roe v wade summary overturned

Roe v Wade Overturned: What It Means, What’s Next

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On Friday, June 24, 2022, the US Supreme Court overturned Roe v. Wade, the landmark piece of legislation that made access to an abortion a federal right in the United States. The decision dismantled 50 years of legal protection and paved the way for individual states to curtail or outright ban abortion rights.  

Already, because of trigger laws put in place before the ruling, abortion is now outlawed in many states automatically or through state action following the decision. In addition, Justice Clarence Thomas wrote that certain other landmark rulings should be reconsidered, including established rights to contraception access, same-sex relationships, and same-sex marriage.  

Incoming Professor of Sociology Tracy Weitz is a national expert on abortion care, policy, culture, and politics. She is the co-founder and former director of the University of California San Francisco’s Advancing New Standards in Reproductive Health research program.  

We asked Weitz to share her opinions on the outcomes of the overturning of Roe and what it will mean for people across the United States.

Q. Roe v Wade has been overturned. What will happen now across the country? 

A. Nine states have already implemented their abortion bans. Another dozen states are in the process. Legal chaos is occurring as injunctions against individual state laws are being lifted and pre- Roe bans are being interpreted. In a few states, new injunctions are being issued before laws can go into effect. Governors who are hostile to abortion, but whose states have not yet fully banned abortion, are contemplating whether to call special sessions of the legislature to consider new abortion bans.  

Abortion providers in all the banned and several of the in-process states have stopped providing abortion care or reduced the type of care they offer. People with previously scheduled appointments are scrambling to find new appointments in states where some abortion is still available. These include abortion-safe states as well as states like Florida, Ohio, and Georgia where there are new gestational limits for abortion but not yet complete bans.  

Abortion clinics in states where abortion remains legal, including Illinois and Kansas, are working hard to expand appointment availability by hiring new staff, increasing the physical plant of their facilities, and adding additional clinic appointments. Clinics in the in-process states are doing their best to manage immediate increased patient demand even as they are preparing for a future in which they may not be able to continue offering abortions.

Q. Who will be most impacted by this decision? What will happen if people can’t access abortions? 

A. The only alternative to abortion is childbirth, which has a 14 times higher risk of death than that abortion. So, in denying a person access to a wanted abortion, states are forcing people to assume significant medical risk against their will. A recent study out of Colorado ominously predicts a significant rise in the maternal mortality rate, especially among Black women who already experience an unacceptably high rate of death in childbearing. 

Research from the Turn Away study demonstrated other deleterious impacts of being denied a wanted abortion. This study followed ~1000 self-identified women for five years after receiving or being denied a wanted abortion. They found that denying these women an abortion creates economic hardship and insecurity that lasts for years. Compared with women who obtained their desired abortion, women denied the abortion had lowered credit scores as well as increased debt, bankruptcies, and evictions. Women turned away from getting an abortion were also more likely to stay in contact with a violent partner. The financial well-being and development of prior and subsequent children was also negatively impacted. Finally, giving birth was connected to more serious long-term health problems than having an abortion. 

Q. Can you tell us a bit about the people who choose to get an abortion — and the reasons why? 

A. Abortion is a health care option most frequently needed by people affected by the structural inequalities of poverty, racism, and xenophobia. Almost 75 percent of US abortion patients live at or below 250 percent of the federal poverty level. More than 50 percent of abortion patients are women of color, and 60 percent of all patients already have children. 

People’s reasons for abortion are as complex as their individual lives, and I fundamentally believe no one should have to justify their reason for abortion; simply wanting to no longer be pregnant, or needing an abortion to save their own life, is enough.

Q, What does this mean for doctors who perform abortions in states where it will be curtailed or outlawed?

A. In all the states where abortion is being banned, physicians stopped providing abortion care immediately after the decision, or will do so after their state law takes effect.  

In some states where abortion is now banned, significant medical care was provided by physicians who traveled from outside the state. These physicians will likely start providing care in one of the places where abortions remain legal, and demand is increasing. However, there are other skilled and dedicated physicians who have provided abortion care for decades to women in their communities. Some of these physicians offer other types of health care and will continue to do so, without offering the abortion care their patients need. Those physicians who only provided abortions will need to decide whether to retire or relocate.  

Other clinical staff including nurses, social workers, patient counselors, and medical assistants are also losing their jobs and their ability to provide economically for their families. Women in communities across the abortion-banned states have relied on these teams of health care providers to care for them during an important time in their lives. It is cruel what is happening to pregnant people, and it is cruel what is happening to the dedicated staff that make up the abortion providers of this country.

Q. What is the difference between emergency contraception and medication abortion?  

A. Emergency contraception (EC) and medication abortion are not the same thing: they use different drugs that work differently on the body. EC stops pregnancy from happening. Medication abortion ends an already existing pregnancy. One brand of EC, Plan B, is available over the counter without a prescription. Medication abortion requires a clinical consultation (either via a telehealth visit or a visit to a clinic). EC can be used up to 72 hours after unprotected sex, while medication abortion is used between the time of a missed period (usually four weeks) and 11 weeks after the first day of the last normal menstrual period.

Q. How will this ruling affect women’s access to each? 

A. At this time, abortion bans include bans of medication abortion. Emergency contraception is not included in abortion bans. However, many politicians who are hostile to abortion also disagree with emergency contraception, and we may see efforts to restrict access to EC in the future. The FDA could help expand access to EC by approving the second EC option, Ella, as an over-the-counter drug. Plan B is less effective for people of higher body weight, and Ella helps ensure these people also have access to an EC option. 

At this time, clinicians who provide medication abortion via telehealth can only provide it in states where abortion remains legal. Abortion-supportive states that wish to ensure access to abortion in states where it is banned could protect clinicians in their state who provide abortion care to people in banned states. The Federal government could explore ways to protect this practice. Until then, people who need medication abortion in states where abortion is banned can self-source these medications from international telehealth providers or international pharmacies.

Q. Almost 90 percent of abortions occur in the first 12 weeks of pregnancy. Can you tell us some of the reasons why women need to have abortions later in pregnancy?  

A. Many people do not know they are pregnant until after the 12th week: some are still bleeding, others are on medications that caused cycle changes, and still other people do not have pregnancy symptoms.  

Another reason people pass the 12th week of pregnancy is that gathering the money to pay for the abortion is extremely hard. Currently, the Federal government and 33 states prohibit people from using Medicaid to pay for abortions. Yet the majority of people who need abortion live at or below poverty. In order to gather the money, they forgo paying rent or food bills, and all of this delays their ability to obtain an abortion when they first want one. And after they pass the 12 weeks mark, the cycle perpetuates itself. The cost of the abortion begins to increase as the clinical care becomes more complex, thus requiring more money and causing more delays.  

For still other people, the abortion decision is made following learning something about their own health status or the health status of the fetus. Medical complications in pregnancy increase as people become more pregnant, and some do not onset until later in pregnancy. Issues with the growth of the fetus occur as the fetus develops and are not diagnosable until later in pregnancy.

Q. Then what will happen now if a mother’s life is in danger? 

A. We do not have data on how often a pregnancy threatens a person’s life because this care has often occurred in hospital settings, which do not routinely advertise that they do abortions. Physicians who treat these pregnancies, including maternal fetal medicine and complex family planning physicians, rarely discuss these cases publicly, in part because of the social discomfort with abortions later in pregnancies. Limited research on hospital policies regarding abortion care demonstrates significant barriers to obtaining institutional support for abortions, regardless of the reason.  

Now that abortion is banned in some states, it is likely that access to abortion care in life- threatening circumstances will be even harder to provide. The media is already reporting cases in which life-saving care was denied to pregnant patients. We can expect to see more of this since the penalty for violating an abortion ban is criminal jail time for the physician and other legal consequences for the institution. The Federal government can help ensure that needed care is provided by identifying and prosecuting denials of care under the federal Emergency Medical Treatment and Labor Act and covering such life-saving care under the exceptions to the federal Hyde amendment.

Q. Are you concerned about the fate of other rights that are not explicitly outlined in the Constitution, including the right to access contraception? Do you think this is a real possibility, and what would this mean for our society? 

A. I am not a legal scholar, so I cannot predict what the Court will do to other legal rights based in the constitutional right to privacy. What I can speak to is that most social conservatives do not draw a hard-line distinction between abortion and contraception. 

The Hobby Lobby Supreme Court decision allowed a corporation to not cover contraceptive methods that its owners believed were abortifacients, namely emergency contraception and intrauterine devices (IUDs). So, it is likely that some state legislatures will seek to limit access to some contraceptive methods or to further limit contraceptive access to people whose sexual lives they disagree with. Too frequently, people see abortion as the exception in law and policy. I would suggest that it is exemplar. The 50-year effort to overturn Roe is part of a larger effort to reverse the wider progressive gains in social, economic, gender, and racial advancement.

Q. What is the bottom line? As someone who has focused on abortion care and policy for your entire career, what do you think American should know right now? 

A. I have heard a lot of people concerned about the risk of people dying from unsafe abortion. One positive advancement since the pre- Roe days is the availability of abortion pills that people can use to end a pregnancy safely with minimal clinical involvement. Today in the United States, these pills are dispensed by abortion clinics as part of a health care visit, increasing through telehealth. As abortion providers become unavailable in many places, people will turn to the Internet to order these pills directly, either through an international telehealth service like Aid Access or from an online pharmacy operating outside the United States. 

Data from studies around the world show us that such self-sourcing of abortion pills is safe, effective, and acceptable for people. So even as the public expresses their anger about the elimination of the fundamental rights of people to bodily autonomy, they should not exaggerate the medical risk of self-managed abortions. Deaths will happen, but likely resulting from people carrying pregnancies to term against their will. Self-managed abortion with pills is safe — that is what I want people to know. What is so wrong is that people who would prefer to receive this care from a trusted health care provider will instead have to shop for drugs online, potentially putting themselves at criminal risk for breaking the law.

The opinions in this interview represent the views of the interviewee and do not necessarily reflect the views of American University or the American University College of Arts and Sciences.

clock This article was published more than  1 year ago

6 takeaways from the Supreme Court opinion that ended Roe v. Wade

The Supreme Court has ended the only federal protections for abortion in America.

It’s a monumental decision that reverses 50 years of abortion rights in America, and one of the most famous Supreme Court decisions in modern history, Roe v. Wade . And it means that abortion could soon be illegal in as many as half of the states. ( Thirteen states have trigger laws banning or curtailing abortion almost immediately.)

Here’s what the final Dobbs v Jackson opinion says , and how it differs from the draft opinion that leaked in May.

1. It compares Roe v. Wade to a case upholding racial segregation

We knew this decision was probably coming because of a draft opinion published by Politico last month, leaked in a breach of Supreme Court policy.

But the public response doesn’t appear to have swayed the six conservative justices’ minds — and certainly not that of the opinion’s author, Justice Samuel A. Alito Jr. “He basically changed nothing,” said Emily Berman, a constitutional law professor at the University of Houston Law Center.

For example, the final opinion keeps the draft’s provocative comparison between abortion rights and racial segregation.

“Like the infamous decision in Plessy v. Ferguson , Roe was also egregiously wrong and on a collision course with the Constitution from the day it was decided,” Alito writes. ( Plessy v. Ferguson was an 1896 case that affirmed the legality of racial segregation, and which the court later overruled.)

Alito’s central argument is that “the Constitution makes no express reference to a right to obtain an abortion,” and that legal abortion lacks “deep roots” in American history. And so back in 1972, he argues, the court overstepped its authority and took on a job more appropriate for elected lawmakers .

2. It claims indifference to how the decision will play out politically

Abortion is difficult to poll , but polling does at least consistently show that a majority of Americans want to keep Roe v. Wade in place. Alito appears very aware of that, and in his opinion he repeatedly professes not to care.

“We do not pretend to know how our political system or society will respond to today’s decision overruling Roe and Casey. And even if we could foresee what will happen, we would have no authority to let that knowledge influence our decision. We can only do our job, which is to interpret the law, apply long-standing principles of stare decisis , and decide this case accordingly,” he writes.

3. A debate about the legal principle of stare decisis

Stare decisis is Latin for entrenched legal precedent. What’s revolutionary about this opinion from a legal standpoint is how it overturns a precedent that many in the legal community (even, arguably, some of the Trump-appointed justices ) said was settled law.

The liberal dissent argues that women have come to rely on this legal protection for abortion. And they argue it’s dangerous for the court to take such a bold step overturning that.

Justices Stephen G. Breyer, Sonia Sotomayor and Elena Kagan obliquely accuse the conservative justices of forsaking legal principle for political ends, saying “weakening stare decisis in a hotly contested case like this one calls into question the Court’s commitment to legal principle. It makes the Court appear not restrained but aggressive, not modest but grasping. In all those ways, today’s decision takes aim, we fear, at the rule of law.”

As The Post’s Aaron Blake has pointed out , even “[r]enowned conservative Judge J. Michael Luttig referred in a 2000 appeals-court ruling to Roe as having attained ‘ super-stare decisis .’ ” (That’s the same Luttig who testified in the Jan. 6 hearings that former president Donald Trump’s plot to overturn his election loss posed a constitutional crisis.)

In his opinion, Alito acknowledges the importance of stare decisis but adds: “some of the Court’s most constitutional decisions have overruled prior precedents.” (That’s where he throws in the comparison between Roe and segregation, to show that it’s sometimes a good thing for the court to go against past rulings.)

4. Alito tears into liberal justices for ignoring history

The final opinion is significantly longer than the draft, in part because Alito responds to arguments from his liberal colleagues on the court. The liberal justices spend a lot of time in their dissent about the decision’s consequences for women and their reproductive health and general freedoms. “It says that from the very moment of fertilization, a woman has no rights to speak of,” they write. (The dissent mentions “woman” or “women” six times just in its first paragraph.)

He points out that they do not dispute his account of the history of abortion law in the United States, writing, “The dissent’s failure to engage with this long tradition is devastating.” And he points out that “the dissent does not identify any pre-Roe authority that supports such a right — no state or constitutional provision or statute, no federal or state judicial precedent, not even a scholarly treatise.”

Alito rounds out this new section by criticizing the liberal justices for writing at length about “the effects of pregnancy on women, the burdens of motherhood, and the difficulties faced by poor women” (which he calls “important concerns”) while leaving out “any serious discussion of the legitimacy of the States’ interest in protecting fetal life.”

In essence, Alito says, the two sides are talking past each other.

5. A debate over whether other rights are at stake

In the draft opinion and the final opinion, Alito explicitly says that his reasoning shouldn’t be understood to apply to other modern rights, such as same-sex marriage, access to contraception or interracial marriage. (He argued that abortion is unique because it deals with “potential life.”) Justice Brett M. Kavanaugh wrote a concurring opinion emphasizing that as well.

But Berman said she’s skeptical of that reassurance. This particular group of conservative justices already are willing to overturn a major Supreme Court decision, and they laid out clear logic for overturning others in this realm. “I don’t know if we can take them at their word,” she said.

Supreme Court Justice Clarence Thomas suggested, in a concurring opinion , that he and his colleagues “should reconsider” certain past rulings.

And the liberal justices warned in their dissent: “No one should be confident that this majority is done with its work.”

6. Roberts’s split decision

Chief Justice John G. Roberts Jr. didn’t sign on to overturning Roe v. Wade , though he agreed with the majority of his colleagues that the case at hand, a 15-week abortion ban in Mississippi, should be upheld .

Roberts wrote a separate opinion arguing for “a more measured approach.” He was in favor of allowing abortion restrictions earlier in a pregnancy than had been allowed by Roe and a later case, Planned Parenthood v. Casey — but said that overturning Roe outright was too much, too quickly.

Today’s “dramatic and consequential ruling is unnecessary to decide the case before us,” he wrote.

