essay on america abortion laws

A Brief History of Abortion in the U.S.

Abortion wasn’t always a moral, political, and legal tinderbox. What changed?

A bortion laws have never been more contentious in the U.S. Yet for the first century of the country’s existence—and most of human history before that—abortion was a relatively uncontroversial fact of life.

“Abortion has existed for pretty much as long as human beings have existed,” says Joanne Rosen, JD, MA , a senior lecturer in Health Policy and Management who studies the impact of law and policy on access to abortion.

Until the mid-19th century, the U.S. attitude toward abortion was much the same as it had often been elsewhere throughout history: It was a quiet reality, legal until “quickening” (when fetal motion could be felt by the mother). In the eyes of the law, the fetus wasn’t a “separate distinct entity until then,” but rather an extension of the mother, Rosen explains.

What changed?

America’s first anti-abortion movement wasn’t driven primarily by moral or religious concerns like it is today. Instead, abortion’s first major foe in the U.S. was physicians on a mission to regulate medicine.

Until this point, abortion services had been “women’s work.” Most providers were midwives, many of whom made a good living selling abortifacient plants. They relied on methods passed down through generations, from herbal abortifacients and pessaries—a tampon-like device soaked in a solution to induce abortion—to catheter abortions that irritate the womb and force a miscarriage, to a minor surgical procedure called dilation and curettage (D&C), which remains one of the most common methods of terminating an early pregnancy.

The cottage abortion industry caught the attention of the fledgling American Medical Association, which was established in 1847 and, at the time, excluded women and Black people from membership. The AMA was keen to be taken seriously as a gatekeeper of the medical profession, and abortion services made midwives and other irregular practitioners—so-called quacks—an easy target. Their rhetoric was strategic, says Mary Fissell, PhD , the J. Mario Molina professor in the Department of the History of Medicine at Johns Hopkins University. “You have to link those midwives to providing abortion as a way of kind of getting them out of business,” Fissell says. “So organized medicine very much takes the anti-abortion position and stays with that for some time.”

Early 19th century and before

Abortion is legal in the U.S. until “quickening”

AMA campaigns to end abortion

At least 40 anti-abortion statutes are enacted in the U.S.

Comstock Act makes it illegal to sell or mail contraceptives or abortifacients

Late 19th century

OB-GYN emerges as a specialty

Griswold v. Connecticut decision finds that the Constitution guarantees a right to privacy, specifically in prescribing contraceptives, paving the way for Roe v. Wade

Supreme Court decision in Roe v. Wade enshrines abortion as a constitutional right

Planned Parenthood of Southeastern Pennsylvania v. Casey protects a woman's right to have an abortion prior to  fetal viability

Four states pass trigger laws making it a felony to perform, procure, or prescribe an abortion if Roe is ever overturned

Roe v. Wade and Planned Parenthood v. Casey overturned; 13 states ban abortion by October 2022

In 1857, the AMA took aim at unregulated abortion providers with a letter-writing campaign pushing state lawmakers to ban the practice. To make their case, they asserted that there was a medical consensus that life begins at conception, rather than at quickening.

The campaign succeeded. At least 40 anti-abortion laws went on the books between 1860 and 1880.

And yet some doctors continued to perform abortions in the late 19th and early 20th centuries. By then, abortion was illegal in almost all states and territories, but during the Depression era, “doctors could see why women wouldn’t want a child,” and many would perform them anyway, Fissell says. In the 1920s and through the 1930s, many cities had physicians who specialized in abortions, and other doctors would refer patients to them “off book.”

That leniency faded with the end of World War II. “All across America, it’s very much about gender roles, and women are supposed to be in the home, having babies,” Fissell says. This shift in the 1940s and ’50s meant that more doctors were prosecuted for performing abortions, which drove the practice underground and into less skilled hands. In the 1950s and 1960s, up to 1.2 million illegal abortions were performed each year in the U.S., according to the Guttmacher Institute . In 1965, 17% of reported deaths attributed to pregnancy and childbirth were associated with illegal abortion.

A rubella outbreak from 1963–1965 moved the dial again, back toward more liberal abortion laws. Catching rubella during pregnancy could cause severe birth defects, leading medical authorities to endorse therapeutic abortions . But these safe, legal abortions remained largely the preserve of the privileged. “Women who are well-to-do have always managed to get abortions, almost always without a penalty,” says Fissell. “But God help her if she was a single, Black, working-class woman.”

Women who could afford it brought their cases to court to fight for access to hospital abortions. Other women gained approval for abortions with proof from a physician that carrying the pregnancy would endanger her life or her physical or mental health. These cases set off a wave of abortion reform bills in state legislatures that helped set the stage for Roe v. Wade . By the time Roe was decided in 1973, legal abortions were already available in 17 states—and not just to save a woman’s life.

But raising the issue to the level of the Supreme Court and enshrining abortion rights for all Americans also galvanized opposition to it and mobilized anti-abortion groups. “ Roe was under attack virtually from the moment it was decided,” says Rosen.  

In 1992 another Supreme Court case, Planned Parenthood of Southeastern Pennsylvania v. Casey posed the most significant existential threat to Roe . Rosen calls it “the case that launched a thousand abortion regulations,” upholding Roe but giving states far greater scope to regulate abortion prior to fetal viability. However, defining that nebulous milestone a became a flashpoint for debate as medical advancements saw babies survive earlier and earlier outside the womb. Sonograms became routine around the same time, making fetal life easier to grasp and “putting wind in the sails of the ‘pro-life’ movement,” Rosen says. Then in June, the Supreme Court overturned both Roe and Casey .

For many Americans, that meant the return to the conundrum that led Norma McCorvey—a.k.a. Jane Roe—to the Supreme Court in 1971: being poor and pregnant, and seeking an abortion in a state that had banned them in all but the narrowest of circumstances.

The history of abortion in the U.S. suggests the tides will turn again. “We often see periods of toleration followed by periods of repression,” says Fissell. The current moment is unequivocally marked by the latter. What remains to be seen is how long it will last.

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What the data says about abortion in the U.S.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The CDC does not track the number of abortion providers.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Jeff Diamant is a senior writer/editor focusing on religion at Pew Research Center .

Besheer Mohamed is a senior researcher focusing on religion at Pew Research Center .

Rebecca Leppert is a copy editor at Pew Research Center .

Cultural Issues and the 2024 Election

Support for legal abortion is widespread in many places, especially in europe, public opinion on abortion, americans overwhelmingly say access to ivf is a good thing, broad public support for legal abortion persists 2 years after dobbs, most popular.

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How the Right to Legal Abortion Changed the Arc of All Women’s Lives

I’ve never had an abortion. In this, I am like most American women. A frequently quoted statistic from a recent study by the Guttmacher Institute, which reports that one in four women will have an abortion before the age of forty-five, may strike you as high, but it means that a large majority of women never need to end a pregnancy. (Indeed, the abortion rate has been declining for decades, although it’s disputed how much of that decrease is due to better birth control, and wider use of it, and how much to restrictions that have made abortions much harder to get.) Now that the Supreme Court seems likely to overturn Roe v. Wade sometime in the next few years—Alabama has passed a near-total ban on abortion, and Ohio, Georgia, Kentucky, Mississippi, and Missouri have passed “heartbeat” bills that, in effect, ban abortion later than six weeks of pregnancy, and any of these laws, or similar ones, could prove the catalyst—I wonder if women who have never needed to undergo the procedure, and perhaps believe that they never will, realize the many ways that the legal right to abortion has undergirded their lives.

Legal abortion means that the law recognizes a woman as a person. It says that she belongs to herself. Most obviously, it means that a woman has a safe recourse if she becomes pregnant as a result of being raped. (Believe it or not, in some states, the law allows a rapist to sue for custody or visitation rights.) It means that doctors no longer need to deny treatment to pregnant women with certain serious conditions—cancer, heart disease, kidney disease—until after they’ve given birth, by which time their health may have deteriorated irretrievably. And it means that non-Catholic hospitals can treat a woman promptly if she is having a miscarriage. (If she goes to a Catholic hospital, she may have to wait until the embryo or fetus dies. In one hospital, in Ireland, such a delay led to the death of a woman named Savita Halappanavar, who contracted septicemia. Her case spurred a movement to repeal that country’s constitutional amendment banning abortion.)

The legalization of abortion, though, has had broader and more subtle effects than limiting damage in these grave but relatively uncommon scenarios. The revolutionary advances made in the social status of American women during the nineteen-seventies are generally attributed to the availability of oral contraception, which came on the market in 1960. But, according to a 2017 study by the economist Caitlin Knowles Myers, “The Power of Abortion Policy: Re-Examining the Effects of Young Women’s Access to Reproductive Control,” published in the Journal of Political Economy , the effects of the Pill were offset by the fact that more teens and women were having sex, and so birth-control failure affected more people. Complicating the conventional wisdom that oral contraception made sex risk-free for all, the Pill was also not easy for many women to get. Restrictive laws in some states barred it for unmarried women and for women under the age of twenty-one. The Roe decision, in 1973, afforded thousands upon thousands of teen-agers a chance to avoid early marriage and motherhood. Myers writes, “Policies governing access to the pill had little if any effect on the average probabilities of marrying and giving birth at a young age. In contrast, policy environments in which abortion was legal and readily accessible by young women are estimated to have caused a 34 percent reduction in first births, a 19 percent reduction in first marriages, and a 63 percent reduction in ‘shotgun marriages’ prior to age 19.”

Access to legal abortion, whether as a backup to birth control or not, meant that women, like men, could have a sexual life without risking their future. A woman could plan her life without having to consider that it could be derailed by a single sperm. She could dream bigger dreams. Under the old rules, inculcated from girlhood, if a woman got pregnant at a young age, she married her boyfriend; and, expecting early marriage and kids, she wouldn’t have invested too heavily in her education in any case, and she would have chosen work that she could drop in and out of as family demands required.

In 1970, the average age of first-time American mothers was younger than twenty-two. Today, more women postpone marriage until they are ready for it. (Early marriages are notoriously unstable, so, if you’re glad that the divorce rate is down, you can, in part, thank Roe.) Women can also postpone childbearing until they are prepared for it, which takes some serious doing in a country that lacks paid parental leave and affordable childcare, and where discrimination against pregnant women and mothers is still widespread. For all the hand-wringing about lower birth rates, most women— eighty-six per cent of them —still become mothers. They just do it later, and have fewer children.

Most women don’t enter fields that require years of graduate-school education, but all women have benefitted from having larger numbers of women in those fields. It was female lawyers, for example, who brought cases that opened up good blue-collar jobs to women. Without more women obtaining law degrees, would men still be shaping all our legislation? Without the large numbers of women who have entered the medical professions, would psychiatrists still be telling women that they suffered from penis envy and were masochistic by nature? Would women still routinely undergo unnecessary hysterectomies? Without increased numbers of women in academia, and without the new field of women’s studies, would children still be taught, as I was, that, a hundred years ago this month, Woodrow Wilson “gave” women the vote? There has been a revolution in every field, and the women in those fields have led it.

It is frequently pointed out that the states passing abortion restrictions and bans are states where women’s status remains particularly low. Take Alabama. According to one study , by almost every index—pay, workforce participation, percentage of single mothers living in poverty, mortality due to conditions such as heart disease and stroke—the state scores among the worst for women. Children don’t fare much better: according to U.S. News rankings , Alabama is the worst state for education. It also has one of the nation’s highest rates of infant mortality (only half the counties have even one ob-gyn), and it has refused to expand Medicaid, either through the Affordable Care Act or on its own. Only four women sit in Alabama’s thirty-five-member State Senate, and none of them voted for the ban. Maybe that’s why an amendment to the bill proposed by State Senator Linda Coleman-Madison was voted down. It would have provided prenatal care and medical care for a woman and child in cases where the new law prevents the woman from obtaining an abortion. Interestingly, the law allows in-vitro fertilization, a procedure that often results in the discarding of fertilized eggs. As Clyde Chambliss, the bill’s chief sponsor in the state senate, put it, “The egg in the lab doesn’t apply. It’s not in a woman. She’s not pregnant.” In other words, life only begins at conception if there’s a woman’s body to control.

Indifference to women and children isn’t an oversight. This is why calls for better sex education and wider access to birth control are non-starters, even though they have helped lower the rate of unwanted pregnancies, which is the cause of abortion. The point isn’t to prevent unwanted pregnancy. (States with strong anti-abortion laws have some of the highest rates of teen pregnancy in the country; Alabama is among them.) The point is to roll back modernity for women.

So, if women who have never had an abortion, and don’t expect to, think that the new restrictions and bans won’t affect them, they are wrong. The new laws will fall most heavily on poor women, disproportionately on women of color, who have the highest abortion rates and will be hard-pressed to travel to distant clinics.

But without legal, accessible abortion, the assumptions that have shaped all women’s lives in the past few decades—including that they, not a torn condom or a missed pill or a rapist, will decide what happens to their bodies and their futures—will change. Women and their daughters will have a harder time, and there will be plenty of people who will say that they were foolish to think that it could be otherwise.

• Historical Abortion Law Timeline: 1850 to Today

Follow the journey of abortion law in the United States — from criminalization in the late 1800s to legalization in the early 1970s — and the ongoing battles for abortion access.

