Reproductive Rights in America: Bodily Autonomy Under Siege

What Happened After the Dobbs Decision?

On June 24, 2022, the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade after 49 years, eliminating the federal constitutional right to abortion. Within months, the consequences became clear: 62.7 million women of reproductive age now live in states that have banned or severely restricted abortion access.

Trigger laws — abortion bans that had been pre-enacted and designed to take effect the moment Roe was overturned — activated in 13 states within weeks of the Dobbs decision. Additional states enacted new bans through legislative action. As of 2024, 14 states have enacted near-total abortion bans, and an additional 7 have implemented bans at 6-15 weeks of gestation — before most women even know they are pregnant. Only 21 states and DC have laws explicitly protecting abortion access.

The impact on access has been devastating. Women traveling across state lines for abortion care has increased by over 100% since Dobbs. Clinics in states bordering ban states are overwhelmed — wait times in Illinois, New Mexico, and Kansas have tripled. Women in Texas, the largest state with a near-total ban, must travel an average of 248 miles to reach a legal abortion provider, compared to 17 miles before the ban. For low-income women — who disproportionately are women of color — the cost of travel, lodging, childcare, and lost wages makes legal abortion financially impossible.

Emergency medical care has been compromised. Doctors in ban states report delaying treatment for ectopic pregnancies, incomplete miscarriages, and other pregnancy emergencies because they fear prosecution under vaguely written ban laws. ProPublica and other investigative outlets have documented cases where women died or suffered permanent injury because physicians waited until patients were "sick enough" to qualify for the life-threatening exception. The Texas Medical Association has reported that physicians are leaving the state rather than practice under these conditions.

The Dobbs decision did not merely return the issue to the states. It created a two-tier system in which a woman's access to basic healthcare depends entirely on her zip code and her bank account. Wealthy women travel. Poor women carry pregnancies to term against their will. This is not a hypothetical — it is the documented reality of post-Dobbs America. For the full impact analysis, see the reproductive rights issue page.

How Does the US Compare to the Rest of the World on Reproductive Rights?

The global trend over the past 30 years has been toward expanding reproductive rights. Since 1994, over 60 countries have liberalized their abortion laws. Only four have rolled them back: the United States, Poland, Nicaragua, and El Salvador. The US is the only wealthy democracy on that list.

The data reveals a clear pattern. Countries that protect reproductive rights, fund abortion and contraception publicly, and invest in maternal healthcare have dramatically lower maternal mortality rates and better health outcomes for women and children. The United States — which restricts abortion access, bans public funding, and has the highest maternal mortality in the developed world — is the cautionary example, not the model.

Canada is particularly instructive. Since decriminalizing abortion entirely in 1988 (with no gestational limit), Canada has seen no increase in late-term abortions, no decline in birth rates, and a maternal mortality rate roughly one-quarter of America's. The absence of a legal gestational limit has not led to the consequences that opponents predicted — because medical ethics, not criminal law, govern medical decisions.

Sources: WHO, Guttmacher Institute, OECD, national health agencies. See the full reproductive rights issue page for complete sourcing.

How Does the Common Good Reproductive Rights Plan Work?

The Common Good plan establishes comprehensive federal protections for reproductive rights — covering abortion, contraception, IVF, maternal health, and sex education — through specific legislative provisions modeled on the best-performing healthcare systems in the world.

Every provision is grounded in medical evidence, constitutional analysis, and the proven experience of peer democracies. This is not a statement of values. It is a legislative framework with implementation details, cost projections, and measurable outcomes.

