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Color-coded map illustrating the legality of elective abortion in the United States as of July 1, 2022 (UTC)[1]    .mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}  Illegal from fertilization [stripes: only civil enforcement]   Legal but no professional providers   Illegal from cardiac-cell activity [2]   Illegal after 15 weeks gestational age   Illegal after 18 weeks   Illegal after 20 weeks   Illegal after 22 weeks (5 months)   Illegal from fetal viability[3]   Illegal after 24 weeks (5½ months)   Illegal in the third trimester[4]   Legal at any stageBorder color indicates more stringent ban blocked by courts
Color-coded map illustrating the legality of elective abortion in the United States as of July 1, 2022 (UTC)[1]
  Illegal from fertilization [stripes: only civil enforcement]
  Legal but no professional providers
  Illegal from cardiac-cell activity [2]
  Illegal after 15 weeks gestational age
  Illegal after 18 weeks
  Illegal after 20 weeks
  Illegal after 22 weeks (5 months)
  Illegal from fetal viability[3]
  Illegal after 24 weeks (5½ months)
  Illegal in the third trimester[4]
  Legal at any stage
Border color indicates more stringent ban blocked by courts

Abortion law in the United States and its territories is largely determined by individual states and differs immensely across the nation. Some jurisdictions ban abortion at any gestational age unless the woman would die from continued pregnancy, while others permit elective abortion at any point in pregnancy. Abortion is a highly controversial and divisive issue in American culture, politics and society. Since 1976, the Republican Party has generally sought to restrict abortion access based on the stage of pregnancy or criminalize abortion, whereas the Democratic Party has generally defended access to abortion and has made contraception easier to obtain.[5] The main actors in the abortion debate are often framed as "pro-choice", believing that a woman is entitled to choose whether to continue her pregnancy, versus "pro-life", believing that the fetus has a right to live, though most Americans are found to agree with some positions of each side.[6] Support for abortion gradually increased in the U.S. after the original Roe v. Wade ruling in January 1973,[7] but stabilized during the 2010s.[8][9]

The abortion rate has continuously declined from a peak in 1980 of 30 per 1,000 women of childbearing age (15–44) to 11.3 abortions per 1,000 women by 2018.[10] In 2018, 77.7% of abortions were performed at 9 weeks or less gestation, and 92.2% of abortions were performed at 13 weeks or less gestation.[10] By 2020, medication abortions accounted for more than 50% of all abortions.[11] Increased access to birth control has been statistically linked to reductions in the abortion rate.[12][13][14]

Before the Supreme Court of the United States decisions of Roe v. Wade and Doe v. Bolton had decriminalized abortion nationwide in 1973, abortion was already legal in several states, but the decision in the former case imposed a federally mandated uniform framework for state legislation on the subject. It established a minimal period during which abortion is legal, with more or fewer restrictions throughout the pregnancy. That basic framework, modified in Planned Parenthood v. Casey (1992), remained nominally in place, although the effective availability of abortion varied significantly from state to state, as many counties had no abortion providers.[15] Planned Parenthood v. Casey held that a law cannot place legal restrictions imposing an undue burden for "the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus".[16] In 2021, the Women's Health Protection Act, which would codify abortion rights into federal law, was introduced by Judy Chu.[17] The bill passed the House of Representatives but was rejected by the Senate.[18]

In 2022, Roe v. Wade was overturned in Dobbs v. Jackson Women's Health Organization, ending federal abortion rights and allowing individual states to regulate their own abortion laws.[19]

Terminology

Main article: Definitions of abortion

The abortion debate most commonly relates to the "induced abortion" of an embryo or fetus at some point in a pregnancy, which is also how the term is used in a legal sense.[nb 1] Some also use the term "elective abortion", which is used in relation to a claim to an unrestricted right of a woman to an abortion, whether or not she chooses to have one. The term elective abortion or voluntary abortion describes the interruption of pregnancy before viability at the request of the woman, but not for medical reasons.[23]

In medical parlance, "abortion" can refer to either miscarriage or abortion until the fetus is viable. After viability, doctors call an abortion a "termination of pregnancy".

History

Rise of anti-abortion legislation

Abortion laws in the U.S. before Roe   Illegal (30)   Legal in case of rape (1)   Legal in case of danger to woman's health (2)   Legal in case of danger to woman's health, rape or incest, or likely damaged fetus (13)   Legal on request (4)[24]
Abortion laws in the U.S. before Roe
  Illegal (30)
  Legal in case of rape (1)
  Legal in case of danger to woman's health (2)
  Legal in case of danger to woman's health, rape or incest, or likely damaged fetus (13)
  Legal on request (4)
[24]

Abortion has existed in America since European colonization. In the early 1800s, methods were published for accomplishing abortion early in pregnancy.[25] By common law, abortion after quickening (the start of fetal movements, usually felt 15–20 weeks after conception) was not allowed but, without written statutes, the rules were "hazy".[25][26] When the United States became independent, most states continued to apply English common law to abortion.

Connecticut was the first U.S. state to outlaw medicinal abortion after quickening in 1821, followed by 10 of the 26 states creating similar restrictions within 20 years.[25][26][27] New York made post-quickening abortions a felony and pre-quickening abortions a misdemeanor in 1829.[28] Other legal scholars have pointed out that some of the early laws punished not only the doctor or abortionist, but also the woman who hired them.[29]

A number of other factors likely played a role in the rise of anti-abortion laws. Physicians, who were the leading advocates of abortion criminalization laws, appear to have been motivated at least in part by advances in medical knowledge. Science had discovered that conception inaugurated a more or less continuous process of development, which produced a new human being. Quickening was found to be neither more nor less crucial in the process of gestation than any other step. Many physicians concluded that if society considered it unjustifiable to terminate pregnancy after the fetus had quickened, and if quickening was a relatively unimportant step in the gestation process, then it was just as wrong to terminate a pregnancy before quickening as after quickening.[30] Ideologically, the Hippocratic Oath and the medical mentality of that age to defend the value of human life as an absolute played a significant role in molding opinions about abortion.[30] Doctors were also influenced by practical reasons to advocate anti-abortion laws. For one, abortion providers tended to be untrained and not members of medical societies. In an age where the leading doctors in the nation were attempting to standardize the medical profession, these "irregulars" were considered a nuisance to public health.[31] The more formalized medical profession disliked the "irregulars" because they were competition, often at a cheaper cost.

Despite campaigns to end the practice of abortion, abortifacient advertising was highly effective and abortion was commonly practiced in the mid-19th century. While the precise abortion rate was not known, James Mohr's 1978 book Abortion in America documented multiple recorded estimates by 19th century physicians which suggested that between around 15% and 35% of all pregnancies ended in abortion during that period.[32] This era also saw a marked shift in the people who were obtaining abortions. Before the start of the 19th century, most abortions were sought by unmarried women who had become pregnant out of wedlock. Out of 54 abortion cases published in American medical journals between 1839 and 1880, over half were sought by married women, and well over 60% of the married women already had at least one child.[33] The sense that married women were now frequently obtaining abortions worried many conservative physicians, who were almost exclusively men. In the Reconstruction era, much of the blame was placed on the burgeoning women's rights movement.

Though the medical profession expressed hostility toward feminism, many feminists of the era were also opposed to abortion.[34][35] In the newspaper The Revolution, operated by Elizabeth Cady Stanton and Susan B. Anthony, an opinion piece was published arguing that instead of merely attempting to pass a law against abortion, the root cause must also be addressed. Simply passing an anti-abortion law would, the writer stated, "be only mowing off the top of the noxious weed, while the root remains. ... No matter what the motive, love of ease, or a desire to save from suffering the unborn innocent, the woman is awfully guilty who commits the deed. It will burden her conscience in life, it will burden her soul in death; But oh! thrice guilty is he who drove her to the desperation which impelled her to the crime."[35][36][37][38] To many feminists of this era, abortion was regarded as an undesirable necessity forced upon women by thoughtless men.[39] Even the "free love" wing of the feminist movement refused to advocate for abortion and treated the practice as an example of the hideous extremes to which modern marriage was driving women.[40] Marital rape and the seduction of unmarried women were societal ills which feminists believed caused the need to abort, as men did not respect women's right to abstinence.[40]

However, physicians remained the loudest voice in the anti-abortion debate, and they carried their agenda to state legislatures around the country, advocating not only anti-abortion laws, but also laws against birth control. This movement presaged the modern debate over women's body rights.[41] A campaign was launched against the movement and the use and availability of contraceptives.

