When Abortion Was Illegal
Major complications from induced abortion are
very rare in the United States, occurring in fewer than
1 percent of abortions. The risk of death from child-
birth, an uncommon event in industrialized coun-
tries, is ten times greater than the mortality risk of
abortion. The safety of legal abortion is in stark con-
trast to the danger women faced before abortion was
decriminalized in the United States in 1973. In the
1950s, for example, there were about 1 million illegal
abortions every year, with at least 1,000 deaths per
year resulting.
Before legalization some courageous and quali-
fied providers took considerable personal risks to
offer safe procedures to women in need. Women with
adequate financial and social resources were some-
times able to seek safe abortions in legal settings out-
side the United States. Desperation often drove other
women to unskilled abortionists working in unsani-
tary conditions. Women who survived so-called back-
alley abortions of this sort or attempts to self-abort
sometimes suffered painful chronic illnesses, lost the
ability to have children, or experienced trauma that
affected their psychological health and well-being.
Judicial and Legislative Rulings
On January 22, 1973, the U.S. Supreme Court
handed down the Roe v. Wade decision, which created
a legal, though limited, right to abortion. Roe v. Wade
concluded that the ‘‘right of privacy... founded in
the Fourteenth Amendment’s concept of personal lib-
erty... is broad enough to encompass a woman’s de-
cision whether or not to terminate her pregnancy.’’
Based on their individual right to privacy, women in
consultation with their doctors were given the legal
right to choose abortion in the first three months (or
first trimester) of pregnancy. State laws were permit-
ted to limit second-trimester abortions ‘‘only in the
interest of the woman’s safety.’’ In the final three
months (third trimester) of pregnancy, Roe v. Wade al-
lowed states to protect the fetus by restricting abor-
tion unless there is potential danger to the life or
health of the pregnant woman.
Roe v. Wade granted women the right to early
abortion with a physician’s consent, but it did not
guarantee financial or medical access to abortion. In
1976 the U.S. Congress passed the Hyde amendment
to a federal appropriations bill, eliminating federal
reimbursement for induced abortions from Medicaid
public insurance coverage for low-income women.
Through 2001, Congress had annually reinstated this
ban on federal funding of abortion, with narrow ex-
ceptions for rape, incest, and threats to the life of the
woman if she continues the pregnancy. As of 1997 the
cost of an abortion in a clinic or doctor’s office ranged
from $100 to $1,535, averaging between $316 and
$401.
Funding issues have been only one arena of de-
bate in the controversy over women’s right to abor-
tion. Religious and personal beliefs lead some people
to reject abortion as an individual option for them-
selves. Among those with personal objections to abor-
tion, some advocate for the right of other people to
make their own decisions. Others attempt to use the
judicial and legislative systems to return to the situa-
tion that existed before legalization. Attitudes toward
sexuality and women’s autonomy, as well as funda-
mental beliefs about social control over individual de-
cision making, motivate activists on different sides of
the abortion issue.
The U.S. Supreme Court heard another major
abortion case in July 1992. In Planned Parenthood v.
Casey, the court reviewed a Pennsylvania statute that
required women seeking abortions to receive counsel-
ing from physicians in favor of continuing their preg-
nancies, and then to wait at least twenty-four hours
before obtaining an abortion procedure. Notification
of spouses and parents about requests for abortions
was also required. Only the provision for spousal noti-
fication was considered to impose an undue burden
on women by the Supreme Court, and this provision
was thus judged unconstitutional. The Court acknowl-
edged the situation of women in abusive relation-
ships, with the potential for violence perceived as part
of the burden for women wishing to act independent-
ly of their partners. Other provisions of the statute
were left intact, although most were seen by the Court
as medically unnecessary and burdensome to a lesser
extent.
Although Roe v. Wade was not overturned by the
Supreme Court in the Planned Parenthood v. Casey de-
cision, the Court’s strict interpretation of undue bur-
den set a precedent for states to impose numerous
restrictions on women exercising their right to abor-
tion. As of January 2001, the majority (31) of states
had parental notification or consent laws in effect for
adolescents seeking abortions. The participation of at
least one parent is expected in these states. In most
states it is possible for a teen to receive a ‘‘judicial by-
pass’’ of parental involvement, but only if the teen has
the information and resources to bring a persuasive
request to a court.Access to Abortion
Restrictions on abortion and lack of broad access
to abortion services are unique for a legal medical
procedure. The controversy over abortion and associ-
ated violence and harassment of patients and provid-2 ABORTION