Abortion in the United States

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Abortion is a divisive issue in the United States. The issue of abortion is prevalent in American politics and culture wars, though a majority of Americans support continued access to abortion.^{[1][2][3][4][5][6]} There are widely different abortion laws depending on state.^[7]

From the American Revolution to the mid-19th century abortion was not an issue of significant controversy; most held to the traditional Protestant Christian belief that personhood began at quickening, sometime between 18 and 21 weeks. It was legal prior to quickening in every state under the common law.^{[8][9][10][11]} Connecticut was the first state to regulate abortion in 1821; it outlawed abortion after quickening, the moment in pregnancy when the pregnant woman starts to feel the fetus's movement in the uterus, and forbade the use of poisons to induce one post-quickening. Many states subsequently passed various laws on abortion until the Supreme Court of the United States decisions of Roe v. Wade and Doe v. Bolton decriminalized abortion nationwide in 1973. The Roe decision imposed a federally mandated uniform framework for state legislation on the subject. It also established a minimal period during which abortion is legal, with more or fewer restrictions throughout the pregnancy. Evangelical Christians were initially generally either supportive or indifferent to Roe — citing what they saw as a lack of biblical condemnation on the matter, its perceived affirmation of religious liberty, and furthering of non-intrusive government — but by the 1980s began to join anti-abortion Catholics to overturn the decision.^[12][13] That basic framework, modified in Planned Parenthood v. Casey (1992), remained nominally in place, although the effective availability of abortion varied significantly from state to state, as many counties had no abortion providers.^[14] Casey held that a law could not place legal restrictions imposing an undue burden for "the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus".^[15] In December 2021, the FDA legalized telemedicine provision of medication abortion pills with delivery by mail, but many states have laws which restrict this option.

In 2022, Roe and Casey were overturned in Dobbs v. Jackson Women's Health Organization, ending protection of abortion rights by the United States Constitution and allowing individual states to regulate any aspect of abortion not preempted by federal law.^[16] Since 1976, the Republican Party has generally sought to restrict abortion access based on the stage of pregnancy or to criminalize abortion, whereas the Democratic Party has generally defended access to abortion and has made contraception easier to obtain.^[17]

The abortion-rights movement advocates for patient choice and bodily autonomy, while the anti-abortion movement maintains that the fetus has a right to live. Historically framed as a debate between the pro-choice and pro-life labels, most Americans agree with some positions of each side.^[18] Support for abortion gradually increased in the U.S. beginning in the early 1970s,^[19] and stabilized during the 2010s.^[20][21] The abortion rate has continuously declined from a peak in 1980 of 30 per 1,000 women of childbearing age (15–44) to 11.3 by 2018.^[22] In 2018, 78% of abortions were performed at 9 weeks or less gestation, and 92% of abortions were performed at 13 weeks or less gestation.^[22] By 2023, medication abortions accounted for 63% of all abortions.^[23] Almost 25% of women will have had an abortion by age 45, with 20% of 30 year olds having had one.^[24] In 2019, 60% of women who had abortions were already mothers, and 50% already had two or more children.^[25][26] Increased access to birth control has been statistically linked to reductions in the abortion rate.^[27][28][29]

As of 2024, California, Michigan, Ohio, and Vermont are the only U.S. states to have explicit rights to abortion in their state constitutions. Other states have implicit rights to abortion subject to state judicial review, such as Kansas and Montana, or simply protect it via state law such as Colorado and Massachusetts. The state constitutions of Alabama, Louisiana, Tennessee, and West Virginia explicitly contain no right to an abortion.

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