WASHINGTON — President Donald Trump delivered his Day One promise to the anti-abortion movement four days into his second term: He pardoned nearly two dozen anti-abortion activists convicted of federal offenses that included using physical force to block access to and invade abortion clinics, as well as for threats to clinic staff and patients. And after months of Trump distancing himself from the abortion issue and a week of lobbying by anti-abortion leaders, the president and Vice President J.D. Vance spoke at the movement’s annual March for Life rally on Friday.

“I am proud to be the first president ever to have joined you in person,” Trump said in a video recorded in the Oval Office, referring to his 2020 appearance, to the cheers of an estimated tens of thousands of activists and students gathered on the National Mall.

But the president failed to offer specific federal policy plans to further the movement’s goal of banning abortion nationally and gave what appeared to be a scripted speech that evoked religious language, referring to every child as “a beautiful gift from the hand of our creator.” He touted the controversial Dobbs v. Jackson Women’s Health Organization decision that ended federal abortion rights and the pardons he issued Thursday. Trump insisted, as he did throughout his campaign, that the abortion issue has returned “to the state legislatures and to the people, where it belongs.”

“In my second term, we will again stand proudly for families and for life. … We will work to offer a loving hand to new mothers and young families, and we will support adoption and foster care,” Trump said, but did not offer specific plans. As during his campaign, he accused Democrats of supporting abortion until “after birth,” a falsehood.

Vice President J.D. Vance, who spoke on stage after Trump, to raucous applause, referred to the anti-abortion movement as “our movement” and emphasized the need for government to make it easier for people to afford kids. Vance also did not name any policy plans the administration would pursue, beyond potentially raising the child tax credit. Vance said he and the president support the recent abortion bill that passed the U.S. House this week, which would have created penalties for health care professionals who don’t provide medical care for babies born after an attempted abortion. U.S. Senate Democrats blocked the bill arguing it was unnecessary and could have prevented parents from making decisions.

Vance, who was criticized during the presidential campaign for his comment about “childless cat ladies,” doubled down on the idea that a “culture of radical individualism” has taken root in this country and called for more Americans to reproduce.

“Our society has failed to recognize the obligation that one generation has to another is a core part of living in a society to begin with,” Vance said. “So, let me say very simply: I want more babies in the United States of America.”

Concerns about Trump’s anti-abortion commitment

Many activists at the march celebrated the return of a presidential administration friendlier to the anti-abortion cause than the Biden administration. Several sported red Make America Great Again hats, while others expressed reservation about Trump, following his shifted abortion language during his presidential campaign.

“When Trump went kind of more pro-choice, really, for a lot of us, we felt abandoned,” said Bryan Gebhart, a parent helping to chaperone about 45 students bussed from St. Francis DeSales High School in Columbus, Ohio. He told States Newsroom he didn’t vote for Trump, but for the American Solidarity Party, a minor political party based on Catholic teachings.

“I would like to see an end of abortion at the federal level,” Gebhart said, noting that banning abortion nationally is a long-term effort and unlikely to be realized during Trump’s second term.

Already, Trump has received praise from anti-abortion leaders. In its first week, his administration scrubbed information from its national health site about reproductive rights and abortion access and withdrew the U.S. from the World Health Organization, which anti-abortion news outlet LifeNews referred to on X to as the “Pro-Abortion World Health Organization.”

But some anti-abortion leaders are also concerned that the new administration is not fully committed to their cause. For the first time since federal abortion rights were overturned in 2022, Republicans control the White House, Congress and the U.S. Supreme Court. But unlike his major policy pronouncements in other areas, Trump has not signaled any major federal actions to limit abortion. In fact, he has repeatedly said he would veto a federal abortion ban, would not prohibit the mailing of medication abortion via the Comstock Act of 1873 and says he supports in vitro fertilization, something many in the anti-abortion movement oppose. Trump continues to take credit for overturning Roe v. Wade, despite the decision’s unpopularity, but campaigned as a moderate on abortion, which he says is a state issue.

“This is not just a states’ rights issue; this is a federal issue that must be remedied by this court or by a constitutional amendment,” said Mark Harrington, who runs the Ohio-based Created Equal group, on Wednesday at an event in front of the Supreme Court to commemorate the 52nd anniversary of the Roe decision. Several leaders said they were disappointed by the lack of a statement from the White House on the anniversary.

Harrington later told States Newsroom he plans to speak out if Trump does not deliver on some of the movement’s major asks, such as eliminating family-planning federal funding to reproductive health organizations and reinstating regulations to abortion drugs.

