The end of Roe v. Wade in June 2022 has had a profound effect on maternal healthcare and abortion access across the country. Fourteen states have now completely banned abortion and two dozen more have bans at 22 weeks or less. As a result, an already grim maternal health care landscape has worsened.

New data reveals an unexpected consequence of these developments: Young women, even those in states where abortion remains legal, say they are foregoing having children because they are afraid to get pregnant because of changes that followed the Dobbs decision that ended Roe.

Polling conducted in August by my organization, All In Together, in partnership with polling firm Echelon Insights found that 34 percent of women aged 18-39 said they or someone they know personally has “decided not to get pregnant due to concerns about managing pregnancy-related medical emergencies.” Put another way, poor or unavailable maternal health care post-Dobbs is leading people to alter some of their most important life choices.

For young people, the maternal healthcare crisis is deeply personal. More than a third of young people and 22 percent of young women told us they have personally dealt with or know someone who has “faced constraints when trying to manage a pregnancy-related emergency.” And 23 percent of 18- to 39-year-old women say they have themselves or know someone else who has been unable to obtain an abortion in their state — a number almost three times higher than respondents in other age groups.

Perhaps most surprisingly however, these results are similar regardless of whether the respondents are living in states with abortion bans or states without restrictions on abortion access. The consistency between red and blue states suggests that the statistics on maternal mortality and the stories and struggles of women navigating the new normal on abortion access have penetrated the psyche of young people everywhere. The Dobbs decision, it seems, has fundamentally altered how people feel about having families and the calculus for getting pregnant.

Alexis McGill Johnson, CEO of Planned Parenthood, told me that the stories of women dying or facing near-death experiences because of abortion restrictions has struck fear in the hearts of young people, many of whom were already ambivalent about having children because of the costs and pressures that generation faces.

“Abortion bans make pregnancy less safe,” she said, “and women are acutely aware of the consequence of restricting access to reproductive health care in their own lives.”

In the wake of Dobbs, stories of women enduring horrific medical trauma in states where abortion is illegal have been widely reported. For instance, Carmen Broesder, an Idaho mom, documented her 19-day long harrowing miscarriage on TikTok – including her three trips to the emergency room. While only six weeks pregnant, she was denied access to a D&C (dilation and curettage) surgery because of Idaho’s abortion ban.

It goes almost without saying that this is not good news for the already declining birthrates in the U.S. According to research from Pew, birthrates in the U.S. had been falling since the early 2000s and plummeted during the Covid pandemic. Fertility rates briefly rebounded after the pandemic but now, post-Dobbs, they have dropped again.

Should this trend continue, the reluctance of young women to have children now will have vast and long-term consequences for the American economy and fabric of the nation. Falling birth rates can affect everything from tax revenue to labor force participation, schools, housing, elder care and more.

But beyond the macro-economic ramifications, there is also a human and emotional toll for people who may want children but are too afraid to have them. The hallmark of a flourishing society is one where people can fulfill their hopes and dreams, and for many, those dreams include raising a family. But for a generation of Americans, that dream now appears frustrated. Gen Y and Z Americans report higher rates of mental health challenges and stress than other generations. The Dobbs decision has clearly contributed to that anxiety.

All of this signals troubling, unexpected and ominous continuing consequences of the Supreme Court’s deeply unpopular Dobbs ruling and the ripple effects that abortion bans, which polls show a majority of Americans oppose, have created. It’s a trend worth watching and weighing – for lawmakers, for women, for families and for all Americans.