Governor Phil Murphy and First Lady Tammy Murphy visited and toured a new Planned Parenthood facility in Absecon NJ, Tuesday March 26 2024 (Rich Hundley III/ NJ Governor’s Office)

On the second anniversary of the U.S. Supreme Court ruling that overturned the federal right to an abortion, New Jersey Senate lawmakers advanced the first measure of what they hope to be a nine-bill package protecting reproductive rights in the Garden State.

The bill passed by the Senate Budget Committee Monday would require insurance and Medicaid coverage for abortions and prohibit insurers from taking any retaliatory action, such as raising rates or denying coverage, even if those people seeking care are not from New Jersey.

“We have to look at the state of New Jersey under the worst-case scenario,” said bill sponsor Sen. Teresa Ruiz (D-Essex). “What if the administration changes to someone who’s dramatically far thinking from what we’re thinking today?”

The bill was amended after it was introduced to expand protections for family planning and reproductive health services, which would include abortion, emergency services such as screenings for mothers and newborns, family planning counseling, lab tests, postpartum care for mothers, and medical care for newborns. It advanced by a vote of 9-3, with the Republicans on the committee opposing the bill.

Ruiz is sponsoring eight other bills lawmakers aim to pass in the fall that she said will further strengthen protections for abortion and other family planning methods. While the language for those bills is not yet available, officials say some of the bills would:

• Create a fund to finance clinical training programs and security grants, and direct health officials to identify gaps in access to services.
• Protect the data privacy of people using period tracking apps by requiring consent for disclosure.
• Require Medicaid to cover emergency contraception without a prescription.
• Provide for voluntary contributions for taxpayers on gross income tax returns to support reproductive health care services.

“As we come into the session into the fall, we’ll work collectively together to be sure that every woman, child, and human being is protected,” Ruiz said.

New Jersey saw a spike in abortions after the 2022 Supreme Court decision, known as Dobbs, which overturned the 1973 Roe v. Wade decision that protected abortion rights nationally. Since the Dobbs decision, nearly half of the nation’s states have banned abortions or placed restrictions more severe than those allowed by Roe.

In New Jersey, abortion access is protected by the 2022 Freedom of Reproductive Choice Act. That law codified the right to an abortion for people in New Jersey, which had been previously protected by court precedent.

Senate President Nick Scutari (D-Union), who joined Ruiz Monday to announce the package, said there are “two Americas right now for women that are seeking reproductive care and freedom.”

“There are individuals that had the money, the access, the knowledge to be able to move and go to other places where they can get those services, but there are so many countless others that are just stuck, that don’t know where to go,” Scutari said.

The insurance bill that advanced Monday would allow religious employers to request exemptions, which an insurance carrier may grant if the coverage conflicts with the employer’s beliefs and practices. It would prohibit carriers from excluding coverage for care to preserve the life or health of the mother.

Gov. Phil Murphy is expected to sign the bill. Murphy spokesman Mahen Gunaratna said it is one of Murphy’s priorities.

Pro-choice advocates stood with Ruiz as she announced the bill package. Kaitlyn Wojtowicz of Planned Parenthood New Jersey said there is still more that can be done to “meet this moment in a post-Roe health care landscape.”

“We know the fight isn’t over. Those who oppose our personal freedoms and seek to control our bodies, our health, our futures, will continue to tax on abortion, contraception, gender-affirming care and IVF and more,” Wojtowicz said.

Ruiz said the state should look into a constitutional amendment to protect the codified abortion law from being repealed by lawmakers in the future. Scutari said he “wholeheartedly” agrees that lawmakers should consider an amendment, which would have to be approved by voters.

“Elections have consequences and people don’t, can’t possibly imagine New Jersey changing, but we had a Republican governor for eight years,” he said.

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A blanket given to Anne Angus at the Boulder Abortion Clinic in Colorado, one of the only clinics in the country that offers termination after the second trimester. Angus said a former patient makes the blankets, called Bananas for Annie, for others who had to terminate for medical reasons. (Courtesy of Anne Angus)

Editor’s note: This is the fifth installment of an occasional States Newsroom series called When and Where: Abortion Access in America, profiling individuals who have needed abortion care in the U.S. before and after Dobbs. The first installment can be found here, the second installment is here, the third is here, and the fourth ishere.

Anne Angus has been ready to start growing her family for years now.

She got pregnant on her first try and felt lucky to escape the morning sickness and extreme fatigue that often comes with the first trimester of pregnancy. She quit her job in anticipation of being a full-time mom.

“It was so exciting, I was so ready,” said Angus, who lives in Montana.

She’d bought a few items off Facebook Marketplace by the time she was close to the halfway point, including a bassinet, some toys, a bouncer — and the teddy bear onesie that she holds onto when she tells the story of her doomed pregnancy.

At her routine 19-week anatomy scan, Angus’ doctor said something didn’t look right with the abdomen. But that could mean any number of things with varying degrees of severity, according to her doctor, and they wouldn’t know more until further tests could be completed. And those tests would need to be done by a team of specialists almost 700 miles away, at a children’s hospital in Denver, Colorado. Her appointment was four weeks out from the anatomy scan.

At the end of a series of tests, she met with a team of doctors at the children’s hospital to discuss the diagnosis and next steps. It was called Eagle-Barrett Syndrome, a rare genetic defect that can cause the partial or complete absence of stomach muscles, urinary tract malformations and abnormalities of the testes.

“The little glands running from the kidney to the bladder — his were three times the size of an adult’s,” Angus said. “You’re not even supposed to be able to see them at an ultrasound, let alone have them be very obvious.”

There’s a 50-50 chance her future pregnancies would have the same mutation, which led her to decide in vitro fertilization was the safer way to get pregnant and be able to test embryos prior to implantation in the uterus. But like abortion, access to IVF treatments is becoming another political argument at the state and federal level, leaving Angus to worry that her remaining option for having a child is also at risk.

Following Dobbs decision, clinic was overrun with patients

Before arriving in Denver, Angus had told her husband that even if the diagnosis was severe, she didn’t want to terminate. He understood and supported whatever decision she wanted to make, she said.

But after determining the status of the fetus’ condition, the Denver doctors started to discuss dialysis, kidney transplants, and a variety of other courses of treatment that would be needed after birth.

“All of which sounded to me like they would just be experimenting on my baby, with the experiment being, ‘How long can we keep him alive?’” Angus said. “That did not feel loving and compassionate to me.”

While talking it over with her husband, Angus said they discussed a family member who had a terminal illness.

“It has been devastating to the family to watch this person’s pain increase as they slowly fall apart over the years,” she said. “We didn’t want that for our son.”

It was at that time that they made the decision to let him go without the medical interventions and the idea that he might just slowly slip away in a neonatal intensive care unit, she said.

By that time, it was mid-October 2022, four months after the Dobbs decision that allowed states to once again regulate access to abortion and the ensuing legal and legislative chaos. One of the only places in the country where Angus could terminate at her stage of pregnancy was a clinic in Boulder, Colorado. Montana has a gestational age limit of 21 weeks for termination, so she knew she couldn’t go back home.

“That clinic (in Boulder) was overrun because all of the states that used to have access now didn’t have it, or they were being pushed until much later,” Angus said. “We had a two-week wait from when we made the decision.”

