In the United States, abortion is a divisive issue in politics and culture wars. Prior to the mid-19th century, English common law formed the basis of abortion law in the colonies and the early Republic.
Connecticut was the first state to regulate abortion in 1821; it outlawed abortion after quickening, the moment in pregnancy when the pregnant woman starts to feel the fetus's movement in the uterus, and forbade the use of poisons to induce one post-quickening. Many states subsequently passed various laws on abortion until the Supreme Court of the United States decisions of Roe v. Wade and Doe v. Bolton decriminalized abortion nationwide in 1973. The Roe decision imposed a federally mandated uniform framework for state legislation on the subject. It also established a minimal period during which abortion is legal, with more or fewer restrictions throughout the pregnancy.
That basic framework, modified in Planned Parenthood v. Casey (1992), remained nominally in place, although the effective availability of abortion varied significantly from state to state, as many counties had no abortion providers. Planned Parenthood v. Casey held that a law could not place legal restrictions imposing an "undue burden" for "the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus."Casey, 505 U.S. at 877. In December 2021, the FDA legalized telemedicine provision of medication abortion pills with delivery by mail, but many states have laws which restrict this option.
In 2022, Roe and Casey were overturned in Dobbs v. Jackson Women's Health Organization, ending federal protection of abortion rights and allowing individual states to regulate any aspect of abortion not preempted by federal law. Since 1976, the Republican Party has generally sought to restrict abortion access based on the stage of pregnancy or to criminalize abortion, whereas the Democratic Party has generally defended access to abortion and has made contraception easier to obtain.
The abortion-rights movement advocates for patient choice and bodily autonomy, while the anti-abortion movement advocate that the fetus has a right to live. Historically framed as a debate between the pro-choice and pro-life labels, most Americans agree with some positions of each side. Support for abortion gradually increased in the U.S. beginning in the early 1970s, and stabilized during the 2010s. The abortion rate has continuously declined from a peak in 1980 of 30 per 1,000 women of childbearing age (15–44) to 11.3 by 2018. In 2018, 78% of abortions were performed at 9 weeks or less gestation, and 92% of abortions were performed at 13 weeks or less gestation. By 2023, medication abortions accounted for 63% of all abortions. Almost 25% of women will have had an abortion by age 45, with 20% of 30 year olds having had one. In 2019, 60% of women who had abortions were already mothers, and 50% already had two or more children. Increased access to birth control has been statistically linked to reductions in the abortion rate. The first state to decriminalize abortion prior to Roe was Hawaii.
As of 2025, Arizona, California, Colorado, Maryland, Michigan, Missouri, Montana, New York, Ohio, Vermont have explicitly enshrined a right to abortion in their state constitutions, while in Alaska, Illinois, Kansas, Minnesota and Wyoming court rulings have enshrined such protections.The Guardian, Tracking abortion laws across the United States, 1 May 2024 Other states, such as Massachusetts and Oregon, protect abortion under state law. The state constitutions of Alabama, Arkansas, Louisiana, Tennessee, and West Virginia explicitly contain no right to an abortion, while the state constitution of Nebraska prohibits abortion after the first trimester.
Terminology
In medical parlance, "abortion" refers only to the end of an intrauterine pregnancy before the embryo or fetus can survive outside the uterus. This is inclusive of spontaneous abortion (more commonly referred to as miscarriage or early pregnancy loss) and to induced abortion, where a pregnancy is ended through medication or a medical procedure. The abortion debate most commonly relates to the induced abortion of a pregnancy, which is also how the term "abortion" is used in a legal sense.
Because abortion has been politicized, there has been a proliferation of ill-defined, inconsistently applied terms with no medical or clinical basis. Concepts like "late-term abortion", or "partial-birth abortion" are not medical terms and do not have clinical significance. Similarly, terms like "elective abortion" append unnecessary qualifiers that are not rooted in medical or legal distinctions. The American College of Obstetricians and Gynecologists recommends using the terms "induced abortion" or simply "abortion" instead. Additionally, some drugs that do not induce medical abortions, such as levonorgestrel, have been referred to as abortifacients by a US Senator.
History
Early history and rise of anti-abortion legislation Abortion in what eventually became the United States was governed by English Common law, which held that abortion after quickening was murder. This was repeated by Henry de Bracton, Matthew Hale, and William Blackstone. The common law on abortions before quickening was varying.
