Jodi Enda
Overturning the constitutional right to abortion was the first step. When Donald Trump returns to the White House next year, the former abortion-rights supporter — who has since proclaimed himself to be “the most pro-life president” in history — is expected to do much more.
During the presidential campaign, Trump touted his role in overturning Roe v. Wade by nominating three anti-abortion justices to the Supreme Court. But given the public backlash to the 2022 ruling and numerous stories of women who suffered life-threatening consequences, or death, he declined to outline what he would do on abortion in a second term.
There are, however, many clues. Trump is likely to reinstate domestic and international anti-abortion policies that he imposed in his first term, and that President Joe Biden revoked. He also could adopt proposals on abortion and other reproductive health care contained in the 900-page blueprint for the next conservative administration, Project 2025.
The court’s decision to overturn abortion rights “is just the beginning,” states the document, which was drafted by the Heritage Foundation with the help of many Trump administration alumni. The next conservative administration, it says, “should push as hard as possible to protect the unborn in every jurisdiction in America.”
Trump said during the run-up to the election that he was unfamiliar with Project 2025 and that he would not sign a national abortion ban. But that remains an open question, depending in part on the final makeup and resolve of Congress. In the meantime, statewide bans and restrictions have popped up around much of the country, forcing women to travel great distances to obtain care and leaving some bleeding outside hospitals when they suffer complications from wanted pregnancies.
“We know that there’s already people dying from these bans, and I think we would expect to see that to go up,” said Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, an abortion-rights research organization.
Abortion opponents have recommended any number of policies aimed at limiting or eliminating women’s reproductive freedom. Many are things Trump could impose without an act of Congress. Among the possibilities: Banning or sharply curtailing the use of medication abortion, allowing hospitals to stop providing emergency abortion care, permitting employers to stop providing insurance coverage for contraceptives, allowing pharmacists to refuse to dispense contraceptives, reinstating abortion-related restrictions through a federal program for people with low incomes, eliminating federal insurance payments for Planned Parenthood patients.
“Now the work begins to dismantle the pro-abortion policies of the Biden-Harris administration. President Trump’s first-term pro-life accomplishments are the baseline for his second term,” Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said in a statement. “In America, where you live should never determine whether you live. Across the nation there are still hundreds of thousands of babies to save and moms to serve and we can’t stop fighting for them now.”
Internationally, Trump is almost certain to invoke — and possibly to expand — abortion-related restrictions on recipients of U.S. foreign assistance. In his previous term, Trump adopted the Reagan-era Mexico City Policy, which prohibits foreign organizations that receive U.S. aid from performing, advocating for or providing counseling or referrals on abortion, even with non-U.S. money. But unlike previous Republican presidents, he expanded the policy considerably. Under Trump, it applied not only to family-planning aid but to all health-care assistance.
A journal of the National Academy of Sciences said that expansion caused 108,000 women and children to die and 360,000 people to contract HIV/AIDS.
Project 2025 recommends expanding the Mexico City Policy again, to encompass all foreign aid, including humanitarian assistance. That, say opponents in the U.S. and abroad, would lead to more deaths.
Trump already has committed to re-joining an international agreement that declares there is “no international right to abortion.” The Trump administration launched the nonbinding document, called the Geneva Consensus Declaration on Promoting Women’s Health and Strengthening the Family, shortly before the 2020 election that he lost. Biden withdrew from it a few months later. While the one-page agreement has no teeth, abortion-rights advocates worry that with the power of the U.S. behind it, it could create new international norms that do not include abortion in women’s health care.
Imposing abortion restrictions on women in countries that rely on U.S. financial assistance has served conservatives well for decades. It shows their constituents they are trying to curb abortion without either running up against Roe, the first constitutional right to be overturned, or angering the overwhelming majority of Americans who support legal abortion in this country.
But despite their support for abortion rights, only a small portion of voters based their selection for president on the issue, according to exit polls.
That empowers Trump to impose greater restrictions on abortion or other reproductive rights, like contraception or in-vitro fertilization. He also will have the support of a Republican Senate should he have the opportunity to nominate additional justices to the Supreme Court.
With all his elections behind him, Trump faces few — perhaps no — risks.
The same cannot be said of the women whose lives his policies will affect.
