It triggered a wave of change. Abortion bans were brought in, court cases mounted, clinics closed. Here is what has happened in the seven months since US abortion rights were overturned.
First off, what is Roe v Wade?
Roe v Wade refers to the 1973 Supreme Court case that said the government could not prohibit abortions because the constitutional right to liberty includes the right to decide whether to continue a pregnancy.
Roe refers to Texan woman Norma McCorvey – known by the pseudonym Jane Roe – who challenged the state’s abortion laws after she couldn’t get a termination in 1969 because her life was not in danger. Wade is district attorney Henry Wade, who defended the anti-abortion laws.
The court decision meant every woman in the US had the right to an abortion in the first 12 weeks of pregnancy. Another ruling – Planned Parenthood v Casey in 1982 – built on that by saying states could not have laws that create a “substantial obstacle” to a woman seeking an abortion up to 24 weeks.
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States ban abortion
In 12 states, there are now near-total bans on abortion. In five of these states, the ban is being challenged in court but remains in effect.
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The 12 states are: Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas and West Virginia.
Two further states – North Dakota and Wisconsin – do not have bans in place but abortions are unavailable because clinics have closed.
Georgia has banned abortions past six weeks of pregnancy, severely limiting access to terminations because so many women do not find out they are pregnant – and have time to organise the procedure – before the six-week mark.
According to the Guttmacher Institute, which specialises in reproductive health, these 15 states are home to almost 22 million women aged 15 to 49. That means almost a third of America’s women of reproductive age are living in states where abortion is either unavailable or severely restricted.
More states could follow
A further nine states have introduced restrictions to abortion that would have been unconstitutional under Roe v Wade, have bans currently blocked by the court or are likely to introduce bans in the near future.
Arizona and Florida do not allow abortions past 15 weeks, while Utah has an 18-week ban.
In three states – Indiana, Wyoming and Ohio – near-total or early-gestation bans have been blocked by state courts for now, but lawmakers have indicated they intend to fight them.
In Iowa, Montana and Nebraska, anti-abortion policymakers have indicated that they want to ban abortion soon, but abortion care remains available for now.
What’s happened to abortion clinics?
At least 66 abortion clinics have stopped offering abortion care in the 15 states where abortion is banned or severely restricted.
The loss of these clinics is felt nationwide, according to the Guttmacher Institute, as clinics in states where abortion remains legal are inundated with people travelling interstate.
As the institute explains: “These dramatic increases in caseloads mean clinic capacity and staff are stretched to their limits, resulting in longer wait times for appointments even for residents of states where abortion remains legal.”
Astudyfrom the Society of Family Planning estimated legal abortions nationwide fell by more than 10,000 in the two months following the overturning of Roe v Wade, although some women may have sought abortion pills privately.
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Abortion revolution in the US
Exacerbating inequality
Many of the states that have banned or restricted abortion have high proportions of black, Latina and indigenous women.
Research by the Kaiser Family Foundation revealed how overturning Roe v Wade disproportionately impacts women of colour, as they are more likely to get abortions, have more limited access to health care, and face barriers to travelling out of state for an abortion.
The Guttmacher Institute notes in addition that “people living with low incomes… transmen and nonbinary people, immigrants, adolescents and people living with disabilities are all particularly likely to encounter compounding obstacles to abortion care and be harmed as a result”.
Some states have introduced protections
While the US has seen significant rolling back of abortion rights, there are pockets of good news for pro-choice activists.
Voters in Kansas protected abortion rights in the state’s constitution by rejecting an amendment that would have allowed lawmakers to restrict access to abortions.
New York will provide free abortion pills at four public clinics, making its health department the first in the nation to offer free medication abortion.
In the midterms, voters in five states chose to protect reproductive rights. Vermont, Michigan and California added protections to their state constitutions while voters in Kentucky rejected an amendment that would have removed any protection for abortion rights from the constitution.
In Montana, a bill that could have criminalised doctors for providing abortions was defeated.
Medical abortions account for the majority of abortions in the US – in 2020, the most recent year for which data is available, abortion pills were used in 53% of cases.
Early evidence suggests they have become even more popular since Roe v Wade was overturned – one studysuggested the number of people seeking medical abortions has increased threefold.
