Abortion
The debate over whether abortion should be a legal option has long divided people around the world. Split into two groups, pro-choice and pro-life, the two sides frequently clash in the United States.
Early history
Abortion techniques were developed as early as 1550 bce, when the Egyptian medical text Ebers papyrus suggested that the vaginal insertion of plant fiber covered with honey and crushed dates could induce an abortion. Abortion was an accepted practice in ancient Greece and Rome. Greek philosopher Aristotle (384–322 bce) wrote that “when couples have children in excess, let abortion be procured before sense and life have begun.” In the latter days of the Roman Empire, abortion was not considered homicide but a crime against a husband who would be deprived of a potential child. [86][87]
Throughout much of Western history, abortion was not considered a criminal act as long as it was performed before “quickening” (the first detectable movement of the fetus, which can occur between 13–25 weeks of pregnancy). American states derived their initial abortion statutes from British common law, which followed this principle. Until at least the early 1800s, abortion procedures and methods were legal and openly advertised throughout the United States. Abortion was unregulated, however, and often not only unsafe, but also potentially fatal. [86][88][89][90][91][106]
In 1821, Connecticut became the first U.S. state to criminalize abortion. The state banned the selling of an abortion-inducing “poison,” but it did not punish those who took the poison. Legal consequences began in 1845 when New York criminalized a woman’s participation in her abortion, regardless of whether it took place before or after “quickening.” In the mid-1800s, early pro-life advocate Dr. Horatio Robinson Storer (1830–1922) convinced the American Medical Association to join him in campaigning for the outlawing of abortion nationwide. By the early 1900s, most states had banned abortion. By 1965, all 50 states had outlawed abortion, with some exceptions varying by state. [41][42][90][92]
The motivation behind these early abortion laws has been disputed. Some writers argue that the laws were not aimed at preserving the lives of unborn children, but rather were intended to protect women from unsafe abortion procedures, or to allow the medical profession to take over responsibility for women’s health from untrained practitioners. Others say that pro-life concerns were already prevalent and were a major influence behind the efforts to ban abortion. [86][90][93]
Roe v. Wade
Federal action on abortion didn’t occur until Roe v. Wade, which declared most state anti-abortion laws unconstitutional. On January 22, 1973, the U.S. Supreme Court’s 7–2 decision established rules based on a pregnancy trimester framework, banning legislative interference in the first trimester of pregnancy (0–12 weeks), allowing states to regulate abortion during the second trimester (weeks 13–28) “in ways that are reasonably related to maternal health,” and allowing a state to “regulate, and even proscribe” abortion during the third trimester (weeks 29–40) “in promoting its interest in the potentiality of human life,” unless an abortion is required to preserve the life or health of the mother. The decision also allowed states to prohibit abortions performed by anyone who is not a state-licensed physician. [49][95]
The initial Roe v. Wade lawsuit was filed at the Dallas federal district courthouse on Mar. 3, 1970 by pregnant Texas resident Norma McCorvey, named in court documents as “Jane Roe.” Henry Wade, Dallas County District Attorney from 1951 to 1987, was the named defendant. McCorvey was seeking to end her pregnancy, but abortion was illegal in Texas except to save the mother’s life. McCorvey said the pregnancy was the result of rape, but she later retracted that claim, admitting she lied in the hope of increasing her chances of procuring an abortion. The baby was eventually delivered and given up for adoption. McCorvey later abandoned her support of abortion rights, becoming a pro-life activist and an evangelical Christian in 1995. She then converted to Catholicism and took part in silent prayer vigils outside abortion clinics. In the 2020 documentary, AKA Jane Roe, McCorvey claimed anti-abortion activists paid her to support their cause. [96][97][100][123][218]
Hyde Amendment & Mexico City Policy
Immediately following Roe v. Wade, pro-life proponents pushed for federal legislation that would restrict abortion. In 1976, Congress passed the appropriations bill for the Departments of Labor, Health, Education, and Welfare (now the Department of Health and Human Services) which included an amendment ending Medicaid funding for abortions. Known as the “Hyde Amendment,” this provision banning federal funding for abortions has been renewed with various revisions every year since its inception. [60][168][221]