Criminalization of abortion accelerated from the late 1860s, through the efforts of concerned legislators, doctors, and the American Medical Association.[42] In 1873, Anthony Comstock created the New York Society for the Suppression of Vice, an institution dedicated to supervising the morality of the public. Later that year, Comstock successfully influenced the United States Congress to pass the Comstock Law, which made it illegal to deliver through the U.S. mail any "obscene, lewd, or lascivious" material. It also prohibited producing or publishing information pertaining to the procurement of abortion or the prevention of conception or venereal disease, even to medical students.[43] The production, publication, importation, and distribution of such materials was suppressed under the Comstock Law as being obscene, and similar prohibitions were passed by 24 of the 37 states.[44]

In 1900, abortion was normally a felony in every state. Some states included provisions allowing for abortion in limited circumstances, generally to protect the woman's life or to terminate pregnancies arising from rape or incest.[45] Abortions continued to occur, however, and became increasingly available. The American Birth Control League was founded by Margaret Sanger in 1921; it would become Planned Parenthood Federation of America in 1942.[46][47]

By the 1930s, licensed physicians performed an estimated 800,000 abortions a year.[48]

Sherri Finkbine

Main article: Sherri Chessen

In the early 1960s, a controversy centered around children's television host Sherri Finkbine that helped bring abortion and abortion law more directly into the American public eye. Living in the area of Phoenix, Arizona, Finkbine had had four healthy children, but during her pregnancy with her fifth child, she discovered the child might have severe deformities when born.[49] This was likely because Finkbine had been taking sleeping pills that she was unaware contained thalidomide, a drug which increases the risk of fetal deformities during pregnancy.[50] Finkbine wanted an abortion, but the abortion laws of Arizona only allowed abortions if a pregnancy posed a threat to the woman's life. The situation gained public attention after Finkbine shared the story with a reporter from The Arizona Republic, who disclosed her identity in spite of her requests for anonymity. On August 18, 1962, Finkbine traveled to Sweden to obtain a legal abortion, where it was confirmed that the fetus had severe deformities.[51] Finkbine's story marked a turning point for women's reproductive rights and abortion law in the United States. Still, Finkbine was only able to get an abortion because she could afford to travel overseas for it,[52] highlighting an inequality in abortion rights persisting to this day whereby many women cannot afford or otherwise don't have the resources to obtain a legal abortion.[53][54] In such cases, women may turn to illegal forms of abortion.

Pre-Roe precedents

In 1964, Gerri Santoro of Connecticut died trying to obtain an illegal abortion, and her photo became the symbol of an abortion-rights movement. Some women's rights activist groups developed their own skills to provide abortions to women who could not obtain them elsewhere. As an example, in Chicago, a group known as "Jane" operated a floating abortion clinic throughout much of the 1960s. Women seeking the procedure would call a designated number and be given instructions on how to find "Jane".[55]

In 1965, the U.S. Supreme Court case Griswold v. Connecticut struck down one of the remaining contraception Comstock laws in Connecticut and Massachusetts.[56] However, Griswold only applied to marital relationships, allowing married couples to buy and use contraceptives without government restriction. It took until 1972, with Eisenstadt v. Baird, to extend the precedent of Griswold to unmarried persons as well.[57] Following the Griswold case, the American College of Obstetricians and Gynecologists (ACOG) issued a medical bulletin accepting a recommendation from six years earlier that clarified that "conception is the implantation of a fertilized ovum",[58] and consequently birth control methods that prevented implantation became classified as contraceptives, not abortifacients.

In 1967, Colorado became the first state to decriminalize abortion in cases of rape, incest, or in which pregnancy would lead to permanent physical disability of the woman. Similar laws were passed in California, Oregon, and North Carolina. In 1970, Hawaii became the first state to legalize abortions on the request of the woman,[59] and New York repealed its 1830 law and allowed abortions up to the 24th week of pregnancy. Similar laws were soon passed in Alaska and Washington. In 1970, Washington held a referendum on legalizing early pregnancy abortions, becoming the first state to legalize abortion through a vote of the people.[60] A law in Washington, D.C., which allowed abortion to protect the life or health of the woman, was challenged in the Supreme Court in 1971 in United States v. Vuitch. The court upheld the law, deeming that "health" meant "psychological and physical well-being", essentially allowing abortion in Washington, D.C. By the end of 1972, 13 states had a law similar to that of Colorado, while Mississippi allowed abortion in cases of rape or incest only and Alabama and Massachusetts allowed abortions only in cases where the woman's physical health was endangered. In order to obtain abortions during this period, women would often travel from a state where abortion was illegal to one where it was legal. The legal position prior to Roe v. Wade was that abortion was illegal in 30 states and legal under certain circumstances in 20 states.[61]

In the late 1960s, a number of organizations were formed to mobilize opinion both against and for the legalization of abortion. In 1966, the National Conference of Catholic Bishops assigned Monsignor James T. McHugh to document efforts to reform abortion laws, and anti-abortion groups began forming in various states in 1967. In 1968, McHugh led an advisory group which became the National Right to Life Committee.[62][63] The forerunner of the NARAL Pro-Choice America was formed in 1969 to oppose restrictions on abortion and expand access to abortion.[64] Following Roe v. Wade, in late 1973, NARAL became the National Abortion Rights Action League.

Roe v. Wade

Main article: Roe v. Wade

The United States Supreme Court membership in 1973
The United States Supreme Court membership in 1973

Prior to Roe v. Wade, 30 states prohibited abortion without exception, 16 states banned abortion except in certain special circumstances (e.g., rape, incest, health threat to mother), 3 states allowed residents to obtain abortions, and New York allowed abortions generally.[65] Early that year, on January 22, 1973, the Supreme Court in Roe v. Wade invalidated all of these laws, and set guidelines for the availability of abortion. Roe established that the right of privacy of a woman to obtain an abortion "must be considered against important state interests in regulation".[66] Roe established the end of the first "trimester" (i.e., 12 week) as the threshold for state interest, such that states were prohibited from banning abortion in the first trimester but allowed to impose increasing restrictions or outright bans later in pregnancy.[66]

In deciding Roe v. Wade, the Supreme Court ruled that a Texas statute forbidding abortion except when necessary to save the life of the mother was unconstitutional. The Court arrived at its decision by concluding that the issue of abortion and abortion rights falls under the right to privacy (in the sense of the right of a person not to be encroached by the state). In its opinion, it listed several landmark cases where the court had previously found a right to privacy implied by the Constitution. The Court did not recognize a right to abortion in all cases:

State regulation protective of fetal life after viability thus has both logical and biological justifications. If the State is interested in protecting fetal life after viability, it may go so far as to proscribe abortion during that period, except when it is necessary to preserve the life or health of the mother.[67]

The Court held that a right to privacy existed and included the right to have an abortion. The court found that a mother had a right to abortion until viability, a point to be determined by the abortion doctor. After viability a woman can obtain an abortion for health reasons, which the Court defined broadly to include psychological well-being.

A central issue in the Roe case (and in the wider abortion debate in general) is whether human life or personhood begins at conception, birth, or at some point in between. The Court declined to make an attempt at resolving this issue, noting: "We need not resolve the difficult question of when life begins. When those trained in the respective disciplines of medicine, philosophy, and theology are unable to arrive at any consensus, the judiciary, at this point in the development of man's knowledge, is not in a position to speculate as to the answer." Instead, it chose to point out that historically, under English and American common law and statutes, "the unborn have never been recognized ... as persons in the whole sense", and thus, the fetuses are not legally entitled to the protection afforded by the right to life specifically enumerated in the Fourteenth Amendment. So, rather than asserting that human life begins at any specific point, the court simply declared that the State has a "compelling interest" in protecting "potential life" at the point of viability.

