Abortion In The United States

"As we noted at the beginning of the paper, facts matter. The stakes in achieving a more accurate appreciation of what occurred before (and after) Roe v. Wade are substantial for our understanding of the relationship between courts and politics. An account of the pre-Roe period in all its multidimensional richness instructs us, on the one hand, that extremes of conflict can occur, and important social conversations can emerge, without reference to courts at all. On the other hand, from the perspective of nearly four decades after the decision, we see that judicial review, far from forcing an end to politics, offers a canvas on which nonjudicial actors continue to paint, reconfiguring legal meaning to their own uses, until Roe v. Wade the case is all but effaced and “Roe” the symbol is what remains."

"There are many possible explanations for how Roe has come to matter as it has. Perhaps polarization around abortion occurred because the Supreme Court repressed politics. Or perhaps partisan conflict escalated because the Court channeled politics into federal arenas, by enunciating law for the nation that was most easily reversed through national institutions. With polls in the wake of Roe showing growing public support for liberalizing access to abortion, perhaps conflict escalated because a cohesive and well-organized minority opposed the decision and was encouraged to resist it by voting on a single-issue basis. Or perhaps conflict escalated because in the years after the decision Roe came increasingly to be associated with feminist challenges to the family, and so came to be viewed as a threat to traditional and religious forms of social order. Or perhaps conflict escational authority because they associated the decision with a line of cases that the legal academy had criticized for a generation. Or perhaps conflict escalated because criticism of Roe by liberal elites legitimized demands to replace Supreme Court Justices by Americans who hated the Supreme Court’s race decisions but who no longer felt as free to campaign against those rulings as they once had. Or perhaps conflict escalated because the Court’s involvement in abortion gave political leaders the opportunity to unite disparate groups against the Court and in a quest for constitutional restoration, forging a new governing coalition of citizens who before never made common cause with one another."

"Fifteen individual or collective “friends of the court”—amici curiae—filed briefs in Roe v. Wade, eight for the challengers to the Texas law and seven in the state’s defense. (Several on both sides also filed supplemental briefs for the second argument.) This was a substantial number for the time, although it looks small by the standards of today, when even in cases of only moderate importance, the Court often receives two dozen briefs or more."

"Opinion polls offer an important window into political developments, even if opinion polls supply no information about who enters politics in order to vindicate their views, who has the resources to persuade others, or how issues are bundled or presented. In this case, it is striking that polling data from the period just before and after the Roe decision seem to show rising public support for liberalizing access to abortion."

"Why did the abortion debate escalate and become the defining site of political division in the nation? The history of the abortion conflict in the period before Roe raises a variety of questions about Court-centric explanations for Roe rage—and accordingly suggests the need for historical inquiry into the sources of the polarization so often attributed to the decision. While the history of conflict over abortion before Roe cannot tell us what happened after the Court ruled, it can and does raise powerful questions about the logic of polarization in the decades after Roe precisely because it demonstrates how the abortion conflict could accelerate and become entangled in party politics in a period when the abortion conflict cannot be plausibly construed as a response to judicial review. The history of the pre-Roe period thus illustrates the need for a deep history of the post-Roe period if we are to make any reliable judgments about how and why Roe came to be the site of polarizing and identitarian conflict that it now is."

"There were, in short, several institutions engaged in conflict over abortion in the decade before Roe that had independent motives and independent pathways for conflict in the decades after Roe (for example, the Catholic Church, the adversaries in the campaign to ratify the ERA, and the national political parties competing for voters)."

"We estimate the impact of changes in abortion access in the early 1970s on the average living standards of cohorts born in those years. In particular, we address the selection inherent in the abortion decision: is the marginal child who is not born when abortion access increases more or less disadvantaged than the average child? Legalization of abortion in five states around 1970, followed by legalization nationwide due to the 1973 Roe v. Wade decision, generates natural variation which can be used to estimate the effect of abortion access. We find that cohorts born after abortion was legalized experienced a significant reduction in a number of adverse outcomes. Our estimates imply that the marginal child who was not born due to legalization would have been 70% more likely to live in a single parent family, 40% more likely to live in poverty, 50% more likely to receive welfare, and 35% more likely to die as an infant. These selection effects imply that the legalization of abortion saved the government over $14 billion in welfare expenditures through 1994."

"The underlying assumption is that the Court blundered by issuing a decision that shut down politics, short-circuiting a process of democratic-based legislative change that would have been accorded more legitimacy, even by those members of the public who disagreed with it. In What’s the Matter with Kansas, Thomas Frank charged that: [Roe] unilaterally quashed the then-nascent debate over abortion, settling the issue by fiat and from the top down. And it cemented forever a stereotype of liberalism as a doctrine of a tiny clique of experts, an unholy combination of doctors and lawyers, of bureaucrats and professionals, securing their “reforms” by judicial command rather than by democratic consensus."

