Roe v. Wade was the 1973 U.S. Supreme Court decision that recognized a constitutional right to abortion, grounded in the right to privacy the Court read into the Fourteenth Amendment’s guarantee of liberty. The ruling held that this right was not absolute and had to be balanced against state interests in maternal health and potential life as pregnancy progressed. It stood as the controlling law on abortion in the United States for nearly fifty years, until the Court overturned it in 2022.
The Case Behind Roe v. Wade
The case began in Texas, where Norma McCorvey, using the pseudonym “Jane Roe,” challenged a state law that criminalized abortion except when necessary to save the mother’s life. McCorvey was pregnant with her third child and had been unable to obtain a legal abortion. Attorneys Linda Coffee and Sarah Weddington filed suit on her behalf against Henry Wade, the Dallas County District Attorney charged with enforcing the statute.1Justia U.S. Supreme Court Center. Roe v. Wade
Texas’s restriction was typical for its time. Most states had similarly narrow abortion laws, and the question the Court agreed to decide was whether the Constitution protected a woman’s decision to end a pregnancy at all.
What the Court Decided in 1973
On January 22, 1973, the Court ruled 7-2 that it did. Justice Harry Blackmun wrote the majority opinion, joined by six colleagues; Justices Byron White and William Rehnquist dissented.1Justia U.S. Supreme Court Center. Roe v. Wade The Constitution contains no explicit reference to abortion, so the majority located the right in the Due Process Clause of the Fourteenth Amendment, which forbids states from depriving anyone of “life, liberty, or property, without due process of law.”2Legal Information Institute. Supreme Court 410 US 113 – Jane Roe v Henry Wade
That liberty, the Court held, was broad enough to cover a woman’s decision about pregnancy. The reasoning built directly on Griswold v. Connecticut (1965), where the Court had struck down a ban on contraceptives and recognized a constitutional right to privacy drawn from several provisions of the Bill of Rights.3Justia U.S. Supreme Court Center. Griswold v. Connecticut Roe extended that privacy principle to abortion.
The right was not unlimited. The majority identified two state interests that grew stronger as pregnancy advanced: protecting the pregnant woman’s health, and protecting potential life.
The Trimester Framework
To balance the woman’s right against those state interests, the Court divided pregnancy into three stages.
In the first trimester, the decision belonged to the woman and her doctor, and states could not interfere. In the second trimester, states could regulate the procedure in ways reasonably related to maternal health, such as facility standards, but could not ban it.4Congress.gov. Abortion, Roe v Wade, and Pre-Dobbs Doctrine
After viability, the point at which a fetus could survive outside the womb, the state’s interest in protecting potential life became strong enough to justify a ban. The Court placed viability at roughly 28 weeks but noted it could come as early as 24. Even after viability, an abortion had to remain available when necessary to protect the mother’s life or health.4Congress.gov. Abortion, Roe v Wade, and Pre-Dobbs Doctrine
How Casey Reshaped Roe in 1992
Nineteen years later, Planned Parenthood v. Casey preserved Roe’s core holding but scrapped the trimester structure. The case tested a Pennsylvania law that imposed informed consent rules, a 24-hour waiting period, parental consent for minors, and a spousal notification requirement on women seeking abortions.
In a joint opinion, Justices Sandra Day O’Connor, Anthony Kennedy, and David Souter kept the constitutional protection for the decision to end a pregnancy before viability but rejected the trimester framework as unnecessarily rigid. In its place they adopted the “undue burden” test: a state regulation is unconstitutional if its purpose or effect is to place a substantial obstacle in the path of a woman seeking a pre-viability abortion.5Justia U.S. Supreme Court Center. Planned Parenthood of Southeastern Pa. v. Casey
The Court upheld most of Pennsylvania’s provisions and struck down only the spousal notification requirement.5Justia U.S. Supreme Court Center. Planned Parenthood of Southeastern Pa. v. Casey States gained meaningful room to regulate abortion in early pregnancy that Roe’s first-trimester rule had denied them. Casey controlled the law for the next thirty years.
How Dobbs Overturned Roe in 2022
On June 24, 2022, the Court reversed both Roe and Casey in Dobbs v. Jackson Women’s Health Organization. Mississippi had passed a law banning most abortions after 15 weeks, well before viability. The state’s last remaining clinic challenged it, and under Casey the law should have fallen.