By the time she got to the intake appointment, she was at 26 weeks. There were protesters outside of the clinic, so an escort with an umbrella covered Angus and her husband as they walked inside.

“I remember feeling so much anger and rage at them. You have no idea what’s going on,” she said. “You don’t care at all about my baby’s suffering if he’s born.”

The termination was a few days later. Angus said it was difficult to face the reality of letting go of any shred of hope she had left.

“That was probably the most scared I’ve ever been. Nobody talks about what it’s like to get an abortion at the end of your second trimester. What am I supposed to feel? What’s going to happen? Who do I talk to about this?” she said.

After the procedure, the doctor told her it was a difficult process because of the amount of water retention in the fetus’ body. Angus said she could tell just by looking at him.

“I didn’t see his whole body just because of how medically fragile he was, but you could just tell that it would’ve been a really ugly death for him earthside,” she said.

Insurance didn’t cover the costs. With the travel, lodging and the price of the procedure, Angus and her husband spent $10,000 of their savings.

Frustration continues for Angus as IVF becomes new political target

Throughout 2023, Angus had many appointments for egg retrievals, but she said the process has been emotionally and financially draining.

“We are extremely lucky that my husband has benefits through his work, but we’re also at the end of (those benefits), which is why this is our last IVF retrieval cycle,” she said.

She has a planned embryo transfer in September, but if it’s not successful, she worries about future political decisions around IVF limiting her options. There is only one clinic that offers IVF treatment in Montana.

The Alabama Supreme Court ruled in February that embryos are “children” and several IVF clinics in the state closed their doors over liability concerns. In the months since, some states have taken steps to ensure access to the treatment, but congressional bills to protect IVF federally have failed to advance and a politically influential religious sect came out against it for ethical reasons, potentially igniting more ideological battles.

The new political fight over IVF on top of her experience getting an abortion has made Angus fearful about not having explicit protection for the treatment in her state. It has also made her passionate about telling her story, including at the Montana Legislature in early 2023, when legislators did not advance a bill that would have eased some of the remaining restrictions to abortion access in the state.

Although access is still broadly available in Montana, Republicans have tried to change that since the Dobbs decision. Gov. Greg Gianforte signed several anti-abortion bills in 2023, including a 20-week ban, but they’ve so far been blocked in the courts. Gianforte continues to use executive authority to try to limit Medicaid funding and who can perform abortions.

Republicans in the legislature have also made it clear they don’t support a November ballot initiative to amend the state constitution with a right to abortion access, and at least one candidate endorsed by a national anti-abortion group is running for a congressional seat.

“I’m so angry that politicians are inserting themselves into an extremely intimate part of my life. I am trying to grow my family in a way that I can and in a way that is loving and sustainable, and they think they know better than me, and I am so insulted by that,” she said.

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Supporters of reproductive rights protested outside the U.S. Supreme Court on Tuesday, March 26, 2024, as justices heard oral arguments over access to mifepristone, one of two pharmaceuticals used in medication abortion. (Photo by Ashley Murray/States Newsroom)

WASHINGTON — Top Democratic campaign officials Thursday pressed their case for control of Congress and the White House by pointing toward the upcoming two-year anniversary of the U.S. Supreme Court overturning the constitutional right to an abortion.

More than a dozen Democrats also introduced legislation in Congress to prevent a future Republican administration from using an 1873 law, known as the Comstock Act, to bar mailing abortion medication.

On a call with reporters, the three campaign leaders said voters must flip the House from red to blue, keep Democrats in control of the Senate against the long odds and ensure President Joe Biden stays in the Oval Office to prevent the GOP from potentially implementing nationwide restrictions on reproductive rights.

Democratic National Committee Chair Jaime Harrison, Democratic Senatorial Campaign Committee Vice Chair Sen. Tina Smith of Minnesota and Democratic Congressional Campaign Committee Chair Rep. Suzan DelBene of Washington repeatedly said that Democrats would restore nationwide protections for abortion access if given unified control of government.

They, however, didn’t provide a clear road map for what Democrats would do on reproductive rights, including access to contraception and in vitro fertilization, if divided control of government continues.

Instead, they pointed to what Donald Trump, the presumptive Republican presidential nominee, might do in the event voters elect him president during November’s elections.

“We need to be clear that Trump and MAGA Republicans want to ban abortion and they have a plan to do it through executive action without any bill ever passing Congress; because they believe that politicians should have the power to make these decisions for women, whose lives and stories they will never know,” Smith said on the call.

Comstock Act fears

The Heritage Foundation, a conservative think tank, has released “Project 2025,” a lengthy document that outlines what it believes Trump should do during a second term.

The Trump campaign hasn’t endorsed the document or said it would seek to implement it in full or in part, though a former Trump administration official led its development.

The proposal includes using the Comstock Act —  a law enacted more than 150 years ago to prevent the mailing of obscene materials, contraceptives and anything that could produce an abortion — to bar the shipment of medication abortion throughout the United States.

Smith on Thursday introduced a three-page bill that would eliminate that as a possibility, though the legislation may not advance in the Senate and is very unlikely to make it through the GOP-controlled House before November.

Medication abortion, which includes mifepristone and misoprostol, accounts for about 63% of abortions nationwide, according to the Guttmacher Institute. The two pharmaceuticals are also used for miscarriage care. Misoprostol has other medical uses, as well.

The Comstock Act, enacted in 1873, originally barred the mailing of materials considered lewd or obscene at the time, but is written so broadly that it has been used to bar boxing photographs, art and information about contraception.

The law explicitly prohibits mailing “every article or thing designed, adapted, or intended for producing abortion, or for any indecent or immoral use.” Smith’s bill would seek to eliminate those provisions.

Smith, when asked about the Comstock Act on the call Thursday, said the “zombie law” could be used to make medication abortion illegal without a vote in the Congress.

“It’s very clear what their plan is,” Smith said of Republicans. “And so this is another example of the very clear choice that American voters have.”

DelBene, who is leading Democrats’ campaign arm in the House, said on the call that Republicans are already trying to change when and how Americans have access to various reproductive rights by attaching amendments to the must-pass government funding bills.

“This election is fundamentally about our rights, our freedoms, our democracy and our future,” DelBene said. “House Republicans have made it clear they’re willing to do anything to take those away.”

A divided Congress predicted

The most likely outcome of November’s elections isn’t currently unified Democratic control in the eyes of some analysts however.

Three experts at Moody’s Analytics released an analysis this week, showing the most probable result is that Biden will remain president with a divided Congress.

That scenario had a 40% probability, while a Republican sweep had a probability of 35%. Trump winning the presidential election and gaining a divided Congress had a 15% probability. A Democratic sweep had a 10% probability, according to the report.

The most likely scenario of Biden remaining president with a split Congress suggests that the GOP would flip the Senate and the Democrats would regain the House of Representatives.

“With the retirement of West Virginia Democrat Joe Manchin, the deep-red state will almost surely elect a Republican senator, leaving the Senate evenly divided,” the report states. “But while recent polling shows that Senate races in Arizona, Maryland, Montana, Nevada and Ohio are close, Republicans need to take only one of these seats to regain the majority.”

“Each race has its own story, but helping the Republicans’ cause is angst over inflation and heightened concern over the immigrant crisis at the southern border,” the report adds.

