Abortion did not play as big a role in the US election as many anticipated. What might happen on this issue now?

Online, people predicted the 2024 US election would be Roevember.

According to a 2024 Pew Research Center poll, 63% of Americans believe abortion should be legal in all or most cases, which is up four percentage points from 2021.

In another poll by Gallup, nearly a third of registered voters said they would “only vote for a candidate who shares their views on abortion”.

Abortion rights were central throughout the campaign. Many predicted it would mean huge numbers of women turned out in support of Kamala Harris and the Democrats.

That did not happen.

In fact, exit polling indicates that while women of colour overwhelmingly voted for Harris, a majority of white women voted for Donald Trump. This mirrors their electoral choices in 2016 and 2020.

Yet voters clearly were concerned about abortion.

Seven of the 10 state reproductive rights ballot initiatives passed, including in the swing state of Arizona. And while the Florida initiative was defeated, it still received a clear majority of the vote, while failing to reach the 60% supermajority required in that state.

This seeming anomaly may indicate that voters genuinely believe that after the Supreme Court overturned Roe v Wade and found there was not a constitutional right to abortion, the issue is now exclusively a state matter.

If so, they are in for a rude awakening.

Conservatives see the federal government as central in their fight against legal abortion.

So what might a Trump victory mean for abortion access in the US and beyond?

Trump, abortion, and the election

Early in the primaries, Trump claimed to be the “MOST pro-life President in history”, taking sole credit for the end of Roe v Wade.

Yet simultaneously, because abortion had become politically toxic for Republicans, Trump distanced himself from the bans that had swept the nation. He insisted abortion regulation was now exclusively a state matter.

After months of questioning, Trump indicated he would veto a federal abortion ban (a promise few put any stock in).

For his running mate, Trump chose J.D. Vance, who has previously said he would like “abortion to be illegal nationally” and called for a federal response to block travel to access abortion. He also argued against rape and incest exceptions in abortion law.

And Trump has pledged to put Robert F. Kennedy junior, a notable vaccine and fluoride sceptic, “in charge of” women’s health.

Kennedy has made contradictory statements about abortion, including expressing support for a federal ban after 15 weeks.

Abortion in the US under Trump 2.0

After spending all election denying a connection between Project 2025 and Trump, some conservatives, including Steve Bannon who is fresh out of prison, “joked” on election eve that finally, the charade was over.

Read more: Project 2025: what is it and why does Trump say he knows nothing about it?

If Trump follows the regulatory vision outlined by conservatives and anti-abortion groups, there will be consequences that transcend state borders.

An immediate priority for opponents of abortion is preventing women and pregnant people in states with bans from accessing abortion care.

Idaho, Tennessee and Alabama have laws making it a crime to assist someone to access an abortion out of state. Several Texas counties have made it illegal to travel on their roads to access abortion.

Multiple pro-choice states have passed “shield laws” to protect doctors from being prosecuted by other states for providing medical abortion via Telehealth.

Anti-abortion legislators condemn this as states “circumvent[ing] each other’s laws”. They want to see these strategies challenged in court.

In both situations, a Trump Department of Justice will energise anti-abortion activists, legislators and lawyers.

Many opponents of abortion call for Congress to establish a “national minimum standard” after which abortion would be illegal. This is simply a rebranded federal ban.

A much broader threat is the Comstock Act of 1873, a federal obscenity law that dates back almost to the Civil War era.

Conservatives, including the authors of Project 2025, interpret this law as prohibiting the mailing of abortion-related drugs or paraphernalia.

Comstock featured in a recent Supreme Court case about Mifepristone, one of the key drugs in medication abortion used in the first 10 weeks of pregnancy. In 2023, 63% of abortions in the US were medication abortions.

Some conservatives also argue that Comstock extends to the medical equipment and supplies used to provide surgical abortion.

In January 2023, some Congressional Republicans, including Vance, wrote to the attorney-general calling on the Department of Justice to enforce what was once viewed as a zombie law.

There is also the very real likelihood that Trump will have at least one Supreme Court vacancy to fill. Both Clarence Thomas and Samuel Alito are rumoured to be planning to retire.

Trump has been clear he would appoint “young” nominees to judicial vacancies with the goal of extending his legacy decades into the future.

Even with the fall of Roe v Wade, the Supreme Court is still a crucial vehicle for people who want to make abortion completely illegal. Their goal is a decision that interprets the 14th Amendment as giving fetuses the same rights as all other persons.

“Fetal personhood” arguments gained international attention this year because they underpinned the 2024 Alabama state court decision that found that embryos were legally “children”. This renders most forms of IVF illegal.

US election, global impact

Another Trump presidency will also have global consequences for abortion provision, access and politics.

Like every Republican dating back to Ronald Reagan, Trump will reintroduce the so-called “global gag rule”. This prevents foreign NGOs that receive US aid from providing information, counselling or referrals for legal abortion.

Previously, this rule applied solely to NGOs engaged in family planning services.

Under Trump, it was dramatically expanded and applied to the US$9.5 billion worth of foreign aid for global health assistance. This had particularly dire consequences for initiatives relating to sexual and reproductive health.

In the United Nations, we should again expect the US to start finding common cause on issues like abortion with Russia, Iraq, Saudi Arabia and other countries dubbed the “Axis of Medievals”.

Meanwhile, the US election result will further embolden opponents of abortion globally, including here in Australia.

Only a few days ago, Opposition Leader Peter Dutton read his MPs the “riot act” over the abortion issue. He warned it was a distraction that had cost the LNP votes in the recent Queensland election.

Read more: Abortion is back in the headlines in Australia. The debates in the United States tell us why

Given how quickly anti-abortion senators like Matt Canavan and Alex Antic congratulated Trump on his victory, one cannot help but wonder whether they will be drawing quite a different lesson from this election result.