In his first month in office, President Donald Trump and his team have taken several steps that influence abortion and reproductive healthcare access, both within the United States and globally. These actions have sparked worries among advocates for reproductive rights about what could come next.

While Trump has expressed strong anti-abortion views, he was often vague about specific policies during his campaign, particularly when asked about endorsing a nationwide abortion ban. Despite his ambiguity, those advocating for reproductive rights, along with healthcare professionals, lawmakers, and legal experts, anticipated that his administration would seek to limit access to abortion and reproductive health services.

Mary Ziegler, a law professor specializing in abortion at the University of California, Davis, points out that many of the Trump administration’s actions reflect typical Republican strategies. She observes that the political climate shifts with the party in power, but emphasizes that Trump has amplified certain actions, like the Justice Department’s decision to minimize prosecutions of anti-abortion protesters who obstruct clinic access. Ziegler notes that while significant actions regarding abortion have already occurred, “we’re still in a wait-and-see phase” about what may happen next.

Nancy Northup, President and CEO of the Center for Reproductive Rights, warns that even though Trump has not promptly pushed Congress for a national abortion ban, it would be unwise to assume this reflects a lack of ambition. She states, “This administration is shaping up to be the most anti-abortion in U.S. history, especially with no federal constitutional protections currently in place. The actions taken so far indicate a strong anti-abortion agenda.”

Here are some significant actions launched by the Trump administration that affect access to reproductive healthcare.

What domestic actions has the Trump Administration taken?

In his first week, Trump pardoned several anti-abortion activists convicted under the Freedom of Access to Clinic Entrances (FACE) Act, which was enacted in 1994 to safeguard abortion clinics and their patients from threats and obstructions. The following day, a senior official from Trump’s Justice Department distributed a memo indicating that prosecutions under the FACE Act would now only occur in “extraordinary circumstances” or when there are “significant aggravating factors,” essentially instructing the department to limit such prosecutions.

In contrast, the previous Biden administration actively pursued numerous prosecutions related to FACE Act violations. Ziegler expects a decrease in enforcement under a Republican administration, and this new directive signals a clear reduction in prioritizing these cases.

Read More: The Impact of Trump’s Appointees on Abortion Policies

Northup highlights that six of the pardoned individuals had been found guilty of blocking access to a reproductive healthcare facility in Michigan, which the Center for Reproductive Rights advocates for. She remarks, “This sends a strong message to anti-abortion extremists that the Trump administration will turn a blind eye to the blockades, violence, and threats women face while seeking clinic services, as well as the daily struggles of clinic staff.”

Additionally, Trump signed an Executive Order during his first week to enforce the Hyde Amendment, which bars federal funding for abortions. This action reversed two Executive Orders from Biden’s administration that aimed to enhance access to reproductive healthcare and recognized abortion as a healthcare service.

Northup asserts that Trump has woven anti-abortion sentiments into various policies enacted in his initial month. She points out an Executive Order declaring that the U.S. recognizes only “two sexes, male and female,” arguing that it undermines access to gender-affirming care and incorporates personhood language that implies personhood begins at conception. “They are subtly embedding the concept of personhood from fertilization into all federal policies, rather than acknowledging that rights begin at birth,” she explains.

Advocates for reproductive rights assert that Trump and his administration have made their anti-abortion position unmistakably evident. Shortly after Trump’s inauguration, reproductiverights.gov—a federal site launched during the Biden era that provided information on abortion and reproductive healthcare—was taken offline. That same week, Vice President J.D. Vance spoke at the March for Life rally in Washington, D.C., praising Trump as “the most pro-life president in our history” and applauding his actions on abortion during his first term, attributing credit for the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade. Although Trump was not present at the rally, he sent a pre-recorded message, expressing his support for anti-abortion activists.

What international actions has the Administration taken?

Experts point out that one of Trump’s most impactful actions in his first month concerning global reproductive healthcare access is the suspension of foreign aid. Historically, the U.S. government has provided over 40% of humanitarian aid tracked by the United Nations and is the largest single donor globally. For the 2024 fiscal year, Congress allocated $575 million for family planning and $32.5 million for the United Nations Population Fund, which focuses on sexual and reproductive health, according to the Guttmacher Institute, known for its research and advocacy in this area. Elizabeth Sully, a principal research scientist at the Institute, notes that this funding has generally received bipartisan support and has remained steady for nearly a decade. Due to the Helms Amendment, which prohibits using foreign assistance funds for abortions, this support had not been directed toward abortion services.

According to a Guttmacher analysis, these funds provide contraceptive care for 47.6 million women and couples annually and prevent 17.1 million unintended pregnancies, potentially saving the lives of around 34,000 women and girls who could face pregnancy-related complications without such care. “Family planning is a vital life-saving measure,” Sully states.

