Demonstrators hold signs during a rally to defend abortion access and codify Roe v Wade into law, in Foley Square in New York City on Oct. 8, 2022. (Photo by BRYAN R. SMITH/AFP via Getty Images)

The fate of abortion rights and abortion access will be determined this November at the state and local level during midterm elections. Since the Supreme Court overturned Roe v. Wade in June of this year, most abortions have been banned in 14 states and are actively threatened in seven. Now, voters will directly influence the future of abortion in five states, while local gubernatorial and judicial races across the country will similarly shape the makeup of each state’s abortion access—either acting as stopgaps between the state and abortion bans or paving the way for expanding an already staggering abortion desert. 

“It’s never been a more important time for voters to really make our voices heard, and the time is now for candidates to have the boldest plans that they can have on abortion rights and access,” said Morgan Hopkins, interim executive director of campaigns and strategies at All* Above All Action Fund. “It’s not enough to say that you would restore protections or restore the right to abortion, especially if you were in a state that has had restrictions for decades. We really need to see full, comprehensive policy platforms from all candidates running for office.”

All eyes will be on battleground states like Pennsylvania and Florida, where conservative legislators have continuously threatened abortion rights. In Pennsylvania, the GOP-controlled General Assembly has repeatedly tried to pass an abortion ban. In July, they sidestepped Democratic and pro-abortion Gov. Tom Wolf’s veto power by approving a constitutional amendment that would allow for a statewide abortion ban in the future. With Wolf’s term ending this January 2023, voters will have to choose between two gubernatorial candidates with starkly different positions on abortion access.

“We have a really consequential midterm election here in Pennsylvania, and the potential outcomes are pretty scary,” said Julie Zaebst, senior policy advocate for ACLU of Pennsylvania. “We’ve had an anti-abortion majority in our state legislature for a long time. For many years, the only thing that stood between us and abortion restrictions and bans in this state has been the governor’s veto.”

According to Zaebst, if Pennsylvania elects an anti-abortion governor on top of the existing anti-abortion majority, they could see access to abortion vanish overnight as early as January. In addition to the gubernatorial race, voters will determine the fate of nationwide abortion restrictions through the U.S. Senate race.  

Zaebst said the stakes could not be higher as abortion deserts continue to grow in the midwestern and central U.S. Ohio and West Virginia both border Pennsylvania and rely on the state’s access to abortion. Ohio is attempting to pass an abortion ban even though a judge just ordered it blocked, and West Virginia banned abortion in September. 

“Folks from Ohio and folks from West Virginia have been pouring into western Pennsylvania to seek care,” said Zaebst. “[This has] repercussions for Pennsylvania patients too because [though] I might live in Pittsburgh down the street from a clinic, if they are dealing with an influx of patients from out of state, I’m going to have to wait weeks for an appointment too.” 

Florida’s upcoming gubernatorial race against incumbent and anti-abortion Republican Gov. Ron DeSantis could result in shifts in the reproductive rights landscape. Abortion is currently limited to 15 weeks, but the state Supreme Court will hear abortion providers’ and the ACLU’s case for blocking the ban. DeSantis is facing off against former Florida Gov. Charlie Crist, and with a Democrat in the governor’s seat, Crist could veto further limitations. On the judicial side of the election, voters will get to decide whether to retain many of DeSantis’ appointed judges to the state Supreme Court, including Jamie Grosshands, who has explicit ties to anti-abortion organizations and prevented a 16-year-old from getting an abortion in 2011.

Advocates are hoping abortion will mobilize more voters to the polls, especially after the successful primary ballot initiative in Kansas, where 59% of voters voted no to a state constitutional abortion ban.

“Kansans sent a very clear message to politicians across the political spectrum that they want abortion to be protected,” said Josh Siebenaler, an organizer with the Kansas Abortion Fund.

Looking toward the November election, Siebenaler said all eyes in Kansas are on the retention races for state governor and Supreme Court. According to Siebenaler, most of the judges that are up for the retention vote were a part of the opinion that secured protections for abortion rights in the Kansas State Constitution in 2019. If voters vote out these judges, Kansans could see a future where that previous 2019 decision is overturned or overruled.

“The state legislature is not likely to flip and become pro-abortion anytime soon,” said Siebenaler. “The election of a governor that will protect reproductive health and rights is an important backstop. It is, so to speak, the last line of defense from the aggressive overreach and frankly purposeful ignorance of people’s voices by the state legislature.”

Like Pennsylvania, banning abortion in Kansas would similarly impact access for people across the country. Over 7,800 abortions were performed in the state last year, nearly half of which were for out-of-state residents from states such as Missouri, Oklahoma, and Texas. 

“The anti-abortion legislation that has been enacted in these states not only puts pressure on the patients that have now been forced to travel to Kansas, but also reduces the amount of availability of appointments for Kansans as well,” said Siebenaler. “There’s an adage going around that, I think, is particularly pertinent to Kansas, that there are 24 states that are expected to protect abortion rights. Those 24 states cannot meet the health care needs of all 50 states.”

Though Kansas may have been the first successful ballot initiative for abortion rights, it’s certainly not the last in the lead up to the November elections. California, Michigan, and Vermont will all have ballot initiatives asking voters to codify abortion rights into law, while Montana voters will have to grapple with a vaguely worded and redundant initiative that would penalize doctors that do not act to preserve the lives of “born alive infants,” including fetuses extracted during an attempted abortion. 

In Kentucky, where an abortion ban has already gone into effect but will be reviewed in the state Supreme Court, abortion advocates are following in Kansas’ footsteps and trying to pass Amendment Two, a ballot initiative that says the state constitution cannot be interpreted to protect abortion rights. 

“The language is definitely confusing,” said Erin Smith, a Kentucky Health Justice Network organizer. “I think people need to know that it’s going to be absolutely devastating to the future of Kentucky.”

Since the abortion ban passed, Smith said their organization’s hotline has been receiving calls for help, but now they can only send people out of state.

“It’s very limited,” said Smith. “If you’re living in an area and you don’t have easy access to get to the airport or to get a ride to travel for 50-plus miles, then the odds are that you’re going to be stuck in your situation, and you might not necessarily have the means to take care of yourself or that life that you’re now being forced to have.”

Smith hopes voters in Kentucky remember to simply turn over their ballot and fill out all of the races and questions. Meanwhile, abortion advocates across the country hope elected officials will take the boldest action that they can to ensure that abortion isn’t just legal but that it’s available, accessible, and affordable.

“The best case scenario is that folks get informed and get engaged around the current state of abortion access and really step in, in their own communities to make access a reality right now, right here today,” said All* Above All Action Fund interim director Hopkins.

Alexandra Martinez is the Senior News Reporter at Prism. She is a Cuban-American writer based in Miami, Florida, with an interest in immigration, the economy, gender justice, and the environment. Her work...