New book explores how abortion care and law has changed since Dobbs

David Cohen and Carole Joffe are leading scholars on the topic.

Two leading abortion rights scholars released a book this year that details how legal precedent surrounding the issue has evolved since the Dobbs decision.

David Cohen and Carole Joffe published After Dobbs: How the Supreme Court Ended Roe but Not Abortion in March. The book’s central premise is that abortion didn’t end after Roe was overturned, with a focus on how it has continued despite the unprecedented legal challenges.

In 2022, the authors repeatedly interviewed people who are deeply involved in the abortion rights world. They chose twenty-four people who worked in different fields in abortion and provided their services in other states and political environments. They interviewed almost all of them three times over.

The account starts with the story of a 10-year-old rape victim in Ohio who had to travel to Indiana to get an abortion after the Supreme Court had ruled that abortion bans could go into effect. Other stories included Amanda Zurawski, who had a health-threatening pregnancy in Texas, where she filed a lawsuit against the state to get an abortion. That became a seminal case called Zurawski v. Texas.

Some things I had been unaware of, including how the National Abortion Federation has gathered post-Roe stories via its hotline that it posts on abortionafterroe.com. That site shows how women have had to endure logistical and personal challenges that did not exist when Roe was the law of the land.

The book demonstrates how the reshaping of the Supreme Court following Ruth Bader Ginsburg’s death enabled all of this to occur. Once states realized that the institution would likely uphold bans, they began filing challenges, as in Mississippi, to make sure their laws were upheld.

That led to the Dobbs v. Jackson Women's Health Organization decision, which overturned Roe v. Wade. Antiabortion states had made contingency plans in the event the Supreme Court overturned Roe. They passed what were known as trigger laws, or abortion bans that would go into effect once Roe was declared unconstitutional. That happened across the country after the Dobbs decision.

The first chapter delves into the legal history of the Roe v. Wade decision. It gave a succinct summary of the three-trimester legal framework that the opinion, written by Justice Harry Blackmun, established. If I could offer one criticism, it’s that the history described in that chapter tends to focus exclusively on legal challenges, when so much of abortion history during that time was cultural.

This is something of which most abortion scholarship focuses on, to the exclusion of the other aforementioned things. It’s understandable why Cohen and Joffe decided to focus on that, given the space limitations and their desire to write more extensively about recent events.

The work does a good job explaining how the Dobbs decision devastated abortion care, with so many clinic closures in the immediate aftermath. One of the more unique aspects of the book was focusing on the unemployment and disruption it created for abortion workers. It has also caused issues with medical training on obstetrical care, especially in states with abortion bans. Most journalism has focused on the impact on patients.

Those clinics that remained open had innovative solutions to overcoming the challenges presented by abortion bans. Some moved to states where it was legal. Others opened clinics in unusual parts of the state, such as Casper, Wyoming. There were attempts to fly patients to care.

The authors discuss the trends within abortion jurisprudence. While much of the previous courtroom battles had been at the federal level, now it’s being fought in state courtrooms as clinics and activists filed lawsuits challenging abortion bans. Attorney Generals have charged medical professionals in other states, as happened with the case of Dr. Margaret Carpenter, an abortion provider in New York City, who was indicted in Louisiana.

That also ties into the shift toward medication abortion as the primary option for ending pregnancies. We are in uncharted territory when it comes to figuring out how courts should handle it. In 2023, 63 percent of abortions in the United States were in the form of medication abortion (up from 53 percent in 2020). There’s also been a shift toward telehealth to prescribe those pills.

The book details how clinics in states where it was still legal have been overwhelmed by the volume of patients. In late 2023, the Guttmacher Institute released data comparing abortion numbers in various states in 2020 to those in the first six months of 2023. In Colorado, the number of abortions increased by 89 percent; in Illinois, by 69 percent; in New Mexico, by 220 percent; in Washington State, by 36 percent; and in California by 16 percent, according to the book.

The book’s research ends with the election of Donald Trump. So they didn’t capture the changes that have happened since he assumed office. No matter when you publish a book on abortion, there are constantly changing dynamics and significant events that will occur in the near future, so it’s not a failure of the authors that they haven’t captured those things. Cohen and Joffe continue to research and write about abortion. I look forward to reading more of their work.