"Not only is it commonly assumed that Roe started the conflict over abortion but the common assumption, both outside and within the legal academy, is that Roe has driven the realignment of Republican and Democratic voters around abortion. According to Benjamin Wittes, “One effect of Roe was to mobilize a permanent constituency for criminalizing abortion—a constituency that has driven much of the southern realignment toward conservatism.” As Cass Sunstein put it, “[T]he decision may well have created the Moral Majority, helped defeat the equal rights amendment, and undermined the women’s movement by spurring opposition and demobilizing potential adherents.” Or as Sandford Levinson explains, “I have often referred to Roe as ‘the gift that keeps on giving’ inasmuch as it has served to send many, good, decent, committed largely (though certainly not exclusively) working-class voters into the arms of a party that works systematically against their material interests but is willing to pander to their serious value commitment to a ‘right to life.’” David Brooks charges yet more harshly: “Justice Harry Blackmun did more inadvertent damage to our democracy than any other 20th-century American. When he and his Supreme Court colleagues issued the Roe v. Wade decision, they set off a cycle of political viciousness and counter-viciousness that has poisoned public life ever since.” Robert P. George invokes Roe in warning the Supreme Court not to accept the constitutional claim for same-sex marriage: “By short-circuiting the democratic process, Roe inflamed the culture war that has divided our nation and polarized our politics.”"

"The assumption that Roe caused backlash by repressing politics is now part of how we reason about courts. It made an appearance in the case challenging the"

"Polarization of the national parties over abortion did not appear at the time of Roe but took shape years after. While party platforms began to diverge on abortion in the 1970s, it took years after Roe for Republicans to vote more consistently against abortion than Democrats, a shift that seems to have begun with party leaders and then spread to its base. Greg Adams, examining abortion-related votes in Congress from 1973 through 1994 as a measure of the abortion views of the political system’s elites, concluded that it was not until 1979 (perhaps not coincidentally, at the same time Weyrich and Viguerie organized pro-life PACs) that congressional Republicans began to vote against abortion at a higher rate than Democrats in Congress."

"pp.299-300"

"In this Part, we survey commentary in the academy and popular press that attributes escalating conflict over abortion to the Court’s decision in Roe. The “Roe-caused-backlash” narrative has acquired a life of its own, such that those who invoke it scarcely look to history."

"Part III surveys expressions of this “common-sense” understanding in the popular media and the academy, where Roe is regularly invoked as the sole and sufficient cause of political polarization around abortion. The history of abortion conflict in the years before Roe offers a rich counterpoint as it illustrates motives for conflict emanating from institutions other than the Court. Attuned to these alternative institutional bases for conflict over abortion, we can pick out features of the post-Roe landscape that raise deep questions about the sufficiency of Court-centered accounts of backlash and confront a series of puzzles about the institutions and actors that have helped make Roe matter as it has. Of course, no history of the pre-Roe period can settle the story of Roe’s reception. But it can unsettle that story, as our history does. If we are to better understand Roe’s role in causing political polarization, we need a history that attends to the different institutions that distinctively contributed to the abortion conflict—including the national political parties in a realignment contest. Only with such history can we look to Roe to teach us about the prospects and limits of judicial review."

"[T]he pre-Roe history that we chronicle is significant, among other reasons, because it demonstrates the motivations that different actors had for engaging in conflict over abortion at a time when their engagement cannot be construed as a reaction to the Court. As different groups joined and changed the stakes of the abortion conflict, conflict escalated without the intermediation of judicial review. Understanding the dynamics of conflict before Roe changes the questions that we might ask of the record after Roe. The dynamics of conflict before the Court ruled suggest many reasons to explore the role played by nonjudicial actors and institutions in helping make the Supreme Court’s decision notorious as a source of polarization. In particular, it raises the question of how the competition of the national political parties for voters might have shaped reception of the decision. “Roe” is now a shorthand reference for positions staked out in long-running debates over gender, religion, and politics. But is the decision a cause or a symbol of these conflicts? We conclude the paper with a call for scholarly inquiry, in the hope that this history of the abortion conflict before Roe demonstrates why facts matter in any conversation about Roe as an exemplar of the possibilities and limits of judicial review."

"That the major political parties have decisively changed positions on abortion is clear. On the eve of Roe, as we have noted, the Gallup Poll reported that a sizeable majority of all Americans—by 64% to 31%—agreed with the statement that “the decision to have an abortion should be made solely by a woman and her physician”; 68% of Republicans supported that categorical statement compared with 58% of Democrats. Today, of course, it is the Republican Party that opposes constitutional protections for abortion, and the Democratic Party that supports them."

"[F]ar from reconciling abortion opponents to a woman’s fundamental right to terminate her pregnancy, the decision actually spawned a right-to-life opposition which did not previously exist."

"It is also commonly asserted that the Court caused conflict because it rendered a decision that diverged from popular opinion. Jeffrey Rosen, for example, contrasts Roe with Brown, which he asserts “was supported by more than half of the country when it was handed down . . . [while] Roe v. Wade was an entirely different matter. The Court’s decision, in 1973, to strike down abortion laws in forty-six states and the District of Columbia was high-handed, and represents one of the few times that the Court leaped ahead of a national consensus.” Jeffrey Rosen, The Day After Roe, THE ATLANTIC, June 2006, at 56, 56-57. Rosen also contends that the Court could have avoided backlash if only it had limited its holding to the termination of early pregnancies. Jeffrey Rosen, The Supreme Court: Judicial Temperament and the Democratic Ideal, 47 WASHBURN L.J. 1, 8 (2007) (“The parts of Roe that provoked a backlash were those that called into question later term restrictions that most Americans support.”). Historical evidence does not suggest that a more temporally limited abortion right would have been acceptable to the antiabortion movement at the time of Roe. The fervent minority who entered politics to work against abortion rights before and after Roe sought criminalization and were not willing to settle for less. To those who believe that abortion is murder, there is no middle ground; it makes no difference whether a judicial or legislative decision permits abortion up to twelve weeks’ gestation or twenty. That is why the Catholic Church began to organize at the national level to block abortion reform when the only reform on offer was the ALI therapeutic legislation. see supra notes 66-79 and accompanying text; see also Eugene Quay, Justifiable Abortion—Medical and Legal Foundations, 49 GEO. L.J. 173, 173 (1960) (attacking, from a Catholic perspective, the abortion provisions of the proposed Model Penal Code, recently tentatively approved by the ALI, and describing the proposal as “a violent departure from all existing laws”)."

