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The overturning of Roe v. Wade made history in 2022

ALINA SELYUKH, HOST:

2022 saw the overturning of Roe v. Wade, the historic Supreme Court decision that had guaranteed the right to abortion in the U.S. for nearly 50 years. NPR's national correspondent Sarah McCammon covers abortion rights policy, and she has this look back on a history-making year.

SARAH MCCAMMON, BYLINE: The year began with high hopes for the anti-abortion rights movement.

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JEANNE MANCINI: We are hoping and praying that this year, 2022, will bring a historic change for life.

MCCAMMON: In January, March for Life president Jeanne Mancini told activists gathering on the National Mall for their annual rally that she was full of anticipation as the Supreme Court prepared to release its decision in a major abortion case. The court's conservative majority was more powerful than ever, with three justices appointed by former President Trump. Mancini told marchers from around the country that soon the fight would become much more local.

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MANCINI: If Roe falls, the battle lines will change. But make no mistake, the fight for life will need to continue in the states and here in D.C.

MCCAMMON: Meanwhile, in Texas, the reality of what a post-Roe America could look like was already coming into view. Most abortions had become illegal after the U.S. Supreme Court allowed a state law called SB 8 to take effect a few months earlier, banning most abortions after about six weeks of pregnancy. In a novel legal strategy designed to get around existing precedent, SB 8 empowered individuals to sue abortion providers and others believed to be involved in illegal abortions. The law meant some patients like Anna, a woman from central Texas who suffered a miscarriage in 2021, were denied emergency terminations.

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ANNA: They couldn't even say the word abortion. Like, I could see the fear in these doctors' eyes that they were just so scared to even talk about it.

MCCAMMON: In an interview with NPR a few months later, Anna, who asked us not to use her last name for fear of potential legal repercussions for her doctor, said her water broke at 19 weeks, just under halfway through the pregnancy. She and her husband went to an emergency room, where doctors told her there was no chance the baby could survive and that continuing the pregnancy could put her at risk.

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ANNA: You're at a high chance of going septic or bleeding out, and unfortunately, we recommend termination. But we cannot provide you one here in Texas because of this law.

MCCAMMON: Anna became one of the first patients facing an abortion ban, but certainly not the last, to get on a plane and travel to another state while in the midst of a medical crisis.

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ANNA: I had to come up with a game plan with my OB in case I went into labor on the flight, and I made sure that I bought us front-row of seats so I could be close to the bathroom in case it happened. And - (crying) like, no one should ever have to do that.

MCCAMMON: Then in late June, the U.S. Supreme Court released the Dobbs v. Jackson Women's Health Organization decision, sending the status of abortion law into chaos around the country. Some clinics had to shut down with patients still in the waiting room in states with laws designed to quickly ban abortion after the fall of Roe. Reproductive rights lawyers fought back, challenging some of those laws in state courts. In Louisiana, just days after the Dobbs decision. They won a brief reprieve. At the Hope Medical Group for Women in Shreveport, staff members scrambled to keep up with calls from confused and anxious patients.

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STEFFI CHAFFEE: We're back to being able to schedule. What, did you have an appointment with us or what? You mean for your first visit? OK, well, we're not scheduling for first visits right now, honey. We're already booked up. So - well, I understand, honey. The whole thing isn't fair.

MCCAMMON: One patient who managed to get an appointment, there was a 27-year-old woman from Texas. She asked us to call her by the letter J rather than her full name for fear of stigma back home. J told me she was struggling as a stay-at-home mom to three young children. And after serious medical complications in previous pregnancies, she was devastated to find out she was pregnant again.

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J: I was really scared. I thought I was going to have to travel 12 hours to Albuquerque because of Roe v. Wade being overturned. I had a panic attack that day.

MCCAMMON: That same week in Indiana, Dr. Caitlin Bernard was taking care of a 10-year-old who'd become pregnant as a result of rape. The girl had traveled from neighboring Ohio after a near-total abortion ban with no exceptions for rape or incest took effect there.

In an interview with NPR in late July, Dr. Bernard said she was worried about the impact of abortion bans on patients facing a variety of complex pregnancy decisions in an increasingly confusing legal environment.

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CAITLIN BERNARD: When you take away someone's right to privacy about their medical decisions, the challenges that they face to access lifesaving health care is going to be enormous.

MCCAMMON: After prominent conservatives questioned Bernard's credibility without providing evidence. The story became a symbol of the fight over abortion access that had been triggered by the Dobbs decision. The state of Indiana eventually produced documents supporting Bernard's version of events. Many anti-abortion rights activists continued to oppose rape exceptions, insisting abortion is always wrong.

Pam Whitehead, who lives in Texas and leads the anti-abortion group ProLove Ministries, says her views were shaped partly by her own experiences.

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PAM WHITEHEAD: I can't imagine being in that situation. I know what it's like to be raped, though. I also know what it's like to have an abortion. And I'll tell you this, that that abortion impacted me greatly.

MCCAMMON: Around the country, clinics and states where abortion remains legal have been coping with an influx of patients by the thousands determined to get abortions, even if they have to travel out of state. Abortion funds and logistical support networks have stepped in to help with the costs of travel and other needs.

LaQuetta Cooper with Planned Parenthood of the Saint Louis region and southwest Missouri, says the influx to Illinois was even bigger than expected. Her affiliate recently announced the launch of a mobile abortion unit that can travel throughout southern Illinois, offering abortion pills and eventually procedures closer to patients in states like Missouri, where abortion is unavailable.

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LAQUETTA COOPER: The biggest needs that we are seeing is the fact that they have to travel so far to get the care that they need. This will be helpful so that they don't have to travel three to five hours trying to get the abortion care that they need.

MCCAMMON: Anti-abortion rights groups are taking notice, working to tighten regulations on pills and looking for ways to make it harder for providers to serve patients across state lines. Just months after the Supreme Court overturned Roe, voters had a chance to weigh in. Nationwide, voters in the 2022 midterms listed abortion rights among their top concerns in exit polls. And in several states where the issue was on the ballot, including red states like Kansas and Kentucky, voters signaled support for abortion rights. Already, abortion rights groups say they're looking ahead to future elections, hoping to put the question directly to voters in more states.

Sarah McCammon, NPR News, Washington.

(SOUNDBITE OF JONNY GREENWOOD'S "TOKI NO SENREI WO UKETEINAI MONO WO YOMUNA") Transcript provided by NPR, Copyright NPR.

Sarah McCammon is a National Correspondent covering the Mid-Atlantic and Southeast for NPR. Her work focuses on political, social and cultural divides in America, including abortion and reproductive rights, and the intersections of politics and religion. She's also a frequent guest host for NPR news magazines, podcasts and special coverage.