Here Are Trump’s Major Moves Affecting Access to Reproductive Healthcare

In his first month in office, President Donald Trump and his Administration have taken a number of actions affecting abortion and reproductive healthcare access, both within the United States and internationally—and reproductive rights advocates worry that more is still to come.

Trump has publicly expressed his anti-abortion views, but he was vague during his most recent presidential campaign about the specific moves he would make on abortion, sidestepping questions about whether he would veto a national ban if it crossed his desk. However, reproductive rights activists, medical providers, politicians, and legal experts feared and expected that his Administration would curtail access to abortion, as well as other reproductive health services.

Mary Ziegler—a professor at the University of California, Davis School of Law with an expertise in abortion—says that some of the actions the Trump Administration has taken so far on the issue are “part of the standard playbook for Republican presidents.” She adds, “There’s a sort of pendulum that swings back and forth depending on whether a Republican or Democrat is in the White House.” At the same time, Ziegler says Trump has taken some of these actions a step further, such as when his Justice Department said that it would be curtailing prosecutions against anti-abortion protesters accused of obstructing access to abortion and reproductive health clinics. While the Administration has already taken several significant steps on abortion, Ziegler says, “we’re still in kind of a wait and see mode” for others.

“He didn’t ask day one for Congress to pass and deliver to his desk an abortion ban, [but] no one should take comfort in that,” says Nancy Northup, president and chief executive officer of the Center for Reproductive Rights. “This Administration is going to be the most anti-abortion Administration that we’ve ever seen in U.S. history, with no backstop of federal constitutional protection. The steps that he’s taken so far do reveal that it is going to be a vibrant anti-abortion agenda.”

Here are the major moves the Trump Administration has made so far affecting reproductive healthcare access.

What has the Trump Administration done to affect access domestically?

In his first week in office, Trump pardoned several anti-abortion protesters convicted of violating the Freedom of Access to Clinic Entrances (FACE) Act, a 1994 law meant to protect abortion clinics and their patients by prohibiting people from physically blocking or threatening force against patients. A day later, a top official in Trump’s Justice Department issued a memo that said prosecutions against people accused of violating the FACE Act will now “be permitted only in extraordinary circumstances” or in situations where there are “significant aggravating factors,” effectively ordering the department to curtail such prosecutions. 

Under former President Joe Biden, the Justice Department pursued cases against dozens of people accused of violating the FACE Act. While Ziegler says many expect that the law won’t be enforced as rigorously under a Republican president, this announcement takes it a step further by openly declaring that the department won’t be prioritizing these cases.

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Northup says that six of the people who were pardoned by Trump’s order had been convicted last year of violating the FACE Act, after they had blocked patients from entering a Michigan reproductive healthcare clinic that the Center for Reproductive Rights represents. “This is sending a clear signal to anti-abortion extremists that the Trump Administration will turn a blind eye to the type of blockades and violence and threats of violence that women have to go through to get access to the clinics, and that clinic staff have to deal with on a daily basis,” Northup says.

Also in his first week in office, Trump signed an Executive Order committing to enforcing the Hyde Amendment, which prohibits federal funds from being used for abortion. The order revokes two Executive Orders that Biden had signed during his presidency—one that encouraged the government to widen and protect reproductive healthcare access, and another that categorized abortion as healthcare.

Northup accuses Trump of slipping anti-abortion sentiment into other policies he’s enacted in his first month in office. She points to the Executive Order the President signed that proclaimed that the U.S. will only recognize “two sexes, male and female.” “That [order] obviously both guts access to gender-affirming care, which is of deep concern, but also in that Executive Order itself, it embedded personhood language because when it talked about there being a policy of the United States to recognize two genders, they basically said that a person begins at conception,” Northup says. “They are sneaking into all federal policy this notion of personhood beginning with a fertilized egg as opposed to all rights and privileges that begin at birth.”

