Just after 8:30 p.m. on May 2, my phone started blowing up with text messages. Friends, relatives, and acquaintances wanted to know whether I had seen the leaked draft of the Supreme Court opinion now poised to strike down the precedent set by Roe v. Wade. They all wanted to hear what I, a reproductive justice advocate, thought about the bombshell.
While certainly jarred by the draft, I was far from shocked. Those of us fighting for reproductive rights have long known that Roe v. Wade will eventually fall, and have been preparing for that reality. This is particularly so here in New Hampshire, which has been grappling with new abortion restrictions that went into effect earlier this year.
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People in states like Massachusetts, which have proactively enshrined abortion rights into law, may have heard about restrictions here and assumed they wouldn’t have a far-reaching impact. But not only do they foreshadow what’s to come for the rest of the country, they should also set off alarms for neighboring New England states.
Despite a high rate of support for abortion access in New Hampshire, Governor Chris Sununu, a Republican, last June signed into law a 24-week abortion ban, with virtually no exceptions, that included mandated ultrasounds for every person accessing an abortion. The groundwork was laid in the 2020 election, when Republicans swept control of the State House, state Senate, and Executive Council (a five-person governing body that recently defunded reproductive health centers), in addition to the governorship.
Fortunately, activists here helped spearhead the repeal of the ultrasound requirement, as well as the passage of a bill that would allow for abortions after 24 weeks in cases of fatal fetal anomalies. Meanwhile, the law on the books still bans abortions past 24 weeks, even for cases of rape and incest, despite polls that show the law is deeply unpopular with Granite Staters.
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So how does this impact the rest of New England, and beyond?
Foremost, New Hampshire abortion restrictions will push patients to get care in surrounding states, with Massachusetts likely to receive the highest volume of them. Clinics here currently don’t provide abortion care beyond the end of the 15th week, even though it’s legal, according to research by the Reproductive Freedom Fund of New Hampshire, where I am executive director. Our organization — which provides financial support for those in need of abortion services — already sends the majority of patients who are 16-plus weeks along to Boston. If we start seeing a higher volume of patients in this situation, this could impact patient care for all by straining the system.
This won’t be limited to the Northeast. When Roe falls and half the country bans or strictly limits abortion, many seeking care will be forced to cross borders to states considered safe havens. Already, we’ve seen patients from Texas, which recently passed a near-total abortion ban, traveling as far as Maine for care. Longer wait times for appointments will lead to people needing abortions later in their pregnancies, which becomes increasingly expensive, not to mention the increased costs for travel, hotel rooms, and child care.
As abortion continues to get restricted across the country, it’s imperative that every method of accessing safe abortion is available; otherwise, patients are more likely to turn to unsafe methods. As a result of New Hampshire’s ultrasound mandate, for example, patients could not access medication abortion pills shipped directly to their homes, but instead had to visit a clinic to get those medications along with an ultrasound. Abortion pills by mail are the future of abortion access, as more than 11 million women of reproductive age live over an hour away from the nearest clinic. This is a huge issue for rural patients, including those in my state; studies show a direct correlation between distance from clinics and decreased abortion rates among those who need them.
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Another lesson from New Hampshire is that legislators shaping antiabortion policy often don’t know the impact of the legislation they’re voting on. Some who voted in favor of the new restrictions were unclear about the concept of fatal fetal anomalies — conditions that make it unlikely a baby will survive after birth — or the process of diagnosing them. But through education, and the brave testimony of women who learned of such anomalies late in pregnancy, Republicans came around and saw why these laws were more harmful than they originally had thought.
What we’re seeing now might only be the beginning. Antiabortion politicians will be emboldened by the pending Supreme Court ruling and continue to introduce an onslaught of restrictions limiting the reproductive freedom of Granite Staters. The only way to guarantee the right to abortion is to pass a state law codifying the rights granted by Roe v. Wade, but New Hampshire has failed to do that multiple times.
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Before that day when we wake up to see Roe v. Wade overturned, the Northeast must increase our regional capacity to provide abortions. Protected states like Massachusetts should be considering ways to increase the number of providers to help meet the increased volume that will inevitably come.
For supporters of reproductive rights, the time is now to use our voices, our time, our votes, and our dollars to make clear that abortion is an essential form of freedom that we aren’t willing to give up — in New England and beyond.
Josie Pinto is the executive director of the Reproductive Freedom Fund of New Hampshire. Send comments to magazine@globe.com.