essay on should abortion be banned

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Pro and Con: Abortion

To access extended pro and con arguments, sources, and discussion questions about whether abortion should be legal, go to ProCon.org .

The debate over whether abortion should be a legal option has long divided people around the world. Split into two groups, pro-choice and pro-life, the two sides frequently clash in protests.

A June 2, 2022 Gallup poll , 55% of Americans identified as “pro-choice,” the highest percentage since 1995. 39% identified as “pro-life,” and 5% were neither or unsure. For the first time in the history of the poll question (since 2001), 52% of Americans believe abortion is morally acceptable. 38% believed the procedure to be morally wrong, and 10% answered that it depended on the situation or they were unsure.

Surgical abortion (aka suction curettage or vacuum curettage) is the most common type of abortion procedure. It involves using a suction device to remove the contents of a pregnant woman’s uterus. Surgical abortion performed later in pregnancy (after 12-16 weeks) is called D&E (dilation and evacuation). The second most common abortion procedure, a medical abortion (aka an “abortion pill”), involves taking medications, usually mifepristone and misoprostol (aka RU-486), within the first seven to nine weeks of pregnancy to induce an abortion. The Centers for Disease Control and Prevention (CDC) found that 67% of abortions performed in 2014 were performed at or less than eight weeks’ gestation, and 91.5% were performed at or less than 13 weeks’ gestation. 77.3% were performed by surgical procedure, while 22.6% were medical abortions. An abortion can cost from $500 to over $1,000 depending on where it is performed and how long into the pregnancy it is.

• Abortion is a safe medical procedure that protects lives.
• Abortion bans endangers healthcare for those not seeking abortions.
• Abortion bans deny bodily autonomy, creating wide-ranging repercussions.
• Life begins at conception, making abortion murder.
• Legal abortion promotes a culture in which life is disposable.
• Increased access to birth control, health insurance, and sexual education would make abortion unnecessary.

This article was published on June 24, 2022, at Britannica’s ProCon.org , a nonpartisan issue-information source.

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Article Contents

I. the hope that abortion bans will deter abortion, ii. the hope that abortion bans will send a message, iii. the hope that abortion bans will be competently implemented and enforced, iv. conclusion, acknowledgements, ethics approval statement.

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What will and won’t happen when abortion is banned

Katharine & George Alexander Professor of Law, Santa Clara University School of Law.

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Michelle Oberman, What will and won’t happen when abortion is banned, Journal of Law and the Biosciences , Volume 9, Issue 1, January-June 2022, lsac011, https://doi.org/10.1093/jlb/lsac011

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For the past 50 years, abortion opponents have fought for the power to ban abortion without little attention to how things might change when they won. The battle to make abortion illegal has been predicated on three nebulous assumptions about how abortion bans work. First, supporters believe banning abortion will deter it. Second, they hope bans will send a message about abortion—specifically, that abortion is immoral. And third, they expect bans to be competently implemented and enforced. Drawing on empirical work from within and outside of the U.S., this Article offers an evidence-based assessment of each of these assumptions. Part One examines the question of deterrence by exploring findings from countries with relatively high and relatively low abortion rates. After explaining why restrictive abortion laws alone do not reduce aggregate abortion rates, I consider the matter of individual deterrence. By identifying those most likely to be deterred by U.S. abortion bans, I illustrate how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children. Part Two tests the idea that abortion bans send a message. I consider the bans’ meaning in context with U.S. laws and policies affecting families, exposing the difference between laws discouraging abortion, and those encouraging childbirth. Then, drawing from literature on the expressive function of the law, I assess the limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitment to children living in poverty. Part Three turns to the expectation that abortion bans will be competently enforced, noting the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans. This article concludes by considering why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.

For the past 50 years, abortion opponents have fought for the power to ban abortion without paying much mind to the details of how things might change when they won. The battle to make abortion illegal has been waged over a surprisingly nebulous assumption that banning abortion would, in itself, lead to meaningful changes in the practice of abortion in America. It has been a policy based on hopes and prayers, rather than on actual evidence about how restrictive abortion laws work in practice.

When the law on the ‘books’ changes in the United States, what might the law on the ground look like? Drawing on empirical work from within and outside of the USA, this article offers an evidence-based answer to the question of what will and would not happen where abortion is banned.

In the spirit of full disclosure, like almost everyone who engages with the abortion war, I have a bias: I am an unambivalent supporter of abortion rights. Nonetheless, I strive in this article to maintain a tone that I hope will permit readers who disagree with me to hear my message. I do so because those on all sides of our abortion war should care about it. For 50 years, the USA abortion war has been fought almost exclusively around the issue of legalization. 1 Yet all evidence suggests the changes likely to be wrought by banning abortion should leave even ardent supporters of abortion bans not just disappointed, but profoundly disturbed by their downstream consequences.

The question of how abortion bans work in practice is a live one among abortion-rights advocates, with many, (including myself), working to identify what happens, and to whom, so as to permit advocates and policy makers to mitigate their harsh impact on the vulnerable. 2 By contrast, anti-abortion Americans who have spent decades working to enact such laws have paid relatively little attention to how things actually change when abortion is illegal. Instead, they have rested their support for outlawing abortion on three general assumptions about how abortion bans will work. First, they believe banning abortion will deter it. 3 Second, they hope the bans will send a message about abortion—specifically, that abortion is immoral. 4 And third, they expect the laws will be competently implemented and enforced. 5

This article interrogates each of these expectations. Part One begins its consideration of the question of deterrence by exploring research from countries with relatively high and relatively low abortion rates. This comparison offers powerful evidence that restrictive abortion laws alone do not reduce abortion rates. But while outlawing abortion is unlikely to cause an aggregate decline in abortion rates, bans will cause some to carry to term pregnancies they might otherwise have aborted. 6 This section concludes with an examination of how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children–already the most vulnerable and marginalized Americans.

Part Two tests the assumption that outlawing abortion will send a message that abortion is morally wrong, thereby helping to foster a culture that rejects abortion as an option. This section considers the messages sent by US abortion bans by placing them in context with our laws and policies that inform when and whether people seek abortions. Then, drawing from literature on the expressive function of the law, this section explores the practical and symbolic limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitments to children living in poverty.

Part Three moves to the expectation that abortion bans will be competently enforced. Here, I examine the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans.

This article concludes with a consideration of why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.

Abortion opponents anticipate that banning abortion will deter it. That said, they are not overly sanguine about this hope; anti-abortion advocates acknowledge that abortions will continue to take place, even if illegal. 7 But their support for abortion bans rests firmly on the expectation that there will be fewer of them, once abortion is a crime. 8 In this section, I explore the question of deterrence, first considering the population-wide impact of bans on abortion rates, and then describing the Americans most likely to be deterred by abortion bans.

I.A. Deterrence, in the Aggregate

To think about whether abortion can be deterred by outlawing it, we must begin by reflecting on what leads people to have abortions. Abortion demand is driven by a host of factors—health status, relationship status, job status—but the most commonly cited concern is lack of money. 9 Half of all US abortions go to the 13 per cent of Americans living below the poverty line–which in 2022, means living on less than $13,590. 10 Those living in poverty or near poverty make up a full 76 per cent of abortions every year. 11 These are people whose abortion decisions are motivated, at least in part, because they cannot afford the costs of child rearing. 12

Rather than focusing on reducing abortion demand by offsetting the costs of having children, abortion bans aim to deter abortion solely by reducing access to legal abortion. Even a cursory glance at worldwide abortion rates suggests that strategy might not work. Abortion rates vary dramatically by region. In Latin America, (home to countries with the world’s strictest abortion bans), we find some of the highest abortion rates in the world: 32 abortions for every 1000 women. 13 At the other end of the spectrum, Western Europe, (with relatively liberal abortion laws), has the world’s lowest abortion rates: only 12 abortions per 1000 women. 14

The variation in abortion rates is best understood as an artifact of variation in rates of unintended pregnancy. 15 The single biggest predictor of abortion rates is not the legal status of abortion, but rather, the percentage of pregnancies that occur among those who were not looking to have a baby. In 2014, the most recent year for which data is available, 44 per cent of pregnancies globally were unintended. 53 per cent of those unintended pregnancies ended in abortion. 16 Rates of both unintended pregnancy and abortion vary by a country’s wealth status. In the world’s wealthier nations, over the past quarter century, rates of unintended pregnancies dropped by 30 per cent, triggering a decline in abortion rates from 46 abortions per 1000 women of reproductive age to an average of 27. 17 By contrast, over the same time frame in the developing world, unintended pregnancy rates fell by only 16 per cent, while abortion rates remained static. 18

Like other wealthy countries, U.S. abortion rates have dropped significantly in recent decades. 19 The decline is evident across almost every demographic in the country—younger, older, Northern, Southern. With one exception: abortion rates have remained constant among the poorest Americans. 20 This finding underscores the significance of unintended pregnancy in driving abortion rates: nearly half of all pregnancies in the United States are unintended—a higher rate than in many other developed countries. 21 These rates vary dramatically by class: a poor woman in the USA is more than five times as likely as an affluent woman to have an unintended pregnancy. 22

The single most effective way to help people avoid unwanted pregnancies, thereby deterring abortion, is by increasing contraception rates. When the Affordable Care Act mandated insurance coverage for contraception, the unintended pregnancy rate dropped from 44.7 to 37.9 per cent. 23 And yet, the anti-abortion movement has opted to oppose efforts to increase access to contraception. 24 Indeed, abortion opponents vigorously fought the Affordable Care Act’s birth control mandate, which the Supreme Court ultimately struck down in 2014. 25

If the goal of banning abortions is to deter them, a strategy that fails to focus on reducing unintended pregnancy seems limited, at best. But even if one accepts that abortion opponents are too ambivalent about promoting contraception to center the goal of deterring abortion by reducing unwanted pregnancy, the plan to deter abortion by banning it is flawed for a second reason. Specifically, owing to the ready availability of abortion medicines, abortion bans cannot effectively restrict access to a safe, effective, and affordable means to end a pregnancy.

The widespread availability of abortion medicines has completely transformed the world of illegal abortion. Unlike the pre-Roe era, medication abortion solves the problem of finding a doctor to perform an illegal abortion, while simultaneously reducing the health risks. 26 The most common and widely available abortion medicine is misoprostol. 27 Although less effective than the FDA-approved combination of mifepristone and misoprostol typically used in medical abortions in the USA, misoprostol alone causes an abortion in approximately 90 per cent of cases. 28 Efforts to restrict access to misoprostol are complicated for two reasons. It is both cheap and easy to manufacture, costing only pennies to make, and it also is an important life-saving medicine. 29 Indeed, the World Health Organization lists misoprostol as an ‘essential medicine,’ owing in part to its vital role in reducing deaths from postpartum hemorrhages, miscarriages, and illegal abortions. 30

There is a robust international market in misoprostol across the world today—particularly in countries where abortion is strictly banned. 31 Even in Central America, which boasts the world’s strictest abortion bans, one in three pregnancies ends in abortion, largely induced by medicines purchased online or on the street. 32 Americans familiar with the black market in opioids should have little trouble imagining how a market in abortion medicines will proliferate, where abortion is banned. As is all too evident from the scope of the opiate problem, it is unrealistic to think the government can prosecute away the expanding market in abortion medicines. 33

Outlawing abortion may lead to a short-term decline in US abortion rates, while people adjust to new market conditions. 34 But as we learn from the experiences of countries throughout the world, this decline is unlikely to be sustained. If anything, given the availability of reliable online information and buying options, it should take far less time for people to adapt to accessing illegal abortion than was true for alcohol access after Prohibition. 35

I.B. Deterrence, in the Specific

Even if abortion bans are unlikely to cause an aggregate decline in abortion rates–at least not independently of other trends 36 –we can predict that they will cause some to carry to term pregnancies they might otherwise have aborted. 37 In fact, we have a surprisingly clear picture of those who the bans are most likely to deter: they will be disproportionately young, poor, Black, and brown women. Abortion bans come as one in a long list of factors that circumscribe the reproductive lives and life options of these Americans. 38 They are more likely to experience unintended pregnancy, and where abortion is outlawed, they are more likely to struggle with accessing abortion, whether by traveling to a legal jurisdiction, or by identifying reliable information about how to safely end an unwanted pregnancy with abortion medications. 39

Those who support abortion bans on deterrence grounds have yet to fully grapple with what happens to those for whom abortion, legal or otherwise, is out of reach. The standard response is to promote the solution of placing newborn babies for adoption. Justice Amy Coney Barrett nodded to this viewpoint at oral argument in the Dobbs case, correcting the assertion that abortion bans amount to ‘forced motherhood’ by noting that safe haven laws permit them to surrender their newborns without legal consequences. 40 Adoption proponents point to the ways in which open adoptions have become the norm, hopeful that the prospect of staying involved in their baby’s life will encourage more people to place them for adoption. 41 Banning abortion, as they see it, can be a ‘win-win-win’ situation, in which the baby survives, the mother gets to go on with her life, and a married couple or family gets to raise the child. 42

Yet all available evidence suggests that banning abortion is unlikely to transform adoption from an outlier into a commonplace response to unwanted pregnancy. Even in the years prior to Roe, when the stigma of unwed motherhood led some facing pregnancy to place their babies, only 9 per cent of women chose adoption. 43 Much of that rate was driven by white women, because the two-parent family norm was less entrenched among Black and brown Americans. Today, the stigma is gone: 40 per cent of all children are born out of wedlock. 44 When faced with an unintended pregnancy, fewer than 5 per cent of people seriously consider adoption, and of those, fewer than 2 per cent ultimately place their children with adoptive families. 45

The best indication of what is likely to happen to those unable to access abortion is found in the Turnaway study, a 10-year longitudinal investigation of the impact of being denied an abortion. 46 That study followed hundreds of women who sought abortions, but were turned away because they were beyond the clinic’s gestational limits. 47 Fully 91 per cent of them opted to raise their child. 48

The Turnaway study also tells us about the consequent intensification of poverty for these families:

[C]hildren of women who are denied an abortion had greater odds (72 vs 55%) of living in poverty compared to children of women who received a wanted abortion. Similarly, existing children were more likely (87 vs 70%) to live in a household in which their mother is not able to afford necessary living expenses such as food, housing, and transportation compared to children of women who received a wanted abortion. 49

As we look to understand what happens when an abortion ban ‘works’ by deterring abortion, the only question is how broad a lens to use. More than one in three single-mother families lived in poverty in 2016. 50 Poverty is not color-blind. Instead, far more women of color live in poverty than do their white counterparts: close to 25 per cent of all American Indian or Alaskan native and 20 per cent of all Black and Hispanic women live in poverty, compared to only 9 per cent of their white counterparts. 51

So severe are the downstream consequences for children born into poverty that the American Academy of Pediatrics issued a statement decrying the short and long-term consequences of the ‘medicalization of poverty’:

Children who experience poverty, particularly during early life or for an extended period, are at risk of a host of adverse health and developmental outcomes through their life course. Poverty has a profound effect on specific circumstances, such as birth weight, infant mortality, language development, chronic illness, environmental exposure, nutrition, and injury. Child poverty also influences genomic function and brain development…. Children living in poverty are at increased risk of difficulties with self-regulation and executive function, such as inattention, impulsivity, defiance, and poor peer relationships. Poverty can make parenting difficult, especially in the context of concerns about inadequate food, energy, transportation, and housing. Child poverty is associated with lifelong hardship. Poor developmental and psychosocial outcomes are accompanied by a significant financial burden, not just for the children and families who experience them but also for the rest of society…. 52

We should read these statistics as a forecast. To the extent abortion bans deter abortion, we will likely see a disproportionate increase in the number of poor families of color experiencing the devastating consequences of living in poverty. Abortion bans work by leveraging existing inequalities. 53

Abortion opponents are of two minds about how to respond to the poor predicted outcomes for those who opt to raise children after being unable to access abortion. Small numbers of advocates–largely drawn from the volunteer ranks of pregnancy support or ‘crisis pregnancy’ centers–advocate helping women who are in desperate straits by offering housing, counseling, job training, and other support. 54 But the dominant voice of the anti-abortion movement–those advocates engaged in political activism and law reform, rather than direct service–focuses not on supporting poor mothers, but instead, on promoting adoption. 55

The suggestion that adoption is the optimal solution to a poorly timed pregnancy is as convenient as it is naïve. It allows abortion opponents to avoid a reckoning with consequences of having made the Republican party their political home. 56 The GOP’s historical and ongoing objection to family-friendly government policies 57 will make it hard, in the years to come, for abortion opponents to gain much traction for laws aimed at blunting the crushing impact of poverty on those whom the bans deter from having abortions.

Those who support abortion bans do not rest their support solely on the expectation that such laws will deter abortion. Instead, abortion opponents often invoke the belief that changing the law will send a message, thereby promoting culture change. 58 This section first considers the nature of that message, and then turns to whether it will be received.

It is helpful, when considering the message sent by outlawing abortion, to note the difference between an anti-abortion message (one that condemns abortion) and a pro-natal message (one that urges people to have babies). This distinction is easiest to observe when contrasting U.S. laws with those of countries that actively encourage childbearing.

Consider the case of Israel, which makes abortion a crime unless the person can prove to an official ‘pregnancy termination committee’ that they qualify for one of the statute’s exceptions. 59 This law would send a message that, outside of exceptional circumstances, abortion is wrong. 60 But it also exists alongside a host of laws and policies that encourage people to have children. 61 In Israel, there is guaranteed paid maternity leave—you can leave your job for 26 weeks, still get paid, and your employer cannot fire you. 62 Parents enjoy access to local neighborhood, government-subsidized day care. 63 In addition to tax deductions, the Israeli government pays everyone—rich and poor alike—a small monthly allowance for each child under eighteen. 64

In addition to the ways in which these policies help offset some of the most immediate costs associated with having a child, they send a message about how the government feels not just about abortion but also about babies. Israel’s laws send a message that the government wants people to have babies.

By contrast, US laws reflect little interest in encouraging people to have babies, particularly ones they cannot afford to raise. There is no paid parental leave, and no job security at all beyond the first 12 weeks of unpaid leave. 65 There is no child allowance. The Covid-related child income tax break, which reduced child poverty by 30 per cent, was permitted to lapse after a single year. 66 The goal of providing universal access to quality day care and preschool remains a pipedream. 67 The federal assistance program, Temporary Assistance to Needy Families, is so under-funded that no state’s subsidy amounts to more than 60 per cent of the federal poverty line, with the result that even in states with relatively generous monthly allocations, families cannot afford modest rent. 68

Those who believe abortion bans promote a culture of life might do well to recognize that any message sent by an abortion ban is necessarily entwined with the messages sent by government laws and policies that set the price of having a child. The message of an abortion ban on its own says little about embracing life, and instead merely suggests that abortion is wrong. 69

As to whether that message will be received, the answer is complicated. For all that, it is common to suggest the law can send messages, there is surprisingly little evidence for how it might do so. Professor Richard McAdams, one of the leading authorities on the ‘expressive function’ of the law, posits that an expressive law reveals the lawmakers’ beliefs, which in turn causes individuals to update their beliefs and ultimately to change their behaviors, usually in the direction of compliance. 70 He points to the example of indoor smoking bans by way of illustration. In the face of mounting evidence on the harmfulness of secondhand smoke, lawmakers enacted indoor smoking bans that served, in part, to send the message that tobacco was dangerous. In turn, these bans helped shift the culture away from smoking. 71

According to McAdams, smoking bans succeeded because lawmakers had a clear, credible message. But government credibility is not automatic; rather, it is earned. To send a message, government actors must offer some reason why the public should trust their conclusions. McAdams suggests the government earned credibility by persuading the public they were acting on data showing that the hazards of secondary smoke inhalation required nothing less. 72

Unlike smoking bans, abortion bans address themselves to a question of morality—one that cannot be settled by aggregated data or special expertise. A government hoping to persuade the public that abortion is immoral will struggle simply because it lacks the expertise needed to settle the question. 73

The challenge of sending a message by banning abortion is intensified by the impact of the ongoing battle over abortion’s legality. When it comes to the law’s ability to send a message, Professor McAdams notes, background noise can be fatal:

Individuals are constantly being bombarded by information from sources other than the law: the print media, Internet, social acquaintances, etc. For expression to change beliefs, there must be some factor that makes the legal signal strong enough to stand out against this background. 74

To send a message, abortion bans must compete for air time with a world of counter-messages. After all, the fight over abortion does not end with abortion bans. Together with the likelihood that abortion remains commonplace, even where banned, and remains legal in almost half the country, the message-sending capacity of abortion bans is more akin to that of marijuana bans than to indoor smoking bans. 75

At the end of the day, perhaps the most that can be said for the message-sending capacity of abortion bans is that, where popularly embraced by an anti-abortion electorate, the bans might contribute to a broader cultural message that abortion is wrong. As Katrina Kimport forcefully demonstrates in her book, No Real Choice , the ‘abortion as killing’ narrative can combine with structural constraints like legal barriers and cost to render abortion ‘unchoosable.’ 76

The final set of expectations harbored by those who support outlawing abortion involves tacit baseline assumptions about how the law will work, in practice. Specifically, supporters assume that abortion bans will be competently implemented and enforced—that the laws will have integrity. Competent implementation and enforcement are not abstract ideals, but rather, are necessary preconditions for a law to be considered a legitimate exercise of state authority. The failure to competently implement an abortion ban will undercut its legitimacy, thereby undermining both the law’s capacity to deter abortion and also its ability to send a message.

