# Abortion: Judicial Control

> Briefs, arguments, decisions, and more.

URL: https://www.frixlaw.com/law-library/documents/crs%3AIB88006

## Record

- **Collection:** Congressional research report
- **Document type:** CRS Report
- **Published:** March 10, 1988
- **Citation:** IB88006

## Text

CONTENTS

SUMMARY

ISSUE DEFINITION
BACKGROUND AND ANALYSIS
Judicial History
Development and Status of the Law Prior to 1973
The Supreme Court's 1973 Abortion Rulings
The Public Funding of Abortions
The 1977 Trilogy -- Restrictions on Public Funding of
Nontherapeutic or Elective Abortions
The Public Funding of Therapeutic or Medically Necessary
Abortions -- The Supreme Court's Decisions in McRae
and Zbaraz
U.S.

Supreme Court Decisions Subsequent to Roe and Doe Involving the
Substantive Right to Abortion
Informed Consent, Spousal Consent, Parental Consent, and
Reporting Requirements
Parental Notice
Advertising of Abortion Services
Abortions by Non-Physicians
The Definition of Viability
U.S. Supreme Court Decisions -- 1983-1987

FOK ADD1 TIONAL KEADI NC

ABORTION:

JUDICIAL CONTROL

SUMMARY

I n 1973 t h e U.S. Supreme C o u r t h e l d t h a t t h e C o n s t i t u t i o n p r o t e c t s a
woman's d e c i s i o n w h e t h e r o r n o t t o t e r m i n a t e h e r p r e g n a n c y , R z v . ,-W
410 U.S. 1 1 3 , and t h a t a S t a t e may n o t u n d u l y burden t h e e x e r c i s e o f t h a t
f u n d a m e n t a l r i g h t by r e g u l a t i o n s t h a t p r o h i b i t o r s u b s t a n t i a l l y l i m i t
a c c e s s t o t h e means of e f f e c t u a t i n g t h a t d e c i s i o n , D o e v . B o l t o n , 410 U.S.
179. But r a t h e r t h a n s e t t l i n g t h e i s s u e , t h e c o u r t ' s r u l i n g s h a v e k i n d l e d
h e a t e d d e b a t e a n d p r e c i p i t a t e d a v a r i e t y of g o v e r n m e n t a l a c t i o n s a t t h e
n a t i o n a l , S t a t e and l o c a l l e v e l s d e s i g n e d e i t h e r t o n u l l i f y t h e r u l i n g s o r
hinder t h e i r effectuation.
These g o v e r n m e n t a l r e g u l a t i o n s h a v e , i n t u r n ,
spawned f u r t h e r l i t i g a t i o n i n which r e s u l t i n g j u d i c i a l r e f i n e m e n t s i n t h e
law h a v e been no more s u c c e s s f u l i n dampening t h e c o n t r o v e r s y .
Thus, a s
t h e p r e v i o u s C o n g r e s s e s h a v e been, t h e 1 0 0 t h c o n t i n u e s t o be a forum f o r
p r o p o s e d l e g i s l a t i o n and c o n s t i t u t i o n a l amendments aimed a t l i m i t i n g o r
p r o h i b i t i n g t h e p r a c t i c e of a b o r t i o n .
The law w i t h r e s p e c t t o a b o r t i o n i n mid-19th
c e n t u r y America
f o l l o w e d t h e p r e - e x i s t i n g common law of England i n a l l b u t a few S t a t e s .
By t h e t i m e of t h e C i v i l War a number o f S t a t e s had begun t o add t o o r
r e v i s e t h e i r s t a t u t e s i n o r d e r t o p r o h i b i t a b o r t i o n a t a l l l e v e l s of
gestation.
The S t a t e s v a r i e d i n t h e i r e x c e p t i o n s f o r t h e r a p e u t i c
abortions.
1967 saw t h e f i r s t v i c t o r y of an a b o r t i o n r e f o r m movement w i t h t h e
passage of l i b e r a l i z i n g l e g i s l a t i o n i n Colorado.
The l e g i s l a t i o n was
b a s e d on t h e Model P e n a l Code.
Between 1967 and 1973, a p p r o x i m a t e l y onet h i r d of t h e S t a t e s had a d o p t e d , e i t h e r i n whole o r i n p a r t , t h e Model
P e n a l C o d e ' s p r o v i s i o n s a l l o w i n g a b o r t i o n i n i n s t a n c e s o t h e r t h a n where
o n l y t h e m o t h e r ' s l i f e was i n d a n g e r .
Between 1968 and 1972 t h e c o n s t i t u t i o n a l i t y o f r e s t r i c t i v e a b o r t i o n
s t a t u t e s o f many S t a t e s was c h a l l e n g e d on t h e g r o u n d s o f v a g u e n e s s ,
v i o l a t i o n of t h e f u n d a m e n t a l r i g h t o f p r i v a c y , and d e n i a l of e q u a l
p r o t e c t i o n under t h e s e laws.
I n 1973, t h e Supreme C o u r t r u l e d , i n Roe v.
W a d e , 410 U.S. 113, and D o e v. B o l t o n , 410 U.S. 1 7 9 , t h a t T e x a s and
G e o r g i a s t a t u t e s r e g u l a t i n g a b o r t i o n i n t e r f e r e d t o an u n c o n s t i t u t i o n a l
e x t e n t w i t h a woman's r i g h t t o d e c i d e w h e t h e r t o t e r m i n a t e h e r p r e g n a n c y .
The c o n s t i t u t i o n a l b a s i s f o r t h e d e c i s i o n s r e s t e d upon t h e c o n c l u s i o n t h a t
t h e F o u r t e e n t h Amendment r i g h t o f p e r s o n a l p r i v a c y embraced a woman's
d e c i s i o n whether t o c a r r y a pregnancy t o term.
v. B o l t o n d i d
The Supreme C o u r t ' s d e c i s i o n s i n R z v. W a d e and
n o t a d d r e s s a number o f i m p o r t a n t a b o r t i o n - r e l a t e d i s s u e s which h a v e
s u b s e q u e n t l y been r a i s e d by S t a t e a c t i o n s s e e k i n g t o r e s t r i c t t h e s c o p e of
the court's rulings.
These i n c l u d e t h e i s s u e s o f i n f o r m e d c o n s e n t ,
s p o u s a l c o n s e n t , p a r e n t a l c o n s e n t , and r e p o r t i n g r e q u i r e m e n t s .
In
a d d i t i o n , R o e and D o e n e v e r r e s o l v e d t h e q u e s t i o n o f w h a t , i f a n y t y p e , of
a b o r t i o n p r o c e d u r e s may b e r e q u i r e d o r p r o h i b i t e d by s t a t u t e .
The C o u r t
h a s h e a r d a number o f a b o r t i o n - r e l a t e d c a s e s s i n c e 1 9 7 3 a s a t t e m p t s a r e
made t o c l a r i f y t h e s e i s s u e s .

ISSUE DEFINITION
I n 1973 t h e U.S. Supreme C o u r t h e l d t h a t t h e C o n s t i t u t i o n p r o t e c t s a
woman's d e c i s i o n w h e t h e r o r n o t t o t e r m i n a t e h e r p r e g n a n c y , R o e v . W s ,
and t h a t a S t a t e may n o t unduly burden t h e e x e r c i s e o f t h a t f u n d a m e n t a l
r i g h t by r e g u l a t i o n s t h a t p r o h i b i t o r s u b s t a n t i a l l y l i m i t a c c e s s t o t h e
The i s s u e o f a
means o f e f f e c t u a t i n g t h a t d e c i s i o n , Doe v. B o l t o n .
S i n c e 1973,
woman's r i g h t t o an a b o r t i o n , however, i s f a r from s e t t l e d .
t h e r e h a v e been F e d e r a l and S t a t e l e g i s l a t i v e e f f o r t s d e s i g n e d e i t h e r t o
n u l l i f y t h e rulings or hinder t h e i r effectuation.
Subsequent l i t i g a t i o n
challenging t h i s l e g i s l a t i o n has led t o f u r t h e r j u d i c i a l refinements.

