Two years since Roe v. Wade was overturned, there's reason to believe reproductive rights could affect the outcome of the US presidential race.

Donald Trump's term as president left a devastating legacy for reproductive rights in the United States.

Now, as Trump vies again for the presidency, his anti-abortion stance could come back to bite him.

There has been a subtle but noticeable shift among some Republicans away from a hardline anti-abortion stance. And this month, the US Supreme Court rejected a bid to limit access to a common abortion pill—the latest in a string of wins for reproductive rights in the US.

But the extent to which reproductive rights will impact the presidential election result in November will depend on several factors, including whether pro-choice voters go to the polls in sufficient numbers to tip the balance in key states.

How Trump damaged reproductive rights

Trump's victory in 2016 has proved to be one of the most consequential events in shaping Americans' reproductive rights in the last 50 years.

In that campaign, Trump—who once called himself "the most pro-life president ever"—promised to appoint justices who would overturn Roe v. Wade, the 1973 US Supreme Court decision that established a person's right to terminate a pregnancy prior to fetal viability.

After he took office in 2017, Trump delivered on that pledge—appointing three justices who, in June 2022, went on to join the six-vote majority that overturned the Roe decision.

Following this ruling, Dobbs v. Jackson, old state laws criminalising abortion went back into effect, and some state legislatures have sought new ways to limit access to reproductive care.

Fourteen states now criminalise abortion in all circumstances except some medical emergencies, and three others ban the procedure after six weeks—before many women even know they are pregnant.

More than 29 million women of childbearing age live in states with total or near-total bans on abortion.

Despite these dramatic changes to reproductive rights, polls consistently show that fewer than one in five Americans (across all genders) believes abortion should be banned in all circumstances.

A 2024 Pew survey found that 63 percent of Americans, including 64 percent of women, believe abortion should be legal in "all or most cases".

The consequences of the Dobbs decision have mostly been felt in private, as many women are now forced to quietly travel across state lines for reproductive care.

But news reports of some high-profile cases have put the spotlight on stories of women being denied terminations of pregnancies that are nonviable or dangerous to the woman's health.

A Louisiana woman whose fetus had no skull was forced to travel to New York to terminate her pregnancy. A Texas woman, Kate Cox, was denied an exemption from the state's abortion ban to terminate her pregnancy. Her fetus was afflicted with Trisomy 18, a devastating chromosomal condition that nearly always results in stillbirth or death within the first year of life.

Other women and their families worry that medical professionals in states with abortion bans, wary of losing their medical licences or being sued, limit information about dangerous pregnancies to the detriment of their patients.

Pro-choice voter stances

Given this state of affairs, there is much conjecture on what the end of Roe might mean for November's presidential election.

The issue of abortion access has proven to drive voter turnout in state elections in the wake of Dobbs.

In a series of referenda, voters have sought to protect reproductive rights.

In 2022, Kansas and Kentucky voters rejected amendments that would have declared that their state constitutions did not protect abortion rights.

Michigan voters added an amendment protecting abortion access to their state's constitution. In November 2023, Ohio residents voted in favour of an amendment to that state's constitution that protects abortion access. These were all states won by Trump in 2016.

There is more evidence that the issue of reproductive rights influences the outcomes of elections. In the 2022 midterm elections, support for abortion rights contributed to better-than-expected results for Democratic candidates.

A recent Gallup poll shows that 54 percent of voters now identify as pro-choice, while the share of voters who view abortion as "morally wrong" has dipped to 37 percent from 50 percent in 2019.

The same poll revealed that nearly twice as many voters who favour abortion access say they will only vote for a candidate who shares their views on the subject as compared to those who oppose abortion.

The increased fervour to protect abortion access is primarily concentrated among those who already vote for Democratic candidates. And midterm elections typically have lower voter turnout than presidential elections.

What will happen in November is dependent on whether these voters go to the polls in sufficient numbers to tip the balance in statewide elections. (The United States uses an electoral college system for presidential elections that awards votes to the winner of the popular vote in that state.)

At the same time, there is evidence that the fallout from the Dobbs decision is already shaping Republican politics.

Abortion bans are not popular with a majority of voters. This has left Republicans on the defensive. There is some evidence that some Republicans are backing away from hardline pro-life stances.

Trump himself has not yet clarified his abortion policy during his 2024 campaign. He has said, however, that voters in each state should decide the rules governing abortion, not lawmakers in Washington.

In several swing states, pro-choice stances have had success this year.

In Arizona, where the state supreme court recently allowed a Civil War-era abortion ban to go back into effect, the legislature recently voted to repeal the law. Both houses of the legislature are controlled by Republicans. Trump won Arizona in 2016, but Biden prevailed there in 2020.

Abortion rights will be on the ballot in some other key states in November. In Florida—another battleground state—voters will decide whether to inscribe abortion access until fetal viability in the state constitution via a referendum. Similar measures will likely be on the ballot in Missouri, Nebraska, Nevada, South Dakota and a handful of other states.

If the 2022 midterm elections are instructive, it appears that access to reproductive rights will shape at least some state elections this year—and the flow-on effects may well affect the outcome of the presidential race.