Doe v. Bolton

Main article: Doe v. Bolton

Under Roe v. Wade, state governments may not prohibit late terminations of pregnancy when "necessary to preserve the life or health of the mother", even if it would cause the demise of a viable fetus.[68] This rule was clarified by the 1973 judicial decision Doe v. Bolton, which specifies "that the medical judgment may be exercised in the light of all factors—physical, emotional, psychological, familial, and the woman's age—relevant to the well-being of the patient".[69][70][71] It is by this provision for the mother's mental health that women in the U.S. legally choose abortion after viability when screenings reveal abnormalities that do not cause a baby to die shortly after birth.[72][73][74][75]

Later judicial decisions

In the 1992 case of Planned Parenthood v. Casey, the Court abandoned Roe's strict trimester framework but maintained its central holding that women have a right to choose to have an abortion before viability.[76] Roe had held that statutes regulating abortion must be subject to "strict scrutiny"—the traditional Supreme Court test for impositions upon fundamental Constitutional rights. Casey instead adopted the lower, undue burden standard for evaluating state abortion restrictions,[76] but re-emphasized the right to abortion as grounded in the general sense of liberty and privacy protected under the constitution: "Constitutional protection of the woman's decision to terminate her pregnancy derives from the Due Process Clause of the Fourteenth Amendment. It declares that no State shall "deprive any person of life, liberty, or property, without due process of law." The controlling word in the cases before us is 'liberty'."[77]

The Supreme Court continues to make decisions on this subject. On April 18, 2007, it issued a ruling in the case of Gonzales v. Carhart, involving a federal law entitled the Partial-Birth Abortion Ban Act of 2003 which President George W. Bush had signed into law. The law banned intact dilation and extraction, which opponents of abortion rights referred to as "partial-birth abortion", and stipulated that anyone breaking the law would get a prison sentence up to 2.5 years. The United States Supreme Court upheld the 2003 ban by a narrow majority of 5–4, marking the first time the Court has allowed a ban on any type of abortion since 1973. The opinion, which came from justice Anthony Kennedy, was joined by Justices Antonin Scalia, Clarence Thomas, and the two recent appointees, Samuel Alito and Chief Justice John Roberts.

In the case of Whole Woman's Health v. Hellerstedt, the Supreme Court in a 5–3 decision on June 27, 2016, swept away forms of state restrictions on the way abortion clinics can function. The Texas legislature enacted in 2013 restrictions on the delivery of abortions services that, it was argued by its opponents, created an undue burden for women seeking an abortion by requiring abortion doctors to have difficult-to-obtain "admitting privileges" at a local hospital and by requiring clinics to have costly hospital-grade facilities. The Court supported this argument and struck down these two provisions "facially" from the law at issue—that is, the very words of the provisions were invalid, no matter how they might be applied in any practical situation. According to the Supreme Court, the task of judging whether a law puts an unconstitutional burden on a woman's right to abortion belongs with the courts, and not the legislatures.[78]

The Supreme Court ruled similarly in June Medical Services, LLC v. Russo on June 29, 2020, in a 5–4 decision that a Louisiana state law, modeled after the Texas law at the center of Whole Woman's Health, was unconstitutional.[79] Like Texas' law, the Louisiana law required certain measures for abortion clinics that, if having gone into effect, would have closed five of the six clinics in the state. The case in Louisiana was put on hold pending the result of Whole Woman's Health, and was retried based on the Supreme Court's decision. While the District Court ruled the law unconstitutional, the Fifth Circuit found that unlike the Texas law, the burden of the Louisiana law passed the tests outlined in Whole Woman's Health, and thus the law was constitutional. The Supreme Court issued an order to suspend enforcement of the law pending further review, and agreed to hear the case in full in October 2019. It was the first abortion-related case to be heard by President Donald Trump's appointees to the Court, Neil Gorsuch and Brett Kavanaugh.[80] The Supreme Court found the Louisiana law unconstitutional for the same reasons as the Texas one, reversing the Fifth Circuit. The judgment was supported by Chief Justice John Roberts who had dissented on Whole Woman's Health but joined in judgment as to upholding the court's respect for the past judgment in that case.[79]

Dobbs v. Jackson Women's Health Organization

The composition of the Supreme Court at the time of Dobbs
The composition of the Supreme Court at the time of Dobbs

Main article: Dobbs v. Jackson Women's Health Organization

The Supreme Court granted certiorari to Dobbs v. Jackson Women's Health Organization in May 2021, a case that challenges the impact of Roe v. Wade in blocking enforcement of a 2018 Mississippi law that had banned any abortions after the first 15 weeks.[81] Oral arguments to Dobbs were held in December 2021, and a decision was expected by the end of the 2021–22 Supreme Court term. On September 1, 2021, the state of Texas passed one of the most restrictive abortion laws in the nation, banning most procedures after six weeks.[82] On May 2, 2022, a leaked draft majority opinion in this case was reported by Politico.[83] That opinion would overturn Roe should it become the official majority opinion of the court.

On June 24, 2022, the Supreme Court overruled both Roe v. Wade and Planned Parenthood v. Casey in the Dobbs case by a vote of 6–3 with the Chief Justice of the United States concurring in the decision.[84][85] This enabled trigger laws which had been passed in 13 states to effectively ban abortions in those states.[86][87][88]

Current legal status

Federal legislation

Since 1995, led by congressional Republicans, the U.S. House of Representatives and U.S. Senate have moved several times to pass measures banning the procedure of intact dilation and extraction, commonly known as partial birth abortion. Such measures passed twice by wide margins, but President Bill Clinton vetoed those bills in April 1996 and October 1997 on the grounds that they did not include health exceptions. Congressional supporters of the bill argue that a health exception would render the bill unenforceable, since the Doe v. Bolton decision defined "health" in vague terms, justifying any motive for obtaining an abortion. Congress was unsuccessful with subsequent attempts to override the vetoes.

The Born-Alive Infants Protection Act of 2002 ("BAIPA") was enacted August 5, 2002 by an Act of Congress and signed into law by George W. Bush. It asserts the human rights of infants born after a failed attempt to induce abortion. A "born-alive infant" is specified as a "person, human being, child, individual". "Born alive" is defined as the complete expulsion of an infant at any stage of development that has a heartbeat, pulsation of the umbilical cord, breath, or voluntary muscle movement, no matter if the umbilical cord has been cut or if the expulsion of the infant was natural, induced labor, cesarean section, or induced abortion.

On October 2, 2003, with a vote of 281–142, the House approved the Partial-Birth Abortion Ban Act to ban intact dilation and extraction, with an exemption in cases of fatal threats to the woman. Through this legislation, a doctor could face up to two years in prison and civil lawsuits for performing such a procedure. A woman undergoing the procedure could not be prosecuted under the measure. On October 21, 2003, the United States Senate passed the bill by a vote of 64–34, with a number of Democrats joining in support. The bill was signed by President George W. Bush on November 5, 2003, but a federal judge blocked its enforcement in several states just a few hours after it became public law. The Supreme Court upheld the nationwide ban on the procedure in the case Gonzales v. Carhart on April 18, 2007, signaling a substantial change in the Court's approach to abortion law.[89] The 5–4 ruling said the Partial Birth Abortion Ban Act does not conflict with previous decisions regarding abortion.

The judicial interpretation of the U.S. Constitution regarding abortion, following the Supreme Court of the United States's 1973 landmark decision in Roe v. Wade, and subsequent companion decisions, is that abortion is legal but may be restricted by the states to varying degrees. States have passed laws to restrict late-term abortions, require parental notification for minors, and mandate the disclosure of abortion risk information to patients prior to the procedure.[90]

The official report of the U.S. Senate Judiciary Committee, issued in 1983 after extensive hearings on the Human Life Amendment (proposed by Senators Orrin Hatch and Thomas Eagleton), stated:

Thus, the [Judiciary] Committee observes that no significant legal barriers of any kind whatsoever exist today in the United States for a mother to obtain an abortion for any reason during any stage of her pregnancy.[91]

One aspect of the legal abortion regime now in place has been determining when the fetus is "viable" outside the womb as a measure of when the "life" of the fetus is its own (and therefore subject to being protected by the state). In the majority opinion delivered by the court in Roe v. Wade, viability was defined as "potentially able to live outside the mother's womb, albeit with artificial aid. Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks". When the court ruled in 1973, the then-current medical technology suggested that viability could occur as early as 24 weeks. Advances over the past three decades allow survival of some babies born at 22 weeks.[92]

As of 2006, the youngest child to survive a premature birth in the United States was a girl born at Kapiolani Medical Center in Honolulu, Hawaii, at 21 weeks and 3 days gestation.[93] Because of the split between federal and state law, legal access to abortion continues to vary by state. Geographic availability varies dramatically, with 87 percent of U.S. counties having no abortion provider.[94] Moreover, due to the Hyde Amendment, many state health programs do not cover abortions; as of 2022, 17 states (including California, Illinois and New York) offer or require such coverage.[95]

The legality of abortion is frequently a major issue in nomination battles for the U.S. Supreme Court. Nominees typically remain silent on the issue during their hearings, as the issue may come before them as judges.[citation needed]

The Unborn Victims of Violence Act, commonly known as "Laci and Conner's Law" was passed by Congress and signed into law by President Bush on April 1, 2004, allowing two charges to be filed against someone who kills a pregnant mother (one for the mother and one for the fetus). It specifically bans charges against the mother and/or doctor relating to abortion procedures. Nevertheless, it has generated much controversy among pro-abortion rights advocates who view it as a potential step in the direction of banning abortion.

