The supreme court has ruled there is no constitutional right to abortion in the United States, upending a precedent set nearly 50 years ago in the landmark Roe v Wade case – a rare reversal of long-settled law that will fracture the foundations of modern reproductive rights in America.

The court’s ruling came in the pivotal case Dobbs v Jackson Women’s Health Organization, in which the last abortion clinic in Mississippi opposed the state’s efforts to ban abortion after 15 weeks and overturn Roe in the process.

“We hold that Roe and Casey must be overruled,” said the majority opinion, written by Justice Samuel Alito and joined by four other conservative justices.

The constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision,” it said.

Separately, Chief Justice John Roberts said he would have upheld Mississippi’s law, but not overruled Roe altogether.

The court’s three liberal justices dissented. The majority opinion “says that from the very moment of fertilization, a woman has no rights to speak of”, and that conservative justices well knew states across vast regions of the US would enact – and in many cases had already enacted – abortion restrictions that would go to the moment of conception.

Under state restrictions, “a woman will have to bear her rapist’s child or a young girl her father’s – no matter if doing so will destroy her life,” liberal justices wrote.

The reversal of the 1973 opinion will again allow individual US states to ban abortion. At least 26 states are expected to do so immediately or as soon as practicable.

The Dobbs decision is certain to be one of the most consequential in generations. It will have profound, immediate and enduring consequences for the lives of tens of millions of American women and other people who can become pregnant, and unpredictable ripple effects that could play out over decades.

“This is kind of unparalleled, and even if it’s not completely unprecedented it’s extremely rare,” said Mary Ziegler, a visiting professor of constitutional law at Harvard Law School, professor at the University of California, Davis School of Law and a historian of abortion.

“It’s also extraordinary to do something like this so quickly, with no kind of advance notice,” said Ziegler.

The final ruling from the conservative-dominated court comes after a draft opinion was leaked in early May. In it, right-leaning associate justice Samuel Alito laid out a caustic argument for reversing Roe v Wade.

Experts believe the coming days and weeks will bring chaotic attempts by conservatives to ban the procedure as soon as possible, as a patchwork of some of the most severe abortion restrictions in the world go into effect.

Large swaths of the US south and midwest are expected to ban abortion or impose severe restrictions, possibly forcing patients who want the procedure to travel hundreds of miles or self-manage abortions at home.

At least one economist has estimated such bans could result in an additional 60,000 births a year among women who want an abortion, but are unable to obtain one. Such bans are likely to affect 41% of women of reproductive age in the US, and hit the young, poor, Black and brown women and people who already have children the hardest.

The ripple effects of the decision could also herald greater restrictions in other areas of private life, with ramifications for gay marriage, sex and possibly even birth control. Justice Clarence Thomas, in a separate concurring opinion, explicitly encouraged fellow justices to “reconsider all of this court’s” cases that establish rights to contraception, gay marriage and sex.

“Backlash to the decision is really unpredictable, and part of the reason we know that is because backlash to Roe was unpredictable,” said Ziegler.

The decision is likely to spark more protests and rallies, and intensify debate within and between states about abortion, and even between cities. The shock decision could also upend the midterm elections in November.

The decision was immediately celebrated by anti-abortion groups and condemned by a wide range of groups who said it would harm and criminalize people who can become pregnant.

“Today’s decision is a direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States,” said Dr Iffath A Hoskins, president of the American College of Obstetricians and Gynecologists.

“The principle of shared decision-making is founded on respect for peoples’ expertise in their own bodies and lives and clinicians’ expertise in science and medicine. There is no room within the sanctuary of the patient-physician relationship for individual lawmakers who wish to impose their personal religious or ideological views on others,” said Hoskins.

In the run-up to the decision, Democratic-led states have enacted laws to aid patients who travel for abortions. Republican-led states have done the opposite. Many have worked to further restrict abortion and some have already debated prosecuting women who seek abortions under homicide statutes.

Although an estimated 85% of Americans support legal abortion under certain circumstances, extreme partisan manipulation of electoral districts, or gerrymandering, has insulated right-leaning Republican leaders from popular opinion.

Moments after the decision, Republican-led states were already working to enact abortion bans passed in anticipation of the decision. Missouri claimed to be the first, when the attorney general signed a certification Roe v Wade had been overturned. South Dakota quickly announced a special session to consider more abortion restrictions, even though the procedure is already expected to be banned.

In Illinois, conversely, the governor, JB Prizker, called the Illinois General Assembly into special session “to further enshrine our commitment to reproductive health care rights and protections”.

Internationally, the decision will make the US one of only four countries since 1994 to restrict abortion, according to the Center for Reproductive Rights, the other countries being Poland, Nicaragua and El Salvador. This will further set America apart from peer countries as life expectancy falls. It could also damage the nation’s ability to advocate for the rights of women and girls globally.

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