to increased uncertainty and fear for many seeking care. In fact, studies have found that in states where abortion is banned, there is a “significant increase in self-reported anxiety and depression symptoms,” evidence of one more negative outcome of the Dobbs decision.
However, it’s important to know that there are numerous organizations fighting for abortion rights at the state and federal levels, including the ACLU and the Center for Reproductive Rights.
It’s easy to feel like these issues are out of our control, but there are still a lot of ways you can stay engaged and support progress toward a safer America for all.
You can start by learning about the abortion policies in your state and the states around you, and talk about them with your friends, family, and community. If you live in a state with non-protective policies or bans, I highly suggest directly calling your elected officials to voice your concerns and demand state-level protection. You can also volunteer or donate directly to your local clinics to further your impact.
Reflecting on these past four years, there’s no denying the fact that post-Roe America has become a more uncertain— and, for many, more dangerous — place to seek proper healthcare. But we’re living this reality together and must continue protecting and helping each other in any way we can.
I hope that this article helps you in some way, whether it serves as an educational message or a signal of support.
If you or someone you know needs help accessing abortion information, you can use the Planned Parenthood website or other online resources.
Stay safe and informed, support your local resources, and continue looking out for one another!
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