The analysis goes on to say that “federal judicial decisions on redistricting efforts have also leaned in Democrats’ favor, boosting their chances” of regaining control of the House.

“Also, given that incumbents win reelection more than 90% of the time, the relatively high number of congressional retirements relative to previous cycles creates the potential for more change in the body,” the analysis states.

The report details the four outcomes of November’s election as well as the various economic scenarios that would play out under either a Biden or a Trump presidency for the next four years.

The report was written by Chief Economist Mark M. Zandi, Director/Senior Economist Brendan La Cerda and Economist Justin Begley.

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After justices rejected the legal standing of anti-abortion doctors, activists search for plaintiffs that say they were harmed by the drug Mifepristone, an FDA-approved for pregnancy terminations. (Photo by Chris Coduto/Getty Images)  

In the aftermath of the U.S. Supreme Court’s unanimous ruling Thursday to maintain current access to the abortion medication mifepristone, abortion-rights advocates and opponents vowed to continue their respective battles over the drug.

Mifepristone is one of two drugs used to treat miscarriages and terminate a pregnancy during the first trimester, and is the most common method of abortion in the U.S.

Anti-abortion groups, in conjunction with conservative religious law firm Alliance Defending Freedom, sought to revert the FDA guidelines to 2016, when the prescribed gestational time frame was three weeks shorter and there were more requirements around who could prescribe it and where and when provider visits had to take place.

The case made its way to the nation’s highest court after outspoken anti-abortion U.S. District Judge Matthew Kacsmaryk in Texas ruled that mifepristone’s approval should be revoked, followed by a Fifth Circuit Court of Appeals opinion that agreed in part, saying the restrictions should revert to pre-2016 rules.

In a unanimous decision rejecting the anti-abortion groups’ challenge to the U.S. Food and Drug Administration’s regulation of the drug, justices agreed that the case lacked standing, saying there was no clear injury to the plaintiffs to warrant reinstating the restrictions.

“The plaintiffs do not prescribe or use mifepristone. And FDA is not requiring them to do or refrain from doing anything. Rather, the plaintiffs want FDA to make mifepristone more difficult for other doctors to prescribe and for pregnant women to obtain,” Justice Brett Kavanaugh wrote in the opinion. “Under Article III of the Constitution, a plaintiff’s desire to make a drug less available for others does not establish standing to sue.”

Wendy Heipt, attorney for advocacy organization Legal Voice, said the fact that the unanimous ruling is focused on standing is helpful, because that’s an area of law that has been in question in many reproductive rights-related cases since the Dobbs decision in 2022.

“I’m not relaxing; it’s not over. But the fact that this one rogue judge in Texas opened the courthouse doors to people who had no right to be there was a real challenge to the way our judicial system works, so I am reassured that there are still rules,” Heipt told States Newsroom.

Many reproductive rights and medical organizations issued statements following the ruling, including the Guttmacher Institute, a reproductive rights research organization that has closely tracked abortion pill use in the two years since the Dobbs decision.

“We are relieved by this outcome, but we are not celebrating,” said Destiny Lopez, acting co-CEO of the Institute, in a statement. “From the start, this case was rooted in bad faith and lacking any basis in facts or science. This case never should have reached our nation’s top court in the first place and the Supreme Court made the only reasonable decision by leaving access to medication abortion using mifepristone unchanged.”

Nikki Madsen, co-executive director of the Abortion Care Network, said she wasn’t surprised by the ruling, but noted it only preserves the status quo.

“It’s just not enough,” Madsen told States Newsroom. “We know that the anti-abortion extremists are relentless, and their goal is to truly chip away at any abortion access. So today’s decision just preserves access, but it’s really not enough for the people across the country who are truly navigating a human rights crisis right now.”

Three intervenor states expected to continue fight at district court level

Alliance Defending Freedom, the conservative law firm that argued the case, is the same organization that argued in favor of the Dobbs decision that returned abortion regulation to the states. In a statement, ADF attorney Erin Hawley said the ruling was disappointing, but that they will continue to “advocate for women’s health.”

“The FDA recklessly leaves women and girls to take these high-risk drugs all alone in their homes or dorm rooms, without requiring the ongoing, in-person care of a doctor,” Hawley said, adding that ADF is grateful to attorneys general in Idaho, Kansas and Missouri who successfully intervened in the case at the district court level with Kacsmaryk’s approval, because they intend to keep litigating the case there.

In a statement posted on X on Thursday, Missouri Attorney General Andrew Bailey wrote, “Today’s ruling only applies to standing; the court did not reach the merits. My case is still alive at the district court. We are moving forward undeterred with our litigation to protect both women and their unborn children.”

Bailey’s spokesperson did not give any further details about what that case would look like, and Idaho Attorney General Raúl Labrador’s office did not respond to a request for comment.

According to Susan B. Anthony Pro-Life America, a national anti-abortion organization, those attorneys general will move forward with the case “based on harms suffered by women in their states.”

Abortion opponents target abortion drugs from multiple angles 

Anti-abortion opponents have been fighting against the expansion of access to medication abortion since the FDA first approved the regimen in 2000, and they say they are not deterred by Thursday’s ruling.

“The Justices simply discussed the issue of legal standing and did not reach the merits of the case,” Carolyn McDonnell, litigation counsel at national anti-abortion policy shop Americans United for Life, told States Newsroom in a statement. “It’s still an open question whether the FDA unlawfully deregulated mifepristone.”

Longtime anti-abortion activist Rev. Pat Mahoney, chief strategy officer for the Stanton Public Policy Center, said the Supreme Court’s decision in this case was instructive, if not what abortion opponents wanted.

“There’s, I think, a misconception that a loss is a loss, and that isn’t always the case,” Mahoney told States Newsroom. “Sometimes a loss helps define the parameters for bringing the next case and next case, and believe me, there are going to be next cases on medical and chemical abortions. So now we know this isn’t a route to go.”

Mahoney said that like past legal defeats for the anti-abortion movement, this ruling offers at least a partial road map, such as the one abortion opponents followed after the Supreme Court ruled in 1992’s Planned Parenthood v. Casey that abortion until fetal viability was a federal right but that states could pass regulations that didn’t create an “undue burden” for people seeking abortions.

That ruling led to hundreds of restrictions and regulations around the country that kept nudging the viability and undue burden lines — limiting abortion access even before Roe v. Wade was overturned. Mahoney said his organization and others are pursuing various legislative proposals, such as regulating the disposal of embryonic and fetal remains following a medication abortion, which most people have at home or in private settings.

Americans United for Life said in a statement following the ruling that it “will continue to offer legal prescriptions for the strengthening of protections for unborn children from abortion pills through action on the federal and state levels in both executive and legislative branches of government, including through executive enforcement of the Comstock Act and RICO Act.”

Ever since Roe v. Wade was overturned, resurrecting the long-dormant Comstock Act to ban the mailing of abortion drugs and equipment (something legal scholars and historians say is an inaccurate interpretation of the law and how it was applied) has been the long-term focus of East Texas pastor Mark Lee Dickson and his partner Texas attorney Jonathan Mitchell.

