“We won’t go back”—it’s an inadequate rallying cry, prompted only by events that belie its message. But it is true in at least one sense. The future that we now inhabit will not resemble the past before Roe, when women sought out illegal abortions and not infrequently found death. The principal danger now lies elsewhere, and arguably reaches further. We have entered an era not of unsafe abortion but of widespread state surveillance and criminalization—of pregnant women, certainly, but also of doctors and pharmacists and clinic staffers and volunteers and friends and family members, of anyone who comes into meaningful contact with a pregnancy that does not end in a healthy birth. Those who argue that this decision won’t actually change things much—an instinct you’ll find on both sides of the political divide—are blind to the ways in which state-level anti-abortion crusades have already turned pregnancy into punishment, and the ways in which the situation is poised to become much worse.