"Roe not only is believed by many to have ignited conflict over abortion but also is commonly represented as having single-handedly caused societal polarization and party realignment around the question of abortion. Backlash narratives about Roe thus rest both on temporal assumptions (that conflict over abortion and polarization began with Roe) and on institutional assumptions (that the Supreme Court decision caused the abortion conflict, societal polarization, and party realignment). Those who claim that the Court caused the abortion conflict in fact offer different accounts of why the Court’s decision had such powerful effects on the nation’s politics. They assert that Roe caused backlash because the decision nationalized conflict, because the Court was too far ahead of public opinion,163 or because the decision prevented compromise. The premise on which all of these accounts rest is that bad judicial decisionmaking—whatever the opinion’s precise flaws—caused bad politics. Escalating conflict is a symbol of a politics deformed by judicial overreaching."

"See William n. Eskridge, Jr., Pluralism and Distrust: How Courts Can Support Democracy by Lowering the Stakes of Politics, 114 YALE L.J. 1279, 1312 (2005) (“Roe essentially declared a winner in one of the most difficult and divisive public law debates of American history. Don’t bother going to state legislatures to reverse that decision. Don’t bother trying to persuade your neighbors (unless your neighbor is Justice Powell).”); Michael Klarman, Fidelity, Indeterminacy, and the Problem of Constitutional Evil, 65 FORDHAM l. REV. 1739, 1751 (1997) (describing the “conventional understanding of Roe v. Wade” as being that, “far from reconciling abortion opponents to a woman’s fundamental right to terminate her pregnancy, the decision actually spawned a right-to-life opposition which did not previously exist”)."

"Cf. FRANK, supra note 164, at 121 (invoking “the great abortion controversy, which mobilizes millions but which cannot be put to rest without a supreme Court decision overturning Roe v. Wade”)."

"Critics of Roe frequently assert that Roe disrupted a process of state-by-state legislative compromise on abortion that would have produced general public acceptance of laws liberalizing access to abortion. The case is very far from clear. liberalization efforts seem to have stalled after 1970."

"The dominant account of the abortion conflict is Court-centered: it explains the abortion conflict as a bad form of politics triggered in response to the Supreme Court’s efforts to shut down democratic decision making. Our history of the pre-Roe period, by contrast, shows how ordinary politics can produce escalating forms of conflict over abortion, without the intervention of courts. This political account of conflict generates a variety of historical questions about the genesis and shape of the abortion controversy. With an appreciation of the many ways in which nonjudicial actors can provoke escalating forms of conflict, the political account is interested in the role that the Catholic Church played in escalating and in nationalizing the abortion conflict in the years before Roe. By 1967, the National Conference of Catholic Bishops responded to the introduction of ALI reform bills in state houses across the nation by creating a national organization devoted to blocking abortion reform. What led the National Conference of Catholic Bishops to found what would come to be known as the National Right to Life Committee—an organization that funded and organized opponents of abortion reform at the state level and helped develop secular and nonsectarian arguments against abortion’s decriminalization? The provocation was not judicial review but instead increasing popular support for reforming abortion law. Conflict intensified precisely because law was beginning to change in response to growing public interest in abortion reform, and a minority that cared passionately about the issue had the resources to organize in opposition—a possibility that the Court-centered account of backlash does not consider."

"The political account understands that countermobilization and escalating conflict (often referred to as “backlash”) is a normal response to increasing public support for change that may—but certainly need not—have a relationship to judicial review. Just as the political account suggests why increasing public support for change can motivate conflict, it understands that countermobilization can block change, despite increasing public support. The political account of conflict thus generates questions about the dynamics of legislative change in the period before Roe. Does the fact that legislative abortion reform seemed to stall after 1970 reflect the countermobilizing efforts of a large, well-financed, and nationally networked group that voted on a single-issue basis, or does the failure of legislative reform after 1970 instead reflect the views of a popular majority? Examining the logic of conflict in the pre-Roe era identifies important questions about the dynamics of conflict in the period after the decision and, more generally, about the model of politics that implicitly organizes stories of constitutional change."

