WASHINGTON — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
Maybe you had a bad experience with your last Pap smear and you’re wary of going back to the ob-gyn. Or maybe you’ve never had one before and are scared to make the appointment. It’s understandable to feel anxiety about women’s health care, but a Pap smear is an important screening tool for cervical cancer.
“A lot of people feel really nervous or anxious to get a Pap smear, and some people aren’t quite sure of exactly what we’re testing for,” says Dr. Jayme Trevino, an ob-gyn and fellow with the American College of Obstetricians and Gynecologists (ACOG). “One of my goals when a patient is coming to me for a Pap test is to thoroughly explain exactly what we’re looking for and the steps of the process.”
Here, two ob-gyns explain what a Pap smear entails and dispel some common misconceptions about the potentially life-saving test.
What is a Pap smear?
A Pap smear involves collecting a sample from the cervix to test for abnormal cells that are cancerous or could lead to cervical cancer. The procedure typically only lasts for a minute, if that. Your medical provider will insert a speculum into your vagina, and then swab a sample from your cervix.
Cervical cancer grows slowly, says Dr. Jennifer Lincoln, an ob-gyn in Portland, Ore. The earlier you can catch precancerous cells, the faster you and your medical provider can come up with a plan to treat them and prevent them from turning into cancer.
People often confuse the procedure with a human papillomavirus (HPV) test or a pelvic exam. While an HPV test involves the same steps as a Pap smear—a speculum and a swab of the cervix—the lab tests specifically for strains of HPV, which can also lead to cervical cancer. A pelvic exam, meanwhile, is when a medical provider checks the uterus, cervix, and other parts of the reproductive system by using their fingers and hands or a speculum.
“The biggest misconception is that people think any time they’re having a speculum placed in their vagina, that that is a Pap smear,” says Lincoln, who previously made a YouTube video demonstrating the different procedures. “It’s really important for people to know that a Pap smear is a procedure where we are getting a little brushing or a sample of cervical cells in order to see if they look abnormal—either that they are cervical cancer or they could potentially become cervical cancer. It’s a very specific test.”
How often should you get one?
Generally speaking, you should start getting regular Pap smears at age 21, according to ACOG’s guidelines. That’s a better guideline to follow than when you first become sexually active, experts say, even though the latter date might be sooner, because the chances of someone under the age of 21 getting cervical cancer is so small.
How frequently you should go for a Pap smear after that depends on your age and risk factors. But typically, you should get the screening done every three years between ages 21 and 29, according to ACOG’s guidelines. Between the ages of 30 and 65, you can choose one of three options: get a Pap smear and an HPV test every five years, get a Pap test alone every three years, or get an HPV test alone every five years.
If you’re 65 or older, you may not need to get regular Pap smears anymore if you have no history of cervical changes and have tested negative on three Pap smears in a row, two HPV tests in a row, or two HPV andPap tests in a row within the past 10 years, according to ACOG.
Does it hurt?
While a Pap smear can be uncomfortable, it should not hurt.
“If a Pap smear is hurting, that’s a sign that something is not right,” Lincoln says. It could be how the test is being performed—for instance, if it’s not being done in a gentle manner or if you’re clenching because you’re not sure what to expect from the test—or it could be a sign of an underlying condition, such as a pelvic floor dysfunction issue or vaginal dryness, according to Lincoln.
“It should feel like pressure; it can feel uncomfortable for a couple of minutes, but if it’s causing acute pain, it is absolutely okay to say, ‘Stop, this hurts.’ And they should absolutely stop and then try to figure out what’s going on,” Lincoln says. “You’re not supposed to be crying or in pain.”
What happens afterward?
It’s possible that you may experience cramping or some spotting after the procedure, according to Lincoln. But heavy bleeding is not normal, she says.
The test results typically take a couple of days. Lincoln recommends asking your provider how you’ll be getting the results back—if your provider will call you to walk you through the results or if you’ll be getting them electronically, for instance—because it can vary depending on your provider and their office.
If the results come back normal, all is well. If they come back unsatisfactory, it may mean you need to come back in for another Pap smear because the sample didn’t provide enough cells for the test. If the results are abnormal, don’t panic—most of the time that doesn’t mean you have cervical cancer. Talk to your provider about what the results mean for you. Depending on your risk factors and the types of cells detected—minor or serious ones—your provider might recommend coming in for additional tests, like a colposcopy, which is when a medical provider inserts a speculum into your vagina and uses a magnifying instrument to get a better look at your cervix.
Talk to your doctor in advance
While Lincoln and Trevino understand why people may feel anxious or wary of getting a Pap smear—“It’s not super fun,” Lincoln acknowledges—they both emphasize the importance of the test.
“I always encourage my patients to feel really empowered, especially during the exam, to let me know what’s going on and if they need me to stop,” Trevino says.
Both doctors say there are ways to make yourself feel at ease during a Pap smear—whether that’s bringing someone to the appointment with you for support, listening to music, or taking ibuprofen an hour or so before the exam to help avoid cramps.
Lincoln and Trevino also encourage people to talk to their provider about what the test entails so they can be informed before getting the procedure done.
“I just wish more people knew that for the vast majority of people, getting a Pap smear is not painful,” Lincoln says. “We fear the unknown. So being informed about what to expect, I think, is huge.”
In 2017, Dr. Barbi Phelps-Sandall, an obstetrician who has been practicing in the San Francisco Bay area for more than two decades, had just learned about a new blood test only available at select labs for predicting premature birth when the perfect case walked into her office.
At 40, she was pregnant with her third child. Her first was born full term, but during her second pregnancy, she went into labor at 32 weeks.
Because she had a history of premature labor, she was at higher risk of delivering her third baby early as well. But as the primary earner for her family, she could not afford to take time off on bed rest like she had for her second. Phelps-Sandall decided to give her the blood test to help inform any decision they made about her options.
The test, called PreTRM, tracks levels of two proteins in the blood that tend to rise during the second trimester in women who are at risk of delivering early. This patient’s test was negative. That helped Phelps-Sandall and her patient decide to schedule more regular vaginal exams and get more frequent fetal monitoring, but gave them a little more reassurance that she wouldn’t need bed rest.
The baby ended up sticking to its due date. “The blood test made life so much easier because it made us feel more secure,” says Phelps-Sandall.
She now offers the test to every patient she sees, regardless of their risk of delivering prematurely. “It gives us information we never really had before.” Now, women can order it whether or not their ob-gyn knows about it or offers it.
Who can get the test?
