On the 45th anniversary of Roe v. Wade, the U.S. Supreme Court decision that legalized abortion in the United States of America, many people may be wondering if the era of safe and legal abortion in our country is coming to an end. While the reality is that access to safe and legal abortion is actually out of reach for too many Americans, recent court cases  have reaffirmed the fundamental right to access legal abortion care in this country. But political rhetoric, policy proposals and anti-abortion extremism at the state and federal levels have continued advance and enact unnecessary, dangerous, and ideologically-motivated roadblocks to a form of basic healthcare that one-in-four American women  will access in their lifetimes.
In the 45 years since the legalization of abortion, North Carolina – a once fairly progressive state for abortion access – has enacted more than its share of unnecessary political restrictions , and anti-abortion lawmakers keep trying to pass more.  The General Assembly gave anti-abortion, non-evidence-based crisis pregnancy centers  significantly  more tax dollars  in the latest budget than they did the previous year, while still withholding money from Planned Parenthood, despite the work the its health centers have done to prevent unplanned pregnancies (which, consequently, lowers the abortion rate). And local governments are struggling to respond to escalating harassment at abortion clinics, as anti-abortion groups are quick to bring lawsuits  against municipalities if they try to protect patients.
As we commemorate the 45th anniversary to legal access to abortion, we are doing so in a political moment in which anti-abortion extremists across the country have increasing access to power with which to impose their anti-reproductive rights agenda, one that includes more than restricting abortion.
This past year has brought numerous attacks on access to birth control ; attempts to dismantle the Affordable Care Act, including allowing insurance companies to drop maternity care ; and multiple attempts by the Department of Justice to strip undocumented immigrants of their right to access abortion care , using the young women’s youth and immigration status as a way of controlling their bodies and decisions.
We’ve also seen energetic support from anti-abortion extremists for politicians who have been accused of numerous instances of sexual assault and/or pedophilia, including the anti-abortion group Operation Rescue naming President Donald Trump its “2017 person of the year,” and a local anti-abortion extremist stumping for A labama candidate  Roy Moore during last year’s Senate campaign. We’re seeing power being wielded by people who are both anti-abortion, and hostile to the idea that people can have a say over their own bodies.
We are also witnessing renewed efforts to enshrine the belief of “personhood” for embryos and fetuses into our legal system. Whether through efforts to sneak the concept into tax law  or into Department of Health and Human Services strategic plans, this would be a new and terrifying aspect of our criminal legal system if abortion were once again made illegal. What would that mean not just for people who obtained or performed abortions, but for all pregnant people?
The county attorney in Big Horn County, Montana is already using the premise of “protecting the unborn” to implement an “immediate crackdown policy of civilly prosecuting any expecting mothers found to be using dangerous drugs or alcohol ,” including imprisonment if the county believes this is warranted. This “crackdown” includes encouraging county residents to report any suspicions of drug or alcohol use by pregnant people to the county sheriff’s office or to county social services.
The American College of Obstetrics and Gynecology has repeatedly stated  that this kind of adversarial approach to treating pregnant people does not result in positive birth outcomes, but we know this is not be the point of such a policy. Rather, reproductive rights advocates are concerned that this “zero tolerance policy” rhetoric is an attempt to establish state power to monitor, control and punish people on the basis of pregnancy and pregnancy outcomes. Women do go to prison in countries  that have completely criminalized abortion for outcomes such as stillbirth and miscarriage, and we’ve seen that also happen here in the U.S. despite abortion being legal (including a 2015 Indiana case , when Vice President Pence was governor of that state). These “personhood” efforts aren’t just elevating the fetus to the status of a person: they are also degrading the status of women and pregnant people to one that is secondary and less than.
On the 45th anniversary of the right to access abortion in the U.S., we know that 7 in 10 Americans , no matter their own personal feelings on the issue, ultimately support access to safe and legal abortion for those who decide that is what they need to do. Americans support this right because they trust pregnant people to make whatever decision is best for them at that moment in their lives. Forty-five years on from Roe, though, we the people must remain diligent that we don’t once again retreat into the darkness of the back alley.