BACKGROUND AND ANALYSIS
Judicial History
Development and S t a t u s O E the Law P r i o r t o 1973
The law w i t h r e s p e c t t o a b o r t i o n i n mid-19th c e n t u r y America f o l l o w e d
t h e p r e - e x i s t i n g common law of England i n a l l b u t a few S t a t e s .
Thus, no
i n d i c t m e n t would o c c u r f o r a b o r t i n g a f e t u s f o r a c o n s e n t i n g f e m a l e p r i o r
t o "quickening."
But by t h e t i m e o f t h e C i v i l War, a n i n f l u e n t i a l a n t i a b o r t i o n movement began t o a f f e c t l e g i s l a t i o n by i n d u c i n g S t a t e s t o a d d t o
o r r e v i s e t h e i r s t a t u t e s i n o r d e r t o p r o h i b i t a b o r t i o n a t a11 s t a g e s of
gestation.
By 1910 e v e r y S t a t e had a n t i - a b o r t i o n l a w s , e x c e p t Kentucky
whose c o u r t s j u d i c i a l l y d e c l a r e d a b o r t i o n s t o b e i l l e g a l .
I n 1 9 6 7 , 49 o f
t h e S t a t e s and t h e D i s t r i c t o f Columbia c l a s s i f i e d t h e c r i m e of a b o r t i o n
a s a felony.
The c o n c e p t of q u i c k e n i n g was no l o n g e r u s e d t o d e t e r m i n e
c r i m i n a l l i a b i l i t y b u t was r e t a i n e d i n some S t a t e s t o s e t p u n i s h m e n t .
N o n - t h e r a p e u t i c a b o r t i o n s were e s s e n t i a l l y u n l a w f u l .
The S t a t e s v a r i e d i n
t h e i r exceptions f o r therapeutic abortions.
Forty-two S t a t e s p e r m i t t e d
a b o r t i o n s o n l y i f n e c e s s a r y t o save t h e l i f e of t h e mother. Other S t a t e s
a l l o w e d a b o r t i o n t o s a v e a woman from " s e r i o u s and permanent b o d i l y
i n j u r y t ' o r h e r " l i f e and h e a l t h , "
Three S t a t e s allowed a b o r t i o n s t h a t
were n o t "unlawfully
~ e r f o r r n e d " o r t h a t were n o t "without
lawful
j u s t i f i c a t i o n " , l e a v i n g i n t e r p r e t a t i o n of t h o s e s t a n d a r d s t o t h e c o u r t s .
T h i s , however, r e p r e s e n t e d t h e h i g h w a t e r mark i n r e s t r i c t i v e a b o r t i o n
laws i n t h e U n i t e d S t a t e s , f o r 1967 saw t h e f i r s t v i c t o r y o f a n a b o r t i o n
r e f o r m movement w i t h t h e p a s s a g e of l i b e r a l i z i n g l e g i s l a t i o n i n C o l o r a d o .
The l e g i s l a t i o n was b a s e d upon t h e Model P e n a l Code.
The movement had
s t a r t e d i n t h e e a r l y 1950s and c e n t e r e d i t s e f f o r t s on a p r o p o s e d c r i m i n a l
a b o r t i o n s t a t u t e d e v e l o p e d by t h e American Law I n s t i t u t e t h a t would a l l o w
a b o r t i o n s when c h i l d b i r t h posed g r a v e d a n g e r t o t h e p h y s i c a l o r m e n t a l
h e a l t h o f a woman, when t h e r e was h i g h l i k e l i h o o d of f e t a l a b n o r m a l i t y , o r
when p r e g n a n c y r e s u l t e d from r a p e o r i n c e s t .
Between 1967 and t h e Supreme C o u r t ' s 1973 d e c i s i o n s i n R o e and Doe,
a p p r o x i m a t e l y o n e - t h i r d of t h e S t a t e s had a d o p t e d , e i t h e r i n whole o r i n
p a r t , t h e Model P e n a l C o d e ' s p r o v i s i o n s a l l o w i n g a b o r t i o n s i n i n s t a n c e s
o t h e r t h a n where o n l y t h e m o t h e r ' s l i f e was i n d a n g e r .
A l s o , by t h e end

of 1 9 7 0 , 4 S t a t e s ( ~ l a s k a , H a w a i i , New York, and W a s h i n g t o n ) h a d r e p e a l e d
c r i m i n a l p e n a l t i e s f o r a b o r t i o n s performed i n e a r l y p r e g n a n c y by a
l i c e n s e d p h y s i c i a n , s u b j e c t t o s t a t e d p r o c e d u r a l and h e a l t h r e q u i r e m e n t s .
-.

The f i r s t U.S.
Supreme C o u r t d e c i s i o n d e a l i n g w i t h a b o r t i o n was
r e n d e r e d i n 1971
( U l v. V u i t c h , 402 U.S.' 6 2 ) .
I n Vuitch, t h e Court
d e n i e d a v a g u e n e s s c h a l l e n g e t o t h e D i s t r i c t o f Columbia a b o r t i o n s t a t u t e .
The n e t e f f e c t o f t h e V u i t c h d e c i s i o n was t o expand t h e a v a i l a b i l i t y o f
a b o r t i o n s u n d e r t h e D.C.
l a w ' s p r o v i s i o n a l l o w i n g a b o r t i o n s where
health."
" n e c e s s a r y f o r t h e p r e s e r v a t i o n of t h e m o t h e r ' s

...

The Supreme court's

1973 A b o r t i o n R u l i n g s

Between 1968 and 1972 t h e c o n s t i t u t i o n a l i t y o f r e s t r i c t i v e a b o r t i o n
s t a t u t e s of many S t a t e s was c h a l l e n g e d on t h e g r o u n d s o f v a g u e n e s s ,
v i o l a t i o n of t h e f u n d a m e n t a l r i g h t o f p r i v a c y , and d e n i a l o f e q u a l
p r o t e c t i o n under t h e s e laws.
T h e s e c h a l l e n g e s met w i t h mixed s u c c e s s i n
t h e l o w e r c o u r t s . However, on J a n . 22, 1973, t h e Supreme C o u r t i s s u e d i t s
r u l i n g s i n R o e v. W a d e , 410 U.S. 1 1 3 , and Doe v. B o l t o n , 410 U.S. 179. I n
t h o s e c a s e s t h e C o u r t found t h a t Texas and G e o r g i a s t a t u t e s r e g u l a t i n g
a b o r t i o n i n t e r f e r e d t o an u n c o n s t i t u t i o n a l e x t e n t w i t h a woman's r i g h t t o
d e c i d e w h e t h e r t o t e r m i n a t e h e r pregnancy.
The Texas s t a t u t e f o r b a d e a l l
a b o r t i o n s not n e c e s s a r y " f o r t h e purpose of s a v i n g t h e L i f e of t h e
The G e o r g i a e n a c t m e n t p e r m i t t e d a b o r t i o n s when c o n t i n u e d
mother
p r e g n a n c y s e r i o u s l y t h r e a t e n e d t h e woman's l i f e o r h e a l t h , when t h e f e t u s
was v e r y l i k e l y t o h a v e
s e v e r e b i r t h d e f e c t s , o r when t h e p r e g n a n c y
r e s u l t e d f r o m r a p e . The G e o r g i a s t a t u t e r e q u i r e d , however, t h a t a b o r t i o n s
be p e r f o r m e d o n l y a t a c c r e d i t e d h o s p i t a l s and o n l y a f t e r a p p r o v a l by a
h o s p i t a l c o m m i t t e e and two c o n s u l t i n g p h y s i c i a n s .

."

The c o u r t ' s d e c i s i o n s were d e l i v e r e d by Mr. J u s t i c e Blackmun f o r
h i m s e l f and s i x o t h e r J u s t i c e s .
J u s t i c e s White and R e h n q u i s t d i s s e n t e d .
The C o u r t r u l e d t h a t S t a t e s may n o t c a t e g o r i c a l l y p r o s c r i b e a b o r t i o n s by
making t h e i r p e r f o r m a n c e a c r i m e , and t h a t S t a t e s may n o t make a b o r t i o n s
u n n e c e s s a r i l y d i f f i c u l t t o o b t a i n by p r e s c r i b i n g e l a b o r a t e p r o c e d u r a l
guidelines.
The c o n s t i t u t i o n a l b a s i s f o r t h e d e c i s i o n s r e s t e d upon t h e
c o n c l u s i o n t h a t t h e F o u r t e e n t h Amendment r i g h t o f p e r s o n a l p r i v a c y
embraced a woman's d e c i s i o n w h e t h e r t o c a r r y a p r e g n a n c y t o term.
The
C o u r t n o t e d t h a t i t s p r i o r d e c i s i o n s had "found a t l e a s t t h e r o o t s of
...[a ] g u a r a n t e e of p e r s o n a l p r i v a c y ' '
i n v a r i o u s amendments t o t h e
C o n s t i t u t i o n o r t h e i r penumbras e . ,
p r o t e c t e d o f f s h o o t s ) and
c h a r a c t e r i z e d t h e r i g h t t o p r i v a c y a s grounded i n " t h e F o u r t e e n t h
~ r n e n d m e n t ' s c o n c e p t o f p e r s o n a l l i b e r t y and r e s t r i c t i o n s upon S t a t e
action."
(Roe v. W a d e , 410 U.S. 113, 152, 1 5 3 ( 1 9 7 3 1 . ) R e g a r d i n g t h e
s c o p e of t h a t r i g h t , t h e C o u r t s t a t e d t h a t i t i n c l u d e d " o n l y p e r s o n a l
r i g h t s t h a t c a n be deemed ' f u n d a m e n t a l ' o r ' i m p l i c i t i n t h e c o n c e p t of
ordered liberty"'
and " b e a r s some e x t e n s i o n t o a c t i v i t i e s r e l a t e d t o
m a r r i a g e , p r o c r e a t i o n , c o n t r a c e p t i o n , f a m i l y r e l a t i o n s h i p , and c h i l d
r e a r i n g and e d u c a t i o n . "
( I d . a t 152-153.)
Such a r i g h t , t h e C o u r t
c o n c l u d e d , " i s b r o a d enough t o encompass a woman's d e c i s i o n w h e t h e r o r n o t
t o t e r m i n a t e h e r pregnancy." ( I d . a t 153.)

