Roe v. Wade, decided in 1973, was the U.S. Supreme Court ruling that recognized a constitutional right to abortion under the Fourteenth Amendment and struck down state laws that broadly criminalized the procedure. The 7–2 decision created a trimester-based framework that governed how far states could go in regulating abortion, and it stood as the controlling law for nearly fifty years before the Court overturned it in Dobbs v. Jackson Women’s Health Organization in June 2022. Understanding what Roe actually held, and where its reasoning gave way, is the starting point for making sense of abortion law today.
What the Court Decided
The case came out of Texas, where nineteenth-century criminal statutes made performing or assisting with an abortion a crime unless the procedure was necessary to save the pregnant woman’s life. In 1970, a pregnant woman using the pseudonym “Jane Roe” filed a federal lawsuit against Henry Wade, the Dallas County district attorney, arguing that the statutes were unconstitutionally vague and violated privacy rights protected by the Ninth and Fourteenth Amendments.1Legal Information Institute. Roe v. Wade, 410 U.S. 113 (1973)
Justice Harry Blackmun wrote the majority opinion. The district court had relied primarily on the Ninth Amendment, but the Supreme Court grounded the right to abortion in the Due Process Clause of the Fourteenth Amendment, which prohibits states from depriving any person of liberty without due process of law. The Court read “liberty” as including a right to personal privacy broad enough to cover the decision whether to continue a pregnancy.1Legal Information Institute. Roe v. Wade, 410 U.S. 113 (1973)
Earlier decisions had already recognized privacy interests in marriage, contraception, child-rearing, and family relationships, and the Roe majority placed the abortion decision within that same protected sphere.2Congress.gov. Abortion, Roe v. Wade, and Pre-Dobbs Doctrine The right was not absolute. Any state regulation that infringed on it had to be justified by a compelling government interest, and the Court recognized two: protecting maternal health, and protecting potential life. The question was when each interest became strong enough to override the woman’s privacy right. The answer produced the trimester framework.
The Trimester Framework
Rather than drawing a single bright line, the Court split pregnancy into three stages and assigned different levels of state authority to each.
- First trimester, roughly the first twelve weeks: the abortion decision belonged to the woman and her physician, and the state could not interfere. The Court reasoned that medical data at the time showed a first-trimester abortion was statistically safer than carrying a pregnancy to term, so the state had no legitimate health justification for restricting it.3Congress.gov. Abortion, Roe v. Wade, and Pre-Dobbs Doctrine
- Second trimester, roughly weeks thirteen through twenty-four: the state’s interest in maternal health became compelling. States could regulate the procedure in ways reasonably related to the woman’s safety, such as facility standards or physician qualifications, but could not ban it outright.
- Third trimester, after viability: the state’s interest in potential life became compelling. States could restrict or prohibit abortion, subject to a mandatory exception where the procedure was necessary to preserve the life or health of the mother.4Justia. Roe v. Wade, 410 U.S. 113 (1973)
The framework gave legislatures a clear roadmap, but it drew criticism from both sides. Supporters of abortion rights viewed the physician-centered language as paternalistic. Opponents argued the justices had essentially written a regulatory code that belonged in a legislature.
Viability and the Health Exception
Viability was the pivot point of the framework. The Court defined it as the stage at which a fetus can survive outside the womb, and placed it at roughly twenty-four to twenty-eight weeks of gestation.4Justia. Roe v. Wade, 410 U.S. 113 (1973) Before viability, the woman’s privacy interest took legal priority. After it, the state gained authority to ban the procedure, subject to the health exception.
The scope of “health” was defined in a companion case decided the same day. In Doe v. Bolton, the Court held that a physician’s medical judgment could account for all factors relevant to well-being: physical, emotional, psychological, familial, and the woman’s age.5Justia. Doe v. Bolton, 410 U.S. 179 (1973) Critics argued that definition was so wide it made post-viability bans unenforceable in practice. Supporters saw it as a necessary safeguard against rigid laws that ignored real medical complexity.
The Court did not fix viability to a specific week. It deliberately tied the legal threshold to medical capability, acknowledging that the point would shift over time as neonatal care advanced.
The Dissents
Only two justices dissented, Byron White and William Rehnquist, and their objections mattered because they became the basis for overturning Roe decades later.
Justice White, writing in the companion Doe v. Bolton case but aiming at Roe, called the ruling “an improvident and extravagant exercise” of judicial power. Nothing in the Constitution’s language or history, he argued, supported a right to terminate a pregnancy, and the Court had substituted its own policy preferences for those of state legislatures.
