On November 5, abortion access and reproductive rights will be top of mind for millions of voters as they head to the polls to determine the next president of the United States.
Constitutional amendment measures in 10 key states could restore abortion rights that have been restricted since the U.S. Supreme Court overturned Roe v. Wade in 2022.
Presidential candidates Vice President Kamala Harris and former President Donald Trump have conflicting views on abortion and reproductive healthcare.
Harris and running mate Tim Walz remain committed to protecting reproductive rights. Meanwhile, Trump has changed his position on abortion several times throughout his presidential campaign and over 25 years as a public figure.
Trump has neither confirmed nor denied whether he would sign a nationwide abortion ban if elected to office.
The rights to other reproductive freedoms, such as access to in vitro fertilization (IVF), are also on the ballot, with some religious groups condemning the procedure and conservative state courts challenging the concept of personhood.
Continued access to contraceptive care, including birth control, comprehensive sex education, and family planning services, also rests in the hands of voters this election.
“Donald Trump and JD Vance and their allies are extremely dangerous for our reproductive freedom,” said Olivia Capella, associate director for state advocacy communications at Planned Parenthood Votes.
“We saw under the previous Trump administration unprecedented attacks on the abortion care landscape nationwide and the federal family planning program, which provides essential care to low-income people across the country, as well as attacks on the broader healthcare system. We’re extremely concerned about the prospect of a second Trump administration as well as control of Congress,” Capella told Healthline.
Abortion access
A recent Pew Research poll shows 63% of U.S. adults believe that abortion should be legal in all or most cases. Despite this, millions of people have been unable to access safe and legal abortion in the 2 years since the landmark Dobbs v. Jackson Women’s Health Organization ruling that overturned Roe v. Wade.
According to Guttmacher Institute data:
- 14 states have total abortion bans with very limited exceptions
- 27 states have abortion bans based on gestation, 8 states ban abortion at or before 18 weeks, and 19 states ban abortion after 18 weeks
Most abortions occur during the first trimester, while abortions later in pregnancy are less common. According to recent data from the Centers for Disease Control and Prevention (CDC), 93.5% of abortions occur within or at the end of the first trimester, and only 0.9% of abortions occur at 21 weeks or later.
Post-Dobbs, a national survey shows 1 in 5 OB-GYNs feel constraints on miscarriage management and pregnancy-related emergencies. In addition, a much larger percentage of OB-GYNs (70%) believe that racial and ethnic inequities in maternal health have increased as a result of the Dobbs decision.
A growing body of evidence sheds light on the negative reproductive health outcomes tied to abortion bans and restrictions. In 2023, the Guttmacher Institute estimated that 171,000 people traveled to another state to obtain abortion care.
- In Alabama, the state’s attorney general has threatened to prosecute people for crossing state lines to obtain an abortion.
- In Georgia, one woman died after being denied lifesaving abortion care.
- In Florida, where there is a 6-week abortion ban, a woman was forced to carry a baby to term who was born without kidneys and would later die in her arms.
In some states, there are exceptions to abortion bans, such as rape or incest, but access to abortion care in these places remains an obstacle, particularly for people of color, people with low incomes, and people living in rural areas or maternal care deserts.
“Abortion has always been essential reproductive healthcare for so many people. In the post-Dobbs era, it’s become very apparent to people across the country how critical that care is, regardless of where in pregnancy a person is or their life circumstances,” Cappello said.
“When people are denied abortion care, they are more likely to struggle financially, more likely to have healthcare complications later, and for their children to have a tougher time as well, both in their development and in their future education, continuing the cycle of poverty and strife for families.”
— Olivia Cappello, Planned Parenthood Votes
A national abortion ban remains at the forefront of the anti-abortion movement, whether through legislation or enforcing a 19th-century anti-obscenity law known as the Comstock Act.
Under a second Trump administration, a looming political initiative known as Project 2025 could threaten reproductive freedom for all.
Donald Trump’s stance on abortion
- Trump has neither confirmed nor denied he would sign an abortion ban if passed by Congress. He dodged questions about it during the presidential debate.
- Trump has repeatedly denied involvement with Project 2025 despite some of his former advisers being heavily involved with the conservative roadmap for the next administration. A nationwide abortion ban is central to this right-wing agenda.
- Trump and running mate JD Vance argue that access to abortion should be left to each state.
- While Trump has shifted his abortion stance throughout his campaign, Vance openly opposes abortion and has said it should be “illegal” in all 50 states.
- Trump has said his administration “will be great for women and their reproductive rights” in a post on his social media platform Truth Social.
- Trump also said that he supports exceptions to abortion bans in cases of rape, incest, and when the “life of the mother is at risk.”
“Our biggest concern is that we know that if we have a second Trump presidency, we will see an abortion ban nationwide, and I cannot begin to convey how dangerous that would be,” Amy Williams Navarro, director of government relations at Reproductive Freedom for All, told Healthline.