1847: Formation of the American Medical Association (AMA)

In 1847, doctors banded together to form the AMA. It became the male-dominated authority on medical practices. The AMA scrutinized reproductive health care workers, like midwives and nurses, and the obstetric  services they provided were phased out. 

AMA members believed they should have the power to decide when an abortion could be legally performed. At the same time, the AMA was composed of physicians who lacked expertise in pregnancy and reproductive health.

• AMA members launched a full-fledged criminalization campaign against abortion and female abortion providers. State legislatures moved to ban abortion.

1880s: Criminalization and Vilification

This backlash kicked off a “century of criminalization,” which was ended by Roe v. Wade in 1973 (see below).

Laws restricting abortion access became the norm. 

By 1880, all states had laws to restrict abortion — with exceptions in some states if a doctor said the abortion was needed to save the life or health of the patient, or for therapeutic reasons . 

As abortion became criminalized, the stigma surrounding it grew.

1910: Abortion Bans Nationwide

By 1910 , abortion was not only restricted but outright illegal at every stage in pregnancy in every state in the country. These abortion bans had some exceptions in instances to save the patient’s life — a decision that only doctors, 95% of whom were men , had the power to make.

By this time, America had experienced several decades of increased immigration. Worried about losing their hold on the country, white men in power supported abortion bans as a way to get upper-class white women to have more children.

1930: Deaths from Illegal, Unsafe Abortions

Criminalizing abortion sent the practice underground, which resulted in a high death toll. 

Unsafe, illegal abortion was the cause of death for nearly 2,700 women in 1930 — almost one out of every five (18%) of recorded maternal deaths that year, according to the Guttmacher Institute .

1955: Conference on Abortion Legalization

In response to increasingly alarming media coverage of unsafe, illegal abortions, Planned Parenthood held a first-of-its-kind conference on the issue of abortion.

The doctors who attended the national conference on abortion made the bold move to publicly call for abortion law reform. 

Conference attendees said that laws should be rewritten to allow doctors greater latitude to provide abortion services, which would improve public health and access to reproductive health care for people of different economic circumstances.

1962: Thalidomide

In the late 1950s and early ’60s, thousands of pregnant women took a drug called thalidomide to ease pregnancy symptoms. The problem: It was found to cause severe birth defects. 

In 1962, a pregnant TV host who ingested thalidomide could not obtain a legal abortion in the United States. The media tracked her journey to get an abortion in Sweden, and 52% of Americans supported her.

The thalidomide fallout brought greater support for abortion law reform.

1964 : Association for the Study of Abortion (ASA)

In 1964, abortion law reform activists registered their first national group: the Association for the Study of Abortion (ASA).

Planned Parenthood joined doctors and laypeople leading the ASA in advocating for abortion law reforms and for studies that would advance abortion procedure safety.

In a strategic move to incrementally increase abortion access, the ASA advocated only for " medically necessary " abortions. But members of the larger abortion law reform movement wanted a full repeal to legalize abortion for all people.

1966 : Trial of the San Francisco Nine  

Nine well-respected doctors were sued in California for performing abortions on women who had been exposed to rubella, a disease known to cause birth defects. 

Doctors across the country came to the defense of the San Francisco Nine, including the deans of 128 medical schools. 

This resulted in one of the first abortion reform measures in the United States. California amended its prohibition on abortion to allow hospital committees to approve requests for abortion.

1969: NARAL Established

The National Association for the Repeal of Abortion Laws (NARAL) was established in Chicago at the First National Conference on Abortion Laws.

NARAL was the first national group created solely to campaign for the legalization of abortion, marking the start of direct action to repeal abortion bans.

Late 1960s and early 1970s: Abortion Reform

By the late 1960s, a nationwide effort was underway to reform abortion laws in nearly every state. 

Health care providers, advocates, clergy members, and the legal community lobbied state legislatures and went to court to overturn statutes that had been in place since before the turn of the century. 

Between 1967 and 1973, four states — Alaska, Hawaii, New York, and Washington — repealed their abortion bans entirely, while 13 others enacted reforms that expanded exceptions. Instead of just allowing for abortion to save the patient’s life, they now allowed it in instances where a pregnancy was dangerous for the physical or mental health of a patient, fetal abnormalities, and when the pregnancy resulted from rape or incest.

1970: Legal Abortion in New York

In 1970, New York state legalized abortion . One day after that law took effect, a Planned Parenthood health center in Syracuse became the the first Planned Parenthood health center to provide abortion services, and the first free-standing abortion center nationwide. 

In the first two years after abortion was legalized in New York, two-thirds of the abortions performed in the state were on patients who had traveled from other states  — most of which still outlawed abortion. At the time, other states that had legalized abortion required patients to be state residents.

1973: Roe v. Wade

In a landmark decision, the U.S. Supreme Court ruled that the due process clause of the 14th Amendment to the Constitution protects the right to abortion. 

In particular, the Supreme Court recognized for the first time that the constitutional right to privacy “is broad enough to encompass a woman’s decision whether or not to terminate her pregnancy.”

Roe v. Wade protected the right to abortion in all 50 states, making abortion services safer and more accessible throughout the country. The decision also set a legal precedent that affected dozens of subsequent Supreme Court cases.

1976: Hyde Amendment Put Into Place

The Hyde Amendment is a discriminatory and racist policy that prevents federal dollars from being used in government insurance programs like Medicaid for abortion services (except in instances of incest, rape, or life-threatening risk to the pregnant person). 

The legislation was created by Rep. Henry Hyde. “I would certainly like to prevent, if I could legally, anybody having an abortion: a rich woman, a middle class woman, or a poor woman,” he said. “Unfortunately, the only vehicle available is the [Medicaid] bill.”

Because of centuries of systemic racism and bias, Medicaid disproportionately serves Black, Latino, and LGBTQ+ communities — people who already face other barriers to care and economic opportunity.

Despite the federal law, 16 states currently include abortion in their Medicaid programs using state funds. (The remaining 34 states and the District of Columbia do not have abortion coverage in their Medicaid programs due to the Hyde Amendment).

Thanks in large part to the advocacy of reproductive justice organizations, in 2021 the Biden-Harris administration became the first administration in decades to exclude the Hyde Amendment from its presidential budget.

1984: Global Gag Rule

Former President Ronald Reagan introduced the Mexico City policy, otherwise known as the global gag rule, in 1984. 

The global gag rule prevents foreign organizations that receive U.S. health aid from providing information on and referrals for abortions or advocating for abortion access.

Every president since Reagan who supports abortion access has rescinded the global gag rule, while every president since Reagan who opposes abortion access has reinstated it. That includes President Donald Trump , who not only reinstated it, but expanded the global gag rule to make it even more harmful.

1992: Planned Parenthood of Southeastern Pennsylvania v. Casey

This landmark case reaffirmed that the Constitution protects the right to abortion.

However, Casey created an “undue burden” framework, under which laws restricting access to abortion would be judged. This framework made it more difficult to challenge laws that were less than absolute prohibitions on abortion — requiring challenges to show that a law has the purpose or effect of placing a substantial obstacle in the path of a patient seeking an abortion.

Following Casey , state politicians passed numerous medically unnecessary abortion restrictions across the country which courts have found do not impose an undue burden.

2007: Gonzales v. Carhart and Gonzales v. Planned Parenthood Federation of America

The Supreme Court upheld the first federal legislation to criminalize abortion , allowing Congress to ban certain second-trimester abortion procedures — which are sometimes the safest and best way to protect a patient’s health.

Because the legislation does not contain an exception for the patient’s health, the Supreme Court effectively overruled a key component of Roe v. Wade : that the patient’s health must be of paramount concern in laws that restrict abortion access.

2016: Whole Woman's Health v. Hellerstedt

The Supreme Court ruled that two Texas abortion restrictions were unconstitutional because they would shut down most abortion providers in the state and impose an “undue burden” on access to safe, legal abortion in Texas.

2020: June Medical Services v. Russo

On June 29, 2020 — in June Medical Services v. Russo — the Supreme Court struck down a medically unnecessary law that was nearly identical to the one it had struck down in Whole Woman’s Health . This law would have made abortion virtually inaccessible in Louisiana.

Four justices dissented, and it was the last time Ruth Bader Ginsburg had a chance to rule on abortion access before she died later that year. Ginsburg was replaced by Amy Coney Barrett — who is one of three Supreme Court justices nominated by Donald Trump.

2021: Texas Six-Week Ban

On Sept. 1, 2021, Texas implemented a dangerous law called S.B. 8. which bans abortion at approximately six weeks of pregnancy — before many people even know they’re pregnant. 

The AMA denounced the Texas abortion ban, but the Supreme Court allowed it to take effect.

Where We’re Headed 

This history of abortion laws and court decisions provides important context to the road ahead.

Right now, 80% of Americans want abortion to be legal. 

On December 1, 2021 , the Supreme Court will hear oral arguments in Dobbs v. Jackson Women’s Health Organization — a case about a Mississippi ban on abortion at 15 weeks that’s a direct challenge to Roe v. Wade . The state of Mississippi not only has asked the Supreme Court to allow a pre- viability abortion ban, in violation of one of the core tenets of Roe v. Wade , but also has asked the Supreme Court to overrule Roe and Casey entirely.

The Supreme Court will issue a decision in Dobbs v. Jackson Women’s Health Organization by the end of June 2022. If Roe is overturned or its protections are dismantled, then the laws governing abortion will fall to individual state governments. Many people of reproductive age will lose access to safe, legal abortion in the United States.

No matter what happens, Planned Parenthood will continue to fight to uphold access to safe, legal abortion.

Abortion Access

• Roe v. Wade Overturned: How the Supreme Court Let Politicians Outlaw Abortion
• Federal and State Bans and Restrictions on Abortion
• Types of State Attacks on Abortion
• The State of Emergency for Women's Health
• Timeline of Attacks on Abortion: 2009–2021

The History of Abortion in America

Abortion has been legal for much of American history. Learn how.

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• HISTORY & CULTURE

How U.S. abortion laws went from nonexistent to acrimonious

Most scholars say that at the nation's founding ending a pregnancy wasn’t illegal—or even controversial. Here’s a look at the complex early history of abortion in the United States.

There’s no more hot-button issue in the United States than that of abortion. And every time the divisive battle flares up, someone is bound to invoke the historical legacy of abortion in America.

But what is that history? Though interpretations differ, most scholars who have investigated the complex history of abortion argue that terminating a pregnancy wasn’t always illegal—or even controversial. Here’s what they say about the nation’s long, complicated relationship with abortion.

Before abortion law  

In colonial America and the early days of the republic, there were no abortion laws at all. Church officials frowned on the practice, writes Oklahoma University of Law legal historian Carla Spivack in the William & Mary Journal of Race, Gender, and Social Justice , but they treated the practice as evidence of illicit or premarital sex—not as murder.

Some localities prosecuted cases involving abortions. In 1740s Connecticut, for example, prosecutors tried both a doctor and a Connecticut man for a misdemeanor in connection with the death of Sarah Grosvenor, who had died after a botched abortion. However, the case centered around the men’s role in the woman’s death, not abortion per se, and such prosecutions were rare.

In fact, says Lauren MacIvor Thompson , a historian of women’s rights and public health and an assistant professor at Kennesaw State University, “abortion in the first trimester would have been very, very common.”

That’s in part because of society’s understanding of conception and life.

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Many historians agree that in an era long before reliable pregnancy tests, abortion was generally not prosecuted or condemned up to the point of quickening—the point at which a pregnant woman could feel the fetus’ first kicks and movements . At the time quickening might be the only incontrovertible evidence of pregnancy; indeed, one 1841 physician wrote that many women didn’t even calculate their due dates until they had felt the baby kick, which usually takes place during the second trimester, as late as 20 weeks into the pregnancy. That’s when the fetus was generally recognized as a baby or person.

Until the mid-19th century, writes University of Illinois historian Leslie J. Reagan in her book When Abortion Was a Crime, “What we would now identify as an early induced abortion was not called an ‘abortion’ at all. If an early pregnancy ended, it had ‘slipp[ed] away,’ or the menses had been ‘restored.’”

How early abortion worked

At the time, women who did not wish to remain pregnant had plenty of options. Herbs like savin, tansy, and pennyroyal were common in kitchen gardens, and could be concocted and self-administered to, in the parlance of the time, clear “obstructions” or cause menstruation.

“It was really a decision that a woman could choose in private,” MacIvor Thompson says.

A pregnant woman might consult with a midwife, or head to her local drug store for an over-the-counter patent medicine or douching device. If she owned a book like the 1855   Hand-Book of Domestic Medicine , she could have opened it to the section on “emmenagogues,” substances that provoked uterine bleeding. Though the entry did not mention pregnancy or abortion by name, it did reference “promoting the monthly discharge from the uterus.”

Though reasons varied, a lack of reliable contraception, the disgrace of bearing a child outside of marriage, and the dangers of childbirth were the main reasons women terminated their pregnancies. Though birth rates were high—in 1835, the average woman would give birth more than six times during her lifetime—many women wanted to limit the number of times they would have to carry and bear a child. In an era before modern medical procedures, the grave dangers of childbirth were widely understood. In the words of historian Judith Walzer Leavitt, “Women knew that if procreation did not kill them or their babies, it could maim them for life.”

( Women's health concerns are dismissed more, studied less .)