Reproductive rights advocates say that Trump and his Administration have made their anti-abortion views clear. Soon after Trump was sworn in, reproductiverights.gov, a federal website launched under the Biden Administration that shared information about abortion and reproductive healthcare, went dark. That same week, Vice President J.D. Vance gave an in-person speech at an annual anti-abortion rally, March for Life, in Washington, D.C., calling Trump the “most pro-life American President of our lifetimes” and praising the actions Trump took on abortion in his first presidential term, crediting him for the U.S. Supreme Court’s ruling in the 2022 Dobbs v. Jackson Women’s Health Organization decision that overturned Roe v. Wade. While Trump didn’t appear at the rally in person, he gave a pre-recorded video address, in which he promised to support anti-abortion protesters.

What has the Administration done to affect access internationally?

Experts say that one of the most significant actions Trump has taken in his first month affecting access to reproductive healthcare globally is the Administration’s freeze on foreign aid. The U.S. government provided more than 40% of all humanitarian aid that the United Nations tracked during 2024, and is the largest single aid donor in the world. For the 2024 fiscal year, Congress appropriated $575 million for family planning, in addition to $32.5 million for the United Nations Population Fund, the UN’s sexual and reproductive health agency, according to the Guttmacher Institute, which researches and supports sexual and reproductive health and rights. Elizabeth Sully, principal research scientist at the Institute, says that level of funding has generally received bipartisan support and has been stable for nearly a decade. Because of the Helms Amendment, which bars using foreign assistance to fund abortions, that money wasn’t going toward abortion care, Sully says.

According to a recent Guttmacher analysis, those funds can provide 47.6 million women and couples with contraceptive care every year and prevent 17.1 million unintended pregnancies, which can save the lives of an estimated 34,000 women and girls who, without that care, could have died from pregnancy and childbirth complications. “Family planning is a life-saving intervention,” Sully says.

But with the freeze, international family planning programs receiving U.S. aid have been forced to halt services, and the Guttmacher Institute estimates that more than 3 million women and girls have been denied contraceptive care so far as a result. The Guttmacher Institute predicts that, over the course of the full 90-day review period, about 11.7 million women and girls will be denied contraceptive care, leading to 4.2 million women and girls experiencing unintended pregnancies, and 8,340 dying from pregnancy and childbirth complications. On Feb.13, a federal judge ordered the Trump Administration to temporarily lift the suspension of foreign aid, but the Administration’s lawyers are defending the freeze, arguing that the judge’s order doesn’t prevent the State Department from suspending foreign assistance programs. At this point, it’s unclear if the judge’s order will lead to the resumption of foreign assistance programs.

“What’s so hard right now is the unpredictability of all of this,” Sully says. “You can go to a clinic now that maybe you’d been to before, and that’s where you’d been receiving your injections or your contraceptive pills, or you were talking with a provider about an IUD, and you show up to that clinic now and its doors are closed, or there’s no commodities in stock, and no one can tell you when to come back.”

Dr. Sierra Washington, director of Stony Brook’s Center for Global Health Equity and a member of the International Federation of Gynecology and Obstetrics’ Committee on Safe Abortion, practices medicine in Mozambique. She says the United States Agency for International Development (USAID) provides a lot of care in Mozambique, and that the impact the freeze will have “keeps [her] up at night.” She worries the freeze will lead to a resurgence of HIV, rise in unsafe abortions, and an increase in maternal mortality.

“It’s just a matter of weeks before we’ll start to see real impact on shortages in condoms and contraceptives starting to plague the entire health system, and that just means we’re going to see more women dying of unsafe abortion and dying of unsafe delivery,” Washington says. “It’s just a real tragedy.”

“I don’t believe that [Trump Administration officials] understand how interrelated we all are, and that condoms … actually prevent the spread of HIV, and that HIV doesn’t really respect international borders,” she continues, adding that a rise in HIV prevalence could “reach the American border and will permeate throughout the world.”