To understand the practical considerations relevant to enforcing abortion bans, begin by noting what is required in order to implement them. The standard form of US abortion bans includes a general prohibition, accompanied by a small number of exceptions. 77 This structure gives rise to two implementation and enforcement questions, both of which will determine whether the laws are ultimately seen as legitimate exercises of government authority. When and how will prosecutors endeavor to enforce the bans, and by what mechanisms will states evaluate cases involving exceptions to the bans?

Let us examine each of these in turn.

III.A. Enforcing Abortion Bans

Supporters of abortion bans have given relatively little thought to the question of how abortion laws will be enforced. In late 2021, movement leader Marjorie Dannenfelser, President of the Susan B. Anthony List (a nonprofit that supports pro-life politicians) explained how she views the question of enforcement:

[M]y view, and the view of the entire movement—without any exception that I’m aware of—is that the doctor, the one who has been planning to break the law, is the guilty party. The law is enforced against that person, not the woman. 78

But illegal abortion today need not involve a doctor or any third party besides an overseas pharmacy, outside the easy reach of US laws. 79 Given abortion medicines, the reality is that there are no doctors to prosecute.

When abortion becomes a crime, the question of who is the criminal will require an answer. And rather than being answered by movement leaders, the decision will rest in the hands of locally-elected prosecutors. No county can afford to prosecute every crime–far from it–so local District Attorneys set priorities when enforcing the law. 80 Their choices may be informed by many factors: staff resources, strength of evidence, heinousness of crime, perception of public will, or say, pro-choice or anti-abortion sentiment. As Judge Stephanos Bibas notes, there is no check on ‘idiosyncratic prosecutorial discretion.’ 81

A quick review of abortion prosecutions both historically and today helps us understand what idiosyncratic abortion prosecutions might look like. Historian Leslie Regan’s work documents the episodic nature of abortion prosecutions in the years prior to Roe , showing how they tended to be sporadic—an occasional crackdown, motivated by a zealous prosecutor, rather than a comprehensive effort at enforcement. 82

A similar pattern is seen today in places where abortion is outlawed. For example, consider El Salvador, which bans abortion without exception. In the 10 years from 2000–2010, there were 129 prosecutions. 83 This number suggests enforcement is relatively rare—just over 10 prosecutions per year—when, by the government’s own estimates, the country sees tens of thousands of abortions every year. 84 But there is a pattern to the prosecutions. Those charged with abortion crimes are drawn from the most vulnerable, marginalized sectors of society. 85 Almost half were illiterate; only a quarter had attended high school. 86

In the U.S. we already see a version of this pattern: abortion-related prosecutions are brought by zealous prosecutors 87 , and they disproportionately target Black and brown women. 88 The work of National Advocates for Pregnant Women helps us to understand the scope of abortion-related prosecutions in the years since Roe legalized abortion. They have tracked 1600 USA such cases since 1973. 89 These cases involve a range of allegations, linked by the common thread of alleged harm to a pregnancy. 90 The prosecutions overwhelmingly target poor people, and in particular, poor Black pregnant women. Of 413 cases arising from 1973 to 2005, 71 per cent involved low income women, of whom 59 per cent were women of color, with 52 per cent identifying as Black. 91

These patterns in abortion-related prosecutions tell us two important things. First, we can expect abortion bans to be enforced against those who end their own pregnancies. 92 And second, abortion prosecutions are likely to target the most marginalized, vulnerable members of society—those whom prosecutors view, or at least believe others will be willing to view, not as victims but rather, as villains. 93

Supporters of abortion should stop insisting that bans won’t be enforced against women, and should start figuring out what to do about the fact that, when abortion bans are enforced, the defendants will likely be Black and brown. It is, of course, unfair to make one subset of the population pay the price for acts that go unpunished when committed by others. Furthermore, as we learn from racial disparities in drug law enforcement, such patterns undermine the legitimacy of the law, and have downstream corrosive effects both on the people disproportionately targeted by the law and on society as a whole. 94

III.B. The Return of Conditional Abortion Access

Setting aside the question of prosecution, abortion laws also must be fully implemented in the regulatory sense of the word. A law that limits abortion access to patients with qualifying conditions presupposes an adjudicatory mechanism for determining eligibility. And barring a dramatic evisceration of the right to life for those who are pregnant, every state will have to make at least one exception to their abortion bans, for life-threatening pregnancies. 95

How will a patient establish their right to an abortion when they are experiencing a life-threatening pregnancy?

There are a variety of models by which states might screen such claims, ranging from relatively formal proceedings, such as those seen in cases involving termination of government benefits, to loosely structured processes like school disciplinary hearings. 96 Indeed, we already have a model for abortion-related adjudications in the judicial bypass system, by which minors can seek permission to end a pregnancy without parental involvement. 97

Each model is fraught, when it comes to screening for abortion eligibility. Formal judicial hearings pose challenges in terms of accuracy (there is surprisingly little agreement on what constitutes a life-threatening pregnancy) 98 and efficiency (given the urgent, technical nature of the inquiry). 99 A judge could not conceivably rule on such petitions without expert testimony, which raises numerous questions about process and evidence.

Prior to Roe , rather than ask judges to decide these cases, states delegated the determination to doctors, essentially leaving the medical profession to devise its own ways of complying with the law. 100 For reasons ranging from lack of consensus about qualifying conditions, 101 to concern over the legal implications of their decisions (which might trigger prosecution on the one hand, or a wrongful death suit if the pregnant patient dies, on the other), 102 doctors eschewed this responsibility. By the mid-20th century, hospitals around the country used so-called ‘therapeutic abortion committees’ to establish eligibility. 103 These committees were marked by inconsistent outcomes, stemming from a lack of consensus over what constituted a ‘valid’ reason for terminating a pregnancy, whether legally or morally. 104 Rather than standardizing the application of the law, the committee process facilitated ad hoc decision-making. 105

As states set about banning abortion, it is urgent that they erect a scientifically sound, impartial process by which to evaluate cases involving potentially life-saving abortions. Given that the vast majority of Americans support abortion in cases of life-threatening pregnancy, we can expect an enormous outcry from all quarters in the case of an incompetent oversight process, let alone a highly publicized death. 106

Yet the struggle to define what constitutes a life-threatening pregnancy, (or depending upon the law, a qualifying rape or fetal anomaly), is just the start. Which parties’ interests will be represented at these adjudicatory proceedings; however, they are configured? Will the pregnant patient be entitled to a lawyer? 107 Will the fetus? If unhappy with the outcome, can either side appeal? Will there be an expedited appeals process? By what criteria will adjudicators be chosen? Will these be adversarial proceedings, with experts from the state and from the pregnant patient’s medical team, or will the patient’s doctor’s testimony suffice? How will the government determine whose interests it represents: those of the patient in peril, or those of the fetus?

These are serious questions, made all the more so because they implicate vital interests and therefore trigger Constitutional due process rights. 108 Surely, there will be litigation over the answers in the years to come. But what is interesting about these questions is not so much their answers, but instead, the reality that they demand answers now. We are past the time when those who support banning abortion can respond to such questions about how the laws will be implemented with vague references to ‘traditional means of enforcement.’ 109 And the quality of those answers matters because inconsistent, incompetent or otherwise corrupt law enforcement cannot help but undermine the legitimacy of abortion bans.

We have spent half a century reckoning with abortion largely in abstractions, fighting over rights rather than focusing on the people whose lives are affected by those rights. If nothing else, the impact of abortion bans seems likely to put human faces on the abortion war. And if we stay true to the patterns laid out in this essay, those faces will be disproportionately poor, Black and brown women and children.

Abortion bans are not color blind.

It has become common for abortion opponents to invoke allegations of eugenics and racism when talking about abortion rates among Black Americans. 110 That rhetoric–already contested 111 –will become strained as the country witnesses the actual racist impact of abortion bans: their disparate impact on poor Black families, coupled with the disparate rates of prosecution of Black women for acts that go largely unpunished when committed by whites. 112

By bringing into focus the struggles facing the most vulnerable among us, abortion bans have the potential to transform the abortion war by forcing a direct engagement with the structural forces driving abortion, poverty, and racism. We are approaching a moment of truth for advocates on all sides of the abortion war.

For advocates of abortion rights, there will be a reckoning with the question of whether being pro-choice simply means supporting the right to abortion, rather than a commitment to working to offset the forces that constrain all reproductive options–including having a child. As Sister Song, a leading voice of the reproductive justice movement puts it, the commitment is to support, ‘the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.’ 113 As the impact of abortion bans brings structural inequality into sharp focus, will pro-choice movement leaders stay focused on legalizing abortion, or will the movement commit to this more robust understanding of reproductive autonomy?

For abortion opponents, the question is whether the term ‘pro-life’ has come to mean anything beyond one’s support for abortion bans. The years ahead likely will pose an existential challenge for people who have supported abortion bans, but who cannot help but be disturbed by the ways in which they fall short of expectations. Perhaps this result will embolden those who care deeply about deterring abortion, and find them laboring to craft policies that might actually help those contemplating abortion to continue their pregnancies. 114

Certainly, anti-abortion movement leaders are aware of the need to do something proactive in response to the impact of abortion bans on the poor. As Marjorie Dannenfelser, of the Susan B. Anthony Fund, put it: ‘Speaking for the pro-life movement, which is obviously attempting to lead Republicans, we absolutely, without question, have a responsibility to serve the needs of women and children as we pass ambitious laws. There’s no question about it.’ At the same time, Dannenfelser is aware that such policies are unlikely to fly, at least not in states dominated by a Republican party that has long opposed family-friendly government programs. 115

There’s a quote I keep on my desk these days: “How will we go when we’re faced with this? I don’t think it’s predetermined, and a great human moral drama is being played out in front of us.” 116 It is from a historian of pandemics, written in the early days of Covid-19. I keep it there because it speaks to me as we navigate the era of abortion bans. There is comfort in the invitation to step back and notice that we are in a time of high moral drama, in which things are in flux. But there is also, within it, a call to action. “How will we go when we’re faced with this?”

For helpful suggestions and conversation, I’m grateful to Diana Greene Foster, Julia Hejduk, Carole Joffe, Katrina Kimport, Larry Marshall, and my anonymous reviewers. I was particularly lucky to work with Jenai Howard (SCU Law, 2022), who provided outstanding research assistance. All errors are my own.

Human Subjects Research for this article was approved by Santa Clara University’s IRB, Protocol 17-03-950.

Research was funded in part by a Hackworth Grant (Santa Clara University, Markkula Ethics Center).

See Mary Ziegler, After Roe: The Lost History Of The Abortion Debate (2015), for a rich history of the anti-abortion movement in the early years after Roe v. Wade, illustrating among other things the way the anti-abortion movement shifted its focus from efforts to support pregnant women to the narrow issue of criminalization.

See generally Michelle Oberman, How Abortion Laws Do and Don’t Work , 36 Wis. J. L. Gender & Soc’y 163 (2022); see also Michelle Oberman, Her Body, Our Laws: On The Front Lines Of The Abortion War, From El Salvador To Oklahoma (2018); Diana Greene Foster, The Turnaway Study: Ten Years, A Thousand Women, And The Consequences Of Having Or Being Denied An Abortion (2020) [hereinafter, greene foster, the turnaway study]; Ushma Upadhyay, Alice F. Cartwright, and Daniel Grossman, Barriers to Abortion Care and Incidence of Attempted Self-Managed Abortion Among Individuals Searching Google for Abortion Care: A National Prospective Study , 106 Contraception 49 (2021); Lizzie Widdecombe, What Does an At-Home Abortion Look Like in 2021 , The New Yorker (Nov. 11, 2021), https://www.newyorker.com/news/news-desk/what-does-an-at-home-abortion-look-like-in-2021 (profiling self-managed abortion researcher, Abigail Aiken).

For example, see Ross Douthat, The Case Against Abortion , N.Y. Times (Nov. 30, 2021), https://www.nytimes.com/2021/11/30/opinion/abortion-dobbs-supreme-court.html (celebrating the impact of Texas’ S.B. 8, credited with causing a 93 per cent drop in the number of abortions taking place in the state).

See eg Richard Garnett, One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), ( https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ (‘The point of criminalization, after all, is not merely to put people in prison, or deter people from engaging in harmful behavior. It is, instead, to make a statement—a public statement, in the community’s voice—that certain actions, or certain harms caused, are morally blameworthy.’). See also Oberman, supra note 2, at 85–86 (quoting an anonymous Oklahoma state senator):

The purpose of the law is to stop abortion. To send a moral message. To get the message out via the law, to spark a debate in the population. The government’s responsibility is to give people education. It is up to the government to tell them that abortion is wrong. It’s not an acceptable solution.

This assumption is largely a tacit one, inherent in assertions about how abortion bans will be received by the public, and how they are likely to inspire others states to follow suit. See eg Issac Chotiner, The Pro-Life Movement Plans for a Future Without Roe , The New Yorker (Dec. 7, 2021), https://www.newyorker.com/news/q-and-a/the-pro-life-movement-plans-for-a-future-without-roe (interviewing Marjorie Dannenfelser, president of the Susan B. Anthony List, on her expectations for passing abortion bans in 30 states).

See Diane Greene Foster, Stop Saying That Making Abortion Illegal Won’t Stop People From Having Them , Rewire News Group (Oct. 4, 2018) [hereinafter Green Foster, Stop Saying ], https://rewirenewsgroup.com/article/2018/10/04/stop-saying-that-making-abortion-illegal-doesnt-stop-them/ ; see generally Greene Foster, The Turnaway Study, supra note 2.

See eg Stephanie Ranade Krider, Pro-life Advocates Focused on Legal Battles. They’re Not Enough to End Abortion , Wash. Post (Oct. 15, 2021), https://www.washingtonpost.com/outlook/pro-life-after-roe/2021/10/15/7e2a059e-2cf8-11ec-985d-3150f7e106b2_story.html (Krider, an abortion opponent, acknowledges that while ‘the end of Roe would be a victory and a cause for celebration for those…who oppose abortion, [it] would not end the practice nationwide.’).

See Douthat, supra note 3.

See Biggs, M. Antonia, Heather Gould & Diana Greene Foster, Understanding why Women Seek Abortions in the US , 13 BMC Women’s Health 1–13 (2013); see also Sophia Chae et al., Reasons Why Women Have Induced Abortions: A Synthesis of Findings From 14 Countries , 96 Contraception 233–41 (2017). (Analyzing data from 14 countries to identify the primary reasons given for seeking abortion, and finding that, although people often listed several reasons, the dominant reason involved socioeconomic concerns).

See Annual Update of the HHS Poverty Guideline, 87 Fed. Reg. 3315, 3316 (Jan. 21, 2021).

See Rachel K. Jones & Jenna Jerman, Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014, 107 Am. J. Publ. Health 1904–909 (2017), https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.304042 ; see also Abortion Rates by Income Level , Infographic , Guttmacher Inst. (Oct. 19, 2017), https://www.guttmacher.org/infographic/2017/abortion-rates-income .

More accurately, because almost 60% of those having an abortion already have at least one child, they cannot afford the costs of another child. Jerman J, Jones RK & Onda T, Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008 , Guttmacher Inst. (2016), https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014 .

Bearak J et al., Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019 , 8 lancet global health 9 (2020).

An unintended pregnancy is one that occurred when a woman wanted to become pregnant in the future but not at the time she became pregnant (‘wanted later’) or one that occurred when she did not want to become pregnant then or at any time in the future (‘unwanted’). See Unintended Pregnancy in the United States , Guttmacher Inst. (Jan. 2017), https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states . In recent years, this frame has been problematized by calling into view the reality that, for many people, pregnancies are not so much planned as they are responded to. That is to say, the relevant question is not whether it was intended, but whether it is wanted or unwanted. See Abigail R.A. Aiken, et al., Rethinking the Pregnancy Planning Paradigm: Unintended Conceptions or Unrepresentative Concepts? , 48 Perspect Sex Reprod Health 147–151 (2016).

See generally Unintended Pregnancy Rates Declined Globally from 1990 to 2014 , Guttmacher Inst. (Mar. 5, 2018), https://www.guttmacher.org/news-release/2018/unintended-pregnancy-rates-declined-globally-1990-2014 .

Between the 1990s and 2020, abortion rates declined by almost 40%. See Sabrina Tavernise, Why Women Getting Abortions Now Are More Likely to Be Poor , N.Y Times (July 9, 2019), https://www.nytimes.com/2019/07/09/us/abortion-access-inequality.html . In the years since 2010 alone, rates have declined by almost 20%. Elizabeth Nash & Joerg Dreweke, The U.S. Abortion Rate Continues to Drop: Once Again, State Abortion Restrictions Are Not the Main Driver , Guttmacher Inst. (Sept. 18, 2019), https://www.guttmacher.org/gpr/2019/09/us-abortion-rate-continues-drop-once-again-state-abortion-restrictions-are-not-main . Scholars are divided in their explanations for the decline, which vary from increasingly effective contraceptive practices to declines in rates of sexual activity. See Pam Belluck, America’s Abortion Rate Has Dropped to its Lowest Ever , N.Y. Times (Sept. 20, 2019), https://www.nytimes.com/2019/09/18/health/abortion-rate-dropped.html ; see also Diana Greene Foster, Dramatic Decreases in US Abortion Rates: Public Health Achievement or Failure? , 107 Am J. Public Health 1860 (2017); Alia E. Dastagir, Fewer Women are having abortions. Why? , USA Today (June 13, 2019), https://www.usatoday.com/story/news/nation/2019/06/13/abortion-law-fewer-women-having-abortions-why/1424236001/ ; Doug Stanglin, US Abortion Rate is at its Lowest, but Restrictive Laws aren’t the Likely Cause, Study Says , USA Today (Sept. 18, 2019), https://www.usatoday.com/story/news/nation/2019/09/18/number-of-abortions-us-drops-guttmacher-institute-study/2362316001/ .

See U.S. Abortion Rate Continues to Decline, Hits Historic Low, Guttmacher Inst. (Jan. 17, 2017), https://www.guttmacher.org/news-release/2017/us-abortion-rate-continues-decline-hits-historic-low .

See Guttmacher Inst., supra note 15. Although poor Americans have higher rates of unintended pregnancy for a range of reasons, central among them is that they struggle to access contraception. See Michele Troutman, Saima Rafique & Torie Comeaux Plowden, Are Higher Unintended Pregnancy Rates Among Minorities a Result of Disparate Access to Contraception? , Contracept Reprod Med 5, no. 16 (2020), https://doi.org/10.1186/s40834-020-00118-5 (describing the factors underlying the disparate rates of unintended pregnancy by race and class). One finds evidence of this struggle in the data on contraceptive use among sexually active women not seeking pregnancy. While 90% of those covered by private health insurance and 87% of those covered by Medicaid use contraception, that figure drops to 81% for those who have no insurance coverage. Megan L. Kavanaugh & Emma Pliskin, Use of Contraception Among Reproductive-aged Women in the United States , 2014 and 2016 , Guttmacher Inst. (July, 2020). On the cost of contraception, see Eliana Kosova, How Much Do Different Kinds of Birth Control Cost Without Insurance? , Nat’l Women’s Health Network (Nov. 17, 2017), https://nwhn.org/much-different-kinds-birth-control-cost-without-insurance/ (noting that the most effective methods, long-acting implants and devices, cost upwards of $800, and that oral contraceptives can cost up to $600 per year).

Cost is not the only barrier to contraception, ranging from cost to personal preferences. For example, Black women tend to report higher rates of dissatisfaction with existing contraceptive options, putting them at further disadvantage in terms of risk of unwanted pregnancy. Andrea V. Jackson, Deborah Karasek, Christine Dehlendorf, and Diana Greene Foster, Racial and Ethnic Differences in Women’s Preferences for Features of Contraceptive Methods , 93 Contraception 406–411 (2016).

See Colleen L. MacCallum-Bridges & Claire Margerison, The Affordable Care Act Contraception Mandate & Unintended Pregnancy in Women of Reproductive Age: An Analysis of the National Survey of Family Growth, 2008–2010 v. 2013–2015 , 101 Contraception 34–39 (2020) (Overall, the odds of experiencing unintended pregnancy decreased 15% from the pre-mandate to post-mandate period); See also Susan Christiansen, The Impact of the Affordable Care Act Contraceptive Mandate on Fertility and Abortion Rates (Dec. 2020) (Ph.D. dissertation, Johns Hopkins University), https://jscholarship.library.jhu.edu/handle/1774.2/63939 (last visited Jan. 28, 2022).

See Molly Jong-Fast, The Anti-Birth Control Movement Is the New Anti-Abortion Movement , Vogue (July 1, 2021), https://www.vogue.com/article/anti-birth-control-movement .