At the Aug. 1984 United Nations International Conference on Population held in Mexico City, Mexico, President Ronald Reagan announced the Mexico City Policy, which restricted all non-governmental organizations funded by the U.S. Agency for International Development (USAID) from performing or promoting abortion services. President Bill Clinton rescinded the policy (Jan. 22, 1993); President George W. Bush reenacted it (Jan. 22, 2001); President Barack Obama again rescinded it (Jan. 23, 2009); President Donald Trump again reinstated it (Jan. 23, 2017); and President Joe Biden revoked it once again (Jan. 28, 2021). [60][168][221]
Planned Parenthood v. Casey
On June 29, 1992 the U.S. Supreme Court case Planned Parenthood of Southeastern Pennsylvania v. Casey (5–4) upheld the constitutional right to have an abortion, but it abandoned the “rigid trimester framework” outlined in Roe v. Wade and adopted a less restrictive standard for state regulations. The decision allowed states to impose waiting periods before an abortion could be obtained, allowed some legislative interference in the first trimester in the interest of health, and permitted parental consent requirements for minors seeking abortions. The Court ruled that none of these conditions imposed an “undue burden” upon those seeking abortions, but some pro-choice advocates warned that Roe v. Wade had been significantly weakened and that states would limit abortion access. [57][107][108][109]
Federal regulation post-Casey
On Nov. 5, 2003, after passing in the U.S. House of Representatives (281–142) and the U.S. Senate (64–34), the Partial-Birth Abortion Ban Act of 2003 was signed into law by President George W. Bush. This federal legislation banned physicians from providing intact dilation and extraction (also called a “partial-birth” abortion, a term created by the National Right to Life Committee (NRLC) in 1995 that is not used by the medical profession), a late-term (after 21 weeks gestation) method used when a mother’s life is in danger or the fetus has such severe abnormalities that it will not survive, The procedure, which is most often performed before viability, accounted for 0.17% of abortion procedures in 2000. The act defines a “partial-birth abortion” as “an abortion in which the provider deliberately and intentionally vaginally delivers a living fetus until…the entire fetal head is outside the body of the mother, or…any part of the fetal trunk past the navel is outside the body of the mother, for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus.” Pro-choice advocates challenged the constitutionality of the Partial-Birth Abortion Ban Act of 2003; however, the Apr. 18, 2007 U.S. Supreme Court case Gonzales v. Carhart/Gonzales v. Planned Parenthood upheld the act, ruling 5–4 that it did not impose “an undue burden on a woman’s right to abortion.” [43][58][59]
The topic of abortion was again raised during the 2009–2010 U.S. Congress health care debate. Some pro-life advocates said the Patient Protection and Affordable Care Act would allow federal funding for abortions, a claim denied by abortion rights supporters. To ensure passage of the bill, President Barack Obama signed an executive order “to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services,” reaffirming Hyde Amendment restrictions and extending them to cover the newly created health insurance exchanges. [63]
In Mar. 2017 the Department of Health and Human Services announced that all federally funded shelters housing undocumented unaccompanied minors are henceforth prohibited from taking “any action that facilitates” access to abortion. The American Civil Liberties Union (ACLU) challenged this decision in Garza v. Hargan, and on Mar. 30, 2018 the U.S. District Court for the District of Columbia issued an injunction, ruling that the federal government must not interfere or obstruct any “unaccompanied immigrant minor children who are or will be in the legal custody of the federal government” from having an abortion while the case is being heard. [198][199][200]
Roe v. Wade in 2022
On May 2, 2022, a U.S. Supreme Court first draft majority opinion written by Justice Samuel Alito was leaked to and verified by Politico. The draft indicated the court would overturn Roe v. Wade and Planned Parenthood v. Casey. Alito wrote, “Roe was egregiously wrong from the start....The inescapable conclusion is that a right to abortion is not deeply rooted in the Nation’s history and traditions.” Justice Alito indicated the decisions to allow, regulate, or ban abortion lies with individual states. Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett were reported to have voted with Alito to overturn Roe and Casey, while Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan were writing dissents. How Chief Justice John Roberts would vote was unclear at the time of the leak. [227][228]