They have been pushing various legal and legislative strategies to prevent people from obtaining abortions in states where it’s still legal. They have helped pass dozens of local ordinances in Texas and other states with restrictions that challenge current federal law, such as banning interstate travel to obtain an abortion. In New Mexico, where abortion is legal and largely unrestricted, a challenge to two local ordinances based on the Comstock Act await a ruling from the New Mexico Supreme Court.

The U.S. Supreme Court did not address the Comstock Act in its opinion, but Kascmaryk cited the old law in his initial ruling last year. Major conservative groups are pushing former President Donald Trump, if reelected this fall, to enforce the Comstock Act along with other federal abortion regulations. Trump has stayed silent about what he will do.

In the meantime, anti-abortion groups have not stopped pursuing other cases.

“I can confirm that there are several attorneys in the pro-life movement that are planning on bringing a number of different lawsuits relating to abortion-inducing drugs and the harm that they cause to mothers and their unborn children,” Dickson told States Newsroom.

Mahoney also said groups like his are working with attorneys on a potential class-action lawsuit against abortion-pill manufacturers. He said they are “actively gathering testimony and information from women who have been hurt through medical chemical abortions.”

“We’re working on it,” said Mahoney, adding, “It took us 50 years to overturn Roe.”

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ROCKVILLE, MARYLAND - APRIL 13: In this photo illustration, packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023 in Rockville, Maryland. A Massachusetts appeals court temporarily blocked a Texas-based federal judge’s ruling that suspended the FDA’s approval of the abortion drug Mifepristone, which is part of a two-drug regimen to induce an abortion in the first trimester of pregnancy in combination with the drug Misoprostol. (Photo illustration by Anna Moneymaker/Getty Images)

WASHINGTON — The U.S. Supreme Court ruled in a much-anticipated decision Thursday that mifepristone, one of two pharmaceuticals used in medication abortion, can remain available under current prescribing guidelines.

The high court unanimously rejected attempts by anti-abortion groups to roll back access to what was in place more than eight years ago, writing that they lacked standing to bring the case.

Those limits would have made it more difficult for patients to get a prescription for mifepristone, which the Food and Drug Administration has approved for up to 10 weeks gestation and is used in about 63% of U.S. abortions.

Erin Morrow Hawley, senior counsel at Alliance Defending Freedom, who argued the case in front of the court on behalf of the legal organization, doesn’t believe this is the end of efforts to challenge access to mifepristone.

She said on a call shortly after the ruling was released the three states that intervened in a lower court — Idaho, Kansas and Missouri — could still advance their arguments against mifepristone and potentially hold standing, the legal right to bring a case.

“I would expect the litigation to continue with those three states,” Hawley said.

Kavanaugh writes opinion

Justice Brett Kavanaugh wrote the opinion in the united ruling from the Supreme Court, with Justice Clarence Thomas writing a concurring opinion.

“Plaintiffs are pro-life, oppose elective abortion, and have sincere legal, moral, ideological, and policy objections to mifepristone being prescribed and used by others,” Kavanaugh wrote.

The four anti-abortion medical organizations and four anti-abortion doctors who originally brought the lawsuit against mifepristone have protections in place to guard against being forced to participate in abortions against their moral objections, he noted.

“Not only as a matter of law but also as a matter of fact, the federal conscience laws have protected pro-life doctors ever since FDA approved mifepristone in 2000,” Kavanaugh wrote. “The plaintiffs have not identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience.”

“Nor is there any evidence in the record here of hospitals overriding or failing to accommodate doctors’ conscience objections,” he added.

Alliance Defending Freedom has not “identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience since mifepristone’s 2000 approval,” the opinion said.

Kavanaugh might have also included hints on how the court will rule later this session on a separate abortion access case that addresses the Emergency Medical Treatment & Labor Act, known as EMTALA.

“EMTALA does not require doctors to perform abortions or provide abortion-related medical treatment over their conscience objections because EMTALA does not impose obligations on individual doctors,” Kavanaugh wrote.

Thomas agrees but questions who can sue

Thomas wrote a concurring opinion in the case, saying that he agreed with the court’s unanimous decision, which he did join, but brought up concerns with how a certain type of standing is used by the Court.

“Applying these precedents, the Court explains that the doctors cannot establish third-party standing to sue for violations of their patients’ rights without showing an injury of their own,” Thomas wrote.

“But, there is a far simpler reason to reject this theory: Our third-party standing doctrine is mistaken,” Thomas added. “As I have previously explained, a plaintiff cannot establish an Article III case or controversy by asserting another person’s rights.”

Reaction pours in

Politicians, anti-abortion groups and reproductive rights organizations all reacted to the ruling within hours of its release, often pointing to November’s elections as a potential next step.

President Joe Biden released a written statement saying the “decision does not change the fact that the fight for reproductive freedom continues.”

“It does not change the fact that the Supreme Court overturned Roe v. Wade two years ago, and women lost a fundamental freedom,” Biden added. “It does not change the fact that the right for a woman to get the treatment she needs is imperiled if not impossible in many states.”

Former President Donald Trump, the Republican Party’s presumptive nominee, was in meetings most of Thursday with U.S. House Republicans and then separately with Republican U.S. Senators.

Neither Trump nor his campaign released a statement by early Thursday afternoon addressing the Supreme Court’s ruling.

Louisiana Republican Sen. Bill Cassidy, ranking member on the Health, Education, Labor and Pensions Committee, wrote in a statement that the justice didn’t actually address the merits of the case.

“The Court did not weigh in on the merits of the case, but the fact remains this is a high risk drug that ends the life of an unborn child,” Cassidy wrote. “I urge FDA to follow the law and reinstate important safeguards.”

President of the American College of Obstetricians and Gynecologists Stella Dantas related a statement saying the ruling “provides us with long-awaited relief.”

“We now know that patients and clinicians across the country will continue to have access to mifepristone for medication abortion and miscarriage management,” Dantas wrote. “Decades of clinical research have proven mifepristone to be safe and effective, and its strong track record of millions of patient uses confirms that data.”

Hawley from Alliance Defending Freedom wrote in a written statement the organization was “disappointed that the Supreme Court did not reach the merits of the FDA’s lawless removal of commonsense safety standards for abortion drugs.”

“While we’re disappointed with the court’s decision, we will continue to advocate for women and work to restore commonsense safeguards for abortion drugs—like an initial office visit to screen for ectopic pregnancies,” Hawley wrote. “And we are grateful that three states stand ready to hold the FDA accountable for jeopardizing the health and safety of women and girls across this country.”

Nancy Northup, president and CEO of the Center for Reproductive Rights, wrote in a statement she had “both relief and anger about this decision.”

“Thank goodness the Supreme Court unanimously rejected this unwarranted attempt to curtail access to medication abortion, but the fact remains that this meritless case should never have gotten this far,” Northup wrote.

“The FDA’s rulings on medication abortion have been based on irrefutable science,” Northup wrote. “Unfortunately, the attacks on abortion pills will not stop here — the anti-abortion movement sees how critical abortion pills are in this post-Roe world, and they are hell bent on cutting off access.”

Scientific evidence argued

The Supreme Court heard oral arguments in the case in March, during which Solicitor General Elizabeth Prelogar argued the FDA’s guidelines for prescribing mifepristone were based on reputable scientific evidence and years of real-world use.