Burwell v. Hobby Lobby Stores, Inc., 573 U.S. 682 (2014) (striking down the ACA’s contraception mandate because it ‘created a substantial burden’ on Hobby Lobby’s religious freedom and it was not the ‘least restrictive means of satisfying the government’s interests.’) . See eg Tom Cohen, Hobby Lobby Ruling Much More Than Abortion , Cnn Politics (July 2, 2014), https://www.cnn.com/2014/07/02/politics/scotus-hobby-lobby-impacts/index.html (describing anti-abortion advocates opposition to contraception mandates).

See Carole Joffe, Failing to Embed Abortion Care in Mainstream Medicine Made it Politically Vulnerable , Wash. Post (Jan. 11, 2022), https://www.washingtonpost.com/outlook/2022/01/11/failing-embed-abortion-care-mainstream-medicine-made-it-politically-vulnerable/ (describing the range in quality of abortion providers when abortion was illegal).

See Elizabeth G. Raymond et al., Efficacy of Misoprostol Alone for First-Trimester Medical Abortion: A Systematic Review , 133 Obstet Gynecol 133–147 (2019).

Id. (This consolidated report of existing research finds that misoprostol alone successfully terminates a pregnancy in 93% of cases).

See How to Buy Abortion Pills That Are Safe and Effective , https://www.ipas.org/our-work/abortion-self-care/abortion-with-pills/how-to-buy-abortion-pills-that-are-safe-and-effective/ (Noting that manufacturers sell the pills to pharmacies for very little cost—less than $0.05 per pill—and that the highest sales price found in a recent study was $2 per pill).

See eg Celina Schocken, Business Case: Investing in Production of High Quality Misoprostol for Low-Resource Settings , Concept. Found. (Dec. 2014), https://www.conceptfoundation.org/wp-content/uploads/2015/06/BusinessCase_Misoprostol_web.pdf (describing misoprostol’s vital role in treating postpartum hemorrhage); see also Essential Medicines List includes Misoprostol tablets for use during pregnancy, childbirth and postpartum care , World Health Organization, https://www.who.int/data/gho/indicator-metadata-registry/imr-details/essential-medicines-list-includes-misoprostol-tablets-for-use-during-pregnancy-childbirth-and-postpartum-care .

Beverly Winikoff & Wendy Sheldon, Use of Medicines Changing the Face of Abortion , Guttmacher Inst. (Sept. 2012), https://www.guttmacher.org/journals/ipsrh/2012/09/use-medicines-changing-face-abortion . For a description of the misoprostol market in countries where abortion is illegal, see Michelle Oberman, What Happens When Abortion is Banned? , N.Y. Times (May 31, 2018), https://www.nytimes.com/2018/05/31/opinion/sunday/abortion-banned-latin-america.html .

See Gilda Sedgh et al., Induced Abortion: Incidence and Trends Worldwide from 1995 to 2008 , 379 The Lancet 625, 625 (2012) (comparing the one out of three pregnancies in Central America end in abortion with one out of five in the United States); see also Susheela Singh et al., Abortion Worldwide: A Decade of Uneven Progress , Guttmacher Inst. (Oct. 2009), http://www.guttmacher.org/pubs/Abortion-Worldwide.pdf .

There is evidence of an expanding market in misoprostol in the U.S. See Caroline Kitchener, Self-Managed Abortion Could be the Future—But it’s Very Hard to Talk About , The Lily (Dec. 20, 2021), https://www.thelily.com/self-managed-abortion-could-be-the-future-but-its-very-hard-to-talk-about/ . See also, Erica Hellerstein, The Rise of the DIY Abortion in Texas , The Atlantic (June 27, 2014), https://www.theatlantic.com/health/archive/2014/06/the-rise-of-the-diy-abortion-in-texas/373240/ .

Kari White et al., Initial Impacts of Texas’ Senate Bill 8 on Abortions in Texas and at Out-of State Facilities , Texas Policy Evaluation Project (Oct. 2021), http://sites.utexas.edu/txpep/files/2021/11/TxPEP-brief-SB8-inital-impact.pdf .

In the immediate aftermath of Prohibition–evidenced by mortality rates, mental health, and crime statistics–alcohol consumption fell to approximately 30% of its pre-Prohibition level. But this drop in alcohol consumption was short-lived. Within a few years after Prohibition, alcohol consumption had increased to 60–70% of its pre-Prohibition level. See Annika Nekalson, Prohibition was a Failed Experiment in Moral Governance, The Atlantic (Jan. 16, 2020), https://www.theatlantic.com/ideas/archive/2020/01/prohibition-was-failed-experiment-moral-governance/604972/ .

See Nash & Dreweke, supra note 19, regarding the various reasons behind declining abortion rates.

See Greene Foster, Stop Saying , supra note 6; see also Greene Foster, The Turnaway Study, supra note 2.

Hence the insistence of the reproductive justice movement that advocates center the goals of racial justice. RJ Squared. For a detailed description of the ways in which structural inequities circumscribe the reproductive choices of poor women and women of color, see Jamila K. Taylor, Structural Racism and Maternal Health Among Black Women , 48 Journal Of Law, Medicine & Ethics 506–517 (2020).

See generally, Katrina Kimport, No Real Choice: How Culture And Politics Matter For Reproductive Autonomy (2021) (positing that for the most marginalized Americans faced with an unwanted pregnancy, the question is not whether to have an abortion or have a baby, but rather, whether they can actually get an abortion or not).

At oral argument, Justice Barrett said, “Both Roe and Casey emphasized the burdens of parenting, and insofar as you and many of your amici focus on the ways in which the forced parenting, forced motherhood would hinder women’s access to the workplace and to equal opportunities, it’s also focused on the consequences of parenting and the obligations of motherhood that flow from pregnancy. Why don’t the safe haven laws take care of that problem?” Transcript of Oral Argument at 56, Dobbs v. Jackson Women’s Health, No. 19–1392. For a compelling analysis and indictment of safe haven laws, see Laury Oaks, Giving Up Baby: Safe Haven Laws, Motherhood, And Reproductive Justice (2015); see also Lizzie Widdicombe, The Baby-Box Lady of America , The New Yorker (Dec. 18, 2021) https://www.newyorker.com/news/news-desk/the-baby-box-lady-of-america .

See Mardie Caldwell, Open Adoption is a Win-Win Situation (Apr. 7, 2018), https://mardiecaldwell.com/open-adoption-is-a-win-win-situation/ ; see also Julia D. Hejduk, Gift Motherhood, the Prius, and the Peace Corps: Reducing Abortion by Incentivizing Adoption , The Public Discourse (Sept. 27, 2017), https://www.thepublicdiscourse.com/2017/09/20054/ .

Id . On the merits, what limited scholarly evidence there is on adoption runs counter to this rosy characterization of adoption’s outcomes, at least for birth mothers. See eg Are Birth Mothers Satisfied with Decisions to Place Children for Adoption? , Science Daily (June 8, 2018), https://www.sciencedaily.com/releases/2018/06/180608131605.htm (a longitudinal study of birth mothers that found women reported a mean satisfaction of 3.11 on a scale of 1–5). See also Gretchen Sisson, ‘Choosing Life’: Birth Mothers on Abortion and Reproductive Choice , 25 Women’s Health Issues 349–54 (2015) (a study involving in-depth interviews with 40 women who had placed infants for adoption from 1962 to 2009. The majority of the participants–many of whom placed their babies in closed adoptions, which are less typical today–described their adoption experiences as ‘predominantly negative,’ a response that Sisson attributes in part to the reality that adoption is not a preferred course of action, but rather, something chosen by those who feel they have no other options).

Olga Khazan, Why So Many Women Choose Abortion Over Adoption , The Atlantic (May 20, 2019). ( https://www.theatlantic.com/health/archive/2019/05/why-more-women-dont-choose-adoption/589759 ; S ee also Olga Khazan, The New Question Haunting Adoption , The Atlantic (Oct. 22, 2020), https://www.theatlantic.com/politics/archive/2021/10/adopt-baby-cost-process-hard/620258/ (‘Since the mid-1970s—the end of the so-called baby-scoop era, when large numbers of unmarried women placed their children for adoption—the percentage of never-married women who relinquish their infants has declined from nearly 9% to less than 1%.’).

See Elizabeth Wildsmith, Jennifer Manlove et al., Dramatic Increase in the Proportion of Births Outside of Marriage in the United States from 1990 to 2016 , Child Trends (Aug. 8, 2018), https://www.childtrends.org/publications/dramatic-increase-in-percentage-of-births-outside-marriage-among-whites-hispanics-and-women-with-higher-education-levels#:∼:text=Recent%20estimates%20show%20that%20about , worldwide%20(Chamie%2C%202017). The most rapid growth is among white women: as of 2016, 28% of all births to white women were non-marital. See also Khazan , supra note 43 (Starting in the 1970s, single white women became much less likely to relinquish their babies at birth: nearly a fifth of them did so before 1973; by 1988, just 3% did).

Khazan, Id .

The Turnaway Study is a longitudinal study examining the effects of unintended pregnancy on women’s lives. For the study and its findings, see Greene Foster, The Turnaway Study, supra note 2.

See id . See also Diana Greene Foster, What Happens When It’s Too Late to Get an Abortion , N.Y. Times (Nov. 22, 2021), https://www.nytimes.com/2021/11/22/opinion/abortion-supreme-court-women-law.html .

See Gretchen Sisson, Lauren Ralph, Heather Gould & Diana Greene Foster, Adoption Decision Making among Women Seeking Abortion, 27 Women’s Health Issues 136 (2017).

See Women’s Access to Abortion Improves Children’s Lives , Ansirh (Jan. 2019), https://www.ansirh.org/sites/default/files/publications/files/womens_access_to_abortion_improves_childrens_lives.pdf .

See generally Kayla Patrick, National Snapshot: Poverty Among Women & Families , National Women’s Law Center, https://nwlc.org/wp-content/uploads/2017/09/Poverty-Snapshot-Factsheet-2017.pdf . (The poverty rate for female-headed families with children was 36.5%, compared to 22.1% for male-headed families with children and 7.5% of families headed by married couples with children).

Robin Bleiweis, Diana Boesch & Alexandra C. Gaines, The Basic Facts About Women in Poverty , American Progress (Aug. 3, 2020), https://www.americanprogress.org/article/basic-facts-women-poverty/ .

See American Academy of Pediatrics, Council on Community Pediatrics, Poverty and Child Health in the United States , Pediatrics 137 no. 4 (2016): e20160339.

See kimport, supra note 39, at 37, and generally.

See Leah Outten, Birth Mothers and the Adoption Option , Focus On The Family (Nov. 9, 2021), https://www.focusonthefamily.com/pro-life/the-adoption-option-birth-mothers-need-your-support/ ; Stephanie McCrummen, A Maternity Ranch is Born: How Evangelical Women in Texas are Mobilizing for a Future Without Abortion , Wash. Post (Nov. 16, 2021), https://www.washingtonpost.com/nation/2021/11/16/evangelical-women-texas-abortion/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most&carta-url=https%3A%2F%2Fs2.washingtonpost.com%2Fcar-ln-tr%2F354c967%2F6193e9909d2fdab56b8e7f16%2F5a1f90909bbc0f4d5203bb72%2F8%2F73%2F6193e9909d2fdab56b8e7f16 . see also Michelle Oberman, The Women the Abortion War Leaves Out , N.Y. Times (Jan. 11, 2018), https://www.nytimes.com/2018/01/11/opinion/sunday/abortion-crisis-pregnancy-centers.html (describing Oklahoma City’s Rose Home, a pro-life organization that houses up to five pregnant women and their children at any given time).

See Outten, supra note 54. See also Eleanor Bartow, 12 Pro-Life Truths to Counter Every Abortion Myth , The Federalist (Oct. 11, 2021) https://thefederalist.com/2021/10/11/12-pro-life-truths-to-counter-every-abortion-myth/ (where Bartow asserts adoption is ‘a better option than killing an unborn child’ because there are many ‘loving, screened, financially stable parents [who] are waiting to adopt babies.’).

See Sue Halpern, How Republicans Became Anti-Choice , The N.Y. Rev. (Nov. 8, 2018), https://www.nybooks.com/articles/2018/11/08/how-republicans-became-anti-choice/ (reviewing Reversing Roe , a documentary film directed and produced by Ricki Stern and Annie Sundberg).

See Robert Reich, Republicans, So Called party of Family Values, Do Not Support Needy Families , The Guardian (Jul. 18, 2021), https://www.theguardian.com/commentisfree/2021/jul/18/child-allowance-payments-american-rescue-plan-republicans

See eg Richard Garnett, supra note 4. See also Hadley Arkes, in One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ , (‘[T]he law does not need to invoke the harshest penalties for the sake of teaching moral lessons.’).

§315, Penal Law, 5737–1977, LSI Special Volume (1977), as amended (Isr.),

https://knesset.gov.il/review/data/eng/law/kns8_penallaw_eng.pdf [ https://perma.cc/N9QZ-8JEV ].

Or at least it would do so if the law were interpreted in a way that strictly limited abortion access. Instead, as I explain elsewhere, the committees close to 100% of the requests they receive, making legal abortion readily available in the country. See Oberman, supra note 2, at 172.

And they do. Recall that Israel has the highest fertility rates of any country in the OECD. Families have an average of 3.1 children. See Family Database: Fertility Rates , Org. Econ. Coop. Dev., https://www.oecd.org/els/family/SF_2_1_Fertility_rates.pdf [ https://perma.cc/5J2Y-YGWG ] (last updated June 2021).

See Maternity Leave , Kol Zchut, https://www.kolzchut.org.il/en/Maternity_Leave [ https://perma.cc/Q29Q-T6Q6 ] (last visited June 19, 2021).

See Childcare in Israel , Expat.Com (Sept. 18, 2017) https://www.expat.com/en/guide/middle-east/israel/15420-childcare-in-israel.html [ https://perma.cc/2Z7S-SJCK ] (describing the relative level of state support that young Israeli families receive, compared to the U.S.). See also, Register to State Recognized Daycare and Afternoon Care, and Request State Participation in Tuition Fees , Gov. IL, https://www.gov.il/en/service/registration_for_day_care_centers_and_nurseries1 (last updated Feb. 7, 2020) (Israeli government website describing eligibility for state supported day care). Rates of enrollment in both day care and preschool are among the highest in the developed world. Indeed, preschool enrollment rates are double that of the OECD average. https://issuu.com/bernardvanleerfoundation/docs/publication_taub_center_early_childhood_education_ (at 27).

See, eg Children , Nat’l Ins. Inst. Of Isr., https://www.btl.gov.il/English%20Homepage/Benefits/Children/Pages/default.aspx [ https://perma.cc/8KE2-3K8L ] (last visited on Dec. 19, 2021). Although these policies may not significantly offset the costs of having a child, surely, they are a benefit to Israel’s poorest families.

The only government support for those who have babies lies in family medical leave, which promises twelve weeks of unpaid leave time after the birth of a child. See Family and Medical Leave Act (FMLA), 29 U.S.C. § 2612.

Ben Casselman, Child Tax Credit’s Extra Help Ends, Just as Covid Surges Anew , N.Y. Times (last updated Jan. 3, 2022), https://www.nytimes.com/2022/01/02/business/economy/child-tax-credit.html .

Ali Safawi & Cindy Reyes, States Must Continue Recent Momentum to Further Improve TANF Benefit Levels , Cntr on Budget & Pol’y Priorities (updated Dec. 2, 2021), https://www.cbpp.org/research/family-income-support/states-must-continue-recent-momentum-to-further-improve-tanf-benefit .

For signs that anti-abortion advocates are beginning to grapple with the need to take systemic realities into account, see Tish Harrison Warren, The Systemic Realities Created by Legal Abortion , N.Y. Times (Jan. 22, 2022), https://www.nytimes.com/2022/01/22/opinion/roe-legal-abortion.html .

See Richard H. McAdams , A Focal Point Theory of Expressive Law, 86 V.A. L. Rev.1649, 1713–28 (2000) (applying expressive law theory to smoking bans and landlord liability law). See generally Richard H. McAdams, The Expressive Powers Of Law: Theories And Limits (2015).

He offers little evidence, by way of proof. However, numerous studies both domestically and worldwide document an association between smoking bans and an overall decline in smoking rates, including a reduction in smoking by smokers. See eg Thomas W. Carton, Michael Dardon, et al., Comprehensive Indoor Smoking Bans and Smoking Prevalence: Evidence from the BRFSS , 2 J Health Econ. 535–56 (2016); see also Silke Anger, Michael Kvasnicka, Thomas Seidler, One Last Puff? Public Smoking Bans and Smoking Behavior , 30 J Health Econ. 591–601 (2011).

See McAdams, supra note 70, at 197.

These lawmakers also must contend with considerable public opposition to their position. As of 2020, 79% of Americans say that the decision to have an abortion is best left to women, not lawmakers, according to a Kaiser Family Foundation study from 2020. See Ariana Eunjung Cha & Emily Guskin, Most Americans Want Abortion to Remain Legal, but Back S ome State Restrictions , Wash. Post (Jan. 22, 2020), https://www.washingtonpost.com/health/2020/01/22/most-americans-want-abortion-remain-legal-back-some-state-restrictions/ .

See McAdams, supra note 70, at 180.

Recreational cannabis is legal in 18 states, while 11 states criminalize it. (See https://disa.com/map-of-marijuana-legality-by-state for a breakdown of the various jurisdictions’ laws). Experts estimate that at least 15 states will keep abortion legal, and perhaps even expand abortion rights, regardless of the absence of a Constitutional right. https://www.guttmacher.org/state-policy/explore/abortion-policy-absence-roe .

Kimport, supra note 37, at 28 and 62–69.

See eg Anna North, All the Near-Total Abortion Bans Passed This Year Have Now Been Blocked in Court, Vox (updated Oct. 29, 2019), https://www.vox.com/2019/10/2/20895034/alabama-abortion-ban-blocked-georgia-law ; see also Sean Murphy, Oklahoma Supreme Court Blocks 3 New Anti-Abortion Laws, ABC News (Oct. 25, 2021), https://abcnews.go.com/Health/wireStory/oklahoma-supreme-court-blocks-anti-abortion-laws-80779946 .

See Chotiner, supra note 5. See also O. Carter Snead, in One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ (Offering a pragmatic justification for not punishing self-abortion: ‘[T]he public is more willing to accept a law that punishes doctors rather than mothers. Pro-lifers can thus achieve their goal of ending abortion without provoking a political backlash.’).

Although there are legal strategies a government might employ in response to overseas entities that sell abortion medicines to U.S. consumers (eg border patrol agents or diplomatic pressure), we learn from both the heroin and the fentanyl epidemics that the government’s options in the face of high demand are limited. See Claire Felter, Backgrounder: The U.S. Opioid Epidemic , The Council on Foreign Relations, (Sept. 8, 2021), https://www.cfr.org/backgrounder/us-opioid-epidemic .

Stephanos Bibas, Prosecutorial Regulation Versus Prosecutorial Accountability , 157 U. Pa. L. Rev. 959 (2009).

Stephanos Bibas, The Need for Prosecutorial Discretion , 19 Temp. Pol. & Civ. Rts. Rev. 369, 371 (2010).

See Leslie Reagan, When Abortion Was A Crime: Women, Medicine, And Law In The United States, 1867–1973 (1997), at 114, 164.

See From Hospital to Jail: The Impact on Women of El Salvador’s Total Criminalization of Abortion , 22 Repr. Health Matters 52–60 (2014); see also Oberman, supra note 2 , at 8–10 and 49–55 (describing similar patterns in Chile and El Salvador).

See Oberman , supra note 2, at 44.

See Repr. Health Matters, supra note 83.

See eg Chelsea Becker’s prosecution for murder, following stillbirth allegedly caused by methamphetamine use. Judge Dismisses Murder Charge Against Califronia Mother After Stillbirth , N.Y. Times (May 21, 2021), https://www.nytimes.com/2021/05/20/us/chelsea-becker-stillbirth-murder-charges-california.html .

They may also conscript doctors into law enforcement. See Michelle Oberman, Abortion Bans, Doctors, and the Criminalization of Patients ,48 Hastings Ctr. Rep.5 (2018); see also Oberman, Her Body Our Laws, supra note 2, at 43–67 for a discussion of how reports from doctors to police in El Salvador overwhelmingly involve poor, marginalized women.

Priscilla Thompson & Alexandra Turcios Cruz, How an Oklahoma Women’s Miscarriage Put a Spotlight on Racial Disparities in Prosecutions , Nbc News (Nov. 5, 2021), https://www.nbcnews.com/news/us-news/woman-prosecuted-miscarriage-highlights-racial-disparity-similar-cases-rcna4583 . For a detailed discussion of these cases, see Lynn M. Paltrow & Jeanne Flavin, Arrests of and Forced Interventions on Pregnant Women in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health , 38 J. Health Pol., Pol’y And L. 299, 304–05 (2013) (discussing these findings and the limitations of the research which led the authors to conclude that their findings represent a substantial undercount of cases). See also Michele Goodwin, Policing The Womb: Invisible Women And The Criminalization Of Motherhood (2020).