The Pain-Capable Unborn Child Protection Act is a United States Congress bill to ban late-term abortions nationwide after 20 weeks post-fertilization on the basis that the fetus is capable of feeling pain during an abortion at and after that point of pregnancy. The bill was first introduced in Congress in 2013. It successfully passed the House of Representatives in 2013, 2015, and 2017, but has yet to pass the Senate. Opponents of the bill reject the claims made by the bill's supporters regarding fetal development, and argue that such a restriction would endanger women's health.

After the Dobbs decision, U.S. Attorney General Merrick Garland asserted that under federal law, states do not have the right to restrict access to FDA-approved abortion pills, but Louisiana passed a law to ban mailing them.[96]

Penalties by state

Some states, starting on June 24, 2022, have criminal penalties for performing abortions.[97][98][99][100][101] The penalties in states that have made abortion illegal vary, as outlined below.

State Sentencing
 Alabama Performing an abortion is a Class A felony with up to 99 years in prison, and attempted abortion is a Class C felony punishable by 1 to 10 years in prison under a pending law.[102]
 Arkansas Class D felony. Maximum penalties are 6 years imprisonment and $10,000 in fines.[103]
 Kentucky Class C felony. 5 to 10 years imprisonment and $5,000 to $10,000 fine.[104] As of 30 June 2022, enforcement has been temporarily blocked. [105]
 Louisiana Up to 10 years imprisonment and fines of $10,000 to $100,000.[106][107] Maximum penalties are 15 years imprisonment and $200,000 in fines for performing a late-term abortion.[108][109] As of 27 June 2022, enforcement has been temporarily blocked.[110]
 Missouri Class B felony to induce an abortion. Imprisonment of 5 to 15 years.[111]
 Oklahoma 2 to 5 years imprisonment.[112]
 South Dakota Class 6 felony. Up to two years imprisonment and up to a $4,000 fine.[113]
 Texas A Trigger law takes effect July 24, 2022, which will make providing or attempting to provide an abortion "chargeable as a first- or second-degree felony," and a $100,000 civil penalty for each violation.[114][115] If charged as a first-degree felony, the penalties are 5 to 99 years imprisonment, and if charged as a second-degree felony, it is 2 to 20 years imprisonment and possibly up to a $10,000 fine.[116][117][118]
 Utah Up to 15 years imprisonment,[119][120] enforcement temporarily blocked.[121]
 Idaho A trigger law takes effect July 24, 2022, which will make attempted or completed abortion punishable by two to five year imprisonment, as well as suspension of medical license on first offense, and permanent loss of license on second offense.[122]
 Tennessee A trigger law takes effect July 24, 2022, which will make "providing or attempting to provide" an abortion a Class C felony.[123]
 Mississippi A trigger law will take effect on certification by attorney general. Up to 10 years imprisonment.[124]
 North Dakota A trigger law will take effect as soon as the "Legislative Council approves a recommendation from attorney general that the abortion ban is constitutional". Anyone who performs an abortion will be charged with a Class C felony.[125]
 Wyoming A trigger law will take effect as soon as it is certified by the Governor, who is advised by the Attorney General before July 24, 2022. Punishable by up to 14 years imprisonment.[126]

State-by-state legal status

States in which the right to an abortion is protected, either through state law, a state supreme court ruling, or both.[127]   Abortion access protected by state law   Abortion access protected by state Constitution   Abortion access protected via both state law and state Constitution   No state level protections
States in which the right to an abortion is protected, either through state law, a state supreme court ruling, or both.[127]
  Abortion access protected by state law
  Abortion access protected by state Constitution
  Abortion access protected via both state law and state Constitution
  No state level protections

Main articles: Abortion in the United States by state and Types of abortion restrictions in the United States

Prior to 2022 abortion was legal in all U.S. states, and every state had at least one abortion clinic.[128][129] Abortion is a controversial political issue, and regular attempts to restrict it occur in most states. Two such cases, originating in Texas and Louisiana, led to the Supreme Court cases of Whole Woman's Health v. Hellerstedt (2016) and June Medical Services, LLC v. Russo (2020) in which several Texas and Louisiana restrictions were struck down.[130][131]

The issue of minors and abortion is regulated at the state level, and 37 states require some parental involvement, either in the form of parental consent or in the form of parental notification. In certain situations, the parental restrictions can be overridden by a court.[132] Mandatory waiting periods, mandatory ultrasounds and scripted counseling are common abortion regulations. Abortion laws are generally stricter in conservative Southern states than they are in other parts of the country.

In 2019, New York passed the Reproductive Health Act (RHA), which repealed a pre-Roe provision that banned third-trimester abortions except in cases where the continuation of the pregnancy endangered a pregnant woman's life.[133][134]

Abortion in the Northern Mariana Islands, a United States Commonwealth territory, is illegal.[135][136][137]

Alabama House Republicans passed a law on April 30, 2019, that will criminalize most abortion if it goes into effect.[138] Dubbed the "Human Life Protection Act", it offers only two exceptions: serious health risk to the mother or a lethal fetal anomaly. Amendments that would have added cases of rape or incest to the list of exceptions were rejected[139] It will also make the procedure a Class A felony.[140] Twenty-five male Alabama senators voted to pass the law on May 13.[141] The next day, Alabama governor Kay Ivey signed the bill into law, primarily as a symbolic gesture in hopes of challenging Roe v. Wade in the Supreme Court.[142][143]

Since Alabama introduced the first modern anti-abortion legislation in April 2019, five other states have also adopted abortion laws including Mississippi, Kentucky, Ohio, Georgia and most recently Louisiana on May 30, 2019.[144]

In May 2019, the U.S. Supreme Court upheld an Indiana state law that requires fetuses which were aborted be buried or cremated.[145] In a December 2019 case, the court declined to review a lower court decision which upheld a Kentucky law requiring doctors to perform ultrasounds and show fetal images to patients before abortions.[146]

On June 29, 2020, previous Supreme Court rulings banning abortion restrictions appeared to be upheld when the U.S. Supreme Court struck down the Louisiana anti-abortion law.[147] Following the ruling, the legality of laws restricting abortion in states such as Ohio was then called into question.[148] It was also noted that Supreme Court Chief Justice John Roberts, who agreed that the Louisiana anti-abortion law was unconstitutional, had previously voted to uphold a similar law in Texas which was struck down by the U.S. Supreme Court in 2016.[149]

In May 2021, Texas lawmakers passed the Texas Heartbeat Act, banning abortions as soon as cardiac activity can be detected, typically as early as six weeks into pregnancy, and often before women know they are pregnant due to the length of the menstrual cycle (which usually lasts a median of four weeks and in some cases can be irregular).[150] In order to avoid traditional constitutional challenges based on Roe v. Wade, the law provides that any person, with or without any vested interest, may sue anyone that performs or induces an abortion in violation of the statute, as well as anyone who "aids or abets the performance or inducement of an abortion, including paying for or reimbursing the costs of an abortion through insurance or otherwise."[151] The law was challenged in courts, though had yet to have a full formal hearing as its September 1, 2021, enactment date came due. Plaintiffs sought an order from the U.S. Supreme Court to stop the law from coming into effect, but the Court issued a denial of the order late on September 1, 2021, allowing the law to remain in effect. While unsigned, Chief Justice John Roberts and Justice Stephen Breyer wrote dissenting opinions joined by Justices Elena Kagan and Sonia Sotomayor that they would have granted an injunction on the law until a proper judicial review.[152][153]

On September 9, 2021, Attorney General Merrick Garland, the head of the United States Department of Justice sued the State of Texas over the Texas Act on the basis that "the law is invalid under the Supremacy Clause and the Fourteenth Amendment, is preempted by federal law, and violates the doctrine of intergovernmental immunity".[154] Garland further noted that the United States government has "an obligation to ensure that no state can deprive individuals of their constitutional rights."[155] The Complaint avers that Texas enacted the law "in open defiance of the Constitution".[156] The relief requested from the U.S. District Court in Austin, Texas includes a declaration that the Texas Act is unconstitutional, and an injunction against state actors as well as any and all private individuals who may bring a SB 8 action.[156][155] The idea of asking a federal court to impose an injunction upon the entire civilian population of a state is unprecedented and has drawn eyebrows.[157][158]

