In the first month of his presidency, Donald Trump and his administration have already undertaken several actions that significantly affect abortion and reproductive healthcare access, both within the United States and abroad. This has sparked alarm among advocates for reproductive rights regarding potential future developments.
While Trump has made his anti-abortion views clear, he has not defined specific policies during his campaign, frequently sidestepping direct inquiries about a possible nationwide abortion ban. Nonetheless, professionals in reproductive health, legal experts, and lawmakers have anticipated that his administration would move to limit access to abortion and other related services.
Mary Ziegler, a law professor at the University of California, Davis who focuses on abortion issues, observes that many of the Trump administration’s actions align with traditional Republican strategies. She notes that political dynamics tend to shift with the party in power. However, Ziegler points out that Trump has amplified certain strategies, such as the Justice Department’s directive to reduce prosecutions against anti-abortion protesters obstructing clinic access. Although significant actions concerning abortion have already been initiated, Ziegler remarks, “we’re still in a wait-and-see phase” regarding forthcoming actions.
Nancy Northup, president and CEO of the Center for Reproductive Rights, stresses that while Trump hasn’t pressed Congress for a national abortion ban immediately, it would be naive to interpret this as a lack of intention. She asserts, “This administration is poised to be the most anti-abortion in U.S. history, especially with no federal constitutional protections in place. The actions taken so far indicate a strong anti-abortion agenda.”
Here’s a look at the key initiatives undertaken by the Trump administration that affect access to reproductive healthcare.
What actions has the Trump Administration taken domestically?
In his first week as president, Trump granted pardons to several anti-abortion protesters previously convicted under the Freedom of Access to Clinic Entrances (FACE) Act, a law designed to safeguard abortion clinics and their patients from obstruction and threats. The following day, a high-ranking official in Trump’s Justice Department circulated a memo indicating that FACE Act violations would only be prosecuted under “extraordinary circumstances” or in cases with “significant aggravating factors,” effectively instructing a decrease in such prosecutions.
Under the Biden administration, the Justice Department aggressively prosecuted numerous individuals accused of violating the FACE Act. Ziegler anticipates that enforcement will decline under a Republican administration, and this new directive signals a clear lack of prioritization for these cases.
Read More: The Influence of Trump’s Appointees on Abortion Policies
Northup highlights that six individuals pardoned by Trump had been convicted for obstructing access to a reproductive healthcare facility in Michigan, which her organization represents. She states, “This sends a decisive message to anti-abortion extremists that the Trump administration will overlook the blockades, violence, and threats that women face when trying to access clinics, as well as the daily challenges clinic staff encounter.”
Additionally, Trump signed an Executive Order in his first week aiming to enforce the Hyde Amendment, which prohibits federal funding for abortions. This order rescinded two Executive Orders enacted by Biden, one of which promoted expanded access to reproductive healthcare and the other recognizing abortion as a healthcare service.
Northup argues that Trump has woven anti-abortion sentiment into various policies, including an Executive Order that states the U.S. will recognize only “two sexes, male and female.” She contends that this order undermines access to gender-affirming care and incorporates language suggesting personhood begins at conception. “They are subtly infusing the concept of personhood from fertilization into all federal policies, rather than recognizing rights beginning at birth,” she explains.
Advocates for reproductive rights believe that Trump and his administration have made their anti-abortion stance unmistakably clear. Soon after Trump’s inauguration, reproductiverights.gov—a federal website launched during the Biden administration offering information on abortion and reproductive healthcare—was taken offline. During that same week, Vice President J.D. Vance addressed the March for Life rally in Washington, D.C., praising Trump as “the most pro-life president in our history” and commending his actions regarding abortion during his initial term, attributing credit for the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade. Although Trump did not attend the rally, he provided a pre-recorded message expressing his support for anti-abortion activists.
What international actions has the Administration taken?
Experts suggest that one of Trump’s most significant actions concerning global reproductive healthcare access is the suspension of foreign aid. Historically, the U.S. government has provided over 40% of humanitarian aid tracked by the United Nations and is the largest donor worldwide. For the 2024 fiscal year, Congress allocated $575 million for family planning and $32.5 million for the United Nations Population Fund, which focuses on sexual and reproductive health, as reported by the Guttmacher Institute, known for its research and advocacy in this area. Elizabeth Sully, a principal research scientist at the Institute, notes that this level of funding has enjoyed bipartisan support and remained stable for nearly a decade. Due to the Helms Amendment, which prohibits using foreign assistance funds for abortions, this support had not been directed toward abortion services.
An analysis by Guttmacher reveals that these funds can provide contraceptive care for 47.6 million women and couples annually and prevent 17.1 million unintended pregnancies, potentially saving the lives of approximately 34,000 women and girls who could otherwise die from pregnancy-related complications. “Family planning is a critical life-saving measure,” Sully emphasizes.