"If we are to understand not only “whether” but also “how” and “why” judicial review played a role in escalating the abortion conflict, there is much that we yet need to investigate concerning the dynamics of conflict over abortion the years after Roe. For example, if the Court’s decision in Roe was the sole cause of backlash, why did polls after Roe show no sign of decline in public support for abortion—and by some measures, record an increase in support for liberalizing access to abortion? Who attacked the Court’s abortion decision and when? Why, for example, was there not a single question asked about Roe at the confirmation hearings of Justice John Paul Stevens nearly three years after the decision? Why did it take until the end of the 1970s for the Southern Baptist Convention to oppose abortion categorically185 and for leaders of conservative Protestant evangelicals to enter politics in opposition to Roe? And, strikingly, why did those affiliated with the Democratic and Republican parties switch positions on abortion in the decades after Roe? For that matter, how is it that leaders of the national political parties seem to have switched positions on abortion nearly a decade before citizens affiliated with the parties? A Court-centered account of conflict does not seem well suited to notice these historically specific features of polarization over abortion—or to explain them. Where the Court-centered account interprets signs of extraordinary conflict over abortion as evidence that the Court has repressed politics,188 the political account of backlash asks whether extraordinary conflict and polarization over abortion might instead be the very expression of politics."

"Popular support for abortion’s legalization had been rising before the decision, see supra note 119 and accompanying text, and, depending on the poll, either continued to rise afterward or remained stable at a high level. See, e.g., Donald Granberg & Beth Wellman Granberg, Abortion Attitudes, 1965- 1980: Trends and Determinants, FAM. PLAN. PERSP., Sept.-Oct. 1980, at 250, 252 (“Following the 1973 supreme Court decisions that ruled restrictive state abortion laws unconstitutional, there was a five-point rise in average approval. . . . The one-year increase between 1972 (before the supreme Court abortion decisions) and 1973 (after the decisions) was sharper than the average annual increase of about three points between 1965 and 1972.”). More than two years after Roe, the Harris survey reported that approval of permitting access to abortion during the first trimester of pregnancy had reached “the highest level of support the Harris survey has ever recorded for legal abortion [54 percent] and a turnabout from 1972 when abortion in the first trimester of pregnancy was opposed by a 46 to 42 percent plurality.” Louis Harris, Majority Supporting Abortion Laws Grows, CHI. TRIB., May 26, 1975, at 7. This article concluded that “[t]here is no doubt that the U.S. Supreme Court decision solidified public support for legalizing abortion.” Id. Also in 1975, the respected California-based Field Poll reported a sharp increase in support for abortion among California adults. See Mervin D. Field, Poll Shows Dramatic Rise in Support for Abortions, L.A. TIMEs, Apr. 2, 1975, at D1. Whatever these various polls have to offer in the nature of scientific proof, they at least serve to refute any notion that the public greeted Roe with a spontaneous negative reaction."

"Note how very different are these various explanations for Roe’s role in polarization. Note, too, how very different are their implications for the institution of judicial review. With a better account of the facts, we might conclude that the particular storm of forces that made “Roe” is not likely to converge again. Or, we might identify features of the Court’s decision responsible for inflaming an already ongoing conflict. Even so, our ability to identify which aspects of the Court’s decision aggravated an ongoing conflict would still require some account, beyond that provided by the conventional Court-centered narrative, of the structure of conflict in which the Court ruled."

"To be clear, we do not argue that the Supreme Court played no role in provoking conflict over the legalization of abortion. We suggest rather that the dominance of the “Court-caused-it” backlash narrative has shortchanged both legal scholars and the general public of a more complete understanding of an important chapter in America’s social, political, and legal history. Our book’s account of the sources and dimensions of the abortion conflict before Roe suggests a considerably more complex explanation than what the conventional backlash narrative provides for what happened after Roe, as we demonstrate here with further evidence of the entanglement of abortion with party realignment not only after the decision but before it, as well. The powerful preemptive effect of the juricentric narrative has blunted curiosity about Roe’s roots and its reception; it has become a barrier to the kind of scholarly reexamination that we hope this paper inspires. A generation of lawyers and political actors has come of age schooled in Roe as a chastening lesson on the consequences of relying on courts to address the claims of those engaged in challenging social norms and existing arrangements. But we believe that a more complete understanding of Roe’s story may offer a different, more productive lesson. That lesson is not that adjudication inevitably causes political conflict and polarization and is thus to be avoided at all cost. Conflict is a part of our political life. And adjudication plays a special role in defining our political community. Rather, the history of conflict before and after Roe suggests that in thinking about the possibilities and limits of adjudication, we need to be attentive to the motives for conflict that emerge from sources outside as well as inside the courtroom, from directions and actors that may shift over time."

"We find evidence of sizeable positive selection: the average living circumstances of cohorts of children born immediately after abortion became legalized improved substantially relative to preceding cohorts, and relative to places where the legal status of abortion was not changing. Our results suggest that the marginal children who were not born as a result of abortion legalization would have systematically been born into worse circumstances had the pregnancies not been terminate: they would have been 70% more likely to live in a single parent household, 40% more likely to live in poverty, 35% more likely to die during the first year of life, and 50% more likely to be in a household collecting welfare. The last of these finding implies that the selection effect operating through the legalization of abortion saved the government over $14 billion in welfare payments through the year 1994."