With r e s p e c t t o p r o t e c t i o n o f t h e r i g h t a g a i n s t S t a t e i n t e r f e r e n c e ,
t h e Court held t h a t s i n c e t h e r i g h t of personal privacy i s a fundamental
r i g h t , o n l y a " c o m p e l l i n g S t a t e i n t e r e s t " c o u l d j u s t i f y i t s l i m i t a t i o n by
a S t a t e . Thus w h i l e i t r e c o g n i z e d t h e l e g i t i m a c y of t h e S t a t e i n t e r e s t i n
p r o t e c t i n g m a t e r n a l h e a l t h and t h e p r e s e r v a t i o n of t h e f e t u s ' p o t e n t i a l
l i f e ( I d . a t 148-1501, and t h e e x i s t e n c e of a r a t i o n a l c o n n e c t i o n b e t w e e n
t h e s e two i n t e r e s t s and t h e S t a t e ' s a n t i - a b o r t i o n l a w , t h e C o u r t h e l d
t h e s e i n t e r e s t s i n s u f f i c i e n t t o j u s t i f y a n a b s o l u t e ban on a b o r t i o n s .
I n s t e a d , t h e C o u r t emphasized t h e d u r a t i o n a l n a t u r e o f p r e g n a n c y a n d h e l d
t h e S t a t e ' s i n t e r e s t s t o be s u f f i c i e n t l y compelling t o permit c u r t a i l m e n t
o r p r o h i b i t i o n o f a b o r t i o n o n l y d u r i n g s p e c i f i e d s t a g e s of p r e g n a n c y .
The
High C o u r t c o n c l u d e d t h a t u n t i l t h e end of t h e f i r s t trimester a n a b o r t i o n
i s no more d a n g e r o u s t o m a t e r n a l h e a l t h t h a n c h i l d b i r t h i t s e l f , and f o u n d
that:
[ W l i t h r e s p e c t t o t h e s t a t e ' s i m p o r t a n t and l e g i t i m a t e
i n t e r e s t i n t h e h e a l t h of t h e m o t h e r , t h e " c o m p e l l i n g " p o i n t , i n
l i g h t of p r e s e n t m e d i c a l knowledge, i s a t a p p r o x i m a t e l y t h e end
of t h e f i r s t t r i m e s t e r .
( I d . a t 163.)
Only a f t e r t h e f i r s t t r i m e s t e r d o e s t h e s t a t e ' s i n t e r e s t i n p r o t e c t i n g
maternal h e a l t h provide a s u f f i c i e n t b a s i s t o j u s t i f y S t a t e r e g u l a t i o n of
a b o r t i o n , and t h e n o n l y t o p r o t e c t t h i s i n t e r e s t .
( I d . a t 163-164.)
The " c o m p e l l i n g " p o i n t w i t h r e s p e c t t o t h e S t a t e ' s i n t e r e s t i n t h e
Following v i a b i l i t y , t h e
p o t e n t i a l l i f e of t h e f e t u s "is a t v i a b i l i t y . "
S t a t e ' s i n t e r e s t p e r m i t s i t t o r e g u l a t e and even p r o s c r i b e a n a b o r t i o n
e x c e p t when n e c e s s a r y ,
i n a p p r o p r i a t e m e d i c a l judgment,
for the
p r e s e r v a t i o n o f t h e l i f e o r h e a l t h of t h e m o t h e r . . ( I d . a t 163-164.)
The
C o u r t d e f i n e d v i a b i l i t y a s t h e p o i n t a t which t h e f e t u s i s " p o t e n t i a l l y
a b l e t o l i v e o u t s i d e t h e m o t h e r ' s womb, a l b e i t w i t h a r t i f i c i a l a i d . "
(Id.
The C o u r t summarized i t s h o l d i n g a s f o l l o w s :
F o r t h e s t a g e p r i o r t o a p p r o x i m a t e l y t h e end o f t h e f i r s t
t r i m e s t e r [ o f p r e g n a n c y ] , t h e a b o r t i o n d e c i s i o n and i t s
e f f e c t u a t i o n must be l e f t t o t h e m e d i c a l judgment o f t h e
p r e g n a n t woman's a t t e n d i n g p h y s i c i a n .
F o r t h e s t a g e s u b s e q u e n t t o a p p r o x i m a t e l y t h e end o f t h e
f i r s t t r i m e s t e r , t h e S t a t e , i n promoting i t s i n t e r e s t i n
t h e h e a l t h of t h e m o t h e r , may, i f i t c h o o s e s , r e g u l a t e t h e
a b o r t i o n p r o c e d u r e i n ways t h a t a r e r e a s o n a b l y r e l a t e d t o
maternal health.
For t h e s t a g e subsequent t o v i a b i l i t y , t h e S t a t e , i n
p r o m o t i n g i t s i n t e r e s t i n t h e p o t e n t i a l i t y o f human l i f e
may, i f i t c h o o s e s , r e g u l a t e , and even p r o s c r i b e , a b o r t i o n
e x c e p t where i t i s n e c e s s a r y , i n a p p r o p r i a t e m e d i c a l
judgment, f o r t h e p r e s e r v a t i o n o f t h e l i f e o r h e a l t h o f t h e
mocher.
( 4 1 0 U.S. a t 164-165)
I n Doe v. B o l t o n , 410 U.S, 179 ( 1 9 7 3 ) , t h e C o u r t r e i t e r a t e d i t s
h o l d i n g i n ER
v . W a d e t h a t t h e b a s i c d e c i s i o n o f when a n a b o r t i o n i s
p r o p e r r e s t s w i t h t h e p r e g n a n t mother and h e r p h y s i c i a n , b u t e x t e n d e d R o e
by w a r n i n g t h a t j u s t a s S t a t e s may n o t p r e v e n t a b o r t i o n by making t h e
p e r f o r m a n c e a c r i m e , S t a t e s may n o t make a b o r t i o n s u n r e a s o n a b l y d i f f i c u l t

t o o b t a i n by p r e s c r i b i n g e l a b o r a t e p r o c e d u r a l b a r r i e r s .
I n Doe,
t h e r e f o r e , t h e C o u r t s t r u c k down S t a t e r e q u i r e m e n t s t h a t a b o r t i o n s b e
p e r f o r m e d i n l i c e n s e d h o s p i t a l s ; t h a t a b o r t i o n s b e a p p r o v e d b e f o r e h a n d by
a h o s p i t a l e o m m i t t e e ; and t h a t two p h y s i c i a n s c o n c u r i n t h e a b o r t i o n
decision.
( I d . a t 196-199.) The C o u r t a p p e a r e d t o n o t e , however, t h a t
t h i s would n o t a p p l y t o a s t a t u t e t h a t p r o t e c t e d t h e r e l i g i o u s o r m o r a l
b e l i e f s o f d e n o m i n a t i o n a l h o s p i t a l s and t h e i r employees.
( I d . a t 197-98.)
The C o u r t i n
a l s o d e a l t with t h e question whether a f e t u s i s a
p e r s o n u n d e r t h e F o u r t e e n t h Amendment and o t h e r p r o v i s i o n s o f t h e
constitution.
The C o u r t i n d i c a t e d t h a t t h e C o n s t i t u t i o n never
s p e c i f i c a l l y d e f i n e s " p e r s o n , " b u t added t h a t i n n e a r l y a l l t h e s e c t i o n s
where t h e word p e r s o n a p p e a r s , " . . . t h e u s e o f t h e word i s s u c h t h a t i t h a s
None i n d i c a t e s , w i t h a n y a s s u r a n c e , t h a t
a p p l i c a t i o n only post-natal l y .
i t has any p o s s i b l e pre-natal application."
( 4 1 0 U.S. a t 1 5 7 . ) The C o u r t
emphasized t h a t g i v e n t h e f a c t t h a t i n t h e major p a r t of t h e 1 9 t h c e n t u r y
p r e v a i l i n g l e g a l a b o r t i o n p r a c t i c e s were f a r f r e e r t h a n t o d a y , t h e C o u r t
a s used i n t h e F o u r t e e n t h
was p e r s u a d e d " t h a t
t h e word ' p e r s o n , '
Amendment, d o e s n o t i n c l u d e t h e unborn."
( I d . a t 158.)
The C o u r t d i d n o t , however, r e s o l v e t h e q u e s t i o n o f when l i f e
a c t u a l l y begins.
While n o t i n g t h e d i v e r g e n c e o f t h i n k i n g on t h i s i s s u e ,
i t , i n s t e a d , a r t i c u l a t e d t h e l e g a l c o n c e p t o f " v i a b i l i t y ," which i s
d e f i n e d a s t h e p o i n t a t which t h e f e t u s i s p o t e n t i a l l y a b l e t o l i v e
o u t s i d e t h e womb, a l t h o u g h t h e f e t u s may r e q u i r e a r t i f i c i a l a i d .
(Id. a t
160. )
The Supreme C o u r t ' s d e c i s i o n s i n R o e v. W a d e , and D o e v. B o l t o n d i d
n o t a d d r e s s a number o f i m p o r t a n t a b o r t i o n - r e l a t e d i s s u e s which h a v e
s u b s e q u e n t l y been r a i s e d by S t a t e a c t i o n s s e e k i n g t o r e s t r i c t t h e s c o p e o f
the Court's rulings.
These i n c l u d e t h e i s s u e s of informed c o n s e n t ,
s p o u s a l c o n s e n t , p a r e n t a l c o n s e n t , and r e p o r t i n g r e q u i r e m e n t s .
In
a d d i t i o n , Roe and Doe n e v e r r e s o l v e d t h e q u e s t i o n of w h a t , i f a n y , t y p e of
a b o r t i on p r o c e d u r e s may b e r e q u i r e d o r p r o h i b i t e d by s t a t u t e .
Moreover,
t h e r e remained t h e m a t t e r of w h e t h e r f e t a l p r o t e c t i o n s t a t u t e s were
constitutional.
Unanswered by t h e 1973 c a s e s a s w e l l was t h e
c o n s t i t u t i o n a l i t y of t h r e e o t h e r t y p e s o f s t a t u t e s a f f e c t i n g a c c e s s t o
abortion:
( 1) t h o s e
p r o s c r i b i n g t h e advertising regarding the
a v a i l a b i l i t y o f an a b o r t i o n o r a b o r t i o n - r e l a t e d s e r v i c e s i n a n o t h e r S t a t e ;
( 2 ) t h o s e p r o h i b i t i n g a b o r t i o n s by n o n - p h y s i c i a n s ; and ( 3 ) t h o s e a l l o w i n g
p r i v a t e h o s p i t a l s t o r e f u s e t o perform a b o r t i o n s .
In addition, since R o e
and D o e , q u e s t i o n s have a r i s e n w i t h r e s p e c t t o t h e c o n s t i t u t i o n a l i t y o f :
( 1 ) t h e experimental use of fetuses; (2) waiting period requirements; ( 3 )
t e r m i n a t i o n of p a r e n t a l r i g h t s ; ( 4 ) t h e r i g h t o f a p h y s i c i a n t o r e f u s e t o
Finally, the
p a r t i c i p a t e i n a n a b o r t i o n ; and ( 5 ) n o t i c e r e q u i r e m e n t s .
e n t i r e m a t t e r o f Government f u n d i n g of a b o r t i o n s was n o t d e a l t w i t h i n R o e
and Doe, s i n c e p u b l i c f u n d i n g was n o t a v a i l a b l e a t t h a t t i m e .

