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Brian Lehrer: Brian Lehrer on WNYC. The Supreme Court issued new rulings today, as we've been discussing. Tomorrow is the one-year anniversary of the so-called Dobbs decision, which overturned the Court's own Roe versus Wade ruling, which had protected the right to an abortion since 1973. With that constitutional protection gone, here are some stats on what has actually changed in the last year. First, from the Society of Family Planning. From last July through March of this year, there are around 25,000 fewer abortions provided at in-person medical settings than would have been expected based on the year before. 25,640 fewer abortions, to be precise, from that report.

Also, though, the numbers have gone in different directions in different states. While there was a dramatic reduction in abortion procedures in states that newly banned them, states where abortion remained legal saw an increase in the number of procedures. That could reflect women traveling from their home states, as well as other factors. There's also this from the health policy think tank KFF. Since the Dobbs decision, half of OB-GYNs practicing in states where abortion is banned say they have had patients in their practice who were unable to obtain an abortion they sought.

Also, most OB-GYNs, 68%, say the ruling has worsened their ability to manage pregnancy-related emergencies. Large shares of OB-GYNs also believe that the Dobbs decision has worsened pregnancy-related mortality, 64% of them believe that, racial and ethnic inequities in maternal health, 70% of OB-GYNs said that, and the ability to attract new OB-GYNs to the field, 55%. That from KFF until recently known as the Kaiser Family Foundation.

There are also some new stats pegged to the Dobbs decision anniversary about public opinion. A new NBC News poll just out finds 61% of voters disapprove of the Dobbs ruling that overturned Roe. When you look at the results among perhaps the only people who should even get a vote on this, nearly 80% of female voters, ages 18 to 49, disapproved, and at 80% disapproval, that obviously cuts way across party lines. Also in that poll, two-thirds of suburban women and 60% of independents said they disapprove.

In the states eliminating abortion rights, now that they can, this NBC poll indicates that these laws are basically the policies of Republican men imposing them on everyone else. With us now, Alice Miranda Ollstein, healthcare reporter for POLITICO. Her latest article is called 10 Things We've Learned About Abortion in the Year Since Roe Fell. Alice, thanks for coming on and thanks for sharing those KFF and Society of Family Planning reports with us before the show that I cited some of those numbers from. Welcome to WNYC.

Alice Miranda Ollstein: Thank you so much.

Brian Lehrer: That estimate of 25,000 fewer in-the-office abortions in the first nine months after the decision, and all those OB-GYNs saying they personally have had patients who couldn't get an abortion they sought, this is not just a philosophical debate. This has already affected many people's lives. Maybe it's obvious, but I just feel like we should say that out loud. Are you surprised that the number of abortions in the remaining legal states actually went up?

Alice Miranda Ollstein: I'm not surprised by that. That was absolutely predicted when we knew Roe versus Wade was going to be overturned. I will also just say that I'm taking all of these data points with somewhat of a grain of salt. Really solid data takes a long time to collect and analyze. These are some potentially early signals, but they are incomplete. Not all abortion providers responded to these requests for data, so there are some holes there. It also doesn't account for people who procured abortion pills and self-managed their abortion at home in privacy. There's just a lot we still don't know.

Brian Lehrer: Which is actually the majority of abortions in this country, as I understand it. Done through the pill or pills and not in offices.

Alice Miranda Ollstein: Yes, but there's a difference between using pills within the medical system, getting them from a doctor officially prescribed, and these extra-legal gray area ways that people are obtaining them.

Brian Lehrer: Right. I see. So even some people getting medication abortions with pills are counted in these stats because they may have gotten them from doctors or clinics?

Alice Miranda Ollstein: That's right, yes, but not all, and so-

Brian Lehrer: Great.

Alice Miranda Ollstein: -the official federal government data on abortion will take years. I think while we can draw a lot of conclusions and see a lot of really fascinating trends from the past year, it's somewhat premature to make sweeping declarations and takeaways. So much is still in flux.

Brian Lehrer: The stats from the survey of OB-GYNs is really chilling in several respects, including that most say the Dobbs decision has worsened pregnancy-related mortality and racial and ethnic inequities in maternal health. The pregnancy-related mortality concern, does that indicate the OB-GYNs feel they can't provide proper care to women who are not there seeking abortions, but rather having serious complications from a pregnancy they're trying to carry?

Alice Miranda Ollstein: That's right, and we have been hearing that anecdotally for a long time but it is really striking to see the survey results from the medical professionals who are on the front lines of this issue. To know that some of the stories we've reported on are not isolated incidents at all but are very widespread is certainly something to keep exploring. We have heard from people who found that their fetus was not viable and wanted an abortion and were turned away by doctors who feared prosecution under sometimes vague state laws.

