Abortion in Alabama is illegal. Historically, Alabama's abortion laws have evolved from strict regulations in the late 19th and early 20th centuries to a period of liberalization following the landmark 1973 Supreme Court decision in Roe v. Wade, which legalized abortion nationwide. However, Alabama has consistently enacted legislation aimed at restricting access to the abortion.
In May 2019, Alabama passed one of the nation's most restrictive abortion laws, the Human Life Protection Act. This law sought to ban most abortions at any stage of pregnancy, with no exceptions for cases of rape or incest, only allowing abortions if there was a serious health risk to the mother.ref name="2022 law"> The law was granted an injunction until June 2022 when the U.S. Supreme Court overturned Roe v. Wade in Dobbs v. Jackson Women's Health Organization, allowing the Act to go into effect. The remaining three abortion clinics in the state were ordered to cease operating.
Abortion regulations in Alabama also include mandatory waiting periods, parental consent requirements for minors, and stringent guidelines for abortion clinics that many advocates argue are designed to limit the availability of abortion services in the state. In 2024, the Alabama Supreme Court ruled that frozen embryos should be considered children. The Constitution of Alabama explicitly bans the legal recognition of abortion.
Abortion remains a divisive issue in Alabama, with a 2014 survey by Pew Research Center concluding that 58% of surveyed adults in the state believe abortion should be illegal in most or all cases, and 37% indicating it should be legal. A strong correlation was observed between the opposition to abortion and conservative political views. The 2023 American Values Atlas reported that, in their most recent survey, 54% of Alabamians said that abortion should be legal in all or most cases.
History In Alabama between 1892 and 1935, there were 40 prosecutions and five convictions of women having abortions.
Legislative history
By the end of the 1800s, all states in the nation except Alabama had therapeutic exceptions in their legislative bans on abortions. In the 19th century, bans by state legislatures on abortion targeted protecting the life of the mother given the number of deaths abortions caused.
By the end of 1972, Mississippi allowed abortion only in cases of rape or incest, Alabama and Massachusetts allowed abortions only in cases where the woman's physical health was endangered. In order to obtain an abortion during this period, women would often travel from a state where abortion was illegal to states where it was legal.
Judicial history The 1973 Supreme Court of the United States's decision in the Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester.
A 2016 Alabama law banned dilation & evacuation (D&E) which is the most common abortion procedure used in the second trimester. In August 2018, the Eleventh Circuit court ruled the D&E legislation to be unconstitutional, blocking it from enforcement. The US Supreme Court refused to hear an appeal in its 2019 term.
On February 6, 2019, Ryan Magers filed a wrongful death lawsuit against an abortion clinic, Alabama Women's Center, after his girlfriend had a then-legal elective abortion in January 2017. Magers also sued three employees of the clinic and the pharmaceutical company that manufactured the medication used to induce the abortion. Madison County Probate Judge Frank Barger recognized the status of the unborn fetus as a person on March 4, 2019, in accepting the case.
In May 2019, Planned Parenthood and the American Civil Liberties Union both said they would challenge Alabama's recently-enacted abortion ban in the federal courts. In June 2019, it was reported that a woman, Marshae Jones, whose pregnancy was terminated after she was shot in the stomach in 2018 during a fight was arrested on grounds of manslaughter of the fetus, though the case was eventually dismissed.
On February 16, 2024, the Alabama Supreme Court ruled that frozen embryos used for in vitro fertilisation should be considered children. The UAB Hospital and other providers ended their IVF treatments in response. This is because couples are now allowed to create a lawsuit for the wrongful death of their embryos. This ruling raises questions about the status of frozen embryos, including whether they can be destroyed and the implications for pre-implantation genetic testing. The decision also intersects with broader debates around abortion and reproductive technology. On October 7, 2024, the United States Supreme Court declined to review the case.
In 2025, a federal judge ruled that the Alabama state's attorney general cannot prosecute people or organizations who help Alabama residents seek an abortion by traveling to another state.
Clinic history
Between 1982 and 1992, the number of abortion clinics in Alabama decreased by 25 clinics, going from 45 in 1982 to 20 in 1992. In 2014, there were five abortion clinics, and 93% of the counties in the state did not have any clinics, leaving 59% of women in the state aged 15–44 without access to a local abortion clinic as of that year. In 2017, there were two Planned Parenthood clinics, both of which offered abortion services, in Alabama which at the time had a population of 1,117,288 women aged 15–49.
In March 2019, there were five abortion clinics in Alabama, all of which were located in urban areas Birmingham, Huntsville, Tuscaloosa, Mobile and Montgomery. Of the five clinics operating in March 2019, one was only open on weekends.