See Arrests and Prosecutions of Pregnant Women, 1973–2020 , Napw (Sept.18, 2021), https://www.nationaladvocatesforpregnantwomen.org/arrests-and-prosecutions-of-pregnant-women-1973-2020/ (summarizing the range of cases). See also Lynn M. Paltrow, Constitutional Rights for the ‘Unborn’ Would Force Women to Forfeit Theirs , Ms. Magazine (Apr. 15, 2021), https://msmagazine.com/2021/04/15/abortion-constitutional-rights-unborn-fetus-14th-amendment-womens-rights-pregnant/ (The rate of arrests and prosecutions is increasing. ‘From 2006–2020, we have documented over 1000 such arrests—more than double in half as many years. Black, Brown and low-income, rural white women are the typical targets of these arrests.’).

Thompson & Turcios Cruz, supra note 85 (noting that the Black defendants were also significantly more likely to be charged with felonies than white women, with 85% of Black women receiving felony charges compared to 71% of white women); see also Lynn M. Paltrow, Roe v. Wade and the New Jane Crow: Reproductive Rights in the Age of Mass Incarceration , 103 Am. J. Pub. Health 17, 19 (2013). Note that healthcare experts object strenuously to these prosecutions on the grounds that they deter people from seeking treatment essential both to their own welfare and to that of the fetus. See eg Katherine C. Arnold, Viewpoint: Criminalizing Young Women is not the Way to Improve Birth Outcomes , The Oklahoman (Dec. 26, 2021, 5:00 AM), https://www.oklahoman.com/story/opinion/2021/12/26/viewpoint-prosecuting-oklahoma-women-who-miscarry-wrong/8930865002/ .

While beyond the scope of this Article, it bears noting the range of options that state lawmakers have given prosecutors, when it comes to abortion crimes, outlawing things like purchasing abortion medicine, or aiding and assisting an abortion. See eg Emily Bazelon, A Mother in Jail for Helping her Daughter Have an Abortion , N.Y. Times (Sept. 22, 2014), https://www.nytimes.com/2014/09/22/magazine/a-mother-in-jail-for-helping-her-daughter-have-an-abortion.html . See also Sabrina Tavernese, Citizens, not the State, Will Enforce New Abortion Law in Texas , N.Y. Times (Nov. 1, 2021), https://www.nytimes.com/2021/07/09/us/abortion-law-regulations-texas.html (Describing the ways that Texas S.B. Eight criminalizes all those who aid and assist abortion, and quoting Prof. Melissa Murray, ‘If the barista at Starbucks overhears you talking about your abortion, and it was performed after six weeks, that barista is authorized to sue the clinic where you obtained the abortion and to sue any other person who helped you, like the Uber driver who took you there.’).

See Paltrow , supra note 91. See generally Michele Bratcher Goodwin, Invisible Women: Mass Incarceration’s Forgotten Casualties , 94 Tex. L. Rev. (2015).

See Race & Justice News: Eliminating Crack/Cocaine Sentencing Disparity The Sentencing Project (July 27, 2021), https://www.sentencingproject.org/news/race-justice-news-senate-hearing-crack-cocaine-sentencing-disparity/ (summarizing the ongoing work toward sentencing equality in drug crimes, starting with the 2010 Fair Sentencing Act). On the negative downstream consequences of race bias in drug law enforcement, Republican Governor Asa Hutchinson noted that racial disparities, “undermined community confidence in the fairness of the criminal justice system. I talked with drug task force officers and front-line agents at the DEA who said this sense of injustice had a real impact in the fight against illegal drugs; it made it more difficult for agents to build trust and work with informants in the areas most impacted by the crack epidemic. The disparity in sentencing led to more harm than help in our federal anti-crime efforts.” ( Gov. Asa Hutchinson: It’s Time to Fix an Old Wrong and End the Disparity Between Crack and Cocaine Offenses , Fox News (June 8, 2021)), https://www.foxnews.com/opinion/end-crack-cocaine-offenses-gov-asa-hutchinson .

See Caroline Kitchener, The Texas Abortion ban has a Medical Exception. But some Doctors Worry it’s too Narrow to use, The Lily, Oct. 22, 2021 (describing existing legal protections and the limitations of Texas S.B. 8’s ‘medical emergency’ exception to its abortion ban), https://www.thelily.com/the-texas-abortion-ban-has-a-medical-exception-but-some-doctors-worry-its-too-narrow-to-use/ .

See Michael Asimow, Federal, Administrative Adjudication Outside The Administrative Procedure Act 3–4 (2019) (classifying these hearings into three categories, according to level of formal process).

See Kari White, Subasri Narasimhan, Sophie A. Hartwig, Erin Carroll, Alexandra McBrayer, Samantha Hubbard, Rachel Rebouché, Melissa Kottke & Kelli Stidham Hall, Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care , Sexuality Rsch. & Soc. Pol’y (Jan. 18, 2021), https://link.springer.com/content/pdf/10.1007/s13178-021-00539-0.pdf .

See David S. Cohen & Carole Joffe, Obstacle Course: The Everyday Struggle To Get An Abortion In America 209 (2020) (quoting Ohio doctor Chrisse France, decrying this standard in U.S. practice today; ‘She cannot be seen at our public hospital unless pretty much she’s going to die today or maybe tomorrow’).

See Kari White, Subasri Narasimhan, Sophie A. Hartwig, Erin Carroll, Alexandra McBrayer, Samantha Hubbard, Rachel Rebouché, Melissa Kottke & Kelli Stidham Hall, Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care , Sexuality Rsch. & Soc. Pol’y (Feb., 2021) (noting the impact of these policies in delaying access to early abortion among those ultimately deemed eligible to end their pregnancies).

See Herbert L. Packer & Ralph J. Gampell, Therapeutic Abortion: A Problem in Law and Medicine , 11 Stan. L. Rev. 417, 418, 421 (1959). (Explaining that hospitals developed protocols at least in part as a defensive measure: to protect themselves from potential downstream criminal or civil liability). See also, Carole Joffe, Doctors Of Conscience 31 (1995) (describing how doctors who performed abortions illegally would do so outside of the hospital setting, but legal abortions that met the test of necessary to save life would necessarily have been performed in a hospital, thereby implicating both medical and hospital oversight).

See generally Packer & Gampell, id . at 418 . (Noting these questions, among others: Is the procedure limited to cases where its purpose is to avoid shortening the pregnant woman’s life? If so, how do we determine whether carrying the child to term will shorten life? If not, what other considerations are relevant? Is a threat to health necessarily a threat to life? Must the threat to life (or health) be on account of a somatic illness? Or is the woman’s mental condition also to be considered? If so, is a probability that suicide will ensue a justification for therapeutic abortion?). For a searing indictment of U.S. therapeutic abortion committee practices in the mid-twentieth century, see Rickie Solinger, ‘A Complete Disaster:’ Abortion and the Politics of Hospital Abortion Committees, 1950–1970 , 19 Feminist Stud. 241 (1993).

See Packer & Gampell, supra note 100, at 449. (‘[R]eputable members of the medical profession may well find it galling that their freedom from criminal and civil liability turns merely on the nonenforcement of provisions of the law which, on their face, appear to embrace the conduct in question.’). Texas’s S.B. 8 law employs such a threat by way of subjecting doctors who provide abortions after six weeks to civil suit. See Sabrina Tavernese, supra note 75.

Id. at 421 (citing Alan F. Guttmacher, The Shrinking Non-Psychiatric Indications for Therapeutic Abortion , in Therapeutic Abortion 12 (Rosen, ed. 1954)).

Id . at 430. Their study concluded with a call for law reform—a call that was echoed by their Canadian counterparts in the 1977 Badgley report, which found “gross inequities existed in the availability of therapeutic abortion to the women of Canada.” W.D.S. Thomas, The Badgley Report on the Abortion Law, 116 Can. Med. Ass’n. J. 966, 966 (1977).

See Carole Joffe and Jody Steinauer, Evan Texas Allows Abortions to Protect a Woman’s Life. Or Does It? , N.Y. Times (Sept. 12, 2021), https://www.nytimes.com/2021/09/12/opinion/abortion-texas-roe.html (describing how contemporary abortion bans will likewise challenge medical integrity).

See Oberman, supra note 2, at 13–42 (describing the highly public Salvadoran case of Beatriz, a woman forced to continue a life-threatening pregnancy until her doctors agreed that death was imminent, which then triggered her right to self-defense, permitting doctors to end her pregnancy).

For a thoughtful consideration of the constitutional protections owed to one who is pregnant, when abortion is illegal, see Meghan Boone, Reproductive Due Process , 88 Geo. Wash. L. Rev. 511, 526 (2020) (‘Beyond its flexibility and ability to evolve, a third feature of due process is simply its function as a catchall constitutional backstop for determining the fairness of government action’).

See Matthews v. Eldridge, 424 U.S. 319, 335 (1976) (“Identification of the specific dictates of due process generally requires consideration of three distinct factors: first, the private interest that will be affected by the official action; second, the risk of erroneous deprivation of such interest through the procedures used, and probable value, if any, of additional or substitute procedural safeguards; and, finally, the Government’s interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirements would entail.”). See also Simona Grossi, Procedural Due Process , 13 Seton Hall Cir. Rev. 155, 158 (2017) (‘[A]…procedural law that is not supported by logic, fairness, and efficiency considerations,…violates due process.’).

See Chotiner, supra note 5, (citing Marjorie Dannenfelser).

See eg Box v. Planned Parenthood, 139 S. Ct. 1780 at 1783 (Thomas, J., concurring) (supporting an Indiana law banning abortion on grounds of fetal anomaly by invoking the state’s ‘compelling interest in preventing abortion from becoming a tool of modern-day eugenics.’).

See eg Eli Rosenberg, Clarence Thomas Tried to Link Abortion to Eugenics. Seven Historians Told the Post He’s Wrong , Wash. Post (May 30, 2019, 9:50 PM), https://www.washingtonpost.com/history/2019/05/31/clarence-thomas-tried-link-abortion-eugenics-sevenhistorians-told-post-hes-wrong [ https://perma.cc/5DNR-PJT5 ]; Imani Gandy, When It Comes to Birth Control and Eugenics, Clarence Thomas Gets It All Wrong , Rewire (May 29, 2019, 5:11 PM), https://rewire.news/ablc/2019/05/29/when-it-comes-to-birth-control-and-eugenics-clarencethomas-gets-it-all-wrong [ https://perma.cc/3HZ3-689B ]; Lydia O’Connor, What Justice Clarence Thomas Gets Wrong About Eugenics and Abortion , Huff. Post (May 29, 2019, 5:50 PM), https://www.huffpost.com/entry/clarence-thomas-eugenics-abortion_n_5ced6c87e4b0356205a07182 [ https://perma.cc/6AHJ-MS5U ].

See Melissa Murray, Race-ing Roe: Reproductive Justice, Racial Justice, and the Battle for Roe v. Wade , 134 Harv. L. Rev. 2025 (2021) (providing a compelling response to the eugenics charge); see also Jennifer L. Holland, Tiny You: A Western History Of The Anti-Abortion Movement (2020) (arguing that the goals of the anti-abortion movement are deeply entwined with those of the white supremacy movement). Indeed, one might find evidence of racism in the suggestion that adoption is the best solution for poor Black and brown babies, which echoes the U.S. Indian Adoption Project of 1958–1967, under which as many as one-third of indigenous children were separated from their families. 85% of those children were placed in non-native homes or institutions. See Stephanie Woodward, Native Americans Expose The Adoption Era and Repair Its Devastation , Indian Country Today (updated Sept. 13, 2018), https://indiancountrytoday.com/archive/native-americans-expose-the-adoption-era-and-repair-its-devastation .

Reproductive Justice–Sister Song   https://www.sistersong.net/reproductive-justice . See also, Mission and Vision , If, When, How, https://www.ifwhenhow.org/about/mission-vision/ [ https://perma.cc/3RRJ-LKT5 ] (last visited Dec. 21, 2021) (A leading reproductive justice organization, their vision statement reads: ‘We envision a transformation of the legal systems and institutions that perpetuate oppression into structures that realize justice, and a future when all people can self-determine their reproductive lives free from discrimination, coercion, or violence.’).

They might begin by looking to Germany. Not, as Chief Justice Roberts suggested in the Dobbs oral argument, because its law restricting abortion to 12 weeks’ gestation is a good compromise. (Transcript of Oral Argument at 53–55, Dobbs v. Jackson Women’s Health, No. 19-1392). Rather, because of the story of how anti-abortion German lawmakers concluded that the best way to deter abortion was to enact, along with a partial ban, “a suite of services that had to be made available to women and families as part of any law regulating abortion: financial assistance for stay-at-home parents; a guaranteed return to a parent’s prior job if he or she took off up to three years to care for a child; extended day care and extensive tax credits for day care costs; increases for child support payments; extended paid leave to care for sick children; reemployment guarantees for empty nesters; sex education services; and a host of other measures relating to adoption, housing and taxation.” Jamal Greene, How Rights Went Wrong: Why Our Obsession With Rights Is Tearing America Apart 130 (2021).

See Chotiner interview, supra note 5. (“We make sure there’s child care in the first few years of that child’s life that’s cheap or free. That’s going to look very different in Minnesota than it does in Georgia. In Minnesota, there very well may be a political appetite for passing more state-supported aid…. There is not a one-size-fits-all when it comes to…how the needs of women will be met. That is vital work for the pro-life movement, and the Republican Party.”).

See Isaac Chotiner, How Pandemics Change History , The New Yorker (Mar. 3, 2020), https://www.newyorker.com/news/q-and-a/how-pandemics-change-history (quoting Frank M. Snowden).

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The independent source for health policy research, polling, and news.

Abortion Experiences, Knowledge, and Attitudes Among Women in the U.S.: Findings from the 2024 KFF Women’s Health Survey

Ivette Gomez , Karen Diep , Brittni Frederiksen , Usha Ranji , and Alina Salganicoff Published: Aug 14, 2024

• Methodology

Key Takeaways

• Among women of reproductive age, one in seven (14%) have had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women. Across partisanship, similar shares of Republican women, Democratic women, and independents report having had an abortion.
• Nearly one in ten (8%) women of reproductive age personally know someone who has had difficulty getting an abortion since Roe v. Wade was overturned, including 11% of Hispanic women and 13% of women living in states with abortion bans.
• Among women of reproductive age who report knowing someone personally who has had difficulty getting an abortion since Roe v. Wade was overturned, many say they had to travel out of state for care (68%), did not know where to go (40%), and/or did not have the money to cover the cost (35%).
• More than six in ten women of reproductive age are concerned that they, or someone close to them, would not be able to get an abortion if it was needed to preserve their life or health (63%) and that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them (64%).
• Less than half of reproductive age women in the United States are aware of the current status of abortion policy in their state (45%). Nearly a quarter describe the status incorrectly (23%) and a third are unsure about the status of abortion in their state (32%).
• One in four (26%) reproductive age women say if they needed or wanted an abortion they would not know where to go nor where to find information.
• Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Actions taken include starting birth control, getting a sterilization procedure, switching to a more effective method, or purchasing emergency contraceptive pills to have on hand.
• While two-thirds of women have heard about medication abortion pills, only 19% of women say people in their state can get medication abortion pills online.
• Three in four reproductive age women in the United States think abortion should be legal in most or all cases (74%). The majority support a nationwide right to abortion (70%), oppose a nationwide abortion ban at 15 weeks (64%), and oppose leaving it up to the states to determine the legality of abortion (74%). This is the case for the majority of women who are Democrats and independents as well as smaller but still substantial shares of Republicans.

Introduction

In the two years since the Dobbs decision, which overturned Roe and eliminated the federal standards that had protected the right to abortion for almost 50 years, the abortion landscape in the United States has drastically changed. Abortion is banned in 14 states and an additional six states have implemented early gestational limits between 6 and 15 weeks.

Abortion will likely be a key issue in the upcoming 2024 election . The Democratic and Republican parties have starkly different visions of what access to abortion in the U.S. should look like. Vice President and Democratic Nominee Kamala Harris has been an outspoken advocate of abortion rights and has thrown her support behind efforts to restore Roe v. Wade’ s abortion standards in all states. Former President Donald Trump endorses leaving abortion policy up to states, allowing full bans to stay in effect, although he has also previously said he would consider a 15 or 16-week national ban on abortion. At the state level, voters in up to 11 states will vote on abortion-related ballot initiatives that will shape access to abortion in their states.

This brief provides new information about women’s experiences with abortion, the fallout of overturning Roe v. Wade , women’s knowledge about abortion laws in their states including medication abortion, as well as their opinions on the legality of abortion. The 2024 KFF Women’s Health Survey was fielded from May 15 to June 18, 2024, before President Biden withdrew from the 2024 Presidential race, and was developed and analyzed by KFF staff. It is a nationally representative survey of 5,055 women and 1,191 men ages 18 to 64, and the findings in this brief are based on a sample of 3,901 women ages 18 to 49. See the methodology section for detailed definitions, sampling design, and margins of sampling error.

Women’s Experiences With Abortion

Among women of reproductive age, one in seven (14%) report having had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women ( Figure 1 ). A higher share of women with lower incomes had an abortion (17%) compared to women with higher incomes (13%).

Smaller shares of women living in rural areas report having had an abortion compared to those living in urban/suburban areas (7% vs. 15%, respectively). Many rural women face long travel distances to access abortion services.

Similar shares of Republican women (12%), independent women (15%), and Democratic women (14%) say they have had an abortion. Throughout this brief, partisans include independents who lean to either party, while independents are individuals who say they do not lean toward either political party. Nearly one in 10 women (8%) who currently identify as pro-life say they have had an abortion compared to almost one in five (17%) who currently identify as pro-choice.

Smaller shares of women living in states with abortion bans or gestational limits between 15 and 22 weeks have had an abortion compared to women living in states with gestational limits at or after 24 weeks or without any gestational limits. Even before the Dobbs decision, abortion access was very limited in many of the states that currently ban abortion or have gestational limits before viability. Most of these states had laws restricting access to abortion, including waiting periods, counseling and ultrasound requirements, and insurance coverage restrictions which resulted in the closure of many abortion clinics in the years preceding the Dobbs decision.

Among women who say they have ever wanted or needed an abortion, 15% (2% of all reproductive age women) report that at some point in their lives, they have wanted or needed an abortion that they did not get ( Figure 2 ). A larger share of Black women (24%) (5% of all Black women of reproductive age) who have ever been pregnant and have wanted or needed an abortion report that they have wanted or needed an abortion they did not get compared to White women (12%) (1% of all White women of reproductive age). When asked why they did not get a wanted or needed abortion, a third (33%) report access and affordability issues, with affordability issues making up the majority of the category. One in five women also identify religious, moral, or societal pressures as the reason why they did not get the abortion, and another 16% say they changed their mind or couldn’t go through with the abortion. One in 10 women say they were too far along to end the pregnancy. Among the women who report ever wanting or needing an abortion they did not get, 31% say they had an abortion at some other time (data not shown).

In their own words: There are many reasons why someone may not get an abortion. What was the reason you did not get the abortion(s)?

“Unable to afford the procedure and would be reaching [the] point where it would be too late to complete if able.”

“Was a day over the amount of days in order to have an abortion. I waited too long to get it.”

“Changed my mind. Decided to keep the baby but was initially scared and unsure of what to do.”

“I decided I wanted to keep and raise my child despite societal pressures that would advise against it (I was a minor).”

“My family made me feel like I couldn’t and I was scared so I followed through with my pregnancy.”

“I was intimidated by the child’s father showing up at the clinic.”

“I could not afford to go out of state and had no way out of [the] state.”

“Ended up miscarrying before proceeding with appointment.”

“I was too far along in the pregnancy when I found out I was pregnant”

“Religious reasons. We are Catholic and it’s not an option for us.”

“The service wasn’t easily accessible to me, and my partner’s family pressured me into having the child.”

“Guilt, moral compass”

“Nurse convinced me not to get it.”

“I could not afford it at the time and unsure if I really wanted to do it.”

“Family pressure, difficulty finding a place to perform an abortion.”

“I lived an hour and a half from the location and my ride didn’t show up.”

The Impact of Overturning Roe

Two years after the Supreme Court overturned the constitutional right to abortion, 14 states have banned abortion, and 11 states have implemented gestational restrictions between 6 and 22 weeks LMP (last menstrual period). Nationally, 8% of reproductive age women say they personally know someone, including themselves, who has had difficulty getting abortion care since Roe was overturned due to the restrictions in their state ( Figure 3 ). Larger shares of Hispanic women (11%) than White women (8%) report knowing someone who has experienced difficulty getting an abortion. Similarly, larger shares of women living in states with abortion bans (13%) and women living in states with gestational limits between 6 and 12 weeks (11%) report knowing someone who has experienced difficulty compared to women living in states with gestational limits at or after 24 weeks or without gestational limits (6%). Even in states with few abortion restrictions, access to abortion services can be limited by lack of providers, poor coverage, and other factors.

Among those who say they know someone (including themselves) who had difficulty getting abortion care since Roe was overturned, the majority report they (or the person they knew) had to travel out of state (68%) ( Figure 4 ). Women with higher incomes who say they or someone they know had difficulty accessing abortion care are more likely to report that they or the person they know had to travel out of state compared to women with lower incomes (75% vs. 62%). Many abortion patients living in states with abortion bans or restrictions have to travel to neighboring states to get abortion care, while others may need to travel farther .

