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 — and the governor signed it a day later. 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.”

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 sought to create uncertainty about laws he says are clear — especially with assertions that the bans bar abortion 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.