The P u b l i c Funding o f A b o r t i o n s
Two c a t e g o r i e s of p u b l i c f u n d i n g c a s e s have been h e a r d and d e c i d e d by
t h e 'supreme Court:
( 1 ) t h o s e involving funding r e s t r i c t i o n s f o r
n o n t h e r a p e u t i c ( e l e c t i v e ) a b o r t i o n s , and ( 2 ) t h o s e i n v o l v i n g f u n d i n g
l i m i t a t i o n s f o r therapeutic (medically necessary) abortions.
The 1977 T r i l o g y -- R e s t r i c t i o n s on P u b l i c Funding o f N o n t h e r a p e u t i c o r
E l e c t i v e Abort i o n s
On J u n e 2 0 , 1977, t h e Supreme C o u r t , i n t h r e e r e l a t e d d e c i s i o n s , r u l e d
on t h e q u e s t i o n w h e t h e r t h e Medicaid s t a t u t e o r t h e C o n s t i t u t i o n r e q u i r e s
p u b l i c f u n d i n g of n o n t h e r a p e u t i c ( e l e c t i v e ) a b o r t i o n s f o r i n d i g e n t women
o r a c c e s s t o p u b l i c f a c i l i t i e s f o r t h e p e r f o r m a n c e o f s u c h a b o r t i o n s . The
C o u r t h e l d t h a t t h e S t a t e s have n e i t h e r a s t a t u t o r y n o r a c o n s t i t u t i o n a l
( B e a l v. Doe, 432 U.S. 438 ( 1 9 7 7 ) ; Maher v.
o b l i g a t i o n in t h i s regard.
Roe, 432 U.S. 464 ( 1 9 7 7 ) ; and P o e l k e r v. D o e , 432 U.S. 519 ( 1 9 7 7 ) ( p e r
curiam). )
In
v. D o e , t h e Supreme C o u r t d e a l t w i t h t h e q u e s t i o n o f w h e t h e r
T i t l e X I X o f t h e S o c i a l S e c u r i t y Act r e q u i r e d t h e f u n d i n g o f nont h e r a p e u t i c a b o r t i o n a s a c o n d i t i o n of p a r t i c i p a t i o n i n t h e Medicaid
program e s t a b l i s h e d by t h e A c t .
The C o u r t h e l d t h a t n o t h i n g i n t h e
l a n g u a g e o r l e g i s l a t i v e h i s t o r y of T i t l e X I X r e q u i r e s a p a r t i c i p a t i n g
S t a t e t o fund e v e r y medical procedure f a l l i n g w i t h i n t h e d e l i n e a t e d
c a t e g o r i e s of medical c a r e .
The C o u r t r u l e d t h a t i t was n o t i n c o n s i s t e n t
w i t h t h e A c t ' s g o a l s t o r e f u s e t o fund unnecessary medical s e r v i c e s .
However, t h e C o u r t d i d i n d i c a t e t h a t T i t l e X I X l e f t a S t a t e f r e e t o
i n c l u d e coverage f o r non-therapeutic a b o r t i o n s should i t choose t o do so.
I n Maher v.
&, t h e Supreme C o u r t r e s o l v e d a c o n s t i t u t i o n a l
c h a l l e n g e t o C o n n e c t i c u t ' s r e f u s a l t o r e i m b u r s e Medicaid r e c i p i e n t s f o r
a b o r t i o n e x p e n s e s e x c e p t where t h e a t t e n d i n g p h y s i c i a n c e r t i f i e s t h e
a b o r t i o n t o h a v e been m e d i c a l l y o r p s y c h i a t r i c a l l y n e c e s s a r y .
The C o u r t
held that
t h e Equal P r o t e c t i o n C l a u s e d o e s n o t r e q u i r e a S t a t e
p a r t i c i p a t i n g i n t h e Medicaid program t o pay e x p e n s e s i n c i d e n t e o nont h e r a p e u t i c a b o r t i o n s s i m p l y b e c a u s e t h e S t a t e h a s made a p o l i c y c h o i c e t o
pay e x p e n s e s i n c i d e n t t o c h i l d b i r t h .
More p a r t i c u l a r l y , ~ o n n e c t i c u t ' s
p o l i c y of f a v o r i n g c h i l d b i r t h o v e r a b o r t i o n was h e l d n o t t o i m p i n g e upon
which p r o t e c t s
t h e f u n d a m e n t a l r i g h t of p r i v a c y r e c o g n i z e d i n R o e v. ,-W
a woman f r o m undue i n t e r f e r e n c e i n h e r d e c i s i o n t o t e r m i n a t e a p r e g n a n c y .

Doe,
t h e C o u r t u p h e l d a r e g u l a t i o n of
the
I n P o e l k e r v.
m u n i c i p a l i t i e s of S t . L o u i s t h a t d e n i e d i n d i g e n t p r e g n a n t women nontherapeutic abortions a t public hospitals.
The P u b l i c F u n d i n g o f T h e r a p e u t i c o r M e d i c a l l y N e c e s s a r y A b o r t i o n s
Supreme C o u r t ' s D e c i s i o n s i n McRae a n d Z b a r a z

-- The

The 1977 Supreme C o u r t d e c i s i o n s l e f t open t h e q u e s t i o n w h e t h e r
F e d e r a l l a w , s u c h a s t h e Hyde Amendment, o r s i m i l a r S t a t e l a w s , c o u l d
v a l i d l y p r o h i b i t g o v e r n m e n t a l f u n d i n g of t h e r a p e u t i c a b o r t i o n s .

On J u n e 3 0 , 1980, i n a 5-4 d e c i s i o n , t h e U.S. Supreme C o u r t r u l e d
that
t h e Hyde ~ m e n d m e n t ' s a b o r t i o n f u n d i n g r e s t r i c t i o n s w e r e
constitutional.
The c o u r t ' s m a j o r i t y found t h a t t h e Hyde Amendment
n e i t h e r v i o l a t e d t h e d u e p r o c e s s o r e q u a l p r o t e c t i o n g u a r a n t e e s of t h e
F i f t h Amendment n o r t h e E s t a b l i s h m e n t C l a u s e of t h e F i r s t Amendment.
The
C o u r t a l s o u p h e l d t h e r i g h t o f a S t a t e p a r t i c i p a t i n g i n t h e Medicaid
program t o fund o n l y t h o s e m e d i c a l l y n e c e s s a r y a b o r t i o n s f o r which i t
r e c e i v e d F e d e r a l r e i m b u r s e m e n t . Harris v. McRae
-9
448 U.S. 297 ( 1 9 8 0 ) .
In
companion c a s e s r a i s i n g s i m i l a r i s s u e s , t h e Court h e l d t h a t a S t a t e of
I l l i n o i s s t a t u t o r y f u n d i n g r e s t r i c t i o n comparable t o t h e F e d e r a l Hyde
Amendment a l s o d i d n o t c o n t r a v e n e t h e c o n s t i t u t i o n a l r e s t r i c t i o n s o f t h e
e q u a l p r o t e c t i o n c l a u s e o f t h e F o u r t e e n t h Amendment.
W i l l i a m s v. Z b a r a z ;
Miller v. Z b a r a z ; &
U
v. Z b a r a z , 448 U.S.
358 ( 1 9 8 0 ) .
The C o u r t ' s
r u l i n g s i n McRae and Z b a r a z mean t h e r e i s no s t a t u t o r y o r c o n s t i t u t i o n a l
o b l i g a t i o n of t h e S t a t e s o r t h e F e d e r a l Government t o f u n d a l l m e d i c a l l y
necessary abortions.

U.S.

