Anti-choice activists may have a better shot than you think at getting the Supreme Court to revisit Roe v. Wade under Donald Trump. (Photo by ZACH GIBSON/AFP/Getty Images)

When Donald Trump ran for president, despite his long history of pro-choice positions, he essentially offered evangelical Christians a deal: Help elect me, and I will appoint pro-life, conservative justices to the Supreme Court. Sure enough, less than three months into his presidency, Trump's first SCOTUS appointee—Neil Gorsuch—was confirmed, and anti-choice advocates seemed to be one step closer to their ultimate goal of overturning Roe v. Wade.

It may take another appointee to truly tilt the scales of justice against reproductive rights in America's highest court. But in the meantime, conservatives have been eyeing the Eighth Circuit Court of Appeals, based in St. Louis, Missouri, as a vehicle to bring such a challenge. That's where, in 2015, appellate judges urged the nation's highest court to revisit existing abortion jurisprudence, and turn matters over to the states, as conservatives have long dreamed.

Now that same federal appeals court, which may be more hostile than any other to abortion rights, is getting a bunch of new opportunities to go after a woman's right to choose in Arkansas—and maybe even set the stage for the end of Roe nationally.

Over the past several years, legislators in Arkansas—one of seven states under the Eighth Circuit's purview—have passed some of America's most restrictive abortion laws. Already in 2017, Arkansas passed a statute that would criminalize doctors who perform dilation and evacuation (the most common second-trimester procedure), and also permit husbands to sue to prevent their wives from obtaining abortions—with no exceptions even for rape or incest.

Set to go into effect on July 30, the law was blocked after the American Civil Liberties Union, the ACLU of Arkansas, and the Center for Reproductive Rights sued over it and three other recently passed abortion restrictions. Lawyers brought the suit on behalf of a physician working at one of the last two abortion clinics in the state, and argued the laws posed unconstitutional burdens on a woman's right to choose.

On July 28, federal judge Kristine Baker blocked the laws' enforcement, and Arkansas Attorney General Leslie Rutledge filed for an appeal two weeks ago. A spokesman for the AG did not return multiple requests for comment.

What should worry abortion-rights advocates is that there's plenty of reason to suspect the Eighth Circuit will be sympathetic to Rutledge's challenge. In March 2016, Judge Baker issued another injunction against a 2015 Arkansas law requiring physicians who prescribe abortion-inducing drugs to secure contracts with doctors with hospital-admitting privileges—a high bar to meet in the increasingly conservative state, and one the American College of Obstetricians and Gynecologists and the American Medical Association said had no medical basis. This past July, the Eighth Circuit lifted Baker's injunction, ruling she would need to more concretely prove that a sizable number of women will face harm under that law.

In an interview with VICE, Steve Aden, chief legal officer and general counsel for Americans United for Life, said he felt the Eighth Circuit's request for "some real math" was reasonable. He also defended the admitting privileges requirement as a common-sense measure to protect women's health, noting that other outpatient surgical procedures generally require it. "If you or I go to a clinic and get Lasik or a colonoscopy, chances are really good that the doctors will have admitting privileges," he said.

Meanwhile, the US Supreme Court last year heard arguments for Whole Woman's Health v. Hellerstedt, widely considered to be the most significant reproductive rights case in nearly 25 years. In a 5–3 decision, the justices ruled that a package of Texas abortion restrictions imposed an unconstitutional burden on women seeking to end their pregnancies.

Fatima Goss Graves, the president and CEO of the National Women's Law Center, told VICE anti-abortion opponents haven't been much deterred by that outcome. On the contrary, she said, they are eagerly working to put more abortion cases before the Supreme Court as soon as possible. "They are still purposely trying to pass extreme laws that conflict with Whole Women's Health, with Roe, so they'll [then] be challenged in court," she said. "That is the strategy."

Another Arkansas case that could reach the Supreme Court concerns conservative boogeyman Planned Parenthood. In 2015, following the release of doctored videos purporting to show Planned Parenthood illegally profiting from the sale of fetal tissue, Arkansas Republican governor Asa Hutchinson announced he would be terminating Medicaid contracts with the women's health organization. Judge Baker blocked the move that September, but last month, a three-person panel on the Eighth Circuit decided Arkansas could cancel its Medicaid contract with Planned Parenthood—a notable departure from rulings in the Fifth, Seventh, and Ninth Circuits. On August 30, the plaintiffs appealed to make their case again before the entire Eighth Circuit.

Aden, of Americans United for Life, thinks this case stands a shot of reaching the Supreme Court given the Eighth Circuit's first decision diverged so sharply from other Appeals Courts nationwide.

I asked Bonyen Lee-Gilmore, a spokesperson for Planned Parenthood Great Plains (an affiliate overseeing Arkansas, Kansas, Missouri, and Oklahoma), if they would appeal to the Supreme Court, should the full Eighth Circuit uphold the Medicaid ruling. "When it comes to next steps in the legal world, we really play it one step at a time," she said. "Every time a decision comes down, we're evaluating all our legal options, and the reality is we could end up in the Supreme Court, but we're not there yet. Right now, we're just seeing if we can successfully secure an en banc appeal." (To hear a case 'en banc' means before the entire bench of judges, rather than a three-person panel.)

It's worth noting that even though Arkansas's governor cancelled state Medicaid contracts with Planned Parenthood over the 2015 fetal tissue videos, three Republican-led congressional investigations and 13 state-level probes—including one by a Texas grand jury—found no evidence of wrongdoing.

Gillian Metzger, the Stanley H. Fuld Professor of Law and vice dean at Columbia Law School, thinks the Eighth Circuit "has really pushed the envelope" on constitutional retraction of reproductive rights in America. But whether these specific cases make it to the Supreme Court, she said, comes down—as always—to how willing justices are to engage with the abortion issue again. "The bigger question is does the Court have an appetite for this after 2016? And my guess it might wait a little bit to see how the Whole Women's Health decision plays out," she said.

In the meantime, President Trump will have the opportunity to fill three vacancies on the Eighth Circuit. If all are confirmed, according to longtime legal writer Rox Laird, only one of the Eighth Circuit's 11 judges will have been appointed by a Democratic president, making it "the most ideologically lopsided of all the US Court of Appeals."

Even if pro-choice advocates secure Medicaid funding for Planned Parenthood and defeat this round of abortion restrictions in the Eighth Circuit—by no means a safe bet—advocates aren't expecting legislators to slow down their anti-abortion efforts anytime soon. In mid August, Planned Parenthood Great Plains and the ACLU argued yet another case in Arkansas federal court, protesting a law mandating the suspension of an abortion provider's license for any minor error found during an inspection. That rule doesn't apply to any other licensed health center in the state.

"We'll be on high alert when the legislature returns in 2019 and continue to fight these extreme attacks on women and their rights," said Rita Sklar, the executive director of the ACLU of Arkansas. "Often, the only way to get Arkansas politicians out of the exam room is to take them to court."