Executive Summary: The Anti-Abortion Movement’s Extremist Playbook

In June 2022, the U.S. Supreme Court overturned the right to abortion in Dobbs v. Jackson Women’s Health Organization, upending a half-century of precedent. Since then, 14 states have outlawed abortion, three others have effectively banned the procedure by making it illegal after roughly 6 weeks of pregnancy, and at least 66 abortion clinics have closed or stopped offering abortion services.

The Dobbs decision was one of the most significant far-right victories in modern political history. Subsequent legislation outlawing or limiting abortion has rendered people who can become pregnant unable to make crucial decisions about their own reproduction, families and futures. For the far right, restricting access to abortion is a major step toward constructing the kind of society they want – namely, one in which the state enforces policies that repress and disempower certain groups of people, hardening gender, racial and class hierarchies.

The anti-abortion movement is fundamentally antidemocratic. A country can hardly claim to be a democracy if roughly half of its citizens are prevented from exercising control over their own bodies – prohibited, in some cases, from accessing lifesaving health care in service of a male supremacist political project. Ensuring abortion access has wide public support, yet an emboldened and extreme group of activists and legislators continue to limit American women’s access to reproductive care. In some states, Republican Party legislators have attempted to keep abortion measures off the ballot, or to increase the threshold to pass ballot initiatives beyond a simple majority. With Dobbs, constitutional scholar and Georgetown Law Professor Michele Goodwin has argued, “the court restored the notion that women’s equality is contestable and that their right to bodily autonomy deserves lesser protection than a man’s.”

Violence and terror have long been key tools of the militant anti-abortion movement. Since 1977, anti-abortion activists have committed 11 murders and 42 bombings, as well as many hundreds acts of arson and assault. Today, abortion providers, clinic workers, activists and people seeking abortion care are facing a new oppressive landscape, crafted by government bodies that limit, criminalize and surveil reproductive care in addition to anti-abortion activists who rely on violence, intimidation, harassment and misinformation to dissuade people from having abortions or legalizing access to abortion care.

Largely because of their success in their decades-long effort to overturn Roe v. Wade, the anti-abortion movement has become more emboldened and militant. According to a 2022 report published by the National Abortion Federation, anti-abortion violence has increased since Dobbs, especially in “protective” states that offer broad abortion access. It is little surprise that large numbers of well-known anti-abortion activists were at the U.S. Capitol on the day of the Jan. 6, 2021, insurrection – the goal of which was the suppression, through force, of pluralistic democracy. In statehouses, a network of activists who call themselves “abortion abolitionists” is attempting to outlaw all abortion and criminalize the procedure as murder. White power activists are increasingly engaging in anti-abortion activism while, in the realm of more mainstream politics, right-wing politicians and activists feel empowered to pursue policies that would lead to the further erosion of rights for women, LGBTQ+, gender nonconforming and transgender people.

For the far right, restricting abortion has always been about creating a rigid social order where men, especially those who are white, maintain a privileged status and control over other, marginalized groups. With the Dobbs decisions, the anti-abortion movement now has far greater power to pursue that agenda – a reality that has emboldened its most extreme elements while demeaning and endangering the lives of women and all those who can become pregnant.

The Playbook

The right has been transparent about their future goals. “Conservatives should gratefully celebrate the greatest pro-family win in a generation: overturning Roe v. Wade, a decision that for five decades made a mockery of our Constitution and facilitated the deaths of tens of millions of unborn children,” a Heritage Foundation document called Mandate for Leadership states. “But the Dobbs decision is just the beginning.” The Mandate is an expansive, nearly 900-page blueprint for the next Republican administration created by a right-wing coalition called Project 2025, composed of longstanding right-wing think tanks, anti-abortion groups, and SPLC-designated hate groups including Alliance Defending Freedom, the Center for Immigration Studies and Moms for Liberty. While laying out innumerable ways the coalition plans to unleash authoritarian policies, it features, in great detail, the ways movement loyalists could use their powers to further dramatically restrict access to abortion.