"By being first movers in increasing abortion access, the five repeal states revealed their willingness to make abortion available. The states that were forced into legalization by Roe v. Wade may have been less positively disposed towards abortion availability, so even de jure legalization may not have implied a large increase in de facto access. Moreover, the women who wanted abortions most in the non-repeal states may have travelled to the repeal states to obtain them, so that the shift in use of abortion after Roe v. Wade was muted. In fact, this view is supported by the evidence on abortion legalization and birth rates in Levine et al. (1996). Their results for the effect o legalization on birth rates are depicted in Figure 2. This figure graphs the relative birth rates of the repeal and non-repeal states over time. Following legalization of abortion in the repeal states in 1970, birth rates in these states fell precipitously relative to birth rates in other states. There is then a corresponding fall in birth rates in the non-repeal states after 1973, so that by 1976 relative birth rates were once again equalized. However, the “bounceback” is slow, only reducing the gap somewhat by 1974-75. Levine et al. present regression results which support the narrative above: relative birth rates fell precipitously in the repeal states during 1971-73, recovered to some extent by 1974-75, and fully recovered by 1976-80. Overall, abortion legalization appears to be correlated with roughly a 6% decline in relative birth rates, which occurred immediately in the repeal states and more gradually in the non-repeal states."

"The Harris Poll® has been measuring attitudes toward the Roe v. Wade decision legalizing abortion ever since it was handed down by the Supreme Court in 1973. During the 34 years since, Harris Polls found majorities, between 49 and 65 percent of all U.S. adults, in favor of Roe v. Wade. The latest Harris Poll finds that support for Roe v. Wade has increased fairly significantly in a relatively short time. A majority – 56 percent – now favors the U.S. Supreme Court decision, the highest level since 1998 and an increase of seven percentage points from just last year when a slender 49 to 47 percent is supported the decision. Furthermore, only 20 percent of U.S. adults favor not permitting a woman to get an abortion under any circumstances. This Harris Poll also finds that a substantial 69 to 24 percent majority of all adults do not think it is likely that this Supreme Court will overturn Roe v. Wade. (Of course, that is not a prediction)."

"While it is perhaps not surprising that most Democrats (63%) favor Roe v. Wade and half of Republicans (51%) oppose it, substantial percentages disagree. Over four in ten (45%) Republicans favor Roe v. Wade and a third (33%) of Democrats oppose it;"

"From 1998 until this year, the U.S. adult public’s support for Roe v. Wade had been declining. A year ago, The Harris Poll reported that Roe v. Wade was supported "only by a slender 49 percent to 47 percent plurality" – "support and opposition are almost equal". Today, a majority now supports the U.S. Supreme Court decision (56% vs. 40%) and almost seven in ten think that the U.S. Supreme Court decision will remain unchanged. What might explain such a shift in 18 months?"

"In the Wade case, this Court held unconstitutional a Texas statute making it a crime to procure or attempt an abortion except on medical advice for the purpose of saving the mother's life. The constitutional underpinning of Wade was a recognition that the "liberty" protected by the Due Process Clause of the Fourteenth Amendment includes not only the freedoms explicitly mentioned in the Bill of Rights, but also a freedom of personal choice in certain matters of marriage and family life. [Footnote 18] This implicit constitutional liberty, the Court in Wade held, includes the freedom of a woman to decide whether to terminate a pregnancy. But the Court in Wade also recognized that a State has legitimate interests during a pregnancy in both ensuring the health of the mother and protecting potential human life. These state interests, which were found to be "separate and distinct" and to "gro[w] in substantiality as the woman approaches term," id. at 410 U. S. 162-163, pose a conflict with a woman's untrammeled freedom of choice. In resolving this conflict, the Court held that, before the end of the first trimester of pregnancy, neither state interest is sufficiently substantial to justify any intrusion on the woman's freedom of choice. In the second trimester, the state interest in maternal health was found to be sufficiently substantial to justify regulation reasonably related to that concern. And at viability, usually in the third trimester, the state interest in protecting the potential life of the fetus was found to justify a criminal prohibition against abortions, except where necessary for the preservation of the life or health of the mother. Thus, inasmuch as the Texas criminal statute allowed abortions only where necessary to save the life of the mother and without regard to the stage of the pregnancy, the Court held in Wade that the statute violated the Due Process Clause of the Fourteenth Amendment. In Maher v. Roe, 432 U. S. 464, the Court was presented with the question whether the scope of personal constitutional freedom recognized in Roe v. Wade included an entitlement to Medicaid payments for abortions that are not medically necessary. At issue in Maher was a Connecticut welfare regulation under which Medicaid recipients received payments for medical services incident to childbirth, but not for medical services incident to nontherapeutic abortions. The District Court held that the regulation violated the Equal Protection Clause of the Fourteenth Amendment because the unequal subsidization of childbirth and abortion impinged on the "fundamental right to abortion" recognized in Wade and its progeny. It was the view of this Court that "the District Court misconceived the nature and scope of the fundamental right recognized in Roe." 432 U.S. at 432 U. S. 471. The doctrine of Roe v. Wade, the Court held in Maher, "protects the woman from unduly burdensome interference with her freedom to decide whether to terminate her pregnancy," id. at 432 U. S. 473-474, such as the severe criminal sanctions at issue in Roe v. Wade, supra, or the absolute requirement of spousal consent for an abortion challenged in Planned Parenthood of Central Missouri v. Danforth, 428 U. S. 52. But the constitutional freedom recognized in Wade and its progeny, the Maher Court explained, did not prevent Connecticut from making "a value judgment favoring childbirth over abortion, and . . implement[ing] that judgment by the allocation of public funds." 432 U.S. at 432 U. S. 474. As the Court elaborated:"

