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Abortion rights activists gather for a protest following the U.S. Supreme Court's decision to overturn Roe v. Wade, at Washington Square Park, New York, on June 24.Yuki IWAMURA/The Associated Press

In a Bronx coffee shop near the end of a New York subway line, Elizabeth Estrada reminded herself that hope is a discipline. She was quoting Mariame Kaba, a Black activist, educator and grassroots organizer whose wisdom is resonating with reproductive justice campaigners devastated by the United States Supreme Court’s decision to overturn Roe v. Wade.

“It’s hard to even talk about this without getting choked up, because the impact is so deep,” Ms. Estrada, a field and advocacy manager for the National Latina Institute for Reproductive Justice, said about the ruling, which ended nearly 50 years of abortion rights.

“As an immigrant it makes me feel, this is what my family immigrated to the United States for? We’ve regressed, and white supremacists, capitalists, the patriarchy are winning at this particular moment but that doesn’t mean that our fight stops. It’s not just a punchline. La lucha sigue.” The struggle continues, she said in Spanish.

With the legality of abortion now in the hands of state legislatures, there’s a flurry of legal activity on both sides. Conservative lawmakers who support the overturned ruling are threatening to block people from getting abortions in other jurisdictions, while “safe haven” states where abortion rights are still protected are shoring up legal provisions and providing funding for the procedure.

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Pro-choice activists such as Ms. Estrada, 38, and organizations that have been preparing for the fall of Roe v. Wade are now in high gear – planning protests, raising money, attracting volunteers and strengthening networks of support that aim to ensure people can access the health care that they need.

“This is an emergency,” New Jersey State Representative Mila Jasey said last week. The state enacted some of the strongest abortion protections in the country in anticipation of the court ruling. “We have been betrayed by some Supreme Court justices and their supporters who simply hate women, and we have to protect our sisters in New Jersey and throughout the country.”

New Jersey legislators passed a bill that bans the extradition of people who get or perform abortions to states that prohibit the procedure. They also approved a bill that bars abortion providers from assisting in investigations in states that criminalize abortion, and from releasing patient information to those states without the patient’s consent.

Referring to the various abortion bans, assemblyman Raj Mukherji said: “What’s truly ironic is that all of this is happening in states that don’t have paid family leave like we do in New Jersey. States with no universal health care, or child care or safety nets.”

Clinics in New Jersey and New York have already seen an influx of out-of-state residents seeking abortions, in particular from Texas after it restricted the procedure to the first six weeks of pregnancy last September. New York alone is anticipating it will be the nearest provider of care for 190,000 to 280,000 out-of-state people of reproductive age.

Andrea Long, who co-runs the volunteer escort program at Metropolitan Medical Associates abortion clinic in Englewood, N.J., said organizations are trying to expand their capacity.

Since 2014, she has escorted people seeking abortions into the building, through what is sometimes a gauntlet of vitriol being hurled their way from protesters who chase them in. Ms. Long, 39, fears those who target clinics will now feel emboldened. As a result, they are looking at increased security training for volunteers. She has mentally prepared herself for the prospect of a shooter, especially after the Supreme Court relaxed gun laws around concealed carry. One volunteer couple with children won’t escort people on the same Saturday, the day protesters target the clinic the most. “They just feel it’s too much of a risk,” she said.

She continued: “It feels like an overwhelming challenge but the volunteers, we’re just going to focus on helping who we can. It’s going to be hard and it’s going to be sad.”

Of course, even in states where protections are strong, access is not guaranteed for everyone who lives there. Undocumented workers, immigrants, people of colour, young people, the poor and those with disabilities face greater barriers, such as money, language and lack of information.

“If you have to choose between rent and getting an abortion, is it really a right?” said Alejandra Sorto, a campaign strategist with the New Jersey American Civil Liberties Union, which is pushing for more financial support to cover the full spectrum of reproductive health care.

People are asking her organization for more information on what the fall of Roe means, Ms. Estrada said. And she has even greater concerns: “My biggest fear is that our community was already oversurveilled by police and immigration authorities. … Are staff members at certain hospitals going to rat you out to the cops?”

Ms. Estrada’s own abortion stories illustrate the range of experiences in the United States.

When she unexpectedly got pregnant at the age of 21 in Georgia, she knew she didn’t want to be a parent. Still, the stigma often associated with abortion was something she had to work through. She enlisted two friends to wait with her and travelled an hour to a clinic, where the procedure cost US$535. When it was done, she felt relief – and an overwhelming need to cry. She remembers the clinic security guard putting his hand on her shoulder as she walked outside with her friend. “It was just the kindest gesture of compassion,” she said.

She had her second abortion with her New York OB/GYN at the age of 34. The clinic was accessible, the procedure was covered through her insurance, and she felt empowered and cared for by her community.

She thinks about the security guard from her first experience as she supports people through their own reproductive health decisions.

“I want to be that caring hand that tells you that you’re not making a mistake, that there’s no punishment for this,” she said.

Amid the weight of this moment in American history, she believes there is a chance to make a difference.

“Now we have the opportunity to imagine what the future will look like for all people,” she said. “We want to build a world that creates access not just for the rich, that is free of stigma.”

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