Each year in late January, activists from around the country who want abortion to be illegal come to Washington, D.C., to march, often in bracingly cold temperatures, to the steps of the U.S. Supreme Court.
Organizers of this year's March for Life hope it will be the final year before the Court reverses itself, and overturns decades of precedent on abortion rights.
"This could be the decision of a generation," said activist Kristen Waggoner, who is scheduled to speak at the march on Friday. "My hope is that the United States Supreme Court has the courage to do what it ought."
Waggoner is general counsel for Alliance Defending Freedom, a legal advocacy group opposed to abortion rights. The group is working closely with Mississippi's attorney general to help defend a state law banning most abortions after 15 weeks of pregnancy. If the Supreme Court upholds the law, almost 50 years of precedent would be upended.
A battle over 'generations'
Nationwide polls suggest a majority of Americans support abortion rights. But years of activism by abortion rights opponents at all levels of government have brought Roe v. Wade and related precedent closer than ever to being reversed.
That activism has culminated with a strong conservative Supreme Court majority – including three out of nine justices chosen by former President Trump - who promised to choose judges who would overturn Roe.
"There have been generations ... of people that have been marching year after year who have been tirelessly laboring and relentlessly praying for the day when every human life is protected," Waggoner said. "The idea that we will make the most significant stride toward that in the law is – it's incredibly inspiring, it's exciting."
Jeanne Mancini, president of the March for Life, said she's "very hopeful" about the outcome of the Mississippi case. But Mancini, whose organization has hosted the march since 1974, the year after the Roe decision, cautions that she doesn't expect the status of abortion rights to change overnight.
"If they do go so far as to overturn Roe, what that does is return the question to different states so that they have the right to enact what their constituents want," Mancini said. "It's not making abortion illegal in the United States, and I think that that's, you know, really fear-mongering to spread that."
Waiting on the court with 'bated breath'
But already, conservative leaders in many states are laying the groundwork to quickly ban most abortions. The Supreme Court has allowed a Texas law banning most abortions after about six weeks of pregnancy to remain in effect since September, prompting many patients to travel to surrounding states for the procedure.
During a press conference this week previewing today's March for Life, Kentucky Attorney General Daniel Cameron expressed admiration for that law.
"I appreciate what Texas has tried to do, and I know our folks here in our General Assembly are watching with bated breath to see how that plays out – and how it plays out in Dobbs," Cameron said.
"Our lawmakers have recently ramped up their attacks," she said. "And they've been doing it for at least the last five or 10 years, but they've increased it at such a rate that it's likely that this will be our last anniversary that we celebrate for Roe."
An NPR/PBS News Hour/Marist poll last year found that most Americans - including a majority of Republicans - oppose the Texas law. But many state leaders are taking steps to prepare for a new era of abortion battles at the state level.
In Ohio, lawmakers are considering what's known as a "trigger ban," which would prohibit abortion if Roe and related precedents are overturned.
"It would completely ban access to abortion in Ohio right away," Harvey said. "So we're right at that cusp and are very concerned about it."
For people living in places with conservative-leaning state legislatures, the end of Roe v. Wade could mean a swift end to abortion access. An analysis by the Guttmacher Institute, which supports abortion rights, estimates that without Roe, roughly two dozen states would quickly move to ban most or all abortions.
Meanwhile, some states like New Jersey are taking steps to explicitly protect abortion rights in state law. And nationwide, some reproductive rights advocates are working to ease access to medication abortion, which is seen as particularly important for patients in places where clinics are few and far between.
Even with Roe still in place, access is limited
For activists who've also been fighting for decades to preserve abortion rights, this moment is "sad; it's frustrating," said Michelle Colon, executive director of SHERO Mississippi, a reproductive rights group focused on Black and Brown people.
"It has me very angry," she said.
For many pregnant women in her state who face hurdles like childcare, transportation, and inflexible work schedules, she said it's already very difficult to get an abortion.
"It's tiring because this is something I've been working on for 20 years here," Colon said. "And it just seems like today – now we're in 2022 – it is harder, more difficult to access abortion healthcare in this country and specifically in this state than it was 25, 30 years ago."
Mississippi is one of several states that's down to just one abortion clinic – the one at the center of the Supreme Court case.
The lack of access is felt most heavily by marginalized people, says Kari White, a sociologist at the University of Texas at Austin and researcher with the Mississippi Reproductive Health Access Project. She was the lead author of a study published last month in the journal Contraception that found that Mississippians were more likely to wait longer for an abortion if they were low-income or Black.
"So if the Supreme Court rules in the Mississippi case in a way that weakens or overturns Roe v. Wade, this means it's going to be even more difficult for people to access abortion care," White said, "And that this will fall most heavily on people who are already experiencing structural disadvantages."