A History of Key Abortion Rulings of the U.S. Supreme Court
Sept. 19, 2008
In this article:
Roe v. Wade
The Post-Roe Court
The Divided Court in Casey
The Partial-Birth Abortion Decisions
During
the past 35 years, federal courts, particularly the U.S. Supreme Court, have
superseded states as the driving force in crafting abortion policy. Indeed, since
the high court’s 1973 decision in Roe v. Wade,
which granted women the constitutional right to terminate their pregnancies,
state legislatures and governors have encountered a number of limitations in
the ways they can regulate abortion.
Prior
to Roe, and throughout much of American
history, states banned or severely restricted abortion. State abortion laws,
many of which were enacted in the 19th and early 20th centuries, often targeted
those who performed abortions rather than the pregnant women who sought to have
the procedure performed. The aim of many of these laws was to protect pregnant
women (and their fetuses) from injury, not to prosecute them.
Despite
the near-universal prohibition on abortion in the early 20th century, social
forces in the decades that followed – such as the fight for women’s suffrage
and later the feminist movement – pushed the country toward greater political
and sexual freedom for women. In 1967, Colorado
became the first state to greatly broaden the circumstances under which a woman
could legally receive an abortion. By 1970, 11 additional states had made
similar changes to their abortion laws and four other states – New
York, Washington, Hawaii and Alaska
– had completely decriminalized abortion during the early stages of pregnancy.
Meanwhile,
abortion rights advocates launched a series of court challenges to many older
state abortion laws, often arguing that these statutes were overly vague or
that they violated the right to privacy or the right to equal protection under
the law guaranteed under the U.S. Constitution. State and lower federal courts
usually rejected these arguments.
Roe v. Wade
In
the early 1970s, the Supreme Court agreed to hear two cases challenging laws
that restricted abortion. In Roe v. Wade (1973), the high court considered a
challenge to a Texas
law outlawing abortion in all cases except those in which the life of the
mother was at risk. The second case, Doe v. Bolton (1973),
focused on a more lenient Georgia
law that allowed a woman to terminate her pregnancy when either her life or her
health was in danger. In both cases, lower federal courts had declared the
statutes unconstitutional, ruling that denying a woman the right to decide
whether to carry a pregnancy to term violated basic privacy and liberty
interests contained in the Constitution.
In two
separate but related decisions, the Supreme Court affirmed the lower courts’ conclusions
and struck down both statutes by a vote of 7-2. In Roe, the more significant of the two decisions, the court concluded
that constitutional rights to privacy and liberty protected a woman’s right to
terminate her pregnancy. Writing for the majority, Justice Harry Blackmun
acknowledged that while “the Constitution does not explicitly mention any right
to privacy,” a number of prior decisions had found “a guarantee of certain
areas or zones of privacy.” This guarantee of privacy, Blackmun added, is
grounded in several amendments within the Bill of Rights and in the 14th Amendment’s
guarantee of liberty, which taken together create zones of privacy in areas of
society such as marriage, contraception, family relationships and child-rearing.
Justice
Blackmun’s argument for the right to privacy in Roe grew out of earlier high court decisions, most notably Griswold v. Connecticut (1965). In Griswold, the court had struck
down a Connecticut
anti-contraception law on the ground that it intruded on the right to marital
privacy. Justice William Douglas, writing for the majority, had asserted that “zones”
of personal privacy are fundamental to the concept of liberty under “the
protected penumbra of specific guarantees of the Bill of Rights.”
Having
concluded in Roe that access
to abortion is a “fundamental right,” the court declared that only a “compelling
state interest” could justify the enactment of state laws or regulations that
limit this right. The court also recognized that the state has an “important
and legitimate interest” in protecting the health of the mother and even “the
potentiality of human life” inside her. The court then asked: When does the state’s
legitimate concern for maternal and fetal protection rise to the level of
compelling interest? To answer this question, Blackmun created a three-tiered legal
framework, based on the nine-month period of pregnancy, which gave the state
greater interest and regulatory latitude in each successive tier.
Drawing Lines: The Three Tiers of Justice Blackmun’s Trimester Framework in Roe
Tier 1
Time Period Covered: First trimester of pregnancy
Legal Standard: State has no real interest in protecting mother’s health
Legal Limits: State can only require basic health safeguards and cannot limit access to abortion
Tier 2
Time Period Covered: End of first trimester to point of fetal viability
Legal Standard: State has interest in protecting mother’s health
Legal limits: State can regulate abortion only to protect health of mother
Tier 3
Time Period Covered: Period after point of fetal viability
Legal Standard: State has interest in protecting “potential life”
Legal Limits: State can restrict or even ban abortion as long as procedure still allowed when mother’s life or health at risk
The
first tier in Blackmun’s framework encompassed the first trimester of
pregnancy. Given that during these first three months the risks associated with
abortion are actually lower than those associated with childbirth, the state has
no real interest in limiting the procedure in order to protect a woman’s
health, Blackmun argued. During this period, the state can only impose basic
health safeguards – such as requiring that the procedure be performed by a qualified
health professional – and can in no way limit access to abortion.