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US supreme court overturns abortion rights, upending Roe v Wade

Biden calls ruling in pivotal case Dobbs v Jackson Women’s Health Organization ‘a tragic error’

The supreme court has ruled there is no constitutional right to abortion in the United States, upending the landmark Roe v Wade case from nearly 50 years ago in a rare reversal of long-settled law that will fracture reproductive rights in America.

Joe Biden called the ruling a “tragic error” and the Republicans celebrating it “wrong, extreme and out of touch”.

The court, the president said, had pointed America down “an extreme and dangerous path”. Sounding an alarm over a concurring opinion by the conservative justice Clarence Thomas, Biden said key rights including same-sex marriage and access to contraception could now be targeted by the rightwing court.

He said: “Justice Thomas said as much today. He explicitly called to reconsider the right of marriage equality. The right of couples to make their choices on contraception.

“This is an extreme and dangerous path the court has now taken us on.”

The ruling, handed down a day after the court overturned a New York gun control law , came in the case Dobbs v Jackson Women’s Health Organization, in which the last abortion clinic in Mississippi opposed state efforts to ban abortion after 15 weeks and overturn Roe.

“We hold that Roe and Casey must be overruled,” said the majority opinion, written by Samuel Alito and joined by four other conservatives, referring also to a 1992 ruling which buttressed Roe. “The constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.”

Chief Justice John Roberts said he would have upheld Mississippi’s law but not overruled Roe.

The three liberal justices dissented, saying the majority opinion “says that from the very moment of fertilization, a woman has no rights to speak of”, and that conservatives well knew states would enact – and in many cases had already enacted – abortion restrictions to the moment of conception.

Under state restrictions, “a woman will have to bear her rapist’s child or a young girl her father’s – no matter if doing so will destroy her life”, the liberal justices wrote.

At least 26 states are expected to ban abortion immediately or as soon as practicable. The Republican attorney general of Texas, Ken Paxton, celebrated the ruling and said : “Abortion is illegal here.”

The Dobbs decision is one of the most consequential in generations. It will have profound, immediate and enduring consequences for tens of millions of women and other people who can become pregnant. Ripple effects could play out over decades.

“Even if it’s not completely unprecedented it’s extremely rare,” said Mary Ziegler, a visiting professor of constitutional law at Harvard Law School, professor at the University of California, Davis School of Law and a historian of abortion. “It’s also extraordinary to do something like this so quickly, with no kind of advance notice.”

A draft opinion , in which Alito laid out a caustic argument for reversing Roe v Wade, was leaked in May.

Swaths of the south and midwest are expected to ban abortion or impose severe restrictions, possibly forcing patients to travel hundreds of miles or self-manage abortions .

At least one economist has estimated such bans could result in 60,000 births a year among women unable to obtain an abortion, affecting 41% of women of reproductive age and hitting young, poor, Black and brown women and people who already have children hardest.

As Biden indicated, the decision could also herald restrictions in other areas of private life. In his opinion, Thomas explicitly encouraged fellow justices to “reconsider all of this court’s” cases that establish rights to contraception and gay marriage and sex.

Thomas did not mention interracial marriage, another right many fear could be targeted. Thomas is Black. His wife, the far-right activist Ginni Thomas, is white.

Massive protests erupted outside the courthouse and in major cities and smaller towns across the US after the decision was announced. Democratic-run states and cities have vowed to uphold abortion rights and welcome people from neighboring states with bans, and some district attorneys have pledged not to prosecute people for abortions even if new laws criminalize the procedure.

“Backlash to the decision is really unpredictable, and part of the reason we know that is because backlash to Roe was unpredictable,” said Ziegler.

Dr Iffath A Hoskins, president of the American College of Obstetricians and Gynecologists, said: “Today’s decision is a direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States.

“The principle of shared decision-making is founded on respect for people’s expertise in their own bodies and lives and clinicians’ expertise in science and medicine. There is no room within the sanctuary of the patient-physician relationship for individual lawmakers who wish to impose their personal religious or ideological views on others.”

Democratic-led states have enacted laws to aid patients who travel for abortions. Republican-led states have worked to further restrict abortion. Some have debated prosecuting women who seek abortions under homicide statutes.

Although an estimated 85% of Americans support legal abortion under certain circumstances, partisan manipulation of electoral districts has insulated Republican leaders from popular opinion.

Biden pointed to the midterm elections in November.

He said: “This fall, Roe is on the ballot. Personal freedoms are on the ballot. The right to privacy, liberty, equality. They are on the ballot.

“Until then, I will do all my power to protect a woman’s right in states where they will face the consequences of today’s decision.

“Though the court’s decision cast a dark shadow over large swaths of the land, many states still recognize a woman’s right to choose. So if a woman lives in a state that restricts abortion, the supreme court’s decision does not prevent her from traveling from her home state to the state that allows it. It does not prevent a doctor in that state from treating her.

“As the attorney general has made clear, women must remain free to travel safely to another state to seek care they need. My administration will defend that bedrock right. If any state or local official, high or low, tries to interfere with a woman exercising her basic right to travel, I will do everything in my power to fight that deeply un-American attack.”

The leak of the draft Roe decision prompted protests, some near justices’ homes. Biden called for protests to remain peaceful, saying: “No intimidation. Violence is never acceptable.”

Among Republican-led states , Missouri claimed to be first to ban abortion. South Dakota announced a special session to consider more restrictions.

In Illinois, the Democratic governor, JB Pritzker, called the general assembly into special session “to further enshrine our commitment to reproductive healthcare rights and protections”.

The US is one of only four countries since 1994 to restrict abortion, according to the Center for Reproductive Rights, the others being Poland, Nicaragua and El Salvador. This will further set America apart from peer countries as life expectancy falls . It could also damage efforts to advocate for the rights of women and girls globally .

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In 6-to-3 Ruling, Supreme Court Ends Nearly 50 Years of Abortion Rights

The decision will lead to all but total bans on the procedure in about half of the states.

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By Adam Liptak

• Published June 24, 2022 Updated Nov. 2, 2022

WASHINGTON — The Supreme Court on Friday overturned Roe v. Wade , eliminating the constitutional right to abortion after almost 50 years in a decision that will transform American life, reshape the nation’s politics and lead to all but total bans on the procedure in about half of the states.

“Roe was egregiously wrong from the start,” Justice Samuel A. Alito Jr. wrote for the majority in the 6-to-3 decision, one of the most momentous from the court in decades.

Bans in at least eight states swiftly took effect after they enacted laws meant to be enforced immediately after Roe fell. More states are expected to follow in the coming days, reflecting the main holding in the decision, that states are free to end the practice if they choose to do so.

The decision, which closely tracked a leaked draft opinion , prompted celebrations and outcries across the country, underlining how divisive the topic of abortion remains after decades of uncompromising ideological and moral battles between those who see making the choice to terminate a pregnancy as a right and those who see it as taking a life.

The outcome, while telegraphed both by the leaked draft opinion and positions taken by the justices during arguments in the case, nonetheless produced political shock waves, energizing conservatives who are increasingly focused on state-by-state-fights and generating new resolve among Democrats to make restoring abortion rights a central element of the midterm elections.

Protests swelled across the country on Friday evening. Outside the Supreme Court, thousands of abortion rights supporters demonstrated alongside small groups of celebrating anti-abortion activists, who blew bubbles. Throngs spilled into the streets in large cities like Los Angeles, Chicago and Philadelphia, and smaller crowds gathered in places like Louisville, Ky., and Tallahassee, Fla.

Speakers at some rallies exhorted abortion rights supporters to take their anger to the polls during the midterm elections in November, a point echoed by President Biden, who said the court’s decision would jeopardize the health of millions of women.

“It is the realization of extreme ideology and a tragic error by the Supreme Court,” Mr. Biden said.

The ruling will test the legitimacy of the court and vindicate a decades-long Republican project of installing conservative justices prepared to reject the precedent, which had been repeatedly reaffirmed by earlier courts. It will also be one of the signal legacies of President Donald J. Trump, who vowed to name justices who would overrule Roe. All three of his appointees were in the majority in the ruling.

Chief Justice John G. Roberts Jr. voted with the majority but said he would have taken “a more measured course,” stopping short of overruling Roe outright. The court’s three liberal members dissented.

The case, Dobbs v. Jackson Women’s Health Organization, No. 19-1392, concerned a law enacted in 2018 by the Republican-dominated Mississippi Legislature that banned abortions if “the probable gestational age of the unborn human” was determined to be more than 15 weeks. The statute, a calculated challenge to Roe, included narrow exceptions for medical emergencies or “a severe fetal abnormality.”

Justice Alito’s majority opinion not only sustained the Mississippi law but also said that Roe and Planned Parenthood v. Casey , the 1992 decision that affirmed Roe’s core holding, should be overruled.

The reasoning in Roe “was exceptionally weak, and the decision has had damaging consequences,” Justice Alito wrote. “And far from bringing about a national settlement of the abortion issue, Roe and Casey have enflamed debate and deepened division. It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”

Justices Clarence Thomas, Neil M. Gorsuch, Brett M. Kavanaugh and Amy Coney Barrett joined the majority opinion.

In an anguished joint dissent, Justices Stephen G. Breyer, Sonia Sotomayor and Elena Kagan wrote that the court had done grave damage to women’s equality and its own legitimacy.

“A new and bare majority of this court — acting at practically the first moment possible — overrules Roe and Casey,” they wrote, adding that the majority had issued “a decision greenlighting even total abortion bans.”

The dissent concluded: “With sorrow — for this court, but more, for the many millions of American women who have today lost a fundamental constitutional protection — we dissent.”

The decision left important questions unanswered and revealed tensions among the five justices in the majority.

One open question was whether the Constitution required exceptions to abortion bans for the life or health of the mother, for victims of rape or incest or for fetal disabilities. The majority opinion noted that Mississippi law made exceptions for medical emergencies and fetal abnormalities, but it did not say that those exceptions were required.

In a concurring opinion, Justice Kavanaugh indicated that an exception for the life of the mother may be required, but he did not say so in so many words. “Abortion statutes traditionally and currently provide for an exception when an abortion is necessary to protect the life of the mother,” he wrote. “Some statutes also provide other exceptions.”

But some of the recent state laws were close to categorical, the dissenters wrote.

“Some states have enacted laws extending to all forms of abortion procedure, including taking medication in one’s own home,” the dissenting opinion said. “They have passed laws without any exceptions for when the woman is the victim of rape or incest. Under those laws, a woman will have to bear her rapist’s child or a young girl her father’s — no matter if doing so will destroy her life.”

Another open question is whether other precedents are now at risk.

Justice Alito said the court’s ruling was limited.

“To ensure that our decision is not misunderstood or mischaracterized,” he wrote, “we emphasize that our decision concerns the constitutional right to abortion and no other right.”

But Justice Thomas, a member of the majority, issued a concurring opinion that sent a different message. He wrote that it was strictly true that the majority opinion addressed only abortion, but he said that its logic required the court to reconsider decisions about contraception, gay sex and same-sex marriage.

“We have a duty to ‘correct the error’ established in those precedents,” he wrote, quoting an earlier opinion.

Justice Kavanaugh took the opposite approach in his concurring opinion, saying the precedents identified by Justice Thomas were secure.

The dissenters, noting that Justice Thomas “is not with the program,” said that “no one should be confident that his majority is done with its work.”

Promises, the dissenters said, were pointless.

“The future significance of today’s opinion will be decided in the future,” they wrote. “And law often has a way of evolving.”

Chief Justice Roberts, who voted with the majority but did not embrace its reasoning, said he would have discarded only one element of Roe: its prohibition of abortion bans before fetal viability.

The right to abortion, he wrote, should “extend far enough to ensure a reasonable opportunity to choose, but need not extend any further — certainly not all the way to viability.”

The chief justice added: “The court’s decision to overrule Roe and Casey is a serious jolt to the legal system — regardless of how you view those cases. A narrower decision rejecting the misguided viability line would be markedly less unsettling, and nothing more is needed to decide this case.”

Justice Alito, once a close ally of the chief justice , said that was a recipe for turmoil.

“If we held only that Mississippi’s 15-week rule is constitutional, we would soon be called upon to pass on the constitutionality of a panoply of laws with shorter deadlines or no deadline at all,” he wrote.

In challenging the law, Mississippi’s sole abortion clinic focused on the 14th Amendment, which says that states may not “deprive any person of life, liberty or property without due process of law.” Justice Alito wrote that the amendment, adopted in 1868, had not been understood to address abortion, which he said was at the time a crime in most states.

The joint dissent responded that only men had participated in the adoption of the amendment. “So it is perhaps not so surprising,” they wrote, “that the ratifiers were not perfectly attuned to the importance of reproductive rights for women’s liberty, or for their capacity to participate as equal members of our nation.”

These days, Justice Alito wrote, women have political clout. “In the last election in November 2020, women, who make up around 51.5 percent of the population of Mississippi, constituted 55.5 percent of the voters who cast ballots,” he wrote.

In his concurring opinion, Justice Kavanaugh wrote that states could not forbid their residents from traveling to other states to obtain abortions. That was scant comfort for women too poor to travel, the dissenters responded.

They added that the majority had left open the possibility that Congress could enact a nationwide ban. Were that to happen, “the challenge for a woman will be to finance a trip not to New York [or] California but to Toronto.”

When the court decided Roe in 1973, it established a framework to govern abortion regulation based on the trimesters of pregnancy. In the first trimester, it allowed almost no regulations. In the second, it allowed regulations to protect women’s health. In the third, it allowed states to ban abortions so long as exceptions were made to protect the life and health of the mother.

The court discarded the trimester framework in 1992 in the Casey decision but retained what it called Roe’s “essential holding” — that women have a constitutional right to terminate their pregnancies until fetal viability.

Two years ago, in June 2020, the Supreme Court struck down a restrictive Louisiana abortion law by a 5-to-4 margin, with Chief Justice Roberts providing the decisive vote. His concurring opinion, which expressed respect for precedent but proposed a relatively relaxed standard for evaluating restrictions, signaled an incremental approach to cutting back on abortion rights.

But that was before Justice Ruth Bader Ginsburg died that September. Her replacement by Justice Amy Coney Barrett, a conservative who has spoken out against “abortion on demand,” changed the dynamic at the court.

Adam Liptak covers the Supreme Court and writes Sidebar, a column on legal developments. A graduate of Yale Law School, he practiced law for 14 years before joining The Times in 2002. More about Adam Liptak

U.S. Supreme Court overturns Roe v. Wade, ends constitutional right to abortion

• Ruling enables U.S. states to ban abortion
• Conservative justices power ruling; liberals dissent
• Biden condemns ruling as a 'sad day' for America
• Justice Alito calls Roe v. Wade 'egregiously wrong'

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Supreme Court Overturns Roe v. Wade, Ending 50 Years of Abortion Rights

Some protestors celebrated, others wept, in front of the US Supreme Court on June 24 after the Court overturned Roe v. Wade . Photo by Jose Luis Magana/AP Photo and Anna Moneymaker/Getty Images

Supreme Court Overturns Roe v. Wade , Ending 50 Years of Abortion Rights

Legal experts react with shock and dismay, as ruling leaves open possibility of nationwide abortion ban. “enormous step backward,” bu president says, alene bouranova.

In a stunning reversal of 50 years of precedent, the US Supreme Court on Friday struck down Roe v. Wade , which protected the rights of women to seek abortions, leaving individual states free to ban outright or severely limit the right to a procedure that women have had since 1973.

“Roe was egregiously wrong from the start,” Justice Samuel Alito wrote in the majority opinion. “Its reasoning was exceptionally weak, and the decision has had damaging consequences… It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”

In the final sentence of the dissent opinion, the court’s liberal justices, Stephen Breyer (Hon.’95), Sonia Sotomayor, and Elena Kagan, wrote: “With sorrow—for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection—we dissent.”

The lengthy 78-page decision (read the full ruling here ) seems to be at odds with public opinion; as one example, a recent SCOTUSPoll found that 62.3 percent of respondents oppose overturning Roe v. Wade , and just 37.8 percent of respondents support overturning it.