In contrast, Colorado passed into law its Reproductive Health Equity Act in April 2022, which assures abortion rights for all citizens of the state. While the bill as passed maintained the status quo for abortion rights, it assures that "every individual has a fundamental right to make decisions about the individual's reproductive health care, including the fundamental right to use or refuse contraception; a pregnant individual has a fundamental right to continue a pregnancy and give birth or to have an abortion and to make decisions about how to exercise that right; and a fertilized egg, embryo, or fetus does not have independent or derivative rights under the laws of the state" regardless of changes that may happen at the federal level.[159]

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On May 25, 2022, Oklahoma imposed a ban on elective abortions after Oklahoma Governor Kevin Stitt signed House Bill 4327. The bill bans elective abortion beginning at conception.[160] The law also permits private citizens to file lawsuits against abortion providers who knowingly provide, perform, or induce elective abortions on a pregnant woman. Abortion in cases of rape, incest, or high-risk pregnancies continue to be permitted.[161] A lawsuit was immediately filed by the ACLU in opposition to the bill[162][163] Currently, Oklahoma is the only U.S. State to pass a bill imposing such restrictions, and, should the bill remain in effect, it will become the first U.S. state to ban elective abortion procedures since prior to the ruling and implementation of Roe v. Wade in 1973.[164][165][160]

After the Supreme Court overturned Roe v. Wade on June 24, 2022, Texas and Missouri immediately banned abortions with the exception only if the pregnancy was deemed to be particularly life-threatening.[166][167]

In response to the coronavirus pandemic

Main article: Impact of the COVID-19 pandemic on abortion in the United States

Amid the COVID-19 pandemic, anti-abortion government officials in several American states enacted or attempted to enact restrictions on abortion, characterizing it as a non-essential procedure that can be suspended during the medical emergency.[168] The orders have led to several legal challenges and criticism by human rights groups and several national medical organizations, including the American Medical Association.[169] Legal challenges on behalf of abortion providers, many of which were represented by the American Civil Liberties Union and Planned Parenthood, successfully stopped most of the orders on a temporary basis.[168]

One challenge was made against the FDA's rule on the distribution of mifepristone (RU-486), one of the two-part drug regimen to induce abortions. Since 2000, it is only available through health providers under the FDA's ruling. Due to the COVID-19 pandemic, access to mifepristone was a concern, and the American College of Obstetricians and Gynecologists along with other groups sued to have the rule relaxed to allow women to be able to access mifepristone at home through mail-order or retail pharmacies. While the Fourth Circuit issued a preliminary injunction against the FDA's ruling that would have allowed wider distribution, the Supreme Court ordered in a 6–3 decision in January 2021 to put a stay on the injunction, maintaining the FDA's rule.[170]

Sanctuary city for the unborn

Since 2019, the anti-abortion movement in the United States has been pushing for anti-abortion rules such as declarations of "sanctuary city for the unborn".[171] In June 2019, the city council of Waskom, Texas, voted to outlaw abortion in the city, declaring Waskom a "sanctuary city for the unborn" (the first such city to designate itself as such), as state governments elsewhere in the United States also were drafting abortion bans.[172][173] As of June–July 2019, there is no abortion clinic in the city.[174][175] The Waskom ordinance has led other small cities in Texas, and as of April 2021 in Nebraska, to vote in favor of becoming "sanctuary cities for the unborn".[176][177][178]

On April 6, 2021, Hayes Center, Nebraska, became the first city in Nebraska to outlaw abortion by local ordinance, declaring itself a "sanctuary city for the unborn."[179] The city of Blue Hill, Nebraska, followed suit and enacted a similar ordinance outlawing abortion on April 13, 2021.[180][181] In May 2021, Lubbock, Texas, with a population of less than 270,000, voted to become the largest city in the U.S. to ban abortion with the "sanctuary city for the unborn ordinance".[182][183][184]

Abortion financing

State Medicaid coverage of medically necessary abortion services (text-based list):   Medicaid covers medically necessary abortion for low-income women through legislation.   Medicaid covers medically necessary abortions for low-income women under court order.   Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment.
State Medicaid coverage of medically necessary abortion services (text-based list):
  Medicaid covers medically necessary abortion for low-income women through legislation.
  Medicaid covers medically necessary abortions for low-income women under court order.
  Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment.

The abortion debate has also been extended to the question of who pays the medical costs of the procedure, with some states using the mechanism as a way of reducing the number of abortions.[citation needed] The cost of an abortion varies depending on factors such as location, facility, timing, and type of procedure. In 2005, a non-hospital abortion at 10 weeks' gestation ranged from $90 to $1,800 (average: $430), whereas an abortion at 20 weeks' gestation ranged from $350 to $4,520 (average: $1,260).[citation needed] Costs are higher for a medical abortion than a first-trimester surgical abortion.[citation needed] A variety of resources from support organizations are available to contribute to the costs of the procedure, as well as travel expenses.[185]

Abortion fund organizations

A variety of organizations offer financial support for people seeking abortions, including travel and other expenses.[185] Access Reproductive Care–Southeast (ARC Southeast), the Brigid Alliance, the Midwest Access Coalition (MAC), and the National Network of Abortion Funds are examples of such groups.[185]

Medicaid

The Hyde Amendment is a federal legislative provision barring the use of federal Medicaid funds to pay for abortions except for rape and incest.[186] The provision, in various forms, was in response to Roe v. Wade, and has been routinely attached to annual appropriations bills since 1976, and represented the first major legislative success by the pro-life movement. The law requires that states cover abortions under Medicaid in the event of rape, incest, and life endangerment. Based on the federal law:

Private insurance

Mexico City policy

Main article: Mexico City policy

Under this policy, U.S. federal funding to NGOs that provide abortion is not permitted. The policy was first announced by President Ronald Reagan in 1984. It has been rescinded by Democratic presidents and reinstated by Republican presidents. The policy was rescinded in 2021 by President Joe Biden.[189]

Qualifying requirements for abortion providers

This section possibly contains original research. due to uncited, undated maps. Please improve it by verifying the claims made and adding inline citations. Statements consisting only of original research should be removed. (May 2022) (Learn how and when to remove this template message)
Map showing which states require parental involvement (minors).   Parental notification or consent not required   One parent must be informed beforehand   Both parents must be informed beforehand   One parent must consent beforehand   Both parents must consent beforehand   One parent must consent and be informed beforehand   Parental notification law currently enjoined   Parental consent law currently enjoined
Map showing which states require parental involvement (minors).
  Parental notification or consent not required
  One parent must be informed beforehand
  Both parents must be informed beforehand
  One parent must consent beforehand
  Both parents must consent beforehand
  One parent must consent and be informed beforehand
  Parental notification law currently enjoined
  Parental consent law currently enjoined
Mandatory waiting period laws in the U.S.   No mandatory waiting period   Waiting period of less than 24 hours   Waiting period of 24 hours or more   Waiting period law currently enjoined
Mandatory waiting period laws in the U.S.
  No mandatory waiting period
  Waiting period of less than 24 hours
  Waiting period of 24 hours or more
  Waiting period law currently enjoined
Abortion counseling laws in the U.S.   No mandatory counselling   Counselling in person, by phone, mail, and/or other   Counselling in person only   Counselling law enjoined[needs update]
Abortion counseling laws in the U.S.
  No mandatory counselling
  Counselling in person, by phone, mail, and/or other
  Counselling in person only
  Counselling law enjoined
[needs update]
Mandatory ultrasound laws in the U.S.   Mandatory. Must display image.   Mandatory. Must offer to display image.   Mandatory. Law unenforceable.   Not mandatory. If ultrasound is performed, must offer to display image.   Not mandatory. Must offer ultrasound.   Not mandatory.
Mandatory ultrasound laws in the U.S.
  Mandatory. Must display image.
  Mandatory. Must offer to display image.
  Mandatory. Law unenforceable.
  Not mandatory. If ultrasound is performed, must offer to display image.
  Not mandatory. Must offer ultrasound.
  Not mandatory.

Qualifying requirements for performing abortions vary from state to state.[190] Vermont has allowed physicians' assistants to do some first-trimester abortions since the mid-1970s.[191] More recently, several states have changed their abortion laws, anticipating that the Supreme Court would overturn Roe v. Wade; now that it has done so, more states are enacting more changes. Currently (July 3, 2022), California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Montana, New Jersey, New York, Rhode Island, Virginia and Washington allow trained non-physician health professionals such as nurse practitioners, nurse midwives, and physicians' assistants, to do some first-trimester abortions.[192] In other states, non-physicians are not permitted to do abortions.

Statistics

Main article: Abortion statistics in the United States

Because reporting of abortions is not mandatory, statistics are of varying reliability. Both the Centers For Disease Control (CDC)[193] and the Guttmacher Institute[194][195] regularly compile these statistics.