Doctors often feel caught between state and federal laws that are conflicting in this new era, and that has had repercussions for patient care. We've seen some really upsetting horror stories about people who faced delays or even denials, had to travel, again, not for an abortion, but for miscarriage management, treatment for an obstetric emergency, et cetera.

Brian Lehrer: Does that relate to one of the items in your article that abortion is difficult to separate from other healthcare?

Alice Miranda Ollstein: That's right. Medically managing a miscarriage and providing an abortion are very similar, in some circumstances, identical. Right now, when you have these state laws, some of them were written a long time ago when medical practices were very different than they are now, and so some of the language is vague or outdated. Doctors are really unsure and afraid of what they can do. They don't want to risk going to jail. They don't want to risk losing their medical license. In a lot of instances, that's led to withholding even perfectly legal care. I think that that's been one of the biggest takeaways from the past year, is that laws aimed just at abortion don't only impact abortion. I think-- oh, sorry, go ahead.

Brian Lehrer: Go ahead, finish your thought. I apologize.

Alice Miranda Ollstein: I think you're seeing the spillover effect in some other ways as well. You're seeing medical providers being deterred from practicing in certain states. You're seeing medical residents choosing not to do their residency in certain states because these are already places where there are medical deserts and shortages of providers. I spent some time in Alabama recently where that was certainly the case. There's a real worry that people won't have a doctor to go to for any kind of maternal or reproductive healthcare, not just abortion.

Brian Lehrer: This all relates to another item on your list, "Most doctors will not break the law." Some people expect it or hope that they would?

Alice Miranda Ollstein: Yes, there was an assumption, I think, from some when Roe versus Wade was first overturned, that there would be this wave of civil disobedience that doctors who believed that abortion was a right and a necessary part of healthcare would continue to provide, even under legal threat. Like I said, that's really not happening. We're seeing a really strong chilling effect. Even when there's uncertainty, doctors are seeming to err on the side of caution. A lot are very open about feeling torn between their ethical obligations to their patients and their livelihoods and freedoms.

Brian Lehrer: Listeners, at this one-year mark after the Dobbs decision, who wants to tell us a story of someone you know who either couldn't get an abortion they were seeking or had to get one in a different way or maybe even had trouble getting care for a pregnancy emergency as we heard our guest describing a minute ago is happening. Any OB-GYNs who want to call in and tell us something you have personally seen change or anyone with a question for our guest, Alice Miranda Ollstein, healthcare reporter for POLITICO whose article is called 10 Things We've Learned About Abortion in the Year Since Roe Fell.

212-433-WNYC, 212-433-9692. You can also text a question or comment or a story to that number, 212-433-WNYC or, of course, call us to talk on the air, 212-433-9692. When we come back from a break in regard to Alice's article, 10 Things We've Learned About Abortion in the Year Since Roe Fell, we'll see what she put as number one on that list, which we haven't talked about yet. Stay with us.

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Brian Lehrer: Brian Lehrer on WNYC. You know how, usually around the end of the show, we invite you to call in and tell us a story about something or other in your life? Well, today it's about how you couldn't get an abortion you were seeking or how your doctor, an OB-GYN dealing with life after Roe versus Wade, or anything related as we continue with our guest, Alice Miranda Ollstein, healthcare reporter for POLITICO. We also have some breaking news on this. Just this morning, I'm being told that Governor Hochul just this morning signed a law for New York State that protects New York healthcare providers who prescribe abortion pills to patients from out of state in states that have restrictions.

That's a big development just this morning. The legislature passed the law and now Governor Hochul has signed it, protecting New York healthcare providers who prescribe abortion pills to patients out of state. All right, Alice, your article, 10 Things We've Learned About Abortion in the Year Since Roe Fell, and your number one was the Supreme Court wanted to wash their hands of the abortion issue. That's not happening. How is it not? How are abortion rights heading back to the Supreme Court?

Alice Miranda Ollstein: They've headed back there already. It took not even a year after some of the conservative justices in the minority said when they issued the Dobbs decision. They said, "Look, this returns the issue of abortion back to the states where it belongs. It was always wrong for courts to set national abortion policy, and yet we have courts continuing to set national abortion policy." The example we've had so far is in the litigation around federal approval of abortion pills. There's this case out of Texas that is attempting to remove FDA approval for them nationwide.