“It is hard to overstate how unusual it is that the Supreme Court has overturned a long-standing civil right,” says Nicole Huberfeld , Boston University School of Public Health Edward R. Utley Professor of Health Law, Bioethics, and Human Rights and a School of Law professor of law . “While the implication is not that abortion is outlawed across the nation—the Supreme Court has said that the US Constitution doesn’t have much to say about this issue. So, states can decide to restrict abortion so long as their laws have a legitimate purpose.”

Huberfeld says 13 states have trigger laws that either outlaw or significantly restrict access to abortion almost immediately, and another 9 states had laws on the books before Roe that outlawed abortion. “And so when you put all of these different kinds of laws together, including a lot of the restrictions that were, you know, stopped by lower federal courts and other significant restrictions that were put in place before this litigation,” Huberfeld notes, “in half of states, abortion will now be significantly restricted or outlawed.”

The decision also moved BU President Robert A. Brown to release a statement: “I had hoped that the day would not come when I would write to express my profound disappointment over an action of the Supreme Court of the United States. However, I believe the Court’s official decision today to annul the 1973 decision of Roe v. Wade is an enormous step backward in protecting the rights of all women in our country. This decision denies women the right to make their own decisions about their reproductive health. Boston University remains steadfastly committed to guaranteeing women’s reproductive rights to the extent allowed under Massachusetts’ law.” (Read the full text of Brown’s letter at the end of this article.)

And responding to the Supreme Court ruling, on Friday Massachusetts Governor Charlie Baker signed an executive order that he says will “protect reproductive health care providers who serve out-of-state residents.”

As shocking as the Court’s decision was, it had been widely anticipated for weeks after the leak of a draft opinion by the Court in early May showing that the conservative-leaning justices, who hold a majority, would end the long-standing precedent. The final vote was 6-3.

“The leak clearly didn’t move anyone on the conservative side of the court,” says Linda McClain , a LAW professor and Robert B. Kent Professor of Law, who is known for her work on family law, gender, and sex equality.

The deciding case, Dobbs v. Jackson Women’s Health Organization , was argued over a Mississippi law that banned almost all abortions after 15 weeks of pregnancy. But that law had not yet gone into effect because lower courts had ruled that it was not in line with Roe V. Wade , which had established the right to abortion in 1973. The Court’s ruling on Friday now clears the way for the Mississippi law, and others like it, to be enacted.

McClain says one passage in the ruling was particularly alarming: a paragraph that says the Court’s decision does not automatically mean that abortion becomes a state-by-state issue, and leaves open the possibility of a nationwide abortion ban through federal law. “Most threatening of all,” she says, the ruling states “no language in today’s decision stops the federal government from prohibiting abortions nationwide, once again from the moment of conception and without exceptions for rape or incest.”

That language will make the upcoming midterm elections even more critical, she says. “Everybody thinks if they had a different composition of the House or Senate, they might try to do that [federal ban]. Who knows? But nothing in the opinion limits this to states. So, the federal government could issue a nationwide prohibition. We have been seeing the reverberations of this possibility ever since it was leaked. Red states will have a field day and blue states will double down on protections.”

And with abortion rights under fire, McClain says, she would not be surprised if the next target of the Court was contraception, banning things like IUDs (tiny devices that can be inserted into the uterus to prevent pregnancy) or morning-after pills. Even women who suffer miscarriages could find themselves facing suspicion or scrutiny, she says.

Jennifer Childs-Roshak (Questrom’10), president and CEO of the Planned Parenthood League of Massachusetts , issued a statement Friday after the announcement of the Court’s decision. “This dangerous and chilling decision will have devastating consequences across the country, forcing people to travel hundreds, sometimes thousands, of miles for care or remain pregnant,” she wrote. “Abortion is healthcare, and access to care should not be based on one’s zip code, income level, or identity.” She went on to note that the right to abortion is still protected in Massachusetts. “Right now, people can look to Massachusetts for care and for leadership. We must meet this moment with the urgency it demands by taking action to expand access to all sexual and reproductive healthcare—in our clinics providing care to all who want it and by legislating reproductive health equity in every corner of the commonwealth.”

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Doug Most is a lifelong journalist and author whose career has spanned newspapers and magazines up and down the East Coast, with stops in Washington, D.C., South Carolina, New Jersey, and Boston. He was named Journalist of the Year while at The Record in Bergen County, N.J., for his coverage of a tragic story about two teens charged with killing their newborn. After a stint at Boston Magazine , he worked for more than a decade at the Boston Globe in various roles, including magazine editor and deputy managing editor/special projects. His 2014 nonfiction book, The Race Underground , tells the story of the birth of subways in America and was made into a PBS/American Experience documentary. He has a BA in political communication from George Washington University. Profile

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Alene Bouranova is a Pacific Northwest native and a BU alum (COM’16). After earning a BS in journalism, she spent four years at Boston magazine writing, copyediting, and managing production for all publications. These days, she covers campus happenings, current events, and more for BU Today . Fun fact: she’s still using her Terrier card from 2013. When she’s not writing about campus, she’s trying to lose her Terrier card so BU will give her a new one. She lives in Cambridge with her plants. Profile

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There are 13 comments on Supreme Court Overturns Roe v. Wade, Ending 50 Years of Abortion Rights

Wonderfully written and well-balanced commentary on this historical judgment.

What follows is a reply I sent to President Brown this morning in response to his letter to the BU Community regarding the Supreme Court’s overturning of Roe v. Wade yesterday. In it I propose the creation of a new, interdepartmental and intercollegiate Center for Feminist Advocacy and Research that will reach beyond the campus of Boston University to push for real change in the public sphere:

Dear President Brown,

Thank you for your letter of support for reproductive rights at this terribly discouraging moment in our nation’s history. I was impressed and moved by it, and felt proud to belong to this community, but I was also disappointed by your last sentence.

We can and must do more than “only hope” to regain and preserve a woman’s right to control her own body. And we should do more than just align our curricula and health services to support this right “to the extent allowed under Massachusetts law.” Isn’t that we’re already doing? And we see the result.

Boston University now has a Center for Antiracist Research. Isn’t it time to do the same for women’s rights? Isn’t it time to act, not “only hope”—to protest and resist, to advocate and educate, not just on our campus but beyond, in the public sphere? To build coalitions with other colleges and universities, and with organizations like Planned Parenthood, so as to promote legislation and policies that will achieve real and permanent change? We, as a community, must act, not just “hope,” if we are to reverse the misogynistic backlash tearing down all that our society has built over the last half century to guarantee equal rights for women of every class, race, and sexual orientation.

I’m not sure precisely what I have in mind, but something on the order of a Center for Feminist Advocacy and Research that would draw on and coordinate resources from departments, schools, and colleges throughout the university (CAS, Theology, Law, Education, Social Work, and Questrom come immediately to mind) with a mandate to do everything possible to restore and advance women’s rights.

“Everything possible” should include the following:

ADVOCATE legislation and policy changes to this end, at every level—local, state, and federal—and in every state where women’s reproductive freedom is under threat, with the long term goal—perhaps decades-long–of preparing to re-introduce an Equal Rights Amendment to the US Constitution.

PROMOTE the health of women throughout the nation—not just in Massachusetts, but also and especially in states that, even as I write, have already outlawed abortion under any and all circumstances and threaten to deny contraceptive services to their female population, placing women’s health and, in many cases, their very lives in danger.

UNITE with sister campuses across the country, but again, especially in states where abortion has been banned, to reach out and offer support services to women seeking to terminate their pregnancies—services like counseling, referrals, accurate information, and yes, even transportation to abortion clinics in other states. (Picture, for example, helping to organize a student volunteer equivalent to the evacuation at Dunkirk!)

RESIST the growing influence of right-wing religious zealotry on public policy and law-making by reaching out to liberal-minded religious denominations, e.g., Unitarian Universalist, UCC, Reform Judaism–and to like-minded congregants of all religions, denominations, and branches, so as to coordinate efforts to build a spiritual foundation for supporting women’s reproductive rights that can counterbalance the current monopolization of public discourse on this issue by Christian evangelicals and fundamentalists.

And, of course, EDUCATE: not just BU students, but students in classrooms at every level, from pre-school to high-school, in cities, towns, and villages across the country, by devising and distributing curricula specifically focusing on women’s reproductive freedom and their dignity as persons.

I’m about to retire. Fall 2022 will be my last teaching semester after more than 40 satisfying and fulfilling years here at Boston University. In three months, I will turn 73. Over the last two decades of my life I have watched as nearly everything my generation has achieved for the cause of social justice and equal rights has been eroded by forces determined to destroy them. If even one of these proposals should be implemented in what remains of my life, I will die knowing that those efforts were not entirely in vain.

Thank you for your time and attention!

Chuck Rzepka

Charles Rzepka Professor of English Boston University

You are an inspiration to us all! Thank you for the words of wisdom, for standing for students’ rights over the years, for fighting for access to healthcare for all, and for supporting this progressive BU administration. I hope other BU faculty will carry the torch of progress and plurality of opinions and tolerance as well as you do.

Really the ruling means nothing because individual states can still legalize abortion if they so choose. It just means pro-abortion forces will have to work through the democratic process. That shouldn’t be a problem in a democracy.

Normally I would agree. I think Roe was not a good ruling as a legal matter. Sound legal reasoning to support SCOTUS rulings is extremely important for rule of law and the legitimacy of courts in general. Roe v Wade decision invented rights that the Constitution simply does not address in any way. In that sense it should be left up to each state’s democratic process.

However there is a big BUT here that this article mentioned that I did not think of: nothing in Dobbs ruling prevents the Federal Congress from outlawing abortion completely from conception on down for ALL states! This is tricky because while that might be legal and maybe would not technically violate the Constitution, it would in my opinion be an insane law. I say maybe would not violate the Constitution because actually it might be violating state’s rights which are protected by …? Need a real Constitutional scholar to help me out here.

I think most Americans are somewhere in the middle when it comes to abortion – extremists notwithstanding. I think the vast majority of Americans would not agree with banning abortion from conception or early pregnancy. I am one of those people. Banning abortion at conception is to me pure religion and extreme. We need to keep religion out of this debate and we need to keep Church and State separate. I think most Americans begin to have doubts about the morality and ethics of abortion in later stages of pregnancy. I am one of those people. I think most would agree with banning it – with exceptions – in the 3rd trimester and definitely at birth, as MOST developed countries do. In fact if you listen only to extremists, you would never be exposed to the fact that the US is one of only a handful of countries (*north Korea and China being two others) where abortion is legal up to the time of birth!

Here are the facts from Wikipedia on abortion in world perspective. It shows that most if not all European countries have MORE restrictions on abortion than most US states!

https://en.wikipedia.org/wiki/Abortion_law

You’d never know this if you only listen to American abortion activists.

So yeah this issue is tricky and complicated. I wish extremists on both sides were not driving the debate. It seems like it’s a less insane topic in other parts of the developed world where people kind of just adopt middle of the road laws on this without screaming bloody murder at each other.

The Federal Government should have never been involved. And Finally they are not, leave it to the States as the LAW is written… It’s now time to kick the Feds out of the rest of there unlawful actions.

I try not to think about it, but this is a woman’s life now, here in America. It is not the “home of the free”. Not for women. Not anymore. We are not free to make our own medical decisions with our doctor anymore. When I was pregnant for the first time before my son, I went in for an ultrasound and was told that the pregnancy was not viable. I got a second opinion, same thing. The doctor said it would continue to develop and I would miscarry at some point or I could do a DNC or a medical abortion. I went in for the DNC a day later. It was heartbreaking just that one day. I went in and the staff was nice. It was not a terrible experience. I cannot imagine being told there is nothing we can do. You just have to carry a nonviable pregnancy because abortions are illegal. Women are getting infections and sepsis right now while I am typing this because their doctors can’t remove dead nonviable fetuses from their wombs. Can you imagine what they are going through? And why? Because some republican Donald Trump wanted some votes? Because a Supreme Court judge was bought by his wealthy conservative friend. The whole Supreme Court was rigged and the American people should be outraged! We should tell the government that we did not fight for 100 years for women’s rights for them to reverse history in one vote! We should tell them we are opening up the clinics and doctors are treating patients the same way they have. We are not listening to nonsense. If we only could. We can’t though because there are insane unvaccinated idiots that live off of McDonalds following their orders.

Both your article and President Brown’s statement speak about women. Trans and non-binary people get and need abortions too. The reproductive rights community has shifted their language to be LGBTQ inclusive, such as pregnant people, people with uteruses, and women, trans, and non-binary people, why hasn’t BU? After President Brown’s horrific double misgendering of a non-binary student at commencement, I would think BU would try to do and be better and demonstrate your care about the trans and non-binary BU students and alums. Many of us are upset about the Supreme Court decision. You don’t have to enact more harm in your exclusionary language.

Please accept our apologies for the exclusionary language. Yes, birthing people would be a much better and more adequate term. We all need to work more on our linguistics sensitivity. Let’s hope in time, after a now certain electoral victory this fall, the SCOTUS ruling will be overrun and we can focus again on promoting equity, and keep advancing the rights of the LGBTQ community.

Thank you Chuck for your terrific suggestions and to President Brown. BU has a long tradition of ground-breaking eduction for women and of social activism on a number of issues. These do stem from a religious foundation that sometimes gets overlooked these days – unfortunately, in my opinion as an old alumnus and former campus pastor-associate chaplain sponsored by what is now the United Church of Christ. Many good wishes Church in your “retirement” (there is no such thing)!- Dick Yeo, CAS’55

Sorry – meant to say Chuck not Church in my final line. I am losing it!.

Based on this piece, and President Brown’s letter, there’s no room for the right-to-life at BU. I’m embarrassed to be an alumnus, to see what my Alma mater has become. It’s yet another dull progressive echo chamber where dissent is quashed. Abortion is inhumane. This is a step forward for humanity. As for BU, I’ll have nothing further to do with it.

Unfortunately a truly “liberal” education is becoming a thing of the past. A moderate leaning left such as myself is no longer comfortable. I’ve always cared for those without a voice. I’m care about animal rights and conservation because they have no voice of their own, nor do pre-born children.

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Roe v. Wade

By: History.com Editors

Updated: April 21, 2023 | Original: March 27, 2018

Roe v. Wade was a landmark legal decision issued on January 22, 1973, in which the U.S. Supreme Court struck down a Texas statute banning abortion, effectively legalizing the procedure across the United States. The court held that a woman’s right to an abortion was implicit in the right to privacy protected by the 14th Amendment to the Constitution . Prior to Roe v. Wade , abortion had been illegal throughout much of the country since the late 19th century. Since the 1973 ruling, many states imposed restrictions on abortion rights. The Supreme Court overturned Roe v. Wade  on June 24, 2022, holding that there was no longer a federal constitutional right to an abortion.

Abortion Before Roe v. Wade

Until the late 19th century, abortion was legal in the United States before “quickening,” the point at which a woman could first feel movements of the fetus, typically around the fourth month of pregnancy.

Some of the early regulations related to abortion were enacted in the 1820s and 1830s and dealt with the sale of dangerous drugs that women used to induce abortions. Despite these regulations and the fact that the drugs sometimes proved fatal to women, they continued to be advertised and sold.

In the late 1850s, the newly established American Medical Association began calling for the criminalization of abortion, partly in an effort to eliminate doctors’ competitors such as midwives and homeopaths.

Additionally, some nativists, alarmed by the country’s growing population of immigrants, were anti-abortion because they feared declining birth rates among white, American-born, Protestant women.

In 1869, the Catholic Church banned abortion at any stage of pregnancy, while in 1873, Congress passed the Comstock law, which made it illegal to distribute contraceptives and abortion-inducing drugs through the U.S. mail. By the 1880s, abortion was outlawed across most of the country.