The GOP publicly supports arbitrary, politically calculated nationwide abortion bans. Many organizations and officials back a ban at 15-weeks gestation, though Donald trump has said he would call for a 16-week ban because, “It’s even. It’s four months” (both limits, notably, come before people would know if their pregnancy was affected by many serious or fatal disorders or birth defects, including conditions like anencephaly). Project 2025 lays out ways a conservative administration could use executive power to curtail access to abortion even more severely. The plan, for example, says that the Food and Drug Administration (FDA) is “ethically and legally obligated” to reverse its approval of mifepristone, a drug used in many medication abortions, which today account for nearly two-thirds of all abortions in the U.S. Regulation of the drug will be decided in FDA. v. Alliance for Hippocratic Medicine, a case that is currently before the Supreme Court. However, whatever the outcome of that case, the drug could still be severely restricted. As Mary Ziegler, a law professor and preeminent historian of abortion, recently pointed out, “The scientists at the FDA might not even need to be on board with this plan for it to work [because] the secretary of the Department of Health and Human Services, a presidential appointee, can override the FDA’s drug approval decisions.” Some of the most uncompromising anti-abortion activists have become especially focused on banning access to mifepristone because it allows people in states with abortion bans continued access to self-managed abortions.

Additionally, Project 2025 supports the revival of the Comstock Act, enacted in 1873 to prohibit the distribution of contraceptives and any “instrument, substance, drug, medicine, or thing” that could induce an abortion. Project 2025 argues that the law, parts of which remains on the books but unenforced, should criminally prohibit the mailing of abortion drugs – an interpretation the Biden administration has argued against.

Bringing back the Comstock Act has emerged as a consensus within the anti-abortion movement. “We believe the Comstock Act should be followed and abortion pills should not be sent through the mail – certainly that should be enforced,” Carol Tobias, the president of the anti-abortion National Right to Life Committee, recently told POLITICO.

Resuscitating the law could have even further repercussions than those explicitly mentioned by Project 2025, impacting abortion generally. “The text of the act itself is so broad,” Rachel Rebouché, Temple University Law School professor and dean, told The Nation recently, “It could effectively shut down, if literally applied, all abortions” by prohibiting the distribution not only of abortion drugs, but any medical instruments or supplies used in the procedure. Right-wing activists have worked to enact local ordinances based on the Comstock Act – some of which have been adopted in counties throughout New Mexico – that they hope will be challenged before the Supreme Court. A decision in their favor could effectively mean a nationwide abortion ban. Justices Samuel Alito and Clarence Thomas signaled their interest in the law during oral arguments in the case that will decide whether increased restrictions should be placed on mifepristone.

Project 2025 contains other suggestions for limiting access to abortion that could be more immediately impactful. The coalition calls on the Department of Health and Human Services (HHS) to reverse Biden administration guidance that tells hospitals they must provide abortion care if a pregnant person’s life is at risk, even if abortion is banned in that state – which could effectively leave people to die even when lifesaving care is possible (the Supreme Court will decide a case on this issue in 2024). Elsewhere, Project 2025 argues that the Center for Disease Control’s “abortion surveillance” is “woefully inadequate,” and needs to be enhanced. Turning the agency into a surveillance network could increase scrutiny and criminalization of those having abortions.

Another important facet of the right’s attack on abortion comes in the form of enshrining “fetal personhood” – the notion that fetuses and embryos should have the same legal rights and protections as children – into law. Pro-abortion activists and academics have, especially since the fall of Roe, been warning that fetal personhood was the next step for the anti-abortion movement. Far-right activists have encouraged their followers that it is “not a far leap from Dobbs to constitutional personhood.”

The right has had recent success on the fetal personhood front: In Alabama, which outlaws abortion, the Supreme Court ruled in February 2024 that embryos are people. While the decision imperiled the use of in vitro fertilization (IVF), a fertility treatment used by a variety of people, including couples struggling to conceive, those with genetic disorders they do not want to pass to their children, same-sex couples and those starting families on their own, it furthers the broader effort to enshrine fetal personhood. Since the beginning of 2024, at least 14 states have introduced fetal personhood bills. Creating legal protections for fetuses could mean the end of abortion at the state or national levels, as well as the expansion of abortion criminalization.