"It is evident that a woman's interest in protecting her health was an important theme in Wade. In concluding that the freedom of a woman to decide whether to terminate her pregnancy falls within the personal liberty protected by the Due Process Clause, the Court in Wade emphasized the fact that the woman's decision carries with it significant personal health implications -- both physical and psychological. 410 U.S. at 410 U. S. 153. In fact, although the Court in Wade recognized that the state interest in protecting potential life becomes sufficiently compelling in the period after fetal viability to justify an absolute criminal prohibition of nontherapeutic abortions, the Court held that, even after fetal viability, a State may not prohibit abortions "necessary to preserve the life or health of the mother." Id. at 410 U. S. 164. Because even the compelling interest of the State in protecting potential life after fetal viability was held to be insufficient to outweigh a woman's decision to protect her life or health, it could be argued that the freedom of a woman to decide whether to terminate her pregnancy for health reasons does, in fact, lie at the core of the constitutional liberty identified in Wade. But, regardless of whether the freedom of a woman to choose to terminate her pregnancy for health reasons lies at the core or the periphery of the due process liberty recognized in Wade, it simply does not follow that a woman's freedom of choice carries with it a constitutional entitlement to the financial resources to avail herself of the full range of protected choices. The reason why was explained in Maher: although government may not place obstacles in the path of a woman's exercise of her freedom of choice, it need not remove those not of its own creation. Indigency falls in the latter category. The financial constraints that restrict an indigent woman's ability to enjoy the full range of constitutionally protected freedom of choice are the product not of governmental restrictions on access to abortions, but rather of her indigency. Although Congress has opted to subsidize medically necessary services generally, but not certain medically necessary abortions, the fact remains that the Hyde Amendment leaves an indigent woman with at least the same range of choice in deciding whether to obtain a medically necessary abortion as she would have had if Congress had chosen to subsidize no health care costs at all. We are thus not persuaded that the Hyde Amendment impinges on the constitutionally protected freedom of choice recognized in Wade. [Footnote 19]"

"In Wade, the Court recognized that the State has an "important and legitimate interest in protecting the potentiality of human life." 410 U.S. at 410 U. S. 162. That interest was found to exist throughout a pregnancy, "grow[ing] in substantiality as the woman approaches term." Id. at 410 U. S. 162-163. See also Beal v. Doe, 432 U.S. at 432 U. S. 445-446. Moreover, in Maher, the Court held that Connecticut's decision to fund the costs associated with childbirth but not those associated with nontherapeutic abortions was a rational means of advancing the legitimate state interest in protecting potential life by encouraging childbirth. 432 U.S. at 432 U. S. 478-479. See also Poelker v. Doe, 432 U. S. 519, 432 U. S. 520-521. It follows that the Hyde Amendment, by encouraging childbirth except in the most urgent circumstances, is rationally related to the legitimate governmental objective of protecting potential life. By subsidizing the medical expenses of indigent women who carry their pregnancies to term while not subsidizing the comparable expenses of women who undergo abortions (except those whose lives are threatened), [Footnote 27] Congress has established incentives that make childbirth a more attractive alternative than abortion for persons eligible for Medicaid. These incentives bear a direct relationship to the legitimate congressional interest in protecting potential life. Nor is it irrational that Congress has authorized federal reimbursement for medically necessary services generally, but not for certain medically necessary abortions. [Footnote 28] Abortion is inherently different from other medical procedures, because no other procedure involves the purposeful termination of a potential life."

"When viewed in the context of the Medicaid program to which it is appended, it is obvious that the Hyde Amendment is nothing less than an attempt by Congress to circumvent the dictates of the Constitution and achieve indirectly what Roe v. Wade said it could not do directly."

"Three years ago, in Maher v. Roe, 432 U. S. 464 (1977), the Court upheld a state program that excluded nontherapeutic abortions from a welfare program that generally subsidized the medical expenses incidental to pregnancy and childbirth. At that time, I expressed my fear "that the Court's decisions will be an invitation to public officials, already under extraordinary pressure from well-financed and carefully orchestrated lobbying campaigns, to approve more such restrictions" on governmental funding for abortion. Id. at 432 U.S. 462 (dissenting both in Maher v. Roe, supra, and in Beal v. Doe, 432 U. S. 438 (1977), and Poelker v. Doe, 432 U. S. 519 (1977)). That fear has proved justified. Under the Hyde Amendment, federal funding is denied for abortions that are medically necessary and that are necessary to avert severe and permanent damage to the health of the mother. The Court's opinion studiously avoids recognizing the undeniable fact that, for women eligible for Medicaid -- poor women -- denial of a Medicaid-funded abortion is equivalent to denial of legal abortion altogether. By definition, these women do not have the money to pay for an abortion themselves. If abortion is medically necessary and a funded abortion is unavailable, they must resort to back-alley butchers, attempt to induce an abortion themselves by crude and dangerous methods, or suffer the serious medical consequences of attempting to carry the fetus to term. Because legal abortion is not a realistic option for such women, the predictable result of the Hyde Amendment will be a significant increase in the number of poor women who will die or suffer significant health damage because of an inability to procure necessary medical services. The legislation before us is the product of an effort to deny to the poor the constitutional right recognized in Roe v. Wade, 410 U. S. 113 (1973), even though the cost may be serious and long-lasting health damage. As my Brother STEVENS has demonstrated, see post, p. 448 U. S. 349 (dissenting opinion), the premise underlying the Hyde Amendment was repudiated in Roe v. Wade, where the Court made clear that the state interest in protecting fetal life cannot justify jeopardizing the life or health of the mother. The denial of Medicaid benefits to individuals who meet all the statutory criteria for eligibility, solely because the treatment that is medically necessary involves the exercise of the fundamental right to chose abortion, is a form of discrimination repugnant to the equal protection of the laws guaranteed by the Constitution. The Court's decision today marks a retreat from Roe v. Wade and represents a cruel blow to the most powerless members of our society. I dissent."

