Strong reactions from Hawaii leaders in politics, law, medicine, religion and other areas followed the U.S. Supreme Court’s decision Friday to strip away constitutional protections for abortion after nearly a half-century under Roe v. Wade.

Abortion remains legal and protected under law in Hawaii; the Democratic-leaning state was the first to legalize abortion in 1970, three years before the landmark Roe v. Wade case.

So as local abortion opponents praised the Supreme Court’s latest ruling on the issue, many other community leaders vowed to step up the fight for abortion rights for all women and to increase protections in the islands. The court’s ruling is expected to spur abortion bans in roughly half the states.

Gov. David Ige said in a statement that “despite the ruling, I can assure you that women in Hawaii will continue to have access to the healthcare they need, and that includes abortion. Hawaii law already protects the right of individuals to make their own deeply personal reproductive health decisions, including the right to seek abortion care. I will do everything in my power to ensure that women retain control over their own reproductive choices.”

Ige added that the “extreme” court ruling “is outrageous and a huge step backward for women’s rights.”

Thousands of demonstrators in major cities from Los Angeles to New York held mostly peaceful protests Friday. An abortion-rights rally near the federal building in downtown Honolulu drew about 150 to 200 demonstrators, many carrying signs with slogans such as “My body, my choice” and “Abortion is health care.”

Lt. Gov. Josh Green, an emergency room doctor who is running for governor as a Democrat; Ikaika Anderson, a Democrat running for lieutenant governor; and Patrick Branco, who is running for Congress, were among those who attended. Another demonstration at the same location was set for 3 p.m. today.

Liz Rees, an organizer with the community groups Rise Up 4 Abortion Rights Hawai‘i and Refuse Fascism Hawai‘i, which spearheaded Friday’s demonstration, said the groups had been preparing for months to “take to the streets,” but especially after a leaked draft of the Supreme Court’s decision was reported last month.

She said she is concerned that too many local residents “tend to feel they’re separate from the attacks across the country. … Make no mistake, this will impact Hawaii. Their goal is a nationwide ban on abortion.”

Leaders who oppose abortion also released impassioned reactions in support of the court’s decision. They also called for more compassion, support and education for pregnant women.

The Catholic Church in Hawaii said in a statement from the Diocese of Honolulu that “while we have no illusions that abortion will be restricted in Hawaii where its legalization has strong political support, the absence of Roe’s false argument that abortion is a constitutional right provides an environment for a more honest civic discussion on the topic.”

The church continued: “The overturning of Roe does challenge the Catholic Church to provide women an alternative to abortion and help through the circumstances that cause women to choose abortion. The church in Hawaii is redoubling efforts to accompany women and couples who are facing unexpected or difficult pregnancies, offering them loving and compassionate care.”

Such support, the church said, includes ministries and counseling; programs to help with housing, food, clothing and infant supplies; and a new initiative called Walking with Moms in Need, sponsored by the U.S. Conference of Catholic Bishops, that helps parishioners connect with local mothers facing difficult circumstances.

Eva Andrade of Hawaii Family Forum, a nonprofit educational and advocacy organization she described as “pro life,” said she was pleased with the court’s ruling. But since abortion is likely to continue to be protected by state law here, she said Hawaii’s next steps should include ensuring that women receive stronger education about all their options, including adoption; improving systemic support to ensure women can get food, housing and child care; and growing awareness of “pregnancy centers” for counseling and health care “to make sure that they know that there are more options than just abortion.”

Lynn Finnegan, state chairperson of the Hawaii Republican Party, said she is glad for the court’s decision but does not anticipate an effort by her party at this time to try to change the Hawaii state law protecting a woman’s right to choose abortion, although her party’s platform continues to oppose it.

“Life is precious,” she said, adding that she hopes the community will seize the moment to “have that conversation within our community and at the state Legislature, reflective of what the people want.”

A medical issue

Hawaii law allows abortion until a fetus would be viable outside the womb. After that, it is legal if a patient’s life or health is in danger.

For many years only licensed physicians could perform the procedure. Last year the state enacted a law allowing advanced practice care nurses to carry out in-clinic abortions during the first trimester. This was to help women on more rural islands who have been flying to Honolulu to obtain abortions because of doctor shortages in their communities.

The law allows the nurses to prescribe medication to end a pregnancy and to perform aspiration abortion, a type of minor surgery during which a vacuum is used to empty a woman’s uterus.

The Hawaii Medical Association, which represents local physicians and is part of the American Medical Association, said in a statement that Friday’s court ruling “endangers the health of millions of women, violates the autonomy and dignity of women, and interferes with the inviolable patient-physician relationship. … HMA considers abortion, like all medical issues, as a decision to be made by patients in conversation with their health care professionals, and free from unwarranted interference by other parties. As with all medical decisions, the privacy, respect, dignity, safety, and support of women receiving an abortion are fundamental rights.”

The association added that it supports thorough education and access to all types of health care, and condemns the harassment of patients and health care professionals, including providers of abortion care.

A statement from the Hawaii, Guam and American Samoa Section of the American College of Obstetricians and Gynecologists condemned the court decision, saying it would “increase pregnancy-related mortality, and violates the values that we as health care professionals swore to uphold. By putting physicians in fear of criminal penalties for providing evidence-based, appropriate, lifesaving care, and denying patients the ability to turn to their trusted physicians for care, this decision fundamentally compromises the patient-physician relationship.”