“We have to be a witness, calling truth to power and reminding him that we helped him get elected, and he better come through for us and the unborn or else — obviously, he’s not getting reelected, but his successor is not going to get our support,” Harrington said. “We’re not going to lay down and play dead, I hope. But a lot of people have been lured to sleep because of Trump’s popularity.”

Terrisa Bukovinac’s Progressive Anti-Abortion Uprising group is affiliated with several of the activists who were serving prison sentences for blockading abortion clinics until the Trump pardons. Bukovinac told States Newsroom that while she is grateful for Trump’s action, she no longer considers Trump and Vance to be “pro-life.”

“Trump has come out in favor of the abortion pill, and so has Vance,” Bukovinac told States Newsroom. “Trump has been clear, and I believe him when he says that he has no intention of setting any kind of federal abortion restrictions. I mean, that’s what we’re fighting for. That’s what the movement is trying to do, and Trump is like, no. So it’s not ideal, but I am optimistic about the things that we can get, … like get FACE repealed.”

The U.S. Department of Justice said Friday it would scale back on prosecuting abortion-clinic protest cases under the Freedom of Access to Clinic Entrances Act, according to the Washington Post.

Bukovinac said her group will continue to fight for full repeal of the law, which Democratic President Bill Clinton signed into law in 1994 after a spate of deadly abortion protests. The Biden administration cracked down on a resurgence of these tactics of physically blocking reproductive health clinics and then resisting arrest and prosecuted dozens under the federal law, including attacks on anti-abortion pregnancy centers, which the law also protects. Anti-abortion activists have claimed the Biden administration disproportionately prosecuted those who oppose abortion.

The Chicago-based nonprofit legal group the Thomas More Society filed petitions on behalf of 21 of the 23 pardoned individuals, arguing Biden’s Justice Department weaponized the law, which is also how Trump has justified his more than 1,500 day-one pardons and commutations of individuals who invaded the U.S. Capitol on Jan. 6, 2021, some of whom violently attacked police officers.

Brittany Fonteno, the CEO and president of the National Abortion Federation, which tracks violence and harassment at abortion clinics, told States Newsroom she is concerned the Trump administration is going to turn a blind eye to dangerous events at abortion clinics.

“What we’ve seen is that over the years, and in particular after the Dobbs decision, there has been a stark increase in violence and disruption from anti-abortion activists and advocates,” Fonteno said. “We’ve seen an increase in burglaries and arson and threats to abortion providers, and we anticipate that that will only increase with this new administration, as anti-abortion extremists are empowered and emboldened to try to create a culture of fear around abortion care.”

‘Personhood’ advocates seize on ‘conception’ language in executive order on gender

Aside from the anti-abortion pardons, none of Trump’s many executive orders issued during his first week in office concerned abortion.

Thus many in the anti-abortion movement are far from confident that Trump will make abortion more difficult to access, let alone get closer to their larger goal of enshrining fetal personhood rights in the U.S. Constitution.

But some leaders were reassured by a different executive order Trump signed, related to another Christian-right issue: gender. He issued an order on his first day in office that says the U.S. will only recognize two genders, declares that “‘Female’ means a person belonging, at conception, to the sex that produces the large reproductive cell,” and “‘Male’ means a person belonging, at conception, to the sex that produces the small reproductive cell.”

Anti-abortion groups, such as Students for Life of America, viewed the order as a win for the so-called fetal personhood doctrine.

Other leaders have praised some of Trump’s appointees for their anti-abortion positions such as Attorney General appointee Pam Bondi and Secretary of State appointee Marco Rubio.

Though many were disappointed that Trump’s Health and Human Services appointee Robert F. Kennedy Jr. has supported abortion rights, they are still working to wield influence in this critical agency.

Students for Life of America president Kristan Hawkins posted this week on X that an alum from her group “will be serving in a key role at HHS! This is a great sign for life saving measures to come!” She also posted a picture of herself holding a “Defund Planned Parenthood” sign alongside Republican Speaker of the House Mike Johnson, who also spoke at the March for Life. Hawkins wrote in the post, “Speaker Mike Johnson is on board! Planned Parenthood, we’re coming for you next.”

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Tabitha Crowe said she woke up around 4 a.m. one Thursday in August covered in blood. She was visiting her parents in southern Louisiana when she started miscarrying her first pregnancy. She said her mom and dad drove her to a nearby hospital while she fought dizziness from the blood loss in their back seat.

“I didn’t even know I could bleed that much,” Crowe told States Newsroom.

Over the course of the next few days, Crowe said she passed baseball-sized blood clots and experienced extreme pain and dizziness in two different hospitals, while never being offered a common miscarriage procedure, even after she requested it.