During the 1960s, during the women’s rights movement, court cases involving contraceptives laid the groundwork for Roe v. Wade .

In 1965, the U.S. Supreme Court struck down a law banning the distribution of birth control to married couples, ruling that the law violated their implied right to privacy under the U.S. Constitution . And in 1972, the Supreme Court struck down a law prohibiting the distribution of contraceptives to unmarried adults.

Meanwhile, in 1970, Hawaii became the first state to legalize abortion, although the law only applied to the state’s residents. That same year, New York legalized abortion, with no residency requirement. By the time of Roe v. Wade in 1973, abortion was also legally available in Alaska and Washington .

In 1969, Norma McCorvey, a Texas woman in her early 20s, sought to terminate an unwanted pregnancy. McCorvey, who had grown up in difficult, impoverished circumstances, previously had given birth twice and given up both children for adoption. At the time of McCorvey’s pregnancy in 1969 abortion was legal in Texas—but only for the purpose of saving a woman’s life.

While American women with the financial means could obtain abortions by traveling to other countries where the procedure was safe and legal, or pay a large fee to a U.S. doctor willing to secretly perform an abortion, those options were out of reach to McCorvey and many other women.

As a result, some women resorted to illegal, dangerous, “back-alley” abortions or self-induced abortions. In the 1950s and 1960s, the estimated number of illegal abortions in the United States ranged from 200,000 to 1.2 million per year, according to the Guttmacher Institute.

After trying unsuccessfully to get an illegal abortion, McCorvey was referred to Texas attorneys Linda Coffee and Sarah Weddington, who were interested in challenging anti-abortion laws.

In court documents, McCorvey became known as “Jane Roe.”

In 1970, the attorneys filed a lawsuit on behalf of McCorvey and all the other women “who were or might become pregnant and want to consider all options,” against Henry Wade, the district attorney of Dallas County, where McCorvey lived.

Earlier, in 1964, Wade was in the national spotlight when he prosecuted Jack Ruby , who killed Lee Harvey Oswald , the alleged assassin of President John F. Kennedy .

Supreme Court Ruling

In June 1970, a Texas district court ruled that the state’s abortion ban was illegal because it violated a constitutional right to privacy. Afterward, Wade declared he’d continue to prosecute doctors who performed abortions.

The case eventually was appealed to the U.S. Supreme Court. Meanwhile, McCovey gave birth and put the child up for adoption.

On Jan 22, 1973, the Supreme Court, in a 7-2 decision, struck down the Texas law banning abortion, effectively legalizing the procedure nationwide. In a majority opinion written by Justice Harry Blackmun , the court declared that a woman’s right to an abortion was implicit in the right to privacy protected by the 14th Amendment .

The court divided pregnancy into three trimesters, and declared that the choice to end a pregnancy in the first trimester was solely up to the woman. In the second trimester, the government could regulate abortion, although not ban it, in order to protect the mother’s health.

In the third trimester, the state could prohibit abortion to protect a fetus that could survive on its own outside the womb, except when a woman’s health was in danger.

Legacy of Roe v. Wade

Norma McCorvey maintained a low profile following the court’s decision, but in the 1980s she was active in the abortion rights movement.

However, in the mid-1990s, after becoming friends with the head of an anti-abortion group and converting to Catholicism, she turned into a vocal opponent of the procedure.

Since Roe v. Wade , many states imposed restrictions that weaken abortion rights, and Americans remain divided over support for a woman’s right to choose an abortion.

In 1992, litigation against Pennsylvania’s Abortion Control Act reached the Supreme Court in a case called Planned Parenthood of Southeastern Pennsylvania v. Casey . The court upheld the central ruling in Roe v. Wade but allowed states to pass more abortion restrictions as long as they did not pose an “undue burden."

Roe v. Wade Overturned

In 2022, the nation's highest court deliberated on Dobbs v. Jackson Women’s Health Organization , which regarded the constitutionality of a Mississippi law banning most abortions after 15 weeks of pregnancy. Lower courts had ruled the law was unconstitutional under Roe v. Wade . Under Roe , states had been prohibited from banning abortions before around 23 weeks—when a fetus is considered able to survive outside a woman's womb.

In its decision , the Supreme Court ruled 6-3 in favor of Mississippi's law—and overturned Roe after its nearly 50 years as precedent.

Abortion in American History. The Atlantic . High Court Rules Abortion Legal in First 3 Months. The New York Times . Norma McCorvey. The Washington Post . Sarah Weddington. Time . When Abortion Was a Crime , Leslie J. Reagan. University of California Press .

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5 key arguments from the Supreme Court’s decision to overturn Roe v. Wade

The Supreme Court on Friday issued its final opinion in a case that overturns Roe v. Wade , the ruling that has given women the constitutional right to an abortion for nearly 50 years.

In delivering the opinion of the court’s conservative majority, Justice Samuel Alito wrote that the 1973 Roe decision was “egregiously wrong and on a collision course with the Constitution from the day it was decided.” His arguments were also made in a draft opinion that was publicly leaked in May, an unprecedented breach that has galvanized abortion rights supporters and their anti-abortion opponents.

Legal experts say the language in the official version does not significantly diverge from Alito’s draft . While the justices voted 6-3 to uphold a Mississippi law banning abortion after 15 weeks of pregnancy, Chief Justice John Roberts wrote in a separate concurring opinion that he does not support the full repeal of abortion rights.

In their dissent, the high court’s three liberal wing justices — Stephen Breyer, Elena Kagan and Sonia Sotomayor — took aim at the majority’s “draconian” ruling as a decision that will curtail women’s rights and their “status as free and equal citizens.”

Both sets of justices made compelling arguments that legal experts say will set off fierce constitutional debate. Among those key takeaways are:

Erik Ortiz is a senior reporter for NBC News Digital focusing on racial injustice and social inequality.

Nigel Chiwaya is the Senior Editor, Data Viz for NBC News Digital.

What Happens if Roe v. Wade Is Overturned?

By Eugene Kiely and Lori Robertson

Posted on May 3, 2022 | Updated on June 24, 2022 | Corrected on June 24, 2022

Update, June 24: The Supreme Court  overruled Roe v. Wade, holding that the “Constitution does not confer a right to abortion … and the authority to regulate abortion is returned to the people and their elected representatives.” The ruling was 5-4 to overturn Roe and 6-3 to uphold the Mississippi law. Chief Justice John Roberts concurred on the ruling on the state law but wrote in a separate opinion that the court could “leave for another day whether to reject any right to an abortion at all.”

A leaked draft opinion indicated that the Supreme Court is ready to abolish the 1973 Roe v. Wade decision establishing a constitutional right to abortion. The draft isn’t final, but what happens if the court decides that Roe “must be overruled” and the issue of abortion returned “to the people’s elected representatives,” as the draft said?

Jurisdiction would go back to the states, likely setting up a patchwork of abortion restrictions and rights across the country. Roe v. Wade said states couldn’t limit abortion before a fetus is viable, or able to survive outside the womb, which is generally considered to be at   about 24 weeks of gestation . But state laws have sought to challenge the point of viability or the standard itself.

The draft decision, obtained by Politico , pertains to Dobbs v. Jackson Women’s Health Organization , a lawsuit over Mississippi’s ban on abortion after 15 weeks of gestation, “except in medical emergency and in cases of severe fetal abnormality.” The state law was blocked from taking effect by lower courts, and the Supreme Court heard arguments on Dec. 1.

The latest abortion surveillance report from the Centers for Disease Control and Prevention said in 2019, “nearly all” abortions — 92.7% — occurred by 13 weeks’ gestation or less; 79.3% occurred by nine weeks’ gestation.

The draft, written by Justice Samuel Alito, is authentic, the high court said in a May 3 statement , noting that circulating draft opinions was a “routine” part of the court’s work and that this one didn’t represent “the final position” of any justice.

What states would heavily restrict or ban abortion?

The Center for Reproductive Rights , an advocacy and legal group supporting abortion rights, brands 25 states as “hostile” to abortion rights, saying they would be likely to prohibit or severely restrict abortion, or make it difficult to get one. The Guttmacher Institute, a reproductive health research group, counts 26 states as “certain or likely to ban abortion” under all or most circumstances or early in the gestation period, such as abortions after six weeks of pregnancy.

Nine states have pre-Roe abortion bans on the books that could take effect, if Roe is overturned, unless state legislatures act to pass a new law, according to the Guttmacher Institute. Those states are: Alabama, Arizona, Arkansas, Michigan, Mississippi, North Carolina, Oklahoma, West Virginia and Wisconsin. Most of them include exceptions in cases where the life of the patient is in danger.

“If Roe is overturned, these laws could be revived in one of two ways,” the Center for Reproductive Rights says of pre-Roe bans. “In some states, a ban was never declared unconstitutional or blocked by the courts, and therefore if Roe is limited or overturned, state officials could seek to enforce it. In other states, where courts have blocked or limited a pre-Roe ban based on the decision, officials could file court actions asking courts to activate the ban if Roe fell.”

Thirteen states have passed so-called “trigger laws” after Roe to ban abortion if Roe is overturned. Those states include Idaho, Kentucky, Louisiana, Missouri, North Dakota, South Dakota, Tennessee, Texas, Utah and Wyoming — as well as three of the states that also have pre-Roe bans.

Seven states have laws that “[e]xpressed intent to limit abortion to maximum extent permitted” in the absence of Roe, the Guttmacher Institute says. Kansas and Ohio are the only two among them that also don’t have “trigger laws” or pre-Roe bans enacted.

In addition, some states had passed laws restricting abortion that were unconstitutional under Roe, but could take effect in a post-Roe world. Beyond states in the above categories, that includes Georgia, Iowa and South Carolina.

The Center for Reproductive Rights includes two more states — Indiana and Pennsylvania — on its “hostile” list, saying it is difficult to access abortion in both states. And Guttmacher includes Florida, Montana and Nebraska as other states that have enacted bans on abortion or certain methods of abortion after 15 or 20 weeks’ gestation.

What states would protect abortion rights?

According to   the Guttmacher Institute, 16 states and the District of Columbia have laws protecting the right to an abortion. They are: California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington state and Washington, D.C.

An estimated 125 million people — 38% of the U.S. population — live in areas with laws protecting abortion rights, based on   July 2021 Census population estimates   for states and the District of Columbia.

A decade ago, only seven states had such laws on the books, Guttmacher said in an   April 1, 2012, report . But more state legislatures have been taking up the issue in anticipation of a possible reversal of Roe v. Wade. New Jersey Gov. Phil Murphy, for example,   signed a law   in January that permits abortions throughout pregnancy.

“With Roe v. Wade under attack, today’s historic legislation makes clear that New Jersey’s position in supporting the right to reproductive choice remains protected,” Murphy said in a   statement   on the day he signed the Freedom of Reproductive Choice Act.

New Jersey is now one of only four states that permit abortion “throughout pregnancy without state interference,” Guttmacher   says . The others are — Colorado, Oregon and Vermont, plus the District of Columbia.

The remaining 12 states protect the right of abortion “prior to viability or when necessary to protect the life or health of the pregnant person,” according to Guttmacher.

In some states, including Alaska and Minnesota , the right to an abortion is protected not by law, but by their state constitutions.

Three states – New Hampshire, New Mexico and Virginia — haven’t enacted legal protections for abortion rights, but they also aren’t likely to restrict or ban abortion, according to the Center for Reproductive Rights .

Update, May 5: We added information on Alaska and Minnesota.

Correction, June 24: We originally wrote that the court overruled Roe by a 6-3 decision. It was 5-4.

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Overturning Roe v. Wade : consequences for midlife women’s health and well-being

Judith a. berg.

1 The University of Arizona College of Nursing, 800 The Mark Lane, San Diego, CA 92101 USA

Nancy Fugate Woods

2 Biobehavioral Nursing and Health Informatics, University of Washington, 4525 E Laurel Dr NE, Seattle, WA 98105 USA

Associated Data

Not applicable.

In July 2022, the United States Supreme Court issued a decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, the Supreme Court decision that legalized access to abortion in the United States. The overturning of Roe v. Wade means women’s ability to choose to have an abortion or continue a pregnancy is no longer protected by the constitution of the Unites States (Rohan, Editorial: Overturning Roe v. Wade: What are the implications for perinatal nurses?, 2021). Consequently, each state can now independently decide the legality of abortion. The purpose of this commentary is to discuss potential consequences of the overturning of Roe v. Wade for women’s health, particularly midlife women’s health, in the United States. The consequences discussed include unintended pregnancy, access to the full array of reproductive health services including abortion, impact on the reproductive health of poor women and women of color, and the impact on midlife women in their caregiving roles.

In July 2022, the United States Supreme Court issued a decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, the Supreme Court decision that legalized access to abortion in the United States. The overturning of Roe v. Wade means women’s ability to choose to have an abortion or continue a pregnancy is no longer protected by the constitution of the United States (US) [ 23 ]. Consequently, each state can now independently decide the legality of abortion, and according to the Guttmacher Institute, in 2022 26 US states had multiple bans ready to enact, 13 of which were trigger laws that automatically took effect when Roe v. Wade was revoked [ 13 ]. Eleven states had early gestational age bans, meaning that abortion was not allowed past the first trimester or another time point in the pregnancy [ 13 ]. At the same time, there are 15 states and DC that have laws in place that are protective of abortion. Of those 15, Maryland, Connecticut, and California introduced more extensive protections in anticipation that women from the 26 states with abortion bans would travel to the protective states for services [ 26 ]. The purpose of this commentary is to discuss potential consequences of the overturning of Roe v. Wade for women’s health, particularly midlife women’s health. The consequences discussed include unintended pregnancy, access to the full array of reproductive health services including abortion, impact on the reproductive health of poor women and women of color, and the impact on midlife women in their caregiving roles.

Unintended pregnancy and access to full array of reproductive health services

The possibility for pregnancy remains until women achieve menopause [ 16 ]. Midlife women may be confronted with an unintended pregnancy, which is defined as a pregnancy that occurs when a woman does not wish to be pregnant. For this manuscript, midlife, the period of the lifespan between younger and older adulthood, is defined as women 40 to 65 years of age [ 32 ]. A 1995 survey revealed 51% of pregnancies among women 40 and older are unintended (Sherman, Harvey & Noel, [ 27 ]). Therefore, the negative consequences of the reversal of Roe v. Wade are likely to be highly relevant to women in midlife. In a systematic review of unintended pregnancies in US women, Aztlan-James and colleagues found factors associated with multiple unintended pregnancies to be increasing age, identity as Black or Hispanic, having a below poverty level income, experiencing a non-voluntary first sexual intercourse especially at a young age, participating in the sex trade, experiencing stressful life events, and having had a previous abortion [ 4 ]. It should be noted sexual health of midlife women often is overlooked by health care providers despite increased rates of sexually transmitted infections and unintended pregnancy during this part of the lifespan [ 30 ]. Many women in their 40 s become pregnant because they incorrectly believe reduced fertility means they no longer need contraception [ 29 ]. With little attention to midlife women’s sexual health, contraceptive needs may go unaddressed and unintended pregnancy will be more likely to occur. Alternatively, midlife women might be told they are no longer fertile when, in fact, fertility can be erratic for years before women stop ovulating completely. Some authorities recommend women under 55 continue to use contraception if they do not want any more children [ 29 ].

