When Americans used to imagine life post-Roe, many seemed to believe that at the very least the country would agree on one thing: the need for an exception to save a woman’s life. These exceptions enjoy sweeping public support; a recent Pew Research Center poll found that 73 percent of Americans favored legal abortion if a woman’s life or health was at risk. Only 8 percent of respondents favored no exception whatsoever to criminal abortion laws.

Life-of-the-patient exceptions do not even require anti-abortion-rights Americans to change their minds about fetal personhood. Even if someone believes that a fetus enjoys the same rights as an adult, abortion could be justified much in the same way that people who are anti-violence can understand the need in certain situations for self-defense. Support for the so-called life-of-the-mother exception seemed unshakable.

Not anymore. Anti-abortion-rights groups, like Wisconsin Right to Life, have described the “life of the mother” exception as unnecessary and wrong. The Idaho GOP just approved a platform with no lifesaving exception. Republican candidates like Matthew DePerno, the Republican running to be Michigan’s attorney general, oppose all exceptions to abortion bans, and that includes to save a mother’s life. Conservative states are rushing to eliminate or narrow existing exceptions to their laws. Powerful groups like Students for Life, Feminists for Life, and the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) argue that “abortion is never medically necessary” and that doctors should always be punished for intentionally taking a fetal life.

Why has what was once unthinkable suddenly become a legal reality, despite its extreme unpopularity? Recent changes in both the GOP and the anti-abortion-rights movement have something to do with it, but the problem runs deeper: a twin skepticism of women and the medical establishment. Even though activists of the anti-abortion-rights movement and the politicians who support them sometimes argued that women must be protected in certain cases, they question the honesty of people—both doctors and patients—who invoke emergency exceptions. These dual suspicions have produced a new definition of abortion—as the intentional, criminal taking of a life—and a growing consensus that abortion bans should have no exceptions.

The roots of current conflicts about emergency exceptions to abortion bans go back to the 1960s, when states began introducing modest reforms to criminal abortion laws. Many of the early bills were patterned on a proposal from the American Law Institute, a group of elite lawyers, judges, and academics, allowing abortion in cases of rape, incest, health threats, and serious fetal conditions.

These bills enjoyed bipartisan support; Republicans including Ronald Reagan and future Vice President Spiro Agnew signed them into law. Opposition came from an anti-abortion-rights movement with strong ties to the Catholic Church—and largely, in Congress and state legislatures, from a subset of Catholic politicians.