Monday marks two years since five United States Supreme Court justices overturned Roe v. Wade and ushered in an era of decimated access to abortion and reproductive health. Former president Donald Trump, who appointed three of the five justices who repealed the 1973 landmark case, is still bragging about the ramifications of the Dobbs decision.

Trump’s own messaging on how he would continue his anti-abortion legacy in a second term has been inconsistent in his ever-evolving attempt to appeal to his evangelical base—while keeping in mind the 63 percent of Americans who say abortion should be legal in all or most cases. (That group of people, as the 2022 midterms and statewide ballot races have shown, vote too).

“We have also achieved what the pro-life movement fought to get for 49 years, and we’ve gotten abortion out of the federal government and back to the states,” Trump told a crowd of evangelical voters at the Faith & Freedom Coalition in Washington, D.C. on Saturday. “The way everybody and all legal scholars always said it should be.”

The last 24 months have culminated in an America where almost half of states restrict abortion earlier in pregnancy than the standard set by Roe, and 14 states ban abortions in practically all cases.

The ripple effects of the decision made by the nation’s highest court led to 171,000 patients seeking abortion care out of state in 2023. Maternal health care deserts are increasing and worsening. Women are asking their state’s supreme courts to have life-saving abortions. In states with abortion restrictions, more pregnant people are dying. Each week seems to bring new challenges to abortion access and new victories for the movement to maintain comprehensive reproductive health care.

With an election cycle in full swing and Dobbs, in many ways, at the center of it, the future of abortion access is uncertain.

At this point in the race, Trump is running on leaving abortion access up to the states—though he previously indicated he would back a 15-week nationwide ban. While he hasn’t followed this rhetoric while talking about Arizona, Alabama, and Florida, the former president recently told House Republicans that they ought to be messaging abortion differently in a closed-door meeting. Trump wanted the house members to prop up the party’s role in ending Roe and speak of abortion as a states’ rights issue, not a federal one.

In 2023, there were approximately 642,700 medication abortions in the US, about 63 percent of all abortions in the formal health care system, according to Guttmacher Institute. The number would likely be higher if the use of abortion pills outside of these channels was accounted for. This is a marked increase from before Dobbs, when medication abortions made up about 53% of all terminations in 2020.

Anti-abortion activists and politicians on the right are hoping to minimize access to abortion pills, which can be uniquely helpful for those experiencing domestic violence.

To do this, conservatives are pushing to enforce an 1873 anti-obscenity law called the Comstock Act. The act prohibits the mailing of “Every article or thing designed, adapted, or intended for producing abortion, or for any indecent or immoral use.” This includes abortion pills, but it could also include the tools needed to perform both medical and procedural abortions. This strategy is outlined explicitly in Project 2025—a guidebook for how the next Republican presidential term should go that’s stewarded by the Heritage Foundation.

“The Department of Justice in the next conservative Administration should therefore announce its intent to enforce federal law against providers and distributors of such pills,” Project 2025’s “Mandate for Leadership” reads.

On Thursday, congressional Democrats introduced new legislation to repeal the part of the law that could be used to prohibit the mailing of abortion related items. The bill, introduced by Senator Tina Smith and co-sponsored by more than a dozen other Senate Democrats, is named the “Stop Comstock Act.”

While Trump, who has said he wouldn’t stop states from tracking individual pregnancies and prosecuting those who get abortions, says he wants to keep these as state-by-state decisions, those in his corner are looking to take action federally—and they’re not being quiet about it.

“What we are communicating is, yes, it’s a states issue. It’s just not only a states issue,” Kristi Hamrick, chief policy strategist for Students for Life, said. “Abortion is federal, paid for by taxpayers and pushed by federal agencies. Any discussion of weaponized agencies and governmental abuse of power must include the issue of abortion—at every level.”

The Hyde Amendment, implemented in 1977, forbids the use of federal funds for abortions except in cases of life endangerment, rape, or incest.

Ahead of this week’s first presidential debate of the election season, it’s clear that Trump’s anti-abortion base is excited to put him in office again but would like some bold messaging around his Dobbs legacy and how he plans to continue it.

“Like Ronald Reagan,” Trump told the evangelical crowd on Saturday, “I believe in exceptions for the life of the mother, rape, and incest.” He also noted, “You have to go with your heart. You have to also remember you have to get elected.” The crowd, per reporting from Reuters, gave a “lukewarm reception” while some started chanting “No dead babies!”

“After the Dobbs decision, for which President Trump deserves massive credit for the three Supreme Court appointments, he certainly needs to reassure pro-life Americans, pro-life voters, that he’s going to act as consistently in the future as he has in the past,” Albert Mohler, a prominent evangelical theologian and president of Southern Baptist Theological Seminary, said.

“The president has an opportunity for a big win.”