Abortion bans that were put on the books in some states in the event Roe v. Wade was overturned started automatically taking effect Friday, while clinics elsewhere — including Alabama, Texas and West Virginia — stopped performing abortions for fear of prosecution, sending women away in tears.
"Some patients broke down and could not speak through their sobbing," said Katie Quinonez, executive director of West Virginia's lone abortion clinic, whose staff spent the day calling dozens of patients to cancel their appointments. "Some patients were stunned and didn't know what to say. Some patients did not understand what was happening."
America was convulsed with anger, joy, fear and confusion after the Supreme Court overturned Roe. The canyon-like divide across the U.S. over the right to terminate a pregnancy was on full display, with abortion rights supporters calling it a dark day in history, while abortion foes welcomed the ruling as the answer to their prayers.
Women who traveled across state lines to end a pregnancy found themselves immediately thwarted in some places as abortions were halted as a result of state laws that were triggered by the court decision or confusion over when those laws would take effect.
In eliminating the constitutional right to abortion that has stood for a half-century, the high court left the politically charged issue up to the states, about half of which are now likely to ban the procedure.
Abortions were immediately halted in nine states. Providers in two other states, Oklahoma and South Dakota, had already stopped performing the procedure in the past month. About 73 million people live in the 11 states where the procedure was not available — more than a fifth of the U.S. population.
The reaction across the country largely fell along predictable political lines.
New Mexico Gov. Michelle Lujan Grisham, a Democrat in a state where abortions are available with few restrictions, called the ruling a "war on women" and vowed to stand as a "brick wall" to help preserve the right. Republican Virginia Gov. Glenn Youngkin vowed to seek a ban on abortions after 15 weeks.
Florida Gov. Ron DeSantis, a conservative Republican widely considered a potential candidate for president in 2024, tweeted: "The Supreme Court has answered the prayers of millions upon millions of Americans."
The issue is certain to intensify the fall election season. Both sides intend to use the issue to energize supporters and get them to vote.
"This country is lurching to the right, taking away rights. The voters are going to have to intervene," said Democratic Rep. Jim Clyburn of South Carolina, the U.S. House majority whip.
Some states, including Louisiana, Arkansas and Missouri, had "trigger law" bans on the books that went into effect as soon as Roe fell.
In Alabama, the state's three abortion clinics stopped performing the procedure for fear providers would now be prosecuted under a law dating to 1951.
At the Alabama Women's Center for Reproductive Alternatives in Huntsville, the staff had to tell women in the waiting room Friday morning that they could not perform any more abortions that day. Some had come from as far away as Texas for an appointment.
"A lot of them just started breaking down crying. Can you imagine if you had driven 12 hours to receive this care in this state and you are not able to?" clinic owner Dalton Johnson said. Patients were given a list of out-of-state places still doing abortions.
Abortion providers across Arizona likewise stopped doing procedures while they try to determine if a law dating to pre-statehood days — before 1912 — means doctors and nurses will face prison time now.
In Texas, providers wondered which law they had to follow: a 1925 ban, a 2021 law that limits abortions to the first six weeks of pregnancy, or a trigger law that bans the procedure outright, but wouldn't take effect for a month or more. The confusion led them to suspend abortions while they seek legal advice.
Texas Republican Attorney General Ken Paxton warned they could face immediate prosecution for performing abortions under the Prohibition-era ban, which carries two to five years in prison.
It was the risk of prosecution under a 19th-century abortion ban punishable by prison that led the Women's Health Center of West Virginia to stop performing the procedure.
West Virginia Gov. Jim Justice, a Republican, said he will not hesitate to call the Legislature into special session if the ban needs to be clarified.
In Ohio, a federal judge dissolved an injunction, allowing a 2019 state law to take effect banning most abortions at the first detectable fetal heartbeat.
The high court ruling drew strong reactions around the country.
Carol E. Tracy, the executive director of the Women's Law Project in Philadelphia, was "absolutely furious."
"They want women to be barefoot and pregnant once again," she said. "But I have no doubt that women and like-minded men, and people in the LGBTQ community, who are also at great risk, ... we're going to fight back. I think it's going to be a long, hard fight."
Garrett Bess, who works with a lobbying arm of the conservative Heritage Foundation, said his group will continue to press states to restrict abortion.
"We'll be working with grassroots Americans to ensure the protection of pregnant mothers and babies," Bess said outside the Supreme Court. "This has been a long time coming, and it's a welcome decision."
Opinion polls show that a majority of Americans favor preserving Roe.
They include Alison Dreith, 41, an abortion activist in southern Illinois, where the governor has vowed to keep the procedure accessible. She said she fears for the safety of abortion workers, especially those who help people from states where the procedure is banned.
Dreith works with the Midwest Action Coalition, which offers gas money, child care and other practical support to women seeking abortions.
"I absolutely believe that they will try to come after me. I'm not built for prison, but I'm ready," she said, "and I say, 'Let's do this.' You want to pick that fight with me? I'm fighting back."
People on both sides of the emotional issue took to the streets to protest or rejoice, gathering in parks, on steps of state Capitols, on sidewalks outside courthouses and at abortion clinics.
In Omaha, Nebraska, about 50 abortion opponents rallied at a federal courthouse, vowing to pressure lawmakers to outlaw the procedure.
A few miles away, more than 1,000 abortion-rights supporters lined a busy street and a bridge overlooking traffic at rush hour, saying they would try to keep abortion legal in the state despite its heavy conservative leanings. They held up signs and shouted as passing motorists honked.
In Little Rock, Arkansas, a man in a crowd of more than 100 people held up a sign that said "Abort the Supreme Court."
Outside Planned Parenthood in St. Louis, Missouri, abortion foes held a victory celebration.
"I never thought I would live to see this day," said Mary McMahan, 64, who has been active in the movement since childhood and has spent many hours on the sidewalk outside the clinic praying. "But here it is. Thank God it is here."
Emma Garland, 18, of Freeburg, Illinois, showed up to support Planned Parenthood, saying she was scared her rights were being "stripped away."
"I thought we had more faith in our country as a whole not to overturn it, but we lost that faith today," Garland said.