Chapter Twelve

             Reproductive Rights

Chapter Outline

A. Overview

B. Procreation and Contraception 

C. Abortion Laws and Cases Before 2022

D.  Dobbs v. Jackson and Current Abortion Laws 

A. Overview

In colonial America, women had minimal control over their reproductive health. They typically gave birth to an average of six to seven children over their lifetimes, though family size varied widely depending on race, legal status, region, and income, and not all infants survived to adulthood. It is not surprising, then, that Indigenous women, enslaved African women, and women in settler communities used herbal remedies and other non-surgical methods in attempts to control fertility, prevent pregnancy, and manage their menstrual cycles. These methods drew on cultural traditions and shared community knowledge reflecting the absence of formal reproductive healthcare. Because birth control methods often failed, women also used a variety of techniques to end pregnancies, some of which carried significant health risks (Demos, 1970; Planned Parenthood Action Fund, n.d.).

These risky practices took place within a legal system that treated early pregnancy differently than how it is treated today. From medieval times through the early 1800s, English common law treated abortion before "quickening", the stage when a woman first feels fetal movement, as legal. This standard carried over into the American colonies. Then, during the second half of the 1800s, states began passing laws that restricted or prohibited abortion. Historians believe these laws were created because the medical profession was becoming more authoritative, and cultural and religious beliefs were changing. Additionally, women had very limited rights. By 1910, nearly every state in the union had passed laws banning abortion at all stages of pregnancy (Planned Parenthood Action Fund, n.d.). 

This historical background provides context for the laws and cases in this chapter that pertain to reproductive rights.  This chapter will start by analyzing early decisions regarding procreation and contraception.  Then, it will examine regulations regarding abortion.  Before doing so, it is helpful to clarify the meaning of the phrase “right to privacy", a phrase used in dozens of  Supreme Court cases.

When most people think about the phrase "right to privacy", they think about the right to live free from government intrusion and overreach, especially in situations where citizens interact with law enforcement.  However, the term is also frequently used in court cases to describe rights that have nothing to do with police officers or criminal investigations.  Over the past fifty years, courts have also used the term “right to privacy” to describe the ability to make personal decisions about reproductive health without government interference, although the current Supreme Court no longer recognizes this right at the federal level. This chapter examines how we arrived at this point and highlights other factors that have shaped laws on procreation and contraception.

B. Procreation and Contraception 

A century ago, courts did not recognize the right to privacy (as it pertains to reproductive rights) at all, a fact demonstrated by the Supreme Court’s ruling in Buck v. Bell.  Carrie Buck was born in 1906 in Charlottesville, Virginia. Shortly after her birth, she was put into a foster home because her mother, Emma Buck, had been committed to the Virginia State Colony for Epileptics and Feebleminded. Emma had been labeled “morally unfit” because she lived in poverty, had several children with different men, and was accused of prostitution. In her foster home, Carrie Buck attended public school for five years, performed as an average student, and reached the sixth grade. She was removed from school when her foster parents decided to keep her home to help with housework (Smith, 2020).

When Carrie was 17, she was placed in the same institution as her mother after being raped by her foster brother and getting pregnant. Instead of investigating the assault or protecting her, local officials claimed that her pregnancy showed she was “immoral” and “feebleminded".  During this period, many states supported eugenics, a movement rooted in the belief that society could be improved by preventing people with hereditary defects from having children (Lombardo, 2008).

Imge 12.1

Carrie Buck (left) at the Virginia State Colony for Epileptics and Feebleminded along with her birth mother Emma Buck. 

Taken by A.H. Estabrook before the Buck v. Bell trial in Virginia, 1924

B. Procreation and Contraception-continued

Dr. Albert Priddy, superintendent of the Virginia State Colony, pushed Carrie Buck’s case through the Virginia trial court system, openly stating that his goal was to “test the validity” of the state’s sterilization law. The trial court upheld the statute and authorized her sterilization. The Virginia Supreme Court affirmed that ruling, and the case eventually reached the United States Supreme Court (Smith, 2020).

