WASHINGTON >> The Supreme Court today stripped away women’s constitutional protections for abortion, a fundamental and deeply personal change for Americans’ lives after nearly a half-century under Roe v. Wade. The court’s overturning of the landmark court ruling is likely to lead to abortion bans in roughly half the states.

The ruling, unthinkable just a few years ago, was the culmination of decades of efforts by abortion opponents, made possible by an emboldened right side of the court fortified by three appointees of former President Donald Trump.

Both sides predicted the fight over abortion would continue, in state capitals, in Washington and at the ballot box. Justice Clarence Thomas, part of today’s majority, urged colleagues to overturn other high court rulings protecting same-sex marriage, gay sex and the use of contraceptives.

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Pregnant women considering abortions already had been dealing with a near-complete ban in Oklahoma and a prohibition after roughly six weeks in Texas. Clinics in at least eight other states — Alabama, Arizona, Arkansas, Kentucky, Missouri, South Dakota, Wisconsin and West Virginia — stopped performing abortions after today’s decision.

Abortion foes cheered the ruling, but abortion-rights supporters, including President Joe Biden, expressed dismay and pledged to fight to restore the rights.

“It’s a sad day for the court and for the country,” Biden said at the White House. He urged voters to make it a defining issue in the November elections, declaring, “This decision must not be the final word.”

Outside the White House, Ansley Cole, a college student from Atlanta, said she was “scared because what are they going to come after next? … The next election cycle is going to be brutal, like it’s terrifying. And if they’re going to do this, again, what’s next?”

Marjorie Dannenfelser, president of SBA Pro-Life America, agreed about the political stakes.

“We are ready to go on offense for life in every single one of those legislative bodies, in each statehouse and the White House,” Dannenfelser said in a statement.

Trump praised the ruling, telling Fox News that it “will work out for everybody.”

The decision is expected to disproportionately affect minority women who already face limited access to health care, according to statistics analyzed by The Associated Press.

It also puts the court at odds with a majority of Americans who favored preserving Roe, according to opinion polls.

Surveys conducted by The Associated Press-NORC Center for Public Affairs Research and others have shown a majority in favor of abortion being legal in all or most circumstances. But many also support restrictions especially later in pregnancy. Surveys consistently show that about 1 in 10 Americans want abortion to be illegal in all cases.

The ruling came more than a month after the stunning leak of a draft opinion by Justice Samuel Alito indicating the court was prepared to take this momentous step.

Alito, in the final opinion issued today, wrote that Roe and Planned Parenthood v. Casey, the 1992 decision that reaffirmed the right to abortion, were wrong had to be be overturned.

“We therefore hold that the Constitution does not confer a right to abortion. Roe and Casey must be overruled, and the authority to regulate abortion must be returned to the people and their elected representatives,” Alito wrote, in an opinion that was very similar to the leaked draft.

Joining Alito were Thomas and Justices Neil Gorsuch, Brett Kavanaugh, Amy Coney Barrett. The latter three justices are Trump appointees. Thomas first voted to overrule Roe 30 years ago.

Four justices would have left Roe and Casey in place.

The vote was 6-3 to uphold the Mississippi law, but Chief Justice John Roberts didn’t join his conservative colleagues in overturning Roe. He wrote that there was no need to overturn the broad precedents to rule in Mississippi’s favor.

Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan — the diminished liberal wing of the court — were in dissent.

“With sorrow—for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection—we dissent,” they wrote, warning that abortion opponents now could pursue a nationwide ban “from the moment of conception and without exceptions for rape or incest.”

Attorney General Merrick Garland said in a statement that the Justice Department will protect providers and those seeking abortions in states where it is legal and also “work with other arms of the federal government that seek to use their lawful authorities to protect and preserve access to reproductive care.”

In particular, Garland said that the federal Food and Drug Administration has approved the use of Mifepristone for medication abortions.

More than 90% of abortions take place in the first 13 weeks of pregnancy, and more than half are now done with pills, not surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

Mississippi’s only abortion clinic, which was at the center of today’s case, continued to see patients today. Outside, men used a bullhorn to tell people inside that they would burn in hell. Clinic escorts wearing colorful vests used large speakers to blast Tom Petty’s “I Won’t Back Down” at the protesters.

Mississippi, Alabama, Kentucky and Missouri are among 13 states, mainly in the South and Midwest, that already have laws on the books to ban abortion in the event Roe was overturned. Another half-dozen states have near-total bans or prohibitions after 6 weeks of pregnancy, before many women know they are pregnant.

In roughly a half-dozen other states, including West Virginia and Wisconsin, the fight will be over dormant abortion bans that were enacted before Roe was decided in 1973 or new proposals to sharply limit when abortions can be performed, according to Guttmacher.

Outside the barricaded Supreme Court, a crowd of mostly young women grew into the hundreds within hours of the decision. Some shouted, “The Supreme Court is illegitimate,” while waves of others, wearing red shirts with “The Pro-Life Generation Votes,” celebrated, danced and thrust their arms into the air.

The Biden administration and other defenders of abortion rights have warned that a decision overturning Roe also would threaten other high court decisions in favor of gay rights and even potentially contraception.

The liberal justices made the same point in their joint dissent: The majority “eliminates a 50-year-old constitutional right that safeguards women’s freedom and equal station. It breaches a core rule-of-law principle, designed to promote constancy in the law. In doing all of that, it places in jeopardy other rights, from contraception to same-sex intimacy and marriage. And finally, it undermines the Court’s legitimacy.”

And Thomas, the member of the court most open to jettisoning prior decisions, wrote a separate opinion in which he explicitly called on his colleagues to put the Supreme Court’s same-sex marriage, gay sex and contraception cases on the table.

But Alito contended that his analysis addresses abortion only. “Nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion,” he wrote.

Whatever the intentions of the person who leaked Alito’s draft opinion, the conservatives held firm in overturning Roe and Casey.

In his opinion, Alito dismissed the arguments in favor of retaining the two decisions, including that multiple generations of American women have partly relied on the right to abortion to gain economic and political power.

Changing the makeup of the court has been central to the anti-abortion side’s strategy, as the dissenters archly noted. “The Court reverses course today for one reason and one reason only: because the composition of this Court has changed,” the liberal justices wrote.

Mississippi and its allies made increasingly aggressive arguments as the case developed, and two high-court defenders of abortion rights retired or died. The state initially argued that its law could be upheld without overruling the court’s abortion precedents.

Justice Anthony Kennedy retired shortly after the Mississippi law took effect in 2018 and Justice Ruth Bader Ginsburg died in September 2020. Both had been members of a five-justice majority that was mainly protective of abortion rights.

In their Senate hearings, Trump’s three high-court picks carefully skirted questions about how they would vote in any cases, including about abortion.

Associated Press writers Jessica Gresko, Fatima Hussein and AP video journalist Nathan Ellgren in Washington, Alanna Durkin Richer in Boston, Emily Wagster Pettus in Jackson, Mississippi, Scott Bauer in Madison, Wisconsin, and Leah Willingham in Charleston, West Virginia, contributed to this report.