Developed by Sera Prognostics, the test is not yet approved by the U.S. Food and Drug Administration but is available for doctors to order as a laboratory-developed test, which means that doctors in any state can order the test but only designated certified labs can perform the analysis. (New York state requires its department of health to certify any laboratory-developed tests for any of its residents, and this approval happened in 2018.)
Doctors can order the prescription test and take a few drops of blood from a fingerprick. They then send the sample to the company’s labs in Salt Lake City for analysis. However, not many doctors are even aware of the relatively simple test for identifying women at highest risk of delivering early.
Beginning Oct. 1, any woman can also order the test from the company’s website, either by getting a prescription from her physician or connecting with one of Sera’s telehealth providers. The test kit and instructions are sent to expectant mothers’ homes, where they can collect the blood sample and send it to Sera’s lab. Either their doctor or the telehealth doctor will receive and discuss the results with them.
Why is preterm birth dangerous?
Doctors consider any birth before 37 weeks gestation to be preterm, and it can lead to both short- and long-term health complications for newborns—including breathing and feeding problems, weaker immune systems, and lengthy stays in the neonatal intensive care unit. About one in 10 babies born in the U.S. is premature, according to the U.S. Centers for Disease Control and Prevention.
“This is a paradigm change,” says Dr. Matthew Hoffman, vice chairman of obstetrics and gynecology at Christiana Care Health System who was involved in the studies of PreTRM. “In obstetrics we are faced with two questions: when and how to deliver the baby. This [test] lets us have insights into who is at risk, and put in preventive services [to prevent preterm birth].”
How the test works
The blood test measures levels of two proteins: the sex-hormone binding globulin, or SHBG, and the insulin-like growth factor binding protein (IBP4). It’s not the absolute levels of each that’s important, says Zhenya Lindgardt, CEO of Sera Prognostics, but the ratio of the two between 18 and 21 weeks gestation. Women with higher ratios—as determined by the company’s studies looking at the levels of women giving birth at term and those giving birth prematurely—are at higher risk of going into labor early compared to those with lower ratios.
Because hormone and protein levels fluctuate constantly during pregnancy, the two proteins PreTRM tracks are carefully chosen and measured only when women are between 18 and 21 weeks of pregnancy. Any earlier or later might yield inaccurate results.
If PreTRM indicates a higher risk of preterm delivery, then doctors can prescribe aspirin, vaginal progesterone, and more frequent vaginal and fetal checks to ensure the cervix remains closed. Currently about half of preterm births in the U.S. occur in women with known risk factors for early delivery, including a history of previous preterm birth or a shortened cervix. But the rest don’t expect, and their doctors can’t predict, that they will deliver early. “In the study, we identified about a third of women who were at higher risk. We were able to identify a much larger group of women, let them understand their risk, and give them tools to manage that risk,” says Hoffman. “This allows us to approach women who didn’t have a history of prior preterm birth, or didn’t have a shortened cervix.”
The promise of preventing more preterm births
With more widespread use of the test, doctors may gain better knowledge about the myriad factors that can contribute to early labor, and ultimately intervene much earlier than 18 weeks if they better understand other factors that are involved. “We should be thinking of this [test] as a population health component to improve the outcomes for both moms and babies long term,” Hoffman says.
The company is completing another study looking at health outcomes for babies whose mothers used PreTRM; the trial was stopped early last December because the initial results also showed benefit.
“PreTRM allows me to get ahead of things,” says Phelps-Sandall. “We don’t have good predictors for this condition. We know of a conglomerate of things that can explain why 50% of babies are born prematurely, but the other 50% are total surprises. This test allows you to catch a lot of those.”
At least 210 pregnant people faced criminal charges for “conduct associated” with pregnancy in the first year after the U.S. Supreme Court overturned Roe v. Wade—the highest number documented in a single year, according to a new report by Pregnancy Justice, a nonprofit dedicated to protecting pregnant people’s rights.
The report, released on Tuesday, covered prosecutions initiated from June 24, 2022 to June 23, 2023, but researchers plan to document all charges of pregnancy criminalization in the country in the years since the decision in Dobbs v. Jackson Women’s Health Organization in June 2022. The report defines pregnancy criminalization as occurring “when the state wields a criminal law to render acts associated with a pregnancy, pregnancy loss, birth, and/or associated healthcare the subject of criminal prosecution.” Pregnancy criminalization can include abortion criminalization, but is not limited to it. The majority of the pregnancy-related charges documented in the report, for instance, alleged substance use during pregnancy.
In the report, researchers called pregnancy criminalization “nothing new.” Pregnancy Justice and other groups have recorded more than 1,800 cases of pregnancy-related charges from 1973 to 2022, according to the report. But researchers attribute the acceleration in pregnancy criminalization in the first year after the Dobbs decision to the rise of “fetal personhood” laws, which grant legal rights to an embryo or fetus. The report found that pregnancy-related prosecutions were highest in Alabama, followed by Oklahoma and South Carolina—states that have abortion bans or restrictions.
TIME discussed the report’s findings and what they mean with Pregnancy Justice President Lourdes Rivera.
This interview has been condensed and edited for clarity.
Can you talk about the types of pregnancy-related charges your team uncovered? The majority of the charges were alleged substance use—why is that significant?
That’s been an ongoing pattern since the war on drugs in the 80s and 90s—that’s been the entry point to help create this idea that there are mothers who are harming their babies. The way people get caught up is they go to their doctors to get access to care. So just imagine: someone has a substance use disorder, they become pregnant, they go to the doctor to get help, and instead they get reported to the family policing system and to law enforcement.
Opioid disorder-related deaths have emerged as [a leading] contributor to maternal mortality, and you do not address that by driving people away from health care, which is what criminalization does. All the major medical associations and public-health associations oppose criminalizing pregnant people and criminalizing substance use during pregnancy because it drives people away from health care, which is exactly what they need.
What would you say is the most important takeaway from the report?
The overarching essential finding is the 210 cases that were uncovered, which is the highest number of criminal cases documented in any single year. The other key finding is that there were 22 cases of people being criminalized for pregnancy loss, a widely shared experience. Post-Dobbs, pregnancy loss is treated as a highly suspicious event.
We were expecting to find, given that it was post-Dobbs, that specific abortion criminalization laws would be used to prosecute people. And we actually, except for one, did not find any cases to date where a specific abortion law was being used to criminalize pregnant people.
The report mentions that four cases included allegations concerning abortion, but that the individuals weren’t prosecuted on an abortion crime charge. Can you talk about the significance of that?