Supreme C o u r t D e c i s i o n s Subsequent t o Roe and Doe
Involving t h e Substantive Right t o Abortion

I n £ ormed C o n s e n t ,
Requirements

Spousal

Consent,

Parental

Consent,

and

Reporting

I n P l a n n e d P a r e n t h o o d v. D a n f o r t h , 428 U.S. 52 ( 1 9 7 6 ) , t h e C o u r t h e l d
t h a t i n f o r m e d c o n s e n t s t a t u t e s , which r e q u i r e a d o c t o r t o o b t a i n t h e
w r i t t e n c o n s e n t o f a woman a f t e r i n f o r m i n g h e r o f t h e d a n g e r s o f a b o r t i o n
and p o s s i b l e a l t e r n a t i v e s , a r e c o n s t i t u t i o n a l i f t h e r e q u i r e m e n t s a r e
r e l a t e d t o m a t e r n a l h e a l t h and a r e n o t o v e r b e a r i n g .
( 4 2 8 U.S. 5 2 , 65-66.)
The f a c t t h a t t h e ' informed c o n s e n t l a w s must d e f i n e t h e i r r e q u i r e m e n t s
v e r y n a r r o w l y i n o r d e r t o be c o n s t i t u t i o n a l w a s l a t e r c o n f i r m e d by t h e
Supreme C o u r t i n 1979.
Freiman v. A s h c r o f t , 584 F.2d 247, 251 ( 8 t h C i r .
The r e q u i r e m e n t s of a n i n f o r m e d
1 9 7 8 ) a f f ' d m e m . , 440 U.S. 941 ( 1 9 7 9 ) .
c o n s e n t s t a t u t e must a l s o be n a r r o w l y drawn s o a s n o t t o unduly i n t e r f e r e
with t h e physician-patient relationship, although the type of information
r e q u i r e d t o b e g i v e n t o a woman o f n e c e s s i t y may v a r y a c c o r d i n g t o t h e
trimester of h e r pregnancy.
I n a d d i t i o n t o informed c o n s e n t , t h e D a n f o r t h d e c i s i o n d e a l t w i t h t h e
i s s u e of spousal consent.
The Supreme Court found t h a t s p o u s a l c o n s e n t
s t a t u t e s , which r e q u i r e a w r i t t e n s t a t e m e n t by t h e f a t h e r o f t h e f e t u s
affirming h i s consent t o t h e abortion, a r e unconstitutional i f t h e
s t a t u t e s a l l o w t h e husband t o u n i l a t e r a l l y p r o h i b i t t h e a b o r t i o n i n t h e
I t s h o u l d b e n o t e d t h a t on t h e same
f i r s t trimester.
( 4 2 8 U.S. 5 2 , 6 9 . )
d a y t h a t t h e Supreme Court d e c i d e d D a n f o r t h , i t a l s o s u m n a r i l y a f f i r m e d
t h e l o w e r c o u r t d e c i s i o n i n *C
v. G e r s t e i n , 376 F.Supp. 695 ( S . D . F l a .
19741, a f f ' d , 428 U.S. 901 (19761, which h e l d u n c o n s t i t u t i o n a l a s p o u s a l
c o n s e n t law r e g a r d l e s s o f t h e s t a g e of t h e woman's pregnancy.
With r e s p e c t t o p a r e n t a l c o n s e n t s t a t u t e s , t h e Supreme C o u r t h e l d i n
Danforth t h a t those s t a t u t e s t h a t allow a parent o r guardian t o absolutely
prohibit
an abortion
t o b e p e r f o r m e d o n a m i n o r c h i l d were
unconstitutional.
S u b s e q u e n t l y , i n B e l o t t i v. B a i r d , 443 U.S. 622 (19791,
t h e C o u r t r u l e d t h a t w h i l e a S t a t e may r e q u i r e a minor t o o b t a i n p a r e n t a l

c o n s e n t , t h e S t a t e must a l s o p r o v i d e a n a l t e r n a t i v e p r o c e d u r e t o p r o c u r e
a u t h o r i z a t i o n i f p a r e n t a l c o n s e n t i s d e n i e d o r t h e m i n o r d o e s n o t want t o
From t h e r e a s o n i n g u s e d i n B e l o t t i , i t a p p e a r s t h a t t h e C o u r t
seek it.
. f e l t a m i n o r i s e n t i t l e d t o some p r o c e e d i n g which a l l o w s h e r t o p r o v e h e r
a b i l i t y t o make a n i n f o r m e d d e c i s i o n i n d e p e n d e n t of h e r p a r e n t s , o r t h a t
e v e n i f s h e i s i n c a p a b l e o f making t h e d e c i s i o n , a t l e a s t showing t h a t t h e
a b o r t i o n would b e i n h e r b e s t i n t e r e s t s .
The C o u r t i n D a n f o r t h a l s o r u l e d t h a t r e p o r t i n g r e q u i r e m e n t s i n
s t a t u t e s r e q u i r i n g d o c t o r s and h e a l t h f a c i l i t i e s t o p r o v i d e i n f o r m a t i o n t o
S t a t e s r e g a r d i n g each a b o r t i o n performed, a r e c o n s t i t u t i o n a l .
The C o u r t
s p e c i f i e d , h o w e v e r , t h a t t h e s e r e p o r t i n g r e q u i r e m e n t s must r e l a t e t o
m a t e r n a l h e a l t h , remain c o n f i d e n t i a l , and may n o t be o v e r b e a r i n g .
(428
U.S. 5 2 , 80-81.)
F i n a l l y , a n o t h e r s i g n i f i c a n t r u l i n g made by t h e C o u r t i n D a n f o r t h was
that
fetal
p r o t e c t i o n s t a t u t e s were g e n e r a l l y overbroad
and
unconstitutional i f they pertained t o pre-viable fetuses.
Such s t a t u t e s
r e q u i r e a d o c t o r p e r f o r m i n g an a b o r t i o n t o u s e a v a i l a b l e means and m e d i c a l
s k i l l s t o s a v e t h e l i f e of t h e f e t u s .
I n a subsequent d e c i s i o n , C o l a u t t i
v. F r a n k l i n , 439 U.S. 379 ( 1 9 7 9 ) , t h e Supreme C o u r t h e l d t h a t s u c h f e t a l
p r o t e c t i o n s t a t u t e s c o u l d o n l y a p p l y t o v i a b l e f e t u s e s and t h a t t h e
s t a t u t e must be p r e c i s e i n s e t t i n g f o r t h t h e s t a n d a r d f o r d e t e r m i n i n g
viability.
I n a d d i t i o n , t h e Court i n C o l a u t t i s t r e s s e d t h a t i n o r d e r t o
meet t h e c o n s t i t u t i o n a l t e s t o f s u f f i c i e n t c e r t a i n t y , f e t a l p r o t e c t i o n
l a w s had t o d e f i n e w h e t h e r a d o c t o r ' s paramount d u t y was t o t h e p a t i e n t o r
w h e t h e r t h e p h y s i c i a n had t o b a l a n c e t h e p o s s i b l e d a n g e r t o t h e p a t i e n t
a g a i n s t t h e i n c r e a s e d odds o f f e t a l s u r v i v a l .
( 4 3 9 U.S. a t 3 7 9 , 397-401.)
Parental Notice
The Supreme C o u r t d i d a t t e m p t t o p r o v i d e f u r t h e r c l a r i f i c a t i o n of t h e
p a r e n t a l c o n s e n t and n o t i f i c a t i o n i s s u e s i n i t s d e c i s i o n i n B e l l o t t i v.
Baird
4 4 3 U.S. 622 ( 1 9 7 9 ) .
There t h e Court held u n c o n s t i t u t i o n a l a
9
Massachusetts s t a t u t e t h a t required parental consultation o r n o t i f i c a t i o n
i n e v e r y i n s t a n c e w i t h o u t a f f o r d i n g t h e p r e g n a n t minor a n o p p o r t u n i t y t o
r e c e i v e a n i n d e p e n d e n t j u d i c i a l d e t e r m i n a t i o n t h a t s h e was m a t u r e enough
t o c o n s e n t o r t h a t t h e a b o r t i o n would be i n h e r b e s t i n t e r e s t s .
The C o u r t
a l s o found u n c o n s t i t u t i o n a l a s t a t u t o r y p r o v i s i o n t h a t p e r m i t t e d j u d i c i a l
a u t h o r i z a t i o n f o r a n a b o r t i o n t o b e w i t h h e l d from a m i n o r who i s f o u n d by
t h e c o u r t t o b e m a t u r e and f u l l y competent t o make t h e d e c i s i o n w h e t h e r o r
n o t t o t e r m i n a t e h e r pregnancy independently.
However, i n a n e f f o r t t o
p r o v i d e some f u t u r e g u i d e l i n e s , t h e C o u r t , i n d i c t a , s u g g e s t e d t h a t i f a
S t a t e w i s h e d t o u s e p a r e n t a l n o t i f i c a t i o n , i t must a f f o r d t h e m i n o r t h e
option of proceeding d i r e c t l y t o court, without parental n o t i f i c a t i o n ,
w h e r e s h e must show t h a t s h e i s a m a t u r e minor o r t h a t , i f s h e i s f o u n d
n o t a b l e t o make t h e d e c i s i o n i n d e p e n d e n t l y , t h e d e s i r e d a b o r t i o n i s i n
her best interests.
Four o f t h e e i g h t j u s t i c e s o b j e c t e d t o t h i s
s u g g e s t i o n on t h e ground t h a t i t was a n a d v i s o r y o p i n i o n .
On Mar. 23, 1981, t h e C o u r t u p h e l d a Utah S t a t e l a w making i t a c r i m e
f o r d o c t o r s t o p e r f o r m a n a b o r t i o n on an u n e m a n c i p a t e d , d e p e n d e n t m i n o r
without notifying h e r parents.
I n & v. Matheson, 450 U.S. 398 ( 1 9 8 1 1 ,
a 6-3 d e c i s i o n , t h e C o u r t examined t h e n a r r o w q u e s t i o n of t h e f a c i a l