The Supreme Court intervened in that case and said, "Let's hit pause. Let's not change things for the time being until the case fully plays out." That case is expected to go back to the Supreme Court next year, but a bunch of other cases could also go back before the Supreme Court next year. The term is almost over now. By next year, I mean this fall when they kick off their new term. There are tons of cases that could come back before them regarding the Title X Family Planning Program and their ability to make abortion referrals.

There's also the Title X Program and their ability to provide contraception to teens without their parents' permission, that's not directly related to abortion but an adjacent issue. There are federal cases around the state abortion bans clashing with federal law requiring patients to be able to receive treatment in an emergency. I talked to some legal experts who said it was pretty naïve of the justices to think that they were going to be able to get out of the abortion game entirely, and that's what we're seeing now.

Brian Lehrer: Yes, that relates to item number 9 on your 10 items list that religion cuts both ways, right?

Alice Miranda Ollstein: That's right. We've seen a lot of anti-abortion folks both in and out of government making religious appeals to back their position. What we're starting to see now is an effort from religious folks on the left who say my religion supports the right to get an abortion, and they are increasingly bringing legal challenges making that point and saying that state abortion bans infringe on their religious liberty. Those cases are mostly in state court. There are a couple in federal court, but I think they will have the most impact at the state level.

Brian Lehrer: Here's a text from a listener who says, "I'm a provider, seeing women travel from Florida and Texas to the Bronx. Also on the American Board of OB-GYN examiners, some are declining to go to Texas to administer the exam because of fear or a protest against the state." Do either of those ring true based on your reporting?

Alice Miranda Ollstein: Yes, definitely. We're definitely hearing of that. Again, I think it's just going to take time. I think it's going to take time to see the full impact of this. Again, state law is not quite settled either. We had a ruling in Wyoming this week, maintaining the legality of abortion pills. We've had other rulings pretty recently in South Carolina and Iowa. The landscape is far from settled. There are a lot more changes yet to come, and it will also depend on how people vote in the coming years. We have after last fall's sweep for the pro-abortion rights side and state ballot initiatives, we're going to see a lot more of those in the year ahead.

Brian Lehrer: Another listener texts, "Is there a potential legal avenue to pursue where a woman seeking a miscarriage--" I don't know you seek a miscarriage, but probably they met going in for treatment of a miscarriage, "was denied care, and could argue the state laws infringed upon her rights or a doctor's right to provide care?"

Alice Miranda Ollstein: We already have some instances of that. We have the Biden administration challenging Idaho and Texas over not providing, or there has been litigation related to that in terms of the availability of care in an emergency. We could definitely see more. I think that it's not impossible, but a lot of abortion litigation requires what's known as third-party standing because of the time-sensitive nature of pregnancy and abortion and how long legal challenges take to play out. Usually, you have doctors or other folks bringing cases on behalf of abortion patients or miscarriage patients. I think we'll mainly continue to see that, going forward.

Brian Lehrer: I cited those new NBC News poll results showing 80%. 80% of women, 18 to 49, disapproved of overturning Roe, plus 60% of Americans overall, including 60% of independents. This goes to your item number 4, abortion rights are winning at the ballot box. You said both sides are behaving accordingly. Can you give us a little of what each side is doing in response to polling like that?

Alice Miranda Ollstein: That's right. You have pro-abortion rights folks trying to do more ballot measures because of the success last year, and especially the success last year in places seen as really conservative like Kentucky, like Kansas, like Montana. It's really changed where people think it's possible to have a popular vote on abortion rights go in the direction of expanding or restoring access. There are efforts now to get this before voters in Missouri and Ohio and Florida and South Dakota and Nevada and probably more states after that.

When I say both sides are behaving accordingly, we've been reporting on a lot of Republican state lawmakers attempting to pass measures or in other ways make it more difficult to hold a popular vote on abortion rights or anything else. This is definitely coming at a time when abortion rights are front and center. Some state lawmakers are open about the fact that it's about abortion. I think it's an interesting acknowledgment of the popularity of the issue.

Brian Lehrer: Yes, we've talked about that on this show before, how some anti-abortion rights legislators at the state level in various states are trying to change the rules for referenda generally, but what it's really targeted at is keeping this question off the ballot. Yet, another item on your list of 10 is that neither the left nor the right are united on a path forward. What does that look like to you on the left, the abortion right side?

Alice Miranda Ollstein: It's definitely more pronounced on the right because the right spent decades and decades having a very singular message of, "We oppose abortion, we are pro-life, we are against Roe versus Wade," but when it came time to be able to nail down the details in this post-Roe era, it wasn't so easy. It wasn't so easy to agree, should there be exemptions? If so, for whom? Should the ban start at conception or at 6 weeks, or at 15 weeks, or at 12 weeks, or at 20 weeks? That's been really hard for Republican lawmakers to agree on. At both the state and federal level, you're seeing a lot of clashes.

