Two years after a leaked draft of a U.S. Supreme Court opinion signaled that the nation’s abortion landscape was about to shift dramatically, the issue is still consuming the nation’s courts, legislatures and political campaigns — and changing the course of lives.

On Wednesday, a ban on abortion after the first six weeks of pregnancy, often before women realize they’re pregnant, took effect in Florida, echoing laws in two other states. In Arizona, meanwhile, lawmakers voted to repeal a total ban on abortion dating back to 1864, decades before Arizona became a state. Also this week, the Kansas Legislature increased funding for anti-abortion centers, while advocates in South Dakota submitted the required number of signatures for a ballot measure to enshrine abortion rights in the state constitution.

The status of abortion in states across the country has changed constantly, with lawmakers passing measures and courts ruling on challenges to them. Currently, 14 states are enforcing bans on abortion at all stages of pregnancy, with limited exceptions. Most Democratic-led states, meanwhile, have taken steps to preserve or expand access.

“Some of it’s exactly what we knew would happen,” said David Cohen, a professor at the Thomas R. Kline School of Law at Drexel University who studies abortion policy, “and others have been big surprises that have put, frankly, the anti-abortion movement on their heels.”

MORE COVERAGE ON ABORTION Arizona governor set to sign repeal of near-total abortion ban from 1864 Florida’s 6-week abortion ban takes effect as doctors worry women will lose access to health care Kansas has new abortion laws while Louisiana may block exceptions to its ban

Although more than 20 states have begun enforcing abortion bans of varying degrees since the Supreme Court overturned Roe v. Wade in June 2022, studies have found that the number of monthly abortions nationally is about the same — or higher — than it was before the ruling. Asked to weigh in on the emotional debate, voters have supported the position favored by abortion rights advocates on all seven statewide ballot measures since then.

The Supreme Court’s decision in the Dobbs v. Jackson Women’s Health Organization case was released officially on June 24, 2022, upending nearly 50 years of abortion being legal nationwide. But the world caught a glimpse of it about six weeks earlier, on May 2, after a news outlet published a leaked draft.

“With the Dobbs decision, the will of the people is now able to be adhered to,” said Stephen Billy, vice president of state affairs for Susan B. Anthony Pro-Life America. He said abortion rights supporters have amplified uncertainty in laws — especially over whether abortion is allowed in medical emergencies: “They’ve tried to sow political division just to advance their policy agenda,” he said.

At the time Politico published the leaked draft, Amanda Zurawski was undergoing fertility treatment and was about two weeks away from learning she was finally pregnant.

The Austin, Texas, woman had always supported abortion rights, and was mad that the right to abortion was on the verge of disappearing. But she didn’t expect a direct impact in her life.

That changed months later when she was denied an abortion despite a premature rupture of membranes, which can lead to dangerous internal bleeding. Days later, she was diagnosed with sepsis, a life-threatening reaction to infection. Her daughter, Willow, was ultimately aborted, but Zurawski nearly died in the process because of the delay.

She emerged from the experience an activist.

“I thought I would be a new mom with a newborn,” she said in an interview. “Instead, I was in Tallahassee, Florida, meeting the vice president.”

Zurawski has been a plaintiff in a court challenge seeking to clarify Texas abortion law and has spoken about her experience before Congress and across the country. She recently left her tech job to spend the next several months supporting abortion rights and President Joe Biden’s reelection campaign.

“I’m definitely somebody who wants to fight for justice,” she said. “This is not the path that I would have guessed.”

Zurawski’s widely publicized experience is a reflection of the central role abortion has assumed on the political stage during this highly charged election year.

In Arizona, one of a handful of battleground states that will decide the next president, the state Supreme Court issued a ruling last month saying that a near-total abortion ban passed in 1864 could be enforced now that Roe v. Wade had been overturned. That decision ultimately led to the repeal proposal that passed the state House last week and the Senate on Wednesday after vitriolic debate. Gov. Katie Hobbs, a Democrat, is expected to sign the repeal.

Florida, Maryland and New York will have measures on the ballot in November to protect abortion access.

“Women are going to be put into an impossible situation of not having access to health care, whether it is in an emergency situation or just family planning,” said Nikki Fried, chair of the Florida Democratic Party. “Floridians are going to have the opportunity to take control back.”

Susan B. Anthony’s Billy said his group was focused on defeating the ballot questions in Florida and other states where passing them would roll back bans in place now.

Arizona is one of at least eight states with a push for a similar measure. A few states also have pushes for measures to enshrine bans in the state constitution.

The issue is also weighing heavily in the presidential election.

President Joe Biden has been blasting his likely opponent, former President Donald Trump, for appointing the Supreme Court justices who swayed the Roe v. Wade decision. Vice President Kamala Harris traveled to Florida on Wednesday to decry the six-week ban passed in the nation’s third most-populous state.

Trump, who said in April that he believes abortion laws should be decided by states, went further this week, telling Time magazine that states should also be able to prosecute women who seek abortions. Proposals to do that have not picked up steam in any state legislatures so far.