The
second tier of Blackmun’s framework encompassed the period from the end of the
first trimester to the point of fetal viability – the point at which a fetus
can survive outside the womb, either through natural or artificial means, which
typically takes place between about 24 and 28 weeks into a pregnancy. At this
point, Blackmun determined, the state has an interest in protecting maternal
health and can regulate abortion only to protect the health of the mother. In
other words, regulations have to be directed toward ensuring maternal health
and cannot be aimed at protecting a fetus or limiting access to abortion
services. Thus, a state law requiring a doctor to describe to a woman seeking
an abortion the risks associated with the procedure before receiving her informed
consent would be constitutional – as long as the requirement aimed to protect
maternal health and was not created to dissuade a woman from terminating her
pregnancy.
The
third tier of Blackmun’s framework encompassed the period after the point of fetal
viability. During this time, Blackmun wrote, the state has an interest in
protecting “potential life” and can even proscribe abortion, as long as the
procedure is still allowed in cases in which the life or health of the mother is
at risk.
In Doe, the same seven-justice
majority largely restated and fleshed out its ruling in Roe. Again writing for the
majority, Justice Blackmun determined that state regulations that could create
procedural obstacles to abortion – such as, in this particular case, the
requirement that an abortion be performed in a hospital or be approved by two
doctors – violate a woman’s right to terminate her pregnancy.
The Post-Roe
Court
Roe proved to be one of the most significant decisions
ever handed down by the Supreme Court and is perhaps rivaled in public
attention in the 20th century only by the landmark 1954 school desegregation
case, Brown v. Board of Education.
Unlike Brown, however,
Roe has remained
controversial in the decades since it was decided.
In
the years immediately following Roe,
the Supreme Court grappled with a host of issues that arose from the decision.
These included questions about laws requiring informed consent, parental consent,
spousal consent and waiting periods for women seeking abortions. In these early
cases, the high court generally struck down most laws regulating abortion and
upheld only a few that, in the court’s view, did not significantly limit a woman’s
right to terminate her pregnancy. In these cases, the court also affirmed Roe and its three-tiered
framework.
The
first small crack in Roe
jurisprudence came in 1989 when the high court decided Webster v. Reproductive Health Services.
This case concerned a Missouri
statute that barred public facilities from being used to conduct abortions and
prohibited public health workers from performing abortions unless the life of the
mother was at risk. The statute also defined life as beginning at conception
and directed physicians to perform fetal viability tests on women who were 20
or more weeks pregnant and seeking abortions.
In a
highly fractured 5-4 decision, the court upheld the constitutionality of the
statute. Writing for the majority, Chief Justice William Rehnquist stated that
the law’s declaration that life begins at conception does not contradict Roe because the declaration is
contained in the statute’s preamble and thus should have no real impact on
access to abortion. The majority also held that prohibiting the use of
government workers or facilities to perform abortions is acceptable because the
right to an abortion established in Roe
does not include the right to government assistance in obtaining one. The
majority also ruled that the requirement of viability testing at 20 weeks is
constitutional, although the justices offered different reasons for this ruling.
In
one opinion, Chief Justice Rehnquist, joined by Justices Byron White and
Anthony Kennedy, argued for dispensing with part of Roe’s three-tiered system, the second tier of which allows
only laws aimed at protecting the mother’s health. According to Rehnquist, the
framework had come to resemble “a web of legal rules” rather than “constitutional
doctrine.” The three justices also maintained that the state has an interest in
protecting potential life before viability, making the 20-week requirement
valid even if fetal viability normally occurs after 20 weeks. “We do not see
why the state’s interest in protecting potential human life should come into
existence only at the point of viability and should therefore be a rigid line
allowing state regulation after viability but prohibiting it before viability,”
Rehnquist wrote.
In a
concurring opinion, Justice Antonin Scalia argued that the majority opinion was
“indecisive” and “stingy” and that Roe
should be overturned. Justice Sandra Day O’Connor, the fifth and final member
of the majority, also concurred in the decision, but for very different
reasons. Unlike her colleagues in the majority, O’Connor argued that Roe’s trimester system, while
problematic, should neither be modified nor overturned in this case. She
determined rather that the testing requirement passed constitutional muster
because it does not impose an “undue burden” on a woman considering an
abortion.