There’s been a lot of focus on the direct attacks on abortion, and we’ve seen backlash to that from the American public. What’s been happening is that pregnant women are being surveilled and investigated and prosecuted—not under specific abortion laws, because I think that would be politically unpopular, but rather, they’re using this mechanism and this architecture that has been built over time that’s been more under the radar.
What’s driving this is this really extreme ideology [of fetal personhood] that used to be on the fringe of the anti-abortion movement, but has now occupied the center and has been embedded in state criminal and civil law—like, for example, in the Alabama IVF decision, where a frozen embryo is now considered a child for purposes of wrongful death.
This infrastructure and architecture is available for prosecutors and law enforcement to use and they don’t have to rely on a specific abortion criminal law.
We have to understand that pregnant people are being criminalized already. And if you’re only looking for the abortion law, then you’re missing a really crucial piece of the big picture.
The report found that the majority of people who were facing pregnancy-related charges in the year post-Dobbs were white and low-income. Oftentimes experts point out that threats to reproductive health disproportionately impact people of color.
Both things continue to be true. If we look at how fetal personhood got a foothold—how it went from the fringey margins and became more like a central strategy—it was in the 80s and 90s, when we were in the midst of the war on drugs, where Black and brown communities were being targeted. And this gave abortion opponents an opportunity to create this whole myth of fetuses as separate victims of Black and brown women’s behavior around the use of substances.
So that mechanism was built, and now as the drug crisis has shifted to opioids and methamphetamines—which is also a crisis that is disproportionately experienced by poor white communities and people in rural areas—you then see the same framework being applied over there.
We’re still seeing Black, brown, and Indigenous women being targeted. The other caveat is that our data relies on the court records, and court records are notoriously under-counting Black and brown and multi-ethnic people.
In 121 of the 210 cases, the information that led to charges was obtained or disclosed in a medical setting. Does that raise concerns for you that people may fear disclosing medical information to their doctors or seeking medical care at all?
Absolutely, this is a huge concern, and that it is really counterproductive. Anyone who goes to the doctor believes that if they share information with their doctor, it’s going to be to the benefit of their own health care. But if you’re a pregnant person, it’s like you have no confidentiality in your medical information. You get treated very differently because of your pregnancy status in health care settings, so this is a glaring gap in patient privacy protection laws.
Sometimes this reporting happens because of bias within those health care settings, and sometimes it is because [of] hospital policy, and sometimes it is because of state law. All of that is just really misdirected and contrary to the positions of major medical associations and public health associations.
What can the government do to address the issues that the report uncovered?
A few things. It depends on the administration, but the Department of Justice and the Office [for] Civil Rights in the Department of Health and Human Services can investigate whether or not this is race and/or sex discrimination.
We also just have to strengthen HIPAA laws to protect patient confidentiality in these circumstances. And we also need to urge states to adopt laws that require patient-informed consent before they can be drug tested at all, or to have their newborns drug tested. They shouldn’t be punished if they refuse to give that consent. There’s so much overtesting that happens without any actual clinical need, and there are false positives—I mean, all kinds of things happen, right? And that just starts this whole cascade of state involvement in your life that could result in a family losing their children or having the pregnant person or the postpartum person be criminalized.
In February, a horrified Elizabeth Carr scrolled through headline after headline about a pause on in vitro fertilization (IVF) procedures in Alabama. The Alabama Supreme Court had ruled that frozen embryos have the legal rights of children, a decision that meant fertility providers could feasibly face prosecution if they destroyed one. Rather than take that risk, some fertility clinics halted IVF services entirely.
Carr, who in 1981 became the first baby in the U.S. born using IVF, felt like “an endangered species.” When Carr was born, IVF—a process of fertilizing eggs outside a woman’s body, then implanting a resulting embryo in her uterus—was new and largely unknown. Carr’s parents, who desperately wanted children but struggled to have them naturally, were willing to face public scrutiny and repeatedly travel from their home in Massachusetts to a pioneering clinic in Virginia to try the cutting-edge procedure. IVF’s success for the Carrs led not only to their daughter’s historic birth, but also compelled Elizabeth to become an advocate for reproductive rights when she grew up. Over those recent days in February, when patients in Alabama were shut out of fertility clinics, Carr acutely felt the importance of her work. Moments like those, she says, are “why we advocate so loudly.”
Elizabeth Carr, pictured with her parents Judith and Roger Carr, in 1981 became the first U.S. baby born using IVF. Bettmann Archive/Getty Images
Despite the backlash, judges in Alabama declined to reconsider their controversial ruling. And more than a dozen other U.S. states have laws in place that could be interpreted as bestowing personhood rights on an embryo, even if it has not yet resulted in a pregnancy. Courts in other states haven’t yet applied these laws in ways that directly threaten IVF—although Louisiana law forces fertility providers to ship embryos out of state for destruction—but the possibility is there if the wrong case comes before the wrong judge, says Rebecca Reingold, an associate director at the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center.
Right now, it is politically unpopular to attack IVF, a technology that has given life to millions of people and hope to some of the one in six adults worldwide with infertility. Only 8% of U.S. adults actively oppose access to IVF, according to recent polling, and even lawmakers from states that have cracked down on abortion, like Texas, have introduced bills to protect IVF.
And yet, in June, Republican senators—including former President Donald Trump’s current running mate, J.D. Vance—voted against a bill that would have established a federal right to IVF care. The same month, members of the Southern Baptist church voted to oppose the use of IVF, a decision that has no legal ramifications but signals a growing willingness among religious conservatives to embrace prenatal personhood concepts that effectively place IVF in the same category as abortion.
How did we get here? And where are we going?
Doctors from the Alabama Fertility Clinic look on and takes photos as lawmakers vote on SB159, a bill providing protections for IVF providers, in the House Chambers in Montgomery, Ala., on March 6, 2024.Butch Dill—AP
Growing anti-IVF sentiment
The concept of prenatal personhood isn’t new, but it has historically been unpopular. In a 2013 legal journal article, reproductive-rights expert Maya Manian argued that’s because “public concern over the ‘side effects’ of personhood laws”—such as infringing on fertility care, contraception access, and women’s health care more broadly—“seems to have persuaded even those opposed to abortion to reject personhood legislation.” It was, in other words, a step too far for most people.
In a relatively short span of time, however, the idea has gone from “radical or fringe” to one that is gaining ground, Reingold says. It has even transcended the anti-abortion movement, with ex-spouses in some cases using the concept to argue that frozen embryos should be treated by the courts as children, not marital property, during divorce proceedings. As such ideas snowball, IVF may become the next frontier in the battle over reproductive rights, advocates and scholars say.