In 1927, the United States Supreme Court upheld the rulings of the lower courts when it issued its decision in Buck v. Bell.  Justice Oliver Wendell Holmes Jr. accepted the state’s characterization of Carrie Buck and her family and wrote the infamous line, “Three generations of imbeciles are enough.” The decision provided legal support for forced sterilization programs nationwide and contributed to tens of thousands of people being sterilized without their consent. Carrie Buck was sterilized shortly after the Supreme Court's ruling (Lombardo, 2008).

Buck v. Bell has never been formally overturned, but it was seriously weakened by Skinner v. Oklahoma (1942). In Skinner, the Court struck down a statute that allowed the sterilization of habitual criminal offenders who repeatedly committed larceny, robbery, and burglary. The statute did not apply to those who violated other laws. The Court explained that the Oklahoma statute violated the Equal Protection Clause. They argued that the ability to have children is a fundamental right and the government should not be able to sterilize one group of individuals while leaving another group exempt. Some scholars have criticized the Supreme Court for imposing constitutional limits on sterilization only when the policy disproportionately affected men, noting that earlier laws targeting women remained unchallenged. Regardless, the principles in the Skinner decision sharply conflict with the reasoning in Buck v. Bell, leaving the earlier case widely discredited and viewed as one of the most harmful rulings in Supreme Court history (Lombardo, 2008).

Debates over sterilization and eugenics were not the only controversies about morality and its intersection with the law in the early twentieth century. Across the country, state legislatures were enacting statutes aimed at prohibiting or restricting activities viewed as morally harmful, including prostitution, gambling, and the sale of alcohol. These laws later became known as vice laws. Reformers who sought to eliminate such behaviors pushed for some of the strictest regulations on human conduct in United States history. In the late 1800s, former U.S. postal inspector Anthony Comstock advocated for strict laws banning the mailing of obscene materials, efforts that led to the federal Comstock Act of 1873, which prohibited sending items related to contraception and abortion through the mail (Supreme Court Historical Society, n.d.).

Many states passed their own versions of the Comstock Act. In 1879, Connecticut enacted one of the strictest laws in the country, making it a crime not only to sell or distribute birth control, but even to use it. Advocates for reproductive health challenged the Connecticut statute multiple times, but the Supreme Court dismissed these cases for lack of standing in 1943 and again in 1961, leaving the law in place (Griswold v. Connecticut, 1965).

Hours after the Court’s second dismissal in 1961, Estelle Griswold, Executive Director of the Planned Parenthood League of Connecticut, announced her plan to directly challenge the statute. Within months, she and Dr. C. Lee Buxton opened a birth control clinic in deliberate violation of the law to prompt enforcement and create a test case that could be brought before the Supreme Court. A Connecticut resident filed a complaint against the clinic the day after it opened, triggering a police investigation. Griswold and Buxton were arrested on November 10, 1961, convicted shortly afterward, and their convictions were affirmed by the Connecticut Supreme Court before the case proceeded to the United States Supreme Court.

On June 7, 1965, the Supreme Court issued a 7–2 decision in Griswold v. Connecticut.  It ruled in favor of Griswold, striking down Connecticut’s ban on the use of contraception by married couples.  Justice William O. Douglas, writing for the majority, acknowledged that the Constitution does not expressly mention a right to privacy, yet he argued that certain constitutional guarantees imply one. To explain this concept, he wrote, “The foregoing cases suggest that specific guarantees in the Bill of Rights have penumbras, formed by emanations from those guarantees that help give them life and substance.” The decision drew on precedent cases involving freedom of association, protections against unreasonable searches, and the Due Process Clause. Douglas concluded that these constitutional “zones of privacy” encompass the private and intimate decisions of married couples regarding contraception. In 1972, the Court extended access to contraception to unmarried couples and relied heavily on Griswold in the decision (Griswold v. Connecticut, 1965; Eisenstadt v. Baird, 1972).

