Forty-six years after the landmark Supreme Court decision Roe v. Wade, which established a pregnant woman's right to abortion in the U.S., legislators in Alabama passed a bill on Wednesday that bans nearly all abortions in the state, and threatens to imprison doctors for up to 99 years if they perform one, even in the case of incest or rape.

Alabama’s bill comes on the heels of another controversial bill signed by Georgia Gov. Brian Kemp last week that bans doctors from performing an abortion if they can detect a fetal heartbeat, which can often happen before a woman even realizes she is pregnant. Ohio, Kentucky and Mississippi have also passed their own versions of a "heartbeat bill," with similar legislation pending in other states.

In an era when more female leaders have been elected to Congress than ever before and women’s rights have been at the forefront of the national political debate, some have expressed surprise at the rush of laws that effectively outlaw abortion. Medical ethicist Art Caplan, the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at New York University's Langone Medical Center, however, said the movement has been simmering for a long time. What’s changed, he said, is the ascent of Donald Trump to the presidency and two new justices on the Supreme Court who are likely to overturn Roe v. Wade.

“[Anti-abortion advocates] are a key element of Donald Trump’s coalition. They put up with Trump because he delivers on the abortion issue basically for them,” Caplan said. “I think [these issues] have been lurking in the background for a long time now. It’s just in full bloom because those who believe those things sense they are in a position to impose them.”

Caplan, and others, believes this wave of anti-abortion laws are part of a broader tactic to take advantage of the appointments of Neil Gorsuch and Brett Kavanaugh to the Supreme Court, and to force the issue to be settled there.

“The anti-choice movement has been working, systematically and strategically, for decades to gut or overturn Roe v. Wade, outlaw abortion, and punish women. This is not only a direct threat to reproductive freedom, but an existential threat to women's equality,” said Rebecca Hart Holder, executive director of NARAL Pro-Choice Massachusetts. “With the elevation of Justice Kavanaugh to the U.S. Supreme Court, anti-abortion forces see a clear path to overturning Roe and they are taking their shot.”

Advocates for "heartbeat bills," such as C.J. Williams, an anti-abortion activist with the group Massachusetts Citizens for Life, say in the modern era, Roe deserves to be heard again. Williams believes that advances in medical technology, such as the ability to monitor an embryo close to after conception, prove that life begins at conception.

“These heartbeat bills are part of a grassroots wave, recognizing the scientific fact that human lives begin before birth,” Williams said. “When Roe was decided, we didn't have the science to see the human being, and hear that human heartbeat at six weeks gestation.”

Caplan disagrees, saying that it’s an overreach on the part of activists and lawmakers to grant a fetal embryo the same rights as a someone who has been born.

“I respect the idea that people want to have respect for fetal embryonic life, but to equate, as some of these laws do, embryos [with people, and] give them the same full rights from the day of conception as a person is madness because it doesn’t make any sense to say a potential person is a person,” Caplan said. “If you start talking that way, then what you’re going to have to do is arrest men who masturbate.”

Though the Alabama and Georgia laws are the latest flashpoint in debate over abortion access, the Supreme Court is already deliberating whether to hear challenges to abortion laws in Indiana and Louisiana, the latter of which could be announced as soon as Monday.