'We are going to be a surveillance state like we've never had before': A reproductive health historian says the stakes will be even higher than pre-Roe

Dr. Joffe is worried about the future of the case. She is worried that people will be accused of faking their abortions or that they will be punished for exercising their reproductive freedom.

On Monday, the landmark Supreme that legalized abortions nationwide was thrown into question after Associate Justice Samuel Alito in a leaked draft opinion characterized it as wrong from the start.

Until the court hands down a final decision, abortion will remain legal in the United States. The draft opinion put reproductive rights activists and doctors on edge.

It would be illegal in 23 states to get an abortion if the Supreme Court overturned it. There could be added restrictions in several others.

People who need an abortion will be punished more heavily than before the Supreme Court legalized it, according to a University of California sociologist.

Joffe told Insider that before abortion was a constitutional protection in the US, women would turn to dangerous means. The coat-hanger method is famous. Doctors have told Joffe that they had to remove coat hangers from cervices in the years before the ruling.

Women would travel to other countries like Japan and Mexico to get an abortion, as well as try sitting in hot water to kill a fetus. They found people who were willing to perform an abortion for a fee.

Joffe said that women went to incompetent abortion providers. Some of them are not doctors. Some of them are not ethical. Would want more money. Some of them were alcoholics.

Back-alley abortions were not always safe for women. Joffe said that the only option was to find someone who would perform the abortion under the radar.

Joffe said she doesn't expect many abortion seekers in the United States to pursue means as drastic. Joffe said that some teenagers who don't have access to an abortion could resort to coat-hanger means. For the most part, Joffe thinks there are still ways to get an abortion.

It will be up to individual states to uphold abortion laws if the Supreme Court overturns the case. If an abortionseeker is in a state with restrictive reproductive laws, they can often travel to another state to get a procedure or medication that helps facilitate an abortion.

Traveling out of state to receive reproductive care isn't an option for people who don't have the finances or social safety net. Abortion restrictions nationwide have made it harder for people of color, low-income individuals, trans and non-binary people, and immigrants to find or receive reproductive care, abortion rights activists argue.

Joffe said that the most vulnerable women were the poor women.

If the Supreme Court overturns the right to an abortion, there would be harsher punishments for those who receive one, according to Joffe.

There was no anti-abortion movement in the pre-Roe era. Even though it was illegal, there was very little conviction of anyone who did it.

According to a 2001 research article, the US courts viewed women who got abortions as victims rather than criminals.

Women were punished in other ways even though they were rarely convicted. Joffe said that officers would sometimes storm the homes of women who received an abortion and question them about where they got it. Police took pictures of women and got doctors to do vaginal exams in some cases.

Slate reported that women were punished for testifying in court. There was a threat of public humiliation.

Joffe said that doctors were not criminalized for performing abortions while facing prison time and disbarment.

She said that very few doctors were convicted.

Today, Joffe warns, some legislation criminalizes both people who get an abortion and perform, marking a completely different landscape for reproductive rights. Police in Texas said that Lizelle Herrera was arrested and charged with murder last month after she had an abortion. The charges have been dropped.

Joffe said that the potential overturn of Wade is so scary because of what happened to Herrera.

She said that people were scared before Roe but the legal environment was not that challenging.

That is going to be part of the future of the post-Roe era in this country. We are going to be a much more legal state.