In a
blistering dissent, Justice Blackmun took Justices Rehnquist, White and Kennedy
to task for attempting to overturn Roe
by what he claimed were stealth tactics; he described their written opinion as
“filled with winks, and nods, and knowing glances to those who would do away
with Roe explicitly.”
The Divided Court in Casey
Although
Roe and its three-tiered
system survived Webster,
Blackmun’s fears were at least partially realized. The Webster decision revealed a new
majority on the court with a greater willingness to uphold state restrictions
on abortion. And while legal scholars and others were not immediately certain
of the ruling’s impact, Webster ultimately
set the stage for more significant changes in Roe’s three-tiered framework,
changes that would come a mere three years later in the 1992 decision Planned Parenthood of Southeastern
Pennsylvania v. Casey.
Casey involved a challenge to a wide-ranging abortion
law that included an informed-consent requirement as well as a 24-hour waiting
period for women seeking abortions. In addition, the statute required a minor
to obtain the consent of at least one parent or guardian, and for a wife to
inform her husband of her plans to terminate her pregnancy. In the cases of
both the minor and spousal requirements, various waivers were available for
extenuating circumstances.
In Casey, the court rendered an
even more splintered decision than it had in Webster. The court’s
three centrists – Justices Kennedy, O’Connor and David Souter – took the
unusual step of issuing a joint opinion authored by all three justices. They
were joined by the court’s liberal wing – Justices Blackmun and John Paul
Stevens – in affirming Roe’s
core principle: that the state may not prohibit pre-viability abortions. But the
three centrists were joined by the court’s more conservative wing – Justices Rehnquist,
Scalia, White and Clarence Thomas – in upholding all of the Pennsylvania statute’s requirements, except
the provision concerning spousal notification.
In
affirming Roe, the high court argued in
favor of maintaining the constitutional status quo for reasons that went beyond
legal precedent. “The Constitution serves human values,” wrote Justices
Kennedy, O’Connor and Souter, “and while the effect of reliance on Roe cannot be exactly measured,
neither can the certain costs of overruling Roe for people who have ordered their thinking and living
around that case be dismissed.” In other words, the justices were arguing, Roe has created expectations
that should not easily be discarded.
At
the same time, the court significantly modified the three-tiered framework that
Roe had created. First,
under Casey states
could now regulate abortion during the entire period before fetal viability,
and they could do so for reasons other than to protect the health of the
mother. The court also dismantled Roe’s
prohibition on the regulation of abortion during the first trimester (Blackmun’s
first tier) and its limitation of regulation between the end of the first
trimester and the point of fetal viability (Blackmun’s second tier). The result
was that a state’s interest in and regulation of potential life could now
arguably extend throughout a woman’s pregnancy.
In
addition, the court in Casey also established
a less rigorous standard for determining whether state abortion laws are
constitutional. In Roe
v. Wade, the court had declared
access to abortion to be a fundamental right and had determined that states
could only regulate abortion (before fetal viability) if there was a “compelling
state interest.” Thus, subsequent abortion statutes had been evaluated under
the “strict scrutiny” standard, the most rigorous legal standard for determining
whether a law passes constitutional muster. As a result, in the years
immediately following Roe,
many abortion regulations were declared unconstitutional.
But
in Casey the court replaced
strict scrutiny with a new and less rigorous “undue burden” standard. Under the new standard, regulating abortion
before the point of fetal viability would be deemed unconstitutional only if it
imposed an undue burden on a woman’s right to terminate her pregnancy.
Casey appeared to accommodate both sides in the abortion
debate. By partially dismantling the three-tiered framework and creating the
less rigorous undue burden standard for determining the constitutionality of
abortion regulations, the high court gave states greater latitude to regulate
abortion before the point of fetal viability. Indeed, in Casey the
court applied the less rigorous undue burden standard to the Pennsylvania laws and,
with the exception of the spousal-consent requirement, found all to be
constitutional.
But abortion
opponents had viewed Casey
as an opportunity to overturn Roe,
and many believed the court, bolstered by new Republican-appointed members
Clarence Thomas and David Souter, would do so. By ultimately affirming Roe, however, the court
solidified the decision’s status as legal precedent, thus affording Roe greater protection from future
challenges. The addition of two abortion rights supporters to the court in the
1990s, Justices Ruth Bader Ginsburg and Stephen Breyer, effectively eliminated
the threat to Roe,
for the time being, by creating a solid six-justice majority in
favor of keeping abortion a fundamental right.