The Most Marginalized Suffer the Most Harm

Abortion bans and limitations have a disparate impact on women of color and those who live in poverty. The United States has the highest maternal mortality rate of any wealthy nation, and women here are 14 times more likely to die in childbirth than during an abortion – meaning, for some, the consequences of Dobbs will be a death sentence. That is especially true for Black women who, regardless of their income or education, have maternal mortality rates 2.6 times higher than their white counterparts. They are also more likely than any other group to experience health complications during pregnancy.

Maternal mortality, as well as the gap between women of color and white women, will likely be further exacerbated by abortion restrictions. The country is reversing policies that protected women’s health: the legalization of abortion in Roe reduced maternal mortality rates for people of color by 30%-40%. A recent study from the University of Colorado predicts that a nationwide abortion ban would increase maternal deaths by 24% overall and by 39% for Black patients.

Pregnancy carries inherent risk and can come with serious or even fatal complications, including conditions like preeclampsia, an increased risk of blood clots, hemorrhaging and sepsis. Even nonviable pregnancies can be deadly – if untreated, an ectopic pregnancy, in which the embryo implants outside the uterus, can rupture and kill the pregnant person. The health risks of pregnancy, combined with draconian and confusing abortion laws that have led doctors to delay or refuse care to women miscarrying or experiencing life-threatening pregnancy complications, have made it far more dangerous to be pregnant in the United States. A recent report on the impact of Louisiana’s abortion ban, which relied on interviews with health care providers and patients, found that prenatal care is being delayed “to avoid the risk of miscarriage care being misconstrued as an abortion in violation of the bans,” and that clinicians are no longer able to use their best medical judgement to provide care because they fear being prosecuted. “Our attorney general, Jeff Landry, sent us all a letter saying, ‘I will put you in jail if you break these rules.’ Literally, I am out to get you,” a maternal fetal medicine specialist told researchers. Pregnant patients facing difficult complications “aren’t clinical scenarios that happen once a year,” they continued, “They happen all the time. Every time I’m on call, I have a patient that’s considered to potentially be in a life-or-death situation.” People’s lives and future fertility are imperiled. “Remember: Dead mothers do not lead to live babies,” Dr. Joseph Valenti, speaking for the Texas Medical Association, recently told the Texas Medical Board during a hearing over whether the state should adopt additional rules that could further delay lifesaving care.

In some cases, women who have discovered their fetus has a fatal defect have been denied abortions and forced to carry their pregnancy to term, only for the baby to die shortly after birth. Others had fled their home state to terminate their pregnancies – choices they have decided are best for themselves and their unborn fetus. Abortion bans have also imperiled safe and dignified miscarriage management. Up to 25% of known pregnancies end in a miscarriage, the management of which – if the fetal tissue does not pass on its own, or a person prefers not to wait for the fetal tissue to pass – uses the same medication and procedures as abortion care. After Dobbs, people are reportedly being denied miscarriage treatment and, in some cases, are being criminalized for suffering a miscarriage in the first place.

Abortion restrictions are heavily concentrated in the South, a region with the country’s highest rates of poverty and where more than half of Black Americans live. People in the South are also most likely to face pregnancy criminalization, which the legal advocacy organization Pregnancy Justice defines as “an instance in which someone is either arrested for reasons related to their pregnancy, or where the terms of their bail, sentencing, or probation are heightened because they became pregnant after being charged with an unrelated crime.” A Pregnancy Justice report documented nearly 1,400 “arrests due to pregnancy criminalization” in the 16.5 years before Dobbs and showed that these cases had dramatically increased over time. Nearly 90% of the arrests they documented took place in the South – nearly half of those were in Alabama alone. They also found that being poor is the greatest predictor of pregnancy criminalization. With more people in the South, especially, forced to carry pregnancies after the Supreme Court’s decision overthrowing Roe, pregnancy criminalization is likely to increase.

The Movement’s Extreme Aims

The anti-abortion movement is inherently a white supremacist, male supremacist and classist political project. The movement believes women and all those who can become pregnant should be afforded fewer rights, furthering the far right’s goals of severely curtailing – through law and cultural practices – the life paths, careers and identities available to women. That goes hand-in-hand with the movement’s broader efforts to construct rigid and “traditional” gender roles by criminalizing, demonizing and restricting the ways LGBTQ+ people can express themselves and build their families.

