Roe v. Wade was the 1973 U.S. Supreme Court decision that recognized a federal constitutional right to abortion, and it governed American abortion law until the Court overturned it in 2022. The ruling held that the Fourteenth Amendment’s protection of personal liberty included a right to privacy broad enough to cover a woman’s decision whether to end a pregnancy. That federal right no longer exists. In Dobbs v. Jackson Women’s Health Organization, the Court eliminated it and handed abortion regulation back to the states. As of early 2026, thirteen states enforce total bans, nine states and the District of Columbia impose no gestational limit, and the rest sit somewhere in between.
What the 1973 Ruling Decided
The case reached the Court after a pregnant Texas woman, using the pseudonym “Jane Roe,” challenged a state law that banned abortion except to save the woman’s life. In January 1973, the Court struck the law down 7–2. Justice Harry Blackmun’s majority opinion rested on the Fourteenth Amendment’s Due Process Clause, which forbids states from depriving any person of “life, liberty, or property, without due process of law.”1Congress.gov. Abortion, Roe v. Wade, and Pre-Dobbs Doctrine The justices read “liberty” as broad enough to encompass a right to privacy, and they held that this privacy right was “broad enough to encompass a woman’s decision whether or not to terminate her pregnancy.”2Justia U.S. Supreme Court Center. Roe v. Wade
To balance that right against state interests, the Court built a trimester framework tying government power to the stage of pregnancy. In the first trimester, the decision belonged to the woman and her physician, with no room for state interference. In the second trimester, states could regulate abortion in ways reasonably related to protecting the woman’s health, such as facility standards and practitioner licensing.3Supreme Court. Jane Roe, et al., Appellants, v. Henry Wade In the third trimester, once the fetus reached viability, states could restrict or ban abortion as long as the law preserved exceptions for the woman’s life and health.1Congress.gov. Abortion, Roe v. Wade, and Pre-Dobbs Doctrine The further along a pregnancy went, the more the state could regulate it.
How Casey Modified Roe in 1992
Nineteen years later, the Court reshaped the framework in Planned Parenthood of Southeastern Pennsylvania v. Casey. The justices reaffirmed that the Constitution protects abortion access but scrapped the trimester system. Viability became the single dividing line: before viability, states could regulate but not ban abortion; after viability, they could prohibit it so long as exceptions for the woman’s life and health remained.4Justia U.S. Supreme Court Center. Planned Parenthood of Southeastern Pa. v. Casey, 505 US 833 (1992)
Casey also created the “undue burden” test for pre-viability restrictions. A regulation was unconstitutional if its purpose or effect was to place a substantial obstacle in the path of a woman seeking an abortion.5Supreme Court of the United States. Planned Parenthood of Southeastern Pa. v. Casey, 505 US 833 (1992) That standard was more permissive than Roe’s strict scrutiny approach and gave states considerably more room for waiting periods, informed consent rules, and similar requirements. Undue burden became the standard lower courts used to judge state abortion laws for the next three decades.
How Dobbs Overturned Roe in 2022
In June 2022, the Supreme Court decided Dobbs v. Jackson Women’s Health Organization, overruling both Roe and Casey. The case involved a Mississippi law banning abortion after fifteen weeks, well before viability. Rather than merely upholding that law, the six-justice majority declared that the Constitution “does not confer a right to abortion.”6Justia. Dobbs v. Jackson Women’s Health Organization
Justice Samuel Alito’s majority opinion applied a historical test: for an unenumerated right to be protected by the Fourteenth Amendment, it must be “deeply rooted in this Nation’s history and tradition.” The Court found that abortion had been widely criminalized across the nineteenth century and was not recognized in American common law, so it failed the test.7Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization
The practical shift was significant. By discarding both viability and undue burden, the Court held that abortion regulations only need to satisfy rational basis review, the most deferential standard in constitutional law. A state law survives rational basis if it is rationally related to a legitimate government interest. The Court said abortion regulations should be “governed by the same standard of review as other health and safety measures,” and that the authority to regulate or ban abortion was “returned to the people and their elected representatives.”7Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization
Where Abortion Is Legal Now
Without a federal floor, abortion law is set entirely by state legislatures, state constitutions, and voter-approved ballot measures. Access varies sharply by geography. As of early 2026, thirteen states enforce total bans at all stages of pregnancy. Nine states and the District of Columbia impose no gestational limit. The rest fall along a spectrum, with cutoffs ranging from roughly six weeks to around twenty-four weeks, often paired with procedural requirements like waiting periods or mandatory counseling.
