Alabama lawmakers passed the most restrictive abortion ban in the US on Tuesday night, outlawing abortion from the point of conception with exceptions only if the woman’s life is seriously at risk.

The law is one example of a severe clampdown on women’s reproductive rights spreading across Republican-led states. The White House has stoked anti-abortion campaigners’ fervor, with conservative court nominations and a litany of bureaucratic changes restricting reproductive freedom and related funding.

This year, more than a dozen US states have sought to make abortion illegal after six weeks of gestation, including six states that successfully enacted the laws.

Where is this happening?

Anti-abortion campaigners have successfully enacted a ban on all or most abortions in seven Republican-led states: Alabama, Arkansas, Kentucky, Mississippi, North Dakota, Ohio and Georgia.

Alabama’s law, which must be signed by the Republican governor, is the most severe.

At least 61 bills like this have been introduced across the country, in states including Louisiana, Missouri, South Carolina, Tennessee, Maryland, Minnesota, Texas and West Virginia. Even in states considered safe havens for abortion rights, such as New York and Illinois, anti-abortion lawmakers have introduced bills as a kind of protest.

The wave of restrictions is due primarily to the Trump administration’s judicial picks. Anti-abortion campaigners believe the chances of further restricting abortion through court cases are better today than they were a year ago.

Who is behind it?

Generally, the anti-abortion elements are made up of social conservatives. The Christian right has fought against abortion rights for decades, but some of its most extreme proposals have only recently started to pick up steam. The Christian right is also one of the Trump administration’s most fervent bases of political support.

In Ohio for example, the leader of one anti-abortion and anti-gay hate group, Janet Porter, pressed for a ban on abortions for nearly a decade. She only succeeded this year, after the Trump administration pushed the supreme court and lower courts to the right.

Could these cases threaten Roe v Wade?

That is the aim for many anti-abortion campaigners. The US supreme court legalized abortion across the country in 1973, through the landmark case Roe v Wade. Until then, states had been left to make their own laws on abortion, leaving a patchwork system where some women lived in places where abortion was illegal, and others where it was safe and accessible.

That changed with Roe. The supreme court ruled that women have a constitutional right to terminate a pregnancy before a fetus can survive outside the womb, generally understood to be about 24 weeks gestation. A full term is 40 weeks.

The supreme court is made up of nine justices. Until last year, there were four generally liberal judges, four conservative, and one swing vote, Anthony Kennedy.

But when Kennedy retired last year Trump nominated Brett Kavanaugh – a conservative and a Catholic. His confirmation, after a contentious series of hearings, has has tilted the court to the right, and although Kavanaugh does not have a long track record on abortion, experts believe he will support more restrictions.

Will these cases end up in the Supreme Court?

To pressure the supreme court to take up a case, anti-abortion campaigners have pushed for these clearly unconstitutional restrictions to be passed in the seven state legislatures. Civil rights groups are forced to challenge the laws in court to stop their implementation, setting up a fight and a chance to get to the highest court.

Some groups want to use these cases to overturn Roe v Wade or severely restrict how it is interpreted.

Unless and until the supreme court speaks on one of these cases, abortion remains legal to the point a fetus can survive outside the womb in the US.

Could this plan actually work?

Abortion providers are taking the threat seriously and making plans for the future, which could include using funding to shuttle women across state lines to obtain abortions.

However, some civil rights lawyers are cautiously optimistic that the supreme court is not interested in revisiting Roe, even with new conservative justices Neil Gorsuch and Kavanaugh in place.

It is impossible to say for certain whether one of the new laws being passed by states will be considered.

But even if states do not succeed in making abortion illegal, the pile-on of restrictions has had an impact. There are fewer abortion providers and the procedure is more expensive, making it ever more difficult for women to exercise their rights.