Two years ago, the Supreme Court overturned the landmark ruling Roe v. Wade, which had legalized abortion for nearly 50 years.
In the hours, days, months, and years since the 2022 decision in Dobbs v. Jackson, a lot has changed for pregnant people. Predictively, many Republican-led states moved swiftly to stop nearly all abortions. Like dominoes, the number of states where abortion could be legally accessed fell. Currently, 21 states ban or restrict access earlier in pregnancy than the standard Roe set. Although self-managed abortion with medication is harder to regulate – and, in fact, increased in incidence post-Dobbs – there have been attempts to shelve mifepristone nationally, including via a case that the Supreme Court rejected this month for lack of legal standing (though they left room for a similar case to come before the Court again in the future).
Meanwhile, a Louisiana law recently classified abortion pills as controlled, dangerous substances. “These things never stay in just one state,” says Rachel Sussman, vice president of strategy and program at Planned Parenthood Action Fund. “That’s scary. A lot of people don’t realize how much these laws ultimately put women’s lives and pregnancies at risk.”
Anti-abortion activists have chipped away at reproductive rights in other ways post-Dobbs, including by threatening access to the fertility procedure in vitro fertilization (IVF) and birth control.
These are just a few examples of the myriad changes that have occurred post-Dobbs – but it can be easy to get bogged down in the policy and regulations, and miss what’s changed most: the lived realities of pregnant people who need or want abortion care.
That’s why we talked to four people about how Dobbs–era abortion bans have impacted them – in one case, nearly costing a patient her life. We’re starting with stories from the last two years and ending with a case showing that, even in the months before Roe fell, the dominoes were already swaying.
Kristen Anaya, 42, Texas
Last January, Kristen Anaya flew backward onto her couch and screamed, giddy with joy, when her doctor told her over the phone that she was pregnant with a girl, whom Anaya would name Tylee. The news came after a grueling IVF journey. “Tylee was our only genetically viable embryo that we were ever able to make after five egg retrievals,” Anaya says, referring to her and her husband, Stephen Anaya. “So when we found out we were pregnant and it worked on the first try, we were just ecstatic.”
But in April of 2023, at 17 weeks pregnant, Anaya felt a scary trickle. “My water broke unexpectedly in the middle of a Saturday,” she says. “I called my doctor right away, and she told me to go straight to Labor & Delivery at the hospital.” When she arrived, Anaya says, she was still losing amniotic fluid and had a spiking fever.
Within a moment’s time, you could be put in a situation where both you and your doctor have zero control.
“I remember apologizing to the nurse who was trying to get an IV in because I was shaking so bad it was hard to get the needle in,” she says. “Looking at my medical records, upon my initial assessment, I was already showing signs of sepsis, so they started me on antibiotics right away.”
Medical providers started running tests, and Anaya felt like she was wading through a horrible fever dream. “As they were doing all these tests, we were asking: ‘Is my daughter okay?’ My husband could see Tylee moving around on the ultrasound, and she seemed fine. She still had a heartbeat, but it showed I only had about a centimeter of amniotic fluid left.”
Anaya was moved to a hospital room about an hour after arriving at the hospital. Soon, her doctor came in to talk. “She sat down on the edge of my bed, and I could just tell then . . .” Anaya says, choking up before finishing the sentence. “She said because I’d lost my fluid and because of the gestation I was at, I was going to lose Tylee.”
That wasn’t the only devastating news. The doctor said protocol called for inducing labor, but, given Texas’s abortion ban – one of the strictest in the nation – she was not allowed to. In order to give Anaya the care she needed, an ethics committee had to approve the induction, and only could do so if her life was at imminent risk. “She told me: ‘We have to let you get really sick; we have to prove that you are close to death before we can intervene,'” Anaya remembers. “It felt like playing Russian Roulette with my life.”
Per her medical records, Anaya’s doctor checked her blood work every three hours until, finally, 22 hours later, she was “sick enough” to induce labor, she says, and then had a D&C to remove the placenta. The sepsis had wreaked such havoc on her body that she needed blood transfusions.
