Originally published in Scientific American.

For supporters of reproductive health care, a glaring contradiction stands at the center of the 2024 election. Most pro-abortion ballot initiatives passed, and the American people reelected the president who was responsible for overturning Roe v. Wade through his Supreme Court appointments.

How to reconcile this contradiction? In many ways the results reflect the complicated dynamics of a post-Roe America.

In the two and a half years since the loss of our federal constitutional right to abortion with the Supreme Court’s Dobbs decision, the legal landscape has been upended, with 13 states currently banning abortion completely and many others banning abortion at different points throughout pregnancy that would have been unconstitutional under Roe. The consequences have been nothing short of disastrous, as the scientific evidence foretold. They include the documented tragic deaths of at least four women, the denial of care for women experiencing pregnancy complications, and the increased criminalization and surveillance of pregnant people. At the same time, the number of abortions has risen. That’s likely a result of monumental efforts by clinics, abortion funds and practical support organizations to expand access to care and reduce stigma, as well as broader availability of telehealth for medication abortion and new supportive policies in protective states like shield laws that offer protection for abortion providers treating patients in other states via telemedicine and the removal of public insurance coverage restrictions that make abortion care more affordable.

Read the full op-ed in Scientific American.