“It’s clear to us—it always has been—that the anti-abortion movement has not, and will not, stop their efforts at limiting or banning abortion,” says Karla Torres, who leads the nonprofit Center for Reproductive Rights’ work on assisted reproductive technology. They are “squarely targeting reproductive freedom more broadly,” drawing everything from IVF to contraception into the fray.
If IVF becomes harder to access, it’s hard to overstate the effect for American families and culture at large. About 2% of babies born in the U.S. in recent years—nearly 100,000 annually—arrived with the help of IVF. But the technology’s impact transcends statistics. In about a half century of use, it has reshaped what it means to be a parent, who gets to be one, and how—progress that’s now under threat.
A collection of needles, injections, syringes, and old pill bottles used during a patient’s IVF journey in Lemoyne, Penn., on March 9, 2024.Hannah Yoon—The Washington Post/Getty Images
A confusing position
In some ways, IVF is an unlikely target. The technology enables people to have badly wanted biological children, a sentiment that could be seen as having a “conservative traditional family aspect to it,” says Amanda Roth, an associate professor of philosophy and women’s and gender studies at the State University of New York at Geneseo. The importance of having children is a regular conservative talking point—see: Vance recently calling child-free women “cat ladies” without a “direct stake” in the future of America—and IVF makes it possible for more people to do that.
But many in the anti-abortion movement argue that life begins at the moment of conception—that is, the moment sperm fertilizes an egg to create an embryo, either the old-fashioned way or in a laboratory. (A fertilized egg is considered an embryo until the end of the 10th week of pregnancy, when it becomes a fetus.)
To that effect, about a third of U.S. states currently have laws that establish prenatal personhood rights at some stage of pregnancy, usually as a means of curtailing access to abortion by establishing that terminating a pregnancy is tantamount to killing a child. Nine of these laws, such as those in Arkansas, Kansas, and Tennessee, are either sweeping enough or vaguely worded enough that they could put IVF services at risk, according to analysis from the nonprofit Pregnancy Justice provided to TIME. Six additional states, including the Dakotas, Michigan, and Oklahoma, have either feticide or wrongful death laws broad enough to potentially apply to embryos. And there’s always the possibility of new laws: already in 2024, more than a dozen bills focused on prenatal personhood have been introduced across the U.S.
Greer Donley, an associate professor at the University of Pittsburgh School of Law who studies abortion law, doesn’t think curtailing access to IVF is a “priority” for the anti-abortion movement, but rather an “unfortunate side effect that [anti-abortion advocates] haven’t been able to account for.” It’s a narrative problem: to argue an embryo in a mother’s womb is a person, but one sitting in a fertility clinic freezer isn’t, would weaken the movement’s argument. So, despite the cognitive dissonance, IVF has become “collateral damage” in the abortion wars, Donley believes.
Graphic for TIME by Lon Tweeten and Jamie Ducharme; Getty Images
Whether the situation was intentional or not, threats to IVF are real. The Alabama Supreme Court demonstrated as much in February, when it ruled that the state’s Wrongful Death of a Minor Act applies to not-yet-implanted embryos, prompting fertility clinics to pause IVF services for fear that patients or providers could be legally liable if embryos were destroyed in the course of care. That’s not an irrational fear: embryos are destroyed all the time in the fertility world, either purposely (perhaps because a patient no longer wishes to pay for storage, or because the embryo is unlikely to result in a healthy pregnancy) or because of human error.
Accidents happen, says Dr. Gerard Letterie, a reproductive endocrinologist at Seattle Reproductive Medicine who has written about the potential impact of fetal personhood laws on clinicians. An embryo could be destroyed through an innocent mistake, like someone tripping while carrying a petri dish. “If that were to be made a felony charge, that’s a big deal,” Letterie says.
In that scenario, clinics might stop services entirely to avoid putting providers in legal jeopardy, as happened in Alabama. Or, even if services proceeded, providers might stop practicing in states with punitive laws, Letterie says, making access to fertility care as scattershot as access to abortion care. Already, fertility clinics tend to be clustered in wealthier urban areas.
Even short of criminal charges for providers, prenatal personhood laws could affect fertility practices, Letterie says. He can imagine policies that limit the number of eggs that may be fertilized per cycle to avoid creating extra embryos that ultimately end up discarded. Such policies—the likes of which have already been implemented elsewhere in the world, such as in Malta—could reduce the odds of patients getting pregnant, since not all embryos are viable, and force people to go through more rounds of treatment, making IVF more expensive and inaccessible than it already is. IVF can already cost upward of $10,000 per cycle without insurance, and coverage varies by state and insurance provider. If costs go up even more, Letterie says, IVF would be inaccessible to virtually everyone who isn’t mega-wealthy or lucky to have excellent health insurance.
Even taking finances out of the picture, threats to IVF have particularly high stakes for certain people. Those who stand to lose the most are those for whom IVF has been revolutionary over its half century of use: namely same-sex couples, people with medical infertility, and those who have decided to have children without a partner or later in life. “The existence of reproductive technologies has opened up new horizons for family life,” says Marcia Inhorn, a medical anthropologist at Yale University and author of Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs. In a future without reliable access to IVF, the possibilities of what families can look like might shrink.
An embryologist works in the IVF lab at Brigham and Women’s Hospital in Boston on March 15, 2024.David L. Ryan—The Boston Globe/Getty Images
A crossroads for U.S. culture
IVF and other fertility services helped break open the narrow definition of family that dominated for so long—a married man and woman and their naturally conceived children—to reveal a whole world of options. A mother can be 45 and single, even if she’s survived cancer or had her fallopian tubes removed or needs to use a donor egg to get pregnant. Same-sex couples can use “reciprocal” IVF to incorporate both of their genetic material. A child can even have three biological parents, a controversial technique that is not currently legal in the U.S. but is in several other countries.
“We’ve seen a significant diversification in how people understand kinship, relatedness, and parenting,” says Sarah Franklin, who directs the Reproductive Sociology Research Group at the University of Cambridge in the U.K.
This progress has not been equally felt around the world. Compared to the U.S., Europe and Asia have historically employed stricter regulations on the use of reproductive technologies like IVF. Although some of those policies have loosened in recent years, single and older women, trans and non-binary people, and/or same-sex couples are still barred from using reproductive technologies in countries including China, Poland, Turkey, and Italy. And in many poorer countries, including most of the ones in Africa, there is next to no access to IVF at all.
