How Access and Attitudes Towards Abortion Have Changed Through The Centuries
Pre-1850: Abortions in early America are commonplace
Mid-1800s: Birth of the American Medical Association shifts abortion, pregnancy oversight from midwives to doctors
1880: Every state has laws restricting or banning abortions
Mid-1960s: ‘Back-alley butchers,’ underground network provide illegal, often unsafe, abortions to the desperate
1960s: Pressure from activists creates reform in some states ahead of Roe v. Wade
1973: Roe v. Wade makes abortion safe and legal in all 50 states
Late-1970s: Racial fearmongering creates rise of the ‘Moral Majority’
The decade after Roe v. Wade saw the beginnings of a shift in political and social allegiances around the issue of abortion. Prior to Roe, and even in the few years after, evangelical Christians did not oppose abortion—in fact, many Southern Baptists supported legal abortion. Abortion was not a major political issue for the right at that time, and most Catholics, the most outspoken anti-abortion voter bloc, tended to vote Democratic prior to 1970.
A few key events changed the priorities and demographics of the political parties. The first, and perhaps most influential, was the elimination of tax exemptions for segregated private schools. Referred to as “segregation academies,” these schools cropped up in the aftermath of the Brown v. Board of Education decision, as white evangelical families pulled their children out of public—now integrated—schools. After Black Mississippi families sued in 1970, the IRS was pressured to crack down on segregation academies by removing their tax-exempt status in the late ’70s.
Another Supreme Court case contributed to a growing backlash amongst white evangelical Christians: Engel v. Vitale, a 1962 ruling that prohibited public schools from sponsoring schoolwide prayer. As the Republican party increasingly became the socially conservative “party of family values,” the issue of abortion became a convenient—and more socially acceptable—proxy through which the right could channel its discontents around desegregation, growing sexual liberalness, and civil rights. Adopting an anti-abortion stance also helped the Republican Party convince more socially conservative Catholics to break with the Democrats.
By the end of the 1970s, these issues had converged to aid the rise of the Moral Majority, a right-wing movement headed by televangelist Jerry Falwell. The Moral Majority merged fundamentalist social and political conservatism and mobilized the Christian right, aiding in the election of Ronald Reagan in 1980 and ushering in a new era of American politics.
1980s-2000s: Legal challenges to Roe v. Wade introduce restrictions
Legal challenges to Roe began long before the Supreme Court decided to hear Dobbs v. Jackson Women’s Health Organization back in 2021, ultimately resulting in Roe’s fall. Starting in the 1980s, cases like Harris v. McRae and Webster v. Reproductive Health Services were already introducing restrictions to the access Roe initially promised.
Harris v. McRae restricted Medicaid funding for abortions to cases of rape, incest, and life endangerment, while Webster v. Reproductive Health Services upheld Missouri’s limitations on who could perform abortions, as well as where.
The 1992 ruling for Planned Parenthood v. Casey both reaffirmed Roe while also introducing a loophole through which states could restrict access to abortions: As long as state laws did not pose an “undue burden” on people seeking abortions before the point of fetal viability, those restrictions could be acceptable. This reworked the trimester framework established by Roe, which ensured access to abortion during the first two trimesters and allowed for states to decide on restrictions or bans on third-trimester abortions.
In 2000, the Supreme Court heard Stenberg v. Carhart, which challenged a Nebraska ban on a late-term abortion method called dilation and extraction—controversially referred to as “partial-birth abortion.” The Court ruled the ban was unconstitutional, because it posed an “undue burden” on those seeking an abortion, as defined in Planned Parenthood v. Casey. But only seven years later, this decision was contradicted by the Supreme Court’s Gonzales v. Carhart ruling, which upheld the passage of the Federal Partial Birth Abortion Ban Act. The act criminalized the dilation and extraction abortion method, the first time a specific technique was banned.
On May 2, 2022, a leaked Supreme Court initial draft majority opinion overturning Roe v. Wade inspired panic and protest amongst supporters of legal abortion and preliminary celebration for opponents of Roe. Then, on June 24, 2022, the Supreme Court released its ruling and Roe officially fell.
For many people living in states with restrictive abortion laws, the reality of getting an abortion over the past several years has already resembled a pre-Roe world: where having the means to drive or fly across state lines and pay for abortion services, as well as other associated travel costs, is often a dealbreaker.
Some things will change, however, now that the Supreme Court has overturned Roe v. Wade. The distances people will need to travel to receive abortion care will increase manifold. Current estimates from the Guttmacher Institute indicate that 26 states are likely or certain to ban abortion. These states are concentrated in the South and Midwest, and would effectively create hundreds of miles-long abortion deserts in parts of the U.S. Residents of Louisiana, Florida, and Texas in particular could see an increase of hundreds of miles to the nearest legal clinic.
But accessing an abortion in the event of a 26-state ban does not mean returning to the days of back-alley butchers and coat-hanger abortions. Abortion services have evolved significantly since the century of criminalization, and have become increasingly safe and simplified. Reliance on surgical abortion has decreased: as of 2020, over half of all U.S. abortions are medication-based. The most common medication for abortion is an FDA-approved combination of two drugs—mifepristone and misoprostol—which are usually administered during the first 10 weeks of pregnancy.
The right to an abortion is codified in state laws or constitutions in 16 states, including New York, Illinois, California, Oregon, and Colorado, as well as Washington D.C. Many of these states are preparing for a surge in the number of out-of-state visitors seeking abortions, or have already seen an uptick in recent years as restrictions on abortions have tightened in neighboring states.