“Only an exceptionally small number of women suffer the kinds of serious complications that could trigger any need for emergency treatment,” Prelogar said. “It’s speculative that any of those women would seek care from the two specific doctors who asserted conscience injuries. And even if that happened, federal conscience protections would guard against the injury the doctors face.”

Hawley of ADF told the court that conscience protections in federal law didn’t do enough to protect anti-abortion doctors from having to possibly treat patients experiencing complications from medication abortion.

“These are emergency situations,” Hawley said. “Respondent doctors don’t necessarily know until they scrub into that operating room whether this may or may not be abortion drug harm — it could be a miscarriage, it could be an ectopic pregnancy, or it could be an elective abortion.”

The case reached the Supreme Court within two years of ADF originally filing the lawsuit in the District Court for the Northern District of Texas, where ADF wrote the FDA “exceeded its regulatory authority” when it originally approved mifepristone in 2000.

ADF filed the case on behalf of Alliance for Hippocratic Medicine, the American Association of Pro-Life Obstetricians and Gynecologists, American College of Pediatricians and Christian Medical & Dental Associations, as well as four doctors from California, Indiana, Michigan and Texas.

Kacsmaryk ruling started journey to high court

Judge Matthew Joseph Kacsmaryk essentially agreed with the anti-abortion groups, in a ruling in April 2023, where he wrote he did “not second-guess FDA’s decision-making lightly.”

“But here, FDA acquiesced on its legitimate safety concerns — in violation of its statutory duty — based on plainly unsound reasoning and studies that did not support its conclusions,” Kacsmaryk wrote.

The U.S. Supreme Court issued a stay at the request of the Justice Department, which put the district court’s ruling on hold until the appeal process could work itself out.

The Justice Department also appealed the district court’s ruling to the 5th Circuit Court of Appeals in Louisiana, where a three-judge panel heard the case in May 2023.

The panel — composed of Jennifer Walker Elrod, who was appointed by former President George W. Bush, as well as James C. Ho and Cory T. Wilson, who were both appointed by former President Donald Trump — issued its ruling in August 2023.

The appeals court disagreed with the district court’s ruling that mifepristone’s original approval should be overturned, though it said that the FDA erred in making changes to prescribing guidelines in 2016 and 2021.

“It failed to consider the cumulative effect of removing several important safeguards at the same time. It failed to consider whether those ‘major’ and ‘interrelated’ changes might alter the risk profile, such that the agency should continue to mandate reporting of non-fatal adverse events,” the appeals judges wrote. “And it failed to gather evidence that affirmatively showed that mifepristone could be used safely without being prescribed and dispensed in person.”

That ruling didn’t take effect under the Supreme Court’s earlier stay.

The Department of Justice wrote to the high court weeks later in September, urging the justices to take up an appeal of the 5th Circuit’s decision.

“The loss of access to mifepristone would be damaging for women and healthcare providers around the Nation,” the DOJ wrote in the 42-page document. “For many patients, mifepristone is the best method to lawfully terminate their early pregnancies. They may choose mifepristone over surgical abortion because of medical necessity, a desire for privacy, or past trauma.”

Briefs filed with court

Dozens of abortion rights organizations and lawmakers filed so-called amicus curiae or friend of the court briefs to the Supreme Court calling on the justices to keep access to mifepristone in line with the FDA guidelines.

A group of more than 16 medical organizations, including the American College of Obstetricians and Gynecologists and the American Medical Association, wrote that “restricting access to mifepristone will not only jeopardize health, but worsen racial and economic inequities and deprive women of the choices that are at the very core of individual autonomy and wellbeing.”

Anti-abortion groups and lawmakers opposed to mifepristone wrote numerous briefs as well.

Attorneys general from Alabama, Alaska, Arkansas, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia and Wyoming sent in a 28-page brief.

They wrote that the availability of mifepristone undermined states’ rights, since some of their states had sought to restrict abortion below the 10 weeks approved for mifepristone use or had sought to bar access to medication abortion.

“The FDA’s actions undermine these laws, undercut States’ efforts to enforce them, and thus erode the federalism the Constitution deems vital,” the attorneys general wrote. “Given these harms to federalism, this Court should view the FDA’s actions with skepticism.”

During oral arguments in March, several Supreme Court justices brought up conscience protections that insulate health care workers from having to assist with or perform procedures they have a religious objection to, like abortion.

Associate Justice Ketanji Brown Jackson said she was “worried that there is a significant mismatch in this case between the claimed injury and the remedy that’s being sought.”

“The obvious, common-sense remedy would be to provide them with an exemption that they don’t have to participate in this procedure,” Jackson said.

Associate Justice Neil Gorsuch said the case seemed “like a prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an FDA rule, or any other federal government action.”

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NATIONAL HARBOR, MARYLAND - FEBRUARY 24: Republican presidential candidate and former U.S. President Donald Trump speaks at the Conservative Political Action Conference (CPAC) at the Gaylord National Resort Hotel And Convention Center on February 24, 2024 in National Harbor, Maryland. Attendees descended upon the hotel outside of Washington DC to participate in the four-day annual conference and hear from conservative speakers from around the world who range from journalists, U.S. lawmakers, international leaders and businessmen. (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — Former President Donald Trump said Monday that if reelected he plans to work “side by side” with a newly formed religious organization that says abortion is the “greatest atrocity facing” the United States and should be “eradicated entirely.”

During two-minute recorded remarks played at The Danbury Institute’s inaugural Life & Liberty Forum in Indianapolis, Trump avoided using the word “abortion,” but said he hopes to protect “innocent life” if reelected in November.

“We have to defend religious liberty, free speech, innocent life, and the heritage and tradition that built America into the greatest nation in the history of the world,” Trump said. “But now we are, as you know, a declining nation.”

Trump, the Republican Party’s presumptive presidential nominee, said that he hopes to work alongside the institute to defend those values.

“These are going to be your years because you’re going to make a comeback like just about no other group,” Trump said. “I know what’s happening. I know where you’re coming from and where you’re going. And I’ll be with you side by side.”

Trump also called on The Danbury Institute and church members to vote for him during the November presidential election, saying that President Joe Biden and Democrats are “against religion.”

Biden-Harris 2024 spokesperson Sarafina Chitika said in a written statement released before Trump’s message was played that a second term for him “is sure to bring more extreme abortion bans with no exceptions, women punished for seeking the care they need, and doctors criminalized for providing care.”

“Women can and will stop him by reelecting President Biden and Vice President Harris this November,” Chitika wrote.

Abortion position

The Danbury Institute writes on its website that it opposes abortion from “the moment of conception, meaning that each pre-born baby would be treated with the same protection under the law as born people.”

“The intentional, pre-meditated killing of a pre-born child should be addressed with laws already in place concerning homicide,” its website states. “We also support bolstering the foster care system and encouraging Christian adoption and are working with churches around the country to help them become equipped to care for children in need of loving families.”

Another section of the Danbury Institute’s website states the organization believes, “the greatest atrocity facing our generation today is the practice of abortion—child sacrifice on the altar of self.”

“Abortion must be ended,” the website states. “We will not rest until it is eradicated entirely.”

The website doesn’t mention if the organization supports exceptions in cases of rape, incest or the woman’s life, nor does it say if women who receive abortions should be protected from criminal prosecution. The institute did not return a request from States Newsroom seeking to clarify if it supports any or all of those three exceptions.

