How Abortion Rights Is Shaping The US Political Landscape

I’m in Tennessee, in the midst of my journey across America as the country plunges into the fevered pitch of election season. From New Hampshire’s sun-baked town halls to Pennsylvania’s packed high school gyms and here in the quiet suburbs of Tennessee, there’s been one constant undercurrent—the fierce determination of young women.

Whether in swing states like Arizona or deeply conservative ones like Georgia, young women are speaking up, mobilising and preparing to make their voices heard on what may be the defining issue of the 2024 presidential election—reproductive rights.

I’m standing outside the Carafem clinic in Mount Juliet, Tennessee, located in the unassuming Providence Pavilion. This clinic was once central to reproductive healthcare in the Nashville area, but it also found itself at the centre of the fight over abortion rights. In 2021, the clinic was targeted by anti-abortion protesters who staged a blockade, hoping to prevent women from accessing care. The protesters live-streamed their efforts, and the scene outside was tense, with patients trying to enter the clinic as protesters chanted slogans and police maintained order.

Back then, abortion was still legal in Tennessee, but now the landscape has completely shifted. In August 2022, after the Supreme Court’s Dobbs v. Jackson decision led to Tennessee’s total ban on abortion, Carafem had to halt all in-person abortion services. The clinic remains open for telehealth and other healthcare services, but the absence of in-person abortion care is deeply felt here.

What’s striking is how this shift has galvanised young women across America. With eight million new voters eligible in 2024, they could be the key to determining the election. According to Change Research, three in four young voters believe abortion should be legal in all or most cases, and four in ten (40 per cent) women under 30 now name abortion as their top issue, a figure that has doubled since earlier this year. Kamala Harris’ campaign has leaned into this momentum, and her focus on reproductive rights is resonating deeply with younger voters. Among younger Democratic women, trust in Harris’ handling of abortion has surged from 35 per cent to 66 per cent since June.

The engagement is not limited to Democratic voters. As I’ve spoken to young women in states like Pennsylvania and Arizona, I’ve met many who are breaking from traditional party lines over the issue of abortion. This reflects a broader trend where young women, regardless of party affiliation, are prioritising personal freedom over partisanship. For them, abortion is not just a political issue—it’s a matter of controlling their bodies, their futures and their economic stability.

As Gloria Steinem, an American journalist and social activist noted: “For the first time, a significant number of women will vote as equal citizens, cutting across party lines and family loyalties.” This evolution marks a turning point in the American politics, one driven by young women determined to protect their rights.

Some students on the Vanderbilt University campus gave me the phone number of a former student who’d experienced a dramatic shift in perspective. “You have to meet her,” they insisted. After a bit of back-and-forth messaging, I arranged to meet her outside the Carafem clinic near Nashville.

She was leaning against her car when I arrived, eyes fixed on the now-empty clinic, a place she knew well for complicated reasons. “I was part of the blockade here,” she confessed, her voice tinged with regret.

A registered Republican, she had once been committed to the anti-abortion cause. But over time, as she faced her own struggles and saw the impact of restrictions on women around her, her perspective began to shift. Now, she stood here for a different reason, with a new sense of urgency. “I’m voting because I can’t afford not to,” she said firmly. “This is about my freedom, my career, and my right to choose when I’m ready for motherhood.” It was a transformation that captured what’s at stake in this election for many women like her.

According to a survey of women voters, 58 per cent trust vice-president Harris over Donald Trump to manage abortion access, including 17 per cent of Republican women.

The fallout from the June 24, 2022, Roe v. Wade’s reversal has been swift and severe. Within a year of the decision, over 200 women have been criminally charged for pregnancy-related actions, whether managing their own abortions, experiencing miscarriages that raised suspicions or engaging in behaviours deemed risky during pregnancy. Between 2006 and June 2022, 1,396 arrests were tied to pregnancy-related issues, and at least 61 people were investigated or arrested for ending their pregnancies between 2000 and 2020. These aren’t just statistics—they represent real women facing real consequences, a fact that is pushing young women to engage with politics like never before.

The consequences of losing Roe extend far beyond abortion access. In March 2024, an appeals court in Texas ruled that the state could ban contraception for minors without parental consent at Title X clinics, the only source of confidential contraception for teens.

On a muggy afternoon in Columbus, Ohio, earlier, I met Zoe, a 20-year-old college student sitting outside a bustling cafe near campus, flipping through a thick stack of textbooks. She wore a faded “Roe, Roe, Roe Your Vote” T-shirt, her curly hair pulled back into a messy bun, with a hint of exhaustion in her eyes. She was juggling a full course load and a part-time job to pay tuition. Her voice cracked with frustration as we spoke. “It’s terrifying,” she said, clutching a notebook covered in feminist slogans. “It’s not just about abortion anymore. It’s everything—contraception, basic healthcare, everything that helps us plan our futures. How can we even think about getting ahead if we can’t control what happens to our own bodies? It feels like they’re trying to take away the tools we need to survive, let alone succeed.”