Now, on the left, it is popping up in a few interesting spaces. We talked about those ballot measures coming up. Most of them would only restore abortion rights up to the point of fetal viability, which was what Roe versus Wade essentially said. There are many on the left who think that that doesn't go far enough. That's capitulating before the fight even begins, that they should restore abortion rights without limits, and so that's been an interesting clash there.

Obviously, a lot of folks on the left think that that would not win at the ballot box, and so they say better to restore most abortion rights than have nothing. We're seeing some divisions on an interesting point, this question of parental consent. There are folks who believe that teens should be able to obtain an abortion without the consent or even notification of their parents, and that makes a lot of Democrats really uncomfortable, and so there's been some interesting tension there as well.

Brian Lehrer: The New York Times reported that another sticking point for advocates is whether to include the word women in the language on referenda. That's the pregnant people debate. Have you run into that in your reporting?

Alice Miranda Ollstein: A bit, and that has definitely been a generational split. Younger abortion rights advocates are more in favor of more inclusive language that acknowledges that trans people and intrasex people and people of different genders have the ability to get pregnant and seek abortions, and there are folks who feel that gender-neutral language can be alienating, and they think that it's much stronger to stick with language about women. That has been an interesting split.

Brian Lehrer: Richard in Westchester, you're on WNYC. Hi, Richard.

Richard: Hello, Brian. Thank you for taking my call again. My question is the following. I have a good friend, I'm not Jewish, but I have a very good friend who is Jewish and he's very intellectual. He's not super conservative, but super orthodox. He makes the argument that in Jewish culture, if there's a conflict between the life of the mother, the pregnant woman, pregnant person, and the fetus, the life of the person must be preserved.

Brian Lehrer: Right. Although that's the most common exception that even the anti-abortion rights people allow if the life of the mother is at stake. Since you cited Jewish law, we have another related text from a listener who writes, "I am Roman Catholic--" sorry, this just popped off my screen. There we go. "I am Roman Catholic and pro-choice. Quite a bit of us women are, but only people like me put up signs on our cars or homes showing support."

It gets back to one of the cases that you were talking about before, Alice, making its way maybe back up to the Supreme Court and it's based on religious liberty. Personally, I love the religious liberty argument. This always looked to me like certain religions using the state to impose their theology about when personhood begins on other religions. Roe was decided on other grounds, not that, but it doesn't matter what I think, maybe we'll eventually see what Amy Coney Barrett and Samuel Alito, those big proponents of religious liberty and other ways, think about that. You think that's going to put them in a tough spot?

Alice Miranda Ollstein: Potentially. I want to note there's two different branches of these religious liberty challenges, and a lot of them are led by Jewish plaintiffs. I will note particularly citing Jewish law that says that life doesn't begin until a baby takes its first breath, which is, obviously, in conflict with a lot of these state abortion laws. You have folks who are challenging these laws in their entirety, trying to get them struck down altogether by arguing, just as you just said, that this is blurring the division between church and state and imposing one religion's view of abortion over everyone else, but there are a lot more cases that are trying to force states to offer religious exemptions to their abortion bans for people of faith whose religions support abortion. There's multiple ways this could go.

Brian Lehrer: If they allow religious exemptions, wouldn't that basically allow exemptions for anybody? Because once upon a time, if you were a conscientious objector to the military draft, you had to prove it based on a specific organized religion that you were a part of. Then that got struck down in court. This goes back 50 years and more, that you could have a personal conscience that's not based on your organized religion that leaves you against taking up arms, and they granted conscientious objector status on those grounds, so maybe that would completely open abortion rights again if anything like that were to come down, and we've got 20 seconds left.

Alice Miranda Ollstein: I will say that the exemptions that are currently offered in law in a bunch of states are not proving accessible in practice. I'm thinking for instances of rape and incest, there's just too many hoops that people have to jump through in order to claim those, and so I would also like you be skeptical of how it would work in practice. For now, we're just seeing will this legal argument even fly in court.

Brian Lehrer: Alice Miranda Ollstein, healthcare reporter for POLITICO. Her latest article is called 10 Things We've Learned About Abortion in the Year Since Roe Fell. Thank you so much for sharing them with us.

Alice Miranda Ollstein: Thank you so much.

Brian Lehrer: Have a great weekend, everyone. Brian Lehrer on WNYC.

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