- Dara Kass, emergency medicine physician1,
- Esther K Choo, emergency medicine physician2,
- Maria I Rodriguez, obstetrician gynecologist3
- 1Department of Emergency Medicine, NYC Health+Hospitals/Lincoln, New York, NY, USA
- 2Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland, Oregon, USA
- 3Oregon Health and Science University Center for Reproductive Health Equity, Portland,Oregon, USA
On 5 November 2024, the United States held its first national election since the Supreme Court reversed the constitutional protection for abortion provided by Roe v Wade. Most Americans support abortion rights, and many US political analysts therefore thought the timing would secure wins for the pro-abortion Democratic party.1 This projection proved wrong. In fact, the 2024 election showed that Americans would uphold the paradox of being a nation whose people are in favour of abortion rights yet elect leaders who are against such rights. What can we learn from this and what does it mean for abortion rights in the US?
Abortion as an election issue
Abortion has rarely been central to US federal elections. But the Supreme Court’s decision in Dobbs v Jackson that the constitution does not confer a right to abortion seemed poised to catalyse a new era, particularly considering compelling evidence about the decision’s harms. For example, maternal mortality has risen disproportionately in Texas, which now has a near total abortion ban.2 A 2022 report concluded that abortion restrictions enabled by Dobbs would cause “deepening of fractures in the maternal health system and a compounding of inequities by race, ethnicity, and geography.”3 Data have also emerged on the impact of abortion restrictions on the reproductive health workforce, which is vital to all women’s and maternal healthcare.4 States with abortion bans are seeing a decrease in residency applications5 and the obstetrician and gynaecology workforce.6
In the face of these ramifications, there seemed to be public eagerness to protect abortion. Going into the election, four states had recently enshrined abortion access into their state constitutions. Further, …
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