The dystopian American reality one month after the Roe v Wade reversal

Severe new restrictions upend reproductive care across whole regions of the US. Patients report delays for procedures that were once common and routine, as doctors fear vague new laws with criminal penalties. A 10-year-old rape victim was forced to travel out of state to terminate a pregnancy. And activists promise more draconian restrictions to come.

Bans at six weeks gestation or earlier, before most women know they are pregnant, are in force in 12 states as of Thursday. The bans have forced patients seeking abortions, and who have the time and money, to travel hundreds of miles from home. At times, that travel has also placed friends, family and abortion rights organizations in legal jeopardy, as states have criminalized helping people obtain abortions. Other patients have seen routine care for miscarriages and ectopic pregnancies delayed, as doctors fear criminal sanctions should they accidentally violate bans.

In those states where abortion remains legal, patients have suddenly found clinic appointments full. In Kansas, the nearest state to Arkansas, Missouri, Oklahoma and Texas (all of which have banned abortion), clinics are at capacity.

A still untold number of patients will carry unwanted or dangerous pregnancies to term, a situation likely to worsen as more states bring bans online in the coming weeks.

North Dakota, Idaho and Wyoming are all expected to begin enforcing bans this summer. Indiana has called a special session to restrict abortion. A more severe criminal ban, providing punishments of 99 years in prison and $100,000 in fines, is also expected in Texas, where abortion is already banned.

Kansas is representative of one such political battle. On 2 August, voters there will cast ballots on the first abortion-related referendum in the country, in what is likely to be a tight and closely watched campaign. Its neighboring states have, one by one, banned abortion: when the supreme court allowed Texas to ban abortion at six weeks gestation in 2021, clinics in Oklahoma began to care for Texas patients; then Oklahoma passed a similar six-week ban, forcing patients to Missouri and Kansas; when the court ruled in Dobbs, Missouri banned abortion, too. That has left Kansas as a legal haven for abortion.

It may not remain that way. Lawmakers have placed a statewide constitutional amendment vote on the primary ballot, which would give the Republican-dominated state legislature more latitude to restrict abortion in a state where lawmakers have already shown interest in banning it.