As a result, the deliberation termination of pregnancy was widely practiced, and by some estimates , up to 35 percent of 19th-century pregnancies ended in abortion.

For enslaved women, abortion was more tightly regulated because their children were seen as property. In the Journal of American Studies , historian Liese M. Perrin writes that many slaveholders were paranoid about abortion on their plantations; she documents that at least one slaveholder locked an enslaved woman up and stripped her of privileges because he suspected she had self-induced a miscarriage. Still, bondswomen’s medical care was usually left to Black midwives who practiced folk medicine.   And at least some enslaved women are known to have used abortifacients, chewing cotton roots or ingesting substances like calomel or turpentine.

Middle- and upper-class white women, however, had an advantage when it came to detecting and treating unwanted pregnancies in the 19th century. Their strictly defined roles in society held that the home—and issues of reproductive health—were a woman’s realm.   And so women, not doctors, were the ones who held and passed down knowledge about pregnancy, childbirth, and reproductive control. “It gave them a space to make their own decisions about their reproductive health,” MacIvor Thompson says.

Criminalizing abortion

That would slowly change throughout the century as the first abortion laws slowly made their ways onto the books. Most were focused on unregulated patent medicines and abortions pursued after quickening. The first , codified in Connecticut in 1821, punished any person who provided or took poison or “other noxious and destructive substance” with the intent to cause “the miscarriage of any woman, then being quick with child.”

Patent medicines were a particular concern; they were available without prescriptions, and their producers could manufacture them with whatever ingredients they wished and advertise them however they liked. Many such medicines were abortifacients and were advertised as such—and they were of particular concern to doctors.

As physicians professionalized in the mid-19th century, they increasingly argued that licensed male doctors, not female midwives, should care for women throughout the reproductive cycle. With that, they began to denounce abortion.

Gynecologist Horatio Storer led the charge. In 1857, just a year after joining the barely decade-old American Medical Association, Storer began pushing the group to explore what he called “criminal abortion.”   Storer argued that abortion was immoral and caused “derangement” in women because it interfered with nature. He lobbied for the association to think of abortion not as a medical act, but a grave crime, one that lowered the profession as a whole.

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A power player within the association, he gathered fellow physicians into a crusade called the Physicians Campaign Against Abortion. The doctors’ public stance helped serve as justification for an increasing number of criminal statutes.

For its opponents, abortion was as much a social evil as a moral one. The influx of immigrants, the growth of cities, and the end of slavery prompted nativist fears that white Americans were not having enough babies to stave off the dominance of groups they found undesirable. This prompted physicians like Storer to argue that white women should have babies for the “future destiny of the nation.”

A nation of outlaws

By 1900, writes University of Oregon historian James C. Mohr in his book Abortion in America , “the United States completed its transition from a nation without abortion laws of any sort to a nation where abortion was legally and officially proscribed.” Just 10 years later, every state in the nation had anti-abortion laws—although many of these laws included exceptions for pregnancies that endangered the life of the mother.

With the help of a U.S. postal inspector named Anthony Comstock, it had also become harder to access once-common information on how to end an unwanted pregnancy. The 1873 Comstock Act made it illegal to send “obscene” materials—including information about abortion or contraception—through the mail or across state lines.

“Americans understood that abortion and birth control went hand in hand,” MacIvor Thompson says.

The combination of anti-obscenity laws, criminal statutes, and the 1906 Pure Food and Drug Act , which made it unlawful to make, sell, or transport misbranded or “deleterious” drugs or medicines, made it increasingly difficult for women to access safer forms of abortion.

“The legal punishments in place absolutely had a chilling effect,” says MacIvor Thompson. “And yet, just like a hundred years earlier, women still sought them frequently.”

As the 20th century dawned, under-the-table surgical abortions became more common, discreetly practiced by physicians who advertised by word-of-mouth to those who could afford their services. Those who could not used old herbal recipes, drank creative concoctions, douched with substances like Lysol, or attempted to remove the fetuses on their own.

Advocates of the growing birth control movement even used now-illegal abortion to argue for legal contraception. Birth control pioneer Margaret Sanger said that she was inspired to make teaching women about contraceptives her career after treating a woman who died from a self-induced abortion—a practice she called a “disgrace to a civilized community.”

( How the first birth control pill was designed .)

It’s still up for debate how frequently women sought abortions in the 20th century—and how often they died from self-induced or botched, “back-alley” abortions. In 1942, the question vexed the Bureau of the Census’ chief statistician, Halbert Dunn, who noted that, despite the lack of accurate reporting, “abortion is evidently still one of the greatest problems to be met in lowering further the maternal mortality rate for the country.”

The modern battle over abortion

By 1967, abortion was a felony in nearly every state, with few provisions for the health of the mother or pregnancies arising from rape.

But all that changed in the 1970s. States across the country had begun to reconsider their laws and loosen their restrictions on abortion, and in 1973, the Supreme Court seemingly settled the question with two landmark rulings— Roe v. Wade and the lesser-known but equally important Doe v. Bolton— that made terminating a pregnancy a legal right nationwide.

( The tumultuous history that led to the landmark   Roe v. Wade ruling. )

The country has debated the merits of those rulings ever since. In June 2022, the Supreme Court made the momentous decision to overturn Roe . Now, generations of women who have never known life before Roe   face yet another shift in the landscape of the nation’s contentious history of abortion.

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The looming battle over abortion in the US

Pro-choice activists say that state lawmakers across the country are trying to restrict abortion at a pace not seen in decades. So what will this mean for a decades-long fight over the issue in America?

On a Friday night, Julie gets ready to go out with her partner while her two boys curl up on the sofa to watch a Disney movie with their babysitter.

It is a typical happy family scene, one that Julie probably never envisaged when, aged just 19, she was raped and took the decision to have an abortion.

"I come from a small town in Ohio. All German Catholics, very conservative. So when I found out I was pregnant I panicked. I didn't know what to do. I knew that I could not have this baby," she says.

She had been fervently anti-abortion then, but when she got pregnant against her will, her views on the subject changed completely.

And, several years later, after an unplanned pregnancy during an emotionally distressing time following her mother's death, she took the decision to have another abortion.

"My abortions, I have no regrets whatsoever for them," she says.

"In fact, it's changed my life. After my first abortion, I had my first examination as a grown woman. I got on birth control. I made yearly appointments for my pap smear and checks. I feel that girls and young women from small, religious communities have a fear or think that they don't need that."

Julie says the current spate of anti-abortion legislation introduced across the country worries her.

"I think it's important for all of us to take a stand and fight for our reproductive rights because, like me, you never know when you are going to be in that position and what you are going to do."

• What is Roe v Wade ruling on abortion?

According to a report by two prominent pro-choice groups, Planned Parenthood and the Guttmacher Institute, more than 500 such restrictions have been introduced so far in 2021 - significantly more than a comparative period in any other year since the 1970s, when abortion was legalised across the country.

These restrictions run the gamut from a near total ban in states like Arkansas and Oklahoma - where new laws would bar access to the procedure except under very limited circumstances - to states like Idaho and Texas that limit abortion after six weeks of pregnancy, before many women might know they are pregnant.

Furthermore, state legislators in Arizona and Ohio have passed laws that will prohibit doctors from performing abortions based on a foetal diagnosis of Down Syndrome.

Some of these laws allow exceptions in cases of medical emergencies, rape and incest.

Republican lawmakers across the country pushing for more abortion restrictions are emboldened by a conservative-leaning Supreme Court shaped by former President Donald Trump's appointments, the most recent being Justice Amy Coney Barrett last year.

Who is the new US Supreme Court judge?

• What is the US Supreme Court?

And for the first time since she joined the top court, it will take up a case challenging a Mississippi law that bans most abortions after 15 weeks of pregnancy. If this law is allowed to come into effect, it could pave the way for more such bans in other states.

Experts say this slew of legislation at the state level is all part of a strategy by anti-abortion groups to get the Supreme Court to overturn the landmark ruling from 1973, Roe v Wade, that legalised abortion nationwide in the United States.

It protects a woman's right to an abortion only until viability - the point at which a foetus is able to live outside the womb, generally by the start of the third trimester, 28 weeks into a pregnancy.

Allie Frazier, 27, from the anti-abortion group Ohio Right to Life says no life should be disposable. "We don't get to choose who lives or dies based on what is most convenient for us.''

So what about people who end up with unwanted pregnancies?

"Abortion ends a distinct human life. Women deserve better than abortion," she says.

Abortion is arguably the most divisive issue in US politics and it has long been highly charged.

Democrats, who largely support abortion rights, are currently in power in Washington. President Joe Biden has said he will protect a woman's right to choose.

However, in recent years conservative anti-abortion groups have put their weight behind bringing in more restrictive abortion legislation in Republican-governed states.

Cathi Herrod, from the group Center for Arizona Policy, which backed the recent state legislation prohibiting abortion on the basis of genetic anomalies like Down Syndrome, says she hopes that abortion in the United States would not only be illegal but unthinkable.

"This directly reflects the will of the people as they have elected legislators who want to regulate abortion and want to look out for the lives of pre-born children as well as the lives of their mothers," she says.

Surveys tend to reveal a complex picture of where Americans stand on the issue.

A 2019 poll by NPR/PBS/Marist indicates that a majority of them do want abortion to remain legal but also want restrictions on abortion rights. A Gallup poll last year suggests that most Americans want abortion to be legal only under certain circumstances .

And a more recent Pew research survey showed that 59% of Americans want it to be legal under all or most cases.

Maleeha, an immigrant from Pakistan who now lives in Texas, says she was stunned at the number of hoops she had to jump through to get an abortion seven years ago.

She ended up having to travel to Colorado to get one because it was such a challenge in her home state. A relative paid for her flight and hotel as she was then a college student who would have struggled to afford it.

"You hear a lot about freedom in the US and how people are so open-minded and things are so much easier," she says.

"In Pakistan, sure, people don't like to talk about it - but it wouldn't garner the same kind of reaction or horror that it evokes here."

Campaigners like Planned Parenthood say 29 states out of 50 have a majority of anti-abortion lawmakers in their legislatures and are actively enforcing ways to limit access to the procedure. They argue a decision on whether to keep a pregnancy is often based on personal circumstances - and that politicians should stay out of it.

Elizabeth Nash, from the Guttmacher Institute, which has been documenting the state-level restrictions across the country, says: "The amount of legislation that we are seeing has been building for a few years and comes from the fact that policymakers are extremely conservative. We also now have a judiciary that is very conservative because of all the Trump appointments."

Many of these restrictions are set to come into effect later this year but will most likely face legal challenges.

Experts believe that several will be struck down by the lower courts but that some of these legal challenges will end up before the nine members of the Supreme Court. Pro-choice groups fear that the existing law could be significantly reshaped by the top court, if not completely overturned.

Top US court to hear case on 15-week abortion ban

Texas governor signs law restricting abortion, biden allows us aid for global abortion providers.

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Abortion Law: Global Comparisons

The U.S. Supreme Court overturned Roe v. Wade, which guaranteed the constitutional right to abortion for almost fifty years. How does regulation of abortion in the United States compare to that in the rest of the world?

Article by Women and Foreign Policy Program Staff

Last updated March 7, 2024 2:30 pm (EST)

The past fifty years have been characterized by an unmistakable trend toward the liberalization of abortion laws, particularly in the industrialized world. Each year, around seventy-three million abortions take place worldwide, according to the World Health Organization (WHO). This translates to about thirty-nine abortions per one thousand women globally, a rate that has stayed roughly the same since 1990. Notably, rates have diverged between countries with fewer restrictions and those with more: Between 1990–94 and 2015–19, the average abortion rate in countries with generally legal abortion (excluding China and India) declined by 43 percent. By contrast, in countries with severe restrictions on abortion, the average abortion rate increased by around 12 percent.

As nations around the globe have expanded the grounds on which people can access reproductive health services, the quality and safety of abortion care has improved, as has maternal survival. However, the safety of abortion procedures diverges widely between countries where abortion is generally legal and countries with high restrictions on abortion. Almost 90 percent of abortions in countries with liberal abortion laws are considered safe, compared with just 25 percent of abortions [PDF] in countries where abortion is banned. According to the WHO, approximately 5–13 percent of maternal deaths worldwide are due to complications from unsafe abortions, the vast majority of which occur in developing countries.

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However, there remains strong opposition to abortion among some constituencies. And in recent years, a number of countries, particularly autocracies, have pushed back against the expansion of women’s and reproductive rights. Abortion opponents in the United States won a major victory in June 2022 with Dobbs v. Jackson Women’s Health Organization , a Supreme Court ruling that struck down the 1973 decision Roe v. Wade , which guaranteed the constitutional right to abortion. Since Dobbs , twenty-one states have moved to ban or restrict abortion access.

What does abortion law look like around the world?

Although the legal status of abortion varies considerably by region, a large majority of countries permit abortion under at least some circumstances; globally, twenty-two countries ban abortion entirely. Most industrialized countries allow the procedure without restriction. Around one hundred countries have some restrictions, typically permitting abortion only in limited situations, including for socioeconomic reasons, risks to a woman’s physical or mental health, or the presence of fetal anomalies. However, legal language concerning exemptions for fetal impairment is often vague, resulting in uncertainty for medical professionals about whether performing certain abortions is legal.