In the decades following the Griswold decision, federal policies gradually expanded access to contraception. Title X of the Public Health Service Act was created in 1970 to fund voluntary family planning programs nationwide. Changes to Medicaid regulations throughout the 1980s and 1990s allowed states to use eligibility waivers to provide family planning services to more people. These developments, combined with greater demands for government-funded health coverage, eventually led to the passage of the Affordable Care Act (ACA) in 2010, which required most employer-sponsored health plans to cover contraceptive services (Britt, Meyer & Day, 2025).

Later legal changes undercut these expansions to the availability of contraception. In Burwell v. Hobby Lobby Stores, Inc. (2014), the Supreme Court ruled that closely held that corporations, which are small private companies not traded on the public stock market, may claim a religious exemption from providing contraceptive coverage required under the ACA. In 2017, President Trump issued Executive Order 13798 directing federal agencies to broaden such religious exemptions. 

In response, federal agencies issued interim and then final rules that changed how the ACA’s contraceptive mandate was implemented by significantly expanding both religious and moral exemptions for employers who objected to providing contraceptive coverage. Although the Biden administration later reversed these regulatory changes, the Supreme Court’s decision in Little Sisters of the Poor v. Pennsylvania (2020) upheld the federal agencies’ power to create these broad exemptions. The Court ruled that the agencies had acted within their lawful discretion when creating expansive religious and moral exemptions to the contraceptive coverage requirement  (2018 Final Rules; Kessler, 2018).

C. Abortion Laws and Cases Before 2022

As mentioned in the introduction to this chapter, early American law generally treated abortion before “quickening,” the stage when a woman first feels fetal movement, as legal. Over the course of the 1800s, however, cultural, medical, and social changes led states to begin criminalizing the practice. By 1910, nearly every state in the nation had enacted laws banning abortion at all stages of pregnancy, except when a woman's life was at risk. What had once been a common and largely uncontroversial practice had become heavily restricted across the United States (Planned Parenthood Action Fund, n.d.).

Starting in the 1960s and early 1970s, several states started to change their laws in response to grassroots reform movements among physicians, legal scholars, and women's rights advocates who pushed for reevaluating the criminal bans.  This resulted in a patchwork of state statutes across the nation that ranged from total bans on terminating pregnancy to abortion on demand. This inconsistency in reproductive health laws set the stage for the Supreme Court’s decision in Roe v. Wade (1973).

Before getting into the facts of the Roe case, it is important to understand the political context surrounding it.  In the early 1970s, political alignments around abortion laws were very different. Most organized opposition to abortion came from the political left, while many conservative Protestants, including evangelicals, supported loosening abortion laws because of their belief in limited government and religious liberty. In modern times, conservative leaders and activists have unified around opposing abortion, while liberals have increasingly unified around abortion rights as part of a broader movement for women’s equality, bodily autonomy, and reproductive freedom. This shift mirrors a broader pattern of American political realignment, similar to how the parties’ positions on slavery and civil rights changed over time due to the major parties gradually reorganizing around new coalitions, regional interests, and social issues. This context is important for understanding the Roe case itself as well as more recent abortion cases (Williams, 2016).

In 1969, Jane Roe, whose real name was Norma McCorvey, became pregnant with her third child.  At that time, she lived in Texas, where abortion was legal only when necessary to save the mother's life. She wanted the abortion because she was in a difficult financial situation and had already placed two children for adoption. Sarah Weddington and Linda Coffee, two local attorneys, agreed to represent her because they had been looking for a way to challenge Texas’s abortion ban through a carefully selected test case. They ultimately chose Norma McCorvey as their plaintiff because she was pregnant and willing to challenge the law, which gave them the standing they needed to move the lawsuit forward. The attorneys filed a lawsuit on McCorvey's behalf in the U.S. District Court for the Northern District of Texas, which ruled in her favor  (Britannica, 2026).