The people who face the most harm from the anti-abortion movement are those who live in poverty, Black women, Latino women, trans men, nonbinary and gender-nonconforming people and others who are already marginalized in American society. Yet the anti-abortion movement has not been interested in pursuing policies that would alleviate the harms abortion restrictions cause, such as improvements in maternal health care, measures to eradicate poverty or ensuring families have access to paid parental leave or childcare. The movement’s agenda simply compounds existing race, class and gender inequalities in the United States.

The anti-abortion movement’s goal is not to protect families, but to construct what they deem the right kinds of families – those in which children are born to married, heterosexual couples where men act as the sole providers and the women as homemakers and caregivers. Many in the far right also make it clear that the abortion restrictions are one tool to ensure that white women, in particular, have more children. Both white supremacist hate groups and far-right politicians have cited abortion bans as a way of fighting the so-called “great replacement” – a conspiracy theory that claims that white people across the Western world are being systematically erased and replaced by non-white people, primarily through declining white birthrates and increasing immigration. “If you’re worried about this quote-unquote replacement, why don’t we start there?” Matt Schlapp, the head of the Conservative Political Action Conference, said in 2022 in reference to abortion restrictions. White supremacist and antigovernment militias have long played important roles in the anti-abortion movement, especially its militant vanguard. But their goals have rarely overlapped so clearly with the mainstream right as they seemingly do today.

Outline of Report

This Southern Poverty Law Center report explores the state of the anti-abortion movement in the United States. We begin, in Section I, by examining the history of the movement’s militant arm, which is responsible for decades of murders, assaults, bombings and other attacks on abortion providers and clinics. This historical view, which relies on archival sources, is especially important now as the anti-abortion movement looks to its militant peak in the 1980s and 1990s for inspiration.

Section II provides a broad outline of the crucial components of today’s anti-abortion movement: well-resourced anti-abortion lobbying and legal firms connected to the Christian Right, abortion “abolitionists” calling for abortion to be treated as murder, “rescuers” and other direct-action anti-abortion activists and, finally, crisis pregnancy centers that are at the forefront of the movement’s efforts to spread abortion misinformation. Section III of the report examines today’s political landscape from the perspective of clinics, activists and providers. Since the Dobbs decision, clinics face increased restrictions, repression and violence. In states with protective abortion laws, clinics struggle not only to meet the increased demands for care from those traveling out of state, but increased threats of violence from an emboldened anti-abortion movement. In states with abortion bans and restrictions, clinics are severely limited in the care and aid they can offer patients, and they see firsthand the harm these laws create. Section IV of the report goes deeper into the harm restrictions have created for communities, especially those in the South.

Finally, Section V explores the role anti-abortion politics play in the broader far-right political sphere, arguing that the anti-abortion movement is ultimately a product of their male supremacist and white supremacist political aims.

Even under Roe, many women – particularly women of color, those living in poverty and those in states hostile to reproductive rights – lacked practical access to abortion and other reproductive care. As many reproductive justice advocates argue, it is not enough to simply reverse the Dobbs decision. Our communities need reproductive justice, defined by SisterSong, a collective of women of color working to bring justice to the systems that govern reproductive care, as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Reproductive justice seeks to build a system in which people have real access to reproductive care and the resources needed for children and families to thrive.

The anti-abortion movement is not going unchallenged. A majority of the public supports abortion access and opposes the Dobbs decision. Providers, organizers and activists are pushing back on restrictions. That means not just protecting abortion, but creating a world in which people are allowed the dignity to create families – or not – when and how they choose.

Illustration at top by Cristiana Couceiro.

---

A note on terminology: Though we often refer simply to “women” in this report, and while cisgender women are numerically most impacted by anti-abortion attacks, they are far from the only ones. The far right’s attacks on abortion impact trans men, nonbinary, and gender-nonconforming people, as well. We want to emphasize that all of these groups suffer harm at the hands of this movement, and it can only be fully reversed when all of these groups can fight together in solidarity.