Also in his first week in office, Trump reinstated the Global Gag Rule, which prohibits foreign organizations receiving U.S. aid from providing, referring to, or discussing abortion care. Many reproductive health experts anticipated the move, since it’s a policy often enacted by Republican presidents and rescinded by Democratic ones. During Trump’s first term in office, he expanded the order to apply to any global health funding distributed by the U.S., not just ones specific to family planning services, which Sully says had “far-reaching impacts” beyond abortion care. The Guttmacher Institute found that in some regions in Ethiopia and Uganda, the previously seen trend of increased contraceptive use came to a halt or even reversed course after the first Trump Administration enacted the Global Gag Rule.

“Its supposed intended aim is abortion, but when you have declines in family planning, you have more people who end up having unintended pregnancies, and you actually have more abortions,” Sully says.

The Trump Administration also announced that the U.S. was rejoining the Geneva Consensus Declaration, a non-binding pact the U.S. had joined toward the end of Trump’s first term that promotes anti-abortion policies and has garnered support from more than 30 countries, including Uganda and Hungary. Biden withdrew the U.S. from the declaration when he took office.

What could Trump do next?

Most experts TIME spoke to agree that the Trump Administration will continue to take steps curtailing abortion and reproductive healthcare access.

One of the most pressing issues experts are watching is what actions the Administration will take on mifepristone, a drug that was approved by the U.S. Food and Drug Administration (FDA) for abortion purposes more than two decades ago but has recently been unsuccessfully challenged in court by a group of anti-abortion doctors and organizations. During his confirmation hearings to be Secretary of Health and Human Services, Robert F. Kennedy Jr. gave vague responses when asked about mifepristone, saying only that the President asked him “to study the safety” of the drug but “has not yet taken a stand on how to regulate it.” 

Ziegler says it’s hard to say if the Trump Administration would revoke the FDA’s approval for mifepristone entirely, or if it would roll back Biden-era policies that made the drug more accessible, including allowing it to be prescribed via telehealth and received by mail. Either move would have a significant impact on abortion access nationwide; Northup says that access to medication abortion through telehealth and mail has been a “lifeline” to many patients in a post-Dobbs America.

Read More: How the Biden Administration Protected Abortion Pill Access—and What Trump Could Do Next

Experts are also waiting to see if the Department of Justice will use the Comstock Act, a 19th century anti-obscenity law, to ban the mailing of abortion pills. Looking further down the line, Ziegler says that Trump will likely continue to appoint conservative federal judges, as he did in his first term, who can have a major impact on abortion laws, now that many state-level restrictions are being fought in court. It can take time for Trump to pick judges and get them confirmed, let alone the years it can take for cases to be filed and work their way up through the court system, so the impact may not be immediate, but it could be considerable.

“Those judges will be making decisions that impact access to abortion, contraception, in vitro fertilization, all kinds of reproductive health services,” Ziegler says. “Over time, the more the courts are transformed, the more, I think, explosive kinds of outcomes we can see on reproductive issues.”

Some expected the Trump Administration to make even more dramatic moves on abortion soon after the President was sworn in. Part of the holdup may be because Trump and his Administration could have “some trepidation” about taking dramatic steps if Trump is trying to appeal to both the majority of Americans who support abortion rights and his anti-abortion supporters, Ziegler says. Sully also notes that, “Trump took office right away, but we’ve had to wait for confirmations for a number of leaders of these departments” who would oversee many abortion-related policy changes, including on mifepristone and the Comstock Act.

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Advocates maintain that people should be concerned about what’s to come. Northup points out that Roe was in effect throughout Trump’s first presidency, offering a “really important protection” that restricted what steps his Administration could take on abortion. Now that Roe has been overturned, that constitutional right guaranteeing abortion access and limiting his authority is no longer in place, Northup says.

“Everybody who cares about access to abortion care—and that is the strong majority of people in the United States—should be on red alert for what this Administration will do to try to cut off access in those states where abortion is still legal,” Northup says.