Some protective states ground abortion access in their own state constitutions, reading them to include a right to privacy or reproductive autonomy independent of federal law. Several restrictive states had “trigger laws” that took effect automatically when Roe fell. Criminal penalties for providers who violate state bans vary widely and can include felony charges with substantial prison sentences. Because no federal rule requires exceptions for rape, incest, or fetal anomalies, those carve-outs exist only where a specific state law provides them.
Emergency Care and EMTALA
One of the sharpest conflicts since Dobbs involves the Emergency Medical Treatment and Labor Act, or EMTALA. This 1986 federal law requires any hospital that accepts Medicare funding to stabilize a patient with an emergency medical condition. In ban states, the question is whether EMTALA overrides a state prohibition when abortion is the medically necessary treatment for a life-threatening pregnancy complication.
The federal position has moved. In 2022, the federal government issued guidance asserting that EMTALA required hospitals to provide abortion care when necessary to stabilize a patient, even in ban states. Litigation followed. A federal court in Texas blocked the guidance in that state, and the Supreme Court declined to take up the dispute in October 2024. In June 2025, the Department of Health and Human Services rescinded the 2022 guidance, and the Department of Justice dropped its case against Idaho’s abortion ban. Hospitals in ban states now face genuine uncertainty: federal law still requires emergency stabilization, but the federal government is no longer arguing that requirement preempts state abortion bans.
Medication Abortion
Medication abortion using mifepristone accounts for a significant share of abortions in the United States, and the FDA has approved its use for pregnancies up to ten weeks. Several ban states have moved to restrict or eliminate access to the drug, raising the question of whether FDA approval preempts conflicting state law under the Constitution’s Supremacy Clause.
Even before Dobbs, some states imposed rules that went beyond FDA requirements, such as requiring the drug to be taken in the physical presence of the prescribing physician or narrowing the gestational window. Whether federal drug approval sets a floor states cannot fall below remains an open, actively litigated question. Courts have not issued a definitive ruling on preemption in this context, and the legal status of medication abortion continues to shift.
Interstate Travel and Shield Laws
People in ban states routinely travel to states where abortion remains legal. The constitutional right to travel between states is well established, though the Court has never fixed a single textual source for it.8Legal Information Institute, Cornell Law School. Interstate Travel Laws that penalize or deter interstate travel face strict scrutiny and are generally struck down absent a compelling government interest.
No state has successfully enforced a law punishing someone for traveling out of state for an abortion, but some restrictive states have explored legislation creating civil liability for anyone who helps a resident do so. In response, as of 2025, eighteen states have enacted “shield laws” protecting abortion providers and patients from out-of-state legal actions. These laws generally block cooperation with out-of-state subpoenas and investigations, prevent extradition for abortion-related charges, restrict the sharing of medical records with other jurisdictions, and in some states let targeted providers or patients countersue for damages. Some apply only when the patient is physically present in the protecting state; others extend to telehealth consultations for medication abortion.
Federal Facilities
Federal property and federal healthcare systems follow their own rules, which do not automatically track the law of the state where they sit. The Department of Veterans Affairs historically excluded abortion from its benefits package. In September 2022, the VA issued a rule creating exceptions: VA facilities may provide abortion services when the life or health of the pregnant veteran is at risk, or when the pregnancy resulted from rape or incest.9Congress.gov. Department of Veterans Affairs – Abortion Policy The VA also extended abortion counseling to eligible patients, and similar exceptions apply to dependents and spouses covered by the VA’s civilian health program. These policies remain in effect regardless of the state where the facility sits, though their long-term durability depends on future rulemaking and legal challenges. Military medical facilities and other federal healthcare programs generally limit coverage to cases involving life endangerment, rape, or incest.