Abortion is set to be a key U.S. election issue. Which side has momentum?

As abortion and women’s health care shapes up to be a key issue in this year’s U.S. elections, the momentum appears to be persistently on the side of those fighting to restore access — while the opposing side struggles to settle on a consistent message to voters.

Ballot measures on whether to guarantee abortion access are likely to be decided in several states in November including Arizona — where lawmakers voted this week to repeal a Civil War-era ban on nearly all abortions that was allowed to come into force — and Florida, where a ban on abortions after six weeks of pregnancy took effect Wednesday.

At the same time, Donald Trump has found himself under fire from all sides of the debate for his current position that the issue should be left to the states, which marks the latest reversal for the Republican presidential candidate.

In the nearly two years since the U.S. Supreme Court struck down the constitutional right to an abortion, stories have mounted of the serious health issues people have faced due to some states’ bans and limits on the procedure. Polls and fundraising reports suggest those real-life impacts have underscored the stakes for many voters, who have continually voted for measures to protect and guarantee abortion access.

Organizers say they expect that trend to continue into November and beyond.

“Since Roe v Wade was overturned, every time a voter has had an opportunity to protect abortion access at the ballot, they do it,” said Sara Tabatabaie, executive director of VoteProChoice, a political action group that works to elect pro-abortion candidates across the U.S.

“Our work no longer has the hurdle of needing to convince folks … that this is a winning issue. It’s clear now that abortion is popular.”

1:05 Arizona abortion ruling: Fallout grows after state Supreme Court upholds 1864 law

The Public Religion Research Institute found 64 per cent of Americans say abortion should be legal in most or all cases in a new poll released Thursday. Majorities of nearly all religious groups and all but five states surveyed support abortion access, the poll suggests. That majority support has stayed consistent for the past decade, the PRRI has found.

Even limited access to abortion retains broad support. Gallup found last year that nearly 69 per cent of people surveyed want abortion to stay legal for women in the first trimester of pregnancy, which lasts 12 weeks and is when the vast majority of abortions are performed.

In states where abortion access has been limited or outright banned, the share of people surveyed by CNN in a poll released Wednesday who say their state’s laws are too restrictive has risen since last year, to roughly half.

At the same time, studies suggest the number of abortions performed in the U.S. has remained roughly the same since those laws were enacted, while the pro-choice Guttmacher Institute says abortions have actually increased between 2020 and 2023, citing expanded protections in other states and a rise in travel to those areas.

“If the point of Dobbs (v. Jackson Women’s Health Organization) was to reduce the number of abortions in the U.S., it has failed spectacularly,” said Jessica Waters, a professor at American University who studies reproductive rights law and policy.

Currently, 21 states have passed restrictions on abortion, including 14 states that are enforcing bans at all stages of pregnancy, with limited exceptions.

Examples of the impact of those laws have exploded. Some of the most harrowing have emerged from Texas, where performing an abortion is punishable by up to life in prison and civilians are allowed to sue anyone who assists someone in getting one.

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A Texas mother facing a life-threatening pregnancy had to travel out of state for an abortion after spending days seeking court permission under the law’s medical exemption clause — a request that was ultimately rejected hours after she left. A man in Texas has launched legal action to investigate his ex-partner’s out-of-state abortion, and another man is suing three women who allegedly helped his ex-wife obtain abortion pills.

Another Texas woman, Amanda Zurawski, stars in a powerful ad for U.S. President Joe Biden’s re-election campaign where she shares her story of being denied an abortion she needed after a miscarriage. As she and her husband, Josh, tearfully look at a baby blanket and books they bought while she was pregnant, the ad says Zurawski almost died twice after contracting sepsis and now may never be able to get pregnant again. She’s suing the state.

“Donald Trump did this,” the ad concludes.

The line refers to Trump’s nomination of three Supreme Court justices who were part of the conservative majority that overturned Roe v. Wade, an accomplishment Trump has bragged about ever since.

Yet Trump has also angered anti-abortion groups who support him for declaring he would not support efforts to ban or limit abortion nationally, instead saying he prefers the patchwork approach of letting states decide.

