As a Donald Trump presidency nears, state lawmakers are readying abortion and reproductive health laws that draw battle lines across the nation.
Last week, Democratic members of the California Legislative Women's Caucus vowed to combat any efforts to restrict reproductive rights.
"California, the most populous state in the country and the sixth-largest economy in the world, has long been a leader in the fight for women's reproductive rights and access to healthcare. In the wake of last Tuesday's election, we will not back down and we will not be silent," said Sen. Hannah-Beth Jackson, a Democrat who chairs the caucus.
In Indiana, a state lawmaker is reportedly planning to propose a bill that would make all abortions in the state a criminal act. Many see it as a move anticipating a Supreme Court with a Trump-nominated justice that will overturn its 1973 landmark decision in Roe v. Wade, which affirmed a woman's right to have an abortion under the right to privacy protected by the 14th Amendment of the Constitution.
But state Rep. Curt Nisly said he had been working on introducing an abortion ban well before the election and that his decision had nothing to do with the results of the presidential race, or how it may effect the Supreme Court. He said the timing was right for the law to reflect what he said were the advancements in science that provide evidence that life begins at an earlier stage than what was once known.
“Roe v. Wade is wrong and is out of date,” Nisly said, who plans to introduce his bill in January. “It's time for us to move past Roe v. Wade.”
Shortly after the election, Texas state health officials sought public input on a proposed measure that would require women who have an abortion or a miscarriage to cremate or bury their fetuses. That came after the U.S. Supreme Court last year shot down a Texas law that required abortion providers to have admitting privileges to nearby hospitals, saying it created an undue burden on those seeking abortions.
Abortion rights activists worry that a Republican president, a GOP-controlled Congress, and the possibility of a conservative Supreme Court justice will embolden states to draw up laws restricting abortion and birth control.
“There has never been a higher threat,” said Terry O'Neill, president of the National Organization for Women.
As of July, there had been more than 1,250 measures related to reproductive health and rights introduced in states in 2016, according to the Guttmacher Institute, with more than a third designed to restrict access to abortion.
Trump and Vice President-elect Mike Pence say they aim to severely limit abortion services. Trump has vowed to defund Planned Parenthood, a leading source of free or discounted birth control, and to appoint Supreme Court justices who would help overturn Roe v. Wade.
While states in the South and Midwest are likely to impose additional limits on abortion, a number of Western and Northeastern states could try to protect or even expand access to reproductive healthcare, said Elizabeth Nash, Guttmacher's senior states issues manager.
Abortion rights under a Trump administration would likely be similar to pre-Roe v. Wade. Before 1973, women received abortions only if they lived in states where the service was legal, had enough money to travel to places where it was legal, or turned to doctors willing to break the law.
According to the Guttmacher Institute, the number of abortion performed illegally in the U.S. ranged from 200,000 to 1.2 million a year during the 1950s and 1960s, with illegal abortion accounting for 17% of all deaths attributed to pregnancy and childbirth in 1965.
Nash believes states that already have the toughest restrictions might double down on limiting preventive care, such as access to contraception.
Those efforts will likely be bolstered by a repeal of the Affordable Care Act, which Republican leaders have targeted as one of the first items they plan to address after inauguration of the president-elect, who has softened his stance on his complete repeal and replacement of the President Barack Obama's signature healthcare reform law.
Under the ACA, insurers are required to cover the cost of birth control, preventive screening and family planning services with no cost-sharing.
In a recent interview, Speaker of the House Paul Ryan (R-Wis.) refused to say whether an ACA replacement would keep the birth control mandate.
Last year Pence, who is currently governor of Indiana, signed a state law banning abortions of fetuses diagnosed with a disability.
The threat to reproductive rights in the U.S. comes during a year that held much promise for their advancement. In 2016 state legislatures enacted 22 measures that sought to expand insurance coverage for contraception.
Many viewed the high court's decision on the Texas access case as its most significant ruling on abortion rights in the last two decades. The court said the law requiring abortion providers to have admitting privileges to nearby hospitals caused undue burden. Abortion rights activists say the law closed the doors of more than half of the 40 providers in the state.
Expectations loomed large that a Democratic president would protect abortion rights and expand access to reproductive healthcare. Democratic nominee Hillary Clinton had hoped to repeal the Hyde amendment, which bans federal funding for abortion to make it more accessible for low-income women.
The proposed Equal Access to Abortion Coverage in Health Insurance Act sponsored by Rep. Barbara Lee (D-Calif.) would require public and private payers to cover abortion the same as any other healthcare service.
Abortion rights activists know that bill is likely dead in the water. They, however, aren't too worried about Roe v. Wade being overturned, at least in the short term.
Even after Trump nominates a justice to fill the current Supreme Court vacancy caused by Antonin Scalia's death last year, there are at least five out of nine justices who would vote against overturning Roe v. Wade. However, three of those justices are also the most likely to retire in the next few years, leaving the possibility of more vacancies for Trump to fill.
Vicki Saporta, president and CEO of the National Abortion Federation, remains optimistic. "Women in this country would not stand for it and there is not the public support for that kind of effort,” she said.
Currently 56% of Americans say abortion should be legal in either all or most cases, according to an analysis by the Pew Research Center, compared to 41% who said it should be illegal in all or most cases.