With the legal and political landscape still roiling, here are 10 surprises from the past year.

1. SCOTUS wanted to wash their hands of the abortion issue. That’s not happening.

The justices who overturned Roe v. Wade declared at the time that decision-making power over abortion access belongs with the public via their elected officials and that it’s wrong for unelected judges to “override the democratic process” and set national abortion policy.

But it took less than a year before the high court intervened in a high-profile lawsuit challenging the abortion drug mifepristone — freezing a lower court order that could have banned its use nationwide.

Several more cases working their way through the courts could land before the justices next term.

One lawsuit pending at the 6th U.S. Circuit Court of Appeals challenges the Biden administration’s rules for the Title X family planning program — particularly a requirement that providers counsel patients about all of their options, including abortion. A different case in Texas targets Title X’s practice of providing contraception to teens without their parents’ permission.

Another case at the 5th Circuit argues Texas’ near-total abortion ban violates the religious rights of Satanists, for whom abortion is a religious ritual. The Justice Department has also sued multiple states with abortion bans for violating the federal law — known as EMTALA — that guarantees the right to treatment in a medical emergency.

2. The right isn’t united on a path forward.

The anti-abortion movement worked for nearly five decades to overturn Roe v. Wade. Now that they’ve achieved that, they’re faced with competing visions about what the post-Roe future should look like.

GOP lawmakers in Indiana, South Carolina and West Virginia spent portions of the past year accusing one another of either being too soft or too extreme on abortion. Some lawmakers favor banning abortion at conception. Others support prohibitions around six weeks. Some support abortions only when the pregnant person’s life is in danger. Others believe in exemptions for rape, incest or a lethal fetal anomaly.

In some cases, the bitter, public fights have delayed or stalled anti-abortion legislation at the state and federal levels.

Soon after winning back the majority earlier this year, House Republicans passed two measures to condemn attacks on crisis pregnancy centers and penalize doctors who refuse to care for infants who are born after an abortion attempt. But they haven’t made good on their pledge to hold a vote on a national abortion ban, despite pressure from anti-abortion groups to do so.

3. The left isn’t united, either.

While state-level Democrats broadly support restoring access to abortion until viability — as was allowed under Roe — some progressive groups want to go further.

In Missouri, the local Planned Parenthood affiliate believes there should be no government limits on abortion and backed out of the campaign to put a constitutional right to abortion on the ballot because most of the versions submitted to the state would prohibit the procedure once the fetus is viable, around 24 weeks of pregnancy.

Other abortion-rights groups, however, argue that the viability standard is broadly supported by the general public and has the best chance of passing at the ballot box.

The left is also divided on parental notification laws. Some abortion-rights advocates pushing to repeal parental notification laws in blue states say they create unnecessary barriers and paperwork problems for minors who want to obtain abortions, and that in some cases, a minor may face emotional or physical harm if their parent is told about the abortion. But they’ve faced resistance from Democratic state lawmakers who are squeamish at the thought that a child would receive an abortion without a parent knowing.

4. Abortion rights are winning at the ballot box. Both sides are behaving accordingly.

Abortion-rights proponents prevailed on all six abortion-related ballot measures last year — including in red states like Kentucky and Montana.

Energized by those wins, abortion-rights groups in Florida, Missouri, Ohio and South Dakota, are angling to get measures on the ballot either this year or in 2024 that would codify the right to abortion in those states’ constitutions.

Meanwhile, anti-abortion groups are mobilizing to prevent those measures from reaching voters, in what they say is an effort to keep deep-pocketed, out-of-state groups from spending millions to sway policy. GOP lawmakers in several states introduced bills this year to make it harder to get abortion-rights measures and other progressive proposals on the ballot. Anti-abortion groups have also appealed to the executive and judicial branches in Missouri and Ohio, respectively, to stymie the proposed measures.

5. Republicans are struggling to define their abortion views heading into 2024.

GOP leaders’ celebration of the fall of Roe quickly gave way to a debate over what a future Republican president could or should do to further restrict abortion access.

Influential anti-abortion advocacy groups are pushing all Republicans running for president in 2024 to commit to signing a national ban — with some disagreement over whether it should bar the procedure after 15 weeks, six weeks or at conception. But few GOP candidates have laid down a clear marker, torn between a primary base that supports sweeping action to limit abortion and a general electorate that largely believes abortion should be legal. Many have deflected and dodged. Some have attacked one another for either going too far or not far enough in their plans to ban abortion, and some, including former President Donald Trump, have blamed anti-abortion groups for GOP losses in the 2022 midterms.