In an interview with Time Magazine published Tuesday, Trump previewed what would effectively be a hands-off approach to the issue if he returns to the White House. He said he wouldn’t intervene if states move to monitor women’s pregnancies or prosecute them for defying abortion bans, even if their health is at risk.

“It’s irrelevant whether I’m comfortable or not,” he told the magazine, “because the states are going to make those decisions.”

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Trump did, however, tell reporters last month the Arizona Supreme Court went too far by ruling that a law passed in 1864 banning all abortions except when the mother’s life is at risk can be enforced, superseding an existing 15-week limit. The 1864 law was quickly repealed, but a 90-day grace period for new legislation means the stricter ban will stay in place until the summer.

Trump’s “states will decide” stance is just the latest policy reversal he’s made on abortion. He said he was “very pro-choice” in 1999, only to shift to saying he was “pro-life” a decade later.

During his 2016 campaign for president, he suggested there should be “some form of punishment” for women who seek an abortion, and during his presidency supported an effort in Congress to pass a national 20-week limit. According to the New York Times, Trump had voiced support for a 15-week limit at the national level, which he now denies.

“I keep being asked, ‘But what do you think of President Trump’s new moderate stance on abortion?'” Waters said. “And I think the real answer is we need to judge him on his record.”

Without a national constitutional right to an abortion, voters are now moving to enact their own at the state level, or reject efforts to remove those rights.

In 2022, ballot measures that would deny abortion rights in the state constitution or state that life begins at conception were defeated in Kansas, Kentucky and Montana. Last year, Ohio voters approved a measure guaranteeing abortion as a constitutional right.

This year, a measure that will provide a constitutional right to abortion before fetal viability will appear on the ballot in Florida. A similar measure is expected to be approved in Arizona, and signature-gathering campaigns are underway for pro-abortion measures in other states including Missouri, Nevada and South Dakota.

Early polling suggests a majority of voters support the measures in Arizona and Florida, although the Florida measure could struggle to reach the 60 per cent threshold needed to get passed.

The campaigns in support of the measures are also outpacing opponents in fundraising. While the group sponsoring the Florida initiative has raised millions, Florida Voters Against Extremism has brought in just US$75,640.

Arizona for Abortion Access has raised US$12.3 million, according to campaign finance records, including over US$700,000 in individual contributions. The opposing campaign, dubbed It Goes Too Far, has amassed US$518,000 in individual contributions to date, plus just US$5,000 from other sources.

The name and stated mission of It Goes Too Far speaks to the difficulty anti-abortion groups and politicians are having in the face of majority support for reproductive freedom.

In an interview with Global News, the group’s spokesperson Cindy Dahlgren described it as a coalition of advocates who have “varying views on abortion and where that limit should be,” including some pro-choice Democrats.

All of them, she said, agree the ballot measure is too vague when it comes to the issue of post-viability abortions — a rare procedure that’s typically performed to save the mother’s life — and what counts as a “health care professional” who could determine such an abortion is necessary.

The group also says the measure would remove requirements for parents of minors seeking an abortion to be notified, and for women and girls to be warned of the potential risks — a requirement often sought by anti-abortion advocates through places like crisis pregnancy centres.

“Voters are not being told the truth,” Dahlgren said.

Yet Dahlgren would not say what limits or regulations on abortion she or the group would support, saying their sole mission is to ensure the constitutional amendment is defeated.

Dahlgren also serves as a spokesperson for the Center for Arizona Policy, a “traditional family” and religious freedom advocacy group that repeatedly urged lawmakers to block attempts to veto the 1864 abortion ban.

Waters says Republicans who are against abortion are also having a difficult time now expressing their views, with some even walking back their support for strict bans.

“It is not a winning issue for them,” she said.

Tabatabaie, from VoteProChoice, says that’s helped political organizers like herself galvanize around the issue. Although she acknowledges the fight to expand abortion access won’t end after November, she said she’s seeing support continue to grow.

“Anyone who is working on this issue is hoping to work themselves out of a job,” she said.