Although the three-judge District Court ruled that Texas’s abortion law was unconstitutional, it did not issue an injunction, meaning the law technically remained in effect. Under federal law at that time that governed three-judge district courts, the State of Texas was permitted to appeal the decision directly to the U.S. Supreme Court to defend its statute. The Court heard the case through this expedited process, bypassing the Circuit Court of Appeals. Even with an expedited path, the Court delayed moving forward with Roe until it first decided two cases, one clarifying that federal courts may intervene in ongoing state criminal prosecutions in limited circumstances and another holding that the phrase “health of the mother” was not unconstitutionally vague (Younger v. Harris, 1971; United States v. Vuitch, 1971).

Only after resolving those issues, and addressing reluctance among the justices about who should draft such a politically controversial abortion opinion, did the Court finally move forward and schedule oral arguments for Roe v. Wade. The first oral argument in the case occurred on December 13, 1971. Sarah Weddington began by presenting constitutional reasons to strike down Texas’s abortion law, not realizing that the justices were primarily focused on jurisdictional issues. As a result, she spent much of her time addressing procedural questions rather than the broader constitutional issues, which meant that the justices did not hear some of the plaintiff’s strongest substantive arguments. During this same argument, Texas’s attorney, Jay Floyd, opened by saying, “It’s an old joke, but when a man argues against two beautiful ladies like this, they are going to have the last word.” The remark was poorly received and created an awkward dynamic that was not conducive to serious legal analysis (Goluboff, 2010). 

Due to changes in the membership of the Supreme Court, both parties were given another opportunity to present their cases. At a second oral argument,  which was scheduled for October 11, 1972, the jurisdictional issues were largely resolved, and the justices focused more directly on the core issues of privacy, substantive due process, and the extent of state power to regulate abortion. At this reargument, a new attorney, Texas Assistant Attorney General Robert Flowers, replaced Floyd and presented a more serious defense of the state law. Norma McCorvey did not attend either oral argument (Britannica, 2026).

On January 22, 1973, the Supreme Court handed down its decision in Roe v. Wade. McCorvey’s daughter, whom she had placed for adoption, was already 2 1/2 years old at this time.  Even though McCorvey was no longer pregnant and the case was technically moot by the time it reached the Supreme Court, the justices agreed to hear it under the "capable of repetition, yet evading review” doctrine. The Court ruled 7–2 in favor of McCorvey, holding that women in the United States had a fundamental right to choose an abortion without excessive government interference and striking down Texas’s abortion ban as unconstitutional. 

Justice Harry Blackmun authored the majority opinion, grounding the decision in the constitutional “right to privacy,” which the Court said was implied in earlier cases such as Griswold v. Connecticut. As Blackmun explained, “The Constitution does not explicitly mention any right of privacy. In a line of decisions, however, the Court has recognized that a right of personal privacy, or a guarantee of certain areas or zones of privacy, does exist under the Constitution… found at least in the roots of the First Amendment; in the Fourth and Fifth Amendments; in the penumbras of the Bill of Rights; in the Ninth Amendment; or in the concept of liberty guaranteed by the first section of the Fourteenth Amendment.”

The Court created the trimester framework to balance a woman’s right to privacy with the state’s interests in health and prenatal life. In the first trimester (0–12 weeks), states could not restrict abortion beyond basic medical requirements. In the second trimester (13–24 weeks), states could regulate abortion procedures to protect the mother’s health. By the third trimester (25+ weeks), once the fetus was viable, states could prohibit abortion entirely except when needed to protect the woman’s life or health.

Three justices wrote concurring opinions. Justice Potter Stewart agreed with the ruling but emphasized that the decision should have been based on substantive due process, which is the doctrine that the Due Process Clause protects certain fundamental rights beyond procedural fairness. Justice William O. Douglas supported the outcome, but he argued that the right to abortion should be grounded in the Ninth Amendment, which states that the people retain rights not specifically listed in the Constitution. Chief Justice Warren Burger stated that the decision did not create “abortion on demand” , and stressed that states could still require reasonable medical safeguards. In dissent, Justice Byron White accused the Court of creating a new constitutional right without historical basis and argued that abortion policy should be left to the states. Justice William Rehnquist's dissent criticized the majority’s use of substantive due process, and insisted that the framers of the Fourteenth Amendment did not intend to limit states’ authority to regulate abortion.