New data from the Guttmacher Institute depicted an increase in abortion numbers from 2017–2020. This demonstrates a reversal of the long-term decline in abortions in the US that began 30 years ago [ 19 ] and was consistent in all four regions of the country. The implication is that overturning Roe v. Wade comes at a time when need for abortion care is increasing. The impact of the loss of Roe v. Wade may be more damaging than predicted especially in areas of the country where access to abortion care is already a struggle. For example, the 930,000 abortions obtained across the US in 2020 represents a sustained increase in abortion and more than one in three of those abortions were obtained in states that are now certain or likely to ban abortion [ 14 ]. As well, decades of research consistently show that abortion bans and restrictions don’t reduce unintended pregnancy or the demand for abortion, and do not improve women’s health. Instead, they impose significant hurdles to obtaining care, causing stress for people in need of abortion and leading some to experience forced pregnancy with all its consequences [ 15 ]. The Guttmacher data were not disaggregated by age, but abortion surveillance data [ 20 ] reported in November 2022, for 2020 suggested a 2% increase in the total abortion ratio but decreased abortion ratio in women aged ≥ 40 years compared with other age groups. Yet, a total of 22,407 abortions were reported in the US for women aged ≥ 40 years in 2020, representing a significant number of midlife women affected by unintended pregnancy who opted for pregnancy termination.

With the loss of Roe v. Wade , women of reproductive potential (menarche to menopause) in states that restrict or completely ban abortion likely will face critical access issues. Abortions probably won’t stop, but global data indicate that they could become less safe [ 28 ]. Global information gleaned from scientific literature, non-governmental organizations’ websites and online discussions combined with statistical modelling estimated how many abortions are safe (done with a method recommended by the WHO), less safe (done by a trained professional using an outdated method or without sufficient information or training) or unsafe (done by an untrained person using a dangerous method). These researchers estimated that almost 90% of abortions in countries that allow abortion on request are safe, but abortions that are categorized as less safe and least safe are much more prevalent in places where abortion is restricted [ 28 ].

Overturning Roe v. Wade has significant implications for medical and nursing education and will reshape the knowledge, skills, and quality of care provided by future physicians and nurses [ 33 ], particularly in states with bans on abortion or pregnancy age restrictions. Medical school graduates without abortion training will be limited in the skills necessary to manage pregnancy complications including placental abruption, infection, ectopic pregnancy, and eclampsia, because the same medications and surgical techniques utilized for abortion also treat obstetric complications [ 33 ]. Moreover, without adequate abortion care education, long-term quality of reproductive healthcare in the U.S. will likely deteriorate, with negative consequences for women’s health [ 33 ]. At the same time, maternal-child nurses (and other health professionals) have long supported policies to reduce maternal mortality, promote health equity, eradicate structural racism, protect the patient-provider relationship, and improve health care delivery for all. With the loss of Roe v. Wade many of these basic policies will be undermined. Therefore, nurses must be educated and trained to care for an increased number of women with delays in seeking prenatal care, as well as with pregnancies complicated by unsafe abortion attempts, that might include drinking toxic fluids; ingesting teratogenic or labor-inducing herbs; inflicting direct injury to the vagina, cervix or rectum; or repeated striking of the abdomen. According to the World Health Organization, over 2.5 million unsafe abortions occur each year and are responsible for pregnancy complications associated with nearly 8% of maternal deaths (Say et al., [ 24 ]). Even with heightened surveillance by nurses, the question becomes whether or not physicians, physician assistants, and advanced practice nurses will be adequately educated and trained to manage serious abortion complications.

Health risks associated with pregnancy in midlife women may be life threatening, particularly because health care provider education may not include abortion care and management of complications. For example, higher maternal age has been associated with spontaneous abortion, fetal death or stillbirth, and ectopic pregnancy [ 2 ]. The risk of spontaneous abortion was 8.9% in women aged 20–24 years and 74.7% in women aged 45 years or more. The overall risk of ectopic pregnancy was 2.3% but showed a steady increase in incidence with increasing maternal age at conception from 1.4% of all pregnancies at the age of 21 years to 6.9% of pregnancies in women aged 44 years. The overall risk of stillbirth was 4.3 per thousand women, and though an increase in stillbirth was associated with maternal age, the association was less than for spontaneous abortions and ectopic pregnancies [ 2 ]. In a more recent study, the risk of fetal loss was higher among women 35 years and older compared to younger women. Influencing factors for fetal loss in women with advanced maternal age (over age 35) were low educational level, unemployment, abnormal pregnancy/labor history, and pregnancy complications [ 34 ]. The consequences of miscarriage later in pregnancy, in the absence of access to abortion, may prevent women from obtaining necessary care to insure their best mental and physical health. As well, lack of access to abortion may force a woman to carry a dead fetus longer than necessary, because the procedure for treatment for miscarriage and abortion are the same [ 6 ].

As women age, they are more likely to have needs that require ongoing medical care, especially because chronic health conditions increase risk for pregnancy complications. These include autoimmune diseases (ankylosing spondylitis, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, scleroderma), conditions that affect the blood, blood vessels, heart and lungs (asthma, heart disease, high blood pressure, human immunodeficiency virus [HIV]), conditions that affect hormones (diabetes, thyroid conditions), and mental health conditions that interfere with daily life, such as depression [ 21 ]. Similarly, women with a history of cancer or any chronic condition may be at serious increased risk during pregnancy. In states with abortion bans, these patients may be told they cannot obtain an abortion until their life is in jeopardy [ 36 ]. A health care workforce untrained in managing pregnancy and/or abortion complications may contribute to the health risks of midlife women, especially if these women are by circumstances, unable to terminate an unintended pregnancy.

Some women with unintended pregnancy living in states with abortion bans will be able to travel to states that are protective of abortion, but that will be limited to women who can afford it. Midlife women are likely to already have children, and women with children will have the additional problem of how to care for those children left behind during the travel period. Although not yet in place, some have rumored abortion foes hope to prosecute women who travel to obtain abortion and even reward “tattle tales” who report women who have travelled to obtain abortion care. Meanwhile, in August, 2022, CBS News announced California is launching a new fund to help women from other states travel there for reproductive care. The state is prepared to spend $20 million to bring women from other states to its abortion clinics [ 5 ]. While this fund is intended to increase access for women residing in states with abortion bans or restrictions, single mothers and mothers unable to find childcare for existing children will likely not be able to take advantage of the available money. Furthermore, there is uncertainty about the capacity of providers and clinics in abortion protective states for providing abortion care to additional numbers of women from states that ban abortion.

Having a safe abortion is not necessarily dangerous or harmful to women, but being denied an abortion may be [ 18 ]. Researchers in 2016 reported that compared with women who were able to have an abortion, those forced to complete their pregnancies were more likely to suffer depression or anxiety disorders five years later [ 9 ] and had poorer physical health [ 22 ]. As well, a 2018 study found that after a woman who already had young children sought but was denied an abortion, the existing children were slightly more likely to have lower developmental scores and to live below the Federal Poverty Level than the children of women who received a wanted abortion [ 12 ]. In another study, two of the 161 women who were denied an abortion died of causes linked to pregnancy or childbirth. None of the women who received abortions died of pregnancy or childbirth-related causes over the following five years [ 22 ]. This is a 100 fold higher rate of mortality than expected (2/161 = 1243/100,000 MMR). Rates of maternal death have been rising in the U.S., and it’s now close to one death per 1000 cases of childbirth. That rate of 0.1% is the highest rate in the industrialized world, and even higher among women in the study who were denied a wanted abortion (1.2%) [ 18 ]. These data do not support policies that restrict women’s access to abortion on the basis that abortion harms women’s mental health [ 9 ] and/or physical health [ 22 ].

Health of poor women and women of color

Evidence shows the disproportionate and unequal impact abortion restrictions have on people who are already marginalized and oppressed, including Black and Brown communities, other people of color, people with low incomes, young people, LGBTQ communities, immigrants and people with disabilities [ 15 ]. This discussion focuses on poor women and women of color. Forty-nine percent of abortion patients have an income below the poverty line, according to the Guttmacher Institute [ 25 ]. In 2019, almost four in ten abortions were among Black women (38%), one-third were among White women (33%), and one in five among Hispanic women (21%), and 7% among women of other racial and ethnic groups [ 3 ]. Therefore, more than half of abortions were among women of color prior to the overturning of Roe v. Wade . Potential reasons why abortion rates were higher among some women of color include their more limited access to health care, which negatively affects access to contraception and other sexual health services that are essential to pregnancy planning. In addition, the US health care system has a history of racist practices targeting the sexual and reproductive health of people of color, including forced sterilization, medical experimentation, the systematic reduction of lay midwifery, and discrimination by individual providers including dismissive treatment, assumption of stereotypes, and inattention to conditions, such as fibroids, that take a disproportionate toll on women of color [ 3 ]. Social determinants of health (income, housing, safety and education) affect decisions related to family planning and reproductive health. Poor women and women of color between ages 18–49 face greater barriers to accessing health care overall compared to their White counterparts, particularly for those with Medicaid for health insurance which has limited coverage for abortions. The Hyde Amendment has prohibited the use of federal funds for coverage of abortion under Medicaid except in cases of rape, incest, or life endangerment for the pregnant person [ 3 ]: even before the loss of Roe , these women had more limited access to abortion care. Plus, federal restrictions have chipped away at comprehensive, evidence-based family planning supported by the Title X program that has historically supported women and families in need [ 31 ].

Many women of color have more limited financial resources and transportation options than White women, which would make it more difficult for them to travel out of state for an abortion. Plus, out of state travel is likely to raise the cost of abortion due to added costs for transportation, accommodations, and childcare. Vehicle access is more limited among women of color; Black women ages 18–49 are over three times as likely as White counterparts (13% vs 4%) to live in a household without access to a vehicle and Hispanic women are more likely than White women (6% vs 4%) to lack access to a vehicle. Coupled with the childcare needs of existing children, limited transportation options may truly make it impossible for these women to travel for services. There may also be more missed work, meaning loss of pay, increasing the economic cost of abortion. Again, the effect will be felt more profoundly by women of color and those with lower incomes [ 11 ]. Further, current employment may make it impossible for women to leave work for the length of time it takes to travel to a state that has abortion care access.

Overall, the loss of Roe v. Wade is predicted to limit poor women and women of color’s access to the full array of reproductive health care, including abortion services. Their restricted access is likely to be a function of no insurance or health insurance that does not cover reproductive health and abortion care, and the high cost of seeking abortion care out of state. Moreover, some states with abortion bans that predate Roe v. Wade had Trigger Laws that went into effect simultaneous to the overturning of Roe . The heavy concentration of states in the South that restrict or ban abortion have a greater impact on communities of color, because more than half of all US Black women and a high proportion of Latina women live in the South [ 17 ]. These groups face disproportionate hardship in attaining abortion care [ 11 ]. The outcome may be that poor women and women of color are forced to continue with an unintended pregnancy that may expose them to greater health risks known to accompany pregnancy.

Impact on midlife women in their caregiving roles

Much has been written about society’s expectations of women as caregivers, particularly unpaid caregivers (informal) in midlife [ 7 , 8 ]. Society assumes women will take on the caregiving for children, spouses, parents, other relatives, or a mix of those. Three out of five caregivers in the U.S. are women and on average, caregivers of adults are 49.4 years old [ 1 ]. Half of all women caregivers work outside the home, and some have an older adult needing care living in their home along with minor children [ 35 ]. Yet, little is known about caregiving stress and unintended pregnancy in the caregiver. Uncovering this issue is now incredibly important since the overturning of Roe v. Wade , as access to reproductive health care and abortion services is likely to become increasingly difficult for caregiving midlife women. We’ve already discussed the numbers of unintended pregnancies in midlife women and must also consider implications of unintended pregnancy in the context of the multiple roles that midlife women perform simultaneously. For example, a single midlife woman who is working full time to support her children and her household may also be responsible for an adult relative or relatives living inside her home. She may reside in a state that has imposed bans on abortion care. In the event she encounters an unintended pregnancy, her ability to travel to a state that is protective of abortion is seriously restricted due to employment issues, financial needs, and her caregiving responsibilities. The likelihood of her being able to absent herself from employment and caregiving responsibilities may be all but impossible. Therefore, this midlife woman may face continuing an unintended pregnancy simply because access is not possible. Should this woman also live in poverty and be of color, she may face serious health issues during her pregnancy.

In another scenario, a midlife woman may have a teenage daughter with an unintended pregnancy. Again, if she is living in a state that has abortion bans in place, the ability of her daughter to travel for abortion care has many contingencies: can the daughter travel alone, can the midlife mother accompany her daughter, can they afford the expenses of travel and abortion services, do they have access to a vehicle in which to travel, and can the midlife mother leave other children at home, be away from her employment, and leave her caregiving responsibilities unattended? Should it not be possible for the pregnant daughter to obtain abortion care, the midlife mother may find herself in a position to be the caregiver of a grandchild—on top of her already multiple responsibilities. All of these issues reflect women’s lived experiences, particularly for poor women and women of color; but they are also particularly relevant to all midlife women who have a daughter with an unintended pregnancy.

Conclusion: how to alleviate consequences of overturning Roe v. Wade

As we begin a new year it is disheartening and infuriating to see the imposition of legal limitations in the United States to women’s agency of our own bodies. Absent social policies supporting access to health care and early childhood education and caregiving, disparities in women’s access to abortion creates disadvantageous conditions for both midlife women and future generations of children born as the product of an unwanted pregnancy. It is time to recognize the ethical implications of this decision for people with and children of unwanted pregnancy. Opportunities to reverse the consequences of the SCOTUS decision [ 10 ] to limit access to abortion should motivate responses among advocates for women’s and children’s health and well-being, including imagining strategies for an equitable society in which all children have rights to a healthy life.

Until policy changes that support abortion access are enacted overall in the U. S., strategies that can be implemented immediately include:

• Strengthen sexual health education provided in schools to increase awareness of options for preventing unwanted or unplanned pregnancy;
• Improve access to information about fertility and fertility management, including monitoring menstrual cycles and menopausal status, and reliable and effective birth control approaches for all reproductive life stages, with attention to the specific needs of midlife women;
• Advocate for inclusion of explicit coverage of effective and reliable contraception and other pregnancy prevention methods in health insurance plans;
• Provide readily accessible and affordable early pregnancy detection;
• Provide “morning after” contraception to women to have on hand “just in case” (Plan B);
• Advocate for policies that would insure women’s right to agency over our bodies.

It is essential that women’s health advocates actively engage in political debates and policy dialogues that are intended to improve access to the full array of sexual and reproductive health care for all women. Now is not the time to remain silent; it is time to once again advocate for policies known to improve health and support women’s self-determination.

Acknowledgements

Abbreviations, authors’ contributions.

JB wrote the manuscript. NFW edited the manuscript. The author(s) read and approved the final manuscript.

Availability of data and materials

Declarations.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Judith A. Berg, Email: ude.anozira@grebaJ .

Nancy Fugate Woods, Email: ude.wu@sdoowfn .

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• Research & Reports

Roe v. Wade and Supreme Court Abortion Cases

Reproductive rights in the United States, explained.

Is abortion a constitutional right?

Roe v. wade, what was the impact of the roe v. wade decision.

• The law after  Roe v. Wade

Supreme Court justices’ abortion views

Not under the U.S. Constitution, according to the current Supreme Court. In  Dobbs v. Jackson Women’s Health Organization  (2022), the Supreme Court overturned  Roe v. Wade  (1973), which guaranteed a constitutional right to abortion. Some state constitutions, however, independently protect abortion rights.

In  Roe v. Wade , the Supreme Court decided that the right to privacy implied in the 14th Amendment protected abortion as a fundamental right. However, the government retained the power to regulate or restrict abortion access depending on the stage of pregnancy. And after fetal viability, outright bans on abortion were permitted if they contained exceptions to preserve life and health. 

For the following 49 years, states, health care providers, and citizens fought over what limits the government could place on abortion access, particularly during the second and third trimesters. But abortion was fundamentally legal in all 50 states during that period.

Writing for the majority in  Dobbs , Justice Samuel Alito said that the only legitimate unenumerated rights — that is, rights not explicitly stated in the Constitution — are those “deeply rooted in the Nation’s history and tradition” and “implicit in the concept of ordered liberty.” Abortion, the majority held, is not such a right. 