However, due to the aid freeze, international family planning programs that rely on U.S. support have been forced to cease operations, with the Guttmacher Institute estimating that over 3 million women and girls have already been denied contraceptive services as a result. The Institute anticipates that by the end of the full 90-day review period, around 11.7 million women and girls will lack access to contraceptive care, leading to 4.2 million unintended pregnancies and 8,340 fatalities from complications related to pregnancy and childbirth. On February 13, a federal judge ordered the Trump administration to temporarily lift the suspension of foreign aid; however, the administration’s attorneys are defending the freeze, asserting that the judge’s ruling does not prevent the State Department from halting foreign assistance programs. The future of the judge’s ruling regarding these programs remains uncertain.
“What’s particularly challenging is the unpredictability of the situation,” Sully comments. “You might arrive at a clinic you’ve previously visited for injections or contraceptive pills, only to find it closed or lacking necessary supplies, with no indication of when services might resume.”
Dr. Sierra Washington, director of Stony Brook’s Center for Global Health Equity and a member of the International Federation of Gynecology and Obstetrics’ Committee on Safe Abortion, works in Mozambique. She expresses significant concerns about the implications of the aid freeze, fearing it may lead to a surge in HIV cases, unsafe abortions, and elevated maternal mortality rates.
“We will soon see substantial shortages of condoms and contraceptives throughout the healthcare system, which will inevitably result in more women suffering from unsafe abortions and complications during childbirth,” Washington warns. “It’s truly tragic.”
“I doubt that officials in the Trump administration understand the interconnectedness of global health issues, such as how condoms help prevent the transmission of HIV, which knows no borders,” she adds, cautioning that an increase in HIV could eventually “reach the U.S. and affect global health.”
In his first week, Trump also reinstated the Global Gag Rule, which prohibits foreign organizations receiving U.S. aid from providing, referring to, or discussing abortion care. This move was anticipated by many reproductive health experts, as Republican presidents typically implement it while Democratic presidents rescind it. During his first term, Trump expanded this policy to encompass all global health funding, not just family planning services, leading to “far-reaching impacts” beyond abortion care. The Guttmacher Institute noted that, in certain regions of Ethiopia and Uganda, the previously observed increase in contraceptive use halted or even regressed after the implementation of the Global Gag Rule during Trump’s first term.
“While the policy primarily aims to restrict abortion, declines in family planning often lead to more unintended pregnancies and, consequently, an increase in abortions,” Sully explains.
The Trump administration also announced that the U.S. would rejoin the Geneva Consensus Declaration, a non-binding agreement that supports anti-abortion policies, which the U.S. had endorsed towards the end of Trump’s first term. This declaration has received backing from over 30 nations, including Uganda and Hungary. Biden withdrew the U.S. from the declaration upon taking office.
What might be on the horizon for Trump?
Most experts consulted predict that the Trump administration will continue to implement measures aimed at restricting abortion and reproductive healthcare access.
One key concern that experts are monitoring is the administration’s approach to mifepristone, a medication approved by the U.S. Food and Drug Administration (FDA) for abortion over two decades ago, which is currently facing legal challenges from anti-abortion groups. During his confirmation hearings as Secretary of Health and Human Services, Robert F. Kennedy Jr. provided vague responses regarding mifepristone, sharing that the President had asked him to “study the safety” of the drug but had not made a definitive decision regarding its regulation.
Ziegler emphasizes that it remains uncertain whether the Trump administration would completely revoke the FDA’s approval of mifepristone or if it would reverse Biden-era policies that made the drug more accessible, such as allowing prescriptions via telehealth and mail. Either option would have a significant impact on abortion access across the nation; Northup mentions that the ability to obtain medication abortions through telehealth and mail has been a “lifeline” for numerous patients following the Dobbs ruling.
Read More: How the Biden Administration Safeguarded Access to the Abortion Pill—and What Trump Might Do
Experts are also closely watching to see if the Department of Justice will invoke the Comstock Act, a law from the 19th century aimed at prohibiting the mailing of abortion-related medications. Looking ahead, Ziegler predicts that Trump will likely continue to appoint conservative judges, as he did in his first term, who will have a significant influence on abortion legislation, especially as numerous state-level restrictions are subjected to judicial review. While appointing judges and securing their confirmations can take time, the long-term implications could be profound.
“These judges will make critical decisions affecting access to abortion, contraception, and various reproductive health services,” Ziegler states. “As the courts evolve, we could witness increasingly extreme outcomes regarding reproductive issues.”
Some anticipated more drastic actions from the Trump administration concerning abortion shortly after the President’s inauguration. However, Ziegler suggests that part of the delay may stem from Trump’s intention to appeal to both his anti-abortion base and the majority of Americans who support abortion rights. Sully adds that, while Trump took office swiftly, many key department leaders responsible for overseeing abortion-related policy changes, including those concerning mifepristone and the Comstock Act, are still awaiting confirmation.
Read More: Why Abortion Rights Succeeded in Three States That Voted for Trump
Advocates stress the need for vigilance regarding future developments. Northup points out that Roe served as a protective measure during Trump’s first presidency, imposing limits on the actions his administration could take regarding abortion. With Roe now overturned, the constitutional protections that previously constrained his authority are no longer in effect, she cautions.
“Anyone who cares about access to abortion services—an overwhelming majority of people in the U.S.—should be on high alert for potential restrictions that this administration may seek to impose in states where abortion remains legal,” Northup concludes.