The decision generated considerable controversy. Abortion-rights groups praised Roe as a victory for women’s autonomy, while the Catholic Church and emerging pro-life organizations condemned it as morally and constitutionally wrong. Some abortion-rights supporters criticized the ruling’s reliance on the right to privacy and argued that a stronger constitutional foundation would have made it less vulnerable to reversal. Opponents quickly mobilized, organizing protests and pursuing state laws aimed at restricting abortion. Additionally, the Hyde Amendment was enacted in 1976 as a rider to the federal appropriations bill that funds Medicaid; the amendment prohibited the use of federal Medicaid dollars for nearly all abortions (Center for Reproductive Rights, n.d.).

In the years following Roe, many states attempted to limit its impact by passing laws designed to restrict access to abortion. One common approach involved repeated efforts by state legislatures to enact parental involvement requirements for minors. In Bellotti v. Baird (1979), the Supreme Court held that states may require parental consent for a minor seeking an abortion as long as they also provide a judicial bypass, which is a confidential and expedited court hearing that allows a judge to authorize the abortion instead of parents if the judge determines the minor is mature enough to make the decision independently or if the procedure is deemed to be in the minor's best interests.  The Court later upheld a similar law to that in Bellotti that required parental notification in addition to a judicial bypass.  In practice, parental-involvement laws and the judicial bypass process impose delays, uncertainty, and fear of exposure, which have a chilling effect on minors’ ability to access abortion care (Ohio v. Akron Center for Reproductive Health, 1990; Joyce, Kaestner, & Ward, 2019).

More restrictions on abortion followed the adoption of parental-involvement laws. In 1984, the federal government adopted the Mexico City Policy, which was created and implemented by President Ronald Reagan. This presidential directive is also known as the “Global Gag Rule" and requires foreign nongovernmental organizations that receive U.S. global health funding to agree not to provide, promote, or counsel about abortion, even with their own funds. In Rust v. Sullivan (1991), the Supreme Court upheld a similar domestic policy that restricted abortion counseling within Title X family-planning programs. The Title X restriction was later revoked by President Biden in 2021; however, the Mexico City Policy was reinstated by President Trump through a presidential memorandum signed in January 2025 (Human Rights Watch, 2018).

In addition to parental-involvement laws and policies restricting abortion counseling, some states experimented with other forms of regulation. Pennsylvania amended its abortion law, the Pennsylvania Abortion Control Act of 1982, in 1988 and 1989. The new provisions required patients to give informed consent and imposed a 24-hour waiting period between receiving information and undergoing an abortion procedure. The provisions also required minors to obtain the consent of one parent, with a judicial-bypass option available.  Lastly, a new provision required married women to certify they had notified their husbands of their intention to terminate the pregnancy. 

In response to these new provisions, a group consisting of five abortion clinics and several physicians who provided abortion services filed suit against the state in the U.S. District Court for the Eastern District of Pennsylvania in 1990. In Planned Parenthood v. Casey, the District Court held that all of the challenged provisions were unconstitutional and issued a permanent injunction preventing their enforcement. The Court of Appeals for the Third Circuit affirmed the ruling in part and reversed in part, upholding all of the regulations except for the husband-notification requirement.

In 1992, Planned Parenthood v. Casey reached the Supreme Court, marking the first major reconsideration of abortion rights since Roe v. Wade. In a plurality opinion, the Court reaffirmed Roe’s central holding that women have a constitutional right to choose abortion before viability. However, the Court upheld all of Pennsylvania’s regulations except the spousal-notification requirement. 