The institute writes on its website that it “does not endorse any candidate for public office nor participate in political campaign activities. Contributions to The Danbury Institute are not used for political campaigning and are conducted in accordance with IRS regulations for nonprofit organizations.”

Florida minister takes issue with abortion letter

Tom Ascol, president of Founders Ministries in Florida, spoke on a panel discussion about the “Sanctity of Life” at Monday’s event, during which he said “abortion is the greatest evil of this nation in our day.”

Ascol also appeared frustrated with a public letter released by dozens of anti-abortion organizations in May 2022, arguing that no laws should criminalize women who have abortions. He took particular exception to the acting president of the Southern Baptist Convention’s Ethics and Religious Liberty Commission signing his name to the document.

“It grieves me that when there was legislation before the Louisiana legislature that had a real opportunity to be passed, because there were lawmakers that were willing to go forward … that 75 pro-life organizations penned an open letter, including the leader of our Ethics and Religious Liberty Commission Brent Leatherwood, who attached his name to that letter, saying, ‘We do not think that any legislature should criminalize abortion to the degree that those who offer their bodies up to be given over to abortion would be held liable,’” Ascol said during the conference.

That letter was released the same day in 2022 that state lawmakers in Louisiana were debating House Bill 813, which had been on track to criminalize women who receive abortions in addition to the doctors who provide them. Prosecutors would have been able to charge the women with murder.

Louisiana lawmakers instead opted to rework the language of the original bill to replace it with another anti-abortion measure that didn’t include criminal penalties for women who receive abortions.

Ascol said he believed the Southern Baptist Convention’s Ethics and Religious Liberty Commission must say publicly if “the goal (is) the abolition of abortion. And if it is and they’re sincere, then okay, let’s work together.”

“If we can do that, I think we can have some opportunity for coalition building,” Ascol said. “If we get more of these open letters by so-called pro-life organizations helping to spike legitimate legislation, then I think we’re going to continue to see the fragmentation and understandably so.”

National Right to Life, Susan B. Anthony List and Americans United for Life were among the organizations that signed the May 2022 letter.

Trump and abortion, contraception

Trump’s comments to The Danbury Institute on Monday didn’t clear up the confusion stemming from his comments to news organizations during the past few months.

Trump said during an interview with TIME Magazine published in April that his campaign would be releasing a policy in the weeks that followed on access to medication abortion, a two-drug regimen approved for up to 10 weeks gestation.

“Well, I have an opinion on that, but I’m not going to explain,” Trump said, according to the transcript of the interview. “I’m not gonna say it yet. But I have pretty strong views on that. And I’ll be releasing it probably over the next week.”

That policy had not been released as of Monday.

Medication abortion, which include mifepristone and misoprostol, makes up about 63% of pregnancy terminations within the United States, according to data from the Guttmacher Institute.

U.S. Supreme Court justices heard oral arguments in a case about mifepristone’s use in late March and are expected to publish their ruling before the Fourth of July.

During an interview with a Pittsburgh TV news station in May, Trump hinted that he might be open to states limiting or banning access to contraception, though he walked back his remarks the same day in a social media post.

“We’re looking at that and I’m going to have a policy on that very shortly and I think it’s something that you’ll find interesting,” Trump said on KDKA after being asked if he could support any restrictions on a person’s right to contraception. “It’s another issue that’s very interesting. But you will find it very smart. I think it’s a smart decision, but we’ll be releasing it very soon.”

Trump later posted on social media that he never had and never would “ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL, or other contraceptives.”

Trump’s campaign had not released a policy on contraception as of Monday.

U.S. Senate vote on IVF set this week

Access to reproductive health care, including contraception and IVF, has become a recurring issue in the U.S. Senate ahead of November’s elections, with Democrats seeking to put GOP members on the record.

The Senate tried to pass legislation last week that would have provided protections for access to contraception, but the vast majority of the chamber’s Republicans voted against advancing that bill.

Access to contraception is currently protected by two U.S. Supreme Court cases — Griswold v. Connecticut and Eisenstadt v. Baird — where the justices ruled that Americans’ privacy rights allow them to make those decisions for themselves.

Democrats and reproductive rights advocates are concerned that the justices could eventually overturn those two cases the same way the court overturned Roe v. Wade.

The Senate is set to vote this week on legislation guaranteeing access to in vitro fertilization, though GOP senators are expected to block that bill as well.

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Protesters gather outside the U.S. Supreme Court on Wednesday, April 24, 2024, while justices hear oral arguments about whether federal law protects emergency abortion care. (Sofia Resnick/States Newsroom)

WASHINGTON — Doctors from throughout the country posted a public letter this week, urging the U.S. Supreme Court to ensure health care professionals can perform abortions in every state when that procedure is essential “stabilizing treatment” under the Emergency Medical Treatment and Active Labor Act.

Thousands of doctors, organized by the advocacy group The Committee to Protect Health Care, signed the letter that calls on the justices to decide in favor of the Biden administration’s interpretation that the law protects doctors who provide abortions in emergency circumstances.

“We know firsthand how complications from pregnancy can lead very quickly to a medical crisis, requiring immediate care and treatment,” the letter states.

“These patients’ complications can range from a miscarriage to heavy bleeding, from placental abruption to a stroke from severe preeclampsia — and doctors and health professionals in emergency departments must be allowed to use the full range of medical options to save these patients’ lives, including abortion,” the doctors wrote.

The Committee to Protect Health Care writes on its website that through “earned and paid media, grassroots advocacy campaigns, and other tools, we help pass policies that expand health care and abortion access, elect health care champions, and hold anti-health care politicians accountable.”

A letter is not the official way for experts or interested parties to weigh in with the justices when they are considering a case.

Typically, individuals or organizations file an amicus curiae, or friend of the court, brief before oral arguments. The publication of the letter, however, comes a full month after that took place in this case and likely after the majority has begun writing the ruling.

The Committee to Protect Health Care confirmed Friday the group didn’t file an amicus brief.

The Supreme Court heard oral arguments in the case, Idaho v. United States, on April 24. The justices are expected to release their ruling before the Fourth of July break.

Biden administration interpretation

The case centers around whether a federal law, known as the Emergency Medical Treatment and Active Labor Act or EMTALA, protects doctors and other healthcare professionals who provide abortions as “stabilizing treatment” during a medical emergency, even when those doctors’ actions might go against state bans or restrictions.

The case in front of the Supreme Court, in part, stems from the Biden administration’s interpretation of the 1986 law.

That law requires emergency departments to either provide stabilizing care or transfer a patient with an emergency medical condition, regardless of their insurance status.

U.S. Health and Human Services Secretary Xavier Becerra announced in July 2022 that under EMTALA “no matter where you live, women have the right to emergency care — including abortion care.”

“Today, in no uncertain terms, we are reinforcing that we expect providers to continue offering these services, and that federal law preempts state abortion bans when needed for emergency care,” Becerra wrote in a statement. “Protecting both patients and providers is a top priority, particularly in this moment.”

The announcement came shortly after the Supreme Court overturned the nationwide, constitutional right to an abortion that was established in the 1973 Roe v. Wade ruling and the 1992 Planned Parenthood v. Casey decision.

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(Joe Raedle/Getty Images)

The state announced that a long-awaited law allowing people to obtain birth control without a prescription went into effect Monday.

