Farah Diaz-Tello is senior counsel for the SIA Legal Team , which transforms law and policy so that people who end their pregnancies outside the formal medical system can do so with dignity and without punishment. Her home is in New York City, but her heart is in Texas forever.

Neither answer, each of which focuses on access to clinics, gets to the real endgame of abortion foes: to make abortion a crime. And when there is a crime, there is, axiomatically, a perpetrator. Under most pre-Roe criminal abortion laws, the “perpetrator” was the provider and the person who obtained the abortion was merely a witness. But as people are increasingly able to access safe means to end a pregnancy at home, prosecutors treat them as their own “illegal provider” and the fetus as the victim of a crime—sometimes even charged as a homicide.

Ironically, the person who has been closest to honest on this point is Donald Trump. Remember in early 2016, seemingly a lifetime ago, when the then-candidate was asked how he planned to make good on his promise to ban abortion? He promised Supreme Court picks who would overturn Roe and parroted the shibboleth that the decision would return to the states. But then he veered revealingly off-script, saying that abortion-seekers “would perhaps go to illegal places.” Pressed further on whether this would permit states to penalize people who have abortions, he said, “There has to be some form of punishment.”

While the statement was almost immediately recanted amid rebukes from all his opponents, from Bernie Sanders to Ted Cruz, Trump’s blunder was not terribly surprising to people who closely follow reproductive rights. There’s no need to guess what would happen if Roe falls: We can look at what is happening in the states already testing the waters of criminalization.

As important of a precedent as Roe is, it is still an empty promise for many. As Robin Marty explains above page, the widespread barriers to access mean that many poor and undocumented people don’t really have a “choice.” So, seeking options that are affordable, accessible and private, people have turned to reproductive health technologies, both ancient and new, to meet their needs. The advent of effective abortion pills and the availability of information online have created options where none previously existed. According to one study, in June 2017 there were more than 200,000 Google searches in the U.S. for information on how to end a pregnancy.

As self-managed abortion has become safer medically, it has become more dangerous legally. Although the Constitution protects one’s right to decide whether to continue a pregnancy, prosecutors have attempted to criminalize people suspected of ending one. Consider Purvi Patel, the Indiana woman sentenced to 20 years behind bars for allegedly ending a pregnancy using pills she ordered from an online pharmacy. She spent three years imprisoned before finally being vindicated on appeal in 2016. Or Jennifer Whalen, the Pennsylvania mother sentenced to 18 months in prison for helping her daughter have a safe abortion with pills. According to the SIA Legal Team’s research, there have been 21 known arrests related to self-managed abortions since 2000, and likely many more we don’t know about. And with Roe under threat, prosecutors and lawmakers will rush to prove their anti-abortion bona fides.

It is a grave miscalculation to believe that post-Roe will look anything like pre-Roe. Our nation has spent the intervening 45 years devising a prison-industrial complex that is unparalleled in the world and in which women are the fastest-growing population. Surveillance technology enables law enforcement to use DNA to connect fetal remains to the person who delivered them. If we want to prevent abortion from being yet another ground for mass imprisonment, the only option is to transform the legal landscape.

Fortunately, there is change on the horizon. Massachusetts’ legislature has finally voted to repeal a 19th-century law that was used to prosecute a woman for a self-managed abortion as recently as 2007. New York gubernatorial candidates Andrew Cuomo and Cynthia Nixon are recognizing the urgent need to reform the state’s outdated abortion criminalization laws, last used in 2011 against a woman who allegedly drank a tea to end her pregnancy.

With the writing on the wall, the question for advocates is no longer how to save Roe, but how to finally ensure all people have genuine access and prevent the next arrest.

Farah Diaz-Tello is senior counsel for the SIA Legal Team, which transforms law and policy so that people who end their pregnancies outside the formal medical system can do so with dignity and without punishment. Her home is in New York City, but her heart is in Texas forever.

Get Ready for Anti-Abortion Terrorism

What alarms me most about the threat to Roe is the potential for an uptick in anti-abortion terrorism. The increasing scarcity of abortion providers will create a vulnerable target range for those committed to ending abortion access through violence. The hostile rhetoric of President Trump—and the reluctance of federal authorities to treat anti-abortion and white supremacist violence as domestic terrorism—signals to vigilantes that they have little to fear from federal prosecution.