An estimated 10 to 20% of known pregnancies in the U.S. end in miscarriage. In about 80% of miscarriages, women are able to expel the pregnancy tissue naturally over a period of one to eight weeks, according to the American College of Obstetricians and Gynecologists. When intervention is necessary in the first trimester, ACOG recommends abortion medications or procedures such as vacuum aspiration or dilation and curettage (D&C). Later in pregnancy, recommended termination procedures include dilation and evacuation (D&E), which has a high safety record but is condemned by anti-abortion groups and banned in some states.

But increasingly, women say they are being denied routine miscarriage care in states like Louisiana, where doctors face imprisonment if they perform an abortion unless a woman is at risk of dying, and where common miscarriage drugs are now more difficult to access. Doctors in Louisiana and Texas have also reported a rise in patients whose pregnancies are no longer viable receiving more risky and invasive terminations, such as Cesarean sections and inductions, in lieu of abortion procedures. It’s a change in practice some doctors involved in the anti-abortion movement endorse.

And in cases like Crowe’s — where death might not be imminent but failing to intervene could increase the risk for infection or other issues — some doctors are telling patients to finish their miscarriages at home.

“I think they were waiting for me to get in bad enough health,” said Crowe, who attributes her experience to Louisiana’s abortion ban, though she said no medical staff mentioned the law or responded to her requests for a D&C.

But waiting for patients’ conditions to worsen can sometimes be fatal, according to an ongoing investigation by ProPublica, which has reported on five deaths linked to abortion bans, most recently a young mom in Texas who spent hours in the ER but was never offered a D&C that could have saved her life.

As stories emerge linking abortion bans to adverse health effects, some state health departments are working to make these stories harder to learn about.

In Georgia, officials recently dismissed all 32 members of the state’s Maternal Mortality Review Committee following ProPublica’s reporting that the committee linked two women’s deaths to Georgia’s six-week abortion ban. The state said it would reset the committee through a new application process and is considering measures to ensure patient confidentiality.

In Texas, ProPublica reported that at least three women have died because of delays in care caused by the state’s abortion bans. Despite these reported deaths, Texas’ Maternal Mortality and Morbidity Review Committee said it wouldn’t examine any pregnancy-related deaths from 2022 and 2023, the first two years after the state’s near-total abortion ban took effect, according to the Washington Post.

Idaho, shortly after banning abortion, disbanded its Maternal Mortality Review Committee in 2023 after members recommended expanding Medicaid. The recently re-established committee is now backlogged and focused on publishing 2023 data in January before tackling 2022 data. The committee’s last report, based on 2021 data, showed the state’s maternal mortality rate had doubled in recent years and most of the deaths were preventable.

Crowe said her experience has moved her to speak out for better reproductive health care.

“For me to have a miscarriage for the first time, it’s already a very scary process,” said Crowe, who said she eventually got the care she needed outside of Louisiana. “You go to a hospital, you expect care, you expect some type of answers on what’s going on. And I didn’t get that.”

‘I had a sense it was because of the abortion laws’

Crowe and her husband, Noah Holesha, live on the Eglin Air Force Base in the Florida Panhandle. Crowe said her husband is in the Army and she was medically discharged from the military in 2023 and now works as a caretaker. The two married in 2022 and were expecting their first baby in February.

But on the way to LSU Health Lallie Kemp Medical Center in Independence, Louisiana, on Aug. 8, Crowe said she felt she would never get to meet this baby. Two weeks earlier, her 10-week-old fetus only measured 6 weeks. Now in the emergency room, Crowe said medical staff gave her pain medicine, cleared her blood clots, and discharged her to finish miscarrying naturally.

Two days later at her parents’ house, Crowe said she woke up with 10 out of 10 pain.

“I was in excruciating pain again, like screaming and crying pain,” she said.

She said her parents took her back to Lallie Kemp, where they transferred her to St. Tammany Parish Hospital Emergency Department in Covington, about a 45-minute drive, because it was the nearest hospital with a dedicated OB-GYN unit.

“Lallie Kemp Medical Center complies with federal patient privacy laws and therefore cannot discuss specific patients’ care,” Dr. Matloob Rehman, the hospital’s medical director, said in an email. “Lallie Kemp is a small, rural hospital without a full complement of specialists, including obstetrical surgery. If a patient is in need of such care, it is Lallie Kemp’s practice to refer or transfer the patient to a hospital that can provide such services.”

At St. Tammany, Crowe said she spent the day receiving pain medicine and transvaginal ultrasounds and having her vaginal canal cleared of clots. Medical records Crowe shared with States Newsroom indicate she was given misoprostol to evacuate her uterus, which Crowe said she was not aware of. She said the ultrasounds were still showing she had not completed the miscarriage. Crowe’s cousin had recently miscarried, so she and her family knew to ask for a D&C.