Young women understand that this election is not just about preserving one right; it’s about defending their futures. For them, reproductive rights are also fundamentally tied to economic opportunity. Women who cannot access safe, legal abortions are four times more likely to live below the poverty line. They are more likely to drop out of school, work in low-wage jobs and struggle to achieve financial stability. 

Harris’ campaign has made this connection explicit, framing reproductive rights as essential to achieving both gender and economic equality. At a rally called the “Conversation on Reproductive Freedom” at the Salus University in Cheltenham Township, Pennsylvania, the room was filled with young women holding signs that read, “My Body, My Choice”, and wearing T-shirts emblazoned with “Protect Roe”. Harris, with the energy of someone deeply committed to the fight, told the crowd, “The stakes couldn’t be higher for this November.”

Her words drew loud cheers and applause.

She spoke passionately about laws that criminalise healthcare providers, particularly highlighting Texas’ law that penalises doctors for non-emergency abortions. “The idea that so-called leaders would deny survivors of violence the right to decide what happens to their bodies is immoral,” she declared, her voice sharp and urgent. The room fell silent, then erupted with applause. Harris didn’t hold back on the reality of six-week bans, either, adding, “Most women don’t even know they’re pregnant at six weeks.”

The audience nodded and murmured in agreement. This message resonates deeply with young women, who see abortion as not just a healthcare issue but as a fundamental component of their everyday lives and independence.

What I’ve seen in my travels is that young women are not just reacting—they are making significant life decisions based on access to reproductive healthcare. Over 70 per cent of high school seniors report considering access to abortion when deciding where to attend college.

Similarly, two-thirds of young workers say they wouldn’t want to live in a state with an abortion ban, while 60 per cent of young women are considering relocating from states with restrictive laws or would if further restrictions are imposed.  Among women voters of reproductive age, Harris holds a two-to-one advantage over Trump in trust to handle abortion policy.

At Washington Square Park, I met a college student originally from Texas, sitting on a bench beneath the shade of a sprawling tree. The noise of street musicians and the chatter of NYU students surrounded us as she spoke candidly about her decision to study in New York.

“It’s not just about choosing a school anymore,” she explained, clutching her backpack strap casually. “It’s about choosing a state where I have control over my own body. I left Texas because I want to build my future somewhere that respects my rights, not somewhere that takes them away.”

For her and millions of others, the 2024 election isn’t just about picking a president—it’s about defining the kind of country America will be.

While the muffled halls of the Carafem clinic and the words on the clinic’s website—It’s with a heavy heart that we’ve closed this much-needed in-office abortion procedure at this clinic—serve as a stark symbol of what has been lost, they also embody what’s at stake in 2024. The young clinic worker at the front desk told me that “our efforts to keep the clinic running to provide online consultations and other reproductive health services reflect the depth of the struggle, and our resolve to ensure that the country moves forward, not backward”.

This struggle isn’t new. The drive to control women’s bodies and limit their choices mirrors tactics used by authoritarian regimes throughout history to reinforce traditional social hierarchies.

By restricting reproductive rights, political forces aim to reassert traditional family structures, making male authority seem “natural” at home and extending this logic to the broader state.

Adolf Hitler argued that Germany’s defeat in World War I was partly due to men losing their masculinity, which he attributed to losing control over women. He blamed the Weimar Republic’s efforts to emancipate women by providing access to childcare, higher education, better jobs and political participation. As part of his campaign to restore male supremacy, he vowed to return women to their traditional roles of “kinder, küche, kirche” (children, kitchen, church), framing these roles as essential to national restoration and reinforcing male authority.

Franco’s Spain and Ceaușescu’s Romania used similar tactics, reinforcing traditional roles and curbing reproductive rights to maintain social order and state control.

In the US today, the Republican nominee for Vice-President J.D. Vance’s rhetoric about women finding happiness only as homemakers may not be as overtly fascistic, but the underlying strategy is similar—using reproductive control to normalise hierarchy. Trump’s campaign, while less explicit, taps into similar fears of declining traditional masculinity. By restricting women’s reproductive rights, he aims to restore a sense of order and control, appealing to voters who feel economically marginalised but still seek power through gender dominance.

Meanwhile, inflation continues to rank as the number one concern for women voters overall. It remains a high priority for Black (51 per cent) and Hispanic (41 per cent) women, who are grappling with rising household expenses, from groceries to rent. But there’s a notable shift among voters of colour—in a flip from earlier this summer, many are now giving Harris the edge over Trump when it comes to managing rising costs. The tie between economic stability and reproductive rights is not lost on voters. As costs rise and wages stagnate, the ability to control the timing and size of one’s family becomes even more crucial.

(Views expressed are personal)

Ruchira Gupta is an Emmy-winning documentarian and author of I Kick and I fly

This story was published as part of Outlook's 11 November, 2024 magazine issue with the title 'Roe, Roe, Roe Your Vote'. To read more stories from the issue, click here