Roe v. Wade was the 1973 Supreme Court decision that recognized a constitutional right to abortion, and it stood as the law of the land until the Supreme Court overturned it on June 24, 2022, in Dobbs v. Jackson Women’s Health Organization. The 6-3 Dobbs ruling erased the federal constitutional right to an abortion and returned the authority to regulate the procedure to state legislatures, producing a patchwork of laws that now varies sharply from state to state.
What Roe v. Wade Decided in 1973
The case began in Texas, where the law criminalized abortion except to save the mother’s life. Attorneys Linda Coffee and Sarah Weddington filed suit in federal court in March 1970 on behalf of a Dallas woman using the pseudonym “Jane Roe,” challenging the statute against Dallas County District Attorney Henry Wade.1Justia U.S. Supreme Court Center. Roe v. Wade, 410 U.S. 113 (1973)
In a 7-2 decision, the Supreme Court held that the Constitution protects a woman’s decision to end a pregnancy. Justice Harry Blackmun’s majority opinion built a framework around the three trimesters of pregnancy, balancing the woman’s right to privacy against the state’s interest in maternal health and potential life.1Justia U.S. Supreme Court Center. Roe v. Wade, 410 U.S. 113 (1973)
- In the first trimester, the decision belonged to the woman and her physician, and the state could not interfere.
- In the second trimester, the state could regulate the procedure through rules aimed at protecting the woman’s health, such as facility licensing.
- After fetal viability in the third trimester, the state could prohibit abortion, provided it allowed exceptions to preserve the life or health of the mother.
The Constitutional Basis for Roe
The Constitution does not mention abortion. The Court grounded the right in a broader right to privacy, which it located in the Due Process Clause of the Fourteenth Amendment. That clause prohibits any state from depriving a person of “life, liberty, or property, without due process of law.”2Cornell Law School. 14th Amendment, U.S. Constitution The Court reasoned that the “liberty” protected by this clause encompasses deeply personal decisions about marriage, family, and procreation, building on Griswold v. Connecticut (1965), which had recognized a right to privacy protecting married couples’ access to contraceptives.
How Casey Modified Roe in 1992
For nearly two decades after Roe, states pushed at its edges with new regulations. In Planned Parenthood of Southeastern Pennsylvania v. Casey (1992), the Supreme Court reviewed a Pennsylvania law that imposed informed consent, a 24-hour waiting period, parental consent for minors, and spousal notification. The Court struck down the spousal notification requirement but upheld the rest.
Casey kept Roe’s central holding that the Constitution protects abortion before fetal viability, but it discarded the trimester framework. In its place, the Court adopted the “undue burden” standard: a pre-viability restriction was unconstitutional if its purpose or effect placed a “substantial obstacle” in the path of someone seeking an abortion. After viability, states could still regulate or ban the procedure so long as exceptions existed for the life or health of the mother. Casey governed abortion law for the next 30 years and gave states considerably more room to regulate than Roe’s original structure had.
The Dobbs Decision That Ended Roe
Mississippi passed a law in 2018 banning most abortions after 15 weeks of pregnancy. Jackson Women’s Health Organization, the state’s only remaining abortion clinic, challenged the law under Roe and Casey, both of which barred states from prohibiting abortion before viability, generally around 23 to 24 weeks. Lower courts struck the law down, and Mississippi appealed.
On June 24, 2022, the Supreme Court not only upheld Mississippi’s 15-week ban but overruled Roe and Casey outright. The vote was 6-3.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion Justice Samuel Alito wrote the majority opinion, joined by Justices Thomas, Gorsuch, Kavanaugh, and Barrett. Chief Justice Roberts concurred in upholding the 15-week ban but did not join the decision to overturn Roe and Casey, preferring a narrower ruling.
The Majority’s Reasoning
The Court’s central argument turned on constitutional text and history. Because the Constitution does not mention abortion, the majority held that any unenumerated right must be “deeply rooted in this Nation’s history and tradition” to receive protection under the Fourteenth Amendment. Abortion, the Court said, failed that test. When the Fourteenth Amendment was adopted in 1868, three-quarters of the states had criminalized abortion at all stages of pregnancy, and the remaining states soon followed. No state constitution, federal court, or legal treatise had recognized a right to abortion before the years immediately preceding Roe.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion
The principle of stare decisis ordinarily discourages the Court from overturning its own precedents. The Dobbs majority acknowledged this but concluded that five factors weighed against keeping Roe and Casey in place: the nature of the error (calling Roe an exercise of “raw judicial power”), the quality of the reasoning, workability in the lower courts, the effect on other areas of law, and reliance interests. The majority argued that overruling Roe would not threaten other rights because abortion involves the destruction of potential life, making it distinct from other privacy-based rights.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion
With no constitutional right to abortion, state laws now face only rational-basis review, the lowest level of judicial scrutiny. A restriction is constitutional as long as it is rationally related to a legitimate government interest, a far easier test than what Roe or Casey required.