c o n s t i t u t i o n a l i t y of a s t a t u t e r e q u i r i n g a p h y s i c i a n t o g i v e n o t i c e t o
p a r e n t s , " i f p o s s i b l e , " p r i o r t o p e r f o r m i n g an a b o r t i o n on t h e i r m i n o r
d a u g h t e r , ( a ) when t h e g i r l i s l i v i n g w i t h and d e p e n d e n t upon h e r p a r e n t s ,
( b ) when s h e i s n o t e m a n c i p a t e d by m a r r i a g e o r o t h e r w i s e , and ( c ) when s h e
h a s made no c l a i m o r showing a s t o h e r m a t u r i t y o r a s t o h e r r e l a t i o n s h i p
with her parents.
The Supreme C o u r t c i t e d t h e i n t e r e s t i n p r e s e r v i n g
f a m i l y i n t e g r i t y and p r o t e c t i n g a d o l e s c e n t s i n a l l o w i n g S t a t e s t o r e q u i r e
t h a t p a r e n t s be i n f o r m e d t h a t t h e i r d a u g h t e r i s s e e k i n g a n a b o r t i o n , and
e m p h a s i z e d t h a t t h e s t a t u t e i n q u e s t i o n d i d n o t g i v e a v e t o power o v e r t h e
minor's
abortion decision.
The C o u r t r e j e c t e d t h e m i n o r woman's
c o n t e n t i o n t h a t a b o r t i o n w a s being s i n g l e d out f o r s p e c i a l t r e a t m e n t i n
c o n t r a s t t o o t h e r s u r g i c a l p r o c e d u r e s , l i k e c h i l d b i r t h , which d o n o t
require parental notice.
Thus, t h e C o u r t found t h e Utah l a w t o be
constitutional.
Advertisement of Abortion S e r v i c e s
The Supreme C o u r t h e l d i n Bigelow v. V i r g i n i a , 421 U.S. 8 0 9 ( 1 9 7 5 1 ,
t h a t a S t a t e may n o t p r o s c r i b e a d v e r t i s i n g r e g a r d i n g t h e a v a i l a b i l i t y o f
an a b o r t i o n o r - a b o r t i o n - r e l a t e d s e r v i c e s - i n a n o t h e r S t a t e .
The c o u r t
f o u n d t h a t t h e s t a t u t e i n q u e s t i o n was u n c o n s t i t u t i o n a l b e c a u s e t h e S t a t e
o f V i r g i n i a , where t h e a d v e r t i s e m e n t a p p e a r e d , had o n l y a minimal i n t e r e s t
i n t h e h e a l t h and m e d i c a l p r a c t i c e s of New York, t h e S t a t e i n which t h e
l e g a l a b o r t i o n s e r v i c e s were l o c a t e d .
A b o r t i o n s by Non-Physicians
I n C o n n e c t i c u t v. M e n i l l o , 423 U.S. 9 ( 1 9 7 5 ) , t h e Supreme C o u r t r u l e d
t h a t S t a t e s t a t u t e s s i m i l a r t o t h e Texas law c h a l l e n g e d i n R o e were
c o n s t i t u t i o n a l t o t h e e x t e n t t h a t t h e s t a t u t e s f o r b i d non-physicians from
performing a b o r t i o n s .
The R o e d e c i s i o n made i t c l e a r t h a t a S t a t e c o u l d
n o t i n t e r f e r e w i t h a woman's d e c i s i o n , made i n c o n s u l t a t i o n w i t h and upon
t h e a d v i c e of h e r d o c t o r , t o h a v e a n a b o r t i o n i n t h e f i r s t trimester o f
h e r pregnancy.
The M e n i l l o C o u r t found t h a t pre-Roe r e s t r i c t i v e a b o r t i o n
( 4 2 3 U.S. a t 9 , 1 1 . )
laws w e r e s t i l l e n f o r c e a b l e a g a i n s t n o n - p h y s i c i a n s .
A b o r t i o n s i n P u b l i c and P r i v a t e H o s p i t a l s
I n P o e l k e r v. D o e , 432 U.S. 519 ( 1 9 7 7 ) ( p e r c u r i a m ) , t h e Supreme
C o u r t h e l d t h a t t h e p o l i c y of t h e C i t y of S t . L o u i s i n r e f u s i n g t o a l l o w
t h e p e r f o r m a n c e o f n o n - t h e r a p e u t i c a b o r t i o n s i n i t s p u b l i c h o s p i t a l s , and
of s t a f f i n g t h o s e h o s p i t a l s w i t h p e r s o n n e l opposed t o t h e p e r f o r m a n c e of
abortions,
d i d n o t v i o l a t e t h e e q u a l p r o t e c t i o n c l a u s e of t h e
Constitution.
P o e l k e r , however, d i d n o t d e a l w i t h t h e q u e s t i o n of p r i v a t e
h o s p i t a l s and t h e i r a u t h o r i t y t o p r o h i b i t a b o r t i o n s e r v i c e s .
In Poelker,
t h e C o u r t d e a l t w i t h t h e r i g h t of a m u n i c i p a l i t y t o e l e c t t o p r o v i d e
publicly financed hospital services f o r c h i l d b i r t h without providing
corresponding s e r v i c e s f o r non-therapeutic abortions.
The C o u r t a p p r o v e d
t h i s practice.

The D e f i n i t i o n o f V i a b i l i t y
The
required

Supreme c o u r t ' s a r t i c u l a t i o n of t h e c o n c e p t o f v i a b i l i t y h a s
f u r t h e r elaboration, p a r t i c u l a r l y with regard t o t h e c r i t i c a l

q u e s t i o n of who d e f i n e s a t what p o i n t a f e t u s h a s r e a c h e d v i a b i l i t y .
In
Roe t h e C o u r t d e f i n e d v i a b i l i t y a s t h e p o i n t a t which t h e f e t u s i s
(
pI
o t e n t i a l l y a b l e t o l i v e o u t s i d e t h e m o t h e r ' s womb, a l b e i t w i t h
a r t i f i c i a l aid."
( 4 1 0 U.S. a t 1 6 0 . )
Such p o t e n t i a l i t y , however, must be
f o r " m e a n i n g f u l l i f e " and t h i s c a n n o t encompass s i m p l y momentary s u r v i v a l .
( 4 1 0 U.S. a t 1 6 3 . )
The C o u r t a l s o n o t e d t h a t w h i l e v i a b i l i t y i s u s u a l l y
p l a c e d a t a b o u t 28 weeks, i t c a n o c c u r e a r l i e r and e s s e n t i a l l y l e f t t h e
p o i n t f l e x i b l e f o r a n t i c i p a t e d advances i n medical s k i l l .
Finally, R o e
s t r e s s e d t h e c e n t r a l r o l e of t h e p r e g n a n t woman's d o c t o r , e m p h a s i z i n g t h a t
11
t h e a b o r t i o n d e c i s i o n i n a l l i t s a s p e c t s i s i n h e r e n t l y , and p r i m a r i l y , a
m e d i c a l d e c i s i o n . " ( 4 1 0 U.S. a t 1 6 0 . )
S i m i l a r themes w e r e s t r e s s e d i n
P l a n n e d P a r e n t h o o d o f C e n t r a l M i s s o u r i v . D a n f o r t h , 428 U.S. 52 ( 1 9 7 6 ) , i n
which a M i s s o u r i law, which d e f i n e d v i a b i l i t y a s " t h a t s t a g e of f e t a l
d e v e l o p m e n t when t h e l i f e o f t h e unborn c h i l d may be c o n t i n u e d
i n d e f i n i t e l y o u t s i d e t h e womb by n a t u r a l o r a r t i f i c i a l L i f e s u p p o r t
s y s t e m s 1 ' , was a t t a c k e d a s a n a t t e m p t t o a d v a n c e t h e p o i n t o f v i a b i l i t y t o
an e a r l i e r s t a g e o f g e s t a t i o n . The C o u r t d i s a g r e e d , f i n d i n g t h e s t a t u t o r y
I t re-emphasized t h a t v i a b i l i t y i s "a
d e f i n i t i o n consistent with R o e .
m a t t e r o f m e d i c a l judgment, s k i l l , and t e c h n i c a l a b i l i t y " and t h a t R o e
meant t o p r e s e r v e t h e f l e x i b i l i t y of t h e term. ( 4 2 8 U.S. a t 6 4 ) Moreover,
t h e D a n f o r t h C o u r t h e l d t h a t "it i s n o t t h e p r o p e r f u n c t i o n o f t h e
l e g i s l a t u r e o r t h e c o u r t s t o p l a c e v i a b i l i t y , which i s e s s e n t i a l l y a
medical concept, a t a s p e c i f i c point i n t h e g e s t a t i o n period.
The t i m e
when v i a b i l i t y i s a c h i e v e d may v a r y w i t R e a c h p r e g n a n c y ,
and t h e
d e t e r m i n a t i o n of w h e t h e r a p a r t i c u l a r f e t u s i s v i a b l e i s , and must b e , a
m a t t e r f o r t h e judgment of t h e a t t e n d i n g ~ h ~ s i c i a n . " ( 4 2 8 U.S. a t 64.)
The p h y s i c i a n ' s c e n t r a l r o l e i n d e t e r m i n i n g v i a b i l i t y , and t h e Lack of
s u c h d e f i n i t i o n a l a u t h o r i t y i n t h e l e g i s l a t u r e s and c o u r t s , was r e a f f i r m e d
by t h e C o u r t i n C o l a u t t i v. F r a n k l i n , 439 U.S. 379 ( 1 9 7 9 ) .
U.S.