Among women who say they or someone they know had difficulty accessing abortion, four in ten women say they or a person they know did not know where to go when trying to get an abortion (40%), three in ten women say they could not afford the cost (35%), and nearly three in ten say they had to take time off work (28%).

When asked about women’s ability to get abortion services in their state, more than half of women residing in states with abortion bans (57%) and over four in ten women in states with gestational limits say it is difficult to access abortion care in their state (Figure 5). Notably, one in five (21%) women residing in states with gestational limits at or after 24 weeks or without gestational limits say it is difficult to get abortion services in their state. While abortion may not be restricted, limitations on Medicaid and insurance coverage of abortion, the scarcity of abortion providers in rural communities, stigma, and other factors (such as the need to take time off from work and childcare costs) are still barriers to abortion.

O ver six in ten reproductive age women in the U.S. (63%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health (Figure 6). While all states with abortion bans and abortion restrictions have an exception in their law to “prevent the death” or “preserve the life” of the pregnant person, six states with abortion bans or early gestational restrictions do not have health exceptions. In general, health exceptions have often proven to be unworkable except in the most extreme circumstances. The abortion policies in these states are generally unclear about how ill or close to death a pregnant person would have to be to qualify for the exception.

With the exception of Republican women, a majority of reproductive age women in all subgroups report that they are very or somewhat concerned about access to abortion if it was needed to preserve their life or health. Larger shares of Asian or Pacific Islander women (75%) than White women (61%) are concerned, and smaller shares of women residing in rural areas (52%) are concerned compared to those residing in urban/suburban areas (65%). Compared to Democratic women (78%), smaller shares of women who identify as independent (61%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health; however, less than half of Republican women report being somewhat or very concerned (41%).

Similarly, over 6 in 10 (64%) reproductive age women say they are concerned that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them ( Figure 7 ). Across most subgroups—except across party affiliation— majorities of women say that they are somewhat or very concerned. Four in ten (39%) Republican women say they are concerned about the impact of abortion bans on the safety of potential pregnancies for themselves or someone close to them, compared to almost eight in 10 Democratic women and six in 10 independent women.

Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Larger shares of Asian or Pacific Islander, Black, and Hispanic women report they started to use birth control (9%, 10%, and 7%, respectively) compared to White women (3%) ( Table 1 ). A higher share of Asian or Pacific Islander women report that they have switched to a more effective method of birth control compared to White women (6% vs. 3%), and 7% of Hispanic women report that they have gotten emergency contraception to have on hand compared to 4% of White women.

Awareness of Abortion Availability and Policy

Nationally, most women of reproductive age are unaware of the status of abortion legality in the state they live in. While 45% can correctly describe the status of abortion in their state, 23% of reproductive age women could not answer correctly and another third (33%) say they are not sure ( Figure 8 ). Awareness is highest among women who live in states where abortion is fully banned (51%) or in states with gestational limits at or after 24 weeks or without bans (47%). Smaller shares of women living in states with gestational limits at 15 to 22 weeks (33%) and limits at 6 to 12 weeks (38%) are aware of the status of abortion in their state. Consistently across state abortion groupings, about a third of women say they are not sure on the status of abortion in their state.

One in four (26%) women of reproductive age in the U.S. report that if they needed or wanted an abortion in the near future they would not know where to go or where to find the information (Figure 9). A quarter of women say they would know where to go for an abortion and half (49%) say they would not know where to go, but would know where to find that information. Since the Dobbs decision, websites like abortionfinder.org and ineedana.com provide individuals seeking abortion services with directories of abortion clinics and services that provide medication abortion via telehealth.

Over a third of Hispanic women (37%) and a third of Black women (33%) report that if they wanted or needed an abortion in the near future, they wouldn’t know where to find information compared to 23% of White women. More women with lower incomes (37%) and women living in rural areas (35%) report they wouldn’t know where to go or find that information compared to women with higher incomes (19%) and women living in urban/suburban areas (25%). Over four in 10 (43%) women living in states where abortion is banned say they wouldn’t know where to find information compared to 17% of women in states with gestational limits at or after 24 weeks or without gestational limits. Women living in banned states seeking abortion services must either travel out of state or obtain medication abortion drugs from companies that will ship pills without requiring a clinician visit or from clinicians practicing in states with shield-laws, which offer clinicians a measure of legal protection from attempts by law authorities in abortion ban states to enforce bans in states that support abortion access.

In the United States, medication abortion is the most common abortion method. It involves taking two different medications, mifepristone and misoprostol, and it has been approved by the FDA to end pregnancies up to 10 weeks gestation. Two-thirds (67%) of women of reproductive age report that they have heard about medication abortion ( Figure 10 ). While still majorities, relatively smaller shares of Asian or Pacific Islander (62%), Black (64%), and Hispanic (59%) women report having heard about medication abortion compared to White women (72%). Similarly, smaller shares of women with lower incomes (60%) have heard about medication abortion compared to women with higher incomes (74%). Compared to women who identify as pro-choice (72%) and women who are Democrats (77%), smaller shares of women who identify as pro-life (56%) or are Republican/Republican leaning (62%) or independents (60%) report hearing of medication abortion.

The majority of women are unsure of the legal status of abortion in their state. While neither mifepristone nor misoprostol are explicitly banned in any state and the drugs can still be used for miscarriage management treatment, their use for abortion is banned in the 14 states with abortion bans. Medication abortion, for the purposes of abortion, is legal in all states with gestational restrictions as well as states without any limits, but is not legal to use for abortion after the state’s gestational limit (for example, after 6 weeks LMP in Iowa, Florida, Georgia, and South Carolina).

The majority of women of reproductive age are unclear about the legal status of medication abortion in their state, regardless of the legal status of abortion in their state ( Figure 11 ). A larger share of women living in states with gestational limits at 24 weeks or without gestational limits (43%) report that medication abortion is legal in their state compared to women living in states with gestational limits between 6 to 12 weeks (19%) and gestational limits between 15 to 22 weeks (18%). Among women living in states where abortion is banned, 6% say medication abortion is legal in their state and 27% say it is illegal. Regardless of the status of abortion in their state of residence, majorities of women of reproductive age are not aware of the legal status of medication abortion in their state or have never heard of medication abortion.

Overall, only one in five (19%) women of reproductive age are aware that medication abortion pills are available online. Since state abortion bans and restrictions have gone into effect, new online services have been created that sell medication abortion pills through online organizations. Among women of reproductive age, 10% say individuals in their state cannot get medication abortion pills online and about three-quarter (71%) were unsure or had never heard of medication abortion ( Figure 12 ). Small shares of women living in states where abortion is banned or states with gestational limits know that people in their states can get medication abortion pills online compared to women living in states without any gestational limits or limits after 24 weeks.

Opinions on Abortion Policy

Three in four (75%) women of reproductive age in the United States, the age group that is most directly impacted by state abortion policies, think that abortion should be legal in most or all cases—38% say legal in all cases and 37% legal in most cases. Only 8% of women say that abortion should be illegal in all cases. This trend is consistent with prior polls which have found that the majority of Americans believe that abortion should be legal.

Across various subgroups, except those who identify as Republican or pro-life, majorities of reproductive age women think abortion should be legal in all or most cases. Among those ages 18 to 49, over eight in 10 Black women (83%) and Asian or Pacific Islander women (83%), and almost three-quarters of Hispanic women (73%) and White women (72%) think abortion should be legal ( Figure 13 ). In contrast, slightly less than half (48%) of Republican women of reproductive age think abortion should be legal, 36% say abortion should be illegal in most cases and 17% say abortion should be illegal in all cases. Not surprisingly, among women who identify as pro-life, 74% say that abortion should be illegal in all or most cases, but one in four (25%) believe that abortion should be legal in all or most cases.

Seven in ten reproductive age women (70%) support a law guaranteeing a federal right to abortion, with half (50%) saying they strongly support this (Figure 17) . While similar shares of Asian, Black, Hispanic, and White reproductive age women support a nationwide right to abortion, support varies widely by income, urbanicity, and party affiliation ( Figure 14 ). Though still a majority, smaller shares of reproductive age women with lower incomes (64%) and women who live in rural communities (62%) support a nationwide right to abortion compared to their urban/suburban (71%) and higher income counterparts (74%). Support is strongest among Democratic (84%) women, but two thirds (64%) of women who identify as independents and nearly half of Republican women (48%) strongly or somewhat support establishing a federal right to abortion. More than three times as many Democrats (71%) than Republicans (22%) strongly support a law that would guarantee this right.

More than half of all women of reproductive age support a law establishing a nationwide right to abortion, regardless of the abortion status in their state of residence. While there are smaller shares of support among women who reside in states with bans and gestational limits before viability, over four in 10 women in these states strongly support a law guaranteeing a federal right to abortion.

On the issue of abortion, former President Trump has previously said he would consider a national ban at 15 or 16 weeks, a position also proposed by other Republican elected officials. Overall, six in ten women of reproductive age (63%) oppose a law that would establish a nationwide ban on abortion at 15 weeks ( Figure 15 ). While still a majority, smaller shares of those with lower incomes (58%) and those who reside in rural areas (55%) oppose a national abortion ban at 15 weeks. Six in ten women in states with abortion bans and gestational limits before viability oppose a national ban on abortion at 15 weeks.

Most recently, former President Trump announced he supports leaving abortion policy up to the individual states, allowing the current bans and restrictions to stay in effect across half the country. Overall, nearly three in four women of reproductive age (74%) oppose this approach ( Figure 16 ). Similar shares of Asian (72%), Black (75%), Hispanic (75%), and White (72%) reproductive age women oppose leaving abortion policy up to the states. Compared to their counterparts, larger shares of women with higher incomes (76%) and those who live in urban/suburban communities (74%) oppose having states decide whether abortion should be legal or illegal in their states.

At least half of all women oppose this approach regardless of party affiliation, but opposition is highest among Democratic women (88%). While there is slight variation in support/opposition by abortion status in a woman’s state of residence, over two thirds of those in states with abortion bans and gestational limits oppose leaving the legality of abortion up to individual states.

• Women's Health Policy
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Also of Interest

• Women and Abortion in Florida: Findings from the 2024 KFF Women’s Health Survey
• Women and Abortion in Arizona: Findings from the 2024 KFF Women’s Health Survey
• Abortion in the United States Dashboard
• 2024 Women’s Health Survey

The negative health implications of restricting abortion access

December 13, 2021— Ana Langer is professor of the practice of public health and coordinator of the Women and Health Initiative at Harvard T.H. Chan School of Public Health.

Q:  Roe v. Wade may soon be overturned by the Supreme Court, while at the same time other countries are loosening restrictions around abortion rights. What are your thoughts on the current climate around this issue?

A: The trend over the past several decades is clear: Safe and legal abortion has become more widely accessible to women globally, with nearly 50 countries including Mexico, Argentina, New Zealand, Thailand, and Ireland liberalizing their abortion laws. During the same period, however, a few countries have made abortion more restricted or totally illegal, including El Salvador, Nicaragua, and Poland.

In the U.S., legal frameworks are increasingly limiting access to abortion. Even while Roe is in place, many people are currently unable to receive abortion care.

If the Supreme Court were to limit or overturn Roe, abortion would remain legal in 21 states and could immediately be prohibited in 24 states and three territories. Millions of people would be forced to travel to receive legal abortion care, something that would be impossible for many due to a range of financial and logistical reasons.

This situation does not surprise me because of the deep polarization that characterizes public views on abortion, and the growing power and relentless efforts of anti-choice groups. Furthermore, it does not surprise me because of the important gender gap that exists in this country, which is to a great extent due to the lack of strong and consistent policies and legal frameworks to support women in their efforts to better integrate their reproductive and professional roles and responsibilities.

The U.S. legalized abortion nearly 50 years ago, at a time when it was legally restricted in many countries around the world, setting an important international precedent and example. It disappoints me to see that while important progress has been made towards equality in other culturally polarized areas such as same-sex marriage, women’s right to terminate an unwanted or mistimed pregnancy is now severely threatened.

Q:  How do laws that restrict abortion access impact women’s health? 

A: Restricting women’s access to safe and legal abortion services has important negative health implications. We’ve seen that these laws do not result in fewer abortions. Instead, they compel women to risk their lives and health by seeking out unsafe abortion care.

According to the World Health Organization, 23,000 women die from unsafe abortions each year and tens of thousands more experience significant health complications globally. A recent study estimated that banning abortion in the U.S. would lead to a 21% increase in the number of pregnancy-related deaths overall and a 33% increase among Black women, simply because staying pregnant is more dangerous than having an abortion. Increased deaths due to unsafe abortions or attempted abortions would be in addition to these estimates.

If the current trend in the U.S. persists, “back alley” abortions will be the last resource for women with no access to safe and legal services, and the horrific consequences of such abortions will become a major cause of death and severe health complications for some of the most vulnerable women in this country.

The legal status of abortion also defines whether girls will be able to complete their educations and whether women will be able to participate in the workforce, and in public and political life.

Improving social safety net programs for women reduces gender gaps and improves girls’ and women’s health and chances to fulfill their potential, and could help reduce the number of abortions over time. Women who are better educated, have better access to comprehensive reproductive health care , and are employed and fairly remunerated will be better positioned to avoid a mistimed and unwanted pregnancy, hence the need for termination will become less common.

Q: Should abortion be considered a human right?

A: Numerous international and regional human rights treaties and national-level constitutions around the world protect the right to safe and legal abortion as a fundamental human right. Access to safe abortion is included in a constellation of rights, including the rights to life, liberty, privacy, equality and non-discrimination, and freedom from cruel, inhuman, and degrading treatment. Human rights bodies have repeatedly condemned restrictive abortion laws as being incompatible with human rights norms.

While a supportive legal framework for abortion care is critical, it is not enough to ensure access for everyone who seeks the service. For universal access to become a reality, policies that cover the cost of abortion care and its integration into the health care system, in addition to societal measures that destigmatize the procedure, are needed.

— Amy Roeder

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• America’s Abortion Quandary
• 1. Americans’ views on whether, and in what circumstances, abortion should be legal

Table of Contents

• Public views of what would change the number of abortions in the U.S.
• A majority of Americans say women should have more say in setting abortion policy in the U.S.
• How do certain arguments about abortion resonate with Americans?
• In their own words: How Americans feel about abortion 
• 3. How the issue of abortion touches Americans personally
• Acknowledgments
• Methodology

As the long-running debate over abortion reaches another  key moment at the Supreme Court  and in  state legislatures across the country , a majority of U.S. adults continue to say that abortion should be legal in all or most cases. About six-in-ten Americans (61%) say abortion should be legal in “all” or “most” cases, while 37% think abortion should be  illegal  in all or most cases. These views have changed little over the past several years: In 2019, for example, 61% of adults said abortion should be legal in all or most cases, while 38% said it should be illegal in all or most cases.    Most respondents in the new survey took one of the middle options when first asked about their views on abortion, saying either that abortion should be legal in  most  cases (36%) or illegal in  most  cases (27%). 

Respondents who said abortion should either be legal in  all  cases or illegal in  all  cases received a follow-up question asking whether there should be any exceptions to such laws. Overall, 25% of adults initially said abortion should be legal in all cases, but about a quarter of this group (6% of all U.S. adults) went on to say that there should be some exceptions when abortion should be against the law.

One-in-ten adults initially answered that abortion should be illegal in all cases, but about one-in-five of these respondents (2% of all U.S. adults) followed up by saying that there are some exceptions when abortion should be permitted. 

Altogether, seven-in-ten Americans say abortion should be legal in some cases and illegal in others, including 42% who say abortion should be generally legal, but with some exceptions, and 29% who say it should be generally illegal, except in certain cases. Much smaller shares take absolutist views when it comes to the legality of abortion in the U.S., maintaining that abortion should be legal in all cases with no exceptions (19%) or illegal in all circumstances (8%). 

There is a modest gender gap in views of whether abortion should be legal, with women slightly more likely than men to say abortion should be legal in all cases or in all cases but with some exceptions (63% vs. 58%). 

Younger adults are considerably more likely than older adults to say abortion should be legal: Three-quarters of adults under 30 (74%) say abortion should be generally legal, including 30% who say it should be legal in all cases without exception. 

But there is an even larger gap in views toward abortion by partisanship: 80% of Democrats and Democratic-leaning independents say abortion should be legal in all or most cases, compared with 38% of Republicans and GOP leaners.  Previous Center research  has shown this gap widening over the past 15 years. 

Still, while partisans diverge in views of whether abortion should mostly be legal or illegal, most Democrats and Republicans do not view abortion in absolutist terms. Just 13% of Republicans say abortion should be against the law in all cases without exception; 47% say it should be illegal with some exceptions. And while three-in-ten Democrats say abortion should be permitted in all circumstances, half say it should mostly be legal – but with some exceptions. 

There also are sizable divisions within both partisan coalitions by ideology. For instance, while a majority of moderate and liberal Republicans say abortion should mostly be legal (60%), just 27% of conservative Republicans say the same. Among Democrats, self-described liberals are twice as apt as moderates and conservatives to say abortion should be legal in all cases without exception (42% vs. 20%).

Regardless of partisan affiliation, adults who say they personally know someone who has had an abortion – such as a friend, relative or themselves – are more likely to say abortion should be legal than those who say they do not know anyone who had an abortion.

Views toward abortion also vary considerably by religious affiliation – specifically among large Christian subgroups and religiously unaffiliated Americans. 

For example, roughly three-quarters of White evangelical Protestants say abortion should be illegal in all or most cases. This is far higher than the share of White non-evangelical Protestants (38%) or Black Protestants (28%) who say the same. 

Despite  Catholic teaching on abortion , a slim majority of U.S. Catholics (56%) say abortion should be legal. This includes 13% who say it should be legal in all cases without exception, and 43% who say it should be legal, but with some exceptions. 

Compared with Christians, religiously unaffiliated adults are far more likely to say abortion should be legal overall – and significantly more inclined to say it should be legal in all cases without exception. Within this group, atheists stand out: 97% say abortion should be legal, including 53% who say it should be legal in all cases without exception. Agnostics and those who describe their religion as “nothing in particular” also overwhelmingly say that abortion should be legal, but they are more likely than atheists to say there are some circumstances when abortion should be against the law.

Although the survey was conducted among Americans of many religious backgrounds, including Jews, Muslims, Buddhists and Hindus, it did not obtain enough respondents from non-Christian groups to report separately on their responses.

Abortion at various stages of pregnancy 

As a  growing number of states  debate legislation to restrict abortion – often after a certain stage of pregnancy – Americans express complex views about when   abortion should generally be legal and when it should be against the law. Overall, a majority of adults (56%) say that how long a woman has been pregnant should matter in determining when abortion should be legal, while far fewer (14%) say that this should  not  be a factor. An additional one-quarter of the public says that abortion should either be legal (19%) or illegal (8%) in all circumstances without exception; these respondents did not receive this question.

Among men and women, Republicans and Democrats, and Christians and religious “nones” who do not take absolutist positions about abortion on either side of the debate, the prevailing view is that the stage of the pregnancy should be a factor in determining whether abortion should be legal.

Americans broadly are more likely to favor restrictions on abortion later in pregnancy than earlier in pregnancy. Many adults also say the legality of abortion depends on other factors at every stage of pregnancy. 

Overall, a plurality of adults (44%) say that abortion should be legal six weeks into a pregnancy, which is about when cardiac activity (sometimes called a fetal heartbeat) may be detected and before many women know they are pregnant; this includes 19% of adults who say abortion should be legal in all cases without exception, as well as 25% of adults who say it should be legal at that point in a pregnancy. An additional 7% say abortion generally should be legal in most cases, but that the stage of the pregnancy should not matter in determining legality. 1

One-in-five Americans (21%) say abortion should be  illegal  at six weeks. This includes 8% of adults who say abortion should be illegal in all cases without exception as well as 12% of adults who say that abortion should be illegal at this point. Additionally, 6% say abortion should be illegal in most cases and how long a woman has been pregnant should not matter in determining abortion’s legality. Nearly one-in-five respondents, when asked whether abortion should be legal six weeks into a pregnancy, say “it depends.” 

Americans are more divided about what should be permitted 14 weeks into a pregnancy – roughly at the end of the first trimester – although still, more people say abortion should be legal at this stage (34%) than illegal (27%), and about one-in-five say “it depends.”

Fewer adults say abortion should be legal 24 weeks into a pregnancy – about when a healthy fetus could survive outside the womb with medical care. At this stage, 22% of adults say abortion should be legal, while nearly twice as many (43%) say it should be  illegal . Again, about one-in-five adults (18%) say whether abortion should be legal at 24 weeks depends on other factors. 

Respondents who said that abortion should be illegal 24 weeks into a pregnancy or that “it depends” were asked a follow-up question about whether abortion at that point should be legal if the pregnant woman’s life is in danger or the baby would be born with severe disabilities. Most who received this question say abortion in these circumstances should be legal (54%) or that it depends on other factors (40%). Just 4% of this group maintained that abortion should be illegal in this case.