"In this case, the Federal Government has taken upon itself the burden of financing practically all medically necessary expenditures. One category of medically necessary expenditure has been singled out for exclusion, and the sole basis for the exclusion is a premise repudiated for purposes of constitutional law in Roe v. Wade. The consequence is a devastating impact on the lives and health of poor women. I do not believe that a Constitution committed to the equal protection of the laws can tolerate this result. I dissent."

"In Roe v. Wade, 410 U. S. 113, and Doe v. Bolton, 410 U. S. 179, the Court recognized that the States have a legitimate and protectible interest in potential human life. 410 U.S. at 410 U. S. 162. But the Court explicitly held that, prior to fetal viability, that interest may not justify any governmental burden on the woman's choice to have an abortion, [Footnote 4/2] nor even any regulation of abortion except in furtherance of the State's interest in the woman's health. In effect, the Court held that a woman's freedom to elect to have an abortion prior to viability has absolute constitutional protection, subject only to valid health regulations. Indeed, in Roe v. Wade the Court held that, even after fetal viability, a State may "regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.""

"Roe v. Wade involved Texas statutes making it a crime to "procure an abortion," except when attempted to save the pregnant woman's life. 410 U.S. at 410 U. S. 117-118. Doe v. Bolton involved the somewhat less onerous Georgia statutes making abortion a crime in most circumstances, the exceptions being abortions to save the pregnant woman from life or permanent health endangerment, cases in which there was a very likely irremediable birth defect in the child, and cases in which the pregnancy was the result of rape. Those exceptions were subject to burdensome prior medical approvals, which were held to be unconstitutional. Subsequent cases have invalidated other burdens on the pregnant woman's free choice to abort. See Planned Parenthood of Central Missouri v. Danforth, supra, (consent required of husband or, for an unmarried woman under 18, of a parent); Bellotti v. Baird, 443 U. S. 622 (consent required of either parent or superior court judge for an unmarried woman under 18)."

"The Court rests heavily on the premise -- recognized in both Roe and Maher -- that the State's legitimate interest in preserving potential life provides a sufficient justification for funding medical services that are necessarily associated with normal childbirth without also funding abortions that are not medically necessary. The Maher opinion repeatedly referred to the policy of favoring "normal childbirth." See 432 U.S. at 432 U. S. 477, 432 U. S. 478, 432 U. S. 479. But this case involves a refusal to fund abortions which are medically necessary to avoid abnormal childbirth."

"In more than four decades since its landmark 1973 Roe v. Wade decision legalizing abortion, the Supreme Court has weighed I on the abortion issue on numerous occasions. Sometimes it has upheld the availability of abortion granted by Roe more often than not, it has leaned toward restricting that availability. Regardless, the Court has repeatedly upheld Roe’s central premise: that the US Constitution guarantees a right of privacy, and that right of privacy includes a woman’s right to have an abortion during the first thirteen weeks of pregnancy (and even after that it necessary in order to safeguard the woman’s life, health, or well-being). But along the way, the anti-abortion (pro-life) movement has convinced legislators in Congress to enact a host of laws aimed at reducing Roe’s effects. Some of these laws require parental notification (in the case of underage females), spousal consent (in the case of married females), or a waiting period before the abortion procedure may be legally performed. Other laws require that women having second-trimester abortions do so in a hospital, rather than in a non-hospital clinic. They also require that physicians use abortion methods that are least harmful to the fetus; that is, they must use methods that will most likely result in the survival of the fetus after removing it from the mother’s womb. More recent laws and regulations also prevent public funds from tax revenues from being spent on abortion procedures. The legislative flood of new laws over the years has led to a string of Supreme Court challenges and ruling that have served not only to limit the scope of Roe, but also to establish Roe as a legal precedent. In so doing, Roe has become the “norm” against which all abortion law challenges are measured."

"In 2004, in an ironic and surprising reversal, Norma McCorvey (Jane Roe, the plaintiff in 1973’s groundbreaking Roe v. Wade) filed a motion with the US District Court in Dallas to have the Roe case overturned. In doing so, she asked the court to consider new evidence that abortion hurts women. Included in her filings were affidavits from more than a thousand women who said they had regretted having had their abortions. For McCorvey, the journey from abortion advocate to abortion foe had been long and winding. In 1970, Norma McCorvey was described as a pregnant woman who “wished to terminate her pregnancy by an abortion ‘performed by a competent, licensed physician, under sage, clinical conditions’; …. Was unable to get a ‘legal’ abortion in Texas,” and the case focused on the idea that “the Texas statutes were unconstitutionally vague and that they abridged her right of personal privacy …” But the true story, as Norma McCorvey later explained it, was nowhere near what had been portrayed in court. A woman who was relatively ignorant of the facts of her own case, McCorvey claimed that her attorneys used her for their own predetermined ends. They “were looking for somebody, anybody, to use to further their own agenda. I was their most willing dupe.” After becoming pregnant with her second child, she sought to end her pregnancy. She was not aware of all the implications of abortion or even what the term meant. ‘Abortion to me,” she said, “meant ‘going back’ to the condition of not being pregnant.” She did not realize that the process would end a human life. She said that her attorney, Sarah Weddington, rather than correcting her misconceptions, merely confused the issue: “For their part, my lawyers lied to me about the nature of abortion. Weddington convinced me, ‘It’s just a piece of tissue. You just missed your period.” Another problem was that Norma claimed that her pregnancy was the result of a gang-rape in order to present a more sympathetic picture. That, as she has since confessed, was untrue. McCorvey has long admitted that her actual involvement in the case was minimal. She had signed the initial affidavit without ever reading it, and “was never invited into court. I never testified. I was never present before any court on any level, and I was never at any hearing on my case … I found out about the decision from the newspaper just like the rest of the country.”"