Chart source: CDC, 2005
[196]
Graph of U.S. abortion rates, 1973–2017, showing data collected by the Guttmacher Institute
[194][195]

Number of abortions

The annual number of legal induced abortions in the U.S. doubled between 1973 and 1979, and peaked in 1990. There was a slow but steady decline throughout the 1990s. Overall, the number of annual abortions decreased by 6% between 2000 and 2009, with temporary spikes in 2002 and 2006.[197]

By 2011, abortion rate in the nation dropped to its lowest point since the Supreme Court legalized the procedure. According to a study performed by Guttmacher Institute, long-acting contraceptive methods had a significant impact in reducing unwanted pregnancies. There were fewer than 17 abortions for every 1,000 women of child-bearing age. That was a 13%-decrease from 2008's numbers and slightly higher than the rate in 1973, when the Supreme Court's Roe v. Wade decision legalized abortion.[198] The study indicated a long-term decline in the abortion rate.[199][200][201]

In 2016, the Centers for Disease Control and Prevention (CDC) reported 623,471 abortions, a 2% decrease from 636,902 in 2015.[202]

Medical abortions

A Guttmacher Institute survey of abortion providers estimated that early medical abortions accounted for 17% of all non-hospital abortions and slightly over one-quarter of abortions before 9 weeks gestation in the United States in 2008.[203] Medical abortions voluntarily reported to the CDC by 34 reporting areas (excluding Alabama, California, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Nebraska, Nevada, New Hampshire, Pennsylvania, Tennessee, Vermont, Wisconsin, and Wyoming) and published in its annual abortion surveillance reports have increased every year since the September 28, 2000 FDA approval of mifepristone (RU-486): 1.0% in 2000, 2.9% in 2001, 5.2% in 2002, 7.9% in 2003, 9.3% in 2004, 9.9% in 2005, 10.6% in 2006, 13.1% in 2007, 15.8% in 2008, 17.1% in 2009 (25.2% of those at less than 9 weeks gestation).[204] Medical abortions accounted for 32% of first-trimester abortions at Planned Parenthood clinics in 2008.[205] By 2020, medication abortions accounted for more than 50% of all abortions.[11]

Abortion and religion

A majority of abortions are obtained by religiously identified women. According to the Guttmacher Institute, "more than 7 in 10 U.S. women obtaining an abortion report a religious affiliation (37% protestant, 28% Catholic, and 7% other), and 25% attend religious services at least once a month. The abortion rate for protestant women is 15 per 1,000 women, while Catholic women have a slightly higher rate, 20 per 1,000."[206]

Abortions and ethnicity

Abortion rates tend to be higher among minority women in the U.S. In 2000–2001, the rates among black and Hispanic women were 49 per 1,000 and 33 per 1,000, respectively, vs. 13 per 1,000 among non-Hispanic white women. Note that this figure includes all women of reproductive age, including women that are not pregnant. In other words, these abortion rates reflect the rate at which U.S. women of reproductive age have an abortion each year.[207]

In 2004, the rates of abortion by ethnicity in the U.S. were 50 abortions per 1,000 black women, 28 abortions per 1,000 Hispanic women, and 11 abortions per 1,000 white women.[208][209]

In-state vs. out-of-state - at time of Roe v. Wade

Roe v. Wade legalized abortion nationwide in 1973. In 1972, 41% of abortions were performed on women outside their state of residence, while in 1973 it declined to 21%, and then to 11% in 1974.[210]

Reasons for abortions

This section needs to be updated. Please help update this article to reflect recent events or newly available information. (May 2022)

A 1998 study revealed that in 1987 to 1988, women reported the following as their primary reasons for choosing an abortion:[211][212]

Percentage

of women

Primary reason for choosing an abortion
25.5% Want to postpone childbearing
21.3% Cannot afford a baby
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy
10.8% Having a child will disrupt education or employment
7.9% Want no (more) children
3.3% Risk to fetal health
2.8% Risk to maternal health
2.1% Other

The source of this information takes findings into account from 27 nations including the United States, and therefore, these findings may not be typical for any one nation.

According to a 1987 study that included specific data about late abortions (i. e., abortions "at 16 or more weeks' gestation"),[213] women reported that various reasons contributed to their having a late abortion:

Percentage

of women

Reasons contributing to a late abortion
71% Woman did not recognize she was pregnant or misjudged gestation
48% Woman had found it hard to make arrangements for an earlier abortion
33% Woman was afraid to tell her partner or parents
24% Woman took time to decide to have an abortion
8% Woman waited for her relationship to change
8% Someone had earlier pressured woman not to have abortion
6% Something changed some time after woman became pregnant
6% Woman did not know timing is important
5% Woman did not know she could get an abortion
2% A fetal problem was diagnosed late in pregnancy
11% Other

In 2000, cases of rape or incest accounted for 1% of abortions.[214]

A 2004 study by the Guttmacher Institute reported that women listed the following amongst their reasons for choosing to have an abortion:[212]

Percentage

of women

Reason for choosing to have an abortion
74% Having a baby would dramatically change my life
73% Cannot afford a baby now
48% Do not want to be a single mother or having relationship problems
38% Have completed my childbearing
32% Not ready for another child
25% Do not want people to know I had sex or got pregnant
22% Do not feel mature enough to raise a(nother) child
14% Husband or partner wants me to have an abortion
13% Possible problems affecting the health of the fetus
12% Concerns about my health
6% Parents want me to have an abortion
1% Was a victim of rape
less than .5% Became pregnant as a result of incest

A 2008 National Survey of Family Growth (NSFG) shows that rates of unintended pregnancy are highest among Blacks, Hispanics, and women with lower socio-economic status.[215]

When women have abortions (by gestational age)

Abortion in the U.S. by gestational age, 2016[216]
Abortion in the U.S. by gestational age, 2016[216]

According to the Centers for Disease Control, in 2011, most (64.5%) abortions were performed by ≤8 weeks' gestation, and nearly all (91.4%) were performed by ≤13 weeks' gestation. Few abortions (7.3%) were performed between 14 and 20 weeks' gestation or at ≥21 weeks' gestation (1.4%). From 2002 to 2011, the percentage of all abortions performed at ≤8 weeks' gestation increased 6%.[216]

Safety of abortions

See also: Abortion § Safety

The risk of death from carrying a child to term in the U.S. is approximately 14 times greater than the risk of death from a legal abortion.[217] The risk of abortion-related mortality increases with gestational age, but remains lower than that of childbirth through at least 21 weeks' gestation.[218][219][220]

Birth control effects

Main article: Birth control

Increased access to birth control has been statistically linked to reductions in the abortion rate.[12][13][14] As an element of family planning, birth control was federally subsidized for low income families in 1965 under President Lyndon B. Johnson's War on Poverty program. In 1970, Congress passed Title X to provide family planning services for those in need, and President Richard Nixon signed it into law. Funding for Title X rose from $6 million in 1971 to $61 million the next year, and slowly increased each year to $317 million in 2010, after which it was reduced by a few percent.[221]

In 2011, the Guttmacher Institute reported that the number of abortions in the U.S. would be nearly two-thirds higher without access to birth control.[222] In 2015, the Federation of American Scientists reported that federally mandated access to birth control had helped reduce teenage pregnancies in the U.S. by 44 percent, and had prevented more than 188,000 unintended pregnancies.[223]

Public opinion

This section needs to be updated. Please help update this article to reflect recent events or newly available information. (May 2022)

Further information: Societal attitudes towards abortion

See also: United States abortion-rights movement and United States anti-abortion movement

Trend percent of Americans self-identifying as either "pro-life" or "pro-choice"
Trend percent of Americans self-identifying as either "pro-life" or "pro-choice"

Americans have been equally divided on the issue; a May 2018 Gallup poll indicated that 48% of Americans described themselves as "pro-choice" and 48% described themselves as "pro-life".[9] A July 2018 poll indicated that 64% of Americans did not want the Supreme Court to overturn Roe v. Wade, while 28% did.[224] The same poll found that support for abortion being generally legal was 60% during the first trimester, dropping to 28% in the second trimester, and 13% in the third trimester.[225]

Support for the legalization of abortion has been consistently higher among more educated adults than less educated,[226] and in 2019, 70% of college graduates support abortion being legal in all or most cases, compared to 60% of those with some college, and 54% of those with a high school degree or less.[227]

In January 2013, a majority of Americans believed abortion should be legal in all or most cases, according to a poll by NBC News and The Wall Street Journal.[228] Approximately 70% of respondents in the same poll opposed Roe v. Wade being overturned.[228] A poll by the Pew Research Center yielded similar results.[229] Moreover, 48% of Republicans opposed overturning Roe, compared to 46% who supported overturning it.[229]