Access to safe abortion has been established as a human right by numerous international frameworks , the UN Human Rights Committee, and regional human rights courts, including the European Court of Human Rights, the Inter-American Court of Human Rights, and the African Commission on Human and Peoples’ Rights. At the 1994 International Conference on Population and Development in Cairo, 179 governments signed a program of action [PDF] that included a commitment to prevent unsafe abortion. And in 2015, the United Nations’ 2030 Agenda for Sustainable Development expanded to call for universal access to services for reproductive-health care. The WHO first recognized unsafe abortion as a public health problem in 1967, and in 2003 it developed technical and policy guidelines that include a recommendation that states pass abortion laws to protect women’s health. According to the UN Population Fund, addressing the unmet need for family planning would both considerably reduce maternal mortality and reduce abortion by up to 70 percent in the developing world.

How does the United States compare?

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The Supreme Court’s decision on June 24, 2022, to strike down Roe v. Wade , overturns almost fifty years of precedent that conferred a constitutional right to receive an abortion. In the 1973 Roe decision, the Court held that the Constitution guarantees the right to choose to have an abortion, though it permitted regulations after the first trimester of pregnancy. With Roe , the United States became one of the first countries to liberalize its abortion laws, along with several Western European nations. In 1992, Planned Parenthood v. Casey reaffirmed the right to an abortion but permitted additional restrictions, such as waiting periods and parental consent requirements.

For decades, states have introduced and implemented various laws regulating abortions. Some passed laws to protect abortion access, while others imposed more onerous regulations on abortion providers and sought to prohibit abortion at earlier points in pregnancy. Many states have passed increasingly strict abortion laws in recent years, sometimes banning the procedure after as few as six weeks of pregnancy. Some states with stringent abortion restrictions, such as Idaho, Oklahoma, and Texas, have implemented so-called vigilante laws allowing members of the public to sue abortion providers and anyone they suspect of providing or facilitating abortions. In the last year, more than sixty Planned Parenthood facilities and doctors’ offices have been forced to close or focus on services other than abortion. Some providers have moved to less-restrictive states, leaving many states with only a single abortion provider . 

Roe’s reversal allows the thirteen states that have so-called trigger laws to either ban abortion automatically or by quick state action. While all of these state laws exempt abortions in cases of life-threatening pregnancies, many do not exempt pregnancies caused by rape or incest. Republican lawmakers and anti-abortion advocates have praised the Supreme Court’s decision, while Democratic lawmakers and abortion advocates have condemned it.

What have been recent trends?

The global trend in abortion law has been toward liberalization. In the last thirty years, more than sixty countries have changed their abortion laws, and all but four—the United States, El Salvador, Nicaragua, and Poland— expanded the legal grounds on which women can access abortion services. Since 2020, Argentina and Thailand legalized abortions, with certain gestational limits; South Korea decriminalized abortion; and New Zealand eased its abortion restrictions. Most recently, amid a growing “ green wave ” in Latin America, Colombia made abortion legal on demand up to twenty-four weeks of pregnancy, and Mexico decriminalized the procedure, removing its ban from the federal penal code. Although most countries have taken steps to expand grounds for abortion, some—including Honduras and the United States—are enacting policies to tighten restrictions.

Here’s a look at how abortion laws have changed in a handful of countries around the globe: 

China . China liberalized its abortion law in the 1950s and promoted the practice under its one-child policy, which was enacted in 1979 in an effort to curb population growth by restricting families to one child. The policy, under which abortion services were made widely available, came with severe coercive measures —including fines, compulsory sterilization, and abortion—to deter unauthorized births. China raised this long-standing limit to a two-child policy in 2016, along with other incentives to encourage population growth amid a rapidly aging population. In 2021, it increased the limit to three children, and China’s State Council issued guidelines on women’s development that called to reduce “non–medically necessary abortions.”

Kenya . Postcolonial Kenya’s abortion law was rooted in the British penal code, which criminalized abortion. When Kenya adopted a new constitution in 2010, it expanded the grounds [PDF] on which women could obtain an abortion to include emergency cases, or those in which the health of the mother is at stake. In June 2019, a court extended the exceptions to include cases of rape . As other former European colonies reevaluate their abortion statutes, many are expanding the grounds for abortion. For instance, Burkina Faso, Chad, Guinea, Mali, and Niger—nations whose restrictive abortion laws were holdovers from the 1810 Napoleonic Code imposed by France—have made abortion legal in cases of rape, incest, or fetal impairment.

Ireland . In 2018, the Irish parliament legalized the termination of pregnancy before twelve weeks, as well as in cases in which the health of the mother is at stake. Previously, Ireland had one of the most restrictive abortion laws in Europe, codified in a 1983 constitutional amendment that effectively banned the practice. The 2012 death of Savita Halappanavar after she was denied an emergency abortion reignited public debate and protest and prompted a countrywide referendum to overturn the amendment; the referendum passed with 66 percent of the vote. In 2019, abortion was legalized in Northern Ireland, which is part of the United Kingdom (UK). The UK’s 1967 Abortion Act, which grants doctors in England, Scotland, and Wales the authority to perform abortions, was extended to Northern Ireland following a vote by the UK Parliament.

Zambia . Zambia is one of the few countries in Africa where abortion is permitted for economic and social reasons, but, despite having a liberal law, structural and cultural barriers make it difficult for Zambian women to obtain abortions. As of 2018, Zambia had one practicing medical doctor per twelve thousand inhabitants; and for the 55 percent of Zambians living in rural areas, health professionals are few and far between. The law stipulates that only a registered medical practitioner [PDF], and not a nurse or midwife, can perform an abortion, rendering safe access out of reach for most. Zambia is plagued by a high rate of abortion-related maternal mortality , with about 30 percent of maternal deaths caused by abortion complications.

Honduras. The Central American country has among the world’s strictest laws on abortion, which has been banned since 1985. In 2021, lawmakers enshrined the ban in the country’s constitution; now, any change to abortion law requires at least a three-quarters majority in the National Congress. UN experts estimate that between around fifty thousand and eighty thousand unsafe abortions take place in Honduras each year. Honduras’s neighbors El Salvador and Nicaragua also have prohibitions on abortion, and they are the only two countries to have imposed new restrictions on abortion since the 1994 Cairo Declaration, which recognized reproductive health as critical to development.

Poland . In 2020, Poland’s Constitutional Tribunal ruled that abortions in cases of fetal impairment are unconstitutional, making the country’s abortion law one of the strictest in Europe. Because the vast majority of abortions performed in Poland prior to the ruling were due to fetal abnormalities, the decision initiated a near-total ban. In response, hundreds of thousands of people took to the streets to protest the decision, though it remains in effect. Polish law still allows abortions in cases of rape, incest, and life-threatening pregnancies, though doctors have reportedly been reluctant to perform legal abortions since the ruling. Doctors face up to three years in prison if the government finds they performed an abortion hastily or without sufficient justification.

France . In 2024, France became the first country to enshrine abortion rights in its constitution. Abortion rights had been decriminalized in 1975 in a controversial act that legalized the procedure up to the tenth week of pregnancy. The gestational limit was extended to twelve weeks in 2001 and fourteen weeks in 2022. That same year, following the overturn of Roe v. Wade, the country sought to formally safeguard the law  with a constitutional amendment. Having passed through the National Assembly and Senate, the amended Article 34 now guarantees a woman’s freedom to have an abortion. Polls show that more than 80 percent of respondents endorsed this amendment.  

Editor’s note: This article is based on original reporting by Rachel B. Vogelstein and Rebecca Turkington that was previously published on CFR.org in 2019.

Noël James,   Haydn Welch, and Antonio Barreras Lozano contributed to this article. Will Merrow created the graphics.

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Answers to Common Questions About Abortion Access

Here are answers to some of the fundamental questions surrounding the Supreme Court’s decision to overturn Roe v. Wade.

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By The New York Times

The United States Supreme Court overruled the landmark Roe v. Wade case on June 24, eliminating the constitutional right to abortion in a monumental recasting of abortion laws.

The decision, which echoed a draft that was leaked in May , strikes down Roe’s standard, which did not allow states to ban the procedure before the point at which a fetus can survive outside the womb, which experts say is about 22 to 23 weeks of pregnancy .

The ruling has abolished the constitutional right to abortion and leaves each state to set its own abortion laws. More than a dozen Republican-led states have legislation in place that would outlaw abortion in most cases immediately, while some states where Democrats are in power have moved to retain and strengthen existing abortion rights or expand on them.

Here are answers to some of the fundamental questions surrounding the latest changes, including where abortion will become illegal and where it will remain accessible by law.

Where is abortion illegal now that Roe is overturned?

With the states now able to regulate abortion access, several states — Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Texas and Wisconsin — have prohibited abortion, and most of these states do not have exceptions for victims of rape and incest.

Another four states — Georgia, Ohio, Idaho and Tennessee — now ban abortion at six weeks of pregnancy, before most women know they are pregnant.

More bans are expected, and a tug of war over the future of abortion access is playing out in courts across the United States, adding to a legal landscape defined by uncertainty, confusion and rapid change. Tennessee and Idaho are expected this week to enact trigger laws that would prohibit all abortions with limited exceptions, though Idaho faces a legal challenge from the Biden administration. In North Dakota and Wyoming, judges temporarily blocked bans on nearly all abortions in each state.

— Claire Cain Miller and Margot Sanger-Katz

What states will retain or expand abortion access?

California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont and Washington, as well as the District of Columbia, have laws that preserve access to abortion, according to the Guttmacher Institute, a reproductive health research group that supports abortion rights.

Some states have also been positioning themselves as “refuges” for abortion rights, by offering support and legal aid to women who travel to their state for an abortion.

Gov. Gavin Newsom has said California would offer tax breaks to companies seeking to move from states where abortion may become illegal. In Oregon, the Legislature approved $15 million in March to help pay for abortion expenses for patients coming from outside the state. In New York, Democratic lawmakers have been working on a package of bills that would strengthen the state’s already robust abortion access laws. Some of those efforts have been focused on shielding providers from liability for patients coming from states where abortion has been criminalized. Others seek to help patients who travel to New York for reproductive health care.

— Fahima Haque

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What are the effects of new ‘trigger’ bans in Tennessee, Idaho and Texas?

Tennessee, Idaho and Texas began enforcing so-called trigger laws on Thursday, placing new restrictions on access to abortion for millions of women and in some cases adding punishments for doctors who perform the procedures.

The took effect weeks after the Supreme Court struck down the constitutional right to an abortion in June. But they are known as trigger laws as the states had each previously passed legislation explicitly intended to ban abortion in the event of the court overturning Roe v. Wade .

Similar laws in other states — like one in South Dakota — took effect immediately after the Supreme Court’s decision, but most required some sort of sign-off from state leaders, either from the attorney general or state lawmakers, or a combination of both.

In all, 13 states with Republican-led legislatures had passed some form of a trigger law, either to outlaw abortion entirely or to allow it only up to about six weeks gestation, a time at which many women do not know they are pregnant. In a few states, including North Dakota, Utah, and Wyoming, judges have blocked those bans.

Here are the states where new laws were set to take effect this week.

Shortly after the Supreme Court lifted the hurdle of Roe, a judge ruled that a 2020 Tennessee law prohibiting abortion after six weeks could take effect.

But the state also had a separate trigger law that prohibited abortion, with no exceptions for cases of rape or incest.

Both the six-week ban and the trigger law include an exemption for cases where the mother is in immediate danger of death or severe injury.

Abortion became illegal after six weeks in the state this month, when a law passed in April went into effect. But the state’s trigger law goes further, prohibiting all abortions, except to save the life of a pregnant woman — but not to protect her health — or in cases of rape or incest that were previously reported to the authorities.

Parts of Idaho’s trigger law faced a challenge from abortion advocates and the Justice Department. The lawsuit argued that the law would prevent emergency room doctors from performing abortions necessary to stabilize the health of women facing medical emergencies.

On Wednesday, Judge B. Lynn Winmill of the Federal District Court in Idaho ruled in favor of the Biden administration , temporarily blocking a part of the law that could have punished doctors in the state for acting to protect the health of endangered mothers.

But he emphasized the narrow scope of the decision, leaving intact most of the bill’s other provisions, which constitute a near-total prohibition on the procedure.

The Texas Supreme Court last month ruled that a 1925 law that banned abortion with no exceptions for rape or incest could take effect.

Even before that ruling resurrected the 20th-century law in Texas, the state enacted a six-week ban in 2021 by deputizing civilians with potential bounties of at least $10,000 to sue anyone who helped a woman get an abortion.

The state’s trigger law raises the penalties for abortion providers.

Under the new statute, anyone who provides or attempts to provide an abortion will face felony charges and fines of at least $100,000. There is a provision that allows doctors to perform abortions in a medical emergency, but states with similar medical exceptions have already struggled with a chilling effect on doctors who questioned whether they would face punishment if a patient did not meet the standard of a “medical emergency.”

North Dakota

A judge on Thursday granted a request for a preliminary injunction against North Dakota’s trigger ban, which would prohibit nearly all abortions and was scheduled to take effect Friday. It was the second time this month that a judge temporarily blocked the law after the state’s sole abortion provider filed a lawsuit.

Glenn Thrush contributed reporting.

How are gestational weeks calculated?