As for where women will need to go to take advantage of the law, that’s unknown. Gov. Phil Murphy’s administration said it does not have a list of participating pharmacies, and only five pharmacists have certified that they have taken the necessary training.

In a statement, Murphy called the move “an important step forward in our efforts to expand access to reproductive health care.” Since the U.S. Supreme Court in 2022 struck down the federal right to abortion, Democrats like Murphy have taken steps to codify abortion rights at the state level and enact other protections for women’s reproductive rights.

“As we witness an attack on reproductive freedom across the country, New Jersey will continue to be a safe haven for women to access the care they need,” Murphy said.

Murphy signed the law allowing qualified pharmacists to dispense self-administered contraceptives like birth control pills, rings, or patches without a prescription in January 2023. It was set to take effect in May, but the state Board of Medical Examiners and the state Board of Pharmacy had to finalize rules before over-the-counter sales could start, leading to the slow implementation of the law.

Now that those rules and protocols are adopted, authorized pharmacists can dole out those products without a prescription. Pharmacists had to complete the state-approved training program, and participation was optional.

New Jersey joins at least 29 other states that allow pharmacists to dispense certain contraceptives without a prescription, according to the Guttmacher Institute.

Pharmacy giant CVS applauded the state’s move in a statement and said it looks forward to bringing this service to the state. CVS says it already provides Opill, an FDA-approved contraceptive that consumers can purchase without a prescription. Opill contains only one hormone, progestin, compared to more common types of contraceptives that include estrogen and progestin.

A Walgreens spokeswoman said the company is still determining its next steps.

The state Division of Consumer Affairs said it would share a list of participating pharmacy locations “once available.”

Since the Supreme Court’s 2022 decision overturning Roe, New Jersey officials have taken numerous steps to protect reproductive rights: requiring health insurers to cover contraceptives for 12 months instead of six, mandating insurance coverage for abortion services, increasing funding for family planning services and abortion clinic security, allowing midwives to perform abortions, and launching a “strike force” to ensure compliance with patient confidentiality restrictions.

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WASHINGTON, DC - MAY 17: Protesters cheer as they attend the "Jewish Rally for Abortion Justice" rally at Union Square near the U.S. Capitol on May 17, 2022 in Washington, DC. The rally, hosted by the National Council of Jewish Women, is taking place more than two weeks since the leaked draft of the Supreme Court's potential decision to overturn Roe v. Wade. (Photo by Anna Moneymaker/Getty Images)

Lawmakers who oppose abortion often invoke their faith — many identify as Christian — while debating policy.

The anti-abortion movement’s use of Christianity in arguments might create the impression that broad swaths of religious Americans don’t support abortion rights. But a recent report shows that Americans of various faiths and denominations believe abortion should be legal in all or most cases.

According to a Public Religion Research Institute survey of some 22,000 U.S. adults released last week, 93% of Unitarian Universalists, 81% of Jews, 79% of Buddhists and 60% of Muslims also hold that view.

Researchers also found that most people who adhere to the two major branches of Christianity — Catholicism and Protestantism — also believe abortion should be mostly legal, save for three groups: white evangelical Protestants, Latter-day Saints and Jehovah’s Witnesses.

Historically, the Catholic Church has opposed abortion. But the poll found that 73% of Catholics of color — PRRI defines this group as Black, Asian, Native American and multiracial Americans — support the right to have an abortion, followed by 62% of white Catholics and 57% of Hispanic Catholics.

The findings show that interfaith views on abortion may not be as simple as they appear during political debate, where the voices of white evangelical legislators and advocates can be the loudest.

States Newsroom spoke with Abrahamic religious scholars — specifically, experts in Catholicism, Islam and Judaism — and reproductive rights advocates about varying perspectives on abortion and their history.

Abortion views in America before Roe v. Wade

The Moral Majority — a voting bloc of white, conservative evangelicals who rose to prominence after the U.S. Supreme Court Roe v. Wade ruling in 1973 — is often associated with spearheading legislation to restrict abortion.

Gillian Frank is a historian specializing in religion, gender and sexuality who teaches at the Stevens Institute of Technology in New Jersey. Frank said evangelical views on abortion were actually more ambivalent before the early ’70s Roe decision established the federal right to terminate a pregnancy. (The Supreme Court upended that precedent about two years ago.)

“What we have to understand is that evangelicals, alongside mainline Protestants and Jews of various denominations, supported what was called therapeutic abortion, which is to say abortion for certain exceptional causes,” Frank said, including saving the life or health of the mother, fetal abnormalities, rape, incest and the pregnancy of a minor. Religious bodies like the Southern Baptist Convention and the National Association of Evangelicals said abortion was OK in certain circumstances, he added.

Evangelical protestants before Roe did not endorse “elective abortions,” Frank said, or what they called “abortion on demand,” a phrase invoked by abortion-rights opponents today that he said entered the American lexicon around 1962.

The 1973 ruling was seismic and led organizations opposing abortion, such as the National Right to Life Committee — formed by the Conference of Catholic Bishops — to sprout across the country, according to an article published four years later in Southern Exposure. Catholic leaders often lobbied other religious groups — evangelicals, Mormons, orthodox Jews — to join their movement and likened abortion to murder in their newspapers.

After Roe, “abortion is increasingly associated with women’s liberation in popular rhetoric in popular culture, because of the activism of the women’s movement but also because of the ways in which the anti-abortion movement is associating abortion with familial decline,” Frank said. Those sentiments, he said, were spread by conservative figures like Phyllis Schlafly, a Catholic opposed to feminism and abortion, who campaigned against and managed to block the Equal Rights Amendment in the 1970s.

Polls suggest the views of Catholic clergy and laypeople diverge

Catholicism is generally synonymous with opposition to abortion. According to the United States Conference of Catholic Bishops, the church has stood against abortion since the first century. The conference points to Jeremiah 1:5 in the Bible to back up arguments that pregnancy termination is “contrary to the moral law.”

But nearly 6 in 10 American Catholics believe abortion should be mostly legal, according to a Pew Research Center report released last month.

Catholics for Choice spokesperson Ashley Wilson said that there’s a disconnect between the church as an institution and its laity. “We recognize that part of the problem is that the Catholic clergy, and the people who write the official teaching of the church, are all or mostly white male — my boss likes to say ostensibly celibate men — who don’t have wives,” Wilson said. “They don’t have daughters. They have no inroads into the lives of laypeople.”

Her group plans on going to Vatican City in Rome this fall to lift up stories of Catholics who’ve had abortions. The organization is also actively involved in efforts to restore abortion access — 14 states have near-total bans — through direct ballot measures in Colorado, Florida and Missouri this year.

Catholic dioceses and fraternities are often behind counter-efforts to proposed ballot questions. They poured millions into campaigns in Kansas and Kentucky in 2022 to push anti-abortion amendments, and also in Ohio last year to defeat a reproductive rights ballot measure but they failed in each state.

Ensoulment and mercy in Islam

Tenets of Islam — the second largest faith in the world — often make references to how far along a person’s pregnancy is and whether there are complications. University of Colorado Law professor Rabea Benhalim, an expert of Islamic and Judaic law, said there’s a common belief that at 40 days’ gestation, the embryo is akin to a drop of fluid. After 120 days, the fetus gains a soul, she said.