However, due to the freeze on aid, international family planning programs that rely on U.S. support have been forced to cease operations, with the Guttmacher Institute estimating that over 3 million women and girls have already been denied contraceptive services because of this. By the end of the full 90-day review period, the Institute predicts that around 11.7 million women and girls will miss contraceptive care, leading to 4.2 million unintended pregnancies and 8,340 deaths from complications related to pregnancy and childbirth. On February 13, a federal judge ordered the Trump administration to temporarily lift the suspension of foreign aid, but the administration’s attorneys are defending the freeze, claiming that the judge’s ruling does not prevent the State Department from halting foreign assistance programs. The outcome of the judge’s order regarding the resumption of these programs remains uncertain.

“What’s particularly challenging is the unpredictability of the situation,” remarks Sully. “You may arrive at a clinic you’ve previously visited for injections or contraceptive pills, only to find it closed or lacking essential supplies, with no indication of when services might resume.”

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, works in Mozambique. She expresses significant concern about the implications of the aid freeze, fearing it may trigger a resurgence of HIV, a rise in unsafe abortions, and increased maternal mortality rates.

“It won’t be long before we witness substantial shortages of condoms and contraceptives across the healthcare system, inevitably leading to more women suffering from unsafe abortions and complications during childbirth,” Washington warns. “It’s a genuine tragedy.”

“I doubt that officials in the Trump administration fully understand the interconnectedness of global health issues, such as how condoms prevent HIV transmission, which knows no borders,” she cautions, indicating that an increase in HIV could eventually “reach the U.S. and impact global health.”

In his first week, Trump also reinstated the Global Gag Rule, which prohibits foreign organizations receiving U.S. aid from providing, referring to, or discussing abortion care. This move was expected by many reproductive health experts, as Republican presidents often implement it while Democratic presidents reverse it. During his initial term, Trump broadened the policy to cover all global health funding, not just family planning services, resulting in “far-reaching impacts” beyond abortion care. The Guttmacher Institute observed that in regions like Ethiopia and Uganda, the previously increasing usage of contraceptives halted or even declined after the Global Gag Rule was reinstated during Trump’s first term.

“While the policy’s primary goal is to limit abortion access, a decline in family planning often leads to more unintended pregnancies and, consequently, an uptick in abortions,” Sully explains.

The Trump administration also declared that the U.S. would rejoin the Geneva Consensus Declaration, a non-binding agreement advocating for anti-abortion policies that the U.S. had supported towards the end of Trump’s previous term. This declaration has received backing from over 30 countries, including Uganda and Hungary. Biden withdrew the U.S. from this declaration when he took office.

What could be on the horizon for Trump?

Most experts consulted predict that the Trump administration will continue to implement measures aimed at restricting abortion and reproductive healthcare access.

One critical aspect experts are monitoring is the administration’s position on mifepristone, a medication approved by the U.S. Food and Drug Administration (FDA) for abortion for over two decades, which is currently facing legal challenges from anti-abortion organizations. During his confirmation hearings as Secretary of Health and Human Services, Robert F. Kennedy Jr. provided unclear answers regarding mifepristone, stating that the President had asked him to “study the safety” of the drug but had not established a clear stance on its regulation.

Ziegler notes that it remains uncertain whether the Trump administration would fully revoke the FDA’s approval of mifepristone or if it would reverse Biden-era policies that increased accessibility, such as allowing prescriptions through telehealth and mail. Either decision could have a substantial impact on abortion access nationwide; Northup points out that the ability to obtain medication abortions via telehealth and mail has been a “lifeline” for many patients following the Dobbs ruling.

Read More: How the Biden Administration Protected Access to the Abortion Pill—and What Trump Might Change

Experts are also closely observing whether the Department of Justice will invoke the Comstock Act, a 19th-century law aimed at prohibiting the mailing of abortion-related medications. Looking further ahead, Ziegler speculates that Trump will likely continue appointing conservative judges, as he did during his first term, who will significantly shape abortion legislation, especially as various state-level restrictions face judicial challenges. Although appointing judges and securing their confirmations is a lengthy process, the long-term effects could be profound.

“Those judges will make pivotal decisions affecting access to abortion, contraception, and various reproductive health services,” states Ziegler. “As the courts evolve, we could see increasingly extreme outcomes regarding reproductive issues.”

Some anticipated that the Trump administration would take even more aggressive actions on abortion soon after the President’s inauguration. However, Ziegler suggests that part of the delay may be due to Trump’s desire to balance the expectations of his anti-abortion supporters with the views of the majority of Americans who favor abortion rights. Sully adds that, while Trump initiated his presidency swiftly, many key department leaders responsible for overseeing abortion-related policy changes, including those regarding mifepristone and the Comstock Act, are still awaiting confirmation.

Read More: Why Abortion Rights Succeeded in Three States That Voted for Trump

Advocates caution that vigilance is essential regarding future developments. Northup emphasizes that Roe offered a protective measure during Trump’s first presidency, placing limits on the actions his administration could take concerning abortion. With Roe now overturned, the constitutional protections that previously restrained his authority are no longer in effect, she warns.

“Anyone who cares about access to abortion services—an overwhelming majority of people in the U.S.—should remain alert to what this administration may attempt to do to limit access in states where abortion continues to be legal,” Northup concludes.