A current Texas law bans abortion after six weeks of pregnancy, and other states like Georgia, Ohio and South Carolina have passed legislation with the intent of prohibiting abortion after six weeks. These bills use the six-week mark as the point when an ultrasound may be able to detect the pulsing of what will become the fetus’s heart .

However, at six weeks many women have no idea they are pregnant.

Doctors measure the beginning of a pregnancy as being the first day of a woman’s last period. Why? They are tracking the length of pregnancy using a nearly 200-year-old calculation called Naegele’s Rule, named after Franz Karl Naegele, the German obstetrician who is credited with creating it in the 1800s.

The rule is somewhat confusing because conception usually does not occur until around 14 days after the first day of a woman’s period, assuming she has a 28-day cycle (which many women do not for a variety of reasons). The reason doctors still use the last menstrual cycle as a benchmark is because it is difficult to know exactly when the sperm fertilized the egg.

So when doctors say a woman is six weeks pregnant, it typically means the embryo started developing about four weeks earlier.

The heart, which can be seen flickering on an ultrasound, is still maturing and cannot be heard until several weeks later.

Perhaps this is the simplest way to say it: Six weeks pregnant is two weeks after a woman misses her period.

Is birth control still legal?

Yes, birth control remains legal everywhere in the United States, though several states allow doctors and pharmacists to refuse to prescribe or dispense contraceptives, according to the Guttmacher Institute. The Supreme Court decision overturning Roe v. Wade does not indicate that the court would revisit past decisions about birth control.

However, some legal experts have raised concerns that justices could apply the argument for overturning Roe to limiting access to contraceptives. As a result, those who support birth control access worry that legislators could use a ban on abortion to make birth control less available.

“We’ve seen folks falsely equating emergency contraceptives and IUDs with abortion,” said Mara Gandal-Powers, director of birth control access and senior counsel at the National Women’s Law Center. “That’s certainly something I’m concerned about.”

One concern that has been raised is whether laws, like one in Oklahoma, that ban abortion from the moment of fertilization would also outlaw intrauterine devices, or IUDs, which are designed to prevent fertilization but also can stop a fertilized egg from implanting in the uterus. (The Oklahoma law specifies that it does not apply to contraception, including Plan B or morning-after pills.)

The two forms of emergency contraception pills, Plan B and Ella, work in a different way to prevent fertilization from occurring. Both delay or prevent ovulation and allow sperm in the reproductive tract to die out.

— Dani Blum and Nicole Stock

Is it legal for women to travel out of state for an abortion?

There are currently no abortion bans that attempt to prosecute women who cross state lines to seek an abortion.

However, states could try in the future, said David Cohen, a law professor at Drexel University. “There is no guarantee that an aggressive prosecutor might try to stretch the law as much as they can.”

In his concurring opinion, Justice Brett Kavanaugh suggested that women who travel to neighboring states to receive an abortion would be protected by the constitutional right to interstate travel.

People who assist a woman seeking an abortion in a neighboring state could also be at risk of prosecution.

“It’s hard to tell at this point, but I think it’s likely that [the prosecutors] will go after the people that help the woman get the abortion,” Mr. Cohen said. “The person who drives them, the doctor who sees them.”

Both Texas and Oklahoma recently passed abortion bans that allow private citizens to sue people who perform abortions or who otherwise help someone get one.

Many organizations are still encouraging patients who cannot seek an abortion in their home state to travel across state lines to receive care, including a handful of companies that have pledged to cover travel expenses for employees who need abortions .

“People should travel, people should get care wherever they can,” said Mr. Cohen. “But it’s not a simple answer.”

Are abortion medications delivered by mail illegal?

It is still legal in most states to receive abortion medication by mail, which has been allowed since December 2021, when the Food and Drug Administration lifted a restriction that required patients to obtain the pills from a certified provider.

There are 19 states that had already prohibited the use of telehealth to prescribe abortion medication by requiring prescribers to be present when the drugs are administered.

The Guttmacher Institute, a research organization that supports abortion rights, found that in 2020, medication abortion — a two-pill regimen of mifepristone and misoprostol — accounted for over half of all abortions.

The end of Roe v. Wade will make little immediate difference on access to these medications, though legal experts say that could change as more trigger laws are certified.

Some telemedicine companies are bracing for anti-abortion trigger laws to take effect, but vow to continue mailing medication in the interim.

Dr. Julie Amaon, medical director of Just The Pill, a company that delivers abortion medication to people in Wyoming, Montana, Colorado, and Minnesota, said they will continue to serve clients in all four states until Wyoming’s trigger law is certified. If that happens, their clients in Wyoming will need to travel to receive care.

“The way it will work is if your state of residence bans access to medication abortion, you can travel to another safe state to have a telehealth appointment,” Dr. Amaon said. “You would then get the medication by pick-up at our mobile clinic or if you are in a state without mobile clinics, you would wait 1-2 days to have the medication mailed to a pick-up location.”

Aid Access, a European service that has continued to send pills to women in the U.S. regardless of the laws in their state, is likely to be unaffected by the recent decision. Anti-abortion lawmakers are generally wary of punishing individuals seeking an abortion, said Mary Zeigler, a law professor at University of California Davis. They tend to focus on clinicians and prescribers who aid the patient seeking an abortion, but overseas providers operate in extralegal channels outside the reach of state lawmakers.

“There’s not going to be an easy enforcement mechanism there,” said Ms. Ziegler “But it’s worth emphasizing, whatever answers I’m giving for today, may not be true tomorrow, the bans are just the tip of the iceberg.”

Will the decision change how ectopic pregnancy is treated?

Women’s health care providers say the ruling has raised questions about their ability to treat ectopic pregnancy, a life-threatening complication that occurs when a fertilized egg implants in the wrong place in a woman’s body instead of attaching to the lining of the uterus.

More than 90 percent of the time, in an ectopic pregnancy, the fertilized egg implants in one of a woman’s fallopian tubes, which connect the ovaries to the uterus. The fallopian tubes are thin and full of blood vessels. If they burst open, as can happen when a fertilized egg grows in the tube, that can cause major internal bleeding and put a woman’s life at risk.

Ectopic pregnancies are never viable, as a fertilized egg cannot survive outside of the uterus. In rare cases, the body will expel an ectopic pregnancy on its own. But for the vast majority of women, the only options are medication to remove the pregnancy or surgery.

The 13 states with abortion trigger laws that took effect after the Supreme Court’s decision, or soon will, allow exemptions if an abortion is needed to prevent a pregnant woman from dying. But the American College of Obstetricians and Gynecologists has warned that abortion bans — even those with an exception for ectopic pregnancies — can create confusion and impede a patient’s timely access to care.

— Catherine Pearson

I’m covered by my employer’s plan. Will my benefits change with the end of Roe?

That will depend on where you live, the type of insurance plan your employer uses and their stance on coverage.

Basically, if a company pays for its employees’ health care from its own coffers, workers, even those in states where abortion is illegal, may have broader access to benefits. But employers that buy insurance policies for workers could be further restricted.

Large employers are often self-insured , which means they collect a share of their workers’ premiums and pay for their health care (though an insurer or administrator usually processes claims). These plans generally follow federal rules under the Employee Retirement Income Security Act of 1974, known as ERISA , which provide broad flexibility in designing a health care plan.

Other employers buy insurance on behalf of their workers, and the insurer is responsible for costs. Health insurers are regulated by the states and must follow their rules — if abortion is banned there, you’re unlikely to receive any coverage, even if you travel out of state.

Many larger employers are providing travel benefits for workers who would need to cross state lines for abortion. This is often an extension of existing policies. Typically these plans have offered travel benefits for people seeking cancer treatments, transplants or other specialized therapies if they don’t have access to a provider in their state or have to travel a certain number of miles to reach one, benefits lawyers said.

But there are still concerns about employers’ criminal and civil liability, particularly in states with laws that would call for criminal prosecution of anyone in the state who “aids and abets” an abortion, even if it occurs in another state where abortion is legal.

Health plans governed by federal ERISA regulations may have additional protections against legal actions brought under state law, benefits experts said, as long as the services are legal in the state where they are provided. Benefits lawyers also point to Justice Brett Kavanaugh’s concurrence in Dobbs, in which he said states with abortion bans could not stop women from seeking the procedure elsewhere. But while ERISA regulations often supersede state laws that may apply to plans, that doesn’t extend to state criminal laws.

“This issue will likely be the subject of continuing litigation and debate,” according to the reproductive rights task force at Morgan Lewis, a law firm in Washington.

Can marketplace insurance plans still cover abortion?

The health insurance marketplace created under the Affordable Care Act has restrictions that are similar to those on Medicaid. Plans offered within the marketplace are not required to cover abortion, and federal money — including premium subsidies in the form of tax credits — cannot be used to pay for them. Here, too, there are exceptions for rape, incest and life endangerment, but they are not universal.

There are 26 states that ban marketplace plan coverage of abortions, said Alina Salganicoff , director of women’s health policy at Kaiser . But a few states don’t make exceptions for rape or incest, and some states make no exceptions at all, she added.

In contrast, insurers in seven states are required to include abortion coverage in all plans sold on the marketplace, according to Kaiser, but no federal dollars are used.

For example, in states like New York , where abortion is legal under state law, policy holders with subsidized marketplace plans have $1 of their monthly premium held separately to be used for abortion and other services.

But if an individual with a marketplace plan lives in a state where abortion is banned, it’s likely their policy won’t provide coverage in their own state or across state lines.

— Tara Siegel Bernard

Will Medicaid cover abortion following the Dobbs decision?

Just like before the ruling, that largely depends on where you live.

Medicaid, a public health program largely for low-income households that is administered by the states, is financed by federal and state money. Even before the Dobbs decision, federal law — known as the Hyde Amendment — didn’t allow federal funds to pay for abortions, except in limited circumstances: if the pregnancy was the result of rape or incest or caused a life-endangering condition for the woman. States could choose to use their own money to pay for abortions beyond those situations, and 16 states had such policies last year, according to the Kaiser Family Foundation (though nine were ordered by courts to have them).

The vast majority of states don’t pay for anything beyond those limited circumstances — and South Dakota, in violation of federal law, covers abortions only in the case of life endangerment, according to a 2019 study by the Government Accountability Office.

Like South Dakota, a growing list of states that ban abortions — including Alabama, Arkansas, Louisiana and Missouri — make exceptions only when the woman’s life is endangered. That puts them in conflict with federal law that also requires abortion coverage in cases of rape or incest.

The Centers for Medicare & Medicaid Services said it would notify states when they were out of compliance with federal requirements, and added that the Department of Health and Human Services was taking steps to expand access to medication abortion in those limited circumstances. Details on how that will happen are still vague .

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Reproductive rights in America

7 persistent claims about abortion, fact-checked.

Jaclyn Diaz

Koko Nakajima

Nick Underwood

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5. Jim Watson/AFP via Getty Images hide caption

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5.

Since the Supreme Court's 1973 Roe v. Wade decision ruled that women have a constitutional right to end their pregnancies, proponents and opponents of abortion rights have worked to own the conversation over the issue.

In 2019, the Centers for Disease Control and Prevention reported that 629,898 legal induced abortions were reported across the United States.

Lingering claims circulate about abortion, including about the safety of it, who gets abortions and even who supports or opposes access to abortion.

Below, seven popular claims surrounding abortion get fact-checked.

According to the Pew Research Center's polls , 37% of Americans want abortion illegal in all or most cases.

But an even bigger fraction — around 6 in 10 Americans — think abortion should be legal in all or most cases.

Current abortion rates are lower than what they were in 1973 and are now less than half what they were at their peak in the early 1980s, according to the Guttmacher Institute , a reproductive health research organization that supports abortion rights.

In 2017, pregnancy rates for females age 24 or below hit their lowest recorded levels, reflecting a long-term decline in pregnancy rates among females 24 or below.

Overall, in 2017, pregnancy rates for females of reproductive age hit their lowest recorded levels, with 87 pregnancies per 1,000 females ages 15 to 44, according to the Guttmacher Institute.

The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973, according to the CDC.

An analysis of data from 2013 to 2018 showed the national case-fatality rate for legal induced abortion was 0.41 deaths per 100,000 legal induced abortions, lower than in the previous five years.

The World Health Organization said people obtaining unsafe abortions are at a higher risk of death. Annually, 4.7% to 13.2% "of maternal deaths can be attributed to unsafe abortion," the WHO said. In developing regions of the world, there are 220 deaths per 100,000 unsafe abortions.

Trans and nonbinary people have undergone abortions as well.

The Guttmacher Institute estimates in 2017 an estimated 462 to 530 transgender or nonbinary individuals in the U.S. had abortions. That same year, the CDC said, 609,095 total abortions were carried out in the country.

The Abortion Out Loud campaign has collected stories from thousands of people who have had an abortion. Included are stories from trans and nonbinary people who have had an abortion — such as Jae, who spoke their experience.

"Most abortions in 2019 took place early in gestation," according to the CDC . Nearly 93% of abortions were performed at less than 13 weeks' gestation.

Abortion pills, which can typically be used up to 10 weeks into a pregnancy, made up 54% of abortions in 2020. These pills were the primary choice in the U.S. for the first time since the Food and Drug Administration approved the abortion drug mifepristone more than 20 years ago.

State legislatures have been moving to adopt 20-week abortion bans, with abortion opponents claiming fetuses can feel pain at that point. Roughly a third of states have implemented an abortion ban around 20 weeks .

