During the Dobbs oral arguments, Coney Barrett suggested that being forced to carry a pregnancy to term and drop off the baby at a safe haven is a reasonable alternative to a routine procedure that in states like Mississippi, which has one of the highest maternal death rates in the country, is significantly safer than childbirth. To understand how we got here, we have to go back to the early 1990s. Roe is common shorthand for the right to an abortion, and many people assume the ruling still unequivocally upholds abortion rights. In reality, Roe was hollowed out in 1992, in a landmark case whose significance was lost on most of the American public because it hinged on legal minutia.

In Planned Parenthood v. Casey, the Supreme Court allowed what were then envelope-pushing restrictions to stand in Pennsylvania, and in doing so it gave states much more leeway to restrict abortion. Casey was pivotal because the Supreme Court changed the standard by which courts would evaluate abortion laws. Whereas Roe allowed pre-viability abortions outright, Casey tasked judges with deciding whether a state law created an “undue burden” for women seeking pre-viability abortions. If a court decided that a law did create an undue burden, the law was unconstitutional. Legal scholars and advocates saw that Casey was subjective and, therefore, slippery and dangerous for abortion rights, but the ruling also retained the core of Roe.

The post-Casey years were a major turning point for the anti-abortion movement, and a missed opportunity for supporters of abortion rights. Following the ruling, the anti-abortion movement pushed novel restrictions through state legislatures, aiming to give Roe a death by a thousand cuts. There was a flurry of state bills specifically designed to seem too arcane, boring, or insignificant to rouse public opposition. Meanwhile, major abortion-rights organizations such as Planned Parenthood and NARAL, much like the Democratic Party and left-leaning interest groups, divested from state-level organizing, electoral work, and lobbying and instead threw most of their weight behind national elections and litigation. For several years, it seemed as though federal protections would safeguard abortion rights, regardless of how zealously activists picketed clinics, threatened and committed acts of violence, and pushed incremental bills through statehouses. That, however, was a major miscalculation.

On the national stage, anti-abortion politicians and activists proactively framed the conversation, inventing terms like “partial-birth abortion,” which described a rarely used dilation-and-extraction procedure, to make abortion seem gory and extreme and put abortion-rights supporters in a defensive crouch. Behind the scenes, Republican strategists were increasingly focused on flipping state legislatures, which they recognized as major seats of structural power. Those forward-thinking strategists saw that state governments have wide control over culture-war issues like abortion and over various areas of interest to Republican donors such as taxes, energy, and the levers of democracy, including redistricting and election policy. After the Casey decision permitted states to restrict abortion, anti-abortion politicking became a surefire way for Republican candidates to motivate their base to show up for elections. Republicans swept state elections in 2010, and increasingly bold anti-abortion restrictions rolled through statehouses at an unprecedented pace. Clinics began to close, particularly in the South and Midwest. According to the Guttmacher Institute, in 1996 there were 452 abortion clinics in the United States. By 2014, there were 272, and that number has almost certainly dropped since. Six states have only one abortion clinic. Poor women have never had equal access to reproductive healthcare, but in the past decade it has become very difficult, if not functionally impossible, for poor and working-class women to access abortion care in large portions of the country.

While abortion rights were being hammered at the state level and the national conversation was becoming ever more vitriolic, where was everyone? For fifty years, women have been relying on reproductive healthcare and rights to participate in the workforce and support themselves and their families. One in four American women will have an abortion during her lifetime. According to a recent study by the New York Times, the typical patient seeking an abortion is already a mother, in her late twenties, and has completed some college. The prevalence of abortion means there isn’t a major business in the entire country that does not profit from the labor, talent, and spending of women who have had abortions. Every union and professional association has members who have relied on abortion care. Every university has students and faculty who have delayed or foregone parenthood to complete their education. Every one of us, whether or not we know it, has benefited from the work, care, and wisdom of people who have had abortions. And yet, despite these facts, nearly everyone has treated abortion rights as a siloed issue.