Some historians argue that abortion was a fairly common practice in the history of the United States, and was not always controversial. At a time when society was more concerned with the more serious consequence of women becoming pregnant out of wedlock, family affairs were handled out of public view. Abortion did not become a public controversy until the health risk of unsafe abortions by (female) unlicensed practitioners was brought to the public attention in the 19th century. James Mohr wrote that even though pre-quickening abortion was legal in the first three decades of the 19th century, only 1 in 25 to 1 in 30 pregnancies ended in abortion. By the 1850s and 1860s, this number had increased to 1 in 5 or 1 in 6. John Keown highlighted some challenges in pinning down the common law view, observing that "evidence of quickening would clearly facilitate prosecution".
In the mid-18th century, Benjamin Franklin included a recipe for an abortifacient in a math textbook. In 1728, Franklin condemned publisher Samuel Keimer for publishing an article on abortion. According to biographer Walter Isaacson, Franklin did not have a strong view on the issue. In The Speech of Polly Baker, Franklin places the blame for abortion and infanticide on the sexual double standard against women. He stated:
Forgive me Gentlemen, if I talk a little extravagantly on these Matters; I am no Divine: But if you, great Men, must be making Laws, do not turn natural and useful Actions into Crimes, by your Prohibitions. Reflect a little on the horrid Consequences of this Law in particular: What Numbers of procur'd Abortions! and how many distress'd Mothers have been driven, by the Terror of Punishment and public Shame, to imbrue, contrary to Nature, their own trembling Hands in the Blood of their helpless Offspring! Nature would have induc'd them to nurse it up with a Parent's Fondness. 'Tis the Law therefore, 'tis the Law itself that is guilty of all these Barbarities and Murders. Repeal it then, Gentlemen; let it be expung'd for ever from your Books: And on the other hand, take into your wise Consideration, the great and growing Number of Batchelors in the Country, many of whom, from the mean Fear of the Expense of a Family, have never sincerely and honourably Courted a Woman in their Lives; and by their Manner of Living, leave unproduced (which I think is little better than Murder) Hundreds of their Posterity to the Thousandth Generation. Is not theirs a greater Offence against the Public Good, than mine? Compel them then, by a Law, either to Marry, or pay double the Fine of Fornication every Year.
In 1716, New York passed an ordinance prohibiting midwives from providing abortion. Founding Father and Second President of the United States John Adams praised the Spartan lawgiver Lycurgus for refusing his sister-in-law from having an abortion even though it prevented him from assuming power. Thomas Jefferson wrote approving of a quote by Montesquieu that "‘there is among savages another custom . . . it is the cruel practice of abortion." Jefferson added that the Natives stopped the practice after becoming "civilized".
Within the context of a sex scandal, Connecticut became the first state to regulate abortion by statute in 1821. Many states subsequently passed various abortion laws. In 1829, New York made post-quickening abortions a felony and pre-quickening abortions a misdemeanor. This was followed by 10 of the 26 states creating similar restrictions within the next few decades, in particular by the 1860s and 1870s. The first laws related to abortion were made to protect women from real or perceived risks, and those more restrictive penalized only the provider. Criminalization did not end the practice of abortion; unlicensed doctors and midwives continued to perform them. Most of the women receiving abortions from unlicensed practitioners were poor. Women's safety continued to be a concern, especially after the highly publicized death of Mary Rogers. Wealthier women could pay willing physicians to broadly interpret health exceptions in their favor. Euphemistic advertisements for abortifacients offered an assortment of herbal remedies.
A number of other factors likely played a role in the rise of anti-abortion laws. As in Europe, abortion techniques advanced starting in the 17th century, and the conservatism of most in the medical profession with regards to sexual matters prevented the wide expansion of abortion techniques. Physicians, who were the leading advocates of abortion criminalization laws, appear to have been motivated at least in part by advances in medical knowledge. Science had discovered that fertilization inaugurated a more or less continuous process of development, which produced a new human being. Quickening was found to be not more or less crucial in the process of gestation than any other step. Many physicians concluded that if society considered it unjustifiable to terminate pregnancy after the fetus had quickened, and if quickening was a relatively unimportant step in the gestation process, then it was just as wrong to terminate a pregnancy before quickening as after quickening. Patricia Cline Cohen, a professor emeritus at the University of California, Santa Barbara, said that these laws had come about not because society saw abortion as a crime but from a small group of doctors who had taken it upon themselves to prove to the rest of the county that pre-quickening abortion should be seen as a crime. The doctors used flawed math to convince the American Medical Association to accept that pre-quickening abortion should also be outlawed, leading to the raft of state laws banning abortion in the latter half of the 19th century. Doctors were also influenced by practical reasons to advocate anti-abortion laws. For one, abortion providers were usually female midwives without formal training or education. In an age where the leading doctors in the nation were attempting to standardize the medical profession, these unlicensed practitioners were considered a nuisance to public health.