This year we saw some major wins in reproductive justice: Ohio voted to enshrine reproductive protection into their state constitution, Virginians blocked Gov. Youngkin’s hopes for a 15-week abortion ban and abortion coverage expanded or resumed in states like Wisconsin.

But it was far from a fairytale ending for 2023. The type of reproductive care one can and cannot access continues to be impacted by state laws and the people who make them. The fall of Roe v. Wade exacerbated long-standing issues like pregnancy criminalization, and forced even more pregnant people to travel significant distances to receive healthcare and abortion.

From pushing for harsher abortion restrictions to taking legal action against FDA-approved medication – that’s used for more than just abortion – these are 5 people who sucked in 2023:

Texas Attorney General Ken Paxton

Kate Cox has become the face of the reproductive rights ban showdown in Texas, forced to flee the state to receive an abortion for a life-threatening pregnancy – even though legislation claims there are exceptions to the law for people in this situation.

After a lower court approved her exception, Attorney General Ken Paxton ran this case to the Texas Supreme Court, then sent a letter to local hospitals threatening the civil and legal liability of anyone involved in Cox’s abortion process.

In February, Paxton filed a lawsuit against the Biden administration to prevent pharmacies in Texas from prescribing abortion-inducing drugs. Paxton has a strong history of chiming in on anti-abortion legislation around the country, which he boasts about on his website.

Florida Gov. Ron DeSantis

Currently on his bid for the White House, Florida Gov. Ron DeSantis said during a Republican presidential debate in October, that he would support a federal 15-week abortion ban, implying that he would continue pushing pro-life initiatives that he’s supported in his state.

This April, DeSantis signed the “Heartbeat Protection Act,” a bill approving a six-week abortion ban in Florida, though he publicly went against the language penned in this law he pushed during an interview with CBS Evening News, stating that he does not support criminalizing women who get abortions.

“We have no criminal penalty. The penalties are for the physician,” he said. The law itself broadly states that “any person who willfully performs or actively participates in a termination of pregnancy” is committing a third-degree felony.

According to Advancing New Standards in Health, one in three people find out that they’re pregnant past the six week mark. This is frequently the case for young people, people of color and people facing food insecurity – meaning that restrictive abortion policies like this impact these communities the most.

Florida’s Supreme Court will decide on the state’s current 15-week ban and, if it’s upheld, the six-week ban would be triggered about a month after. According to the Independent Florida Alligator, there is currently no date set for the court’s decision.

Iowa Gov. Kim Reynolds

Iowa Gov. Kim Reynolds also signed a “heartbeat law” this year, as fetal personhood — laws granting fetuses the same or more rights than a pregnant person — was a major theme in pro-life legislation this year.

In July, Reynolds called for a special legislative session specifically to pass reproductive restrictions.

“I believe the pro-life movement is the most important human rights cause of our time. Not only will I continue to fight against the inhumanity of abortion, but I will also remain committed to supporting women in planning for motherhood, promoting fatherhood and parenting and continuing policies that encourage strong families. These are the most essential building blocks of our society and they are what will keep the foundation of our state and country strong for generations to come,” Reynolds said in a press release.

Ohio Gov. Mike DeWine

Misinformation infiltrated Ohio’s road to implementing constitutional protection over abortion and Ohio Gov. Mike DeWine was accused of playing a major role in this.

With a track record of supporting anti-abortion legislation, Issue 1 — the constitutional amendment on Ohio’s Nov. 7 ballot to protect reproductive freedom — became a major talking point for the Republican.

“Issue 1 is just not right for Ohio,” DeWine said in a political ad in which he sits alongside his wife, Fran. His statements prompted responses from multiple local political commentators, who accused him of gaslighting and making false claims.

Cleveland’s local NBC-affiliate news station also published fact-checking segments on the ads. In a follow-up interview with WKYC, he claimed Issue 1 would override parental consent laws and allow an abortion at any time during pregnancy.

In October, DeWine told reporters, “For many years, in Ohio and in this country, we’ve had a law that said a partial-birth abortion — where the child is partially delivered and then killed and then finally delivered — was illegal in Ohio. This constitutional amendment would override that.”

This statement was also false, according to constitutional scholars interviewed by the AP.

Alliance Defending Freedom

If you haven’t heard this name, get familiar. Alliance Defending Freedom (ADF) is a conservative legal group behind some major lawsuits challenging abortion laws and access to contraception around the country. According to the New Yorker, the group has 14 wins over the past few decades under its belt, including overturning Roe and allowing employer’s health insurance policies to deny birth control coverage.

Their latest venture is challenging medication abortion. ADF represents four doctors and medical organizations questioning the validity of mifepristone’s FDA approval in the Alliance for Hippocratic Medicine v. FDA, a case that will be heard by the Supreme Court later this year.

With more than half of abortions done using pills, this threat to remove access to one of the two drugs considered the standard in medication abortions could shift the status quo of medication abortion and early pregnancy loss management, according to The American College of Obstetrics and Gynecology. Though it would not be an end all be all, as misoprostol alone has also proven to be a safe way to induce a pregnancy termination, ADF, or other groups like it, presumably wouldn’t stop there.

According to a Dec. 20 Reproductive Rights Today newsletter, ADF is also behind several ongoing abortion and contraception cases, including one that would impose penalties on Idaho doctors who perform abortions in emergency settings.