The Court also made two major changes to Roe’s framework. First, it abandoned the strict trimester system and instead emphasized viability, defined as the stage at which a fetus can survive outside the womb with medical assistance. Second, it replaced Roe’s strict-scrutiny standard with the undue burden test, under which a regulation is unconstitutional if its purpose or effect is to place a substantial obstacle in the path of a woman seeking a pre-viability abortion. The opinion also included a significant discussion of stare decisis, which is the practice of following precedent cases and explains why the Court chose to uphold the core tenets of the Roe case. Many legal commentators noted that the shift to a viability-based standard reflected advances in medical technology that made the trimester framework less workable.

In the late 1990s, states began passing “partial birth abortion” bans, and even the name of these laws generated significant controversy. The term “partial birth abortion” first appeared in congressional legislation and was quickly adopted by anti-abortion advocates, even though it is not a recognized medical term. Proponents of these laws argue that “partial birth abortion” describes a procedure in which a doctor deliberately and intentionally delivers a living fetus partly outside the woman’s body, either the fetal head or the trunk past the navel, for the purpose of performing an act that will end the fetus’s life. Reproductive rights advocates counter that the phrase is a politically constructed label used to describe a rare second-trimester medical procedure known to physicians as intact dilation and extraction, which is sometimes used when the fetus has severe abnormalities, such as anencephaly, fatal chromosomal disorders, or profound structural anomalies. It may also be used when necessary to protect the woman’s health in cases of severe infection, hemorrhaging, preeclampsia, or other life-threatening complications. Medical groups note that intact dilation and extraction is the safest option in many cases.  Research suggest that fewer than one percent of abortions involve this procedure, making it extremely rare (Tanne, 2007).

In the late 1990s, Nebraska and other states enacted laws banning so-called partial birth abortions. In Stenberg v. Carhart (2000), the Supreme Court struck down Nebraska’s law because it was overly broad, unconstitutionally vague, lacked a health exception for the woman, and threatened doctors with criminal penalties for performing standard second-trimester procedures. Congress then passed the Partial-Birth Abortion Ban Act of 2003, which included an exception only to save the woman’s life, not to protect her health. In Gonzales v. Carhart (2007), the Supreme Court upheld the federal ban.

Subsequent restrictions on abortion focused on regulating the medical providers and facilities that performed the procedures. In Whole Woman’s Health v. Hellerstedt (2016), the Supreme Court struck down two Texas laws. One required abortion providers to obtain admitting privileges at a nearby hospital, and the other required clinics to meet the standards of ambulatory surgical centers. The Court held that both restrictions created an undue burden on women because they offered no medical benefit while severely reducing access to abortion care. The Justices also emphasized that courts must evaluate the real evidence of a law’s benefits and burdens rather than simply accept lawmakers’ claims. Four years later, in June Medical Services v. Russo (2020), the Court invalidated a nearly identical Louisiana admitting-privileges requirement, concluding that it would have the same unconstitutional effect of closing most of the state’s clinics without improving patient safety.

D.  Dobbs v. Jackson and the Current State of Abortion Laws 

Most Americans know that Dobbs v. Jackson Women’s Health Organization (2022) overturned both Roe v. Wade and Planned Parenthood v. Casey.  It held that the Constitution does not contain a federal right to abortion or a general right to privacy, and it left all abortion regulation to the individual states. Before reading the excerpt of the Dobbs opinion below, it is important to understand what led to it. Otherwise, the decision may seem counterintuitive due to the common perception that Justices who have a conservative approach are firmly committed to stare decisis and that Justices who have a liberal approach are more willing to overturn precedent. However, the reality of Supreme Court jurisprudence is more complex than it seems. The Dobbs decision makes far more sense once shifts in Supreme Court membership and strategic political efforts to overturn Roe are viewed together.

A good starting point is 2005, when Chief Justice John Roberts joined the Supreme Court. For many years, the Roberts Court had a 5–4 conservative majority. Justice Anthony Kennedy, although conservative, had joined the controlling plurality in Casey and was widely viewed as a likely vote to preserve the constitutional right to abortion. Other conservatives included Justices Samuel Alito and Clarence Thomas, the latter of whom openly rejected the doctrine of substantive due process as a “legal fiction.” Chief Justice Roberts also leaned conservative but was known for strongly valuing stare decisis and the Court’s institutional legitimacy (The Politics Teacher, n.d.).