6. State constitutions in some surprising places may protect abortion rights — the state Supreme Court just has to say so.

The South Carolina Supreme Court in January ruled that a state ban on abortions after about six weeks of pregnancy was unconstitutional under the right to privacy in the state constitution. Later the same day, the Idaho Supreme Court found the opposite: that the state has a “legitimate interest in protecting prenatal fetal life in all stages of development, and in protecting the health and safety of the mother.”

Since Roe was overturned, 40 cases challenging abortion bans have been filed in 22 states, and 29 are pending at the trial or appellate court level, according to the Brennan Center for Justice at New York University School of Law.

Because of the key role state supreme courts will play on abortion moving forward, abortion-rights and anti-abortion groups have poured substantial sums into state supreme court races, including last fall in Ohio and North Carolina, where conservatives were victorious, and this spring in Wisconsin, where the liberal candidate won.

7. Most doctors will not break the law.

Progressive activists’ calls for mass civil disobedience in the wake of Dobbs have not been answered by the medical community. Threatened with jail time and the loss of their medical licenses, physicians in states with abortion restrictions have largely erred on the side of caution — with many refusing to provide abortions even in circumstances when they are ostensibly allowed. Reports of patients being turned away when experiencing a miscarriage or other obstetric emergency, or being forced to carry nonviable pregnancies to term, have proliferated.

Some physicians have shied away from providing emergency contraception, which no state prohibits. Many doctors also report being fearful of providing information to their patients — even if it’s already publicly available — on where to obtain abortion pills or where to travel for the procedure.

No physician has been criminally charged for providing an abortion in the past year, but an Indiana OB-GYN was reprimanded and fined by the state medical board for speaking publicly about providing an abortion to a 10-year-old rape victim from Ohio.

8. Abortion is difficult to separate from other health care.

Since the Dobbs ruling, pharmacists across the country have denied and delayed prescriptions for everything from rheumatoid arthritis to lupus to acne out of fear the drugs could be used to terminate a pregnancy. Medical residents are increasingly avoiding states with abortion bans and practicing physicians are relocating, exacerbating existing shortages and leaving patients with few places to turn to for care. Lawsuits targeting abortion pills have the pharmaceutical industry on edge, and medical experts fear they’ll be deterred from submitting new treatments to the FDA.

A national survey by the Kaiser Family Foundation released this week found that about 40 percent of OB-GYNs have run into barriers to providing treatment for miscarriages and pregnancy-related emergencies over the past year because of state bans. A larger share, 64 percent, say they believe the Dobbs decision has “exacerbated pregnancy‐related mortality” though post-Dobbs data is not yet available to substantiate their claim.

Some conservatives have acknowledged that the abortion bans they supported have made other health needs more pressing and are pushing for policies they once fiercely opposed — from expanding Medicaid postpartum coverage to broadening access to contraception.

9. Religion cuts both ways.

State and federal officials have frequently invoked religion when enacting restrictions on abortion over the past year — even, in some cases, putting religious language into the text of the laws. But religious freedom arguments could help topple those bans.

Clergy members and practitioners of everything from Judaism to Satanism have filed nearly a dozen different challenges to state abortion laws in state and federal court. Most of the suits seek religious exemptions to state abortion bans, arguing that the laws infringe on their right to free exercise, while a few ask courts to block the bans altogether because they violate the separation of church and state by imposing one religion’s view of when life begins on the entire population.

Legal experts say the strategy has a decent chance of persuading courts to loosen or block state bans, and challengers have already secured temporary wins in Indiana and Wyoming.

But the plaintiffs say that if they don’t prevail in court, they hope to show the public that there is more diversity of thought about abortion within religious groups than many assume. That argument is reflected in post-Dobbs polling, which found that majorities of most religions believe that abortion should be legal in most or all cases.

10. Fears of states reaching across their borders to prosecute abortion providers have not come to pass.

Several blue states have, over the past year, enacted laws and executive orders to protect doctors who provide abortions to out-of-state residents, shielding medical records and blocking state officials from cooperating with any subpoenas. But no red states to date have tried to prosecute out-of-state doctors who have provided abortions to their residents, though some Republicans have expressed a desire to do so.

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