“They did ultrasounds and all that, but they didn’t help make sure that the miscarriage was completing,” Crowe said. “We kept telling them, ‘Hey, can y’all just do this D&C, so like we can be done with this pain?’ They wouldn’t answer.”

Crowe’s sister, a nurse in Texas, where abortion is also banned, suggested in a text that maybe it was because of Louisiana’s abortion ban that she wasn’t being offered a D&C.

“I had a sense it was because of the abortion laws, because by the time they did the canal sweep of blood clots, they didn’t even want to listen that I was in pain anymore. They were like, brushing it off, like, you’ll be fine,” Crowe said. “Even if them not doing it was wasn’t because of the abortion laws, I still didn’t get the treatment that I needed.”

Crowe said she was still dizzy and in pain when St. Tammany released her late on Aug. 10. Her St. Tammany hospital medical records say her miscarriage was completed at St. Tammany, which Crowe disputes. Medical records from the hospital in Florida, where she received the D&C, say the patient had an “incomplete miscarriage with evidence of retained POC [products of conception] on TVUS [transvaginal ultrasound], continued bleeding and anemia.”

The St. Tammany Health System Communications Department declined to comment on Crowe’s account, citing patient confidentiality, and said in a statement: “At St. Tammany Health System, we place our patients and their families’ wellbeing first. Patient privacy rights are established by the Federal Health Insurance Portability and Accountability Act (HIPAA). In compliance with this act, we are not at liberty to provide information or comment.”

Crowe decided to drive the four hours back to Florida. She said her pain had ebbed, but soon after she got home, her husband rushed her to Eglin Air Force Base emergency department, where she said she received a D&C the following day.

The Eglin hospital did not respond to requests for comment.

Crowe said she was still dizzy in the weeks following, and she was confused and angry, believing — without confirmation — that she was denied health care she needed because of a new abortion law. She said she started reaching out to malpractice attorneys, reproductive rights groups, even President-elect Donald Trump.

“I sent everybody emails.” Crowe said. “I reached out to Congress. I reached out to the office of Trump. I reached out to lawyers. It wasn’t anger that I’ve lost the child — because I had a feeling I was going to lose the child — but it was the anger of they didn’t give their 100% care. I was getting in bad shape, health-wise, because of it.”

Louisiana abortion laws affect miscarriage care

Louisiana was one of the first states to ban abortion after the U.S. Supreme Court overturned Roe v. Wade in 2022. And it’s the first, followed by Texas, to reclassify two abortion and miscarriage medications — mifepristone and misoprostol — as controlled substances, even though they haven’t been shown to cause addiction or dependence. In late October, health care workers sued the state, arguing that the new law is unconstitutional and has added barriers to emergency care.

One of the legal advocacy groups representing plaintiffs in that case, Lift Louisiana, co-published a report with Physicians for Human Rights with detailed interviews from patients, doctors and clinicians of how the state’s abortion ban has changed reproductive health care in Louisiana. The report found that some OB-GYN practices are now deferring prenatal care until beyond the first trimester, when miscarriage care is more common. Some clinicians reported an increase in patient referrals from rural hospitals for routine care.

“To avoid the risk of criminal penalties under the bans, nearly every clinician relayed an account

in which they and/or their colleagues delayed abortion care until complications worsened to

the point where the patient’s life was irrefutably at risk,” the report reads.

Crowe said she was grateful she was able to get treated, not a given in Florida, which has a six-week abortion ban and where patients have also reported being denied miscarriage treatment. But she lives on a military base, under federal jurisdiction. With a soon-to-be GOP majority in Washington, D.C., anti-abortion activists are pushing Trump to restrict pregnancy termination at military hospitals.

Though she personally disagrees with abortion after the first trimester, Crowe said she now believes in abortion rights.

“Growing up, I was always pro-life, because I always wanted to have a kid and all that,” Crowe said. “I was also the type that’s like, I’m not going to judge you if you do. Now I’m like … the choice to have an abortion is important because some women … we need this procedure done to save our lives, too. My child was already lost; it lost its life. Because of the abortion laws, you’re keeping me from having my life. … I couldn’t grieve because I was in so much pain.”

Editor’s Note: This is the sixth installment of an occasional States Newsroom series called When and Where: Abortion Access in America, profiling individuals who have needed abortion care in the U.S. before and after Dobbs. The first installment can be found here, the second installment is here, the third is here, the fourth is here, and the fifth is here.

NC Newsline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. NC Newsline maintains editorial independence. Contact Editor Rob Schofield for questions: info@ncnewsline.com. Follow NC Newsline on Facebook and X.