Supreme C o u r t D e c i s i o n s

-- 1983 - 1987

On J u n e 1 5 , 1983, t h e U.S.
Supreme C o u r t
involving several d i f f e r e n t abortion questions.

decided

three

cases

I n C i t y o f Akron v. Akron C e n t e r f o r R e p r o d u c t i v e H e a l t h , I n c . , 462
U.S. 4 1 6 , ( h e r e i n a f t e r r e f e r r e d t o a s C i t y o f Akron), t h e Supreme C o u r t i n
a 6-3 v o t e d e c l a r e d t h a t f i v e s e c t i o n s of t h e Akron o r d i n a n c e r e s t r i c t i n g
t h e r i g h t of a woman t o an a b o r t i o n were u n c o n s t i t u t i o n a l .
They p r o v i d e d :
(1)

(2)
(3)

(4)

(5

t h a t a f t e r t h e f i r s t t r i m e s t e r of p r e g n a n c y , a l l a b o r t i o n s
be performed i n a h o s p i t a l ;
t h a t t h e r e be n o t i f i c a t i o n o f c o n s e n t by p a r e n t s
b e f o r e a b o r t i o n s may be performed on u n m a r r i e d m i n o r s ;
t h a t t h e a t t e n d i n g p h y s i c i a n make c e r t a i n s p e c i f i e d
statements t o t h e p a t i e n t so t h a t the r e s u l t i n g consent f o r
an a b o r t i o n would amount t o informed c o n s e n t ;
t h a t t h e r e b e a 24-hour w a i t i n g p e r i o d between t h e t i m e t h e
p a t i e n t s i g n s t h e c o n s e n t form and when t h e p h y s i c i a n
p e r f o r m s t h e a b o r t i o n ; and
t h a t f e t a l r e m a i n s be d i s p o s e d o f i n a "humane and s a n i t a r y
manner .I1

I n s t r i k i n g down a l l of t h e s e s e c t i o n s o f t h e Akron o r d i n a n c e a s
b e i n g v i o l a t i v e of t h e U.S. C o n s t i t u t i o n , t h e C o u r t a t t h e v e r y o u t s e t
r e a f f i r m e d i t s 1973 d e c i s i o n , Roe v. ,-W
410 U.S. 113, and p r o c e e d e d t o
a n a l y z e e a c h s e c t i o n of t h e Akron o r d i n a n c e w i t h i n t h e t r i m e s t e r framework
e s t a b l i s h e d by t h a t r u l i n g .
During t h e f i r s t trimester, a woman must be
f r e e i n c o n s u l t a t i o n w i t h h e r d o c t o r t o reach a d e c i s i o n t o have an
a b o r t i o n absent governmental i n t e r f e r e n c e .
I n C i t y of Akron, t h e C o u r t
d o e s p o i n t o u r t h a t a S t a t e may e n a c t some r e g u l a t i o n a p p l i c a b l e t o t h e
f i r s t trimester of p r e g n a n c y , b u t i t c a n n o t h a v e a s i g n i f i c a n t i m p a c t on
t h e woman's r i g h t t o d e c i d e t o t e r m i n a t e h e r pregnancy and must be
j u s t i f i e d by i m p o r t a n t S t a t e h e a l t h o b j e c t i v e s . The i m p o r t a n t p o i n t conc e r n i n g S t a t e r e g u l a t i o n i n t h e f i r s t t r i m e s t e r i s t h a t t h e r e be n o i n t e r f e r e n c e w i t h ( 1 ) d o c t o r - p a t i e n t c o n s u l t a t i o n , o r ( 2 ) t h e woman's c h o i c e
between a b o r t i o n and c h i l d b i r t h .
( C i t y of Akron, 462 U.S. a t 429-430.)
The c h a l l e n g e d Akron o r d i n a n c e p r o v i s i o n r e l a t i n g t o where a b o r t i o n s
c a n be performed p e r t a i n s s p e c i f i c a l l y t o second t r i m e s t e r a b o r t i o n s . The
r e q u i r e m e n t s t a t e d t h a t any second t r i m e s t e r a b o r t i o n had t o b e p e r f o r m e d
in a full-service hospital.
The a c c r e d i t a t i o n of t h e s e f a c i l i t i e s
r e q u i r e d c o m p l i a n c e w i t h comprehensive s t a n d a r d s g o v e r n i n g a n e x t e n s i v e
v a r i e t y o f h e a l t h and s u r g i c a l s e r v i c e s .
The r e s u l t was t h a t a b o r t i o n s
u n d e r t h i s s e c t i o n o f t h e Akron o r d i n a n c e c o u l d n o t b e p e r f c r m e d i n
o u t p a t i e n t e n t i t i e s t h a t were n o t p a r t of a n a c u t e - c a r e , f u l l s e r v i c e
hospital.
The C o u r t found t h i s r e s t r i c t i o n u n c o n s t i t u t i o n a l .
The C o u r t
noted t h a t t h e p o s s i b i l i t y of having t o t r a v e l t o f i n d f a c i l i t i e s could
r e s u l t i n b o t h f i n a n c i a l e x p e n s e and added r i s k t o a woman's h e a l t h .
(Id.
a t 4 3 5 . ) The Court a l s o c i t e d changed m e d i c a l c i r c u m s t a n c e s , and t h e
a v a i l a b i l i t y o f s a f e r p r o c e d u r e s f o r p e r f o r m i n g second trimester a b o r t i o n s
s i n c e R o e , f o r i t s c o n c l u s i o n t h a t t h e Akron h o s p i t a l i z a t i o n r e q u i r e m e n t
imposed a n u n r e a s o n a b l e burden on a woman's r i g h t t o a n a b o r t i o n .
The C o u r t a l s o i n v a l i d a t e d t h e p r o v i s i o n i n t h e Akron o r d i n a n c e which
p r o h i b i t e d a d o c t o r from p e r f o r m i n g a n a b o r t i o n on a n u n e m a n c i p a t e d m i n o r
u n l e s s t h e d o c t o r o b t a i n e d " t h e informed w r i t t e n c o n s e n t of o n e of h e r
p a r e n t s o r h e r l e g a l g u a r d i a n " o r u n l e s s t h e minor h e r s e l f o b t a i n e d "an
o r d e r f r o m a c o u r t h a v i n g j u r i s d i c t i o n o v e r h e r t h a t h e r a b o r t i o n be
performed o r induced."
( I d . a t 439.)
The C o u r t r e l i e d o n i t s e a r l i e r
r u l i n g s i n D a n f o r t h and B e l l o t t i I1 t o c o n c l u d e t h a t t h e C i t y of Akron
c o u l d "not make a b l a n k e t d e t e r m i n a t i o n t h a t a l l m i n o r s u n d e r t h e a g- e of
15 a r e t o o i m a t u r e t o make t h i s d e c i s i o n o r t h a t a n a b o r t i o n n e v e r may be
i n t h e m i n o r ' s b e s t i n t e r e s t s without p a r e n t a l approval."
( I d . a t 440.)
(Emphasis i n o r i g i n a l t e x t ) .
Moreover, t h e Akron o r d i n a n c e ' s p r o v i s i o n
concerning parental approval did not c r e a t e expressly t h e a l t e r n a t i v e
j u d i c i a l p r o c e d u r e r e q u i r e d by B e l l o t t i 11. Thus, t h e Akron o r d i n a n c e ' s
c o n s e n t p r o v i s i o n had t o f a l l b e c a u s e i t f o r e c l o s e d a n y p o s s i b i l i t y f o r
'I
case-by-case e v a l u a t i o n s o f t h e m a t u r i t y of p r e g n a n t minors."
(Id. a t
441, q u o t i n g B e l l o t t i 11, 443 U.S., a t 643, n. 2 3 ( p l u r a l i t y o p i n i o n ) . )
I n C i t y of Akron, t h e Supreme Court a l s o s t r u c k down t h e i n f o r m e d
w r i t t e n c o n s e n t s e c t i o n of t h e o r d i n a n c e .
This provision required t h a t
t h e a t t e n d i n g d o c t o r i n f o r m t h e woman "of t h e s t a t u s o f h e r p r e g n a n c y , t h e
development of h e r f e t u s , t h e d a t e o f p o s s i b l e v i a b i l i t y , t h e p h y s i c a l and
e m o t i o n a l c o m p l i c a t i o n s t h a t may r e s u l t from a n a b o r t i o n , and t h e