But this contradicts widely accepted medical research from 2005. This study , published in the Journal of the American Medical Association , concluded that a fetus is not capable of experiencing pain until somewhere between 29 or 30 weeks.

Researchers wrote that fetal awareness of pain requires "functional thalamocortical connections." Those thalamocortical fibers begin appearing between 23 and 30 weeks' gestational age, but the capacity for pain perception comes later.

The argument against abortion has frequently been based on religion.

Data shows that the majority of people who get an abortion have some sort of religious affiliation, according to the most recent Guttmacher Institute data , from 2014.

The Pew Research Center also shows that attitudes on whether abortion should be legal vary among evangelical Protestants, mainline Protestants and Catholics.

Roe v. Wade and the future of reproductive rights in America

Here's what could happen now that roe v. wade is overturned.

• Supreme Court
• Roe v. Wade

After Roe Fell: Abortion Laws by State

In June 2022, the U.S. Supreme Court overturned Roe v. Wade , opening the door for states to ban abortion outright. Since the decision, 14 states have made abortion illegal.

“After Roe Fell: Abortion Laws by State” examines laws, constitutions, and court decisions on abortion—and assigns each state, territory, and the District of Columbia to one of five categories: Expanded Access, Protected, Not Protected, Hostile, and Illegal. Click through this tool to learn about all the bans and restrictions currently on the books in each state. This tool is updated in real time.

With the overturn of Roe v. Wade by the U.S. Supreme Court in June 2022, abortion policies and reproductive rights are in the hands of each state.

Use this map to explore the breakdown of abortion laws by state in real-time–and understand abortion bans, types of abortion restrictions, what trigger bans are, and more.

Understanding Abortion Bans

Pre- roe bans.

Most states repealed abortion bans in effect as of 1973 once Roe made them unenforceable. However, some states and territories never repealed their pre-Roe abortion bans. Now that the Supreme Court has overturned Roe, these states could try and revive these bans.

Trigger bans

Abortion bans passed since Roe was decided that are intended to ban abortion entirely if the Supreme Court limited or overturned Roe or if a federal Constitutional amendment prohibited abortion.

Pre-viability gestational bans

Laws that prohibit abortion before viability; these laws were unconstitutional under Roe . Gestational age is counted in weeks either from the last menstrual cycle (LMP) or from fertilization.

Method bans

Laws that prohibit a specific method of abortion care, most commonly dilation and extraction (D&X) procedures and dilation and evacuation (D&E) procedures.

Reason bans

Criminalization of self-managed abortion (sma).

Some states criminalize people who self-manage their abortion, i.e., end their pregnancies outside of a health care setting.

SB-8 Copycats

Laws that are modeled after Texas SB 8, the vigilante law that took effect in September 2021. These laws ban abortion at an early gestational age and are enforced through private rights of action, which authorizes members of the public to sue abortion providers and people who help others access abortion care.

Types of Abortion Restrictions

Targeted regulation of abortion providers ( trap).

TRAP laws fall into several categories, including regulation of locations where abortion is provided and/or facility specifications, provider qualifications, and reporting requirements. Compliance is often costly and can require unnecessary facility modifications.

Parental involvement

Laws that require providers or clinics to notify parents or legal guardians of young peoples seeking abortion prior to an abortion (parental notification) or document parents’ or legal guardians’ consent to a young person’s abortion (parental consent).

Consent laws

Laws that require pregnant people to receive biased and often inaccurate counseling or an ultrasound prior to receiving abortion care, and, in some instances, to wait a specified amount of time between the counseling and/or ultrasound and the abortion care. These laws serve no medical purpose but, instead, seek to dissuade pregnant people from exercising bodily autonomy.

Hyde Amendment

In 1976, Rep. Henry Hyde (R-IL) successfully introduced a budget rider, known as the Hyde Amendment, that prohibits federal funding for abortion. Congress has renewed the Hyde Amendment every year since its introduction.

Abortion Protections

Statutory protections for abortion.

Laws passed by states that protect the right to abortion.

State constitutional protection

A declaration from the state’s highest court affirming that the state constitution protects the right to abortion, separately and apart from the existence of any federal constitutional right.

Abortion Access

Public funding.

States are required to provide public funding through the state Medicaid program for abortion care necessitated by life endangerment, rape, or incest. States can also dedicate state-only funding to cover all or most medically necessary abortion care for Medicaid recipients.

Private insurance requirements

States can require private health-insurance plans that are regulated by the state to contain specific benefits, including abortion coverage.

Clinic safety and access

Laws that prohibit, for example, the physical obstruction of clinics, threats to providers or patients, trespassing, and telephone harassment of the clinic, and/or create a protected zone around the clinic.

Abortion Provider Qualifications

Interstate shield.

States hostile to abortion have made it clear that they want to prohibit abortion entirely, both inside and outside of their borders. Interstate shield laws protect abortion providers and helpers in states where abortion is protected and accessible from civil and criminal consequences stemming from abortion care provided to an out-of-state resident.

A law has been enacted, and the effective date in the legislation has passed.

The state cannot enforce a law that would otherwise be effective because of the decision by a court to temporarily or permanently enjoin its enforcement.

Project Summary

Initially, this tool provided an overview of what could happen to abortion rights in the fifty states, the District of Columbia, and the five most populous U.S. territories if the U.S. Supreme Court were to limit or overturn  Roe v. Wade , the landmark Supreme Court ruling from 1973 that established abortion as a fundamental right. Now rebranded as U.S. Abortion Laws by state, this digital tool describes the abortion policy of the U.S. states, the District of Columbia, and the five most populous  U.S. territories, which requires careful legal analysis of constitutions, laws, regulations, and court decisions. This online tool charts how these governments are responding to the reversal of  Roe . 

Methodology

To determine into which category to place each state, D.C., and the U.S. territories, we first examined whether the right to abortion is protected under state, territory, or D.C. law (“Protected”); if it is, we looked to see whether the state, territory, or District of Columbia enacted laws or policies that enhanced access to abortion care (“Enhanced Access”). If abortion is not protected by state or territory law (“Not Protected”), we then looked to see if the government enacted laws or policies to restrict or prohibit access to abortion care (“Hostile”). Finally, we examined states that have criminalized abortion and prohibited it entirely (“Illegal”). Based on our analysis, we then placed each state, territory, and the District of Columbia into one of these five categories, which exist along a spectrum from “Expanded Access” to “Protected” to “Not Protected” to “Hostile” and, finally, to “Illegal.”

The laws and policies identified as creating enhanced access to abortion include public funding and the requirement that abortion be included in private insurance coverage, unrestricted access for young people, the breadth of health-care practitioners who provide abortion care, and protections for clinic safety and access. We assessed hostility and illegality based on abortion bans (pre- Roe , trigger, gestational, reason, method, SB8 copycats, and criminalization of self-managed abortion) and abortion restrictions (TRAP, parental involvement, consent, and physician-only laws). While these bans and restrictions generally have exceptions, this tool does not list them in detail because those exceptions do not provide meaningful access and usually are difficult to utilize. Unless otherwise noted, all bans and restrictions discussed are in effect.

Today, abortion is protected by state law in 21 states and the District of Columbia and is at risk of being severely limited or prohibited in twenty-six states and three territories.

States Where Abortion Is Protected

Expanded access.

The “Expanded Access” category means that the right to abortion is protected by state statutes or state constitutions, and other laws and policies have created additional access to abortion care.

Moving across the spectrum, the “Protected” category means that the right to abortion is protected by state law but there are limitations on access to care

States Where Abortion Is Not Protected

Not protected.

The “Not Protected” category means that abortion may continue to be accessible in these states and territories, but would be unprotected by state and territory law. In some of these states, it is unclear whether the legislature would enact a ban now that Roe has been overturned, but concern is warranted.

The “Hostile” category means that these states and territories have expressed a desire to prohibit abortion entirely. These states and territories are extremely vulnerable to the revival of old abortion bans or the enactment of new ones, and none of them has legal protections for abortion.

Finally, after the Supreme Court overruled Roe v. Wade , states that ban abortion entirely and enforce those bans through criminal penalties are characterized as “Illegal.”

What Did Roe v. Wade Protect Besides Abortion?

Since Roe, the Supreme Court has repeatedly reaffirmed that the Constitution protects for abortion as an essential liberty, which is tied to other liberty rights to make personal decisions about family, relationships, and bodily autonomy. It’s important to understand all of the Rights the Roe v. Wade had protected before it was recently overturned.

Roe v. Wade was Overturned and Reproductive Rights are At Risk

By overturning Roe v. Wade , which for nearly 50 years protected the federal Constitutional right to abortion, the the Supreme Court gave states total leeway to restrict abortion or prohibit it all together. Almost half the states are likely to enact new laws as restrictive as possible or seek to enforce current, unconstitutional laws prohibiting abortion. We are seeing states divide into abortion deserts, where it is illegal to access care, and abortion havens, where care continues to be available. Millions of people living in abortion deserts, mainly in the South and Midwest, are forced to travel to receive legal care, which results in many people simply being unable to access abortion for a variety of financial and logistical reasons. It is critical that “Not Protected” states create a state right to abortion, and that the “Protected” states enact laws and policies that move them into “Expanded Access.”

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Abortion in America, explained in 10 facts

As anti-abortion laws sweep the country, a lot of people have questions. Here are some answers.

by Anna North

Four states have passed “heartbeat” bills this year alone, banning abortion as early as six weeks into pregnancy. Alabama just passed a near-total ban on abortion at any stage of pregnancy, with no exceptions for rape or incest.

And on Thursday, Missouri moved a step closer to passing a ban on abortion at eight weeks’ gestation, also without exceptions for rape or incest — the bill passed the state Senate and now returns to the House for approval.

As legislation to restrict abortion moves forward around the country, many Americans have questions about the procedure. Some wonder whether abortion is still legal (it is, in every state in the country), whether it’s on the rise (it’s not), and how recently passed laws around the country would affect patients (the answers vary by state).

To help answer these questions and more, below are 10 facts that paint a picture of abortion in America today.

1) Abortion is at an all-time low

Given recent efforts by lawmakers to restrict abortion, you might think the procedure was on the rise. In fact, it’s less common than ever before, as Sarah Kliff reported at Vox last December .

Between 2006 and 2015, the American abortion rate declined 26 percent to the lowest level on record, according to the Centers for Disease Control and Prevention .

The biggest reason for the drop, experts say, isn’t tougher abortion laws — it’s better access to contraception.

“When contraceptives aren’t available, women use abortion, even if it isn’t legally sanctioned and even if it puts them at great physical risk,” Diana Greene Foster, an associate professor at University of California San Francisco who studies abortion, told Kliff in 2016 . “When contraceptives are more available, use of abortion declines.”

The recent decline in abortions may have to do, in particular, with long-acting, reversible contraceptives like IUDs, which work for years without the need to take a pill every day. In 2012, the Affordable Care Act made these forms of birth control, which can have a high upfront cost, more accessible by requiring that most employer-provided insurance plans cover them without a copay. But, as Kliff reports, Americans were already moving toward these methods — and possibly as a result, the proportion of pregnancies that were unintended dropped from 51 to 45 percent between 2008 and 2011.

2) Abortion is still common

Even though the abortion rate has declined, the procedure remains commonplace. According to a 2017 analysis by the Guttmacher Institute , 23.7 percent of women in the United States will have an abortion by the age of 45. Nineteen percent will have one by age 30, and 4.6 percent will have one by age 20.

3) Most people who have abortions already have kids

Pop-culture depictions of abortion, from the 2014 romantic comedy Obvious Child to the 2019 anti-abortion biopic Unplanned , typically feature a single, childless woman undergoing the procedure. The decision is often framed as a choice between having an abortion or becoming a parent.

But in fact, the majority of people who have abortions are already parents. As of 2014, 59 percent of people who had abortions had already given birth to at least one child, according to Guttmacher .

And while abortion is often discussed in the context of teen pregnancy, the majority of abortion patients in 2014 — 60 percent — were in their 20s. Another 25 percent were in their 30s and fewer than 4 percent were under 18.

People who get abortions are disproportionately likely to have low incomes — in 2014, 49 percent had family incomes below the poverty line.

And although religious groups have been some of the most vocal anti-abortion advocates in America, the majority of people who got abortions in 2014 identified as religious, with 17 percent listing themselves as mainline Protestant, 13 percent as evangelical, and 24 percent as Roman Catholic. The abortion rate among Catholic women was about the same as the national average, while among evangelical women it was about half the national average.

4) Four states have passed “heartbeat” bills in 2019, and Alabama just passed an even stricter law

A wave of “heartbeat” bills , which ban abortion once a fetal heartbeat can be detected, has been sweeping the country in recent months. These bills ban the procedure as early as six weeks into pregnancy, before many people know they are pregnant.

The first one passed in North Dakota in 2013, but they began gaining steam last year, with Iowa passing its version in May. This year, Kentucky, Mississippi, Ohio, and Georgia have all passed heartbeat bills. Some of these have exceptions for cases of rape or incest; others do not.

On Wednesday, Alabama Gov. Kay Ivey signed into law an even more restrictive bill, which bans abortion at any stage of pregnancy, with no exceptions for rape or incest. Under the law, which is scheduled to take effect in six months, abortion would only be legal if the pregnant person’s life is at risk.