Following  Dobbs , reproductive rights are being decided state by state.  Constitutions in 10 states  — Alaska, Arizona, California, Florida, Kansas, Massachusetts, Minnesota, Montana, New Jersey, and New Mexico — have been interpreted by state high courts to guarantee the right to abortion or protect access more strongly than the federal constitution. Other state legislatures have passed laws protecting abortion rights. Many states, however, have  made abortion illegal .

The road to  Roe

Abortion was illegal in most states in the 1960s, often with no exceptions for cases of rape or threat to life. A pair of high-profile crises, however, shined a spotlight on the impact of these restrictions.

Beginning in the late 1950s, thousands of babies were born with severe birth defects after their mothers took the morning sickness drug thalidomide while pregnant. The most well-known case was that of Sherri Finkbine, a host of the children’s television program  Romper Room , who was forced to travel to Sweden to obtain an abortion. A Gallup poll showed, perhaps surprisingly given the legal backdrop, that a majority of Americans  supported  Finkbine’s decision.

Shortly after the thalidomide scandal, an epidemic of rubella, or German measles, swept across the country. Babies that survived rubella in utero were often born with a  wide range of disabilities  such as deafness, heart defects, and liver damage. (A  rubella vaccine  didn’t become available until 1971.)

It was in this environment of maternal risk that high-profile doctors like  Alan Guttmacher  began to argue publicly that abortion should be treated like other medical procedures — as a decision to be made between physician and patient.

Griswold v. Connecticut  (1965)

While thalidomide and rubella impacted public perspectives on abortion, a series of cases built the foundation for the coming revolution in abortion law. The first involved the right to contraception, and the story begins in the 19th century.

In 1879, Connecticut senator P.T. Barnum (yes,  that  P.T. Barnum)  introduced a bill  barring not only contraceptives but also the distribution of information relating to them. The Barnum Act was still on the books in Connecticut in 1960, when the Food and Drug Administration approved the first oral contraceptive. Estelle Griswold, executive director of the Planned Parenthood League of Connecticut, was fined $100 for violating the law. Her appeal went all the way to the Supreme Court.

In  Griswold v. Connecticut , a seven-justice majority struck down the Barnum Act. Justice William O. Douglas explained that the Bill of Rights implies a right to privacy because when viewed as a coherent whole, it focuses on limiting government intrusions. The  Griswold  majority held that the government cannot prevent married couples from accessing contraception. (At the time, the justices did not extend the right to unmarried people.)  Griswold ’s contention that the Constitution creates a zone of privacy into which the government cannot enter paved the way for  Roe , among other landmark decisions.

Eisenstadt v. Baird  (1972)

The road from  Griswold  to  Roe  was not perfectly straight. Two years after  Griswold , reproductive rights activist  William Baird  offered contraceptives to an unmarried woman after a lecture on contraception to students at Boston University. He was sentenced to three months in prison.

Like Estelle Griswold, Baird appealed his conviction to the Supreme Court. In  Eisenstadt v. Baird , the Justices extended  Griswold . Justice William Brennan, writing for the six-justice majority, explained that the 14th Amendment guarantees equal protection under the law. There was no reason to treat married and unmarried people differently with regard to contraception.

United States v. Vuitch  (1971) 

Over the course of nine years, Washington, DC,–based physician Milan Vuitch was  arrested 16 times  for performing abortions, which had been illegal in the district since 1901 except “as necessary for the preservation of the mother’s life or health.”

Vuitch appealed his eventual conviction, arguing in part that the exception for “health” was unconstitutionally vague. The Supreme Court disagreed in  United States v. Vuitch . Taking a broad view of the word “health,” the justices ruled that abortion was legal in the district whenever necessary to protect mental or physical health.

The significance of  Vuitch , however, was to be short-lived.  Roe v. Wade  was already wending its way through the courts by the time of the decision. The day after they decided  Vuitch , the justices voted to hear  Roe . 

The parties to  Roe

Texan Norma McCorvey became pregnant for the third time in 1969. Struggling with drug and alcohol use, she previously relinquished responsibility for her first two children. She decided that she did not want to continue the pregnancy. 

Texas law, however, allowed abortion only to save the patient’s life. With McCorvey six months pregnant, Texas lawyers Linda Coffee and Sarah Weddington filed a suit on her behalf in federal court under the pseudonym Jane Roe.

Henry Wade was a legendary and  controversial  district attorney with an impressive conviction rate, most famous for prosecuting  Jack Ruby , who killed JFK’s assassin, Lee Harvey Oswald. Wade was, however, an odd foil for pro-choice activists. He did not aggressively prosecute illegal abortions and said little about them.

The lower court

A three-judge panel of the U.S. District Court for the Northern District of Texas  struck down  Texas’s abortion ban, finding it overbroad and locating the right to reproductive choice in the 9th and 14th Amendments. Citing  Griswold , the court noted that the Constitution guarantees “the right of choice over events which, by their character and consequences, bear in a fundamental manner on the privacy of individuals.” While the federal court declared the Texas law unconstitutional, it declined to immediately block its enforcement, putting  Roe v. Wade  on a fast track to the Supreme Court.

Norma McCorvey gave birth to a girl, Shelley Lynn, on June 2, 1970, fifteen days before the federal district court issued its ruling. The baby was adopted when she was three days old. Her identity was not known to the public until 2021. 

The  Roe v. Wade  oral argument

Sarah Weddington, who was just 26 years old when she stood before the justices of the Supreme Court on December 13, 1971, built her case for the constitutional right to abortion around the 9th and 14th Amendments, arguing that “meaningful” liberty must include the right to terminate an unwanted pregnancy.

Although the justices were largely receptive to Weddington’s points, Justice Byron White demanded to know whether the right to abortion extended right up to the moment of birth. After some hesitation, Weddington answered yes. Legal personhood began at birth, Weddington claimed. Until that moment, there should be an unfettered constitutional right to abortion.

After Weddington sat down, Texas Assistant Attorney General Jay Floyd stood to defend the state law. He began, inexplicably, with a sexist joke: “It’s an old joke, but when a man argues against two beautiful ladies like this, they are going to have the last word.” The bafflingly inappropriate comment was followed by three seconds of dead silence.

There was, however, one moment of wit in the argument. When Floyd argued that a woman who becomes pregnant has already made her choice, Justice Potter Stewart shot back, “Maybe she makes a choice when she decides to live in Texas!” The retort brought roars of laughter from the gallery.

Of particular note is how little the oral argument focused on the history of abortion laws during the founding or the post–Civil War era when the 14th Amendment was ratified. The justices focused instead on the biological realities of abortion and the text of the Constitution itself.

Also interesting: Justice Harry Blackmun, who would write the majority opinion in  Roe v. Wade , spoke only twice during the oral argument. By contrast, Justice Thurgood Marshall spoke more than 10 times, Justices White and William Brennan more than 20 times, and Justice Stewart more than 30. (Perhaps this was because Blackmun was initially inclined to  write a much more restrained opinion  than he ultimately did.)

The  Roe v. Wade  opinion

The Supreme Court handed down its decision on January 22, 1973. Seven of the nine justices agreed that the Due Process Clause of the 14th Amendment — which says that no state shall “deprive any person of life, liberty, or property, without due process of law” — implies a right to privacy. The majority seized upon Weddington’s definition of liberty, citing a series of prior cases indicating that the term “liberty” must be interpreted broadly in a free society.

The justices did, however, recognize that the state could place some limits on abortion if necessary to further a compelling state interest. The state’s ability to regulate increased as a pregnancy progressed. And after a fetus reached viability, the state could prohibit abortion, except when necessary to protect health or life.

Justices William Rehnquist and White dissented. Rehnquist argued that privacy, in the constitutional sense of illegal search and seizure, has nothing to do with abortion. In his view, since abortion bans implicate no fundamental rights, they must only have some rational basis, such as protecting a fetus. Foreshadowing the  Dobbs  decision in 2022, Rehnquist also declared that the only recognizable rights not explicitly listed in the Constitution are those with deep roots in the American legal tradition.

Doe v. Bolton  (1973)

On the same day the Supreme Court decided  Roe , it decided  Doe v. Bolton , which challenged Georgia’s abortion ban. The Georgia law limited abortion to cases of documented rape, a severely disabled fetus, or a threat to life. Before the procedure, it was necessary to obtain the approval of a doctor, two additional consulting physicians, and a hospital committee. The law also permitted relatives to challenge the abortion decision. It was, in short, a burdensome process.

In another 7–2 vote, with Blackmun again writing for the majority, the Court ruled that although the rights identified in  Roe  are not absolute, Georgia’s restrictions violated the constitutional right to abortion. He noted that the law established hurdles that were far higher than those that had to be overcome for other surgical procedures.

White and Rehnquist again dissented.

Roe  significantly reduced maternal mortality. A total of 39 women are known to have  died from unsafe abortions  in 1972, and this was almost certainly a drastic undercount. In 1975, there were only three such deaths. In 1965, eight years before  Roe  was decided, illegal abortion  caused 17 percent of pregnancy-related deaths . In modern times, just 0.2 percent of people who undergo abortions even require hospitalization for complications.

It’s not entirely clear what effect  Roe  had on public attitudes toward abortion because public opinion was already in flux before the case was decided. In 1965, just  5 percent  of Americans thought abortion should be legal for married people who simply didn’t want any more children. That number had risen to 36 percent by 1972, the year before  Roe  was decided. After  Roe  came down, pollsters began asking about abortion “for any reason,” and the polls show  relative stability  in the responses to that question since the mid-1970s.

The law after Roe v. Wade

Lingering resistance to abortion, particularly strong in certain parts of the country, led legislatures to test the decision’s boundaries. The Supreme Court issued many major abortion rulings up to the overturning of  Roe v. Wade  in the 2022 case  Dobbs v. Jackson Women’s Health Organization .

• In  Planned Parenthood v. Danforth   (1976), the justices blocked a law requiring spousal consent for abortion.
• Maher v. Roe   (1979) permitted states to exclude abortion services from Medicaid coverage.
• Colautti v. Franklin   (1979) struck down an unconstitutionally vague Pennsylvania law that required physicians to try to save the life of a fetus that might have been viable.
• In  Harris v. McRae   (1980), the Court upheld the  Hyde Amendment , a federal law that proscribed federal funding for abortions except when necessary to preserve life or as a result of rape or incest.
• In  L. v. Matheson   (1981), the Court upheld a law requiring parental notification when the patient is a minor living with parents.
• In  City of Akron v. Akron Center for Reproductive Health   (1983), the justices invalidated a wide range of limitations on abortion, such as a waiting period, parental consent without judicial bypass, and a ban on abortions outside of hospitals after the first trimester.
• Thornburgh v. American College of Obstetricians and Gynecologists   (1986) struck down a law that required informed consent to include information about fetal development and alternatives to abortion.
• In  Webster v. Reproductive Health Services   (1989), Justice Rehnquist upheld rules requiring doctors to test for viability after 20 weeks and blocking state funding and state employee participation in abortion services.
• Rust v. Sullivan   (1991) upheld a ban on certain federal funds being used for abortion referrals or counseling.
• Hill v. Colorado   (2000) upheld a law limiting protest and leafletting close to an abortion clinic.
• Stenberg v. Carhart   (2000) struck down Nebraska’s ban on the  dilation and extraction  abortion procedure.
• In  Gonzales v. Carhart   (2007), a slightly changed Court upheld a federal ban on the dilation and extraction procedure.

Planned Parenthood of Southeastern Pennsylvania v. Casey  (1992)

One case in the period between  Roe  and  Dobbs  deserves special attention. Through the 1980s, abortion opponents demanded the appointment of Supreme Court justices who would overturn  Roe . With the confirmation of Justices Anthony Kennedy, Sandra Day O’Connor, and David Souter, anti-abortion activists were confident they had the votes.

In 1988 and 1989, the Pennsylvania legislature adopted new abortion restrictions, including parental consent requirements, spousal notification, a waiting period, and an expanded informed consent process. Planned Parenthood of Southeastern Pennsylvania challenged the law, and many viewed the case as  Roe ’s last stand — an opportunity for the Court to do away with the constitutional right to abortion.

In  Planned Parenthood of Southeastern Pennsylvania v. Casey , however, the new members of the Court disappointed anti-abortion advocates. While the Court replaced  Roe ’s trimester-by-trimester doctrine with a weaker level of protection and upheld elements of the Pennsylvania law that did not unduly burden the right to abortion, the justices declined to overrule  Roe . A plurality opinion authored by O’Connor, Kennedy, and Souter explained that, while Supreme Court precedents are not eternal, there must be a compelling reason to abandon  stare decisis  — the notion that precedents should be upheld. The Court decided there was no adequate justification for overturning  Roe , especially since Americans had arranged their lives around an expectation of control over their reproductive health, including having access to abortion.  Casey  also acknowledged the strong equality concerns that justify abortion rights, arguing that women cannot participate fully in the social and economic life of the nation if they are forced to continue unwanted pregnancies. 

Dobbs v. Jackson Women’s Health Organization  (2022)

In 2018, the Mississippi legislature  banned abortions  after 15 weeks of gestation, except in cases of narrowly defined medical emergency or severe fetal abnormality. The law was a challenge to both  Roe  and  Casey . Jackson Woman’s Health Organization, the sole abortion provider in the state, contested the ban.

Long before  Dobbs  was decided, signs pointed to the Supreme Court’s intention to rescind the constitutional right to abortion. First, in a separate case that first appeared on the Court’s  shadow docket , the justices  allowed a Texas abortion ban  that contravened  Roe  and  Casey  to remain in force. Then, in the weeks before  Dobbs  came down, a draft decision overturning  Roe  and  Casey  leaked out of the Court in an unprecedented breach of Court protocol. 

The final  decision  was little changed from the leaked draft. Writing for the five-justice majority (with Chief Justice Roberts concurring only in the judgment), Justice Samuel Alito argued that the right to privacy is not specifically guaranteed anywhere in the Constitution. When unenumerated liberty rights exist — the right to raise your child as you see fit, for example — those rights must be “deeply rooted in the Nation’s history and tradition.” Reviewing the history of abortion restrictions in the early United States, Alito concluded that the right to abortion is not.

The opinion ignited a firestorm of controversy. Predictably so:  Dobbs  is arguably the first case to formally rescind a fundamental constitutional right. The opinion also  failed to explain  how its logic would not also result in the overturning of  Griswold ’s right to contraception or a series of other cases that rely on the same logic as  Roe . These include  Lawrence v. Texas  (2003), which invalidated laws criminalizing same-sex intimate sexual conduct, and  Obergefell v. Hodges  (2015), which recognized the right to marriage for same-sex couples. 

Also, for many Americans, Alito’s insistence that rights be “deeply rooted” in U.S. history revealed a broad discounting of historically marginalized communities, including women, people of color, and gay Americans. The only rights “deeply rooted” in our history are the ones that served the white, heterosexual men who dominated government at the time of the founding. While  Casey  had begun to address the equality dimensions of abortion rights,  Dobbs  moved in precisely the opposite direction, suggesting that non-majority groups must overcome special hurdles to have their rights recognized.

Abortion rights will now be defined on a state-by-state basis. Several state courts have ruled that their constitutions  guarantee the right to abortion , whether because of explicit references to “privacy” or by relying on language that broadly protects personal autonomy. The  Kansas Supreme Court , for example, has ruled that the constitution’s guarantee of “equal and inalienable natural rights” protects personal decision-making, self-determination, and bodily integrity. Other states have adopted an approach consistent with  Roe , in which the right to privacy, including reproductive freedom, has been recognized as implied in the state constitution.

Following the  Dobbs  case, anti-abortion activists have proposed state constitutional amendments stating that nothing in the constitution protects abortion rights. In some cases, these measures seek to overrule their state courts’ interpretations of the constitution. In others, there has been no court decision regarding the constitutional right to abortion. Other states have, in contrast, moved to expand or cement abortion rights, including through constitutional amendments.