Thankfully, Anaya eventually fully recovered. But as her physical health improved, the grief deepened: “The first five or six weeks, all I could think about was that we lost Tylee. But, at some point, I realized: this is so messed up what I went through – how in the world was that okay? I got really angry.”
This led her to share her story and join a lawsuit that asked the state of Texas to clarify their laws, so that people in Anaya’s situation could receive life-saving care. However, last month, the Texas Supreme Court rejected the suit, unanimously agreeing to leave the law as is. This was yet another catastrophic blow to Anaya.
“When I joined, I thought, there’s no way they’re not going to understand that this health care is life-saving, and we need these medical exceptions,” she says. “When that decision came out, what made me most angry was that they didn’t even acknowledge us, the women who shared our stories. I felt so ignored. I felt hopeless. How are we going to change this now? It feels like a dead-end road.”
That’s also why Anaya will keep telling her story to “anyone who will listen.” As she puts it: “People think this will never affect them, but pregnancy is complicated. This could happen today, tomorrow, to you, to an aunt, a best friend, a sister. Within a moment’s time, you could be put in a situation where both you and your doctor have zero control.”
Larada Lee-Wallace, 23, California
This past March, when Larada Lee-Wallace learned they were pregnant, they almost immediately knew they wanted an abortion.
They already had abortion pills on hand, which they’d ordered ahead of time. “It wasn’t a hard decision to self-manage my abortion at home,” they say. “I could be on my couch, and I was able to order my favorite tacos, watch ‘Love Is Blind,’ and just be comfortable without having to interface with a health-care provider. . . . I was able to make the decision and take care of myself.”
I can’t allow the opinions of people who are not living inside this body to dictate what I do.
This experience was vastly different from Lee-Wallace’s past interactions with the abortion-care system. They had their first abortion at 19 in Ohio, where they had to overcome bureaucratic hurdles like waiting periods and clinic closures, even pre-Dobbs. During their second abortion in May 2021 in California, the staff was less than welcoming and they felt extremely isolated during the process due to COVID restrictions. “When you’re trying to get care and encountering other people’s stigmatizing attitudes, that in itself is also a barrier,” they say. Their third abortion was a week after the Dobbs decision draft leaked. There were already people coming into California from out of state then because of restrictions already in place that had closed clinics and curtailed access in some states pre-Dobbs.
So when this fourth pregnancy came unexpectedly, they knew getting into a clinic would be even more stressful, thanks to the many state abortion bans that forced folks to travel. That’s also why they’d bought abortion pills in advance. “I had trouble getting it scheduled in a blue state before Roe fell, so I can’t even imagine what it would be like now,” they say.
They were early enough in pregnancy that self-managing was right for them, and felt extra confident in the decision as a reproductive-justice advocate and abortion doula.
Lee-Wallace says they benefited from having prior knowledge about abortion pills and living in a blue state where they didn’t have to worry quite as much about criminalization (though they note that they still took legal and digital safety precautions because even in a fairly liberal place, “people have still been criminalized for pregnancy loss”).
“Self-managed abortion is such an empowering option, but I’d tell anyone thinking about it: do your research, because the risk may look different depending on where you are and it’s really important to be informed on the possible risks,” they say. “Have a kit ready with pads, Ibuprofen – not Tylenol, because it’s a blood thinner – and a heating pad to help with cramps. Have a trusted or supportive companion because, although medication abortion is safe and effective, just like any procedure or anything in life, there are some rare risks that something could go wrong. Everyone deserves to have someone who supports them in that moment.”
Lee-Wallace also thinks it’s incredibly important to destigmatize abortion on the whole. “For me, having had multiple abortions and thinking highly of myself and having supportive people, I’ve learned that people who have abortions are amazing people,” they say. “There’s nothing more inspiring and powerful than being able to make a decision for yourself that you feel is best. Period. . . . At the end of the day, I can’t allow the opinions of people who are not living inside this body to dictate what I do.”
Nekia G., 25, Indiana
When Nekia took a pregnancy test that came up positive last September, she immediately started crying. Her first thought was: “What now?”