Even in the U.S., where IVF is much more broadly used, reproductive medicine has not wiped out persistent stereotypes and social norms, says Arthur Greil, a professor emeritus at Alfred University in New York and author of Not Yet Pregnant: Infertile Couples in Contemporary America. People are willing to pay IVF’s exorbitant fees, at least in part, because society still emphasizes the importance of a genetic relationship between parent and child, Greil says. And, he says, the knee-jerk assumption is still that a child has both a mother and father. “If you are a single woman with a child, people just assume that you must have been divorced,” Greil says. “It’s become impolite to ask questions like, ‘Where is the baby’s father?’ But people still have the questions.”
Still, IVF has made what was once impossible—or, at the very least, difficult or done outside the scope of mainstream medicine—possible for many people. Sex, age, and medical diagnoses don’t necessarily close the road to biological parenthood anymore; they are just speed bumps. Reproductive technologies are expensive and imperfect, working only about half the time in the best circumstances and becoming even less of a sure bet among patients who are older or relying on donated embryos. But it has made the possibility of biological parenthood real for swaths of the population that, a century ago, would have had zero or few options. “Fertility medicine has made all of us parents-in-waiting,” says Laura Mamo, a professor of public health at San Francisco State University who studies the intersection of sexuality and medicine.
IVF is not solely responsible for those shifts—Franklin sees it more as a “mirror” reflecting major societal changes and conditions—but it plays a part. Making the technology harder or impossible to access, then, would have profound effects on countless people, particularly those from marginalized groups. And that, Mamo says, may be exactly the point for some people pushing forward the prenatal personhood movement.
“It’s not really about personhood,” Mamo says. “It’s really about this expansion of gender and family and sexuality and autonomy over people’s bodies.”
Elizabeth Carr speaks with Sen. Tim Kaine in Washington, D.C., on March 7, 2024, the day before attending the State of the Union as Kaine’s guest.Josh Morgan—USA TODAY/Reuters
Fighting back
Already, legislators and reproductive-rights advocates are preparing for battle. In his first speech as Kamala Harris’ vice presidential running mate, Minnesota Gov. Tim Walz reaffirmed his commitment to protecting reproductive health care including IVF, a technology that he and his wife used to have their daughter, Hope. “When Vice President [Harris] and I talk about freedom, we talk about the freedom to make your own health care decisions,” Walz said.
Elsewhere, the Center for Reproductive Rights has for years been working with partner advocacy groups and legislators to expand access to IVF by implementing new state policies around fertility coverage and broadening those that already exist, which are often written in ways that exclude same-sex couples or people who aren’t cisgender. That work is continuing in earnest, Torres says. And in the aftermath of the Alabama decision, lawmakers in at least a dozen states introduced bills meant to either protect IVF providers from liability or specify that embryos outside the human body do not legally qualify as people, according to the Guttmacher Institute, a reproductive-rights nonprofit. A broader package of pro-IVF bills moved forward at the federal level before being blocked by Republican senators in June.
Along with legislative solutions, the reproductive-rights movement is also trying to develop legal defenses that can be used to stop prenatal personhood arguments in court, says Donley, the Pittsburgh law professor. Judges may hold long-term appointments and don’t necessarily need to win elections—which means some can stray from public opinion with fewer consequences than elected officials. “I feel confident right now that the politics of reproductive rights are such that Republican legislatures aren’t going to pass anti-IVF bills,” Donley says. “Republican judges are another story. They get to do whatever they want.”
That means people who want to protect IVF access will need compelling legal arguments, says Georgetown’s Reingold. One, she says, could be pointing out the slippery slope of prenatal personhood. If an embryo is considered a person in one legal context, it could be considered one in many: a pregnant person could arguably claim their embryo as a tax dependent, a beneficiary for public assistance, or (in a lower-stakes scenario) another person for the purposes of driving in a carpool lane. Pointing out “consequences for other areas of the law that haven’t necessarily been completely thought through” could be an effective strategy for limiting the influence of fetal personhood arguments, Reingold says.
Another possible consequence: if an embryo is legally considered a person, a pregnant person could feasibly be criminalized for a miscarriage or pregnancy complication, says Kulsoom Ijaz, a senior staff attorney at Pregnancy Justice. Ijaz says she’s “cautiously optimistic” that pointing out such dystopian ripple effects would sway some judges and lawmakers. “It’s a matter of summoning defiant hope so that we…make sure there is no more rollback on people’s most basic civil and human rights,” she says.
There is some precedent to back Ijaz’ optimism. Even in the 2022 U.S. Supreme Court decision that overturned Roe v. Wade, the justices did not take a position on “if and when prenatal life is entitled to any of the rights enjoyed after birth,” which could foreshadow a broader hesitation for judges throughout the U.S. court system to consider questions of legal personhood.
That reluctance may not last forever. But in the meantime, IVF advocates like Carr, the first U.S. person born using the technology, are leaning on some of the “best tools” they have: their own stories, which underscore how life-changing IVF can be for individuals, couples, and families. “I always knew there were people who didn’t agree with how I was born. Around age 10, I realized I can potentially educate people,” Carr says. “I feel very strongly, and I always have, that people fear things they don’t understand.”
The stakes of that education campaign are high. Carr’s birth was a historic first for the U.S. “I do not want to think about who could potentially be the last,” she says.
As we cross the border into the conservative state in which my older daughter attends college, she often snaps a photo of the state line.
“I’ll just leave my reproductive rights here until I come home for break,” she’ll say, with a sigh.
A Snapchat post the author’s daughter created when she crossed the state line from her home state, where abortion is legal, to the state where she attends college, where abortion is illegal.
She was a sophomore when the Dobbs decision was leaked, and called me, devastated, from her dorm room. I warned her to quickly delete the smartphone app she used to track her menstrual cycle and reminded her that she does not need to answer any doctor’s questions about the date of her last period. I was immediately anxious about what the red state in which she was studying might begin to track.
The next fall, the school’s student government bought hundreds and hundreds of doses of Plan B and Ella “morning-after” pills, which can be used as emergency contraception, assuming you fall within the weight limit. There was little else they could do; the state had already begun the process of outlawing abortions.
By August of 2023, abortion in the state would be completely illegal, but even before then, it was effectively impossible anyway. Doctors didn’t want to take the risk. My daughter covered her computer and her bulletin board in pro-choice slogans, made phone calls for pro-choice candidates in the 2022 election, and kept picking her reproductive rights up at the border on her way home, posting a Snapchat of a cartoon uterus waving at her from the state line.
As college acceptance letters come in this winter, some young people will, as my daughter did, choose schools in anti-choice states. I’ve learned a lot since Dobbs about how to plan for my children’s health care from afar, a part of college planning that would never have occurred to me three years ago. Now I know that, in some states, some forms of health care would be better accessed after crossing a border. If we as parents fail to help our kids prepare, we do them a disservice, as those students coming from states where abortion is legal will be taken by surprise at the restrictions elsewhere.