“We’re already seeing over 20 states with severe restrictions or complete bans on abortion and the consequences of those bans — and we would see that exacerbated across the country, with people in all 50 states unable to access critical abortion care.”
— Amy Williams Navarro, Reproductive Freedom for All
Kamala Harris’s stance on abortion
- Harris has made abortion access and reproductive rights a focus throughout her campaign. She has referred to states where abortion access is restricted as “Trump abortion bans.”
- In her keynote speech at the Democratic National Convention, Harris said she would sign a bill into law that would restore reproductive freedom.
- Harris’s campaign website states that as president, she will never allow a national abortion ban to become law.
“Kamala Harris has shown she is a steadfast champion for reproductive freedom, not only in the executive actions she has supported through the Biden administration to protect and secure access to reproductive healthcare, but also in the ways that she speaks about abortion access, and the importance of fertility care and comprehensive healthcare,” Cappello said.
“We are confident she will continue making progress on those goals if elected president. Of course, not everything can be done via an executive order, so she does need the support of a strong Congress to make some of these changes,” she added.
Abortion pill access
In June 2024, the Supreme Court voted unanimously to preserve access to mifepristone, but some experts speculate the abortion medication could again face scrutiny under a Republican administration.
Post-Dobbs, access to medication abortion, which typically includes mifepristone and misoprostol, is crucial.
- Medication abortion is safe and effective. It has been used in clinical settings since the Food and Drug Administration (FDA) approved mifepristone in 2000.
- Medication abortion has become increasingly common, comprising 63% of clinician-provided abortions in 2023, a 53% jump from 2020, according to Guttmacher Institute data.
- Medication abortion can be safely self-managed at home via telehealth. Self-managed abortions rose sharply after Roe was overturned.
- Using mifepristone or misoprostol alone can safely end a pregnancy.
Will Trump ban the abortion pill?
- Trump has shifted his position on whether or not he’d ban the abortion medication mifepristone.
- Vance said that Trump would not ban the abortion pill shortly after the former president said he would be open to it.
“I have significant concern that a Trump administration would compel the FDA to make non-evidence-based decisions about mifepristone, as well as contraception and other medications and devices within its purview,” said Sarah W. Prager, MD, a professor in the Department of Obstetrics and Gynecology at the University of Washington School of Medicine.
“During COVID, Trump installed a right-wing journalist as the FDA spokesperson, politicizing the organization that historically has maintained more neutrality. If elected again, I would not be surprised if Trump were to further erode the scientific and political integrity of the FDA,” Prager told Healthline.
Harris vows to preserve abortion pill access
- Harris has been a leader during the Biden administration in preserving access to mifepristone.
- When mifepristone became available at retail pharmacies earlier this year, the vice president supported this move.
“The President and I stand with the majority of Americans who believe women should have the freedom to make decisions about their own body and their own lives. We remain committed to defending access to reproductive healthcare, including medication abortion,” Harris wrote in a White House statement.
“Our Administration will not waver in our dedication to preserving access to essential medication and defending the FDA’s independent, evidence-based approval and regulation of safe and effective drugs,” Harris continued.
In vitro fertilization (IVF)
In February, the Alabama Supreme Court ruled that frozen embryos are “children” in the eyes of the law, temporarily halting IVF treatments in the state.
The ruling challenged the concept of personhood, fueling momentum among religious conservatives who oppose abortion at any point after conception.
On September 17, the Senate failed for a second time to pass the Right to IVF Act, which would prevent IVF restrictions at the state level and provide insurance coverage for the procedure.
Fertility support has been a focal point throughout the presidential race. A recent CBS News/YouGov poll shows 86% of U.S. adults support IVF.
As demand increases for assisted reproductive technology, there’s been a push to make costly procedures like IVF more affordable.
“Despite infertility impacting millions, undergoing any fertility treatment — whether it’s IUI, IVF, or another route — can be a significant financial investment,” said Roger Shedlin, MD, CEO of WIN, a fertility and family wellness benefits provider.
“Coverage of IVF or any fertility treatment would help eliminate barriers associated with costs,” Shedlin told Healthline.
“We are seeing companies increase their benefits to help their workforces build their families — whether that’s through IVF, IUI, surrogacy, adoption, or another path. There is rising demand, and we have seen some states already have legislation in place that mandates insurance coverage; as such, coverage of IVF on a national level isn’t a major leap.”
— Roger Shedlin, MD, CEO of WIN
Trump’s views on IVF
- Trump said he would implement a policy requiring insurance companies to pay for IVF treatments if elected.
- While Trump has said he supports access to IVF, this stance has angered some members of the Republican party.
- Some experts are concerned Trump’s support of IVF is just “talking points” to help him get more votes.