“I was shook – I mean, I was actually shaking,” she says. “As soon as I looked at it, I thought: I am not ready.” Indiana had just instituted a near-total abortion ban a month earlier, and she worried that it meant she’d be forced to carry the pregnancy to term. “I started looking to see if I could get out of my lease or find a better job, because at first I felt there was no other choice but to stay pregnant,” she remembers. “At the time, I was afraid to go to the doctor, because I was scared I was going to be arrested or lose my job if I got an abortion.”
Nekia, who is being identified by her first name to protect her privacy, called Planned Parenthood, and they gave her a list of clinics to call out of state. At first, the idea of traveling for an abortion felt overwhelming. “I had just started a new job, and I knew I’d have to take off work and find the money to travel if I wanted to go out of state,” Nekia says. “I was also nervous I wouldn’t be able to get an appointment for weeks.”
No one should have to come up with so much money and go so far out of their way to get this done.
She ultimately got an appointment in Champaign, IL, and it couldn’t come soon enough. She ended up telling her manager she was getting an abortion so she could take the time off unpaid, but she still worried about the cost of travel and the abortion care. But it all worked out: “Once we got to the clinic, one of the people who worked there got me a huge discount on the abortion and even provided me with a gas card. It blew my mind the support they gave me.”
But it was still much more expensive than it would have been if she could have gotten an appointment in-state. According to Nekia, she lost wages for the three days she took off work to get the abortion and recover; the gas was about $120, while the procedure was $700 or $800 before the discount.
“It was a lot of money to drop at one time – on top of bills and rent, it was still tight,” she says. “This should be accessible to everyone and no one should have to come up with so much money and go so far out of their way to get this done.”
DakotaRei Frausto, 19, Texas
In the months before Roe fell, the looming Supreme Court decision was already impacting pregnant people. For instance, DakotaRei Frausto couldn’t get the abortion they needed because of a Texas law known as Senate Bill 8, which passed in 2021 and effectively banned abortions after six weeks of pregnancy. “I knew as soon as they passed that law that the policy was unfair and unrealistic,” they say. “I’d never be able to access an abortion under that timeframe, because my cycle is 38 days long, [or five and a half weeks],” they say. “So as soon as I realized I missed a period, I knew right away that it would be too late.”
They ultimately got an appointment for an abortion in Albuquerque, NM, on April 1, 2022. “I was like: ‘Oh April Fool’s Day – yikes,'” they say. Frausto learned they would have to travel more than 700 miles one way, and would have to spend money on lodging, gas, and food. “I knew I couldn’t cover that alone, so I started calling abortion funds. A bunch of funds were saying, ‘Oh we’re super worried about the laws of aiding and abetting abortions, so we’ve stopped funding them currently.’ That was a huge barrier.”
My abortion saved my life.
Frausto ended up making a video on TikTok talking about their experience, and it went “semi-viral,” they say. They received about $420 in donations from folks online, and they also ultimately told their parents about needing the abortion, who helped them come up with the rest of the money. The entire trip cost a little over $2,000, Frausto says.
That online community also ultimately became vital. “As a pregnant 17-year-old, I felt like a failure,” Frausto says. “I was disappointed in myself, and a lot of the stigma surrounding teen pregnancy and abortion was getting to me. I started feeling like: ‘Oh my God, maybe I am just a promiscuous woman.’ But there were so many kind people on the internet. . . . It helped me realize that I’m so valid as a 17-year-old girl with a health issue to say: ‘Hey, I don’t want to be pregnant and I shouldn’t force myself to be pregnant.'”
Frausto says that they’d tried previusly to get on hormonal birth control, but felt shut down by their doctor. “We don’t have comprehensive sex ed here and we have parental consent laws to access contraceptives,” they add.
Their abortion experience was a stark contrast: the nurse held their hand during the minutes-long procedure, they say, and asked for consent before they did anything. Although they’d grown up hearing abortion could be a traumatic experience, it actually showed them how “compassionate and validating” health care can and should be.
“For so long in my life, being young, being Brown, being a woman, I was told: ‘You’re never going to be credible enough,'” they say. “In the end, my abortion restored my faith in health care, helped me find myself, allowed me to pursue my academic and professional goals, and strengthened my relationship with my fiancé and community. My abortion saved my life.”
Molly Longman is a freelance journalist who loves to tell stories at the intersection of health and politics.