Rebecca Gibron, CEO of Planned Parenthood Great Northwest, Hawaii, Indiana, Kentucky, said, “It is my promise to every person in Hawaii that Planned Parenthood will never back down. We will keep fighting with everything we’ve got to ensure that everyone can access the care you need to control your body and your life. I want to be clear: Planned Parenthood will always be here to help you get the care you need. Abortion remains safe and legal in Hawaii, and our health centers are open and ready to provide you care.”

Call for vigilance

Fifty-seven Democratic members of the Hawaii state Legislature, led by Senate President Ronald Kouchi, issued a joint statement calling the court ruling “disturbing” and urging abortion- rights supporters to “remain vigilant and continue to ensure that a woman’s right to reproductive health care is protected in Hawaii and access is provided to those who need it. Our sisters, daughters and granddaughters deserve to grow up in a country where they are afforded more rights, not less.”

Gary Yamashiroya, a spokesperson for the state Department of the Attorney General, has said the attorney general was carefully considering measures Hawaii might take to protect and strengthen reproductive rights if Roe was ended.

“No matter the outcome, our state remains committed to reproductive freedom and choice,” he said.

In a statement, the state Department of the Attorney General called the ruling “deeply disappointing and profoundly wrong.” The decision “strips away a fundamental right, causing immediate and devastating consequences for those seeking access to safe reproductive health care. Despite the Supreme Court’s decision, abortion care remains protected under Hawaii law. In the state of Hawaii, individuals have the right to make their own decisions about their own bodies and futures; these decisions are profoundly personal. The Department of the Attorney General will continue its work in the fight to protect and strengthen reproductive rights.”

It was not immediately clear whether Hawaii might join the “West Coast offensive,” a cooperative effort by California, Oregon and Washington to protect abortion rights and services. Helping women who travel to seek abortions and shielding patients and medical professionals from being pursued by authorities in states where the procedure becomes outlawed are included in the plan announced Friday by the governors of the three states.

Hilary Rosenthal, staff attorney at ACLU of Hawaii, said her organization is concerned that abortion and health care access “remain inaccessible to many people, especially people who are poor, people who live in rural areas or on islands without easily accessible clinics, and Indigenous people and people of color who already experience significant health disparities. The decision … will affect these people the most.”

Rosenthal added that the decision “puts many other fundamental rights on the chopping block. The decision implies that, because certain rights are not specifically mentioned in the U.S. Constitution, they may not be guaranteed: such rights could include the right to same-sex marriage, access to birth control, and potentially much more. … Going forward, although the right to abortion is currently protected by law in Hawaii, the ACLU of Hawaii will be vigilantly watching to make sure that not only remains the case, but also that access to it becomes more equitable.”

Delegation united

Hawaii’s four-member congressional delegation, all Democrats, issued statements decrying the ruling and condemning the Supreme Court’s conservative majority for restricting women’s rights.

“The Republican-controlled Supreme Court has ripped away abortion rights from millions of American women,” Sen. Brian Schatz said. “While this ruling won’t impact Hawaii, which legalized abortion in 1970, we must fight back to protect reproductive rights for women across the country. A woman’s fundamental right to make decisions about her own body are hers alone — not the government’s.”

Sen. Mazie Hirono said the ruling made Friday “a horrific day in America. The Supreme Court was confronted with a fundamental question: who should have control over a woman’s body, a woman or a bunch of politicians. … The Supreme Court decided it should be a bunch of politicians. Their decision to overturn Roe will go down as one of the worst decisions in the history of the court.”

Hirono continued: “The far-right MAGA majority on the Supreme Court has stripped women in this country of a fundamental constitutional right we have relied on for nearly 50 years — which is what Donald Trump, Mitch McConnell and extreme Republicans have wanted all along. Democrats in Congress are going to keep fighting to do everything we can to support women across the country — including expanding access to free contraception, protecting women’s health data, and passing the Women’s Health Protection Act to enshrine the right to abortion into federal law.

“Women are going to suffer and die because of this decision. Republicans are going to have to answer for this in November.”

Rep. Ed Case called the ruling “tragic on so many fronts. It rejects the basic rights of women, condemns millions of women and their families back to a dark pre-Roe world, dismisses a careful balancing of interests that has stood for two generations, undermines our institutions of government and embarrasses us in the eyes of the world.

“Our Hawaii had it right with our first-in-the-nation law in 1970, and must now stand strong with other like-minded states against the further assault on women’s and other rights already underway until we can reverse this retreat to an intolerant past in our legislatures and courts.”

Rep. Kai Kahele said “the Supreme Court failed us. The court’s decision to overturn Roe v. Wade and eliminate the constitutional right to abortion is an assault on Americans’ means to safely choose their own future, and will further marginalize the most disadvantaged in our communities. I grieve with the women and families in our lives who will mark today as the day they were left behind by their country. … Hawaii was the first state to decriminalize abortion to support our values of equal opportunity and gender equity, and Hawaii will continue to protect a woman’s right to choose.”

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The Associated Press and Star-Advertiser photojournalist Cindy Ellen Russell contributed to this report.