What can you do to prepare your kids?
Find out ahead of time about what kinds of services are available in the school clinics and how those services are tracked. If you live in a state where abortion is legal, you might be surprised by the kinds of restrictions in force in other states. For example, in Alabama, pregnant people have been jailed in order to “protect the fetus” as part of the Chemical Endangerment of a Child Law, for reasons ranging from drug use to firing a weapon while pregnant.
In February, the Alabama Supreme Court ruled that frozen embryos used in IVF qualify as “human children,” citing Christian theological texts to bolster the court’s decision; many are worried about the ways this opinion might impact access to further reproductive health care in the state. If your child becomes pregnant in Alabama or a state with similar laws, it will be important to seek health care in a pro-choice state.
In Ohio, even a miscarriage can be labeled a crime. In January, a jury finally declined to indict a woman whose miscarriage was originally charged as “felony abuse of a corpse.” This could mean that students in Ohio might want to have missed menstrual cycles or other reproductive health concerns evaluated in states without this kind of scrutiny and tracking of pregnant people.
Map out your travel plans now. It’s important to be conscious of how far students will have to travel if they need reproductive health care, including non-abortion care that might be affected, like D&C procedures for endometriosis or access to medications that can be abortifacients even if your student only uses them for other conditions (like methotrexate for rheumatoid arthritis).
In Tennessee and Oklahoma, there are currently “abortion trafficking” laws being proposed in the state legislatures, which would bar anyone from bringing a minor across state lines for an abortion without parental permission. The same type of law was already passed in Idaho, where it’s being stayed by a federal judge pending a legal challenge. If these laws are allowed to go into effect, that would mean your over-18 student could be charged with a felony for helping their 17-year-old friend travel out of state for an abortion without permission from the friend’s parents, regardless of the friend’s home state.
“These are buttons from my time fundraising and advocating for reproductive rights in the 1990s,” the author writes.
Most importantly, parents need to be sure students have safe, reliable plans for birth control — something they should have regardless of where they go to school, but extra-important where their reproductive freedom is curtailed. If you have the means, you might even offer to cover the cost of condoms, though many schools offer them for free in health centers and even in the dorms. Regardless of whether you agree with your college student’s decisions about their sexual activity, you don’t want to be navigating abortion care in a legally hostile environment.
Support safe and legal abortion wherever it’s available. My home state of Illinois is a de-facto island of reproductive autonomy in an ultra-restrictive sea. Though I’ve advocated for abortion rights since fundraising for NARAL when I was in college, after Dobbs I began looking for practical, ground-level ways to help. I’d long supported groups like the Yellowhammer Fund, which helps Alabama women obtain abortions, but then I came across news of an abortion and women’s health clinic opening in Carbondale, Illinois. At first, the location seemed strange and out of the way. Why there? Because, it turns out, that town is on a train line from Memphis, where a state-wide ban in Tennessee forced the clinic’s other location to stop offering abortions. These days, my donations go to places like that clinic, which need them now more than ever before.
In 2023, my younger daughter decided to go to college in a virulently anti-abortion state, too, across another border. Six-and-a-half hours apart, the two offspring of my uterus are living where the uterus is owned by the state. Both of them were gobsmacked by Dobbs but also — because of their proximity to home and our promise that we had the means to help if needed — defiant about not letting it dictate their college decisions.
I’ve insisted that they register to vote in their college towns, and they both have. They’ve made it clear to their friends that they (and we) are available to help if the need arises (a privilege we have because neither of my children live in states with bounty laws or travel restrictions). All of this is good, but I wish it wasn’t necessary.
My older daughter is finishing her studies in the spring and will be a licensed teacher. When I asked if she’d like to stay and look for a job there, she shook her head. There’s no way, she said, that she could continue to live in a state where her choices are so limited. She plans to come home, taking the education she got in a red state and putting it to work in a blue one. Until both of my daughters leave their anti-choice states, though, they’ll be voting to improve the reproductive landscapes there — and I’ll be advocating for change from here.
Debi Lewis has written for The New York Times, Bon Appétit, Wired, and HuffPost and published the memoir “KITCHEN MEDICINE” in 2022. She is at work on a novel about abortion in the Midwest in the 1960s.
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The unpleasant reality facing the anti-abortion movement is that most Americans don’t actually want to ban abortion.
This explains why the pro-life summer of triumph, after the U.S. Supreme Court overturned Roe v. Wade, led to a season of such demoralizing political outcomes. Voters in Montana, Kansas, and Kentucky in November rejected ballot measures to make abortion illegal; just last month, in Wisconsin, voters elected an abortion-rights supporter to the state supreme court.
Yet the movement’s activists don’t seem to care. Thirteen states automatically banned most abortions with trigger laws designed to go into effect when Roe fell; a Texas judge this month stayed the FDA approval of the abortion pill mifepristone, setting in motion what is sure to be a drawn-out legal battle; and some lawmakers are pursuing restrictions on traveling out of state for the procedure—what they call “abortion trafficking.”
Even as the anti-abortion movement lacks a Next Big Objective, a new generation of anti-abortion leaders is ascendant—one that is arguably bolder and more uncompromising than its predecessors. This cohort, still high on the fumes of last summer’s victory, is determined to construct its ideal post-Roe America. And it’s forging ahead—come hell, high water, or public disgust.
The groups this new generation leads “are not afraid to lose short term if they think the long-term gain will be eliminating abortion from the country,” Rachel Rebouché, a family-law professor at Temple University, told me.
One such leader is Kristan Hawkins, the president of the anti-abortion group Students for Life. After Dobbs v. Jackson Women’s Health Organization,“some organizations had to go through this period where they had to reflect and figure out what they were going to do,” she told me. “But nothing changed in our organization—we’d already had that conversation years ago.” Students for Life participants have been calling themselves “the post-Roe generation” since 2019; that’s the year they launched a political-action committee to beef up their state-level presence and begin drafting legislation for a post-Roe society. In 2021, the organization started the Campaign for Abortion-Free Cities to promote what they call “alternatives to abortion” and neighborhood resources for pregnant women.
“What the anti-abortion movement is, who’s leading it, and what it stands for are still being contested,” Mary Ziegler, a UC Davis law professor who has written about abortion for The Atlantic, told me. But organizations such as Students for Life will, in all likelihood, “be the ones running the movement going forward.” To understand the goals of people like Hawkins is, in other words, to peer into the future of America’s anti-abortion project.