While the Quran doesn’t specifically speak to abortion, Benhalim said Chapter 23: 12-14 is considered a description of a fetus in a womb. The verses are deeply “important in the development of abortion jurisprudence within Islamic law, because there’s an understanding that life is something that is emerging over a period of stages.”

In some restrictive interpretations of Islam, there’s a limit on abortion after 40 days, or seven weeks after implantation, Benhalim said. In other interpretations, because ensoulment doesn’t occur until 120 days of gestation, abortion is generally permitted in some Muslim communities for various reasons, she said. After ensoulment, abortion is allowed if the mother’s life is in danger, according to religious doctrine.

Sahar Pirzada, the director of movement building at HEART, a reproductive justice organization focused on sexual health and education in Muslim American communities, confirmed that some Muslims believe in the 40-day mark, while others adhere to the 120-day mark when weighing abortion.

“How can you make a black-and-white ruling on something that is going to be applied across the board when everyone’s situation is different?” she asked. “There’s a lot of compassion and mercy with how we’re supposed to approach matters of the womb.”

The issue is personal for Pirzada, who had an abortion in 2018 after her fetus received a fatal diagnosis of trisomy 18 when she was 12 weeks pregnant. “I wanted to terminate within the 120-day mark, which gave me a few more weeks,” she said.

She consulted scholars and Islamic teachings before making the decision to end her pregnancy, she said, and mentioned the importance of rahma — mercy — in Islam. “I tried to embody that spirit of compassion for myself,” she said.

Pirzada, who is now a mother of two, had the procedure at exactly 14 weeks on a day six years ago that was both Ash Wednesday and Valentine’s Day. She said she felt loved and surrounded by people of faith at the hospital, where some health care workers had crosses marked in ash on their foreheads. “I felt very appreciative that they were offering me care on a day that was spiritual for them,” she said.

Seeing the stories of people with pregnancy complications in the period since the Supreme Court overturned the federal right to an abortion has left her grief stricken. For instance, Kate Cox, a Texas woman whose fetus had the same diagnosis as Pirzada’s, was denied an abortion by the state Supreme Court in December. Cox had to travel elsewhere for care, Texas Tribune reported.

Benhalim, the University of Colorado expert, said teachings in Islam and Judaism offer solace to followers who are considering abortion, as they can provide guidance during difficult decisions.

No fetal personhood in Judaism

In Jewish texts, the embryo is referred to as water before 40 days of gestation, according to the National Council of Jewish Women. Exodus: 21:22-23 in the Torah mentions a hypothetical situation where two men are fighting and injure a pregnant woman. If she has a miscarriage, the men are only fined. But if she is seriously injured and dies, “the penalty shall be a life for a life.”

This part of the Torah is interpreted to mean that a fetus does not have personhood, and the men didn’t commit murder, according to the council. But this may not be a catchall belief — Benhalim noted that denominations of Judaism have different opinions on abortion.

Today, Jewish Americans have been at the forefront of legal challenges to abortion bans based on religious freedom in Florida, Indiana and Kentucky. Many of the lawsuits have interfaith groups of plaintiffs and argue that restrictions on termination infringe on their religion.

The legal challenge in Indiana has been the most successful. Hoosier Jews for Choice and five anonymous plaintiffs sued members of the state medical licensing board in summer 2022, when Indiana’s near-total abortion ban initially took effect.

Plaintiffs argued that the ban violated the state’s Religious Freedom Restoration Act, and the court later let the claim receive class-action status. Several Jewish Hoosiers said they believe life begins after a baby’s first breath, and that abortion is required to protect the mother’s health and life, according to court documents.

Last month, the Indiana Court of Appeals ruled that the plaintiffs have the right to sue the state but sent the request for a temporary halt on the ban back to a lower court.

While the decision was unanimous, Judge Mark Bailey issued a separate concurring opinion explaining his reasoning and criticizing lawmakers — “an overwhelming majority of whom have not experienced childbirth” — who assert they are protectors of life from the point of conception.

“In my view, this is an adoption of a religious viewpoint held by some, but certainly not all, Hoosiers,” he wrote. “The least that can be expected is that remaining Hoosiers of child bearing ability will be given the opportunity to act in accordance with their own consciences and religious creeds.”

Editor’s note: This article was updated to specify Evangelical Protestants in particular did not endorse “elective abortions” before Roe.

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Rep. Mikie Sherrill, right, at Cooperman Barnabas Medical Center in Livingston on April 24, 2024. (Photo courtesy of Sherrill's office)

Rep. Mikie Sherrill was in Livingston Wednesday to — again — defend abortion rights as — again — the U.S. Supreme Court is mulling whether to restrict access to the procedure.

Sherrill (D-11) chose to make her remarks outside the emergency room of the former Saint Barnabas hospital to highlight the particular dangers of the most recent case.

“It’s simple: Politicians, legislators should not be deciding whether pregnant women live or die,” she said.

Idaho’s near-total ban on abortion is at the center of the case, which the high court’s justices heard Wednesday.

The state law allows abortions if “necessary to prevent the death of the pregnant woman.” The Biden administration argues that a 1986 federal law called the Emergency Medical Treatment and Labor Act trumps the state’s law. The federal law says that hospitals participating in Medicare must offer necessary treatment to stabilize care for someone with an emergency medical condition. For the Biden administration, that means the hospital must perform an abortion if necessary to prevent severe health risks to the mother, and not just their death. Idaho argues that is too expansive a reading of the federal law.

Sherrill sounded the alarm about what will happen if the Supreme Court sides with Idaho: Women living in states with draconian abortion laws may not get the medical care they need in an emergency.

“What these Idaho lawmakers fail to understand is that when a woman comes into an emergency room with complications regarding her pregnancy, whether it’s a miscarriage, an ectopic pregnancy, or anything else, often the life-saving medical treatment they need at that moment is an abortion,” she said.

Sherrill’s appearance in Livingston Wednesday came as Democrats, sweating about the prospect of Donald Trump’s return to the White House, see abortion as a, if not the, issue that could save their party. It may also, they hope, give their party a boost statewide next year, when the governor’s race will be at the top of the ticket. Sherrill is expected to jump into that race after November’s election.

Republicans here have argued that other states’ abortion restrictions are irrelevent. We’re run by Democrats who support abortion rights and were quick to codify them when the U.S. Supreme Court overturned Roe v. Wade, they note. State Sen. Holly Schepisi (R-Bergen) has argued New Jersey Democrats who focus on abortion are scaring voters to win elections. Assemblyman John DiMaio (R-Warren), his chamber’s minority leader, wrote an op-ed last year saying abortion rights “aren’t at risk” in New Jersey.

Their message: New Jerseyans shouldn’t care about this issue.

That’s not entirely true, and Sherrill explained to me why. She said the restriction of abortion rights in other states means women’s rights are on shaky ground there and here. What if a New Jersey woman who is pregnant needs to take a business trip to a part of the country where reproductive health care is under attack, she said. Should she go? What about a college graduate thinking of where to start a family, she asked — would she want to pick a part of the country where a future pregnancy could be a death sentence?

“So I don’t think we in New Jersey feel like our protections are built on very safe ground, and as women, we really feel that curtailment of freedoms across our country,” she said.

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