Anti-abortion hardliners want restrictions to go farther. It could cost Republicans

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Anti-abortion activists who describe themselves as "abolitionists" protest outside a fertility clinic in North Carolina in April 2024. / NPR

Two years ago next month, the Supreme Court overturned Roe v. Wade, the landmark decision guaranteeing a federal right to an abortion.

It was an outcome decades in the making – but to abortion opponents, the fight is unfinished. Now they're setting their sights on banning mifepristone, a drug commonly used in medical abortions. Abortion rights opponents have filed several lawsuits, including one awaiting a decision from the Supreme Court.

Abortion medication has made the procedure more accessible. Since June 2022, the number of abortions performed in the U.S. has actually gone up: On average, there were about 4,000 more abortions per month in 2023 compared to 2022, according to the Society of Family Planning's WeCount project.

One factor driving that increase has been the rise in telehealth abortion – where patients receive abortion medication in the mail after consulting with a clinician. Telehealth abortions now make up 19% of all abortions in the U.S., according to Wecount.

"It's affordable. It's convenient, and it feels more private," says Jillian Barovic, a midwife and one of the cofounders of Juniper Midwifery, which offers medication abortion via telehealth in six states where abortion is legal.

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Efforts to further restrict abortion rights

As abortions continue despite state bans, activists are pushing for further restrictions, including the criminalization of patients who pursue abortions, and banning procedures like IVF.

T. Russell Hunter leads a group opposing all abortions, with no exceptions – they call themselves "abortion abolitionists." He accuses mainstream anti-abortion groups of being too willing to accept incremental restrictions inconsistent with their messaging.

"You can't say, 'Life begins at conception ... but we're going to allow abortion in the first five weeks,'" Hunter says. "If life begins at conception, and you believe that human life must be protected, well, you're stuck logically."

Hunter, who is based in Oklahoma, opposes IVF and believes that embryos should have legal rights. He argues that patients who seek abortions and anyone who helps them should be charged with murder.

Kristine Harhoef lives in Texas and has been involved in anti-abortion activism for over a decade. She's frustrated that even where abortion is banned, patients are still accessing abortion medication. She's been talking with lawmakers in Texas and neighboring states, trying to promote legislation that would treat abortion identical to homicide.

"And the penalty could be anything from nothing at all, if she was truly innocent, truly forced into that abortion," she says, "to a fine or community service, to, yes, some jail time and possibly even the death penalty."

What it all could mean for Republicans in November

The issue of abortion rights could be a difficult needle to thread for Republicans.

Several recent polls by Pew and the Public Religion Research Institute confirm that a clear majority of voters say abortion should be legal in many or all cases.

And while abortion abolitionists take aim at IVF, Republicans, including former President Donald Trump, are voicing support for the procedure. After an Alabama Supreme Court decision ruled that embryos should be legally considered children, Republicans there rushed to pass a law designed to protect IVF providers.

Activists like Harhoef, who support the death penalty for abortion patients, are still in the minority of abortion opponents. But they've made strides in state legislatures, including a bill that made it to the Louisiana House floor in 2022.

Rachel Bitecofer, a Democratic political strategist, says the line between the mainstream anti-abortion rights movement and the abortion abolitionists is quite thin.

"[Republicans] have been targeting those folks for 25, 30 years now with ever-increasing hyperbolic rhetoric about abortion and defining any kind of abortion as an act of murder," Bitecofer said.

"So if you accept that abortion is murder, then it makes sense that you have pretty rigid requirements to stop it at all costs," she added.

In today's episode of Consider This, NPR national political correspondent Sarah McCammon dives into the abortion abolitionist movement. Click the play button at the top of the page to hear the full story.