Justice Rehnquist attacked the historical foundation. When the Fourteenth Amendment was ratified in 1868, at least thirty-six states and territories had laws restricting abortion.6Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization If the people who wrote and ratified the amendment lived under those laws without seeing a conflict, Rehnquist reasoned, the amendment could not have been understood to protect abortion as a fundamental right. He also objected to the level of scrutiny the majority applied: in his view, any rational basis for the legislation should have been enough to uphold it, rather than requiring a compelling state interest.
How Casey Changed the Framework in 1992
Roe’s trimester structure did not last twenty years as the governing test. In 1992, the Court decided Planned Parenthood of Southeastern Pennsylvania v. Casey, a challenge to several Pennsylvania restrictions, including a twenty-four-hour waiting period, informed-consent requirements, and spousal notification.
A fractured Court did two things in a single joint opinion. It reaffirmed what the authors called Roe’s “central holding,” that the Constitution protects a woman’s decision to end a pregnancy before viability and that states may restrict or prohibit abortion after viability with life-or-health exceptions.7Justia. Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) At the same time, it discarded the trimester framework entirely, concluding that the structure “misconceived the nature of the pregnant person’s interest and undervalued the state’s interest in potential life.”
In place of the trimesters, Casey adopted the “undue burden” test. Before viability, states could regulate abortion as long as the regulation did not place a “substantial obstacle” in the path of a woman seeking to end her pregnancy.7Justia. Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) Under Roe, most first-trimester regulations were invalid. Under Casey, states had significantly more room for waiting periods, counseling requirements, and other pre-viability restrictions. The standard proved difficult to apply consistently, and lower courts reached conflicting conclusions about which regulations crossed the line.
How Dobbs Overturned Roe in 2022
In June 2022, the Supreme Court decided Dobbs v. Jackson Women’s Health Organization, a challenge to a Mississippi law banning most abortions after fifteen weeks. The Court used the case to overturn both Roe and Casey, holding that “the Constitution does not confer a right to abortion” and returning regulatory authority “to the people and their elected representatives.”8Justia. Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022)
The majority adopted the historical arguments Justice Rehnquist had laid out in 1973, almost point for point. The opinion concluded that Roe had “either ignored or misstated” the history of abortion regulation, noting that by the time the Fourteenth Amendment was adopted, three-quarters of states had criminalized abortion at any stage.6Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization Because the right to abortion was not “deeply rooted in the nation’s history and tradition,” the Court held it did not qualify as a fundamental liberty protected by the Due Process Clause.
With the constitutional right removed, the Court applied rational-basis review, the most deferential standard available. Under that test, a state law is valid as long as it bears a rational relationship to a legitimate government interest. The Mississippi fifteen-week ban cleared that bar, and so would far more restrictive laws.
What Governs Abortion Law Now
The practical effect of Dobbs was immediate. Every state gained full authority to ban, restrict, or protect abortion access as its legislature or voters chose. As of early 2026, thirteen states enforce total or near-total bans, nine states and the District of Columbia impose no gestational limits, and the rest fall somewhere in between with restrictions ranging from six-week to twenty-week limits. Voters in more than ten states, including Arizona, Michigan, Missouri, and Ohio, have passed ballot measures since 2022 amending their state constitutions to protect abortion access. Constitutional amendments are harder for future legislatures to undo than ordinary statutes.
Some federal law still touches abortion access indirectly. The Emergency Medical Treatment and Labor Act, or EMTALA, requires hospitals with emergency departments that accept Medicare funding to screen and stabilize patients experiencing emergency medical conditions.9Office of the Law Revision Counsel. 42 USC 1395dd – Examination and Treatment for Emergency Medical Conditions and Women in Labor In some pregnancy emergencies, stabilizing care can include terminating the pregnancy, and the interaction between EMTALA and state bans remains unsettled. Federal guidance issued in 2022 affirming that EMTALA requires emergency abortion care was rescinded by the Department of Health and Human Services in June 2025, though the agency stated the statute itself still ensures pregnant women facing emergencies receive stabilizing treatment.
Efforts to restore a federal statutory right to abortion have not advanced. The Women’s Health Protection Act was reintroduced in the 119th Congress as H.R. 12, but the bill has not moved beyond introduction.10Congress.gov. Women’s Health Protection Act of 2025 Without federal legislation, abortion access in the United States is now determined almost entirely by where a person lives.
Roe v. Wade no longer controls that question. Its trimester framework is gone, its privacy rationale has been rejected, and the constitutional right it recognized has been formally withdrawn. What remains is its influence on the legal vocabulary that still shapes the debate: viability, the health exception, the balance between privacy and state interest. Those concepts still appear in the laws of states that protect abortion access, even as they no longer bind states that restrict it.