In the first major abortion case of the Trump era, U.S. Supreme Court Chief Justice John Roberts joined his more liberal colleagues Monday to strike down a Louisiana law that would have restricted women’s access to the procedure.

The case, June Medical Services LLC v. Russo, dealt with a Louisiana law, known as Act 620, that required any physicians who perform abortions to have admitting privileges at local hospitals. The law was essentially identical to one in Texas that the high court struck down in 2016, Whole Woman’s Health v. Hellerstedt.

Justice Stephen Breyer wrote an opinion for the court’s liberal wing, and Roberts, who has previously favored abortion restrictions, concurred with the judgment separately, out of respect for precedent set by Whole Woman’s Health.

“I joined the dissent in Whole Woman’s Health and continue to believe that the case was wrongly decided,” Roberts wrote in the Monday opinion. “The question today however is not whether Whole Woman’s Health was right or wrong, but whether to adhere to it in deciding the present case.”

In his conclusion, Breyer’s also cited precedent for striking down the law, which is better known in the legal world as stare decisis, or “to stand by things decided.”

“This case is similar to, nearly identical with, Whole Woman’s Health. And the law must consequently reach a similar conclusion,” he wrote. “Act 620 is unconstitutional. The Court of Appeals’s judgment is erroneous. It is reversed.”

Roberts’ swing vote surprised women’s reproductive rights advocates, who welcomed the victory, at least for the time being.

Mars Earle, director of engagement at the Carolina Abortion Fund, said during a press conference Monday that they were celebrating, but that it was bittersweet because abortion is not easily accessible for all.

“I know that for the dozens of abortion patients who will call our help line this week and next week and the weeks following that their ability to access care is not improved, that the Supreme Court statements about undue burden still leaves enough space that people – particularly poor and low-income Black and Brown families – are being left behind every day,” they said.

They cited cost issues, geography and stigma as unacceptable burdens on access to abortion.

“The ability to choose to terminate a pregnancy is in inherent value and our right to bodily autonomy, and we will not and cannot compromise on our people,” Earle said. “While the law gives us important ground to move forward, true liberation of abortion access will not be achieved until every person facing a pregnancy choice is able to make their own decisions freely, confidently and without fear of retribution.”

Tara Romano, executive director of NARAL Pro-Choice North Carolina, said the high court’s decision to strike down the Louisiana law upholds the precedent set four years ago that anti-abortion politicians cannot impose arbitrary and medically unnecessary burdens on people seeking abortions.

“The court’s ruling earlier today is especially good news for the people of Louisiana, who will still have access to abortion care in their state,” she said. “While this decision upholds the right to access abortion, in practice, abortion is still inaccessible for far too many people – especially Black and Brown people, LGBTQ+ individuals, and people of lower income, including here in North Carolina.

“We urge state and federal lawmakers to expand access to abortion for everyone who needs it and to stop playing political games with our basic human right to access comprehensive reproductive health care.”

Dr. Amy Bryant, a North Carolina OBGYN who provides abortion care, said she sees patients every day who struggle to access essential healthcare, including abortion care.

Abortion care is extremely safe, she said, and admitting privileges for doctors are unnecessary if patients aren’t sent often to hospitals or emergency rooms, which is the reality more often than not.

Bryant also praised the Supreme Court for upholding that doctors have standing to bring cases on behalf of their patients, noting that this has become more common over the past 20 years.

“As a person who provides abortion care, I do try to think about all of the things that my patients go through and the many challenges, the many struggles that they face, and I also know that abortion can be a stigmatized and difficult decision for some people,” she said, adding that it’s a huge win for physicians to be able to continue to fight for their patients in a myriad of ways.

She also pointed out that North Carolina previously tried to pass a similar law but was unsuccessful.

Each of the four Justices who disagreed with the majority wrote their own dissents, including President Donald Trump’s two appointees, Neil Gorsuch and Brett Kavanaugh.

“The plurality and the Chief Justice ultimately cast aside this jurisdictional barrier to conclude that Louisiana’s law is unconstitutional under our precedents,” wrote Justice Clarence Thomas. “But those decisions created the right to abortion out of whole cloth, without a shred of support from the Constitution’s text. Our abortion precedents are grievously wrong and should be overruled.”

A trial judge had said the law would not provide health benefits to women and would leave only one clinic open in Louisiana, in New Orleans, with one provider to serve the 10,000 women annually who seek abortions in the state. The same judge ruled that burden would make it too difficult for women to get abortions, which violated the Constitution.

An appeals court in New Orleans overturned those findings and upheld the law in 2018, which led to the Supreme Court challenge.

Like the advocates, Democratic lawmakers celebrated the win but expressed concern for the future of abortion and vowed to continue fighting for reproductive rights. Sen. Natalie Murdock (D-Durham) said access to abortion care remains a right on paper only for too many people.

“Politicians all over the country, including right here in North Carolina, have pushed basic health care almost out of reach for millions of people, and your ability to access abortion is still determined by where you live, how much money you make, and in this country, that effectively also means the color of your skin,” she said. “For Black people in particular, there can be no reproductive freedom until there is freedom to live without fear of persecution from violence – that violence can be as blatant as police brutality or as subtle as policies that chip away the ability to control one’s body and future.”

Murdock said she will keep fighting in the North Carolina General Assembly. Rep. Julie von Haefen (D-Wake) and Sen. Natasha Marcus (D-Mecklenburg) agreed.

“In addition to being a Senator, I am also an attorney, and I know that precedent is supposed to control, and if our democracy was operating the way it should be, let’s be clear, we would not have had to even worry about the Supreme Court changing the law so soon after deciding a nearly identical case just four years ago,” Marcus said. “A change in who is appointed to the Supreme Court as a justice, it is not supposed to change our most basic rights to control our body. And although there is no current North Carolina restriction that is directly impacted by this Supreme Court decision today … this does send a resounding message to us as legislators that we should not try to go down this road.

“I hope all the legislators who serve with me and Sen. Murdock and with Rep. von Haefen hear that message today very clearly.”