We’ll need to fight to protect US reproductive rights. Here’s what to expect | Sophie Brickman

At around 10pm ET on election night, with prediction needles listing rightwards, and various friends' group chats starting to become inundated by the river-of-tears-down-my-face emoji – even that early, we were collectively way beyond a single tear – I left Steve Kornacki frantically bobbing and weaving around a map of Georgia, and went to bed. Somehow, I slept through until the morning, when I awoke in "Trump's America", as news organizations were calling it, and to a torrent of emails and notes from friends bemoaning, among other things, the very real possibility of a federal abortion ban.

"Are we still gonna have birth control?" one friend texted, in disbelief.

"Sorry for the US you're waking up to," another wrote from Oxford. "Confounding," his wife echoed, from across the pond.

And so, to get a clear-eyed, postmortem picture of what might be facing women and their loved ones in America, two days after the election I called up Nancy Northup, the president and CEO of the Center for Reproductive Rights , an advocacy group with a stated mission of "using the power of law to advance reproductive rights as fundamental human rights around the world".

In practice, that means unleashing an army of seasoned litigators to fight for abortion access, among other things, in courtrooms across the country and around the world – they currently work in five continents. She began as CEO in 2003, 30 years after Roe v Wade constitutionally protected abortion rights. Twenty years later, after fighting the good fight for decades, she and her litigators are revving up for what might be the fight of their careers.

"We were always accused before Roe v Wade was overturned [of] crying wolf," Northup told me on the phone from her office in Manhattan. "People don't need to worry about whether or not we're crying wolf now."

There are the women who have died when denied abortions by healthcare providers who are unsure of the legal ramifications of performing abortions unless the mother's life is at risk. There are those who have spent days in the ICU after being denied care, and emerge with their future fertility forever compromised. There are the obstetricians fleeing states with strict abortion bans (over 20% of practitioners in Idaho, and over half of high-risk obstetricians), feeling that they are unable to safely, and properly, do the job they trained years to do. There are the downstream consequences of bans in restrictive states affecting states with robust abortion protections, simply because those who can travel to receive care end up taking appointments away from local residents.

The question that kept circulating among my friends in the hours after the election results became clear was: How come seven out of 10 measures to protect reproductive rights passed at the state level, and Trump still won?

Northup chalks the dissonance up to two things.

"There's a difference between what policy do I want, and what candidate do I like," she said. "Of course they should be linked, but we can see that they aren't."

On top of that, Northup fears there are too many mental leaps to make.

"Most people think, You know what, if the right to abortion is protected in my state, I'm good. They don't realize a federal abortion ban could override their state's rights."

While she wrote in a statement after the results came in that Trump's first term "lead to the deaths of numerous women who are likely the tip of the iceberg", she said it was too early to paint a picture of just how large that iceberg might loom in his second. Still, she underscored that even if a bill isn't signed into law – something she pointed out Trump has said he wouldn't do, though "consistency isn't the hallmark of the president-elect" – there are ways to threaten abortion access at a national level.

Northup and other colleagues at the Center held an open video meeting a few hours before we spoke, the tone of which was sober, with lots of "no way to sugarcoat what we're facing right now", and "serious situation" and "tough road ahead".

Among her top concerns are, first, the fear that new laws will threaten patients' access to medication abortion – something she calls "a lifeline", as two-thirds of patients in the US use it – either by the FDA restricting mifepristone, or states using a 1873 chastity law known as the Comstock Act, which bans "any drug, medicine, , or thing designed, adapted, or intended for producing abortion" from being transported by a mail carrier; and, second, the targeting of populations in states with bans. She recently found herself on the phone with a woman whose family was leaving Texas to get an abortion in New York, and wasn't sure if her husband should come with her or not.

"That's a culture, or a climate, of fear of prosecution, and intimidation, and silencing," she said. "It has a chilling effect."

And it's a chilling effect that the minority of American voters want to cast over the country. One exit poll noted that while voters in 10 "key states" believe by a wide margin that abortion should be legal, only 14% considered it their most important voting issue.

I reached out to a friend who works in the reproductive rights space for help parsing through this disconnect.

"The lack of urgency that voters placed on this issue may reflect an erroneous belief that state protections can save them; misplaced faith in Trump's softened messaging on abortion; or simply a reality that many are struggling to make ends meet and feel abortion is an issue they can't afford to think about today," she wrote. "Who knows."

Whatever the reason, it means the litigators at CRR have their work cut out for them, as they fight for what the majority of Americans want.

Right now, Northup is revving up for a case that will start on Tuesday in Idaho, arguing that the state, by refusing to give stabilizing care to pregnant women in emergencies, is violating the Emergency Medical Treatment and Active Labor Act (Emtala), a federal law that ensures access to emergency care. And she is gaining strength from success stories, like Missouri, which overturned its near-total abortion ban on Tuesday, despite electing Trump, something she called "stunning". (She remembers having a conversation with a senator in Missouri years ago, and bringing up the question of just how to talk about abortion rights in the state. The senator's advice: "Don't.")

How does she feel?

"Armored up and ready to go."

For those of us who might not feel that way, there are other ways to help. On the video call, one colleague offered three action items: First, take care of yourselves and your communities. Second: sign up for alerts from the Center. Finally, find and donate to a local abortion access fund.

Godspeed.