The thing about Hawkins is that she’s an optimist—and not a cautious one. So when the draft opinion suggesting that the Supreme Court was about to overrule Roe v. Wade leaked last May, she wasn’t particularly surprised, she told me—she felt vindicated. Other pro-lifers had refused “to let themselves even dare think that a post-Roe America was coming,” Hawkins said. “Of course it was.” She’d always assumed it would happen in her lifetime.
As soon as the draft opinion came out, anti-abortion leaders began to consider their response. Some were worried that taking any kind of victory lap would be inappropriate—that it might scare the justices into moderating or reversing their ultimate decision. Hawkins didn’t care about any of that. “Why would we be guarded? It was important, good news!” she told me. “Folks across the country needed to see this generation celebrating.” Students for Life was one of the first anti-abortion organizations to release a statement praising the draft opinion—while being careful to condemn the leak itself.
Hawkins, who is 37, styles herself as a straight shooter. She doesn’t dress up arguments with religious rhetoric—despite being Catholic herself—and she can be an effective, if sometimes abrasive, debater. Which makes sense, because she came to the pro-life movement through electoral politics. Hawkins knocked on doors for local and state Republican candidates; in college, she worked for the Republican National Committee to reelect President George W. Bush—and, for a year, she worked in his administration. Then, when Students for Life came looking for a new president in 2006, she eagerly accepted.
Hawkins “saw the politics in this in ways a lot of people don’t,” Ziegler told me—and she brought that acumen to the movement. She knew how to lead a grassroots campaign, and how a state legislature functions. Then just 20, she was younger than other pro-life leaders, so she had a better idea of how to engage young people. Hawkins is trying, Ziegler said, “to grow the movement in a way that no one else really ever did.”
The organization’s 14,000 participants campaign for state-level anti-abortion candidates and legislation in their local legislatures. Hawkins, who oversees a staff of 100 paid employees, spends her days traveling to meet with chapter leaders, organizing demonstrations, delivering speeches, and generally doing her best, as she put it to me, “to stir up discussion.” In March, during a visit to Virginia Commonwealth University, protesters shouted over Hawkins when she tried to speak. Demonstrators called her a Nazi and a fascist. Eventually, campus security shut down the event, and police arrested two protesters (who weren’t actually VCU students). Hawkins, who livestreamed the drama, later went on Fox News to offer a full account.
The Students for Life YouTube channel has a 22-minute highlight reel called “Greatest Pro-Choice Takedowns,” in which Hawkins responds to questions from young, often-emotional abortion-rights advocates. As you might expect, the videos feel mean. In each clip showing Hawkins facing off against a different student with a shaky voice, she makes them look silly and ill-informed, a relatively easy thing to do when your opponent is not being paid to perfect her talking points. But these exchanges don’t seem intended to change minds; they’re meant instead to humiliate—and thereby reveal the purported weaknesses in abortion-rights arguments.
Doggedness and moral conviction have always characterized the anti-abortion movement. Activists have sustained their energy for 50 years “by believing that success was possible, even in the absence of clear victories,” Daniel K. Williams, a history professor at the University of West Georgia, told me. Dobbs gave this new generation a taste of victory. Activists like Hawkins are bolder now. Without Roe, they reason, anything is possible.
Students for Life, in particular, is “more abolitionist than prior generations of similar groups,” Rebouché told me. In contrast to other organizations that have pursued incremental progress, the group adopts strategies that are “totalizing and absolute.” Throwing out the rule book, they operate as though they’ve got nothing to lose.
“I admire their persistence; I admire their sacrifices,” Lila Rose, the president of the anti-abortion nonprofit Live Action, says of previous generations of anti-abortion activists. “But we’re playing to win. This isn’t just some nonprofit job.” Rose, who is 34, achieved early prominence in the movement back in 2006 for partnering with the conservative activist James O’Keefe to film undercover exposés at abortion clinics. Live Action doesn’t have the kind of nationwide membership that Students for Life has, but its email list contains more than 1 million contacts, Rose told me, and its social-media following runs into the millions.
Students for Life and Live Action frame their anti-abortion efforts as not just saving babies but empowering women—enabling them to avoid the depression and regret the organizations say can be caused by having an abortion. These aren’t new ideas in themselves, but they’ve been repackaged in a way that mimics the language of a modern social-justice movement appealing to young people. “They’re using phrases like born privilege,” Jennifer Holland, a gender-and-sexuality professor at the University of Oklahoma, told me. “Language that’s hip—in the culture—but that still leads back to this one point of view that maybe you thought was old or conservative.”
Historically, there’s been “a lack of vision” in the movement, Rose said. It was great, she allowed, that the National Right to Life Committee fought so hard in the 2000s to ban what they called “partial-birth abortion” (using a pro-life term not recognized by medical professionals). But, to Rose, pill-induced abortion is just as “anti-human and anti-woman”; a 15-week abortion limit is nothing to celebrate. “I don’t think that we do ourselves any favors as a movement by, like, walking over to the opponent’s side of the field and saying that that’s a victory.”
Hawkins’s master plan to completely eradicate abortion in America begins with passing as many state controls as possible. She calculates that 26 state legislatures contain enough anti-abortion Republicans to be amenable to a strict ban of some sort, and her organization is pushing an “early abortion” model, which means that it drafts and supports legislation restricting abortion either entirely or after six weeks. Hawkins claims credit for pressuring reluctant Republican state leaders in Florida to take up the six-week abortion ban that Governor Ron DeSantis signed late Friday night. Gone are the days of small-ball second-trimester limits, Hawkins says, because most abortions happen before then. “We’re not going to spend a significant amount of resources to pass legislation that’s going to save only 6 percent of children.”
Right now the centerpiece of Students for Life’s campaigning is the effort to ban medication abortion—what Hawkins and her allies call “chemical abortion.” For two years, the group lobbied Republicans in Wyoming to prohibit mifepristone from being sold in pharmacies; the governor signed that measure into law last month. Now it’s setting its sights on the pharmacy chains Walgreens, Rite Aid, and CVS—which Hawkins singles out as “the nation’s largest abortion vendor.”
On campuses, Students for Life leaders are trying to mobilize young people who might otherwise be ambivalent about the abortion pill; Hawkins says they’ve had luck with the message that mifepristone, when flushed, enters the water system and threatens the health of humans and wildlife. “Young people are aghast to find out that something they care deeply about—the environment—is now conflicting with their views on abortion,” Hawkins told me. Never mind that there is no evidence for these claims. According to Tracey Woodruff, the director of the Program on Reproductive Health and the Environment at UC San Francisco, the amount of mifepristone found in drinking water is so small that it might not even be measurable.