Gallup declared in May 2010 that more Americans identifying as "pro-life" is "the new normal", while also noting that there had been no increase in opposition to abortion. It suggested that political polarization may have prompted more Republicans to call themselves "pro-life".[8] The terms "pro-choice" and "pro-life" do not always reflect a political view or fall along a binary; in one Public Religion Research Institute poll, seven in ten Americans described themselves as "pro-choice" while almost two-thirds described themselves as "pro-life". The same poll found that 56% of Americans were in favor of legal access to abortion in all or some cases.[230]

A 2022 study reviewing the literature and public opinion datasets found that 43.8% of survey respondents in the U.S. consistently support both elective and traumatic abortion, whereas only 14.8% consistently oppose abortion irrespective of the reason, and others differ in their degree of support for abortion depending on the circumstances of the abortion.[7] 90% approve of abortion when the health of the woman is endangered, 77.4% when there is a strong chance of defects in the baby that could result from the pregnancy, and 79.5% when the pregnancy is the result of rape.[7]

Date of poll "Pro-life" "Pro-choice" Mixed / neither Don't know what terms mean No opinion
2016, May 4–8 46% 47% 3% 3% 2%
2015, May 6–10 44% 50% 3% 2% 1%
2014, May 8–11 46% 47% 3% 3%
2013, May 2–7 48% 45% 3% 3% 2%
2012, May 3–6 50% 41% 4% 3% 3%
2011, May 5–8 45% 49% 3% 2% 2%
2010, March 26–28 46% 45% 4% 2% 3%
2009, November 20–22 45% 48% 2% 2% 3%
2009, May 7–10 51% 42% 0 7%
2008, September 5–7 43% 51% 2% 1% 3%

By gender and age

Pew Research Center polling shows little change in views from 2008 to 2012; modest differences based on gender or age.[231]

The original article's table also shows by party affiliation, religion, and education level.

2011–2012 2009–2010 2007–2008
Legal Illegal Don't Know Legal Illegal Don't Know Legal Illegal Don't Know
Total 53% 41% 6% 48% 44% 8% 54% 40% 6%
Men 51% 43% 6% 46% 46% 9% 52% 42% 6%
Women 55% 40% 5% 50% 43% 7% 55% 39% 5%
18–29 53% 44% 3% 50% 45% 5% 52% 45% 3%
30–49 54% 42% 4% 49% 43% 7% 58% 38% 5%
50–64 55% 38% 7% 49% 42% 9% 56% 38% 6%
65+ 48% 43% 9% 39% 49% 12% 45% 44% 11%

By educational level

Support for the legalization of abortion is significantly higher among more educated adults than less educated, and has been consistently so for decades.[226] In 2019, 70% of college graduates support abortion being legal in all or most cases, as well as 60% of those with some college education, compared to 54% of those with a high school degree or less.[227]

2019
Educational attainment Legal in all or most cases Illegal in all or most cases
College grad or more 70% 30%
Some college 60% 39%
High school or less 54% 44%

By gender, party, and region

A January 2003 CBS News/The New York Times poll examined whether Americans thought abortion should be legal or not, and found variations in opinion which depended upon party affiliation and the region of the country.[232] The margin of error is +/– 4% for questions answered of the entire sample (overall figures) and may be higher for questions asked of subgroups (all other figures).[232]

Group Generally available Available, but with stricter limits than now Not permitted
Overall 39% 38% 22%
Women 37% 37% 24%
Men 40% 40% 20%
Democrats 43% 35% 21%
Republicans 29% 41% 28%
Independents 42% 38% 18%
Northeasterners 48% 31% 19%
Midwesterners 34% 40% 25%
Southerners 33% 41% 25%
Westerners 43% 40% 16%

By trimester of pregnancy

A CNN/USA Today/Gallup poll in January 2003 asked about the legality of abortion by trimester, using the question, "Do you think abortion should generally be legal or generally illegal during each of the following stages of pregnancy?"[233] This same question was also asked by Gallup in March 2000 and July 1996.[234][235] Polls indicates general support of legal abortion during the first trimester, although support drops dramatically for abortion during the second and third trimester.

Since the 2011 poll, support for legal abortion during the first trimester has declined.

2018 Poll 2012 Poll 2011 Poll 2003 Poll 2000 Poll 1996 Poll
Legal Illegal Legal Illegal Legal Illegal Legal Illegal Legal Illegal Legal Illegal
First trimester 60% 34% 61% 31% 62% 29% 66% 35% 66% 31% 64% 30%
Second trimester 28% 65% 27% 64% 24% 71% 25% 68% 24% 69% 26% 65%
Third trimester 13% 81% 14% 80% 10% 86% 10% 84% 8% 86% 13% 82%

By circumstance or reasons

According to Gallup's long-time polling on abortion, the majority of Americans are neither strictly "pro-life" or "pro-choice"; it depends upon the circumstances of the pregnancy. Gallup polling from 1996 to 2021 consistently reveals that when asked the question, "Do you think abortions should be legal under any circumstances, legal only under certain circumstances, or illegal in all circumstances?", Americans repeatedly answer "legal only under certain circumstances". According to the poll, in any given year 48–57% say legal only under certain circumstances, 21–34% say legal under any circumstances, and 13–19% illegal in all circumstances, with 1–7% having no opinion.[234]

Legal under any circumstances Legal only under certain circumstances Illegal in all circumstances No opinion
2021 May 3–18 32% 48% 19% 2%
2020 May 1–13 29% 50% 20% 2%
2019 May 1–12 25% 53% 21% 2%
2018 May 1–10 29% 50% 18% 2%
2017 May 3–7 29% 50% 18% 3%
2016 May 4–8 29% 50% 19% 2%
2015 May 6–10 29% 51% 19% 1%
2014 May 8–11 28% 50% 21% 2%
2013 May 2–7 26% 52% 20% 2%
2012 Dec 27–30 28% 52% 18% 3%
2012 May 3–6 25% 52% 20% 3%
2011 Jul 15–17 26% 51% 20% 3%
2011 June 9–12 26% 52% 21% 2%
2011 May 5–8 27% 49% 22% 3%
2009 Jul 17–19 21% 57% 18% 4%
2009 May 7–10 22% 53% 23% 2%
2008 May 8–11 28% 54% 18% 2%
2007 May 10–13 26% 55% 17% 1%
2006 May 8–11 30% 53% 15% 2%

According to the aforementioned poll,[234] Americans differ drastically based upon situation of the pregnancy, suggesting they do not support unconditional abortions. Based on two separate polls taken May 19–21, 2003, of 505 and 509 respondents respectively, Americans stated their approval for abortion under these various circumstances:

Poll Criteria Total Poll A Poll B
When the woman's life is endangered 78% 82% 75%
When the pregnancy was caused by rape or incest 65% 72% 59%
When the child would be born with a life-threatening illness 54% 60% 48%
When the child would be born mentally disabled 44% 50% 38%
When the woman does not want the child for any reason 32% 41% 24%

Another separate trio of polls taken by Gallup in 2003, 2000, and 1996,[234] revealed public support for abortion as follows for the given criteria:

Poll criteria 2003 Poll 2000 Poll 1996 Poll
When the woman's life is endangered 85% 84% 88%
When the woman's physical health is endangered 77% 81% 82%
When the pregnancy was caused by rape or incest 76% 78% 77%
When the woman's mental health is endangered 63% 64% 66%
When there is evidence that the baby may be physically impaired 56% 53% 53%
When there is evidence that the baby may be mentally impaired 55% 53% 54%
When the woman or family cannot afford to raise the child 35% 34% 32%

Gallup furthermore established public support for many issues supported by the anti-abortion community and opposed by the abortion rights community:[234]

Legislation 2011 Poll 2003 Poll 2000 Poll 1996 Poll
A law requiring doctors to inform patients about alternatives to abortion before performing the procedure 88% 86% 86%
A law requiring women seeking abortions to wait 24 hours before having the procedure done 69% 78% 74% 73%
Legislation 2005 Poll 2003 Poll 1996 Poll 1992 Poll
A law requiring women under 18 to get parental consent for any abortion 69% 73% 74% 70%
A law requiring that the husband of a married woman be notified if she decides to have an abortion 64% 72% 70% 73%

An October 2007 CBS News poll explored under what circumstances Americans believe abortion should be allowed, asking the question, "What is your personal feeling about abortion?" The results were as follows:[233]

Permitted in all cases Permitted, but subject to greater restrictions than it is now Only in cases such as rape, incest, or to save the woman's life Only permitted to save the woman's life Never Unsure
26% 16% 34% 16% 4% 4%

Additional polls

Results of Gallup opinion poll in the U.S. since 1975, legal restriction of abortion[236]
Results of Gallup opinion poll in the U.S. since 1975, legal restriction of abortion[236]

Intact dilation and extraction

Further information: Intact dilation and extraction

See also: Partial-Birth Abortion Ban Act

In 2003, the U.S. Congress outlawed intact dilation and extraction when it passed the Partial-Birth Abortion Ban Act. A Rasmussen Reports poll four days after the Supreme Court's opinion in Gonzales v. Carhart found that 40% of respondents "knew the ruling allowed states to place some restrictions on specific abortion procedures." Of those who knew of the decision, 56% agreed with the decision and 32% were opposed.[244] An ABC poll from 2003 found that 62% of respondents thought "partial-birth abortion" should be illegal; a similar number of respondents wanted an exception "if it would prevent a serious threat to the woman's health".