• Federal Reproductive Rights Act: Establishes a federal statutory right to abortion with no gestational limit. The decision to end a pregnancy at any stage is a medical decision between patient and provider. Modeled on Canada's framework, which has had no gestational limit since 1988 with no increase in late-term procedures.
• Repeal the Hyde Amendment: Eliminates the ban on federal funding of abortion, ensuring that Medicaid, CHIP, military insurance (TRICARE), federal employee health plans, and all federally funded programs cover abortion services. No woman should be forced to carry an unwanted pregnancy because she cannot afford the alternative.
• Universal Free Contraception: All FDA-approved contraceptive methods — including IUDs, implants, oral contraception, and emergency contraception — are covered at no cost under the national health plan. Universal contraception access is the single most effective policy for reducing unintended pregnancies and abortion rates.
• Medication Abortion Protection: Federal preemption of state restrictions on mifepristone and misoprostol. Medication abortion — which accounts for over 63% of all abortions — is protected from state-level bans, pharmacy restrictions, and telemedicine prohibitions. Prescribing protocols follow FDA guidelines, not state legislatures.
• Ban Fetal Personhood Laws: Federal prohibition on state laws that define embryos or fetuses as legal persons. Fetal personhood laws threaten not only abortion access but IVF, miscarriage management, and contraception. The Alabama embryo ruling demonstrated this danger in practice.
• Federal IVF Coverage: Insurance coverage for at least three IVF cycles under the national health plan, with protections for embryo creation, storage, and disposition. Addresses the financial barriers that currently make IVF inaccessible for most Americans (average cost: $15,000-$30,000 per cycle without insurance).
• Comprehensive Sex Education: Federal standards for medically accurate, age-appropriate, inclusive sex education in all public schools. Replaces abstinence-only programs — which have been shown to be ineffective at reducing teen pregnancy or STI rates — with evidence-based curricula that include contraception, consent, and LGBTQ+ inclusion.
• Emergency Maternal Health Act: Federal standards for maternal emergency care that override state abortion bans when a patient's life or health is at risk. Eliminates the legal ambiguity that has caused physicians in ban states to delay lifesaving treatment. Includes mandatory maternal mortality review committees in every state.
• Triple the Midwifery Workforce: Federal funding to expand midwifery education, licensure, and practice authority. Countries with strong midwifery systems — including the UK, Sweden, and the Netherlands — have dramatically lower maternal mortality. The US has approximately 15,000 certified nurse-midwives; the plan targets 45,000 within 10 years.
• 12-Month Postpartum Medicaid: Extends Medicaid coverage to 12 months postpartum for all enrollees, up from the current 60-day federal minimum. Over one-third of pregnancy-related deaths occur between one week and one year after delivery. Extended postpartum coverage addresses the gap that kills hundreds of American women every year.

For the complete plan with legislative detail, legal analysis, medical evidence, and cost projections, see the full reproductive rights issue page.

Why Is US Maternal Mortality So High?

The United States had a maternal mortality rate of 32.9 deaths per 100,000 live births in 2021 (a pandemic-year peak; the 2023 rate declined to 16.7) — the highest in the developed world. In Sweden, the rate is 2.6. In Germany, 3.2. In the UK, 6.9. American women are dying in childbirth at rates that would be scandalous in any peer nation — and the disparity is getting worse, not better.

Racial disparities are the most devastating dimension of US maternal mortality. Black women are 2.6 times more likely to die from pregnancy-related causes than white women — and this disparity persists regardless of income, education, or insurance status. A Black woman with a college degree is more likely to die in childbirth than a white woman without a high school diploma. The causes include systemic racism in healthcare delivery, provider bias, chronic stress from racial discrimination (which produces measurable physiological effects), and geographic access barriers in communities of color.

Lack of universal coverage means millions of women enter pregnancy without adequate prenatal care. Women who are uninsured or underinsured skip prenatal visits, delay reporting complications, and present to emergency rooms in crisis rather than receiving ongoing monitoring. The US is the only wealthy country where a significant portion of pregnant women lack health insurance. Under the Common Good universal healthcare plan, every pregnant woman would have comprehensive coverage from conception through one year postpartum.

Inadequate postpartum care is the third driver. The standard US model provides a single postpartum visit at six weeks after delivery — and then effectively abandons the patient. Over one-third of pregnancy- related deaths occur between one week and one year after delivery, during a period when most women have minimal medical oversight. Every other wealthy country provides home visits, extended monitoring, and postpartum mental health screening. The US does not. The current 60-day Medicaid postpartum coverage window is dangerously inadequate.

Midwifery shortages compound all of these problems. Countries with strong midwifery systems — where midwives manage the majority of low-risk pregnancies — have dramatically lower maternal mortality rates. The UK, the Netherlands, and Sweden all rely on midwife-led care as the standard model. The US has approximately 15,000 certified nurse-midwives for a population of 330 million. The Common Good plan commits to tripling that number within a decade, with federal funding for midwifery education and expanded scope-of-practice laws.

What Are the Biggest Myths About Reproductive Rights?

The campaign to restrict reproductive rights relies on misinformation that has been debunked by medical research, international evidence, and public health data. Here are the four most persistent myths — and what the evidence actually shows.

Reproductive Rights: Frequently Asked Questions

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