“We know that Trump and Vance, once they’re in office, it is all but guaranteed they will implement policies that will ban abortion and continue to threaten access to IVF and birth control,” Cappello said.
Williams Navarro agreed. “During a Trump administration, we would see them using every tool at their disposal that would ban not only abortion but also some forms of birth control and assisted fertility treatments like IVF,” she said.
Harris’s views on IVF
- Harris said the Alabama Supreme Court’s frozen embryo ruling was a “direct result” of the overturning of Roe and referred to Trump as the “architect of this healthcare crisis.”
- In her Democratic National Convention acceptance speech, Harris said she’s heard the stories of couples “just trying to grow their family, cut off in the middle of IVF treatments” since Roe’s reversal.
- Harris has not said whether she would implement a policy requiring insurance companies to pay for IVF. Some have speculated this may be due to the complexities involved.
“Mandating coverage of IVF by insurance companies is certainly feasible as it is already being done on a state-by-state basis,” Shedlin said.
“Massachusetts and Illinois have had IVF and other infertility coverage as state law for several decades. Access to IVF and fertility support should not be inaccessible due to finances. Governments and companies have the ability to help more people build families through well-managed care,” he added.
Access to contraceptive care
Quality sex education, contraceptive access, and federal family planning programs like Title X are integral to reproductive freedom for all.
A year after the Dobbs ruling, females 18 to 44 years old experienced barriers to contraceptive access and lower-quality contraceptive care.
With nearly half of U.S. states banning gender-affirming care for those under age 18 and higher teen pregnancy rates in some states, comprehensive sexuality education has never been more important.
Trump’s views on contraceptive care
- Trump has talked about gutting the Department of Education, which could affect some states lacking quality sex education with an “abstinence only” mindset.
- Trump has said he is open to restrictions on contraception access. However, he later backed away from that statement.
“There are clear data that indicate medically accurate sex education for teens helps to delay initiation of intercourse, decrease frequency of intercourse, and increase use of contraception and condoms with intercourse. Sex education is also associated with decreased homophobia, decreased intimate partner violence, and increased communication skills,” Prager said.
“Abstinence-only sex education is associated with higher adolescent pregnancy and birth rates. An administration that supports national programs of abstinence-only sex education or eliminates medically accurate sex education would likely result in higher teen pregnancy and birth rates, as well as increased STIs.”
— Sarah Prager, MD, OB-GYN
Harris’s views on contraceptive care
- Harris opposes policies that restrict how schools teach students about sexuality.
- In 2023, Vice President Harris participated in an initiative to improve contraceptive access for college students.
- The Biden administration has taken several steps in an attempt to reverse some harmful Trump-era policies, including the domestic gag rule for the Title X family planning program, which barred low-income households from obtaining family planning services, including pregnancy prevention.
- Harris continues to support the right to family planning services.
“When Trump was president, he hamstrung Title X domestic family planning programs, significantly limiting contraception provision around the U.S.,” Prager said.
“I suspect Trump would reinstate all these policies if he were to be elected, whereas Harris would likely maintain, if not expand, funding for global and domestic family planning. Decades of data support funding family planning as a means of improving health and reducing medical costs, which is why I assume a Harris administration would safeguard these programs,” she noted.
Takeaway
Vice President Harris and former President Trump have made abortion access and other aspects of reproductive rights focal points throughout the presidential campaign.
As partisan battles over reproductive care persist, the next administration could have two very different futures: reproductive freedom for all or draconian mandates over bodily autonomy.
Regardless of the outcome of the 2024 presidential election, policymakers already have the resources to end abortion bans and restrictions and support access to reproductive care.
At the state level, policymakers must pass legislation that expands and protects access to abortion, according to the Guttmacher Institute.
Restoring reproductive rights
- The Abortion Justice Act outlines the full spectrum of care around abortion services.
- The Equal Access to Abortion Coverage (EACH) Act ensures insurance coverage for abortion regardless of a person’s socioeconomic status.
- The Health Equity and Access under the Law (HEAL) for Immigrant Families Act could broaden eligibility for health insurance coverage for immigrants and access to reproductive care.
“We’ve already seen in Project 2025 the Republican plan for banning abortion through agency actions and going around the legislative process to essentially ban abortion nationwide,” Williams Navarro said.
“We’ve seen them willfully misinterpreting and misusing the Comstock Act to block access to not just medication abortion and medical equipment used for abortion care — and that would all happen with or without the support of Congress and the courts,” she said.
Early voting for the 2024 presidential election is starting soon. For more information on voter registration, voting by mail, and more, visit Vote.org or USA.gov.
Editor’s note: Healthline Media does not endorse either presidential candidate or their political party. The article focuses on each candidate’s stance on reproductive rights and does not reflect their broader political views.