Gallup has repeatedly queried the American public on this issue.[234]

Legislation 2011 2003 2000 2000 2000 1999 1998 1997 1996
A law that would make it illegal to perform a specific abortion procedure conducted in the last six months, or second and/or third trimester of pregnancy, known by some opponents as a partial birth abortion, except in cases necessary to save the life of the mother 64% 70% 63% 66% 64% 61% 61% 55% 57%

Positions of U.S. political parties

Though members of both major political parties come down on either side of the issue, the Republican Party is often seen as being anti-abortion, since the official party platform opposes abortion and considers fetuses to have an inherent right to life. Republicans for Choice represents the minority of that party. In 2006, pollsters found that 9% of Republicans favor the availability of abortion in most circumstances.[245] Of Republican National Convention delegates in 2004, 13% believed that abortion should be generally available, and 38% believed that it should not be permitted. The same poll showed that 17% of all Republican voters believed that abortion should be generally available to those who want it, while 38% believed that it should not be permitted.[246]

The Republican party was supportive of abortion rights prior to their 1976 convention, at which they supported an anti-abortion constitutional amendment as a temporary political ploy to gain more support from Catholics, though this stance brought many more social conservatives into the party resulting in a large and permanent shift toward support of the anti-abortion position.[247] The Democratic Party platform considers abortion to be a woman's right. Democrats for Life of America represents the minority of that party. In 2006, pollsters found that 74% of Democrats favor the availability of abortion in most circumstances.[245] Of Democratic National Convention delegates in 2004, 75% believed that abortion should be generally available, and 2% believed that abortion should not be permitted. The same poll showed that 49% of all Democratic voters believed that abortion should be generally available to those who want it, while 13% believed that it should not be permitted.[248]

The Green Party of the United States supports legal abortion as a woman's right. The Libertarian Party platform (2012) states that "government should be kept out of the matter, leaving the question to each person for their conscientious consideration".[249] Abortion is a contentious issue among Libertarians, and the Maryland-based organization Libertarians for Life opposes the legality of abortion in most circumstances.

The issue of abortion has become deeply politicized. In 2002, 84% of state Democratic platforms supported the right to having an abortion while 88% of state Republican platforms opposed it. This divergence also led to Christian right organizations like Christian Voice, Christian Coalition and Moral Majority having an increasingly strong role in the Republican Party. This opposition has been extended under the Foreign Assistance Act: in 1973 Jesse Helms introduced an amendment banning the use of aid money to promote abortion overseas, and in 1984 the Mexico City policy prohibited financial support to any overseas organization that performed or promoted abortions. The policy was revoked by President Bill Clinton and subsequently reinstated by President George W. Bush.[250] President Barack Obama overruled this policy by Executive Order on January 23, 2009,[251] and it was reinstated on January 23, 2017, by President Donald Trump.[250] On January 28, 2021, President Joe Biden signed a Presidential Memorandum that repealed the restoration of Mexico City policy and also called for the United States Department of Health and Human Services to "suspend, rescind or revoke" restrictions made to Title X.[252]

Effects of legalization

The 2013 winter issue of Ms. was about abortion rights.
The 2013 winter issue of Ms. was about abortion rights.

The risk of death due to legal abortion has fallen considerably since Roe v. Wade (1973) legalized it; this was due to increased physician skills, improved medical technology, and earlier termination of pregnancy.[253] From 1940 through 1970, deaths of pregnant women during abortion fell from nearly 1,500 to a little over 100.[253] According to the Centers for Disease Control and Prevention, the number of women who died in 1972 from illegal abortion was thirty-nine.[254] The Roe effect is a hypothesis suggesting that since supporters of abortion rights cause the erosion of their own political base by having fewer children, the practice of abortion will eventually lead to the restriction or illegalization of abortion.[255] The legalized abortion and crime effect is another controversial theory that posits legal abortion reduces crime because unwanted children are more likely to become criminals.[256][257][258]

Since Roe, there have been numerous attempts to reverse the decision.[259][260] In the 2011 election season, Mississippi placed an amendment on the ballot that redefined how the state viewed abortion. The personhood amendment defined personhood as "every human being from the moment of fertilization, cloning or the functional equivalent thereof"; if passed, it would have been illegal to get an abortion in the state.[261] On July 11, 2012, a Mississippi federal judge ordered an extension of his temporary order to allow the state's only abortion clinic to stay open. The order was to stay in place until U.S. District Judge Daniel Porter Jordan III could review newly drafted rules on how the Mississippi Department of Health would administer a new abortion law. The law in question came into effect on July 1, 2012.[262]

Between 2008 and 2016, the Turnaway Study followed a group of 1,000 women, two of whom died after giving birth,[263] for five years after they sought an abortion,[264] and compared their health and socio-economic consequences of receiving an abortion or being denied one.[264][265] The study found that those who were provided with abortion performed better, and those who were denied one suffered negative consequences.[266][267] Scientific American described it as landmark.[263]

According to a 2019 study, were Roe reversed and abortion bans implemented in trigger law states, including states considered highly likely to ban abortion, "increases in travel distance are estimated to prevent 93,546 to 143,561 women from accessing abortion care."[268] For the Dobbs v. Jackson Women's Health Organization case,[269] which confirmed the May 2022 leaks obtained by Politico and overruled Roe and Planned Parenthood v. Casey in June 2022,[270][271][272] among the over 130 amici curiae briefs, hundreds of scientists provided evidence, data, and studies, in particular the Turnaway Study, in favor of abortion rights and to rebuke arguments made to the Court that abortion "has no beneficial effect on women's lives and careers—and might even cause them harm".[273] A follow-up Turnaway Study was confirmed to determinate the health and economic impact of Roe being overturned.[266][274]

Unintended live birth

Although it is uncommon,[275][276][277] women sometimes give birth in spite of an attempted abortion.[278][279][280] Reporting of live birth after attempted abortion may not be consistent from state to state, but 38 were recorded in one study in upstate New York in the two-and-a-half years before Roe v. Wade.[281] Under the Born-Alive Infants Protection Act of 2002,[282][283] medical staff must report live birth if they observe any breathing, heartbeat, umbilical cord pulsation, or confirmed voluntary muscle movement, regardless of whether the born-alive is non-viable ex utero in the long term because of birth defects, and regardless of gestational age, including gestational ages which are too early for long-term viability ex utero.[284][285][286]

See also

Notable cases

Footnotes

  1. ^ According to the Supreme Court's decision in Roe v. Wade (1973):

    "(a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgment of the pregnant woman's attending physician.

    (b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health.

    (c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother."[20]

    The 5th edition of the Black's Law Dictionary (1979) defined abortion as "knowing destruction" or "intentional expulsion or removal".[21] Into the 21st century, its free, online version defines it as "artificial or spontaneous termination of a pregnancy before the embryo or foetus can survive on its own outside a woman's uterus."[22]

References

  1. ^ All states make exceptions if the mother's life is in danger.
    Exceptions for risk to mother's physical health: Alabama, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming.
    Exceptions for risk to mother's general health: Arizona, California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Virginia, Washington.
    Exception for pregnancy due to rape: South Carolina, Utah.
    Exception for pregnancy due to incest: South Carolina, Utah.
    Exception for fetal anomaly: Maryland, Utah.
    Exception for lethal fetal anomaly: Delaware, Georgia, Louisiana, Massachusetts, Mississippi, South Carolina.
  2. ^ In 5th or 6th week gestational age
  3. ^ In 23rd or 24th week
  4. ^ Variously defined as after 27 or 28 weeks GA; Massachusetts: after 24 weeks from implantation, ≈ 27 weeks GA
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Further reading