What hasn't changed is that Anthony Kennedy finds partial-birth abortion really disgusting. We saw that in his dissent in Stenberg. That's what animates and drives his decision. His opinion blossoms from the premise that if all women were as sensitive as he is about the fundamental awfulness of this procedure, they'd all refuse to undergo it. Since they aren't, he'll decide for them.
... His opinion pretty much unfurls a roadmap for states seeking to enact broader bans on abortion. As Ginsburg points out in her dissent, the court's rationale for upholding the ban on intact D&Xs would support a ban on the (far more common) nonintact D&E as well.
The floodgates are open, sprung by a procedure that accounts for a minimal percentage of all abortions (0.17%; for context, abortions occurring after the 21st week of gestation account for 1.4% of the total; based on CDC data from 2000, this represents roughly 1,458 intact D&X procedures). Intact D&X is usually the endpoint of an agonizing series of decisions. It is not a procedure elected lightly, sandwiched between the manicure and the colorist. Fewer than two thousand women each year find themselves facing circumstances that make carrying a pregnancy to term a nonviable option (yes, that word was chosen deliberately).
Now the anguish of that decision is being compounded by the court arbitrarily eliminating the procedure that has been demonstrated to be the safest option for terminating a late-term pregnancy, because the religious right has succeeded in focusing on our emotional reaction to an imaginary Gerber baby's gruesome death rather than the reality of parents faced with an enacephalic or hydrocephalic fetus that is guaranteed a short, miserable life should it survive the rest of its gestation and birthing process at all, parents whose ability to make the most loving choice they can imagine has now been stripped away.