“Red states” like Alabama are often written off by the reproductive rights movement as beyond help. But you can’t secure the right to abortion for anyone unless and until everyone has access.

Alabama still has its pre-Roe v. Wade abortion ban on the books, as well as a near-total ban that was temporarily blocked by the courts. But once Roe falls, all bets are off—and the Alabama Constitution even bars the protection of abortion as a right.

Last year, a three-judge panel of the Eleventh Circuit (appointed by Reagan, Clinton, and Obama, respectively) upheld a federal court decision blocking parts of Alabama’s parental consent law.

But the rest of the court, including several Trump appointees, took the case back on appeal and vacated the earlier decision, reinstating the state’s parental consent law—just one of many abortion restrictions effective as of January 1, according to the Guttmacher Institute, including:

• A patient must receive state-directed counseling that includes information designed to discourage the patient from having an abortion, and then wait 48 hours before the procedure is provided.
• The use of telemedicine to administer medication abortion is prohibited.
• A patient must undergo an ultrasound before obtaining an abortion; the provider must offer the patient the option to view the image.
• The state requires abortion clinics to meet unnecessary and burdensome standards related to their physical plant, equipment and staffing.

It’s also an election year, which means the state’s lawmakers are more concerned with introducing legislation to campaign on over passing laws that could actually help Alabamans, including a desperately needed Medicaid expansion.

Instead, Alabama lawmakers introduced a Texas SB 8 copycat bill in December, and last week, a House committee advanced a medication abortion ban. Republicans hold both chambers of the Alabama Legislature.

Nothing that starts in Alabama stays in Alabama. It was one of the first states to field test jailing pregnant people for failed pregnancies and has sent up several test balloons for fetal personhood.

As always, marginalized communities are harmed the most under this iron rule. Alabama has one of the highest maternal mortality rates in the country—and it’s even higher if you’re a Black woman.

But abortion providers in Alabama haven’t given up. And with abortion banned in Texas, West Alabama Women’s Center is taking on additional patients from out of state and can even provide single-day appointments after a waiting period at home, according to clinic operations director Robin Marty.

This post was adapted from a Twitter thread.