This pattern in views of abortion – whereby more favor greater restrictions on abortion as a pregnancy progresses – is evident across a variety of demographic and political groups. 

Democrats are far more likely than Republicans to say that abortion should be legal at each of the three stages of pregnancy asked about on the survey. For example, while 26% of Republicans say abortion should be legal at six weeks of pregnancy, more than twice as many Democrats say the same (61%). Similarly, while about a third of Democrats say abortion should be legal at 24 weeks of pregnancy, just 8% of Republicans say the same. 

However, neither Republicans nor Democrats uniformly express absolutist views about abortion throughout a pregnancy. Republicans are divided on abortion at six weeks: Roughly a quarter say it should be legal (26%), while a similar share say it depends (24%). A third say it should be illegal. 

Democrats are divided about whether abortion should be legal or illegal at 24 weeks, with 34% saying it should be legal, 29% saying it should be illegal, and 21% saying it depends. 

There also is considerable division among each partisan group by ideology. At six weeks of pregnancy, just one-in-five conservative Republicans (19%) say that abortion should be legal; moderate and liberal Republicans are twice as likely as their conservative counterparts to say this (39%). 

At the same time, about half of liberal Democrats (48%) say abortion at 24 weeks should be legal, while 17% say it should be illegal. Among conservative and moderate Democrats, the pattern is reversed: A plurality (39%) say abortion at this stage should be illegal, while 24% say it should be legal. 

Christian adults are far less likely than religiously unaffiliated Americans to say abortion should be legal at each stage of pregnancy.  

Among Protestants, White evangelicals stand out for their opposition to abortion. At six weeks of pregnancy, for example, 44% say abortion should be illegal, compared with 17% of White non-evangelical Protestants and 15% of Black Protestants. This pattern also is evident at 14 and 24 weeks of pregnancy, when half or more of White evangelicals say abortion should be illegal.

At six weeks, a plurality of Catholics (41%) say abortion should be legal, while smaller shares say it depends or it should be illegal. But by 24 weeks, about half of Catholics (49%) say abortion should be illegal. 

Among adults who are religiously unaffiliated, atheists stand out for their views. They are the only group in which a sizable majority says abortion should be  legal  at each point in a pregnancy. Even at 24 weeks, 62% of self-described atheists say abortion should be legal, compared with smaller shares of agnostics (43%) and those who say their religion is “nothing in particular” (31%). 

As is the case with adults overall, most religiously affiliated and religiously unaffiliated adults who originally say that abortion should be illegal or “it depends” at 24 weeks go on to say either it should be legal or it depends if the pregnant woman’s life is in danger or the baby would be born with severe disabilities. Few (4% and 5%, respectively) say abortion should be illegal at 24 weeks in these situations.

Abortion and circumstances of pregnancy 

The stage of the pregnancy is not the only factor that shapes people’s views of when abortion should be legal. Sizable majorities of U.S. adults say that abortion should be legal if the pregnancy threatens the life or health of the pregnant woman (73%) or if pregnancy is the result of rape (69%). 

There is less consensus when it comes to circumstances in which a baby may be born with severe disabilities or health problems: 53% of Americans overall say abortion should be legal in such circumstances, including 19% who say abortion should be legal in all cases and 35% who say there are some situations where abortions should be illegal, but that it should be legal in this specific type of case. A quarter of adults say “it depends” in this situation, and about one-in-five say it should be illegal (10% who say illegal in this specific circumstance and 8% who say illegal in all circumstances). 

There are sizable divides between and among partisans when it comes to views of abortion in these situations. Overall, Republicans are less likely than Democrats to say abortion should be legal in each of the three circumstances outlined in the survey. However, both partisan groups are less likely to say abortion should be legal when the baby may be born with severe disabilities or health problems than when the woman’s life is in danger or the pregnancy is the result of rape. 

Just as there are wide gaps among Republicans by ideology on whether how long a woman has been pregnant should be a factor in determining abortion’s legality, there are large gaps when it comes to circumstances in which abortions should be legal. For example, while a clear majority of moderate and liberal Republicans (71%) say abortion should be permitted when the pregnancy is the result of rape, conservative Republicans are more divided. About half (48%) say it should be legal in this situation, while 29% say it should be illegal and 21% say it depends.

The ideological gaps among Democrats are slightly less pronounced. Most Democrats say abortion should be legal in each of the three circumstances – just to varying degrees. While 77% of liberal Democrats say abortion should be legal if a baby will be born with severe disabilities or health problems, for example, a smaller majority of conservative and moderate Democrats (60%) say the same. 

White evangelical Protestants again stand out for their views on abortion in various circumstances; they are far less likely than White non-evangelical or Black Protestants to say abortion should be legal across each of the three circumstances described in the survey. 

While about half of White evangelical Protestants (51%) say abortion should be legal if a pregnancy threatens the woman’s life or health, clear majorities of other Protestant groups and Catholics say this should be the case. The same pattern holds in views of whether abortion should be legal if the pregnancy is the result of rape. Most White non-evangelical Protestants (75%), Black Protestants (71%) and Catholics (66%) say abortion should be permitted in this instance, while White evangelicals are more divided: 40% say it should be legal, while 34% say it should be  illegal  and about a quarter say it depends. 

Mirroring the pattern seen among adults overall, opinions are more varied about a situation where a baby might be born with severe disabilities or health issues. For instance, half of Catholics say abortion should be legal in such cases, while 21% say it should be illegal and 27% say it depends on the situation. 

Most religiously unaffiliated adults – including overwhelming majorities of self-described atheists – say abortion should be legal in each of the three circumstances. 

Parental notification for minors seeking abortion

Seven-in-ten U.S. adults say that doctors or other health care providers should be required to notify a parent or legal guardian if the pregnant woman seeking an abortion is under 18, while 28% say they should not be required to do so.  

Women are slightly less likely than men to say this should be a requirement (67% vs. 74%). And younger adults are far less likely than those who are older to say a parent or guardian should be notified before a doctor performs an abortion on a pregnant woman who is under 18. In fact, about half of adults ages 18 to 24 (53%) say a doctor should  not  be required to notify a parent. By contrast, 64% of adults ages 25 to 29 say doctors  should  be required to notify parents of minors seeking an abortion, as do 68% of adults ages 30 to 49 and 78% of those 50 and older. 

A large majority of Republicans (85%) say that a doctor should be required to notify the parents of a minor before an abortion, though conservative Republicans are somewhat more likely than moderate and liberal Republicans to take this position (90% vs. 77%). 

The ideological divide is even more pronounced among Democrats. Overall, a slim majority of Democrats (57%) say a parent should be notified in this circumstance, but while 72% of conservative and moderate Democrats hold this view, just 39% of liberal Democrats agree. 

By and large, most Protestant (81%) and Catholic (78%) adults say doctors should be required to notify parents of minors before an abortion. But religiously unaffiliated Americans are more divided. Majorities of both atheists (71%) and agnostics (58%) say doctors should  not  be required to notify parents of minors seeking an abortion, while six-in-ten of those who describe their religion as “nothing in particular” say such notification should be required. 

Penalties for abortions performed illegally 

Americans are divided over who should be penalized – and what that penalty should be – in a situation where an abortion occurs illegally. 

Overall, a 60% majority of adults say that if a doctor or provider performs an abortion in a situation where it is illegal, they should face a penalty. But there is less agreement when it comes to others who may have been involved in the procedure. 

While about half of the public (47%) says a woman who has an illegal abortion should face a penalty, a nearly identical share (50%) says she should not. And adults are more likely to say people who help find and schedule or pay for an abortion in a situation where it is illegal should  not  face a penalty than they are to say they should.

Views about penalties are closely correlated with overall attitudes about whether abortion should be legal or illegal. For example, just 20% of adults who say abortion should be legal in all cases without exception think doctors or providers should face a penalty if an abortion were carried out in a situation where it was illegal. This compares with 91% of those who think abortion should be illegal in all cases without exceptions. Still, regardless of how they feel about whether abortion should be legal or not, Americans are more likely to say a doctor or provider should face a penalty compared with others involved in the procedure. 

Among those who say medical providers and/or women should face penalties for illegal abortions, there is no consensus about whether they should get jail time or a less severe punishment. Among U.S. adults overall, 14% say women should serve jail time if they have an abortion in a situation where it is illegal, while 16% say they should receive a fine or community service and 17% say they are not sure what the penalty should be. 

A somewhat larger share of Americans (25%) say doctors or other medical providers should face jail time for providing illegal abortion services, while 18% say they should face fines or community service and 17% are not sure. About three-in-ten U.S. adults (31%) say doctors should lose their medical license if they perform an abortion in a situation where it is illegal.

Men are more likely than women to favor penalties for the woman or doctor in situations where abortion is illegal. About half of men (52%) say women should face a penalty, while just 43% of women say the same. Similarly, about two-thirds of men (64%) say a doctor should face a penalty, while 56% of women agree.

Republicans are considerably more likely than Democrats to say both women and doctors should face penalties – including jail time. For example, 21% of Republicans say the woman who had the abortion should face jail time, and 40% say this about the doctor who performed the abortion. Among Democrats, far smaller shares say the woman (8%) or doctor (13%) should serve jail time.  

White evangelical Protestants are more likely than other Protestant groups to favor penalties for abortions in situations where they are illegal. Fully 24% say the woman who had the abortion should serve time in jail, compared with just 12% of White non-evangelical Protestants or Black Protestants. And while about half of White evangelicals (48%) say doctors who perform illegal abortions should serve jail time, just 26% of White non-evangelical Protestants and 18% of Black Protestants share this view.

• Only respondents who said that abortion should be legal in some cases but not others and that how long a woman has been pregnant should matter in determining whether abortion should be legal received questions about abortion’s legality at specific points in the pregnancy.  ↩

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How Kamala Harris Can Secure Federal Abortion Protection Once and For All

The Supreme Court’s decision to overturn Roe v. Wade set off a wave of new attacks on abortion, causing a catastrophic public health crisis and rapidly eroding our civil liberties and reproductive freedom. So far, 14 states have banned abortion completely, and others have severely limited access to abortion by criminalizing it after the earliest weeks of pregnancy.

Vice President Kamala Harris, the Democratic party’s nominee, has already indicated her support for abortion access and other forms of reproductive health care. At one of her first campaign events, she stated that if Congress “passes a law to restore reproductive freedom, as president of the United States I will sign it into law.”

The ACLU promises to hold Harris accountable for keeping this campaign promise if she is elected in November. Learn more in our breakdown:

Harris on Abortion Rights

The Facts: The Biden-Harris administration made abortion rights and reproductive health a priority during their four years in office. But anti-abortion politicians have had control of at least one body of Congress ever since Roe was overturned, preventing meaningful congressional action on abortion. Enacting federal legislation to protect the right to abortion throughout the country is a crucial and desperately needed step to rectify the harms of overturning Roe .

To be clear, abortion care was not accessible for far too many even before the end of Roe . If elected, Harris must carry out her promise to restore reproductive freedom by taking bold action to ensure that everyone can get an abortion if they need one, no matter who they are, where they live, or how much money they have. She must not only demand legislation that codifies abortion rights and invalidates state bans and restrictions, but that also ends discriminatory barriers to abortion care, such as insurance coverage bans like the Hyde Amendment.

Why It Matters: Right now, millions of people of reproductive age live hundreds of miles from the closest abortion provider. In 2023 alone, more than 171,000 people were forced to travel outside of their home state to secure abortion access. As a result of abortion bans and other restrictions, countless people are being forced to continue their pregnancies against their will. Some states have gone so far as to criminalize the provision of abortion care in medical emergencies where the inability to get an abortion puts the pregnant person’s health, life, and future fertility in danger.

In the two years since Roe was overturned, however, there has been a groundswell of public support for abortion rights and rising opposition against bans and restrictions on abortion care. People in states across the country — including Kansas, Kentucky, Michigan, Ohio, Pennsylvania, Virginia, and Wisconsin — have repeatedly demonstrated their support for reproductive health care access since Roe was overturned.

Harris on Abortion

The ACLU will use every tool available to ensure that a potential Harris administration delivers on the promise to protect the right to abortion.

Source: American Civil Liberties Union

How We Got Here: Making good on his campaign promise to end Roe , President Donald Trump appointed three Supreme Court justices who were part of the majority opinion that overturned the 50-year-old decision and took away the constitutional right to abortion. Since then, extreme politicians have increased their attacks on our reproductive freedom, enforcing bans that push care out of reach entirely in 14 states and attempting to use junk science to take an abortion pill off the shelves nationwide. These politicians even threatened to put doctors in prison for providing emergency abortion care to pregnant patients facing complications.

Our Roadmap: As a presidential candidate in 2020, Harris committed to working with Congress to pass a federal bill to codify abortion rights. She also promised to end the Hyde Amendment, which places restrictions on Medicaid coverage for abortion and has forced one in four low-income women seeking an abortions to carry an unwanted pregnancy to term. The Biden-Harris administration took steps to remove this harmful restriction and, if Harris is elected, the ACLU will urge her administration to build on past progress to fulfill her campaign commitments.

In addition to ending the Hyde Amendment and protecting abortion access, the threat of misusing the Comstock Act as a national abortion ban must be eliminated. The Comstock Act is an 1873 anti-obscenity law that regulates the use of the mail and common carriers to send or receive anything that is “indecent, filthy, or vile” or “intended for producing abortion.” Trump’s advisors are threatening to misapply this law, claiming incorrectly that the Comstock Act functions as a national abortion ban. To ensure that no future anti-abortion president can weaponize this antiquated law, Harris must urge Congress to repeal it. The ACLU has already asked lawmakers to introduce the Stop Comstock Act, and we will demand that any legislation codifying abortion rights also repeals the Act.

Additionally, we urge a potential Harris administration to robustly defend pregnant people’s rights and ensure all hospitals satisfy their obligations under the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals that receive Medicare funds to provide emergency stabilizing treatment, including abortion, to any patient who needs it. The ACLU will continue to work in the courts and with coalition partners to defend emergency abortion care, including urging Congress to swiftly respond in the event of a Supreme Court decision that eliminates these protections.

Lastly, while the Biden-Harris administration made steps toward expanding reproductive health care and contraception access, it must go further. If Harris is elected, the ACLU will work with her administration to urge Congress to make needed investments in Title X, a federally-funded family planning program that helps low-income people obtain critical health care services for free or at a reduced cost.

What Our Experts Say: “If Vice President Kamala Harris wins the election this year, it will be because she prioritized reproductive freedom as a central tenet of her campaign, but that promise must be met with bold and urgent action. Harris has the opportunity to ensure that Congress enacts federal protections for abortion that reflect the American public's overwhelming support for reproductive freedom. That means demanding Congress send her a bill to sign that ensures everyone who needs abortion care can access it.” — Madison Roberts, ACLU senior policy counsel for reproductive freedom.

What You Can Do Today : Since Roe was overturned, abortion bans have gone into effect in states across the country. Today, anti-abortion extremists continue to attack medication abortion and emergency abortion care. It’s past time to make a change. Join our campaign to urge your congress members to pass federal legislation that safeguards our reproductive freedom.

Learn More About the Issues on This Page

• Reproductive Freedom

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The Supreme Court Ruled, What Now?

Why Exceptions for the Life of the Mother Have Disappeared

The absence of these exemptions is a sign of the anti-abortion-rights movement’s distrust of women and the medical establishment.

Updated at 5:53 p.m. ET on August 2, 2022.

When Americans used to imagine life post- Roe , many seemed to believe that at the very least the country would agree on one thing: the need for an exception to save a woman’s life. These exceptions enjoy sweeping public support; a recent Pew Research Center poll found that 73 percent of Americans favored legal abortion if a woman’s life or health was at risk . Only 8 percent of respondents favored no exception whatsoever to criminal abortion laws.

Life-of-the-patient exceptions do not even require anti-abortion-rights Americans to change their minds about fetal personhood. Even if someone believes that a fetus enjoys the same rights as an adult, abortion could be justified much in the same way that people who are anti-violence can understand the need in certain situations for self-defense. Support for the so-called life-of-the-mother exception seemed unshakable.

From the May 2022 issue: The abortion underground

Not anymore. Anti-abortion-rights groups, like Pro-Life Wisconsin, have described the “life of the mother” exception as unnecessary and wrong. The Idaho GOP just approved a platform with no lifesaving exception . Republican candidates like Matthew DePerno, the Republican running to be Michigan’s attorney general, oppose all exceptions to abortion bans , and that includes to save a mother’s life. Conservative states are rushing to eliminate or narrow existing exceptions to their laws. Powerful groups like Students for Life, Feminists for Life , and the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) argue that “ abortion is never medically necessary ” and that doctors should always be punished for intentionally taking a fetal life.

Why has what was once unthinkable suddenly become a legal reality, despite its extreme unpopularity? Recent changes in both the GOP and the anti-abortion-rights movement have something to do with it, but the problem runs deeper: a twin skepticism of women and the medical establishment. Even though activists of the anti-abortion-rights movement and the politicians who support them sometimes argued that women must be protected in certain cases, they question the honesty of people—both doctors and patients—who invoke emergency exceptions. These dual suspicions have produced a new definition of abortion—as the intentional, criminal taking of a life—and a growing consensus that abortion bans should have no exceptions.

The roots of current conflicts about emergency exceptions to abortion bans go back to the 1960s, when states began introducing modest reforms to criminal abortion laws . Many of the early bills were patterned on a proposal from the American Law Institute, a group of elite lawyers, judges, and academics, allowing abortion in cases of rape, incest, health threats, and serious fetal conditions .

These bills enjoyed bipartisan support; Republicans including Ronald Reagan and future Vice President Spiro Agnew signed them into law. Opposition came from an anti-abortion-rights movement with strong ties to the Catholic Church—and largely, in Congress and state legislatures, from a subset of Catholic politicians.

For them, the fear was that women would take advantage of the already narrow exceptions. In the 1960s, many seeking abortion had claimed to be suicidal, leading to a wave of abortions justified on the basis of mental health . In the eyes of these Catholic activists and their allies, most of these reasons were bogus. The same was true of abortions in cases of rape. What was to stop someone from lying about sexual assault? asked anti-abortion-rights commentators . Exceptions to abortion bans, they worried, would be the exception that swallows the rule.

Debate about abortion-ban exceptions temporarily receded after the Supreme Court recognized a right to choose abortion. Starting in 1980, the GOP platform included support for the long-term fantasy of the anti-abortion-rights movement: a constitutional amendment banning abortion nationwide . As a rite of passage, Republican candidates had to declare their positions on abortion exceptions. But every Republican president supported an exception for rape and incest . Support for lifesaving exceptions went without saying.

Cracks in the consensus on exceptions showed early, however. In 1976, Congress passed the Hyde Amendment, a rider to an appropriations bill for the Department of Health and Human Services that banned Medicaid reimbursement for abortion unless a person’s life would be endangered if they carried a pregnancy to term. Every year, when the Hyde Amendment came up for reconsideration, a fight began about whether it should have additional exceptions. Unless a patient’s life was on the line, the answer for Republican anti-abortion-rights leaders was a firm no.

Health exceptions, argued abortion foes, functionally allowed abortion on demand . Similarly, women could claim to have been raped and get an abortion whenever they wanted. Henry Hyde, the author of the eponymous amendment, complained that women could just claim to have been sexually assaulted, and everyone would believe them. “No additional accountability,” he added, “ is required of them .” The Hyde Amendment fight created two worlds: one for low-income patients, many of them people of color, and another for everyone else.

Read: Why America is the global outlier in abortion

In the past decade, whatever Republican support there once was for many such exceptions disappeared more or less completely. The Republican Party that emerged from the Tea Party wave in the state legislatures of 2010 and the 2016 presidential election was more populist and conservative on abortion. In some red states, lawmakers no longer feared a competitive general election; the only real threat came from conservative primary challengers, who could wield support for any abortion-ban exceptions as a sign of weakness.

Once Donald Trump came on the scene, the national GOP doubled down on extremism. Trump never appealed to a majority of voters, but that hardly seemed to bother him. His recipe for electoral victories was to turn out conservatives and frighten other voters that Democrats were even worse than he was. Identifying plans that appealed to the average voter hardly seemed worth the trouble. Other Republicans tried to replicate Trump’s winning formula, but with a focus on abortion, detailing positions intended to please the most ardently anti-abortion-rights voters, no matter what anyone else thought.

During this same period, leaders of the anti-abortion movement have developed deep suspicion of elite medical organizations like the American College of Obstetricians and Gynecologists and even the CDC. The more that anti-abortion-rights Americans distrust mainstream science, the easier it is for them to believe that there is no need for a woman to have an abortion to save her life, ever. This belief is in some ways dependent on semantics. Pro-life doctors distinguish “direct abortions,” where doctors intend to end a pregnancy, from morally permissible procedures where the termination of pregnancy is the secondary effect of another emergency medical procedure. This distinction lines up with Catholic religious teachings: The United States Conference of Catholic Bishops instructs that abortion, defined as the “directly intended termination of a pregnancy, is never permitted,” but allows for “procedures that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman.”

