The 2024 election was perhaps the biggest referendum on abortion rights since the U.S. Supreme Court overturned Roe v. Wade, and the results are a mixed bag, including for those living in the South.
Vice President Kamala Harris had counted on her promise to restore abortion rights to secure her victory, a strategy that clearly failed. Meanwhile, former President Donald Trump, who appointed the justices who overturned Roe v. Wade, precipitating a wave of extreme abortion bans, won handily. In the 10 states with abortion measures, some voters — incongruously — chose both to elect Trump and enshrine abortion rights at the state level.
Trump’s presidency could usher in new restrictions on abortion and reproductive health that could impact all states, including those with abortion bans.
Florida failed to enshrine abortion rights
This means the South will remain the region with the least access to abortion care.
With 57% in favor of the measure, Florida voters fell short of the 60% threshold needed to pass a constitutional amendment to enshrine abortion rights. That result is the single largest and most immediate impact of the election for reproductive health in Louisiana and neighboring states.
In June, a 6-week ban took effect in Florida that dramatically cut back abortion access in the Deep South. Florida had been a key hub for abortion access in the region after a series of surrounding states banned nearly all abortions in 2022, including Alabama, Mississippi, and Louisiana.
Florida clinics provided over 80,000 abortions in 2023, the year before the 6-week ban went into effect. More patients from Louisiana traveled to Florida that year than to any other state for abortion care, a total of 1,710. Another 1,570 came from Alabama, and 570 from Mississippi.
But travel halted in the wake of Florida’s ban. Had the measure passed, it would have reopened access to the procedure for people across the South. But since it failed, it has cemented a dearth of access.
Overall, seven of the 10 states with abortion ballot measures voted to enshrine abortion rights. Those votes are expected to end post-Roe abortion bans in Missouri and Arizona.
Louisiana abortion rights supporters mourn, opponents celebrate
Louisiana Right to Life, the state’s leading anti-abortion group, celebrated the defeats of abortion rights in South Dakota, Nebraska and Florida last week.
“Thanks to our generous supporters, we were able to reach millions of voters in those states (especially Florida) with text messages and television, radio, and online ads,” executive director Benjamin Clapper said in an emailed statement.
The defeats were the first for abortion rights amendments post-Roe, and Clapper said they “stem the tide of the pro-abortion momentum.”
He praised Harris’s defeat and the Senate’s shift to a GOP majority, which will give Trump the ability to appoint federal judges and Supreme Court justices and continue shifting federal courts to the right.
“With this victory, the U.S. Supreme Court is all but assured to be protected for the next four years,” Clapper said.
He said he was “cautiously optimistic” that Republicans would retain control of the House and keep Louisiana Congressman Mike Johnson as Speaker.
If that happens, Clapper said he hopes Congress will increase funding for crisis pregnancy centers, which have received millions of dollars in support from Louisiana’s legislature. These are typically Christian-affiliated organizations that are not medical clinics and do not provide comprehensive reproductive health care. A 2023 analysis by WWNO/WRKF found that 33 Louisiana crisis pregnancy centers with a website did not refer for or provide contraception or emergency contraception, and some provided reproductive health misinformation.
Gene Mills, a pastor and the president of the Louisiana Family Forum, another powerful anti-abortion voice at the Capitol, celebrated Trump’s “epic comeback” and his ongoing support among evangelicals and Catholics.
Abortion rights supporters released statements of stark disappointment. Michelle Erenberg, the executive director of Lift Louisiana, called the outcome “profoundly unsettling and F-d up.”
“This is especially painful because they have already been hurt by the racism, homophobia, and bigotry embedded in the conservative agenda in Louisiana,” she said in a statement. “And today, as we look ahead, it’s difficult to see a clear path forward.”
Erenberg also celebrated the abortion ballot victories and said they’re a reminder that reproductive freedom “can prevail.”
The Louisiana Abortion Fund struck a similarly dark tone.
“While we were excited to see seven out of ten states voted to protect or expand access, yesterday’s losses are heartbreaking as real people — our neighbors, friends, mothers, and sisters — will pay the price,” Chasity Wilson, the executive director of the Louisiana Abortion Fund said in a statement.
Wilson said the fund will continue to help people travel out of state for abortion care. Erenberg said Lift Louisiana is “steadfast in our commitment to protecting your rights and supporting you every step of the way.”
The rush to obtain abortion medication is legally complicated in Louisiana
Requests for abortion medications have spiked after Trump’s win. One online provider, Aid Access, told the Guardian that requests jumped even higher than after the U.S. Supreme Court overturned Roe v. Wade. Providers of emergency contraception saw a similar surge.
The co-founder of Plan C, which connects patients to online abortion medications, said people fear a “reproductive apocalypse” is coming under Trump.
Medication abortion has played a pivotal role in the post-Roe landscape. One of the key ways women have stalled the impact of state abortion bans is by ordering abortion medications online and giving themselves abortions (the other is by traveling out of state).
Recent data found that Louisianians were giving themselves abortions at a higher rate than any other state in the country — 60% of abortions in the first six months of 2023 were via pills ordered online. Mail-order medication abortions accounted for half of all abortions in Mississippi and over 1,700 abortions in Alabama over the same period.
Then, Louisiana took an unprecedented step this year to crack down on the use of these medications by scheduling the two drugs used to induce abortions, mifepristone and misoprostol, as controlled substances.
Now, anyone caught with the drugs without a valid prescription faces penalties of up to 10 years in prison. The law carries a carve-out to specifically exempt women who are pregnant from those penalties.
But as I reported in the spring, that doesn’t exempt people who aren’t pregnant, but who want to buy the medications in advance for themselves or others.
What a potential national abortion ban could mean for the South
Throughout the campaign, former President Donald Trump has sent mixed messages about his stance on abortion rights. He’s boasted about appointing the three Supreme Court justices who helped overturn Roe. He’s also claimed his second term would be “great for women and their reproductive rights.” He once said there should be punishment for women who have abortions, and then more recently said he would not sign a national ban.
It’s unclear whether Republicans might try to advance such a ban if they gain full control of Congress. But many oppose abortion rights. Johnson was one of 166 members of Congress who co-sponsored legislation that would create a constitutional right to life for every fertilized egg, which could ban abortion and limit access to IVF and potentially some birth control.
Project 2025, the conservative playbook for a second Trump term (which Trump tried to distance himself from during his campaign), calls for the Food and Drug Administration to rescind approval for mifepristone, the abortion medication, and to revive the Comstock Act to ban abortions nationwide.
Any of that would decimate the access to abortions that those in states with bans have been able to preserve for themselves — making medications harder to access and forcing women to travel not just out of state for care, but out of the country.
Reproductive rights advocates are worried about access beyond abortion. Some anti-abortion groups have opposed the Biden administration’s move to approve the first over-the-counter birth control pill. Republicans in Congress blocked bills earlier this year that would have enshrined the right to IVF and contraception. In an interview, Trump also appeared to suggest that he’d leave potential restrictions on birth control up to each state.
Cynthia Harper, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco School of Medicine, said she expects a Trump administration could limit access to contraception for people across the country in a much more direct way through various federal programs that make it more affordable and accessible.
“The prior Trump administration curtailed funds for family planning through the Title IX program,” she said. “They put restrictions on that funding, and they actually made it available to clinics that didn't even have contraceptive services.”
Harper said Republicans could also reduce federal funding for Medicaid and the Affordable Care Act, two programs that people rely on for affordable access to contraception.