Dobbs  also leaves a long list of unanswered practical questions. Can states ban women from traveling to obtain an abortion? How will they police the importation and use of abortion drugs? How will state courts handle the slew of “trigger laws” — state anti-abortion statutes designed to come into effect upon the overturning of  Roe ? Just as  Roe  set off years of legal uncertainty over the precise boundaries of abortion rights,  Dobbs  has launched a long period of uncertainty over states’ power to restrict abortion in the absence of those rights.

The current Court

• Chief Justice John   Roberts , during his time as a lawyer for the George W. Bush administration, wrote that  Roe  has “ no support  in the text, structure, or history of the Constitution.” In his  Dobbs  concurrence, however, Roberts favored preserving a more limited constitutional right to abortion, without specifying how far it would extend. “Surely we should adhere closely to principles of judicial restraint here, where the broader path the Court chooses entails repudiating a constitutional right we have not only previously recognized, but also expressly reaffirmed applying the doctrine of  stare decisis .”
• Justice Clarence Thomas , who was in the  Dobbs  majority, has written that  Roe  was “grievously wrong for many reasons, but the most fundamental is that its core holding — that the Constitution protects a woman’s right to abort her unborn child —  finds no support  in the text of the Fourteenth Amendment.”
• Justice Samuel Alito  complained as a young lawyer in the Reagan administration about “the courts’ refusal to  allow breathing room  for reasonable state regulation” of abortion. In a job application, he wrote, “I personally believe very strongly that the Constitution  does not protect  a right to an abortion.” As the authority of the majority opinion in  Dobbs , he wrote that “ Roe  was . . . egregiously wrong and on a collision course with the Constitution from the day it was decided.”
• Justice Neil Gorsuch , who was in the  Dobbs  majority, has said and written less on abortion than many other justices, but during his confirmation hearing, he noted that  Roe  was “a precedent of the U.S. Supreme Court” and added, “once a case is settled, that  adds to the determinacy  of the law.”
• Justice Amy Coney Barrett  added her name to a 2006 ad  calling for  Roe  to be overturned  and suggested that the possibility of adoption might  obviate the need for abortion rights .
• Justice Brett Kavanaugh , in 2017, proclaimed his admiration of former justice Rehnquist’s  Roe  dissent, noting that his views about unenumerated rights were “successful in  stemming the general tide  of freewheeling judicial creation of unenumerated rights that were not rooted in the nation’s history and tradition.”
• Justice Ketanji Brown Jackson  repeatedly described  Roe  as “settled law” in her confirmation hearings. In the same hearings, when asked when human life begins, she replied simply, “ I don’t know .”
• Justice Sonia Sotomayor  has focused much of her writing about abortion on the cost that bans impose on those who are economically disadvantaged. Objecting to the Court’s decision to allow a Texas abortion ban to stand, Sotomayor wrote, “Those without the ability to make this journey [to a state allowing abortion], whether due to lack of money or childcare or employment flexibility or the myriad other constraints that shape people’s day-to-day lives, may be forced to carry to term against their wishes or  resort to dangerous methods of self-help .” The  Dobbs  dissent, authored by Justice Breyer and joined by Justices Sotomayor and Kagan, continued that theme of disempowerment, lamenting the end of an era in which “respecting a woman as an autonomous being, and granting her full equality, meant giving her substantial choice over this most personal and most consequential of all life decisions.”
• Justice Elena Kagan  has a significant and slightly complicated record on abortion. As a lawyer in the Clinton administration, she wrote a  memo recommending  that the president sign a ban on “partial birth abortion” if it contained an exception in cases of serious risk to health. As a justice, however, Kagan has voted consistently against restrictions on abortion. She called a recent Texas abortion ban “patently unconstitutional” and dissented forcefully in  Dobbs . 

Notable past justices

• Justice Stephen Breyer : “Millions of Americans  believe that life begins at conception  and consequently that an abortion is akin to causing the death of an innocent child . . . Other millions fear that a law that forbids abortion would condemn many American women to lives that lack dignity, depriving them of equal liberty and leading those with least resources to undergo illegal abortions with the attendant risks of death and suffering.”
• Chief Justice Warren Burger : “The Constitution  does not compel a state to fine-tune its statutes  so as to encourage or facilitate abortions. To the contrary, state action ‘encouraging childbirth except in the most urgent circumstances’ is ‘rationally related to the legitimate governmental objective of protecting potential life.’”
• Justice Ruth Bader Ginsburg : “ Roe v. Wade  sparked public opposition and academic criticism, in part, I believe, because the Court  ventured too far in the change it ordered  and presented an incomplete justification for its action.”
• Justice Sandra Day O’Connor : “The  Roe  framework . . . is  clearly on a collision course  with itself.”
• Chief Justice William Rehnquist : “We do not see why the state’s interest in protecting human life should  come into existence only at the point of viability .”
• Justice Antonin Scalia : “We should get out of this area [abortion law], where we have no right to be, and where we  do neither ourselves nor the country  any good by remaining.”
• Justice Byron White : “The Court apparently  values the convenience of the pregnant mother  more than the continued existence of the life or potential life that she carries.”
• Justice William J. Brennan Jr. : “If the right to privacy means anything, it is the right of the individual, married or single, to be  free from unwanted government intrusion  into matters so fundamentally affecting a person as the decision to bear or beget a child.”
• Justice Anthony Kennedy : “Where it has a rational basis to act, and it does not impose an undue burden, the State may  use its regulatory power  to bar certain procedures and substitute others, all in furtherance of its legitimate interests in regulating the medical profession in order to promote respect for life, including life of the unborn.”
• Justice David Souter : “I have not got any agenda on  what should be done with  Roe v. Wade , if that case is brought before me.”

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What's at stake in the Supreme Court mifepristone case

Selena Simmons-Duffin

The Supreme Court overturned the constitutional right to abortion on June 24, 2022. Tracy Lee for NPR hide caption

The Supreme Court overturned the constitutional right to abortion on June 24, 2022.

Just months after the Supreme Court overturned Roe v. Wade in 2022, a newly-formed group called the Alliance for Hippocratic Medicine sued the Food and Drug Administration, challenging its approval of mifepristone, a medication used for abortion.

On Tuesday, the same justices who undid constitutional protection for abortion will hear arguments in the next frontier of abortion restriction: tightening access across the country for a medication that's used in nearly two-thirds of all abortions nationally.

That is the main issue in FDA v. Alliance for Hippocratic Medicine. On one side are anti-abortion rights physicians and organizations. Originally , they argued that the FDA should not have approved mifepristone in 2000; now they're focusing on the argument that it should not have made it easier to access in 2016 and 2021.

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Despite bans in some states, more than a million abortions were provided in 2023.

On the other side is FDA and the drugmaker, Danco, who say that the challengers aren't actually harmed by the prescribing rules (and thus don't have standing to bring the case) and that the FDA followed correct procedure and the scientific evidence in making its decisions.

It's a closely-watched case, because the stakes are extremely high – not just for abortion access and reproductive health care, but for the drug industry and even the authority of federal agencies. Here is a summary of what's at stake.

1. It could make medication abortion much harder to get

At least 63% of all abortions last year were medication abortions. They involve taking one dose of mifepristone, which blocks the pregnancy hormone progesterone, and one dose of misoprostol, which causes cramping and empties the uterus. Dozens of studies have found that the combination of these pills is safe and effective for abortion, whether prescribed in a clinic or through telemedicine .

Last August, the Fifth Circuit Court of Appeals ruled that FDA should roll back its prescribing rules to what they were in 2011. That would dramatically cut down on the number of people able to access this medication, for several reasons. It would shut down telemedicine access to the medication and could undo retail pharmacies' new ability to dispense it .

It would also make it only available until seven weeks of pregnancy, instead of 10 weeks under the current rules, along with other changes. (Globally, the medication can be used as late as 12 weeks .)

Even though the difference between seven and 10 weeks might not sound like much, nearly half of medication abortions happen after seven weeks, according to CDC . Melissa Grant, COO of carafem , which runs abortion clinics and provides telemedicine abortions, explains that's because the earliest someone might find out they're pregnant is at four weeks.

Medication abortion is still possible with just one drug. Here's how it works

A seven-week limit gives people three weeks, at most, "to get a positive pregnancy test, determine what option is best for them, potentially involve people that they care about in their lives, find an appointment, look at potential assistance for the finances of it, and then actually go and get the medication and use it," she says. "That's a rapid turnaround."

Many abortion providers are prepared to switch to another regimen, using only misoprostol , but it requires more doses, which come with more side effects. And Grant says that regimen might be the next target if the challengers succeed in restricting mifepristone. "We wouldn't be surprised if the next move on the political chessboard is to make both of these drugs unavailable," she says.

2. It would hamper miscarriage care

When someone has a miscarriage, doctors often prescribe the same mifepristone plus misoprostol regimen. The treatment can potentially ward off weeks of waiting, worrying and bleeding.

For instance, Michelle Brown told NPR that after she learned she was miscarrying, she was nervous she would start bleeding on her long commute to work in Louisiana, where there was no safe place to pull over. Taking mifepristone allowed her to plan ahead so she could be comfortable at home with her then-fiancé.

Pregnancy care in Louisiana worsened after abortion ban

Larissa Adams explained to NPR that taking mifepristone allowed her to get through years of family planning challenges that involved miscarriage after miscarriage after miscarriage.

"We use this medication in lots of different ways and for lots of different care," including for miscarriage and pregnancy loss, says Dr. Jamila Perritt , an OB-GYN in Washington D.C. who's the President of Physicians for Reproductive Health. "If this medication is restricted or banned completely, no one will be able to get access to it with any ease," she says.

3. It could affect the whole country, including voters' preferences in blue states

In the nearly two years since the Supreme Court overturned Roe , states have moved in two opposing directions – about half of states ban or seriously restrict abortion, and the other half have passed measures to protect access.

A Supreme Court decision that restricts access to mifepristone would affect the whole country.

"I think there's been to some degree a false sense of security created by ballot initiatives [protecting abortion access] in some states," says Mary Ziegler, a law professor at the University of California-Davis. "People are thinking, 'What happens in the Supreme Court doesn't really matter because I live in California or I live in Michigan or I live in Ohio' – that, essentially, if you voted for a ballot initiative or you live in a blue state, you don't have to worry about it."

"This is a reminder that what happens in the federal courts can override what voters decide," she adds.

4. It could interfere with state sovereignty

A ruling to limit access to mifepristone would extend into the states that have attempted to protect access. That's why a group of 22 Democratic governors filed an amicus brief in this case. It argues that, if successful, the challengers' strategy of using federal courts to override FDA's judgment, "would have an enormously disruptive impact on state governance and hamstring governors' ability to fulfill their mandate of protecting public health and safety in the reproductive health care context and beyond."

Ziegler observes there's an irony here.

"When the Supreme Court overruled Roe , the takeaway, if you will, from Justice Alito, was, 'It's time for this question to be returned to the people and their elected representatives,'" she observes. "And yet, fast forward less than two years later and we have two major abortion cases at the Supreme Court, both of which could very much reconfigure what happens in states." (The other case, from Idaho , challenges federal rules requiring abortion during a medical emergency, regardless of state restrictions.)

6. The drug industry could face destabilizing uncertainty

Drugmakers are quite concerned about the mifepristone case. Hundreds of drug company executives signed a letter last year in support of FDA's authority to regulate medications without judicial interference. Many also submitted an amicus brief .

"This case is about mifepristone right now – it's about one medicine, but it really could be any medicine, " Dr. Amanda Banks, a consultant who signed the amicus brief, said in a press conference this month organized by the ACLU.

"The [FDA] regulatory process that we rely upon as an industry is rigorous and long and it's expensive," she explained, adding that it's not a perfect process, but it's predictable. If it can be undone by plaintiffs who morally object to a medicine and friendly federal courts, that predictability goes out the window, she said.

The uncertainty could affect investors and drug companies and "could put innovation for new drugs and much, much needed therapies for patients, not just in the United States, but globally, at fundamental risk," Banks said.

It could also set a new precedent, Ziegler adds. "Any drug could get a second look from federal judges who are not reviewing as much evidence [as FDA scientists], or are not competent to review as much evidence, because they don't like the way the FDA handled it," she says.

In another amicus brief , former FDA commissioners argued that drug companies could make use a precedent set by this case to challenge a competitor's FDA approval. Or, they write, "organizations representing patients who experience rare adverse events could challenge FDA's risk-benefit analyses and attempt to bar access to safe and effective remedies for others who need them."

"I think that's why the pharmaceutical industry is nervous," Ziegler says. "They're saying, if this could happen with mifepristone, which has a very, very low complication rate and which is very, very well studied because it's been controversial, then what would stop anyone from doing it with every other drug?"

7. A path toward a national abortion ban is embedded in the cas e

Legal scholars like Ziegler also note that there's an even bigger way that this case could affect everyone in the country. "You have, lurking in the background, the possibility that the Comstock Act is going to be reinvented as an abortion ban," she says.

The Comstock Act is a 19th century law prohibiting the mailing of things for "indecent" or "immoral" use. The plaintiffs in this case use Comstock in one of their arguments, treating it as a straightforward statute and not a defunct law.

The rules included in the Comstock Act could encompass not just abortion pills but birth control and any equipment used for any type of abortion, and Ziegler says this could effectively inhibit all abortion care in the U.S.

Regardless of what the ultimate decision on mifepristone is, "if the court says, 'your reading of the Comstock Act is right,' there are any number of anti-abortion groups that will try to find a way to get back to the Supreme Court to explore all those implications," Ziegler says.

• FDA v. Alliance for Hippocratic Medicine
• medication abortion
• mifepristone
• Supreme Court

When the Supreme Court overturned Roe v. Wade, it opened the floodgates for abortion-related lawsuits

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What the data says about abortion in the u.s..

Pew Research Center has conducted many surveys about abortion over the years, providing a lens into Americans’ views on whether the procedure should be legal, among a host of other questions.

In a  Center survey  conducted nearly a year after the Supreme Court’s June 2022 decision that  ended the constitutional right to abortion , 62% of U.S. adults said the practice should be legal in all or most cases, while 36% said it should be illegal in all or most cases. Another survey conducted a few months before the decision showed that relatively few Americans take an absolutist view on the issue .

Find answers to common questions about abortion in America, based on data from the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, which have tracked these patterns for several decades:

How many abortions are there in the U.S. each year?

How has the number of abortions in the u.s. changed over time, what is the abortion rate among women in the u.s. how has it changed over time, what are the most common types of abortion, how many abortion providers are there in the u.s., and how has that number changed, what percentage of abortions are for women who live in a different state from the abortion provider, what are the demographics of women who have had abortions, when during pregnancy do most abortions occur, how often are there medical complications from abortion.

This compilation of data on abortion in the United States draws mainly from two sources: the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, both of which have regularly compiled national abortion data for approximately half a century, and which collect their data in different ways.

The CDC data that is highlighted in this post comes from the agency’s “abortion surveillance” reports, which have been published annually since 1974 (and which have included data from 1969). Its figures from 1973 through 1996 include data from all 50 states, the District of Columbia and New York City – 52 “reporting areas” in all. Since 1997, the CDC’s totals have lacked data from some states (most notably California) for the years that those states did not report data to the agency. The four reporting areas that did not submit data to the CDC in 2021 – California, Maryland, New Hampshire and New Jersey – accounted for approximately 25% of all legal induced abortions in the U.S. in 2020, according to Guttmacher’s data. Most states, though,  do  have data in the reports, and the figures for the vast majority of them came from each state’s central health agency, while for some states, the figures came from hospitals and other medical facilities.

Discussion of CDC abortion data involving women’s state of residence, marital status, race, ethnicity, age, abortion history and the number of previous live births excludes the low share of abortions where that information was not supplied. Read the methodology for the CDC’s latest abortion surveillance report , which includes data from 2021, for more details. Previous reports can be found at  stacks.cdc.gov  by entering “abortion surveillance” into the search box.

