PRESIDENT Joe Biden has said “it’s a sad day for the court and the country” after the Supreme Court overturned Roe v Wade – the landmark 1973 decision that legalised abortion nationwide.

“Now with Roe gone, let’s be very clear, the health and life of women across this nation are now at risk,” he said from the White House.

He added that “the court has done what it’s never done before — expressly taking away a constitution right that is so fundamental to so many Americans”, he said.

The White House has been preparing for this moment since a draft of the decision leaked in May.

READ MORE: 'One of the darkest days for women's rights': Right to abortion overturned in US

Officials have been huddling with state leaders, advocates, health care professionals and others to prepare for a future without Roe v Wade.

Now Biden’s plans will be tested in terms of politics and policy. He said his administration would defend a woman’s right to cross state lines to seek an abortion.

Outside the Supreme Court, a crowd of abortion supporters swelled to the hundreds after the ruling was issued.

One chanted into a megaphone, “legal abortion on demand” and “this decision must not stand”. Some shouted “the Supreme Court is illegitimate”.

“It’s a painful day for those of us who support women’s rights,” said Laura Free, an Ithaca resident and women’s rights historian who came to Washington to do research. When she learned of the decision, she said: “I had to come here.”

A competing faction demonstrated in favour of the ruling, holding signs saying “the future is anti-abortion″ and “dismember Roe”.

Garrett Bess, of Heritage Action for America, a lobbying arm of the conservative Heritage Foundation, said his organisation would be working in states to continue efforts to limit abortion.

“This has been a long time coming and it’s a welcome decision,” he said.

Biden and other Democrats hope to use outrage over the court decision to rally voters in November’s mid-term elections.

Although nationwide legislation ensuring access to abortion appears out of reach, more Democratic victories at the state level could limit Republican efforts to ban the practice.

In a statement, Attorney General Merrick Garland said the Justice Department “will work tirelessly to protect and advance reproductive freedom”.

He said that in addition to protecting providers and those seeking abortions in states where it remains legal, “we stand ready to work with other arms of the federal government that seek to use their lawful authorities to protect and preserve access to reproductive care”.

He also noted that the Food and Drug Administration has approved the use of mifepristone, a drug used to end pregnancies.

“States may not ban mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy,” Garland said.

House Speaker Nancy Pelosi said the ruling “is outrageous and heart-wrenching” and fulfils the Republican Party’s “dark and extreme goal of ripping away women’s right to make their own reproductive health decisions”.

House Minority Leader Kevin McCarthy told reporters that he applauds the court decision.

“A lot of lives are going to be saved,” McCarthy told reporters. “But it also goes back to people in the states to have a say in the process.”

Many Republican-controlled states are poised to severely restrict abortion or even ban it outright.

The White House has been exploring options for Biden to take executive action to safeguard abortion rights but his options are limited.

Lawrence Gostin, who runs the O’Neill Institute for National and Global Health at Georgetown Law, said ahead of Friday’s ruling that he expected the Biden administration “to be nibbling around the edges, and is not going to do anything really profound”.

READ MORE: What is Roe v Wade? Explaining the legislation which gave women the legal right to abortion

Gostin said he has discussed a variety of options with administration officials but believes they are “gun shy” given the potential for legal challenges that could lead to more roadblocks from a US Supreme Court that is currently dominated by conservatives.

Some of Gostin’s suggestions included having Medicaid cover the cost of travelling across state lines to end pregnancies, as well as expanding access to abortion medication that can be delivered by mail.

“States couldn’t pick and choose what cancer drug they would allow, and they shouldn’t be permitted to choose what options women have for medication abortions that are fully approved as safe and effective,” he said.

Alexandra LaManna, a White House spokeswoman, said earlier this week that the President “believes we should defend the right of all Americans to make their own decisions” and she added that Republican policies “include abortion bans with no exceptions for rape or incest, and criminalising women who have an abortion and the physicians who perform them”.