Donald Trump's second presidential term could herald a new wave of attacks on abortion access across the United States — with or without a unified Republican Congress.
Here's a closer look at the legal tools available to a future administration intent on curtailing the right — and how abortion rights defenders are preparing to fight back.
Federal actions
For advocates of abortion rights, the nightmare scenario is a Republican-controlled Congress enacting sweeping national restrictions or an outright ban.
But even without that, Trump could "do a lot of damage to abortion access" through federal actions and judicial appointments, American University law professor Lewis Grossman said.
The Republican former president's .
While Trump has at times hinted at moderation during the 2024 campaign — even suggesting he might veto any anti-abortion "ban" that lands on his desk — some fear .
Published by the ultra-conservative Heritage Foundation, the document offers a roadmap for harsher executive branch restrictions, developed with input from former Trump officials. Trump has publicly distanced himself from the document.
New conditions on abortion pills
Experts predict abortion pills could be Trump's first target.
, and misoprostol, which empties the uterus, accounted for nearly two-thirds of US abortions last year, according to the Kaiser Family Foundation.
Medical abortion used to require in-clinic visits. However, President Joe Biden's government made prescription by telehealth and pills in the mail permanent in 2021.
A Trump administration might reinstate in-person requirements or roll back other eased regulations, said George Washington University law professor Sonia Suter — a simpler step than rescinding approval, though that is also possible.
Reviving 19th century obscenity law
Anti-abortion activists are eyeing the Comstock Act, a 19th-century law prohibiting the mailing of "obscene" materials, including items for "producing abortion."
The US Justice Department under Biden currently interprets this law as inapplicable to approved abortion pills.
But Suter said that a broad interpretation could apply to "anything used to produce an abortion — materials for surgical abortions — which could effectively create a national ban."
This could disrupt the supply chain in clinics and hospitals across states where abortion is currently legal and where it will soon be permitted as a result of state-level referendums which ran in parallel to the US presidential election on 5 November.
Residents in a handful of states extended or enshrined into law the right to have an abortion, results showed on Wednesday, while voters in Florida and South Dakota defeated measures that would have increased access.
In Arizona, Colorado, Maryland, Missouri, Montana, Nevada and New York voters cast their ballots favourably for pro-abortion rights measures.
Judicial appointments and more
A Trump administration could also seek to undo the stringent patient privacy protections put in place by Biden for women seeking abortions out-of-state, said Suter, paving the way for possible prosecutions when they return home.
Although the Supreme Court's conservative majority has already overturned Roe v Wade, experts say the power to appoint federal judges remains paramount.
Courts may soon be called on to decide the fate of state laws that make it harder for women to access care in more abortion-friendly states, Grossman explained.
'Deadly threat'
Abortion rights advocates swiftly branded Trump's election victory a "deadly threat."
A second Trump administration would compound the "harms" of the first "with new, potentially far worse ones," warned Nancy Northup, president of the Center for Reproductive Rights in a statement Wednesday.
"We will vigorously oppose any and all attempts to roll back progress," she said, vowing to "take the fight to them at every turn."
