TEXAS — Dr. Harold Miller, a retired obstetrician-gynecologist, said he will never forget the only time a patient of his died. The Air Force veteran who lives in Houston recounted over 50 years ago how he tried to help a woman in her twenties who became infected after undergoing an illegal abortion. He said he almost quit practicing medicine.

“On Saturday morning she died and I cried. I was so upset that I had gone through this training to be in a field and I could not save her life. It was devastating to me,” Miller said.

That was before Roe v. Wade, the landmark 1973 U.S. Supreme Court decision that made access to abortion a constitutional right up to 22 weeks of pregnancy. A majority of the court found that Texas statutes criminalizing abortion violated the implicit right to privacy under the Constitution. 

Saturday marks the 49th anniversary of the decision and comes when the current high court’s conservative majority seems receptive to uphold a Mississippi law that bans abortion after 15 weeks of pregnancy. A decision is expected by early summer. The court already has refused to block a new Texas law banning abortions after six weeks of pregnancy. 

Abortion providers are preparing for the possibility of more people crossing state lines to obtain the procedure in places where such restrictions are not in effect.

Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, said her clinic staff are put in a position against their will to have to explain to patients these new rules.

“People are shocked. They're desperate, they beg us for alternatives,” Hagstrom Miller said. “Abortion has been safe and legal in this country for 49 years this month through a case that Sarah Weddington argued, a Texas case at the Supreme Court. And now look. Texas is basically undoing those decades of civil rights and justice that people all over the country have been able to enjoy.”

Scaling back Roe would return the question of abortion rights to the states. It would create a patchwork of laws across the country, and abortion rights would depend on where one lives. It could also be an issue for Congress to take up. Democrats want to pass legislation making abortion legal, but they currently have no Republican support.

“We have to be sensitive, we have to be compassionate. Women, girls that find themselves in this position of having an unwanted pregnancy have to understand that abortion is not their only option. You know, what are we doing as a community to support them through this?” said Rep. Beth Van Duyne, R-Irving. “What are we sharing with them as far as financial assistance, emotional assistance, medical assistance, that they don't feel like they're cornered into abortion?”

On the House floor last year when the U.S. House took up legislation to protect the right to abortion access, Van Duyne shared the devastation of a miscarriage while holding a model of a fetus.

“It's very difficult and, you know, even years later, it still has an effect on women. You still feel that loss that I think we tend to discount when we glorify abortion,” Van Duyne said.

As for Miller, he fears there will be more unsafe procedures if restrictive abortion laws are allowed to remain.

“Women are going to seek abortions. They're going to be illegal abortions, and they are risking their reproductive health and/or their lives,” Miller said.

If Roe does not make it to 50 years and the landmark decision is overturned or rolled back, nearly half of the states have signaled their intention to quickly further restrict abortion access.