On June 24, 2022, the U.S. Supreme Court overturned Roe v. Wade and Planned Parenthood v. Casey in a 6–3 decision in Dobbs v. Jackson Women’s Health Organization, eliminating the federal constitutional right to abortion. Justice Samuel Alito wrote the majority opinion (the final copy of which was similar to the draft leaked in May), and was joined by Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett. Chief Justice John Roberts did not join the majority, but wrote a concurring opinion that would have upheld Mississippi’s 15-week ban, but would not have overturned Roe v. Wade. Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan dissented, writing: “With sorrow—for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection—we dissent.” [273][274][275]
Post-Roe and -Casey
On July 8, 2022, President Joe Biden signed “Executive Order on Protecting Access to Reproductive Healthcare Services.” The order directs Health and Human Services (HHS) to submit a report within 30 days on what actions HHS is taking to protect access to abortion and other reproductive services; states HHS will expand access to emergency contraception and long-acting reversible contraception as well as education about abortion; directs HHS to update physician responsibilities and protections guidance under the Emergency Medical Treatment and Labor Act; establishes an interagency reproductive health care access task force; collects private pro bono lawyers and organizations to provide legal representation to those seeking and providing abortions; directs the Federal Trade Commission and HHS to consider taking steps to protect patient privacy; and provides safety to those seeking and providing abortions. [277][278]
In guidance issued by HHS Secretary Xavier Becerra on July 11, 2022, the Biden Administration “reaffirmed that it [the Emergency Medical Treatment and Active Labor Act (EMTALA)] protects providers when offering legally-mandated, life- or health-saving abortion services in emergency situations” and that “this federal law preempts state law restricting access to abortion in emergency situations.” On July 14, 2022, Texas sued the federal government, stating: “EMTALA does not mandate access to abortion or codify a right to an abortion as ‘stabilizing treatment’ for an ’emergency medical condition.’ The Abortion Mandate cites no other federal law that would authorize or require an abortion. No federal statute, including EMTALA, supersedes or preempts the States’ power to regulate or prohibit abortion.” [279][280][284]
On July 13, 2022, the Biden Administration issued clarifying guidance with examples of when pharmacies that receive federal assistance (including via Medicare and Medicaid payments) are not allowed to refuse to fill prescriptions for drugs that may end a pregnancy lest they violate federal civil rights laws. The examples of potential civil rights violations (discrimination on the basis of sex or disability specifically) include but are not limited to: refusing to fill mifepristone and misoprostol prescriptions for miscarriages; not stocking or filling prescriptions for misoprostol, which can be used for stomach ulcers, or methotrexate, which can be used for rheumatoid arthritis, because of their alternate uses in abortions; refusing to stock or fill a prescription for emergency contraception if the pharmacy also stocks other contraception including condoms. [281][282][283]
On Aug. 23, 2022, U.S. District Court Judge James Wesley Hendrix ruled that the HHS guidance about the EMTALA was “unauthorized.” Hendrix wrote: “That guidance goes well beyond EMTALA’s text, which protects both mothers and unborn children, is silent as to abortion, and preempts state law only when the two directly conflict. Since the statute is silent on the question, the Guidance cannot answer how doctors should weigh risks to both a mother and her unborn child. Nor can it, in doing so, create a conflict with state law where one does not exist.” [285]
The following day, Aug. 24, 2022, U.S. District Judge B. Lynn Winmill blocked an Idaho ban on emergency abortions. Winmill wrote the court was tasked with determining “whether Idaho’s criminal abortion statute conflicts with a small but important corner of federal legislation. It does.” The conflict between the Aug. 23 ruling and the Aug. 24 ruling could send abortion rights back to the U.S. Supreme Court. [286]
On Sep. 1, 2022, the Department of Veterans Affairs announced an interim final rule that the VA would provide abortions to veterans and VA beneficiaries in some cases, regardless of state laws. Abortions will be available if the life or health of the pregnant person is in danger and in cases of rape and incest. [287]
On Mar. 4, 2024, France became the first country to enshrine abortion rights in the country’s constitution. The constitutional amendment makes abortion up to 14 weeks a “guaranteed freedom,” meaning future lawmakers will not be able to “drastically modify” the protection. Abortions are allowed later in a pregnancy if the mother’s physical or mental health is in danger or if certain anomalies are present in the fetus. The passage was not a surprise; the French have the highest support for legalized abortion, just after Sweden. [300]
On Mar. 14, 2024, Kamala Harris became the first sitting Vice President to visit an abortion clinic when she arrived at a Minnesota Planned Parenthood to speak to health-care providers and patients. [303]