At the beginning of January, the Food and Drug Administration changed its rules to allow retail pharmacies in the US to dispense abortion pills for the first time.
However, abortion pills are now seen as the next frontier in the fight by anti-abortion activists and they are pushing hard to curtail access.
Voters across 50 states are preparing to cast their ballots after a bitterly contested US election campaign, which will see Donald Trump or Kamala Harris become president.
In the last few hours, both candidates have been giving their final pitches. “The momentum is on our side,” Ms Harris told a crowd in Philadelphia that chanted back, “We will win”.
“Tonight, then, we finish as we started: with optimism, with energy, with joy,” she said, while enjoying the support of celebrity endorsements on the day from Katy Perry, Lady Gaga and Jon Bon Jovi.
In contrast, Mr Trump ended his campaign in Michigan, repeating key messages about the economy and immigration.
A handful of states will play a crucial role in determining the outcome of the election. Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin hold the keys to the White House.
To become president, the winning candidate needs 270 electoral votes or more, with each state carrying a different number of votes.
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But the focus has been on Pennsylvania which carries 19 electoral votes, the most of all the swing states.
It has been a remarkable journey for both candidates – with Mr Trump surviving two assassination attempts and Ms Harris not even originally in the running.
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For more than a year, the 2024 presidential race seemed destined for a rematch between Joe Biden and Mr Trump – but a disastrous TV debate by Mr Biden eventually forced him to withdraw from the ticket.
The Democratic party’s decision to replace Mr Biden with his vice president transformed the race and shifted polls in Ms Harris’s favour. But only just.
Many polls are too tight to call and, with a large margin of error, most experts are refusing to predict the outcome.
Later, attention will turn to those battleground states including Georgia, which is among the first polls to close at 7pm local time (midnight UK time).
State election officials told Sky News they could have a result as early as 10pm (3am UK time).
Even so, it could be several days before the US has a definitive result.
Voters are not just selecting a president. In addition, 10 states will hold abortion-related ballots, half of which would overturn existing restrictions.
Predict who you think will win in each swing state and we’ll tell you who the president will be if you’re right.
Tonight, Sky News will have access to the most comprehensive exit poll and vote-counting results from every state, county and demographic across America through its US-partner network NBC.
You can find out more about Sky News’ coverage here.
Up to 4,000 people voting overseas in the US election are having their ballots challenged in Pennsylvania, a key battleground state, according to the American Civil Liberties Union (ACLU).
They include Selma Aldi, 47, from Camden in north London who received a letter on Sunday explaining that her ballot in the US presidential election is at risk of being rejected.
“It was a shock,” she said. “It was terrifying to be targeted, to potentially lose a right that I hold as very important. It’s even a feeling that someone is questioning my identity.”
The trainee GP, who grew up in Hershey, Pennsylvania left America in 2000 but has voted via absentee ballot in every US presidential election since.
A letter from election officials in Dauphin County outlines the legal challenge. It reads: “The applicant is not registered to vote and therefore is not eligible to vote in Pennsylvania.
“Under Pennsylvania law, it is a felony to permit any person to vote who is not registered.”
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A hearing on the legal challenge is scheduled for Friday, in which Ms Aldi can respond.
Around 2.8 million US citizens living abroad are entitled to vote in the election, no matter where they are on polling day.
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But each state has different procedures and rules on how election paperwork can be sent and received.
But Ari Savitzky, senior staff Attorney at the ACLU said “any attempt to challenge [voters] eligibility is a clear violation of their rights”.
He told Sky News: “Between 3,000 and 4,000 challenges have been filed in Pennsylvania to the absentee ballots of US citizens living abroad.
“For decades, federal law has guaranteed the right of US citizens living abroad to vote in federal elections at their last US residence.
“In addition to being legally baseless, these challenges are an abuse to voters and to election administrators.”
Deborah Hinchey from another voting rights group, All Voting is Local, said: “Election deniers across Pennsylvania have submitted thousands of mass challenges to overseas voters.
“They want to block as many ballots as possible and silence our voices… but these baseless challenges have failed before and the proper checks and balances are in place to make sure they’ll fail again,” she added.
Tonight, Sky News will have access to the most comprehensive exit poll and vote-counting results from every state, county and demographic across America through its US-partner network NBC.
You can find out more about Sky News’ coverage here.