This intent-based definition of abortion has spread throughout the anti-abortion-rights movement, and fits into an ascendant anti-abortion-rights model framing abortion as a crime, like homicide, defined by the perpetrator’s state of mind. AAPLOG, the movement’s leading medical organization, argues that “ direct abortion is not medically necessary to save the life of a woman . ” The organization suggests that doctors may separate “a mother and her unborn child for the purposes of saving a mother’s life,” but not with the intention of taking a fetal life. And even doctors with the right intentions must make “every reasonable attempt to save the baby’s life .”

Read: When the religious doctor refuses to treat you

In theory, that would allow doctors to treat ectopic pregnancies and HELLP syndrome, a serious complication tied to high blood pressure during pregnancy. But the truth is that, in practice, the mandate to avoid direct abortion can change or delay the treatment that doctors provide. John Seago of Texas Right to Life recently acknowledged in The New York Times that the prohibition on direct abortions means delaying medical interventions; he stressed that a doctor could not choose to “cause the death of the child today” because of a belief that “they’re going to pass away eventually.”

Although Seago argued that serious complications would justify immediate intervention, it’s hard for many to figure out what doctors are allowed to do or when. That’s all the more true when the penalties for getting it wrong are steep: new abortion laws, including trigger bans, contain harsh prison sentences for doctors, up to life in prison. Doctors less than absolutely certain that they can provide lifesaving care may choose self-preservation over their patients’ well-being. Medically, the erosion of the “life of the mother” exception can mean dangerous delays and uncertainty. In politics, it means a fundamental denial of the idea that abortion ever saves a life. The upshot is that the new mainstream in the anti-abortion-rights movement holds that there is no such thing as a medically necessary abortion.

Since the Supreme Court overruled Roe last month, conservative lawmakers have been quick to say that they do care about women. Anti-abortion-rights groups have announced initiatives that they claim will help expecting parents . Republican lawmakers have made lists of crisis pregnancy centers and promised to funnel more taxpayer dollars to them.

But there is reason to doubt how deep these concerns run, especially when states mandate protection for fetal life while leaving the fate of women to the whims of religious nonprofits. The erosion of “life of the mother” exceptions tells us something important too: Conservative lawmakers do not trust women to make that decision, and that can make “caring” for them all but impossible.

This piece originally misnamed the Wisconsin advocacy group that opposes "life of the mother" exceptions.

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The First Amendment and the Abortion Rights Debate

Sofia Cipriano

4 Prin.L.J.F. 12

Following Dobbs v. Jackson ’s (2022) reversal of Roe v. Wade (1973) — and the subsequent revocation of federal abortion protection — activists and scholars have begun to reconsider how to best ground abortion rights in the Constitution. In the past year, numerous Jewish rights groups have attempted to overturn state abortion bans by arguing that abortion rights are protected by various state constitutions’ free exercise clauses — and, by extension, the First Amendment of the U.S. Constitution. While reframing the abortion rights debate as a question of religious freedom is undoubtedly strategic, the Free Exercise Clause is not the only place to locate abortion rights: the Establishment Clause also warrants further investigation. 

Roe anchored abortion rights in the right to privacy — an unenumerated right with a long history of legal recognition. In various cases spanning the past two centuries, t he Supreme Court located the right to privacy in the First, Fourth, Fifth, Ninth, and Fourteenth Amendments . Roe classified abortion as a fundamental right protected by strict scrutiny, meaning that states could only regulate abortion in the face of a “compelling government interest” and must narrowly tailor legislation to that end. As such, Roe ’s trimester framework prevented states from placing burdens on abortion access in the first few months of pregnancy. After the fetus crosses the viability line — the point at which the fetus can survive outside the womb  — states could pass laws regulating abortion, as the Court found that   “the potentiality of human life”  constitutes a “compelling” interest. Planned Parenthood of Southeastern Pennsylvania v. Casey (1992) later replaced strict scrutiny with the weaker “undue burden” standard, giving states greater leeway to restrict abortion access. Dobbs v. Jackson overturned both Roe and Casey , leaving abortion regulations up to individual states. 

While Roe constituted an essential step forward in terms of abortion rights, weaknesses in its argumentation made it more susceptible to attacks by skeptics of substantive due process. Roe argues that the unenumerated right to abortion is implied by the unenumerated right to privacy — a chain of logic which twice removes abortion rights from the Constitution’s language. Moreover, Roe’s trimester framework was unclear and flawed from the beginning, lacking substantial scientific rationale. As medicine becomes more and more advanced, the arbitrariness of the viability line has grown increasingly apparent.  

As abortion rights supporters have looked for alternative constitutional justifications for abortion rights, the First Amendment has become increasingly more visible. Certain religious groups — particularly Jewish groups — have argued that they have a right to abortion care. In Generation to Generation Inc v. Florida , a religious rights group argued that Florida’s abortion ban (HB 5) constituted a violation of the Florida State Constitution: “In Jewish law, abortion is required if necessary to protect the health, mental or physical well-being of the woman, or for many other reasons not permitted under the Act. As such, the Act prohibits Jewish women from practicing their faith free of government intrusion and thus violates their privacy rights and religious freedom.” Similar cases have arisen in Indiana and Texas. Absent constitutional protection of abortion rights, the Christian religious majorities in many states may unjustly impose their moral and ethical code on other groups, implying an unconstitutional religious hierarchy. 

Cases like Generation to Generation Inc v. Florida may also trigger heightened scrutiny status in higher courts; The Religious Freedom Restoration Act (1993) places strict scrutiny on cases which “burden any aspect of religious observance or practice.”

But framing the issue as one of Free Exercise does not interact with major objections to abortion rights. Anti-abortion advocates contend that abortion is tantamount to murder. An anti-abortion advocate may argue that just as religious rituals involving human sacrifice are illegal, so abortion ought to be illegal. Anti-abortion advocates may be able to argue that abortion bans hold up against strict scrutiny since “preserving potential life” constitutes a “compelling interest.”

The question of when life begins—which is fundamentally a moral and religious question—is both essential to the abortion debate and often ignored by left-leaning activists. For select Christian advocacy groups (as well as other anti-abortion groups) who believe that life begins at conception, abortion bans are a deeply moral issue. Abortion bans which operate under the logic that abortion is murder essentially legislate a definition of when life begins, which is problematic from a First Amendment perspective; the Establishment Clause of the First Amendment prevents the government from intervening in religious debates. While numerous legal thinkers have associated the abortion debate with the First Amendment, this argument has not been fully litigated. As an amicus brief filed in Dobbs by the Freedom From Religion Foundation, Center for Inquiry, and American Atheists  points out, anti-abortion rhetoric is explicitly religious: “There is hardly a secular veil to the religious intent and positions of individuals, churches, and state actors in their attempts to limit access to abortion.” Justice Stevens located a similar issue with anti-abortion rhetoric in his concurring opinion in Webster v. Reproductive Health Services (1989) , stating: “I am persuaded that the absence of any secular purpose for the legislative declarations that life begins at conception and that conception occurs at fertilization makes the relevant portion of the preamble invalid under the Establishment Clause of the First Amendment to the Federal Constitution.” Judges who justify their judicial decisions on abortion using similar rhetoric blur the line between church and state. 

Framing the abortion debate around religious freedom would thus address the two main categories of arguments made by anti-abortion activists: arguments centered around issues with substantive due process and moral objections to abortion. 

Conservatives may maintain, however, that legalizing abortion on the federal level is an Establishment Clause violation to begin with, since the government would essentially be imposing a federal position on abortion. Many anti-abortion advocates favor leaving abortion rights up to individual states. However, in the absence of recognized federal, constitutional protection of abortion rights, states will ban abortion. Protecting religious freedom of the individual is of the utmost importance  — the United States government must actively intervene in order to uphold the line between church and state. Protecting abortion rights would allow everyone in the United States to act in accordance with their own moral and religious perspectives on abortion. 

Reframing the abortion rights debate as a question of religious freedom is the most viable path forward. Anchoring abortion rights in the Establishment Clause would ensure Americans have the right to maintain their own personal and religious beliefs regarding the question of when life begins. In the short term, however, litigants could take advantage of Establishment Clauses in state constitutions. Yet, given the swing of the Court towards expanding religious freedom protections at the time of writing, Free Exercise arguments may prove better at securing citizens a right to an abortion. 

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• Abortion: Effects and Legalization Words: 1141
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Should Abortion Be Banned?

Introduction, arguments for banning of abortion, counterarguments and refutation, works cited.

The issue of abortion has led to divergent opinions in the US with the pro-life activists advocating its illegalization and their pro-choice counterparts arguing in its favor. Pro-choice crusaders assert that a pregnant woman ought to be accorded the right to either sire the child or carry out an abortion before birth. One rationale behind their argument is that such a lady might have been a rape victim who is not prepared to get a baby (Sedgh et al. 224). In contrast, pro-life activists affirm that options should be established instead of abortion, for example, presenting the child for adoption. The reason they give for their position is that if all women were to undertake abortion and not get any child, the continuity of human life would be threatened. Abortion is a contentious and divisive topic in the community, civilization, and politics of the United States, and numerous anti-abortion rules have been in effect in all states from around 1900.

Pro-life activists assert that other options might be preferable in place of abortion. They state that only fewer than 20% of all cases of abortion are associated with rape or even minors (Thomas et al. 358). Therefore, they maintain that among the most effective solutions to the avoidance of abortion is engaging in protected sex when is not prepared to rear a baby. A different practice would be to get the baby and present it to be cared for by other willing individuals rather than termination of its life. One might contact organizations dedicated to nurturing babies who lack proper parents or allow adoption as some amicable solutions against abortion. Some women strongly desire to have a child, which does not happen attributable to infertility. The existence of options for abortion shows that the practice is needless and condemnable regardless of the reason provided.

Pro-life crusaders state that abortion should be banned because in nearly all occurrences it makes the patient develop health complications. For example, many females have experienced hemorrhage, infections, and sometimes death during or even after abortion. Breast cancer is one of the most widespread risks of undertaking abortion attributable to the altered or disrupted structure of the mammary glands (Thomas et al. 359). Carcinogenic practices are apparent in transitional cells of females who have had an abortion. Each time a woman carries out an abortion, she increases the possibility of developing breast cancer. Furthermore, more than a quarter of the females who get abortion-associated cancer lose their lives. Irrespective of the short-lived relief following an abortion, nearly all the women and girls who carry it out report related psychological problems. Some of the signs of abortion-associated psychological problems include flashbacks, guilt, substance use/abuse, anger, suicidal thoughts, hallucination, and sexual dysfunction. Ensuing problems after abortion establishes that it is an unsafe and risky practice that ought to be banned.

Abortion should be illegalized because it is tantamount to murder as it entails the termination of the life of an already living creature. After four weeks of pregnancy, the developing embryo already has a pumping heart, and the appearance of mouth, ears, nose, limbs, and brain follows closely. During that time, there is the possibility of recording brainwaves and perception of heartbeat (White et al. 190). Additionally, there is the emergence of bones, and the unborn child begins to reflectively respond to stimuli. Since these processes are already in existence before the period of any likely abortion, it is evident that undertaking the practices should be illegal because it subjects the unborn baby to agonizing pain and suffering.

The pro-choice drive is established on the belief that no female should be compelled by the regulations in a country to have a baby contrary to her will whenever valid and substantial reasons are given. The argument provided is that siring a child should be a private familial affair, which should not be troubled. The pro-choice conviction is based on the notion that the life of a person begins after birth (Aiken et al. 396). Nevertheless, the American Life League marks a pro-life group that maintains that the right to life should be given to a human being from the fertilization phase hence the need to illegalize abortion.

Consistent with the affirmations of the pro-choice crusaders, bestowing on the embryo or fetus the sense of life infringes the rights of pregnant women for interfering with their independence. Additionally, banning abortion is a way of hindering girls from obtaining the help of health providers when they require tackling some medical concerns. Calling for the illegalization of abortion is being insensitive. For example, illegalization disregards how the education and later life of a teenager who becomes pregnant out of rape are irreparably damaged. This would lead to some female students becoming truants or school dropouts (Jones and Jerman 4). Another aspect that is ignored in the illegalization of abortion is the trauma that a family would suffer while nurturing an unwanted baby. Nonetheless, since there is only a small proportion of teenagers who become pregnant after incidences of rape, the illegalization of abortion would have an insignificant impact on adolescent girls.

The pro-choice movement is convinced that pro-life activists do not consider the fact that the law (such as the illegalization of abortion) will not prevent girls from becoming pregnant and clandestinely going for an abortion. Additionally, although most narcotic drugs are illegal, people are still using them secretly (Sedgh et al. 227). In the same way, enacting laws that illegalize abortion will result in many pregnant girls having abortions in unsafe settings that may leave them at the risk of death over and above the termination of the life of the embryo or fetus. The point is that if a pregnant woman or lady carries an unwanted pregnancy and has the determination of aborting it, they will still do it regardless of whether it is legal or banned. It is irrational for some people to put much significance on the need for an unborn child to live while overlooking the degree to which such a practice jeopardizes the mother’s life and welfare. However, it is imperative for laws to be enacted to control vices devoid of providing reasons for the irrelevance of such regulations.

Abortion leads to the intentional termination of a pregnancy prior to birth. It has elicited mixed feelings with one group establishing that pregnant girl should have the independence of either aborting or bearing the child. However, a different group asserts that options such as adoption should be practiced rather than abortion that denies the unborn child the right to life. Abortion is an argumentative and divisive subject in American civilization, community, and politics, and many anti-abortion guidelines have been in operation in all states since about 1900. Since the illegalization of abortion outshines the advocacy for its legalization, the practice should be banned.

Aiken, Abigail, et al. “Requests for Abortion in Latin America in the Wake of Zika Virus.” The New England Journal of Medicine, vol. 375, no. 4, 2016, pp. 396-400.

Jones, Rachel, and Jenna Jerman. “Abortion Incidence and Service Availability in the United States, 2011.” Perspectives on Sexual and Reproductive Health, vol. 46, no. 1, 2014, pp. 3-14.

Sedgh, Gilda, et al. “Adolescent Pregnancy, Birth, and Abortion Rates across Countries: Levels and Recent Trends.” Journal of Adolescent Health, vol. 56, no. 2, 2015, pp. 223-230.

Thomas, Rachel, et al. “Anti-Legal Attitude toward Abortion among Abortion Patients in the United States.” Contraception, vol. 96, no. 5, 2017, pp. 357-364.

White, Kari, et al. “Women’s Knowledge of and Support for Abortion Restrictions in Texas: Findings from a Statewide Representative Survey.” Perspectives on Sexual and Reproductive Health, vol. 48, no. 4, 2016, pp. 189-197.

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StudyCorgi. (2022, March 7). Should Abortion Be Banned? https://studycorgi.com/should-abortion-be-banned/

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Global health charities warn of ‘huge and terrible’ threat to abortion rights if Trump returns

‘Global gag rule’ and funding cuts will be ‘on different scale’ if Republicans win again, family-planning providers say

Providers of women’s healthcare around the world are preparing for potentially disastrous consequences should Donald Trump win the US presidential election in November.

Policies pursued during Trump’s last presidency caused “devastating” harm in a number of countries, said Beth Schlachter, a senior director at MSI Reproductive Choices in the US. It meant “clinics shuttered, health teams closed, women dying … but a second Trump term will be on a different scale”.

Global health charities lost US funding if they refused to agree not to “perform or actively promote abortion” under the “ global gag rule ”. This frequently meant the closure of facilities offering wider health services, such as family planning.

Joe Biden scrapped the ban in 2021 a week after he was inaugurated as US president in a move celebrated by health groups around the world. However, rightwing US strategists have set out detailed plans in their Project 2025 roadmap for a Republican administration to change the way the US government operates immediately after a Trump victory.

They are pushing for even wider restrictions on the activities of any organisation receiving US funding, the withdrawal of American support from international agencies, and the country’s influence to be used to further restrict access to abortions globally.

Schlachter said the sector needed “to get our heads around the implications of Trump retaking the White House”. Efforts by Trump to distance himself from Project 2025 were disingenuous, she suggested. “These are his people and they are telling us loud and clear the damage they intend to inflict.”

The global gag rule requiring organisations receiving US funding for family-planning services to agree not to perform or actively promote abortion has existed under Republican presidents since Ronald Reagan. The Trump administration went further , however, and made that agreement a condition for organisations to receive US funding for global healthcare in general.

The Project 2025 papers suggest the next Republican president should go further still and apply the gag rule “to all foreign assistance, including humanitarian aid”. This would affect about $51bn (£40bn) in overseas aid at current levels, health policy analysts suggest .

Such an expansion would be “huge and terrible”, said Dr Marleen Temmerman, a professor in obstetrics and gynaecology at the Aga Khan University East Africa and former director of reproductive health at the World Health Organization (WHO).

Under Trump’s last administration, US funding for research into subjects such as cardiovascular disease and diabetes was imperilled by the provision of abortions for foetal malformation at the university’s hospital, she said.

Dr Carole Sekimpi, the senior Africa director for MSI Reproductive Choices, said the 2017 gag rule was “disastrous for women”.

“If anything, it increases the number of abortions – because you have more and more women with limited access to contraception, limited access to information, and therefore with a higher likelihood of unplanned pregnancies, and therefore the need for an abortion,” she said.

The gag rule had a wider chilling effect, Sekimpi added. “It does really embolden the opposition. Those who are anti-rights, anti-choice – the hate movement.”

Temmerman said organisations would need to work together and potentially hive off work in reproductive healthcare into separate organisations to safeguard their other projects.

The US is responsible for almost two-thirds of global funding for sexual and reproductive health and rights promotion, according to a report by the German Foundation for World Population (DSW), a family-planning charity.

During the last Trump presidency, MSI saw annual donor income drop by $30m – or 17% – because it refused to sign the global gag rule. The charity said that meant 8 million women lost access to family-planning services – resulting in an estimated 6m unintended pregnancies, 1.8m unsafe abortions and 20,000 maternal deaths.

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The Guttmacher Institute published a study looking at the impact in Uganda and Ethiopia, which found the global gag rule “stalled and even reversed progress toward expanded access to modern contraception”.

In Nepal , MSI had been working with the government to expand family-planning services, training health workers and establishing clinics.

“Everything changed after the election of Donald Trump,” said Tushar Niroula, operations director at MSI Nepal. “The operation had to be gradually closed down.”

The proportion of women of reproductive age in Nepal using modern contraceptives had stagnated, he said. “Underprivileged populations in hard-to-reach areas are not able to get the access to the services. That’s the effect of the global gag rule.”

Partner agencies were afraid to refer women to MSI for abortion care even in cases of rape, incest or where the mother’s life was at risk, which were all exceptions to the global gag rule, the charity said, adding that desperate women would opt for unsafe methods.

“It’s devastating,” Niroula said. “We have seen a lot of cases where women have opted for traditional methods of abortion and have got complications, and have nearly died.”

Documents published by Project 2025 suggest membership of international organisations such as the UN and WHO should be seen as only “a means to attain defined goals” and stress that withdrawal is an option “when such institutions act against US interests”.

The US should work with a coalition of “like-minded nations” to shape the work of international agencies, building on the anti-abortion Geneva Consensus Declaration signed by the last Trump administration and 33 largely illiberal or authoritarian governments, they suggest. The US rescinded its signature a few months afterwards after Trump left office.

Individuals linked to the last Trump administration and to Project 2025 are already working in countries including Guatemala and Uganda to embed policies based on that declaration, according to analysis by the reproductive rights group Ipas .

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Comparison/Contrast Essays: Two Patterns

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First Pattern: Block-by-Block

By Rory H. Osbrink

Abortion is an example of a very controversial issue. The two opposing viewpoints surrounding abortion are like two sides of a coin. On one side, there is the pro-choice activist and on the other is the pro-life activist.

The argument is a balanced one; for every point supporting abortion there is a counter-point condemning abortion. This essay will delineate the controversy in one type of comparison/contrast essay form: the “”Argument versus Argument,”” or, “”Block-by-Block”” format. In this style of writing, first you present all the arguments surrounding one side of the issue, then you present all the arguments surrounding the other side of the issue. You are generally not expected to reach a conclusion, but simply to present the opposing sides of the argument.

Introduction: (the thesis is underlined) Explains the argument

The Abortion Issue: Compare and Contrast Block-by-Block Format

One of the most divisive issues in America is the controversy surrounding abortion. Currently, abortion is legal in America, and many people believe that it should remain legal. These people, pro-choice activists, believe that it is the women’s right to chose whether or not to give birth. However, there are many groups who are lobbying Congress to pass laws that would make abortion illegal. These people are called the pro-life activists.

Explains pro-choice

Abortion is a choice that should be decided by each individual, argues the pro-choice activist. Abortion is not murder since the fetus is not yet fully human, therefore, it is not in defiance against God. Regardless of the reason for the abortion, it should be the woman’s choice because it is her body. While adoption is an option some women chose, many women do not want to suffer the physical and emotional trauma of pregnancy and labor only to give up a child. Therefore, laws should remain in effect that protect a woman’s right to chose.