Pro-choice and Pro-life groups
Some prominent pro-choice organizations include Planned Parenthood, NARAL Pro-Choice America, the National Abortion Federation, the American Civil Liberties Union (ACLU), and the National Organization for Women. Although many pro-life positions derive from religious ideology, several mainstream faith groups support the pro-choice movement, such as the United Methodist Church, United Church of Christ, the Episcopal Church, Presbyterian Church (USA), and the Unitarian Universalist Association. [169][170]
The 2020 Democratic Party Platform endorsed the pro-choice position, stating: “Democrats are committed to protecting and advancing reproductive health, rights, and justice. We believe unequivocally, like the majority of Americans, that every woman should be able to access high-quality reproductive health care services, including safe and legal abortion. We will repeal the Title X domestic gag rule and restore federal funding for Planned Parenthood, which provides vital preventive and reproductive health care for millions of people, especially low-income people, and people of color, and LGBTQ+ people, including in underserved areas.” [169][170]
Some prominent pro-life organizations include The National Right to Life Committee, Pro-Life Action League, Operation Rescue, the Catholic Church, the Eastern Orthodox Church, Americans United for Life, the National Association of Evangelicals, Family Research Council, Christian Coalition of America, and the Church of Jesus Christ of Latter-Day Saints (Mormon Church). [6][170][171]
The 2016 Republican Party Platform (which was not updated in 2020) opposed abortion, stating: “We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare...We will not fund or subsidize healthcare that includes abortion coverage...We thank and encourage providers of counseling, medical services, and adoption assistance for empowering women experiencing an unintended pregnancy to choose life.” [6][170][171]
While “pro-choice” and “pro-life” have long been the mainstream terms, some prefer “pro-abortion” and “anti-abortion,” either to clarify or scorn the position of the opposing group.
Public opinion: 2017-2024
A 2017 Pew Research survey found that 57% of Americans say abortion should be legal in all or most cases, while 40% say it should be illegal in all or most cases. [201]
A 2018 Marist Poll and Knights of Columbus survey found that 51% of Americans consider themselves to be pro-choice, and 44% consider themselves to be pro-life. [174]
Pew Research found that 69% of Americans—84% of Democrats and 53% of Republicans—surveyed said “No, do not overturn” in response to the question “Would you like to see the Supreme Court completely overturn its Roe versus Wade decision, or not?” [175]
A 2018 PPRI poll found that 45% of women and 42% of men agreed abortions should be covered by most health insurance plans. [172]
A Sept. 22, 2021, Marquette Law School survey found 20% were in favor of overturning Roe v. Wade, 50% were opposed, and 29% said they didn’t have enough information. A 2021 Monmouth University poll reported 62% of Americans were in favor of leaving the Roe v. Wade ruling as is, while 31% supported the Supreme Court revisiting the ruling. And a 2021 Quinnipiac University survey found that 67% agreed with the Roe v. Wade ruling and 27% were opposed. [225]
A June 2021 Gallup poll found 47% of Americans believed abortion to be morally acceptable, while 46% believed it not to be. 48% thought abortion should be legal “only under certain circumstances,” 32% “under any circumstances,” and 19% “illegal in all circumstances.” The majority of Americans opposed overturning Roe v. Wade (58%), while 32% are in favor of overturning the U.S. Supreme Court decision. 56% oppose banning abortion after the 18th week of pregnancy, 58% oppose fetal heartbeat restrictions, and 57% oppose abortion bans if the fetus is found to have a genetic disease or disorder. [222][223]
A June 2, 2022, Gallup poll found 58% of Americans are opposed to overturning Roe v. Wade, a steady majority seen since 1989. 35% would like to see the U.S. Supreme Court ruling legalizing abortion nationwide overturned. There were, however, partisan divides: 80% of Democrats, 62% of independents, and 31% of Republicans would keep Roe, while 58% of Republicans, 34% of independents, and 15% of Democrats want the ruling reversed. [271]
According to the same June 2, 2022, Gallup poll, 55% of Americans identified as “pro-choice,” the highest percentage since 1995. 39% identified as “pro-life,” and 5% were neither or unsure. For the first time in the history of the poll question (since 2001), 52% of Americans believe abortion is morally acceptable. 38% believed the procedure to be morally wrong, and 10% answered that it depended on the situation or they were unsure. [272]
A 2024 Pew Research Center poll found “63% say abortion should be legal in all or most cases, while 36% say it should be illegal in all or most cases.” [304]