Maine’s largest abortion provider is warning that the state’s strong abortion rights laws would not shield patients here from possible federal efforts to restrict access under a second Trump administration.

Abortion rights advocates are arguing that former President Donald Trump, if elected, would use a 19th century law – the Comstock Act – to prevent abortion medication from being shipped. The plan is included in Project 2025, a document written by former Trump advisers as a road map for a second administration. Trump has disavowed Project 2025.

“Nothing is protecting a Department of Justice hostile to reproductive rights (from) misinterpreting and misapplying that law,” said Lisa Margulies, vice president of public affairs in Maine for Planned Parenthood of Northern New England. “The Comstock Act is one pathway to affect abortion rights in Maine. They could immediately make it illegal for providers to mail or ship any abortion supplies, including mifepristone (an abortion medication), and all other supplies required for abortion.”

About 70% of abortions that occur within the first 11 weeks of pregnancy are medication abortions, Planned Parenthood says, and they make up about 60% of all abortions.

Maine’s rural nature – which makes medication abortion even more prevalent and used because of the time it takes to travel to an abortion provider like Planned Parenthood – would make it one of the top 10 states that would lose the most access to medication abortion if the pills became difficult to obtain, according to the Guttmacher Institute, an abortion rights think tank.

But Trump and his campaign have denied having plans to restrict access as the federal level.

Trump campaign spokeswoman Karoline Leavitt said in a written statement to the Press Herald that “Harris and the Democrats are fearmongering because they know she is losing on all the issues top of mind for voters like the economy and the border. President Trump has long been consistent in supporting the rights of states to make decisions on abortion and has been very clear that he will not sign a federal ban when he is back in the White House.”

Trump, when asked by CBS News in August, said that if he wins the election he would not enforce the Comstock Act to prevent the distribution of medication abortion.

“The federal government should have nothing to do with this issue (abortion),” Trump said during the interview. “It’s being solved by the states.”

Vice President Kamala Harris is steadfastly in favor of abortion rights, and has made passing laws to make abortion legal again nationwide a cornerstone of her campaign.

Abortion rights advocates have been skeptical of Trump saying he would not enforce the Comstock Act or sign a national abortion ban, were it to be approved by Congress, because of his history of nominating Supreme Court justices hostile to abortion rights, and the pressure he would be under by anti-abortion groups.

Trump’s nominees for the U.S. Supreme Court during his term paved the way for the court to overturn Roe v. Wade in 2022, giving states the legal authority to ban or restrict access to abortion.

Margulies said that in addition to the Comstock Act, a Trump administration could try to defund abortion providers or pass any number of additional national restrictions to abortion.

“Any federal law overrides a state law,” Margulies said. “We are not out of the woods in Maine, and there would be very real human consequences to a Trump presidency.”

Since the Dobbs v. Jackson Women’s Health Organization ruling that overturned Roe v. Wade in 2022, 21 states have either banned abortion outright or passed strict regulations on when abortion can be performed, according to the Guttmacher Institute.

Maine has gone in the opposite direction, becoming less restrictive on abortion care.

Maine Gov. Janet Mills, a Democrat, is a staunch supporter of abortion rights, and Maine has passed laws to loosen any restrictions on abortions and also passed laws that attempt to shield Maine from efforts to curtail abortion rights.

In 2023, Maine passed a law that allowed abortion at any time during a pregnancy with the approval of a physician.

Maine previously outlawed abortions after fetal viability, when a prematurely born baby could live outside the womb – typically considered to be 22 to 24 weeks. Abortions that occur after 20 weeks are extremely rare, typically performed only a handful of times annually among the more than 2,200 abortions that happen in Maine per year.