For the numbers of deaths caused by induced abortions in 1963 and 1965, this analysis looks at reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. In computing those figures, we excluded abortions listed in the report under the categories “spontaneous or unspecified” or as “other.” (“Spontaneous abortion” is another way of referring to miscarriages.)

Guttmacher data in this post comes from national surveys of abortion providers that Guttmacher has conducted 19 times since 1973. Guttmacher compiles its figures after contacting every known provider of abortions – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, and it provides estimates for abortion providers that don’t respond to its inquiries. (In 2020, the last year for which it has released data on the number of abortions in the U.S., it used estimates for 12% of abortions.) For most of the 2000s, Guttmacher has conducted these national surveys every three years, each time getting abortion data for the prior two years. For each interim year, Guttmacher has calculated estimates based on trends from its own figures and from other data.

The latest full summary of Guttmacher data came in the institute’s report titled “Abortion Incidence and Service Availability in the United States, 2020.” It includes figures for 2020 and 2019 and estimates for 2018. The report includes a methods section.

In addition, this post uses data from StatPearls, an online health care resource, on complications from abortion.

An exact answer is hard to come by. The CDC and the Guttmacher Institute have each tried to measure this for around half a century, but they use different methods and publish different figures.

The last year for which the CDC reported a yearly national total for abortions is 2021. It found there were 625,978 abortions in the District of Columbia and the 46 states with available data that year, up from 597,355 in those states and D.C. in 2020. The corresponding figure for 2019 was 607,720.

The last year for which Guttmacher reported a yearly national total was 2020. It said there were 930,160 abortions that year in all 50 states and the District of Columbia, compared with 916,460 in 2019.

• How the CDC gets its data: It compiles figures that are voluntarily reported by states’ central health agencies, including separate figures for New York City and the District of Columbia. Its latest totals do not include figures from California, Maryland, New Hampshire or New Jersey, which did not report data to the CDC. ( Read the methodology from the latest CDC report .)
• How Guttmacher gets its data: It compiles its figures after contacting every known abortion provider – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, then provides estimates for abortion providers that don’t respond. Guttmacher’s figures are higher than the CDC’s in part because they include data (and in some instances, estimates) from all 50 states. ( Read the institute’s latest full report and methodology .)

While the Guttmacher Institute supports abortion rights, its empirical data on abortions in the U.S. has been widely cited by  groups  and  publications  across the political spectrum, including by a  number of those  that  disagree with its positions .

These estimates from Guttmacher and the CDC are results of multiyear efforts to collect data on abortion across the U.S. Last year, Guttmacher also began publishing less precise estimates every few months , based on a much smaller sample of providers.

The figures reported by these organizations include only legal induced abortions conducted by clinics, hospitals or physicians’ offices, or those that make use of abortion pills dispensed from certified facilities such as clinics or physicians’ offices. They do not account for the use of abortion pills that were obtained  outside of clinical settings .

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The annual number of U.S. abortions rose for years after Roe v. Wade legalized the procedure in 1973, reaching its highest levels around the late 1980s and early 1990s, according to both the CDC and Guttmacher. Since then, abortions have generally decreased at what a CDC analysis called  “a slow yet steady pace.”

Guttmacher says the number of abortions occurring in the U.S. in 2020 was 40% lower than it was in 1991. According to the CDC, the number was 36% lower in 2021 than in 1991, looking just at the District of Columbia and the 46 states that reported both of those years.

(The corresponding line graph shows the long-term trend in the number of legal abortions reported by both organizations. To allow for consistent comparisons over time, the CDC figures in the chart have been adjusted to ensure that the same states are counted from one year to the next. Using that approach, the CDC figure for 2021 is 622,108 legal abortions.)

There have been occasional breaks in this long-term pattern of decline – during the middle of the first decade of the 2000s, and then again in the late 2010s. The CDC reported modest 1% and 2% increases in abortions in 2018 and 2019, and then, after a 2% decrease in 2020, a 5% increase in 2021. Guttmacher reported an 8% increase over the three-year period from 2017 to 2020.

As noted above, these figures do not include abortions that use pills obtained outside of clinical settings.

Guttmacher says that in 2020 there were 14.4 abortions in the U.S. per 1,000 women ages 15 to 44. Its data shows that the rate of abortions among women has generally been declining in the U.S. since 1981, when it reported there were 29.3 abortions per 1,000 women in that age range.

The CDC says that in 2021, there were 11.6 abortions in the U.S. per 1,000 women ages 15 to 44. (That figure excludes data from California, the District of Columbia, Maryland, New Hampshire and New Jersey.) Like Guttmacher’s data, the CDC’s figures also suggest a general decline in the abortion rate over time. In 1980, when the CDC reported on all 50 states and D.C., it said there were 25 abortions per 1,000 women ages 15 to 44.

That said, both Guttmacher and the CDC say there were slight increases in the rate of abortions during the late 2010s and early 2020s. Guttmacher says the abortion rate per 1,000 women ages 15 to 44 rose from 13.5 in 2017 to 14.4 in 2020. The CDC says it rose from 11.2 per 1,000 in 2017 to 11.4 in 2019, before falling back to 11.1 in 2020 and then rising again to 11.6 in 2021. (The CDC’s figures for those years exclude data from California, D.C., Maryland, New Hampshire and New Jersey.)

The CDC broadly divides abortions into two categories: surgical abortions and medication abortions, which involve pills. Since the Food and Drug Administration first approved abortion pills in 2000, their use has increased over time as a share of abortions nationally, according to both the CDC and Guttmacher.

The majority of abortions in the U.S. now involve pills, according to both the CDC and Guttmacher. The CDC says 56% of U.S. abortions in 2021 involved pills, up from 53% in 2020 and 44% in 2019. Its figures for 2021 include the District of Columbia and 44 states that provided this data; its figures for 2020 include D.C. and 44 states (though not all of the same states as in 2021), and its figures for 2019 include D.C. and 45 states.

Guttmacher, which measures this every three years, says 53% of U.S. abortions involved pills in 2020, up from 39% in 2017.

Two pills commonly used together for medication abortions are mifepristone, which, taken first, blocks hormones that support a pregnancy, and misoprostol, which then causes the uterus to empty. According to the FDA, medication abortions are safe  until 10 weeks into pregnancy.

Surgical abortions conducted  during the first trimester  of pregnancy typically use a suction process, while the relatively few surgical abortions that occur  during the second trimester  of a pregnancy typically use a process called dilation and evacuation, according to the UCLA School of Medicine.

In 2020, there were 1,603 facilities in the U.S. that provided abortions,  according to Guttmacher . This included 807 clinics, 530 hospitals and 266 physicians’ offices.

While clinics make up half of the facilities that provide abortions, they are the sites where the vast majority (96%) of abortions are administered, either through procedures or the distribution of pills, according to Guttmacher’s 2020 data. (This includes 54% of abortions that are administered at specialized abortion clinics and 43% at nonspecialized clinics.) Hospitals made up 33% of the facilities that provided abortions in 2020 but accounted for only 3% of abortions that year, while just 1% of abortions were conducted by physicians’ offices.

Looking just at clinics – that is, the total number of specialized abortion clinics and nonspecialized clinics in the U.S. – Guttmacher found the total virtually unchanged between 2017 (808 clinics) and 2020 (807 clinics). However, there were regional differences. In the Midwest, the number of clinics that provide abortions increased by 11% during those years, and in the West by 6%. The number of clinics  decreased  during those years by 9% in the Northeast and 3% in the South.

The total number of abortion providers has declined dramatically since the 1980s. In 1982, according to Guttmacher, there were 2,908 facilities providing abortions in the U.S., including 789 clinics, 1,405 hospitals and 714 physicians’ offices.

The CDC does not track the number of abortion providers.

In the District of Columbia and the 46 states that provided abortion and residency information to the CDC in 2021, 10.9% of all abortions were performed on women known to live outside the state where the abortion occurred – slightly higher than the percentage in 2020 (9.7%). That year, D.C. and 46 states (though not the same ones as in 2021) reported abortion and residency data. (The total number of abortions used in these calculations included figures for women with both known and unknown residential status.)

The share of reported abortions performed on women outside their state of residence was much higher before the 1973 Roe decision that stopped states from banning abortion. In 1972, 41% of all abortions in D.C. and the 20 states that provided this information to the CDC that year were performed on women outside their state of residence. In 1973, the corresponding figure was 21% in the District of Columbia and the 41 states that provided this information, and in 1974 it was 11% in D.C. and the 43 states that provided data.

In the District of Columbia and the 46 states that reported age data to  the CDC in 2021, the majority of women who had abortions (57%) were in their 20s, while about three-in-ten (31%) were in their 30s. Teens ages 13 to 19 accounted for 8% of those who had abortions, while women ages 40 to 44 accounted for about 4%.

The vast majority of women who had abortions in 2021 were unmarried (87%), while married women accounted for 13%, according to  the CDC , which had data on this from 37 states.

In the District of Columbia, New York City (but not the rest of New York) and the 31 states that reported racial and ethnic data on abortion to  the CDC , 42% of all women who had abortions in 2021 were non-Hispanic Black, while 30% were non-Hispanic White, 22% were Hispanic and 6% were of other races.

Looking at abortion rates among those ages 15 to 44, there were 28.6 abortions per 1,000 non-Hispanic Black women in 2021; 12.3 abortions per 1,000 Hispanic women; 6.4 abortions per 1,000 non-Hispanic White women; and 9.2 abortions per 1,000 women of other races, the  CDC reported  from those same 31 states, D.C. and New York City.

For 57% of U.S. women who had induced abortions in 2021, it was the first time they had ever had one,  according to the CDC.  For nearly a quarter (24%), it was their second abortion. For 11% of women who had an abortion that year, it was their third, and for 8% it was their fourth or more. These CDC figures include data from 41 states and New York City, but not the rest of New York.

Nearly four-in-ten women who had abortions in 2021 (39%) had no previous live births at the time they had an abortion,  according to the CDC . Almost a quarter (24%) of women who had abortions in 2021 had one previous live birth, 20% had two previous live births, 10% had three, and 7% had four or more previous live births. These CDC figures include data from 41 states and New York City, but not the rest of New York.

The vast majority of abortions occur during the first trimester of a pregnancy. In 2021, 93% of abortions occurred during the first trimester – that is, at or before 13 weeks of gestation,  according to the CDC . An additional 6% occurred between 14 and 20 weeks of pregnancy, and about 1% were performed at 21 weeks or more of gestation. These CDC figures include data from 40 states and New York City, but not the rest of New York.

About 2% of all abortions in the U.S. involve some type of complication for the woman , according to an article in StatPearls, an online health care resource. “Most complications are considered minor such as pain, bleeding, infection and post-anesthesia complications,” according to the article.

The CDC calculates  case-fatality rates for women from induced abortions – that is, how many women die from abortion-related complications, for every 100,000 legal abortions that occur in the U.S .  The rate was lowest during the most recent period examined by the agency (2013 to 2020), when there were 0.45 deaths to women per 100,000 legal induced abortions. The case-fatality rate reported by the CDC was highest during the first period examined by the agency (1973 to 1977), when it was 2.09 deaths to women per 100,000 legal induced abortions. During the five-year periods in between, the figure ranged from 0.52 (from 1993 to 1997) to 0.78 (from 1978 to 1982).

The CDC calculates death rates by five-year and seven-year periods because of year-to-year fluctuation in the numbers and due to the relatively low number of women who die from legal induced abortions.

In 2020, the last year for which the CDC has information , six women in the U.S. died due to complications from induced abortions. Four women died in this way in 2019, two in 2018, and three in 2017. (These deaths all followed legal abortions.) Since 1990, the annual number of deaths among women due to legal induced abortion has ranged from two to 12.

The annual number of reported deaths from induced abortions (legal and illegal) tended to be higher in the 1980s, when it ranged from nine to 16, and from 1972 to 1979, when it ranged from 13 to 63. One driver of the decline was the drop in deaths from illegal abortions. There were 39 deaths from illegal abortions in 1972, the last full year before Roe v. Wade. The total fell to 19 in 1973 and to single digits or zero every year after that. (The number of deaths from legal abortions has also declined since then, though with some slight variation over time.)

The number of deaths from induced abortions was considerably higher in the 1960s than afterward. For instance, there were 119 deaths from induced abortions in  1963  and 99 in  1965 , according to reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. The CDC is a division of Health and Human Services.

Note: This is an update of a post originally published May 27, 2022, and first updated June 24, 2022.

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Key facts about the abortion debate in America

Public opinion on abortion, three-in-ten or more democrats and republicans don’t agree with their party on abortion, partisanship a bigger factor than geography in views of abortion access locally, do state laws on abortion reflect public opinion, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

The New York Sun

Supreme court hears arguments in first major abortion case since the overturn of roe v. wade.

The drug responsible for the majority of American abortions has its day in court.

In the first major abortion case to reach the Supreme Court since it overturned Roe v. Wade nearly two years ago, court observers say a majority of justices across the spectrum questioned if the doctors bringing the case had legal grounds to sue and appeared unlikely to rule in favor of a crackdown on abortion drugs. 

The case, U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine, centers around whether the Food and Drug Administration’s removal of chemical abortion safeguards when it widened access to mifepristone — the first of two drugs used in chemical abortions — put women at risk. Its challenge of the federal agency could also have implications for the larger regulatory issues and the administrative state. 

If the case is weighed on the merits, it could have wide-ranging effects on abortion in America — where in 2023, there were more than 642,000 drug-induced abortions, representing 63 percent of total abortions, the Guttmacher Institute’s data show. The arguments on Tuesday drew hundreds of protesters outside of the court, both for and against abortion drugs. 

The case was brought by the Alliance Defending Freedom on behalf of doctors who say they are “called on to provide emergency care for many women facing crises because of the FDA’s reckless actions.” The doctors say that when the agency removed rules requiring in-person doctor visits and follow up reporting on the drugs, it betrayed women who should be seen by doctors before taking the “high-risk drugs.”

The doctors’ filing notes that chemical abortion drugs can cause severe injuries to pregnant women and are 50 percent “more likely than surgical abortions to result in an emergency department visit within thirty days.”

Arguing the case for the Alliance Defending Freedom was Senator Hawley’s wife, Erin Hawley. 

“This case seems like a prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an FDA rule or any other government action,” Justice Neil Gorsuch said to Ms. Hawley of the plaintiff’s claims. 

Justice Elena Kagan, too, pressed Ms. Hawley, saying, “You need a person” who has met standing requirements. “Who’s your person?” she asked. Also appearing skeptical was Justice Ketanji Brown Jackson. She asked the lawyer representing the mifepristone manufacturer, Danco, if the company was concerned about “judges parsing medical and scientific studies” rather than FDA experts. 

The federal government, represented by the solicitor general, Elizabeth Prelogar, argued that an “exceptionally small number” of women suffer complications from the drug. Furthermore, she argued the doctors bringing the case lacked standing because no one is forcing them to prescribe the pills or treat women who take the drugs. 

One dissenting voice was Justice Samuel Alito, who sparred with Ms. Prelogar on the standing issue. “Is there anybody who can sue and get a judicial ruling on whether what FDA did was lawful?” he asked. “Shouldn’t somebody be able to challenge that in court? Who?” 

Ms. Prelogar acknowledged that for this case it would be “hard to identify anyone who would have standing to sue” but said that it still doesn’t mean the court should depart from Article III standing requirements. 

“So your argument is that it doesn’t matter if FDA flagrantly violated the law, didn’t do what it should have done, endangered the health of women, it’s just too bad, nobody can sue in court,” Justice Alito said. “There’s no remedy, the American people have no remedy for that?”

Ms. Hroncich is from Pittsburgh and a graduate of Hillsdale College. Her work has appeared in the Wall Street Journal, the Federalist, and The Daily Signal.

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