Justice Samuel Alito, writing for a five-justice majority that included Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett, held that the Constitution “does not confer a right to abortion.” The opinion called Roe “egregiously wrong from the start” and its reasoning “exceptionally weak.” Any right protected by the Due Process Clause, Alito wrote, must be “deeply rooted in this Nation’s history and tradition,” and abortion failed that test because it had been widely criminalized through most of American history.6Supreme Court of the United States. Dobbs v. Jackson Womens Health Organization – Syllabus
Chief Justice John Roberts concurred in the judgment upholding Mississippi’s law but declined to join the full reversal, writing that discarding Roe and Casey outright was “a serious jolt to the legal system.”6Supreme Court of the United States. Dobbs v. Jackson Womens Health Organization – Syllabus With his vote, the judgment was 6-3, though only five justices agreed to overturn Roe.
Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan filed a joint dissent. They wrote that the majority had overruled Roe “for one and only one reason: because it has always despised” the decision and “now it has the votes to discard” it. They warned that the ruling stripped a fundamental right for the first time in the Court’s history and would open the way to state laws with “draconian restrictions.”6Supreme Court of the United States. Dobbs v. Jackson Womens Health Organization – Syllabus
What Other Privacy-Based Rights Face After Dobbs
The Dobbs majority tried to draw a line around its holding. Alito wrote that abortion is “fundamentally different” from other rights the Court has drawn from the same privacy doctrine because it involves what the opinion called “fetal life.”6Supreme Court of the United States. Dobbs v. Jackson Womens Health Organization – Syllabus On that reasoning, decisions like Griswold on contraception, Lawrence v. Texas on intimate relationships, and Obergefell v. Hodges on same-sex marriage were not disturbed.
Justice Thomas went further in a solo concurrence. He described “substantive due process” as an “oxymoron” and urged the Court to reconsider all of its substantive due process precedents, naming Griswold, Lawrence, and Obergefell. No other justice joined that section. The dissenters pointed to it as evidence that the reasoning in Dobbs could reach further than the majority claimed.
Where Abortion Law Stands Now
Dobbs returned abortion policy to state legislatures. Several states had “trigger laws” written to take effect the moment Roe fell, and bans in Mississippi, Arkansas, Oklahoma, Missouri, and South Dakota took hold almost immediately. As of early 2026, 13 states enforce near-total bans, and 28 states impose limits at various points between 6 weeks and around 24 weeks. Penalties on providers range from modest fines in some states to felony sentences of years or decades in others.
Voters have pushed back in some states. Between 2022 and 2024, ballot measures adding abortion protections to state constitutions passed in at least ten states, including California, Michigan, Ohio, Vermont, Arizona, Missouri, Montana, Colorado, Maryland, and New York.
Emergency Care and EMTALA
State bans have collided with the federal Emergency Medical Treatment and Labor Act, which requires hospitals that accept Medicare to provide stabilizing treatment to anyone with an emergency medical condition.7Office of the Law Revision Counsel. 42 US Code 1395dd – Examination and Treatment for Emergency Medical Conditions and Labor When abortion is the necessary stabilizing treatment for a pregnant patient in crisis, state bans and federal law point in opposite directions.
In Moyle v. United States, involving Idaho’s near-total ban, the Supreme Court in June 2024 declined to rule on the merits and sent the case back to the lower courts, temporarily letting Idaho doctors provide emergency abortions under EMTALA. The core question is unresolved. In June 2025, the Trump administration rescinded federal guidance that had reaffirmed hospitals’ obligation to provide abortion care in emergencies under EMTALA.
Medication Abortion
Mifepristone, used in the majority of U.S. abortions, is the other active front. In 2024, the Supreme Court unanimously dismissed a challenge to the FDA’s approval and later loosening of mifepristone rules in FDA v. Alliance for Hippocratic Medicine, holding that the anti-abortion doctors who sued lacked standing because they could not show concrete injury.8Supreme Court of the United States. FDA v. Alliance for Hippocratic Medicine That ruling left in place FDA rules permitting mifepristone by telehealth and mail.
A separate federal case in Louisiana, brought by state attorneys general, is now seeking to force the FDA to require in-person dispensing. If it succeeds, telehealth access to mifepristone could end nationwide, including in states where abortion remains legal. Whether the plaintiffs have the standing that the Alliance doctors lacked will be central to the outcome.