WASHINGTON — Advocates for anti-abortion policies emphasize that further efforts are required to tighten abortion access should Republican Donald Trump reclaim the presidency next year.

They cite a federal policy issued by Democratic President Joe Biden’s administration regarding emergency abortions, mandating that hospitals perform such procedures when a woman’s health or life is at stake. Additionally, they mention a relaxation in restrictions surrounding abortion pill prescriptions, which has enabled women to acquire the medication online with ease.

“The real work now starts to dismantle the pro-abortion strategies established by the Biden-Harris administration,” stated the Susan B. Anthony List, a significant entity in the anti-abortion movement, in a recent announcement. “The pro-life achievements from President Trump’s first term will serve as the foundation for his subsequent term.”

While the group did not elaborate on specific goals, abortion rights advocates are already preparing for more restrictions once Trump assumes office. There are indications that some women are also preparing for this shift, as online orders for abortion pills surged following Election Day.

Trump maintains that abortion regulation should fall to the states rather than the federal government. However, throughout his campaign, he highlighted that he appointed justices to the Supreme Court who voted to eliminate the nationwide right to abortion. His administration’s potential actions could include appointing judges and formulating regulations that align with an anti-abortion agenda.

The Trump administration is anticipated to rescind Biden’s contentious directive that mandates hospitals to provide emergency abortions as necessary to stabilize a woman’s health or life. The Biden administration argued that a long-standing federal law obliging hospitals to deliver stabilizing treatment in exchange for Medicare funding applies to situations where an abortion may be required.

Since the Supreme Court revoked the national right to abortion in 2022, reports have surfaced about women being discharged from hospitals or left without treatment in perilous conditions. Many hospitals have cited state abortion restrictions as a reason for their inability to terminate pregnancies when necessary.

Fatima Goss Graves, president and CEO of the National Women’s Law Center, expressed concern: “We’re witnessing heightened risks to the lives of pregnant individuals. Reports are surfacing about women suffering from infertility, sepsis, and, in some instances, even death.”

Even if a new Trump administration disregards the federal law’s guidelines, Goss Graves stated that advocacy groups will continue to pursue legal recourse in support of the Biden administration’s interpretation of the law.

Some medical practitioners have indicated that the federal instructions provided them legal protection to perform emergency abortions in states with stringent regulations, such as Idaho and Texas, where the threat of prosecution looms over their decisions.

Trump has expressed support for exceptions allowing abortions in cases of rape, incest, or when a woman’s life is endangered. However, he stops short of endorsing exemptions when a woman’s health is at risk.

In serious, albeit rare instances, abortions might be necessary to avert organ loss, severe hemorrhage, or dangerous infections. Situations involving ectopic pregnancies, premature rupture of membranes, and placental abruptions can jeopardize a woman’s health, even if the fetus remains viable. Medical professionals argue that the lack of clarity in the legality surrounding these circumstances has created obstacles for them.

For example, a hospital in Idaho began airlifting women out of state post-enactment of a strict abortion ban that only permitted procedures to save a woman’s life. The Biden administration took legal action against Idaho, contending that the state law conflicted with federal legislation obliging hospitals to provide stabilizing treatment, which might include abortions. Eventually, Idaho modified its law to allow abortions for ectopic cases, yet many hazardous conditions are still unaddressed. Earlier this year, the Supreme Court refrained from ruling on this matter, issuing a limited order that allowed hospitals to provide emergency abortions while the issue progressed through the court system.

Currently, the enforcement of federal law is paused in Texas, which has contested the Biden administration’s guidance on emergency abortions.

A diverse array of state laws regulating abortion will persist throughout Trump’s administration. Recent voting in Florida, Nebraska, and South Dakota resulted in constitutional amendments being rejected, thereby maintaining current bans. Conversely, in Missouri, voters supported a measure to revoke one of the nation’s strictest abortion prohibitions. Rights-oriented amendments were also approved in Arizona, Colorado, Maryland, and Montana. Nevada also passed an amendment, but it requires another validation in 2026 to become effective.

Under a Trump presidency, challenges surrounding access to abortion pills may continue.

During the COVID-19 pandemic, the Food and Drug Administration facilitated easier access to abortion pills, including mifepristone, allowing women to obtain the medication via telehealth. The FDA has affirmed the drug’s safety through the first ten weeks of pregnancy, citing adverse effects in only 0.32% of patients.

Anti-abortion proponents dispute this safety claim, arguing that these medications should not be readily available without direct supervision from a healthcare provider.

Despite the Supreme Court maintaining access to the drug earlier in the year, challenges from anti-abortion activists and conservative states have intensified in lower courts.

Concerns among women are palpable. A telehealth service provider, Wisp, reported a dramatic increase in abortion pill orders between Election Day and the following day, seeing a staggering 600% rise. In states like Florida and Texas, which prohibit legal shipment of the medication, the company noted an almost 1000% increase in orders for emergency contraception, often called the “morning after” pill.

Wisp fills tens of thousands of orders each month for reproductive health products, including birth control and abortion pills, according to CEO Monica Cepak. Currently, the two-step medication regimen utilizing mifepristone and misoprostol is common for women seeking medication abortions. Cepak noted that the company is prepared to monitor the situation surrounding mifepristone closely under a potential Trump administration and is ready to adapt to a misoprostol-only protocol if restrictions on mifepristone are instituted.

However, Trump’s stance on the issue remains unpredictable, according to Mary Ziegler, a law professor specializing in reproductive health at the University of California, Davis. In the latter stages of his campaign, Trump softened his previously hardline views on abortion, even indicating he would not endorse a national abortion ban if proposed to him.

While he has garnered strong support from anti-abortion groups, he has also demonstrated a willingness to diverge from his allies when he sees fit.

“There seems to be no definitive predictability regarding his intentions,” Ziegler remarked.