a v a i l a b i l i t y o f a g e n c i e s t o p r o v i d e h e r w i t h a s s i s t a n c e and i n f o r m a t i o n
w i t h r e s p e c t t o b i r t h c o n t r o l , a d o p t i o n , and c h i l d b i r t h . "
( I d . a t 442.)
The a t t e n d i n g p h y s i c i a n was a l s o r e q u i r e d t o t e l l t h e p a t i e n t o f t h e
r i s k s i n v o l v e d and a n y o t h e r i n f o r m a t i o n which i n t h e p h y s i c i a n ' s m e d i c a l
judgment would b e c r i t i c a l t o h e r d e c i s i o n o f w h e t h e r t o t e r m i n a t e t h e
pregnancy.
The C o u r t found t h i s informed c o n s e n t r e q u i r e m e n t t o be
c o n s t i t u t i o n a l l y u n a c c e p t a b l e b e c a u s e i t e s s e n t i a l l y g a v e t h e government
u n r e v i e w a b l e a u t h o r i t y o v e r what i n f o r m a t i o n was t o b e g i v e n a woman
b e f o r e s h e d e c i d e d w h e t h e r t o have an a b o r t i o n .
I n C i t y of Akron, t h e
C o u r t found t h a t t h e c i t y ' s r e g u l a t i o n c o n c e r n i n g i n f o r m e d c o n s e n t
exceeded p e r m i s s i b l e l i m i t s .
( I d . a t 444-445.)
I n a d d i t i o n , i t was a l s o
o b j e c t i o n a b l e b e c a u s e i t i n t r u d e d upon t h e d i s c r e t i o n of t h e p r e g n a n t
woman's d o c t o r .
( I d . a t 445.)
I n C i t y of Akron, t h e Supreme C o u r t a l s o c h o s e t o i n v a l i d a t e t h e 24hour w a i t i n g period.
( I d . a t 449.)
The C o u r t found t h a t t h e C i t y o f
Akron had n o t shown t h a t a n y l e g i t i m a t e s t a t e i n t e r e s t was b e i n g s e r v e d
I'
by a n a r b i t r a r y and i n f l e x i b l e w a i t i n g p e r i o d . "
( I d . a t 450.)
F i n a l l y , t h e C o u r t r u l e d t h a t t h e p o r t i o n of t h e Akron o r d i n a n c e
r e q u i r i n g t h a t physicians performing a b o r t ions s e e t o i t t h a t t h e remains
of t h e unborn c h i l d be d i s p o s e d " i n a humane and s a n i t a r y M way was v o i d
f o r vagueness.
The l e v e l of u n c e r t a i n t y p r e s e n t was u n a c c e p t a b l e i n a
s i t u a t i o n s u c h a s t h i s where t h e r e was t h e p r o s p e c t of c r i m i n a l l i a b i l i t y
b e i n g imposed.
( I d . a t 451.) T h i s p r o v i s i o n v i o l a t e d t h e Due P r o c e s s
Clause.
J u s t i c e O ' c o n n o r w r o t e a d i s s e n t i n which s h e was j o i n e d by J u s t i c e s
The d i s s e n t i n g o p i n i o n b a s i c a l l y t o o k i s s u e w i t h t h e
W h i t e and R e h n q u i s t .
t r i m e s t e r framework i n R o e v. W a d e .
I n P l a n n e d P a r e n t h o o d A s s o c i a t i o n of Kansas C i t y , M i s s o u r i , I n c . v.
A s h c r o f t , 462 U.S. 4 7 6 , ( h e r e i n a f t e r r e f e r r e d t o a s A s h c r o f t ) , t h e Supreme
C o u r t i n v a l i d a t e d M i s s o u r i ' s second t r i m e s t e r h o s p i t a l i z a t i o n r e q u i r e m e n t
by t h e same 6-3 v o t e a s i n C i t y of Akron; however, t h e C o u r t v o t e d 5-4 t o
u p h o l d t h r e e o t h e r s e c t i o n s of t h a t M i s s o u r i law.
The s t a t u t o r y
p r o v i s i o n s c h a l l e n g e d on c o n s t i t u t i o n a l g r o u n d s :
(1)

(2)

(3)
(4)

r e q u i r e d t h a t a f t e r 12 weeks o f p r e g n a n c y , a b o r t i o n s b e
performed i n a h o s p i t a l ;
mandated t h a t t h e r e be a p a t h o l o g y r e p o r t f o r e a c h a b o r t i o n
performed;
r e q u i r e d t h e p r e s e n c e o f a second p h y s i c i a n d u r i n g
a b o r t i o n s t h a t a r e performed a f t e r v i a b i l i t y ; and
r e q u i r e d t h a t minors o b t a i n p a r e n t a l consent o r c o n s e n t
from t h e j u v e n i l e c o u r t f o r a n a b o r t i o n .

With r e s p e c t t o t h e r e q u i r e m e n t t h a t a l l s e c o n d t r i m e s t e r a b o r t i o n s b e
p e r f o r m e d i n a f u l l s e r v i c e h o s p i t a l , t h e Supreme C o u r t h e l d t h a t i t s
d e c i s i o n and r a t i o n a l e f o r i n v a l i d a t i n g s u c h r e q u i r e m e n t i n C i t y o f Akron
was c o n t r o l l i n g .
( A s h c r o f t , 462 U.S. a t 481-482.)

'

The Court, however, found that the second-physician requirement
during rhe third trimester in Ashcroft was permissible under the
Constitution because i t "reasonably furthers the State's compelling
interest in protecting the lives of viable fetuses..."
(Id. at 486.)
The Court also upheld the pathology report requirement.
This
provision was "related to generally accepted medical standards" and
"further(s) important health-related State concerns."
(Ashcroft at 487,
quoting City of Akron at 430.) The Court further found that the cost of
the tissue examination "does not significantly burden a pregnant women's
abortion decision.'' (Id. at 490.)
The Court also upheld Missouri's parental consent requirement. (Id.
at 490-493.)
It distinguished the provision involved here from that
challenged in the City of Akron case. The Missouri requirement, unlike
the Akron one, did provide an alternative procedure by which a pregnant
immature minor could show in court that she was sufficiently mature to
make the abortion decision herself or that, despite her immaturity, an
abortion would be in her best interests.
In Ashcroft, Justice Blackmun wrote a separate opinion concurring in
the judgment invalidating the hospital requirement for all second
trimester abortions but dissenting with respect to the court's other
findings upholding the remaining provisions in question in the Missouri
law. He was joined by Justices Brennan, Marshall and Stevens.
Justice O'Connor, joined by Justices White and Rehnquist, concurred
in part and dissented in part. Justice O'connor emphasized that for the
same reasons she dissented in City of Akron regarding the hospital
requirement for second trimester abortions, she dissented here.
They
concurred with respect to the court's upholding the other sections of the
Missouri Law: the second-physician requirement, pathology report
requirement, and parental consent provision.
However, they used a
different rationale, one that did not utilize the trimester framework of
Roe v. .&W
'

In Simopoulos v. Virginia, 462 U.S. 506, (hereinafter referred to as
Simopoulos), the Supreme Court in an 8-1 decision ruled that Virginia's
mandatory hospitalization requirement for second trimester abortions is
constitutional. As in City of Akron and Ashcroft, Justice Powell wrote
the opinion for the Court.
Justice Stevens dissented.
The Court
distinguished the requirement in quest ion in Virginia from those it
invalidated in City of Akron and Ashcroft. The determination upholding
the Virginia provision actually turned on the definition of "hospital."
Justice O'Connor wrote a separate concurrence joined by Justices
Rehnquist and White.
Her reasoning, however, was not based on the
She stated: "Rather, I believe that
trimester framework of Roe v. W a d e .
the requirement in this case is not an undue burden on the decision to
undergo an abortion." (O'Connor, Concurrence, at 520.)
In summary, the 1983 Supreme Court decisions in City of Akron,
Ashcroft, and Simopoulos settled questions relating to hospital
requirements for second trimester abortions, informed consent

requirements, waiting periods, parental notification and consent, and
disposal of fetal remains. The Supreme Court reaffirmed its decision in
R o e v. Wade and its intention to continue to follow the trimester
framework balancing a woman's constitutional right to decide whether to
terminate a pregnancy with the State's interest in protecting potential
life.
The state's interest in protecting potential life becomes
11
compelling" at the point of viability, i.e., when the fetus can exist
outside of a woman's womb either on its own or through artificial means.
The definition of viability is the one used by the Court in its R o e v.
- decision in 1973.
Wade
For the Court's most recent reaffirmation of
v. Wade, see also
Thornburgh v. American College of Obstetricians and Gynecologists, 106
S.Ct. 2169 (1986).
In Diamond v. Charles, 106 S.Ct. 1697 (19861, the
Court avoided ruling on the substantive issues involved by finding that
the appellant pediatrician lacked standing to bring the action.
On Dsc. 14, 1987, an equally divided Supreme Court, without opinion,
let stand a 7th Circuit court of appeals decision invalidating an Illinois
law that would have restricted the right of teenagers to have abortions by
requiring them to notify their parents ( ~ a r t i ~ av.
n Zbaraz, 56 U.S.L.W.
4053).
The tie vote means that the ruling sets no nationwide precedent.
There are other States with parental notification laws similar to the one
in Illinois.
Thus, the Supreme Court may have another opportunity to
review the issue in the future.

FOR ADDITlONAL READING
U.S.

Library of Congress.
Congressional Research Service.
Abortion:
[Washington] 1988.
Legislative control [by] Thomas P. Carr.
(updated regularly)
CRS Issue Brief 88007

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/crs%3AIB88006. Public record. Not legal advice.