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Irma, the receptionist at Acacia Women’s Center in Phoenix, Arizona, is repeating a spiel she gives dozens of times a week to different women before their appointments. 

“We are going to do the procedure so you need to prepare,” she says, “arrive early, wear little to no make-up so that we can check the colour in your face.”

“There are protesters here, but mainly on a Saturday,” she tells the women.

Abortion is no longer simply a personal medical matter. Across this country, reproductive rights is a burning election issue.

Especially in the battleground state of Arizona, where abortion is literally on the ballot.

Signs inside and outside the clinic urge people to “vote yes to prop 139”. It’s a special measure which, if passed, would enshrine abortion rights in the state constitution.

The down-ballot measure was added at the demand of Arizona voters after two years of reproductive rights hanging in the balance.

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The overturning of Roe v Wade, which gave women the constitutional right to choose, awoke a dormant law in Arizona from 1864.

The civil war era ruling banned all abortions even in the case of rape or incest. It has since been repealed but the fear over the rowing back of women’s rights remains.

Irma welcomes people to the Acacia Women's Center in Arizona
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Irma welcomes people to the Acacia Women’s Center in Arizona

“It’s horrific and women are losing their lives because of these bans,” said Kristin Gambardella, “we need to fight for them.”

Last year, at 17 weeks pregnant, Ms Gambardella, who is from Tucson, Arizona, was told by a doctor her unborn child had foetal abnormalities.

“Our baby, it was guaranteed she would live a short life and it would be full of pain and surgeries,” she said.

Already a mother to a son, born in 2021, this had been a desperately wanted pregnancy, but Ms Gambardella and her husband, Dave, made the heartbreaking decision to get an abortion.

Kristin Gambardella and her husband David
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Kristin Gambardella and her husband Dave

However, the law in Arizona now bans abortion after 15 weeks, even in cases of foetal abnormalities.

The couple drove seven hours across state lines to New Mexico to have the procedure.

“On the last night of my pregnancy, I fell asleep in a strange short-term rental in New Mexico, trying to cherish my last moments with my baby,” she said,

“I should have been with my family, giving our baby girl love and mourning our loss. I was angry with my state but that anger has turned into action.”

Ms Gambardella is determined to tell her story in the hope that people in Arizona will be moved to support abortion access.

She worries that, if elected, Donald Trump would pursue a national abortion ban, although he has insisted that isn’t part of his platform.

“I’m in disbelief that it’s 2024 and this is at stake,” Ms Gambardella said.

“I didn’t have the opportunity to take my own health care in my own state. The idea of being pregnant under a Donald Trump presidency, which is what it would be for me at this stage, is terrifying.”

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Democratic presidential nominee Kamala Harris, right, on a visit to Arizona in June. Pic: Reuters
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Democratic presidential nominee Kamala Harris, right, on a visit to Arizona in June. Pic: Reuters

The Democratic Party is using abortion rights as a rallying cry.

In a state like Arizona, where polling shows the race for the presidency is on a knife edge, reproductive rights could hold the sway.

I joined Democratic state representative Quanta Crews as she canvassed in a suburb of Phoenix.

The sun was setting on a blisteringly hot day and children were playing in front gardens as she went door to door.

“I’m here to talk to you about abortion access,” she says, “just making sure you know early voting has started”.

Ms Crews is a black woman and a Methodist minister but has been campaigning to protect abortion access.

“When I talk to the voters about the 1864 abortion ban I share with them that in 1864, I would have been considered not a person,” she said.

“That makes it real for them because this is very dangerous. We can’t afford to go back.”

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US election: Millions of Americans vote to decide between Trump and Harris

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US election: Millions of Americans vote to decide between Trump and Harris

Millions of Americans are voting in an historic election that could put Donald Trump back into the White House or make Kamala Harris the first woman to become US president.

The two candidates are neck and neck in the polls after bitter campaign that saw two assassination attempts against Republican Mr Trump as well as the shock withdrawal of President Joe Biden.

In around 100 days, Ms Harris has found her feet and mounted a fierce challenge to her opponent.

With just hours left before polls close, the election has come down to the wire and could be decided by a handful of crucial battleground states.

Follow live: Harris makes surprise stop in Washington

Voting on Tuesday appears to be smooth, with only scattered reports of delays from extreme weather, long lines or technical problems.

The FBI reported that there had been “non-credible” bomb threats to several states, some of which it said came from Russian email domains.

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Pic: AP
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Pic: AP

How the vote works

As well as those lining up at polling booths on Tuesday, tens of millions of Americans cast early ballots – voting by post or in person before today.

To become president, the winning candidate needs 270 electoral votes or more, with each state carrying a different number of votes.

If the polls predicting a close race are correct, the election will likely come down to a few battleground states: Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin.

The first ballots cast on Tuesday mirrored the national divide. Overnight, the six registered voters in the tiny hamlet of Dixville Notch, New Hampshire, split their votes between the two candidates in voting just past midnight.

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Key issues for American voters

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Trump or Harris

Former President Mr Trump, 78, voted in Palm Beach, Florida, near his Mar-a-Lago club.

Wearing his trademark red “Make America Great Again” baseball cap, he said at the polling station that he was feeling “very confident”.

“I hear we’re doing very well,” he said. “It looks like Republicans have shown up in force.”

Elon Musk, the world’s richest man and Trump donor, said he will watch results unfold with the former president.

In the meantime, Ms Harris, the 60-year-old Democratic vice president, did radio interviews in the battleground states of Pennsylvania, Georgia and North Carolina.

Melissa Fehl votes, next to a cat named "Skye", in the 2024 U.S. presidential election on Election Day, at the Mattress Factory in Pittsburgh, Pennsylvania, U.S., November 5, 2024. REUTERS/Quinn Glabicki
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A cat seen at a polling booth in battleground state Pennsylvania. Pic: Reuters

What do the polls say?

Many polls are too tight to call and, with a large margin of error, most experts are refusing to predict the outcome.

Georgia could be among the first battleground to declare, with polls there closing 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).

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North Carolina could also give an early indication of how the vote is going.

Even so, it could be several days before the US has a definitive result.

An exit poll by conducted today by Sky News’ sister outlet NBC News and other US outlets suggests that democracy is the top issue on the minds of voters as they cast their ballots.

Some 35% of people said it was their most important issue, closely followed by the economy on 31% and with abortion ranked third at 14%.

Voters are not just selecting a president. A number of seats in the House of Representatives and the Senate are up for grabs. In addition, 10 states will hold abortion-related ballots, half of which would overturn existing restrictions.

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US election: Who will win the battleground states? Play our game and decide the new president

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US election: Who will win the battleground states? Play our game and decide the new president

Americans are choosing their new president today.

Either Kamala Harris or Donald Trump will be the new occupant of the White House in January.

For many people, their vote will make little difference.

The main crunch points are in seven states and one inner state district.

In the following game, you can predict who will win in each swing state.

We will tell you at the end who the new president will be – if you have made correct predictions.

Good luck!

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Trump or Harris? Millions of Americans set to decide next president

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Trump or Harris? Millions of Americans set to decide next president

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.

US election latest updates

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.

More on Us Election 2024

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.

Katy Perry performs after an appearance by Democratic presidential nominee Vice President Kamala Harris at a campaign rally at the Carrie Blast Furnaces in Pittsburgh, Monday, Nov. 4, 2024. (AP Photo/Gene J. Puskar)
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Katy Perry performed in Pittsburgh in support of Kamala Harris. Pic: AP

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.

Read more:
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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.

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