Meanwhile, the Missouri state Senate on Thursday passed a bill banning abortion at eight weeks’ gestation, with no exceptions for rape or incest. Under the bill, which now goes back to the state House, abortion would only be legal in cases of medical emergency.

5) None of these laws are in effect yet

The heartbeat laws passed around the country have all either been challenged in court or are likely to be challenged soon. None has yet taken effect. The Alabama law has not taken effect yet either, and is likely to be challenged too.

Abortion is currently legal in all 50 states.

6) If it does take effect, the Georgia law could have an impact on people who miscarry

The Georgia “heartbeat” law, in particular, generated concern among many after Mark Joseph Stern of Slate reported that it could be used to prosecute women who seek abortions or who have a miscarriage.

At this point, reproductive rights advocates say they’re not sure if the law would ever be used in this way.

“It seems to be a stretch to what’s actually in the law and I’m really confused as to whether or not this would be possible,” Elizabeth Nash, the senior state issues manager at the Guttmacher Institute, told Vox .

Some of the confusion may stem from the way the Georgia law and others like it are written. “These are not particularly clearly drafted laws,” Mary Ziegler, a law professor at Florida State University who studies the history of the abortion debate, told Vox. “Really the rub is going to be in how these are enforced.”

If the Georgia law does go into effect, it’s more likely that a person who miscarries would be pulled into a criminal investigation of a doctor or other provider, rather than that she would face criminal charges herself, Staci Fox, president of Planned Parenthood Southeast, told the Washington Post .

The symptoms of a miscarriage can be indistinguishable from those of an induced abortion, according to OB-GYN Dr. Jen Gunter . Miscarriages are extremely common, occurring in about 10 percent of recognized pregnancies, as pediatrics professor Aaron E. Carroll writes at the New York Times .

7) Many of the recently passed abortion laws are aimed at overturning Roe v. Wade

Sponsors of several recently passed abortion restrictions have said that part of their goal is to challenge Roe v. Wade , the 1973 Supreme Court decision that established that Americans have the right to obtain an abortion . Since the “heartbeat” bills and the Alabama law all ban abortion long before viability, they are in clear conflict with Roe . They either have been or will be challenged in court, and the cases could make it all the way to the Supreme Court, giving the Court a chance to revisit and possibly overturn Roe .

Alabama state Rep. Terri Collins, the sponsor of her state’s recently passed abortion law, has said this is her goal. “What I’m trying to do here is get this case in front of the Supreme Court so Roe v. Wade can be overturned,” she told the Washington Post .

It may not work. Because the Alabama law lacks exceptions for rape and incest, it is so controversial that the Supreme Court may not want to weigh in on it. However, there are more than a dozen cases involving abortion already one step away from the Supreme Court, and the Court could choose to use any one of them to reexamine Roe. So even if the Alabama law or the “heartbeat” bills don’t end up toppling the landmark abortion decision, something else might.

8) Some recently passed or proposed bills loosen restrictions on abortion

As abortion opponents back increasingly restrictive laws at the state level, abortion-rights advocates have been supporting legislation to loosen abortion restrictions and shore up abortion access. In part, they’re preparing for the possibility that Roe v. Wade could be overturned, giving states the right to regulate abortion as they see fit. Abortion-rights supporters want states to pass laws protecting abortion so that if Roe falls, residents of those states will still have access to the procedure.

One recent example is New York’s Reproductive Health Act , which passed in January. Among other provisions, the law allows abortions after 24 weeks if the fetus is non-viable or if there is a risk to the patient’s health. Previously, most abortions after 24 weeks had been banned in New York.

Another recent effort to loosen restrictions happened in Virginia , where state legislators proposed a bill that would have broadened the circumstances under which someone could get an abortion in the third trimester of pregnancy. That bill was eventually tabled after sparking nationwide controversy, which started when the bill’s sponsor said in a hearing that the bill would allow an abortion if a patient was going into labor.

The sponsor later said that she misspoke, and Dr. Kristyn Brandi, an OB-GYN and board member of Physicians for Reproductive Health, told Vox , “patients do not request abortion when they are in labor and doctors do not provide it.”

But controversy around the bill continued when Virginia Gov. Ralph Northam , asked about the bill during a radio interview, said that if a mother was in labor, “the infant would be delivered. The infant would be kept comfortable. The infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother.”

Some took these comments as an endorsement of infanticide. A spokesperson for the governor said he was “absolutely not” referring to infanticide, but his comments led President Trump and others to claim, repeatedly, that doctors in America are killing babies after birth and that legislation is needed to stop it .

9) Abortion laws do not allow infants to be killed after birth

In reality, no abortion law — not the Virginia bill, the New York law, or any other — allows doctors to kill babies after they are born. This is already illegal everywhere in the United States.

10) The majority of abortions happen early in pregnancy

Though much conversation recently has focused on abortions that happen later in pregnancy (“late-term abortion” is not a medically accurate phrase ), more than 90 percent of abortions happen within the first trimester, or about the first three months.

Only 1.4 percent of abortions happen at 21 weeks’ gestation or later, according to Planned Parenthood .

Patients who seek abortion later in pregnancy may have recently found out about a serious fetal abnormality, some of which are not discovered until 20 weeks or later. Others may have had trouble getting to a clinic.

“I’m at a center where I’m the referral center for the state, and so patients that are seeking care elsewhere may get referred to me and I’m often hours away from where they initially sought care,” Brandi explained to Vox earlier this year. “So it takes a while for them to get up to see me, and that includes not just the time it takes to come up here but also making sure they have child care for the children they already have, getting transportation. There’s so many different types of barriers that are created for health care in general, but specifically abortion care.”

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Five myths about abortion in the US

Subscribe to governance weekly, isabel v. sawhill and isabel v. sawhill senior fellow emeritus - economic studies , center for economic security and opportunity kai smith kai smith research assistant - the brookings institution, economic studies.

September 27, 2024

• Voters nationwide and in battleground states consider abortion to be one of the most important issues in this election.
• So-called “late-term abortions” performed at or after 21 weeks of pregnancy are extremely uncommon and represent less than 1% of all abortions in the U.S.
• Federal authorities have documented dozens of cases where pregnant women have been refused emergency medical treatment because doctors in ban states fear criminal prosecution.

In November, voters in at least 10 states will vote on ballot initiatives seeking to enshrine abortion rights in their state constitutions. Voters nationwide and in battleground states consider abortion to be one of the most important issues in this election.   

For this and other reasons, it is critical that the public be informed about the issue. Here are five myths about abortion in America, compared to the reality.   

MYTH #1: Many women are having abortions in the third trimester of pregnancy, including in the ninth month or later.   

REALITY : The vast majority of abortions (93%) occur in the first trimester of pregnancy, according to the Center for Disease Control (CDC) . So-called “late-term abortions” performed at or after 21 weeks of pregnancy are extremely uncommon and represent less than 1% of all abortions in the U.S. They generally occur because of the discovery of a fatal condition affecting the fetus or serious risks to the life or health of the mother. The claim that abortions happen “moments before birth” or even “after birth” is false. In no state is it legal to kill a baby after it has been born.   

MYTH #2: The overturning of Roe v. Wade has led to fewer abortions. 

REALITY : The number of abortions that occurred in the U.S. increased by 11% in 2023, the first full year since the Supreme Court overturned Roe v. Wade , compared with 2020 levels. This increase was driven primarily by the greater availability of medication abortion pills and privately financed funds that supported women seeking abortions.  

MYTH #3: Because abortion totals have not declined, women cannot have been harmed by abortion bans and restrictions. 

REALITY : Although many women living in states with abortion bans have been able to circumvent those bans by traveling to another state or by obtaining medication abortion pills using telehealth and the mail, others have not been so lucky. So even though abortion rates have increased, on balance, it’s still the case that many women who wanted abortions have been unable to get them . 

In addition, abortion restrictions are putting women’s lives and health at risk. The same procedures used for terminating unintended pregnancies are also essential for addressing a number of other situations, including miscarriages, ectopic pregnancies, and severe fetal abnormalities.  

Federal authorities have documented dozens of cases where pregnant women have been refused emergency medical treatment because doctors in ban states fear criminal prosecution. This has resulted in women having miscarriages in public restrooms, bleeding out in their cars, or experiencing delays in receiving care that have led them to develop infections or sustain bodily harm.  

Already, a woman in Georgia named Amber Thurman has died from infection after doctors delayed performing a routine procedure out of fear of criminal liability under the state’s abortion ban. The state’s maternal mortality review committee called Thurman’s death “preventable” and said the delay in care had a “large” impact in causing her death. Other similarly tragic stories are sure to emerge once state review committees begin to publicize their findings, which operate with a lag.  

MYTH #4: Depending on who is elected, there will be a federal law either banning or legalizing abortion nationwide.

REALITY : It is highly unlikely the election will change the composition of Congress enough to give either party sufficient votes to pass a federal law either banning or legalizing abortion nationwide.

Vice President Harris has consistently supported abortion rights over the course of her political career . As the Democratic presidential nominee, Harris has said she supports legislation that would restore the protections established by Roe v. Wade . She has not answered the question about whether she opposes any restrictions on abortion. Under Roe v. Wade , states could only restrict abortion after the point of fetal viability, or about 22 weeks of pregnancy, except in cases where abortions were necessary to protect the life or health of the pregnant person.

Former President Trump’s position on a national abortion ban has wavered significantly over time. As president, Trump supported a 2018 bill that would have banned abortion after 20 weeks of pregnancy nationwide. Earlier this year, Trump signaled support for a 16-week and then a 15-week abortion ban. His current position is that the legality of abortion should be left to the states. During the presidential debate against Vice President Harris, Trump declined to say whether he would veto a national ban if he were reelected.

To enact legislation that would protect or ban abortion nationwide, the party that won the presidency would also need to secure majorities in both the House and Senate. All three are shaping up to be tight races. Because it is highly unlikely either party will secure sufficient support in this election, including the 60 votes needed to overcome the Senate filibuster , neither will be able to pass a federal law codifying abortion policy nationwide. This means those in favor of protecting reproductive rights need to do so through the kind of measures that will be on the ballot in many states. 

MYTH #5: Women living in states where abortion is legal will not be affected by the outcome of the 2024 election.

REALITY: Federal regulation, largely determined by executive agencies operating under the authority of the president, plays a major role in determining access to abortion.

In recent years, the Food and Drug Administration (FDA) has made multiple revisions to its policy toward mifepristone (one of the two drugs used in medication abortion) that have made medication abortion far more accessible. These pills are now widely used , accounting for nearly two-thirds of all abortions nationwide.

If Trump were reelected, he could limit the use of these abortion pills by appointing a new head of the FDA or Health and Human Services (HHS) who could reverse the FDA’s revised policies toward mifepristone or override the agency’s approval of the drug completely.

Trump could also direct the Department of Justice (DOJ) to enforce a 151-year-old federal law known as the Comstock Act that bans the shipment of abortion-related materials. In 2022, the DOJ under the Biden-Harris administration issued a legal opinion stating that the Comstock Act does not prohibit the mailing of abortion drugs even to recipients in states where abortion is banned. Trump could direct the DOJ to reverse this position to instead outlaw and prosecute the interstate shipment of abortion pills, or other materials related to abortion.

The Heritage Foundation, as part of its Project 2025 initiative, has called for a potential future Trump administration to end medication abortion and prosecute those who ship and transport abortion pills and supplies using these strategies . As Jonathan Mitchell, an anti-abortion advocate and key architect of Project 2025, said to the New York Times, “We don’t need a federal ban when we have Comstock on the books.” Trump has sought to distance himself from the Project 2025 plan whose authors include many former members of his administration.

When asked about these issues during a news conference at Mar-a-Lago in August, Trump said he was receptive to using his authority as president to revoke access to abortion pills. A couple of weeks later, Trump said that he “generally speaking would not” use the Comstock Act to outlaw the shipment of abortion pills.

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Pope Francis praises late Belgian king for abdicating rather than signing abortion law

BRUSSELS (CNS) —Every crisis, including what the Catholic Church can experience when people no longer care about religion or have distanced themselves from the faith, is meant to wake Christians up from their slumber, make them ask questions and to change, Pope Francis told bishops, priests, religious and pastoral workers.

Increased secularization means that “we have moved from a Christianity located within a welcoming social framework to a 'minority' Christianity, or better, a Christianity of witness,” he said during a meeting with some 2,600 churchworkers in the city's Basilica of the Sacred Heart Sept. 28.

“The changes in our time and the crisis of faith we are experiencing in the West have impelled us to return to what is essential, namely the Gospel,” he said, and to share the true joy that comes from being close to God and the mercy that he always shows his children.

On his second full day in Belgium, the pope also stopped at the Church of Our Lady of Laeken to pray before the tomb of King Baudouin of Belgium, who abdicated his throne for a day so he did not have to give his assent to a bill Parliament passed in 1990 legalizing abortion.

In the presence of the late king's nephew, the current King Philippe, and others, the pope praised King Baudouin's courage to step down to “not sign a murderous law,” according to a statement from the Holy See press office.

The pope urged today's Belgians to look to their late leader at a time when “criminal laws” are making headway, the press office said, adding that he hoped the late king would someday be considered a candidate for sainthood.