"When McCorvey was seeking an abortion, she claimed her pregnancy resulted from rape. She thought the lie would help her situation. The first time she made the claim was to an adoption lawyer she met before McCluskey. He would not help her obtain an abortion. After assuming the child was mixed race, he would not help with an adoption either. McCorvey told Weddington and Coffee the same lie. McCorvey wrote in “I Am Roe”, “The horrible lie-this was the second time I’d used it-pulled at the insides of my stomach.” Again, lying did not help. According to McCorbey, Weddington responded, “Well Norma, it’s awful that you were raped. But actually, the Texas abortion law doesn’t make any exception for rape. So it doesn’t matter in terms of our lawsuit.”"

"After listening to McCorvey’s story, Coffee and Weddington asked if she would be interested in being the plaintiff in their case. Weddington explained what that meant. McCorvey’s involvement would hopefully be minimal. She would probably not have to attend court hearings or answer oral questions. And she would not need to pay anything because Coffee and Weddington would donate their time and money to the case. Also, McCorvey could use a pseudonym to remain anonymous, unless she chose to disclose her identity. McCorvey agreed to be their plaintiff. After the meeting at the restaurant, Coffee and Weddington considered whether McCorvey was really their best choice for a plaintiff.. This would be an important case. If the two young lawyers succeeded in overturning Texas’s law, they believed their work would benefit all Texas women. And perhaps they could benefit women in the other 42 states with restrictive provisions for abortion. Some abortion laws had been changed in recent years to allow for the procedure. In some states, new laws legalized abortion or could be interpreted so broadly that abortion was essentially legal. In time, Coffee and Weddington hoped all states might legalize abortion or at least broaden the criteria under which it could be performed. They wanted women to have abortion as an option and for that option to be safe and legal. But in 1970 Texas, as in most other states, abortion statutes were still in effect, leaving very few women eligible for legal abortions. Coffee and Weddington were impatient, unsure when abortion reform legislation would pass in their conservative state. They saw the courts as a faster alternative for change."

"After discussing the pros and cons off McCorvey as their plaintiff, Coffee and Weddington realized the ideal plaintiff simply did not exist. If she were willing to be the plaintiff in the case, the two young lawyers would represent MccCorvey in a fight to change Texas’s abortion legislation. The three women met again. McCorvey signed the legal paperwork, setting into motion a case that would become one of the most controversial and divisive Supreme Court decisions in modern US history."

"Although she wasn’t finding an answer to the abortion referral group’s problem, Weddington felt encouraged by the Griswold case and by the court cases and legislation cropping up across the country challenging or changing state abortion laws. One day in 1969, two of Weddington’s friends asked if she would file a lawsuit challenging the constitutionality of the Texas abortion statute in federal court and add their case to others being filed on the federal level. Their hope was that one of these cases would be heard by the Supreme Court. Weddington has graduated from the University of Texas Law School only in 1967 and had never handled a contested care. Still, her friends respected the research she had already done and believed the case should have a female lawyer since it was a women’s issue. Plus, Weddington was the only attorney they knew who might be willing to do the work for free. Although afraid of failing and uncertain she was really the right person for the job, Weddington agreed."

"Weddington and Coffee decided to file two separate lawsuits to challenge Texas’s abortion statutes. They did that because the issues in each case were slightly different: one of their plaintiffs was pregnant and the other was not. Filing two cases would also incrase their chances of at least one case landing in the court of Judge Sarah Hughes. As Coffee’s former boss, Hughes would probably be sympathetic to their cause. Once one case was assigned, Coffee and Weddington planned to request the oter case be joined with it so they could present a single case with combined facts. The women also requested tha ta federalthree-judge cort hear their case, since a state court couldnot determine their constitutional rights. The lawyers strategized that because a three-judge court included one member of the circuit court and two judges from district court, its decision would carry more weight than that of a single-judge federal court. In addition, three-judge courts were required to proceed with cases as quickly as possible, which meant Coffee and Weddington-and their pregnant plaintiff-would get a speedy hearing."

"Accounts of abortion backlash differ in the particular failings that they ascribe to the Supreme Court, but the assumption that binds them together is that it was the Court’s decision in Roe that began conflict over abortion. As Ken I. Kersch, director of the Clough Center for the Study of Constitutional Democracy at Boston College, explains, “Politically, the Court’s decision to declare abortion to be a national right served as a catalyst for the Right to Life movement. That movement, in turn, played a major role in realigning the party loyalties of millions of Americans.”"