Concurrences and the Dissent
Justice Clarence Thomas joined the majority in full but wrote separately to argue that the Court should reconsider all decisions grounded in substantive due process, the same doctrine that had supported Roe. He named Griswold v. Connecticut (contraceptives), Lawrence v. Texas (private consensual sexual activity), and Obergefell v. Hodges (same-sex marriage) as precedents the Court should revisit.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion The majority opinion itself stated that nothing in the ruling should cast doubt on precedents unrelated to abortion.
Justice Brett Kavanaugh also wrote separately. He said the Constitution is “neither pro-life nor pro-choice” and simply leaves the issue to the democratic process. He addressed whether a state could bar its residents from traveling elsewhere to obtain an abortion and wrote that the answer is no, based on the constitutional right to interstate travel.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion
Justices Breyer, Sotomayor, and Kagan filed a joint dissent. They argued the majority had stripped women of a fundamental right they had relied on for 50 years, with the heaviest consequences falling on women of color and those with fewer financial resources. They warned that the reasoning used to overturn Roe could threaten other rights rooted in the same constitutional principles, despite the majority’s assurances.3Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Opinion
What Abortion Law Looks Like Now
Trigger Laws and Immediate Bans
Thirteen states had passed “trigger laws” designed to ban abortion automatically or through swift state action the moment Roe no longer applied. Some took effect the day of the ruling; others activated after a 30-day waiting period or upon certification by a state official. As of late 2025, 13 states have total abortion bans in effect, and additional states enforce bans tied to early gestational limits.
Exceptions Vary Widely
Nearly all state bans include some exceptions, but the scope differs sharply. The most common categories are threats to the life of the pregnant person, serious health risks, pregnancies resulting from rape or incest, and lethal fetal anomalies. Not every state includes all four. Several states with total bans have no health exception, meaning the pregnant person must face a risk of death rather than a serious health condition before an abortion is permitted. The gap between “life” and “health” exceptions has produced real confusion for physicians weighing medical judgment against the risk of prosecution.
Penalties for Providers
State bans generally target providers, not patients. Penalties for physicians who perform prohibited abortions range from a few months in prison to life imprisonment, along with substantial fines. Some states treat violations as felonies; some also allow revocation of medical licenses. The threat of prosecution has caused some providers in restrictive states to delay or refuse care even in legally ambiguous emergencies.
Travel, Shield Laws, and an Open Question
More than 20 states have passed shield laws to protect patients who travel from restrictive states and the providers who treat them. These laws generally prevent state courts and agencies from cooperating with out-of-state investigations or prosecutions related to abortions that are legal where they were performed. Some go further, explicitly protecting providers who prescribe and mail abortion medication to patients in states with bans.
Whether a state can punish its own residents for obtaining an abortion in another state remains unsettled. Justice Kavanaugh’s Dobbs concurrence suggested the constitutional right to interstate travel would block such enforcement, but no Supreme Court ruling has addressed the question directly. Shield laws currently offer the strongest practical protection for interstate patients and providers.
Medication Abortion and EMTALA
Mifepristone, the most commonly used abortion medication in the United States, became a major legal battleground after Dobbs. A group of anti-abortion physicians challenged the FDA’s approval and relaxed prescribing rules for the drug. In FDA v. Alliance for Hippocratic Medicine (2024), the Supreme Court unanimously dismissed the challenge, ruling that the plaintiffs lacked standing because they did not prescribe or use the drug and the FDA was not requiring them to do anything.4Supreme Court of the United States. FDA v. Alliance for Hippocratic Medicine Opinion The FDA’s existing regulations remain in place, but the ruling did not resolve the underlying questions about the agency’s authority, leaving room for future challenges by plaintiffs with stronger standing.
The federal Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals with emergency departments to stabilize any patient experiencing a medical emergency. Under the Biden administration, the Department of Health and Human Services issued guidance stating that this obligation could include providing an abortion when necessary to stabilize a patient. That guidance was later rescinded, though the underlying EMTALA obligation to provide stabilizing care remains in force. How EMTALA interacts with state abortion bans continues to be litigated.
Ballot Measures and State Constitutional Amendments
Since Dobbs, abortion has appeared on ballots across the country, and voters have consistently favored protecting access. In 2024, voters in seven states approved ballot measures on abortion rights, including in conservative-leaning states such as Missouri and Montana and swing states such as Arizona. These measures typically amended state constitutions to guarantee the right to abortion until fetal viability, with exceptions after that point for the life or health of the pregnant person. Florida’s amendment drew majority support but fell short of the 60 percent supermajority the state requires.
The results have reshaped specific states. Missouri, one of the first to ban abortion after Dobbs through a trigger law, saw voters override the ban by writing abortion protections into the state constitution. Even where legislatures favor restrictions, the broader electorate often does not, making state constitutional amendments a significant counterweight to legislative bans.