The Partial-Birth Abortion Decisions
In
2000, the Supreme Court accepted Stenberg v. Carhart, a
case challenging the constitutionality of a Nebraska law prohibiting partial-birth
abortion. The term “partial-birth abortion” refers to a procedure known in the
medical community as “dilation and extraction” (D&X), which involves
terminating a pregnancy by partially extracting a fetus from a uterus, then
collapsing its skull and removing its brain. This procedure is usually
performed late in the second trimester, between 20 and 24 weeks into a
pregnancy. Violation of the Nebraska
law was made a felony, and punishment included possible fines and jail time, as
well as the automatic revocation of a convicted doctor’s state license to
practice medicine.
In a
5-4 decision, the high court ruled that the Nebraska law violated the Constitution as
interpreted in Casey
and Roe. Justice
Breyer, delivering the majority opinion, stated that the statute lacked the
requisite exception “for the preservation of the ... health of the mother.”
Citing Casey, Breyer
determined that the state may promote but not endanger a woman’s health when it
regulates the methods of abortion.
In
addition, the majority found the wording of the Nebraska ban unclear because it could be
interpreted by doctors to include not only the D&X procedure but other
abortion methods as well. The majority ruled that this ambiguity imposed an
undue burden on a woman’s ability to choose an abortion, as well as on those
who perform abortions using methods similar to the partial-birth procedure who might
face prosecution.
Even
though the decision effectively rendered similar bans in more than 30 states
unenforceable, the vote was unexpectedly close for a court in which support for
the right to abortion was expected to garner the support of six justices. In a
surprising shift, Justice Kennedy dissented, emphasizing what he described as
the “consequential moral difference” between the dilation and extraction method
and other abortion procedures.
Even
so, in 2003 Congress passed and President George W. Bush signed the Federal Partial
Birth Abortion Ban Act, the first federal law banning the D&X procedure.
Abortion rights advocates immediately challenged the law, and lower courts,
citing Stenberg,
struck it down.
But
in 2007, in the case Gonzales v. Carhart, the
Supreme Court reversed course and upheld the federal ban by a vote of 5-4,
giving abortion opponents a major victory and prompting many states to consider
passing tougher restrictions on abortion. The ruling was significant because the high court declared the
federal statute to be constitutional even though it does not contain an
explicit exception in cases in which a woman’s health is in danger. This was a significant
departure from earlier abortion rulings, including the Stenberg decision, which require that laws restricting abortion
include such a health provision.
The
decision also reflected the impact of recent changes on the high court, notably
the replacement in 2006 of the retired Justice O’Connor with Justice Samuel
Alito. O’Connor had provided the fifth and deciding vote in Stenberg. By ruling with the court’s
conservative wing, Alito provided the crucial fifth vote needed to uphold the
law.
The
majority opinion was penned by Justice Kennedy, who in 2006 had replaced O’Connor
as the person most likely to be the court’s “swing vote” in very close
decisions. Indeed, prior to this ruling, some legal analysts had argued that
Kennedy’s recent attempts to position himself between the court’s liberal and
conservative wings meant that, even though he had voted with the conservative
minority in Stenberg and had authored a passionate dissent criticizing
the majority for striking down Nebraska’s partial-birth abortion ban, he could
not be reliably placed with either side in the partial-birth decision. But
Kennedy’s decision made clear that
his views had not significantly changed since Stenberg. The only
difference was that now he was writing for the majority.
Kennedy
devoted a substantial part of his majority opinion to differentiating the
federal partial-birth abortion ban from the Nebraska ban that had been struck down by
the high court in Stenberg. Although he had strenuously dissented in Stenberg,
Kennedy did not overturn the court’s decision in that case; instead, he attempted
to fit the Federal Partial Birth Abortion Ban Act within Stenberg’s parameters.
The decision in Gonzales v. Carhart has already prompted some state
legislatures to consider and, in a number of cases, pass new abortion
requirements. For instance, in 2008, Oklahoma
enacted a measure requiring women who seek abortions to first submit to an
ultrasound test that shows an image of the fetus. Two other states passed laws
in 2008 requiring doctors at clinics to offer to perform ultrasounds on women
seeking abortions, joining 14 states that already have such a requirement. In
addition, in November 2008, voters in California,
South Dakota and Colorado will decide whether three ballot
initiatives restricting abortion will become law.
This whirlwind of action in the states could produce
accompanying gusts at the nation’s court houses, since some new abortion
restrictions are likely to be challenged. Federal district and appeals courts, in
particular, would be charged with trying to understand the contours of Carhart
in order to apply the ruling to these new laws and policies. If a plethora
of resulting lower court cases produces different and contradictory decisions,
the Supreme Court may once again need to revisit its abortion jurisprudence.
This report was written by David Masci, Senior Research Fellow, Pew Forum on Religion & Public
Life.
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