In the US, women die if they don't have safe, legal abortion. Will that translate into votes?

“Promise me you’ll take care of my son.”

Those were Amber Nicole Thurman's last words to her own mother. The 28-year-old Georgia woman died of sepsis after waiting 20 hours for medical attention at an Atlanta hospital because doctors delayed a routine procedure she desperately needed after an incomplete medical abortion. A report available ProPublica confirmed that the death was preventable.

Anti-abortion rhetoric rarely leaves room for reality. For medical professionals, the threat of prosecution can quickly overshadow the patient's need for safe, timely, and appropriate treatment. Death was an inevitable consequence of the gradual rolling back of reproductive rights in America, as was the reduced availability of safe obstetric services, sexual health care, and miscarriage management. The majority of obstetricians and gynecologists report that maternal mortality has increased and racial and ethnic inequalities have worsened since then. Roe v. Wade was repealed.

Pissva “exceptions” to protect the “life of the mother” may be convenient arguments for Republican lawmakers to deny people medical care, but they are meaningless in an emergency room where doctors delay or deny treatment under suspicion of criminal prosecution.

“She was loved,” Democratic Vice President Kamala Harris said of Thurman in a speech in the swing state of Georgia on Friday. “And she should still be alive today.” She had planned her future carefully, Harris said: “What she wanted to do for herself, for her son, for her future.”

As feminist author Jessica Valenti wrote, the speech was a groundbreaking event because politicians too often make the case for reproductive freedom by relying on abortion stories that involve assault, incest, a tragic diagnosis or medical necessity. Harris stretched an abortion story that would not have been particularly notable had doctors not anticipated the state's abortion ban, which went into effect weeks after Thurman's death.

Here was a mother who went to nursing school and had neither the desire nor the ability to have another child. Or, as Valenti put it, Harris expressed a view that too many politicians would not share: “The penalty for wanting to determine your own path in life should not be death.”

Abortion is an important issue to voters in the United States. It has overtaken the economy as the most important issue for voters under 45, and a Fox News poll conducted last week found that 27% of respondents said abortion was the most important factor motivating them to vote in this election.

Donald Trump's public appearance has been a mess for decades. In the 1990s he was “very pro-choice”; in 2011 he described himself as “pro-life.” But in the run-up to the election he was inconsistent.

On the one hand, he gladly took credit for the abolition of the Roe v. Wadebut on the other hand, he refused to sign a national abortion ban, failing to agree on a coherent political message with his running mate, JD Vance, and angering evangelicals who do not want him to soften his stance on the issue of reproductive rights (as other Republicans have strategically done).

He also continues to repeat the disgusting lie that Democrats support “baby executions” or abortions “after birth.” He takes the fact that support for abortion declines with gestation to extremes by spreading fearmongering about something that is no longer abortion at all: faked infanticide. Of course, the vast majority of abortions in the United States occur in the first trimester.

Harris has consistently blamed Trump for his role in the repeal Roe v. Wade (via his Supreme Court appointees) and subsequent federal abortion bans—abortion is now restricted in about half of U.S. states.

“This is a health crisis, and Donald Trump is the architect of that crisis,” Harris repeated on Friday. The next day, Trump claimed that if he won the election, “women will be happy, healthy, confident and free. They will no longer think about abortion because it is now where it always needed to be, which is in the states.”

In fact, a KFF poll released in August found that 74 percent of American women ages 18 to 49 “somewhat” or “strongly” oppose leaving abortion legality to the states (including more than half of Republican voters surveyed).

And what about the ballot initiatives? In November, ten states will vote on ballot initiatives to enshrine abortion access in their constitutions. Democratic strategists may be betting that these could hurt Republican candidates in Arizona, Nevada and Florida, but the relationship between these initiatives and the winning candidates is complicated. The issue of abortion is polarizing, but not always along party lines.

Benjamin Case, a researcher at Arizona State University, wrote: “Just because a voter cares deeply about abortion rights does not necessarily mean they will vote Democrat.” Let's not forget that last year, support for Trump in polls remained stable even among those who wanted to see abortion “broadly legal.” Polls show that Republican voters also overwhelmingly support access to abortion.

Experts have long warned that repealing abortion rights will cost women their lives, either directly, as in the tragic case of Amber Nicole Thurman, or indirectly by damaging reproductive health care and worsening America's already degrading maternal mortality rate (the number of women who died during pregnancy, childbirth, or shortly afterward skyrocketed in Texas after the abortion ban went into effect).

Abortion is a common procedure. If you haven't had one, statistically it's very likely that someone you love has. Yet it's not what most people are most concerned about when it doesn't directly affect their lives, especially during a cost-of-living crisis. The question isn't whether Americans support abortion rights—the majority do—but whether that support translates into votes, and for whom.

Two days later ProPublica Thurman's story was made public, revealing the story of 41-year-old Candi Miller, who stayed home and died because she was too afraid to seek medical help. Her sister said doctors told Miller that her lupus, diabetes and high blood pressure made having another baby medically risky. ProPublica reported that her teenage son had to watch her suffer for days after taking abortion pills she had ordered online. Her husband found her unconscious in her bed, her three-year-old daughter by her side. Maternal health experts said her death was preventable and blamed the state's abortion ban.