At the same time, political developments in other branches of government affected the future of abortion rights. During the Obama presidency, conservative legal groups, like the Alliance Defending Freedom (ADF) and the Federalist Society, began coordinating with Christian conservative lawmakers to pass increasingly restrictive state abortion laws designed as “test cases” to challenge Roe and Casey. In 2016, Senate Republicans, led by Majority Leader Mitch McConnell, blocked President Obama from filling the vacancy created by Justice Antonin Scalia’s death.

These efforts at test cases continued during the Trump administration. Meanwhile, on April 6, 2017, Senate Republicans expanded the “nuclear option", a procedural rule eliminating the filibuster for judicial nominations, so that Supreme Court nominees could be confirmed by a simple majority, rather than 60 votes. This allowed President Trump to appoint Justice Neil Gorsuch.  In 2018, Justice Kennedy retired and was replaced by Justice Brett Kavanaugh, who had criticized Casey, but had also suggested he respected precedent during his nomination hearings. In 2020, Justice Amy Coney Barrett, a staunch opponent to abortion, replaced Justice Ruth Bader Ginsburg, giving the Court a 6–3 conservative supermajority and its strongest opportunity in decades to revisit Roe and Casey. At the time Dobbs was decided, the liberal bloc consisted of Justices Sonia Sotomayor, Elena Kagan, and (after oral argument) Ketanji Brown Jackson (The Politics Teacher, n.d.).

By 2017, Mississippi had become the focus of these coordinated antiabortion efforts because it only had a single remaining abortion clinic, the Jackson Women’s Health Organization, which performed abortions up to 16 weeks. In March 2018, Mississippi enacted the Gestational Age Act, banning abortions after 15 weeks except in cases of medical emergency or severe fetal abnormality. The Act included no exceptions for rape or incest (Oberman & Lehmann, 2023).

Within a day of the Act's passage, Jackson Women’s Health sued to block the 15-week ban, and in 2018 a federal district court issued an injunction, finding that viability occurs at 23–24 weeks and that the state offered no valid justification for banning abortions earlier than that. The district court also rejected Mississippi’s fetal-pain evidence as inadmissible based on issues pertaining to scientific reliability. The Fifth Circuit affirmed this ruling in 2019 and again in 2020 when it struck down Mississippi’s separate 6-week “heartbeat” law for the same reason, which was that states cannot ban abortion before viability (Jackson Women’s Health Org. v. Dobbs, 2019; Jackson Women’s Health Org. v. Dobbs, 2020).

The state of Mississippi appealed to the Supreme Court in June 2020. Its petition, filed by Mississippi Attorney General Lynn Fitch, argued that the viability standard was inflexible and outdated and that states have a compelling interest in protecting fetal life from the beginning of pregnancy.  Jackson Women’s Health argued that viability had been a clear, workable rule for 50 years and that Mississippi’s ban was unconstitutional “by any measure.”

The Supreme Court considered the petition at more than a dozen conferences, far more than usual, and granted review on May 17, 2021. After that, the case was briefed over several months, and oral arguments were heard on December 1, 2021. The case then moved through the Court’s lengthy internal drafting and revision process before the final decision was issued on June 24, 2022. (Jackson Women’s Health Org. v. Dobbs, 2019; Jackson Women’s Health Org. v. Dobbs, 2020).   

D.  Dobbs v. Jackson and the Current State of Abortion Laws - continued 

After the Dobbs decision, access to contraception and abortion worsened across many states. Although President Biden issued Executive Order 14076 directing federal agencies to protect access to abortion medication, expand access to contraception, and ensure hospitals comply with federal emergency care requirements, federal agencies cannot override state laws that restrict reproductive health care. (Exec. Order No. 14076, 2022; Guttmacher Institute, 2023).