Explains pro-life

Abortion is an abomination, argues the pro-life activist. It makes no sense for a woman to murder a human being not even born. The bible says, “”Thou shalt not kill,”” and it does not discriminate between different stages of life. A fetus is the beginning of life. Therefore, abortion is murder, and is in direct defiance of God’s will. Regardless of the mother’s life situation (many women who abort are poor, young, or drug users), the value of a human life cannot be measured. Therefore, laws should be passed to outlaw abortion. After all, there are plenty of couples who are willing to adopt an unwanted child.

If we take away the woman’s right to chose, will we begin limiting her other rights also? Or, if we keep abortion legal, are we devaluing human life? There is no easy answer to these questions. Both sides present strong, logical arguments. Though it is a very personal decision, t he fate of abortion rights will have to be left for the Supreme Court to decide.

Second Pattern: Point-by-Point

This second example is also an essay about abortion. We have used the same information and line of reasoning in this essay, however, this one will be presented in the “”Point-by-Point”” style argument. The Point-by-Point style argument presents both sides of the argument at the same time. First, you would present one point on a specific topic, then you would follow that up with the opposing point on the same topic. Again, you are generally not expected to draw any conclusions, simply to fairly present both sides of the argument.

Introduction: (the thesis is underlined)

Explains the argument

The Abortion Issue: Compare and Contrast Point-by-Point Format

Point One: Pro-life and Pro-choice

Supporters of both pro-life and pro-choice refer to religion as support for their side of the argument. Pro-life supporters claim that abortion is murder, and is therefore against God’s will. However, pro-choice defenders argue that abortion is not murder since the fetus is not yet a fully formed human. Therefore, abortion would not be a defiance against God.

Point Two: Pro-life and Pro-choice

Another main point of the argument is over the woman’s personal rights, versus the rights of the unborn child. Pro-choice activists maintain that regardless of the individual circumstances, women should have the right to chose whether or not to abort. The pregnancy and labor will affect only the woman’s body, therefore it should be the woman’s decision. Pro-life supporters, on the other hand, believe that the unborn child has the right to life, and that abortion unlawfully takes away that right.

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Home — Essay Samples — Social Issues — Abortion — Argumentative Essay Outline On Abortion

Argumentative Essay Outline on Abortion

• Categories: Abortion

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Words: 665 |

Published: Mar 13, 2024

Words: 665 | Page: 1 | 4 min read

Table of contents

Introduction, thesis statement, paragraph 1: the right to bodily autonomy, paragraph 2: the health and safety of women, paragraph 3: reproductive freedom and economic justice.

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Where abortion stands in florida right now, from the law to the ballot amendment, florida currently has a 6-week ban on abortions.

Christie Zizo , Digital Editor

In November, Floridians will decide whether abortion should be more widely available in the state, turning back a state law that severely limited when an abortion could be sought.

That law came amid a concerted push to limit if not outright ban abortions in the state after the U.S. Supreme Court overturned Roe v. Wade with the Dobbs decision in 2022.

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Here’s what has happened with abortion in Florida in the last few years and how the constitutional amendment on the ballot in November could change that if it passes.

What Florida law currently says

Florida law currently allows abortions up to six weeks of gestation. The law defines gestation as beginning from the first day of the pregnant woman’s last menstrual period.

After six weeks, a physician cannot knowingly terminate a pregnancy unless:

• Two physicians certify in writing that the abortion is necessary to save the pregnant woman’s life, or avoid a serious risk of “substantial and irreversible physical impairment of a major bodily function.”
• Or, one physician can certify in writing that there is a medical need for an emergency medical procedure to terminate the pregnancy, again to save the woman’s life or avert substantial or irreversible injury, but there must be no other physician available for consultation.
• Or, the pregnancy is in the second trimester and two doctors certify in writing that the fetus has a fatal fetal abnormality.
• Or, the pregnancy is the result of rape, incest or human trafficking. In this case, the pregnancy is allowed up to 15 weeks as determined by the doctor. The patient must provide a copy of a restraining order, police report, court order or other evidence documenting her victim status.

In addition, Florida law requires a physician to perform or induce an abortion in person. A doctor cannot prescribe medication to induce abortions via telehealth and medical abortion medications cannot be mailed to a patient.

If an abortion is sought in the third trimester, the doctor needs to do all they can to preserve the life and health of the fetus, unless doing so conflicts with preserving the life and health of the pregnant woman. In that case, “the physician must consider preserving the woman’s life and health the overriding and superior concern.”

The legal battle

For the longest time, abortion was allowed in Florida up to the viability of the fetus to live outside the womb (typically around 24 weeks of pregnancy).

In 2022, the Florida Legislature passed a bill, which Gov. DeSantis signed into law, to limit abortions to 15 weeks of gestation. That law was challenged in the state court system, based on a ruling from the 1980s that restricting abortion was a violation of a Floridian’s right to privacy. The law was blocked until a final decision was reached.

While that was happening, in 2023, the Florida Legislature passed a stricter six-week ban on abortion, which DeSantis quietly signed into law in April 2023.

Because of the lawsuit in the courts, this stricter ban was also put on hold until the Florida Supreme Court reached a ruling.

That court did that in April of 2024, ruling that the 15-week law did not violate the right to privacy.

With that question now settled, the stricter ban officially went into effect on May 1, 2024 and is now the law in Florida.

Since then, the number of abortions that have taken place in Florida has fallen, according to data from the Florida Agency for Health Care Administration. As of Aug. 1, 40,499 abortions had been performed in 2024 so far. However, the number of abortions reported between July and August was 31% lower than the number of abortions reported in the same period in 2023.

Of those reported abortions, 37,551 occurred in the first trimester, 2,945 occurred in the second trimester, and three happened in the third trimester.

Amendment 4

After DeSantis signed the six-week ruling into law, a coalition of groups started a petition campaign to get a proposed amendment to the Florida Constitution that would limit government interference in abortion. The campaign was launched in May of 2023, and by September it had enough verified petition signatures to trigger a Supreme Court review, a record for citizens’ initiatives in the state.

The proposed amendment says “Except as provided in Article X, Section 22, no law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider.”

Article X, Section 22 of the Florida Constitution guarantees the right of parents or guardians to be notified before a minor tries to terminate a pregnancy.

Florida Attorney General Ashley Moody challenged the amendment in the Florida Supreme Court, insisting the language was vague and would be a “trojan horse” to allow a further unraveling of Florida abortion laws.

However, the Florida Supreme Court disagreed and approved the amendment for the November 2024 ballot on April 1 . The amendment is labeled Amendment 4. In order to pass, 60% of Florida voters need to approve it.

The state government released a controversial financial impact statement for Amendment 4 that advocates tried to get removed because it posits that it could invalidate laws requiring parental consent for minors (which is protected in the Florida Constitution), or that only licensed physicians can perform abortions. The statement also said any uncertainties about the amendment will lead to lawsuits that will cost the state money.

That issue is currently before the Florida Supreme Court.

Floridians Protecting Freedom is the group behind Amendment 4, with a coalition of dozens of organizations behind it, including Planned Parenthood, ACLU of Florida and the Florida Women’s Freedom Coalition.

There is a concerted effort to defeat the amendment from anti-abortion advocates. A group called Florida Voters Against Extremism launched the “Vote No on 4″ campaign, and has the financial support of several Catholic dioceses and groups, as well as a PAC belonging to Florida House Speaker Paul Renner, R-Palm Coast, called Conservatives for Principled Leadership, according to Florida Division of Elections records.

Eight U.S. states will have a measure on the ballots protecting abortion, according to the Kaiser Family Foundation , and activists in another three states are trying to get one on the ballots.

Get today’s headlines in minutes with Your Florida Daily :

Copyright 2024 by WKMG ClickOrlando - All rights reserved.

About the Author

Christie zizo.

Christie joined the ClickOrlando team in November 2021.

RELATED STORIES

Florida voters can decide in november whether to protect abortion access, legalize recreational marijuana, court says, central florida leaders react to ruling on abortion, marijuana ballot measures, abortion ‘statement’ fight goes to florida supreme court, here’s how florida’s new 6-week abortion ban plans to help pregnant mothers, republican sen. rick scott softens his abortion position after florida supreme court ruling, florida democrats hope abortion and marijuana questions draw young voters despite low enthusiasm.

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On Politics

Free vasectomies and an inflatable iud: abortion rights advocates hit the d.n.c..

This convention is likely to be a head-on display of a new, unbridled abortion politics.

• Share full article

By Jess Bidgood

While delegates are in Chicago for next week’s Democratic National Convention, they will engage in the typical pageantry and traditions: They’ll vote for their nominee, pose for photos with elected officials, and show off their state with cool buttons or themed hats.

They will also have the option of getting a free vasectomy or a medication abortion just blocks away.

A mobile health center run by Planned Parenthood Great Rivers, which serves much of Missouri and part of southern Illinois, plans to park itself near the convention and offer those services early next week to anybody who makes an appointment, delegate or not. (There is so much interest in the vasectomy appointments, I’m told, there is already a waiting list.)

It’s a way of showcasing how reproductive health care providers have had to get creative when operating in or near states like Missouri, which borders Illinois and has a near-total abortion ban.

But it also underscores the way this convention, more than any other, is going to be a head-on display of a new, unbridled abortion politics.

For years, many Democrats believed too much talk about abortion rights might drive away moderate or religious voters. Four years ago, at the Covid-dampened convention of 2020, President Biden did not utter the word abortion in his speech. Neither did Vice President Kamala Harris (although she did refer briefly to racial injustice in “reproductive and maternal health care.”)

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Vance says Trump wouldn't ban abortion pill days after Trump indicated he would be open to it

Republican vice presidential nominee Sen. JD Vance on Sunday sought to walk back former President Donald Trump’s recent comments suggesting that he is open to banning access to mifepristone , one of the two drugs used in medication abortions.

In an interview on CBS’ “Face the Nation,” the Ohio Republican was asked whether a Trump-Vance administration would use the Food and Drug Administration to block access to mifepristone.

“Well, no,” he said. “What the president has said very clearly is that abortion policy should be made by the states, right? You of course want to make sure that any medicine is safe and it’s prescribed in the right way, and so forth.”

Vance said Trump wants individual states and voters in those states to make decisions on abortion policies and for the federal government to respect those decisions.

He added that Trump has “consistently” said the party needs “to get out of the culture war side of the abortion issue.”

Asked by NBC News during a press conference at his Mar-a-Lago resort last week whether he would take steps such as directing the FDA to revoke access to mifepristone, Trump said, “You could do things that ... would supplement — absolutely — those things are pretty open and humane.”

“There are many things on a humane basis that you can do outside of that,” the former president added, saying “you also have to give a vote” to people about abortion.

Trump’s comments on Thursday contrasted with his remarks on the abortion pill during a CNN debate in June in which he said he would “not block it.”

Karoline Leavitt, the Trump campaign’s national press secretary, later clarified to NBC News that Trump has long held the “position of supporting the rights of states to make decisions on abortion.” Leavitt also said the questions asked during the press conference were “difficult to hear” and that Trump has not changed his stance on mifepristone, noting that “the Supreme Court unanimously decided on the issue and the matter is settled.”

The Supreme Court in June unanimously upheld access to mifepristone , rejecting a challenge from a group of anti-abortion doctors. However, laws surrounding access to the drug vary by state in the aftermath of the high court’s 2022 decision overturning Roe v. Wade, a landmark ruling that guaranteed a constitutional right to abortion.

In his interview on CBS, Vance was pressed on Trump’s remarks to NBC News last week. Vance similarly said that people at the press conference had difficulty hearing and understanding the question. He reiterated that the former president stands by the Supreme Court’s decision to allow mifepristone to stay on the market.

“Maybe he couldn’t hear that person super clearly, so I don’t want to put words in President Trump’s mouth,” Vance said. “What he said very clearly in the debate is that he agrees with the Supreme Court decision, but more importantly, he wants these decisions to be made by the states.”

In a separate appearance on ABC News’ “This Week” on Sunday, Vance was not asked about the campaign’s approach to mifepristone but was pressed on how he would advise Trump, a Florida resident, on how to vote in the state’s November referendum on expanding abortion access .

After noting that Trump has said decisions on abortion access should be made on a state-by-state level, Vance said, “I’ll let Donald Trump offer his position and I’ll talk about it then.”

“What I would encourage him to do is to do what he’s done up to this point, which is to try to find some common ground here and try to advance some pro-family policy so that people feel like they have more options,” he said. “A lot of the reason that women choose to terminate a pregnancy is very often they don’t feel like they have any other choice. We want to give them more options to choose to have that baby, to make it easier to raise that baby.”

Summer Concepcion is a politics reporter for NBC News.

Alec Hernández is a 2024 NBC News campaign embed.

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Inside a medical practice sending abortion pills to states where they're banned

Elissa Nadworny

“Welcome to modern abortion care,” says Angel Foster, who leads operations at what’s known as the MAP, a Massachusetts telehealth provider sending pills to people who live in states that ban or restrict abortion. Elissa Nadworny/NPR hide caption

The packages, no bigger than a hardcover book, line the walls of the nondescript office near Boston. It's not an Etsy retailer or a Poshmark seller or, as the nearby post office workers believe, a thriving jewelry business.

These boxes contain abortion pills.

"Welcome to modern abortion care," says Angel Foster, as she holds up a box for mailing. Foster, who has an M.D. degree, leads operations at what's known as the MAP, a Massachusetts telehealth provider sending pills to people who live in states that ban or restrict abortion.

The MAP is one of just four organizations in the U.S. operating under recently enacted state shield laws, which circumvent traditional telemedicine laws requiring out-of-state health providers to be licensed in the states where patients are located. Eight states have enacted these shield laws.

Pregnant patients can fill out an online form, connect with a doctor via email or text and, if approved, receive the pills within a week, no matter which state they live in.

Shots - Health News

Abortion is becoming more common in primary care clinics as doctors challenge stigma.

Shield law practices account for about 10% of abortions nationwide. There were 9,200 abortions a month provided under shield laws from January to March of this year, according to fresh data from the Society of Family Planning's WeCount project . And some researchers estimate that this number has risen since then and could be as high as 12,000 per month.

The rise of telehealth is part of why the number of abortions in the U.S. has continued to go up since the Supreme Court overturned Roe v. Wade in 2022 — even though 14 states have near-total abortion bans. In those states, shield law providers represent the only legal way people can access abortions within the established health care system.

"If you want to have your abortion care in your state and you live in Texas or Mississippi or Missouri, right now shield law provision is by far the most dominant way that you'd be able to get that care," says Foster. Elissa Nadworny/NPR hide caption

Back in Massachusetts, Foster glances down at the list of today's patients. The practice's four OB-GYNs have signed off on prescriptions for nearly two dozen women — in Texas, Florida, Tennessee, Georgia, Alabama, Oklahoma and South Carolina. Most of today's patients are around six weeks along in their pregnancy. Many already have children.

"I really need an abortion pill. My state has banned it. My funds are really low," one patient wrote on the online form she filled out for the doctor.

"I'm a single mom with a kid under two," another wrote. "I can't afford a baby. I can't even afford this abortion."

Foster and her team serve patients who are up to 10 weeks pregnant and who are 16 or older. It costs $250 to get the two-drug regimen — mifepristone and misoprostol — in the mail, but there's a sliding scale and patients can pay as little as $5. The MAP is funded through abortion funds, individual donations and philanthropic gifts, and Foster has plans to apply for grants and state funding to help make the organization more sustainable. The MAP currently sends out about 500 prescriptions a month.

Yet to be tested in court, shield laws have some legal vulnerability

In the eight states with shield laws, abortion providers can treat out-of-state patients just as if they were in-state patients. The laws give abortion providers some protection from criminal prosecution, civil claims and extradition, among other threats. The laws have yet to be tested in court, but they certainly haven't gone unnoticed by lawmakers and groups looking to limit abortion.

"These websites are breaking the law … aiding and abetting crimes in Texas," says John Seago, the president of Texas Right to Life. "We want to use all the instruments that we have, all the tools available, to really fight against this new trend of abortion pills by mail."

Seago says providers should still be held responsible for committing a crime that is executed across state lines. "Mailing the abortion pill is a state jail felony according to our pro-life laws," he says, "but enforcement of those policies has been a real, real challenge."

Mifepristone, a drug used in abortion care, at the MAP's office in Massachusetts. Elissa Nadworny/NPR hide caption

His organization has been looking for the right individual or circumstance to challenge shield laws directly in court. Three Republican-led states recently tried to sue the Food and Drug Administration over regulations allowing doctors to send pills through the mail, but the Supreme Court threw out the case in June over issues of standing . Those plaintiffs say they'll fight on. And a Republican attorney general in Arkansas sent a cease-and-desist letter to a shield law provider.

Abortion providers back to ‘business as usual’ after high court's mifepristone ruling

Seago thinks many conservative prosecutors have been hesitant to take legal action, especially in an election year. But he says it's important to act quickly, before abortion by mail becomes pervasive.

The people who are sending these pills know that there's risk in what they're doing. Some providers say they won't travel to or through states with bans so that they can't be subpoenaed, be served legal papers or even be arrested if there's a warrant. That may mean avoiding layovers at Dallas Love Field airport or a detour around those places on a cross-country road trip. For Foster, it means she can't visit her mom and stepdad, who retired to South Carolina.

"The thing about shield laws is that they're new, so we don't have a precedent to go off of," says Lauren Jacobson, a nurse practitioner who prescribes abortion medication through Aid Access, the largest of the four shield law providers. She says she avoids large swaths of the United States. "We don't really know what will or won't happen. But I'm not going to Texas. I've been before though, so that's OK for me."

Abortion bans still leave a 'gray area' for doctors after Idaho Supreme Court case

Shield laws don't offer blanket protection. The doctors and nurse practitioners who prescribe the pills have malpractice insurance in their states, but it's unclear whether those policies would cover suits from states with abortion restrictions. Patients use third-party payment services like Cash App or PayPal, which are also untested in how they would work under a shield law. Would they give up information on a provider or patient if requested to do so by law enforcement?

How the experience looks

Lauren, who is 33 and lives in Utah, got pregnant while on birth control and decided that she couldn't afford another child. (NPR is not using her last name because she's worried about professional repercussions.)

Abortion is legal in Utah until 18 weeks, but there are only a handful of clinics in the state. The closest one to Lauren was several hours away by car. Several years prior, she had an abortion at a clinic in Salt Lake City, and it hadn't been a pleasant experience — she had to walk through protesters. The guilt from her conservative Christian upbringing was overwhelming.

Shield law practices account for about 10% of abortions nationwide. There were 9,200 abortions a month provided under shield laws from January to March of this year, according to fresh data from the Society of Family Planning's WeCount project. Some researchers estimate that this number has risen since then and could be as high as 12,000 per month. Elissa Nadworny/NPR hide caption

"I got in my car and I cried," she recalls. "I just never wanted to go through it again."

This time, Lauren got pills from Aid Access, a shield law provider similar to the MAP. "I was a little bit sketched out, I won't lie," she says. "Because like, well, where is this coming from? Who is this under? How are they prescribing this?"

She and her partner did research to try to figure out whether what they were doing was legal. She says ultimately she couldn't find anything that clearly stated that what she wanted to do — have pills sent from an out-of-state doctor — was illegal.

She filled out a form online with questions about how far along she was and her medical history and then connected with a doctor via email and text messages. She googled the doctor, who she found was legit and practicing out of New York.

A few days later, she received abortion medication in the mail and had her abortion at home.

"To do it in the privacy of your own home, where I felt more support as opposed to going through protesters," Lauren says. "Especially with a provider within the state of Utah. I feel like there's always a judgmental indication or undertone."

The online doctor also followed up to make sure everything had gone OK, which Lauren appreciated. "I felt it was a little bit more thorough," she says. "They're checking in on you, like, 'How did you respond? What symptoms? What's going on?'"

A staff member of the MAP brings the boxes containing abortion medication to the local post office. Elissa Nadworny/NPR hide caption

In Massachusetts, the folks who run the MAP hear much the same from their patients. Many emails and messages are logistical, like this email: "I took the first pill on Friday and all the other pills on Saturday. For how long should I be bleeding as I'm still bleeding this morning?"

Many others offer disbelief, relief and gratitude. "I just wanted to say thank you so much," wrote one woman. "I was terrified of this process. It goes against everything I believe in. I'm just not in a place where I can have a child. Thank you for making the pills easily accessible to me."

When Foster, who runs operations for the MAP, does a final tally of the patients who are ready to have their pills sent out, she notices a new note from a woman who just paid, bringing the day’s total number of patients from 20 to 21.

"I am a single mother on a fixed income, and I can not afford a kid right now."

It's from a woman in Alabama who is six weeks pregnant and filled out her form around lunchtime. Within an hour, a MAP doctor had reviewed her case and prescribed her the medication. She paid the fee as soon as she was approved. All in all, the whole process took about three hours. Foster is able to pack up those pills and add them to the batch headed to the post office.

By 3 p.m., the Alabama woman's package is scanned by the Postal Service worker.

It's expected to arrive by the week's end.

• abortion drugs
• mifepristone
• abortion provider
• misoprostol
• Dobbs v Jackson Women's Health Organization
• Roe v. Wade