The US Supreme Court has overturned Roe v. Wade. What does that mean?

The US Supreme Court has ruled to overturn Roe v. Wade, the landmark 1973 legal decision that enshrined abortion as a constitutional right. Ending federal protection for abortion access across the US will have lasting health, emotional, and financial repercussions for millions of people and casts American reproductive rights back 50 years.

The final decision ends weeks of speculation following the leak of a draft opinion in May, which detailed the Supreme Court’s resolve to strike down the ruling. It states that the Constitution “does not confer a right to abortion” and that such a right is not deeply rooted in the nation’s history and tradition, adding that the “authority to regulate abortion is returned to the people and their elected representatives.”

Justice Samuel Alito, who wrote the opinion, was joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett, who supported the decision. The court’s three liberals, Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan, dissented, meaning they disagreed with the majority opinion.

“With sorrow—for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection—we dissent,” they wrote.

Alito’s opinion contains an assurance that the decision “concerns the constitutional right to abortion and no other right,” and that “nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion.” In a concurring opinion, however, Justice Clarence Thomas argued that the court should go further in the future, and reconsider “all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell”—the decisions that protect access to contraceptives, same-sex relationships, and same-sex marriage, respectively. Thomas referred to those three decisions as “demonstrably erroneous.”

Access to legal abortion is now subject to state laws, allowing each state to decide whether to ban, restrict, or allow the procedure. Some parts of the country are much stricter than others—Arkansas, Oklahoma, and Kentucky are among the 13 states with trigger laws that immediately made abortion illegal in the aftermath of the ruling. In total, around half of states are likely to either ban or limit abortion, with many of them refusing to make exceptions even in pregnancies involving rape, incest, and fetuses with genetic abnormalities. Many specialized abortion clinics may be forced to close their doors in the next few days and weeks.

While overturning Roe v. Wade will not spell an end to abortions in the US, it’s likely to lower the rate and force those seeking them to pursue different methods. People living in states that ban or heavily restrict abortion may consider traveling to other areas, although crossing state lines can be time consuming and prohibitively expensive for those facing financial hardship.

The likelihood that anti-abortion activists will use surveillance and data collection to track and identify people seeking abortions is also higher following the decision. This information could be used in criminal proceedings, making it particularly dangerous for those leaving home to cross state lines.

Vigilante volunteers already stake out abortion clinics in states including Mississippi, Florida, and North Carolina, filming people’s arrival on cameras and recording details about them and their cars. While activists deny that the data is used to harass or contact people seeking abortions, experts are concerned that footage of clients arriving and leaving clinics could be exploited to target and harm them, particularly if law enforcement agencies or private groups use facial recognition to identify them.

Another option is to order so-called abortion pills to discreetly end a pregnancy at home. The pills, which are safe and widely prescribed by doctors, are significantly less expensive than surgical procedures; they already account for the majority of abortions in the US.

Online activists scrambled to help Texas residents access the pills after the state passed the SB8 law, which made the procedure illegal as soon a heartbeat is detected, last September. As this usually occurs around six weeks into pregnancy, the bill effectively criminalizes abortion because unpredictable cycles mean many pregnancies are not detected by that stage. 

Experts told MIT Technology Review it would be wise to research access to the pills in the state where they live and that some people may want to order the pills, which have a shelf life of at least three years, in advance.

The decision is at odds with the views of a majority of Americans, who oppose overturning Roe and allowing states alone to dictate access to abortions, opinion polls conducted by the Associated Press-NORC Center for Public Affairs Research and others have found.

This story will be updated