Many Planned Parenthood clinics, which are major providers of contraception nationwide, closed as states restricted abortion services and withdrew funding, while deep cuts to Title X and Medicaid further reduced access to contraceptive care. In Medina v. Planned Parenthood South Atlantic (2025), the Supreme Court held that Medicaid recipients cannot sue states for excluding Planned Parenthood from Medicaid programs, effectively giving states broad authority to maintain these funding cuts. More than seventy clinics have closed nationwide since Dobbs. At the same time, growing parental-consent requirements, newly expanded “conscience” laws allowing providers to refuse reproductive services based on personal beliefs, and documented cases of pharmacists declining to dispense contraception have further restricted access to birth control (Tuerkheimer, 2025). Although the Supreme Court unanimously rejected an effort to sharply limit access to the abortion medication mifepristone, access to reproductive care overall continues to erode (FDA v. Alliance for Hippocratic Medicine, 2024).

As expected, numerous states passed more restrictive abortion laws after the Dobbs decision.  Please see Image 12.2 below for details.  In addition to changes to state laws, on January 31, 2025, Executive Order 14182 reaffirmed the Hyde Amendment’s restrictions on federal funding for elective abortions (The White House, 2025). 

The Gender Equity Policy Institute’s 2025 analysis of CDC data underscores how these new laws have affected maternal health. They found that mothers living in abortion-ban states are nearly twice as likely to die during pregnancy or childbirth as mothers in states that protect access to reproductive care, and that Black mothers in states that have abortion bans face a risk 3.3 times higher than white mothers. Based on a 2025 Gender Equity Policy Institute analysis of CDC maternal mortality data, Texas experienced a 56% rise in maternal mortality in the first full year of its ban, while states that support abortion rights  saw a 21% decline (Gender Equity Policy Institute, 2025).

Image 12.2 

Abortion Laws by State 

Guttmacher Institute

Click here for live link.

Conclusion

Congress, the President, the Supreme Court, and state legislatures have continuously shaped the laws governing our ability to make personal decisions about procreation, contraception, and pregnancy. Understanding how these laws evolved both before and after Dobbs helps students see how each branch of government influences civil rights and what changes have expanded or limited reproductive freedom. This knowledge also highlights the continuing work needed to protect and honor civil rights and liberties in this area.

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30. Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531.

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34. Roe v. Wade, 410 U.S. 113 (1973).

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40. The Politics Teacher. (n.d.). Case study: The conservative agenda of the Roberts Court. https://sites.google.com/site/thepoliticsteacherorg/case-study-the-conservative-agenda-of-the-roberts-court

41. The White House. (2025). Memorandum for the Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, and the Administrator of the United States Agency for International Development (Mexico City policy). https://www.whitehouse.gov/presidential-actions/2025/01/memorandum-for-the-secretary-of-state-the-secretary-of-defense-the-secretary-of-health-and-human-services-the-administrator-of-the-united-states-for-international-development/

42. Title X of the Public Health Service Act, 42 U.S.C. §§ 300–300a-6 (1970). https://www.congress.gov/crs-product/IF10051

43. Tuerkheimer, D. (2025). Threats to contraception. 78 Stanford Law Review Online 104. https://www.stanfordlawreview.org/online/threats-to-contraception/

44. United States v. Vuitch, 402 U.S. 62 (1971).

45. U.S. Department of Health and Human Services, U.S. Department of Labor, & U.S. Department of the Treasury. (2018). Religious exemptions and accommodations for coverage of certain preventive services under the Affordable Care Act; final rules. Federal Register, 83(219), 57,536–57,656. https://www.federalregister.gov/documents/2018/11/15/2018-24512

46. Williams, D. K. (2016). Defenders of the unborn: The pro-life movement before Roe v. Wade. Oxford University Press.

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48. Younger v. Harris, 401 U.S. 37 (1971).

49. Guttmacher Institute. (2023). Abortion in the United States. https://www.guttmacher.org/united-states/abortion