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A supporter of U.S. presidential candidate Donald Trump stands outside the Bucks County Administration building voting on demand and ballot drop center in Doylestown, Pennsylvania, on Oct. 31.ED JONES/AFP/Getty Images

Maybe you’ve seen the ad, meant to encourage American women to vote for Kamala Harris. It’s election day, a couple strolls into the polling station. He’s got the MAGA aesthetic nailed, in an eagle ballcap and big, Suburban-driving, white-bro energy. The woman, in her bedazzled stars-and-stripes hat, also gives off the vibe of a Donald Trump supporter. But is she?

From the privacy of the ballot booth, she hesitates, then selects Ms. Harris. The message: nobody has to know who you vote for, including your (creepy, controlling) husband. When he asks if she made the right choice, she replies, “Sure did, honey.”

“The one place in America where women still have the right to choose,” Julia Roberts’s voiceover declares. “What happens in the booth, stays in the booth.”

This is one creepy window into the state of America: where women are told they can lie to their Trump-loving, possibly abusive husbands in order to vote for the candidate who will protect their rights.

For women, there is so much at stake with this election – far beyond the chance to make history with a first female president. This is a critical moment that could see women’s rights built back into the safe fortress of government protection, or melt away into the MAGA mire along with other good things like equal rights, access to health care, and decency.

The U.S. Supreme Court, stacked with Mr. Trump’s conservative appointees, toppled Roe v. Wade with its Dobbs decision, revoking the federal right to abortion. Numerous states implemented abortion bans, denying pregnant women critical care. It’s a total(itarian) debacle. Mr. Trump has said he is against a full abortion ban and wants to leave it for the states to handle. That’s his way of washing his hands of this; not taking the political hit at the ballot box or risk upsetting his strangest of bedfellows, fundamentalist Christians.

Trickling the problem down to the state level is bad for women’s reproductive rights. Currently, one in three U.S. women lives in a state where abortion is banned, in some cases with no exceptions, even for rape or incest, Ms. Harris told her Washington rally this week. “The idea that a woman who survives a crime of a violation to her body should not have the authority to make a decision about what happens to her body next – that is immoral.”

The fallout has been horrendous and the chilling effect severe: women miscarrying without medical assistance; physicians unsure if they can legally intervene in a dangerous pregnancy. A recent paper published in JAMA Pediatrics found higher infant mortality rates after the Dobbs decision.

Women’s clinics have closed; doctors are choosing different specialties. There will be more of this under Mr. Trump, putting “millions of us at risk of undiagnosed issues,” as former first lady Michelle Obama warned in a fiery speech last weekend: “A woman’s body is complicated business, y’all.” One woman spent 22 days in jail on murder charges after she miscarried in her own bathroom, Ms. Obama told the crowd.

A Trump presidency would inform health care for women beyond reproduction; we are not just, as Ms. Obama said, “baby-making vessels.” If Mr. Trump removes the Affordable Care Act, many women will have less access to health care. Further, that dangerous crank Robert F. Kennedy Jr. has said Mr. Trump will put him in charge of public-health agencies.

Under Project 2025, the odious blueprint for the next Republican presidency, women can expect further rollbacks to reproductive rights and gender equality, punitive cuts to single mothers, and “biblically based” definitions of marriage and family. Pulling out even further, a second Trump presidency would have negative outcomes for women with drastic cuts expected to education, housing and environmental spending.

The contempt Mr. Trump has for women is palpable. Beyond his actual sexual crimes, there is the outright misogyny, the jokes, the dismissal, the sexist name-calling targeting whichever powerful female he considers a threat. Hillary Clinton is a nasty woman, Elizabeth Warren is “Pocahontas,” Nancy Pelosi is “crazy,” and Ms. Harris is “a very low IQ individual.” He says he’ll protect women, whether they “like it or not,” as he put it on Wednesday. His ugly, grab-women-by-the-you-know-what line is being immortalized on protest statues popping up in the U.S. This offensive rhetoric helps create the kind of atmosphere where a woman might not feel comfortable telling her husband the truth about how she voted.

What happens in the voting booth will have a major impact on the country – and the world. Imagine the current global turmoil with the added ingredient of Mr. Trump, narcissistic self-promoter, in power. A country “ruled by chaos and division,” as Ms. Harris puts it, is not good for anyone. It would be particularly shattering for women.

“Take our lives seriously, please” Ms. Obama pleaded.

This is not complicated business. This is an existential vote for women’s lives – whether we like it or not.

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