“Of all the things we have to worry about with our drinking water,” she told me, “this is not one of them.” Students for Life’s messaging on this, she added, is “a perverse use of science.” The organization is nonetheless backing new laws in several states that would require women prescribed abortion pills to use medical-waste “catch kits” and return them to a health-care provider.
Hawkins is realistic about the fact that her movement’s progress has a ceiling. Some states, especially the liberal strongholds of Illinois and New York, are never going to go for the kinds of laws that she’s pushing for. This is when, she says, her organization will shift its emphasis to the federal government—pushing for a constitutional amendment that would recognize fetal personhood, or for a ruling from the Supreme Court to affirm that the Fourteenth Amendment already does.
Abortion should become “both illegal and unthinkable” in America, Hawkins said. But even when the anti-abortion movement can no longer change hearts and minds, it plans to find a way to change the law anyway. She favors using the law as a tool because, in her view, people tend to derive morality from legality: “Nothing’s going to change their minds until the law changes their minds.” Hawkins envisions a future, 20 years from now, in which university students will discover with abject horror that other states allow the murder of babies in the womb—culturally, she believes, “that’s gonna be massive.” The idea that young people in college would be shocked to learn that different states have different laws on abortion may seem implausible now, but Hawkins is articulating her larger goal—of making abortion unconscionable.
Yet American culture seems to be moving in the opposite direction. The Dobbs ruling, though exciting for anti-abortion activists, was so enraging for abortion-rights supporters that, in some places, they responded by enshrining the right to abortion into state law. These and other political losses suggest that the pro-life movement is already overreaching—and generating a backlash. “It’s breathtaking to see people so motivated and so well funded to push an agenda that is so incredibly unpopular,” Jamie Manson, the president of the abortion-rights organization Catholics for Choice, told me. The months since Dobbs have exposed a fundamental tension between the outcome that abortion-rights opponents want and the one democracy supports.
As it becomes clear that abortion is not always an election winner—that, on occasion, it is even a predictable loser—some Republican legislators have broken from the movement in order to support rape and incest exceptions; others have simply avoided the issue. “Most of the members of my conference prefer that this be dealt with at the state level,” Senate Minority Leader Mitch McConnell told reporters last fall. Hawkins and Rose are happy to criticize those Republicans they see as wishy-washy on abortion. When former President Donald Trump blamed Republicans’ 2022 midterm losses on the extremism of the anti-abortion movement, Rose called it “sniveling cowardice.” But Hawkins and Rose may be underestimating how much more challenging and complex the post-Roe environment is.
“This is much more expensive politics around abortion,” Holland said. “It used to be cheap: You could promise all sorts of things” without penalty, because with Roe intact, such radical measures would never pass.
Does this give Hawkins any pause—the idea that her movement’s aims are so antithetical to what most Americans want? Hawkins said that public opinion doesn’t concern her. The fact that most Americans support abortion access doesn’t make them morally correct, she argued, and neither does it make her own efforts undemocratic. “Do I look upon abolitionists in pre–Civil War America as undemocratic for trying to change people’s minds and prevent the proliferation of owning another human being for your own financial gain? No,” she said.
Hawkins has spent a lot of time thinking about this question. Consider the civil-rights era, she went on. “We had states that stubbornly refused to integrate.” In the end, federal legislation forced them to comply. The implication is that the same sort of national ban should eventually happen for abortion.
Given this goal, we can expect that abortion will be an issue in almost every single election, in almost every single state, for the next many cycles. In some parts of the country, the anti-abortion-rights movement will fail. In others, it will skate along with utter success. Lawmakers will tighten laws, ban pills, and restrict travel. They may even feel audacious enough to venture into the broader realm of reproductive tools—outlawing or restricting IUDs, the morning-after pill, and even in vitro fertilization.
Post-Roe, we can expect these hungry, mobilized activists to seek new conquests. But even as they do, pro-life leaders will have to wonder whether they are guiding their movement toward righteous victory—or humiliating defeat.
An Idaho bill aimed at providing students with free feminine hygiene products in school failed on Monday after Republicans slammed the prospect as “woke” and “liberal.”
The one-page House Bill 313, introduced on March 13, would have required that public and public charter schools provide students with free tampons, sanitary napkins and other menstrual products.
Dissenting Republicans decried the bill as “woke” and overly generous.
“This bill is a very liberal policy, and it’s really turning Idaho into a bigger nanny state than ever,” said state Rep. Heather Scott, according to The Daily Beast. “It’s embarrassing not only because of the topic but because of the actual policy itself. So you don’t have to be a woman to understand the absurdity of this policy. And you don’t have to feel that you’re insensitive to not address this.”
The cost of the bill would have been $735,400 — $435,000 allocated toward product dispensers and the remainder for the actual menstrual products, according to the fiscal note.
The cost of the products was calculated at about $3.50 per student for 85,825 female students.
“It’s not a lot of money in the state’s budget,” Republican state Rep. Rod Furniss said on March 16 to the House Education Committee before the bill failed, according to the Idaho Statesman. “Today is a step to preserve womanhood, to give it a chance to start right, to not be embarrassed or feel alienated or ashamed, or to feel like they need to stay home from school due to period poverty.”
Still, the House vote was split down the middle, with 35 in favor and 35 against. Ten of the nay votes came from conservative women on the floor.
“What’s gonna be next?” Scott asked. “We can’t help but sweat. So are the schools now going to be providing deodorant for these kids?”
Another conservative lawmaker, state Rep. Barbara Ehardt, said the phrases “period poverty” and “menstrual equity” used to discuss the bill were “woke terms.”
“Period poverty” refers to the idea that some people, particularly low-income students and students of color, can have trouble accessing the menstrual products they need because they can’t afford them. Factors like sales taxes can make it even harder to obtain these necessary products, the American Civil Liberties Union notes.
“Menstrual equity,” meanwhile, refers to the goal of making sure that anyone who needs access to menstrual products can access them.
Twenty-three percent of U.S. students have limited access to menstrual products, according to a 2021 survey by Thinx and PERIOD. Yet, as of last October, just 15 states and Washington, D.C., had passed legislation securing students’ free access to menstrual products in schools, according to the Alliance for Period Supplies.
“It’s so shocking,” Avrey Hendrix, the founder of the Idaho Period Project, told The Daily Beast of female lawmakers denying free menstrual products to others, “because they know what it’s like to go into the bathroom and not have a tampon.”