The pope began the day by visiting the parish of St. Gilles, which offers free breakfast to those living on the streets and to migrants. Over coffee and croissants, the pope thanked the 10 people gathered around the table for their generosity and charity.

Charity, which is love, “is a fire that warms the heart and there is no woman or man on earth who does not need its warmth,” he said.

Parishioners also gave the pope a small case of their own homebrewed beer. “I imagine it is very good beer,” he told them.

The main event of the morning was his meeting with bishops, priests, deacons, religious, seminarians and pastoral workers at the city's immense basilica.

Greeted with great enthusiasm, the pope heard testimonies from several people including Yaninka, a young woman who asked how so many young people with vastly different dreams and hopes for the church could be united in the faith, and Mia, a woman who works at a center that welcomes and assists victims of sex abuse.

The pope told Yaninka that “when we share the Gospel the Lord opens our hearts to encounter those who are different from us. It is good, indeed necessary, that there are different dreams and spiritualities among young people.”

“There can be many personal or community paths, yet leading us toward the same goal, to encounter the Lord. There is room for everyone, everyone, everyone in the church and no one should be a mere copy of anyone else,” he said.

It is about “finding harmony within diversity,” he said to great applause.

In his response to Mia, who had asked how they could create a church culture in which everyone feels safe, authority is “well-balanced,” and policies are transparent, the pope said the church must learn from victims.

Members of the church must learn to be “at the service of all without belittling anyone. Indeed, one of the roots of violence stems from the abuse of power when we use the positions we have to crush or manipulate others,” he said.

When he returned to the nunciature, where he was staying during his Sept. 26-29 trip, the pope met two families: a Christian family that had fled from Syria and a Muslim family from Djibouti. As refugees, they had reached Belgium thanks to the help of the Rome-based Community of Sant'Egidio and its “humanitarian corridors.”

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Pro-life group launches ad debunking false claim that Georgia abortion law killed women

By Peter Pinedo

Washington, D.C. Newsroom, Sep 27, 2024 / 17:27 pm

One of the country’s leading pro-life groups has launched a $500,000  television and digital ad  campaign debunking misinformation that Georgia laws protecting unborn life killed two women.

Susan B. Anthony Pro-Life America, the group behind the ad, said the two women, Amber Thurman and Candi Miller, were victims of “reckless misinformation” being spread by Democrats about Georgia’s pro-life laws.

“Candi and Amber should be alive; the left’s scare tactics are deadly,” the ad’s narrator says, adding that “Democrats’ abortion lies put women at risk.”

The 30-second ad, which will reach cable and broadcast markets in Atlanta, Augusta, Macon, and Savannah in Georgia as well as targeted digital audiences, says that “no Georgia law blocks lifesaving care for women or treating complications after abortion.”

Miller, 41, and Thurman, 28, both died from infection due to complications after taking the abortion pills mifepristone and misoprostol.

The left-leaning outlet ProPublica reported earlier this month that Georgia’s laws protecting unborn life starting at six weeks caused medical providers to delay giving Thurman the care necessary to save her life. In Miller’s case ProPublica said she chose to not even visit a medical provider “due to the current legislation on pregnancies and abortions.”

Several doctors, experts, and lawmakers, however, have  debunked  that claim by pointing out that Georgia law explicitly allows exceptions for abortion in cases in which the mother’s life is in danger. This means that Miller and Thurman could have legally been given the care they needed promptly.

Nevertheless, Democrats have continued to advance the narrative that pro-life laws, and former president Donald Trump, are responsible for the deaths of Miller, Thurman, and many other women across the country. 

Law protecting life at conception officially repealed by North Dakota court

Democratic presidential nominee Kamala Harris appeared on a  televised town hall  with Oprah Winfrey last week in which she spoke with Thurman’s family and blamed Trump and Republicans for what she called a maternal “health care crisis.”

Georgia is one of the swing states that will be critical in deciding the outcome of this year’s presidential election. Both Trump and Harris have been devoting significant amounts of time and money to making their case to Georgians.

The latest poll from  FiveThirtyEight  shows support for the two candidates within the margin of error, with Trump polling just 0.9 percentage points ahead of Harris (48.3% versus 47.4%).

Harris has largely focused her pitch to Georgia voters on expanding abortion access in the state and across the country. Trump, meanwhile, has focused his rhetoric on other issues such as the economy and the border.

Marjorie Dannenfelser, president of SBA Pro-Life America, said it is crucial to the well-being of women to spread the truth about pro-life laws. In a press statement shared with CNA, Dannenfelser said that “Amber, Candi, and their babies should be alive today” and that “there would be no confusion if abortion advocates were not spreading confusion.”

“Georgia’s law, like pro-life laws in every other state, allows emergency care, miscarriage care, and treatment for ectopic pregnancy. The laws do not penalize women who have abortions and they use plain, commonly accepted legal language,” she said. “Democrats are putting countless lives at risk and we will relentlessly call them out.” 

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Inequality in Access to Abortion Rights in Latin America

• by Mariela Jara ( lima )
• Friday, September 27, 2024
• Inter Press Service

LIMA, Sep 27 (IPS) - The struggle for women's right to decide in Latin America and the Caribbean, for their access to legal, safe and free abortion continues in the region, with some countries fully criminalising it, others with severe regulations, and a few guaranteeing better conditions, while threats of regression persist.

This Saturday 28 September marks, as every year, the Global Day of Action for Access to Safe and Legal Abortion , launched in 1990, at the 5th Latin American and Caribbean Feminist Meeting, held in Argentina.

Since then, the international day of action for safe abortion has been nurtured by the agreements reached at the Cairo Conference on Population and Development in 1994, which recognised sexual and reproductive rights as part of human rights, and by the mandates of Human Rights Committees demanding that countries decriminalise abortion and protect the rights of girls, adolescents and women.

"This is a historic struggle of the feminist movement. We have made progress in the recognition of women's human rights in the region, but those related to sexual and reproductive rights and abortion continue to be polarising; however, we have no doubt that they must be integrated into our rights as a whole".

So said Aidé García, director of the non-governmental organisation Catholic Women for the Right to Decide in Mexico and former director of the organisation's Latin American network, present in 10 countries.

The activist spoke to IPS from New York, where this September she takes part in several meetings in the framework of the High-Level Segment of the 79th General Assembly of the United Nations and the Summit of the Future.

About 51% of the more than 660 million people in Latin America and the Caribbean are women. This population faces diverse gender inequalities, according to a joint report by the Economic Commission for Latin America and the Caribbean (ECLAC) and UN Women in 2023.

The report claims that three out of every 10 women in the region live in poverty; one out of every 10 has experienced violence and, in addition, the maternal mortality rate is 87.6 per 100,000 live births.

In this context, preventing women who freely decide from terminating a pregnancy or persecuting and criminalising them for doing so, aggravates the violation of their human rights, with the connivance between the prevailing patriarchy, the Catholic Church and now even more of evangelical denominations.

A study by the Guttmacher Institute revealed that in 2010-2014 there were 6.5 million induced abortions in the region. When these are performed in unsafe conditions due to legal barriers or lack of economic resources, they cause many deaths and harm women's overall health.

The other side of the coin is forced maternity.

A scenario with gaps

"There is great inequality in Latin America and the Caribbean on the issue of abortion," said García, who is a social worker and feminist with vast experience in contributing to debates on this issue in Mexico and in international forums.

"We have seen the great influence of right-wing fundamentalist religious groups in countries where abortion is criminalised and in others where it is barely advancing on the grounds of risk to the woman's life, malformations and danger to health," she said.

Among the 10 countries or territories where abortion is fully criminalised are Belize, El Salvador, Haiti, Jamaica, Honduras, Nicaragua, Dominican Republic and Suriname.

Cuba was the first to fully decriminalise voluntary termination of pregnancy in the region, in 1965, followed by Guyana in 1995. Then, in this century, Uruguay, Argentina, Colombia and Mexico, first in 13 states and then at the federal level.

In most, legislation regulates it only under the restricted grounds - and in many cases full of obstacles to its implementation - of rape, health and risk to the pregnant woman's life, non-consensual artificial insemination, and foetal malformations incompatible with life.

The most favourable frameworks are in Colombia, where abortion is legalised during the first 24 weeks of gestation, Argentina and Guyana, where it is legal up to 14 weeks, Uruguay and Mexico, with up to 12 weeks, and Cuba during the first quarter.

These legal loopholes for access to abortion also reflect the resistance to recognising women's right to voluntarily terminate a pregnancy.

"We are fighting for respect for the autonomy and the possibility that women and people with gestational capacity have to decide about our reproduction. We demand the recognition of the moral authority that is ours, because from a Judeo-Christian culture where the religious sphere often intervenes, women who make decisions about sexuality are blamed", said García.

She drew attention to political, religious and economic interest groups in the region that seek to preserve a fundamentalist tradition that denies women decision-making and public and political participation.

"It has to do with a patriarchal and misogynist sense of the role that we are assigned in society, and that is a great struggle that we have in feminism because at the end of the day, it is about the control of our bodies", she stressed.

Women and feminist movements in Latin America are fighting to spread throughout the region the tide of green scarves, which emerged in Argentina, with which they fill the streets in several demonstrations a year and which symbolise the struggle for the right to legal and safe abortion.

Criminalised and persecuted

Brenda Álvarez is a lawyer and president of Proyecta Igualdad , a non-governmental organisation in Peru, which through its Green Justice line provides legal counsel to prevent criminalisation in the care of obstetric emergencies related to abortion, a dramatic and little known reality in the country.

With 33 million people, the South American country is one of the most restrictive in the recognition of women's reproductive rights. Since 1924, abortion has been criminalised, except for therapeutic reasons, when the life of the pregnant woman is in danger or there is a risk of serious and permanent damage to her health.

The struggles of feminists and women's movements in recent decades to decriminalise abortion have come up against the opposition of conservatives linked to Catholic and evangelical religious groups, to the point that, although therapeutic abortion celebrated its 100th anniversary in 2024, the protocol for its implementation is barely 10 years old, and with limitations.

"In the midst of the pandemic, we learned of the case of Diana Aleman, a Venezuelan irregular migrant who died in a public hospital due to the criminalisation of abortion and the harassment she experienced. As we followed the case, we realised it was not the only one, that more people were experiencing this situation and were being prosecuted," Álvarez told IPS at her office in Lima.

She said that women who go to health facilities for an obstetric emergency related to abortion are poor and vulnerable, uninformed of their rights, and in these circumstances face state violence.

"It is not only poor medical care or harassment at the time of service, but also dealing in the emergency room with interrogations by the police, the prosecutor's office, even with samples taken by representatives of the Institute of Forensic Medicine, as was the case of a teenager a few weeks ago who arrived unconscious with pneumonia and septic shock. That's how they wanted to take her statement," she revealed.

In 2020-2021 they carried out the Being Born with Uterus study, which states that each year more than 184 police reports for abortion and more than 633 of prosecutorial investigations are filed in Peru. "It was alarming, even cases of therapeutic abortion that are not punishable were prosecuted, we found 55; and we found sentences including adolescents," she explained.

Health personnel report obstetric emergencies if they suspect abortions under the questionable article 30 of the General Health Law No. 26842, and "the authorities are ready to respond as if there were no serious crimes to prosecute in the country". Álvarez explained that the guarantee of due process is not fulfilled and that these are illegal processes.

"This is problematic because often the only evidence that ends in a conviction for abortion is the statement taken from women, girls and adolescents in health services in a context of coercion and absolute lack of legal protection," she denounced.

Among the impacts of the criminalisation of abortion on women's lives, she mentioned the loss of employment and mental health opportunities, the uncertainty that having a criminal record entails for the possibility of finding a job, the cost of going to the justice system "even when the legal defence is ex officio , which, we have seen, is not effective and part of the conviction system".

In addition to the urgency of decriminalising abortion, she said there is a need to promote citizen empowerment by creating tools so that women can know and exercise their rights when they go to a hospital with an obstetric emergency. In this regard, her organisation has developed outreach and awareness-raising materials.

Improving the law and risks in the region

Twelve years ago, Uruguay passed the law on the Voluntary Interruption of Pregnancy up to 12 weeks of gestation, an important step forward in the region and the result of a long struggle by women and feminists for the legalisation of abortion. The law also established grounds for abortion in cases of serious health risk to the woman, rape and malformations incompatible with life outside the womb.

Soledad Gonzales, a political scientist specialising in gender issues, told IPS from Montevideo that there is a need to work for a new law that would remove the persistent restrictions.

In practice, this means barriers to the exercise of the right, such as the interdisciplinary board that evaluates the woman's request, the appointment she must undergo to inform her of alternatives, and the five-day waiting period after which she either ratifies her will to end the pregnancy or not, in order to proceed according to her decision.

"A new law is in order. For example, women do not always realise they are pregnant after three months. They end up having abortions clandestinely, having started the abortion legally," she said.

Gonzales said that the chances for this proposal, on which women's and feminist organisations agree, will depend on the results of the Uruguayan general elections on 30 October.

García, from Catholic Women for the Right to Decide, also said that the risks of setbacks in women's reproductive rights, such as the freedom to decide about their bodies and access to abortion in safe and free conditions, depends on the positions of governments, whether they are conservative or progressive.

"This is part of the historical struggle that leads us to never lower our guard," she said.

© Inter Press Service (2024) — All Rights Reserved Original source: Inter Press Service