In 2019, the Yellowhammer Fund provided financial assistance (paying for their abortions) to women at three abortion clinics in Alabama. In May and June of that year, Alabama's abortion clinics were receiving regular calls from women inquiring whether they could obtain a legal abortion as legislative changes resulted in confusion over abortion rights in the Alabama.
As of 2021, only three abortion clinics remained in Alabama: West Alabama Women's Center in Tuscaloosa, Reproductive Health Services in Montgomery, and Alabama Women's Center in Huntsville. Currently, Alabama restricts advertising of abortion clinics. In order for abortion clinics in Alabama to remain in business at that time, they had to abide by abortion-care policies. Alabama passed additional medically unnecessary codes, and required that they be followed in order to operate an abortion clinic. In some cases codes were passed to target specific clinics; for example, a 2016 law was enacted that prohibited abortion clinics from renewing their current license if the clinic was within 2,000 feet of an elementary or middle school to target a specific clinic. Clinics must have access to a hospital in the same geographical area as the abortion facility.
As of 2022, Alabama's three remaining abortion clinics have been ordered to stop all abortion procedures.
Alabama and cardiogenesis In 2006, Alabama was one of 23 states to have a detailed abortion-specific informed consent requirement. By law, abortion providers in Alabama, Louisiana and Mississippi were required to perform an ultrasound prior to providing women with an abortion, despite that an ultrasound in the first trimester has no medical necessity. In 2013, state Targeted Regulation of Abortion Providers (TRAP) law applied to medication induced abortions and private doctors' offices in addition to abortion clinics.
Alabama was one of five states nationwide that tried, and failed, to pass a so-called 'fetal heartbeat bill'The American College of Obstetricians and Gynecologists states that:They also argue that the term 'fetal heartbeat' should be replaced with:ACOG Guide to Language and Abortion in 2014. House Bill 490 prohibiting abortions once a cardiogenesis or "fetal heartbeat" is detected passed the Lower House (73–29) on March 4, 2014. The bill later died in committee. Despite this, Alabama's Lower House was the first state in the nation to pass such a bill. The Alabama state legislature tried and failed in 2015, 2016, and 2017 to pass a fetal heartbeat bill, each time being joined by two, three, and seven other states respectively.
As of March 2019, the law required women wait 24 hours after their initial consult before they could obtain a second appointment for the actual procedure. State law at the time prohibited state-funded health insurance companies from offering abortion services unless the life of the woman was at risk, or the pregnancy was a result of rape or incest.
One of the most active years for state legislatures in terms of trying to pass abortion rights restrictions was 2019. State governments with Republican majorities began to push these bills after conservative Supreme Court candidate Brett Kavanaugh was confirmed as a US Supreme Court judge, replacing the more liberal Anthony Kennedy. These state governments generally saw this as a positive sign that new moves to restrict abortion rights would face less resistance from the courts.
The Alabama Human Life Protection Act The most recent act relating to the abortion in Alabama is "The Alabama Human Life Protection Act" also known as the Human Life Protection Act. Formally, the act has the name of House Bill 314. The bill was drafted by the Alabama Pro-Life Coalition. The bill, which banned abortions at every stage of pregnancy and made it a crime for doctors to perform the procedure (except in the case of a medical emergency), was introduced into the Lower House on April 2, 2019. The bill passed the Lower House on April 30, the Senate on May 14, and was signed into law by then-Governor Kay Ivey on May 15, 2019.
Formerly, abortion was allowed in cases of incest or rape. With the introduction of the Human Life Protection Act, these cases were no longer exempt. Additionally, cases in which mothers faced mental illness were declared insufficient to provide an exception. These restrictions made the bill one of the most aggressive anti-abortion laws in American history. Although the bill was approved by Alabama legislators, then-Governor Kay Ivey recognized that its aggressiveness would most likely not be approved in the federal court due to Roe v. Wade. Despite this, Alabama legislators hoped the introduction of the bill could weaken pre-existing abortion protections.
Shortly after the introduction of the Human Life Protection Act, Planned Parenthood and ACLU of Alabama filed a lawsuit to challenge the anti-abortion bill on May 24, 2019. Serving as plaintiffs to the case were the three remaining abortion clinics in Alabama: Alabama Women's Center, Reproductive Health Services, and the West Alabama Women's Center.
The controversial bill was set to go into effect on November 15, 2019. However, on October 29, 2019, the bill was blocked by the federal court. US District Judge Myron Thompson granted a preliminary injunction on October 28, 2019, until the court was able to resolve the case in full. Federal judge Myron H. Thompson declared the bill defied previous rulings seen in Roe v. Wade and the U.S. Constitution. Furthermore, Judge Thompson expressed that the bill could cause "serious and irreparable harm", referring to the Planned Parenthood Southeast v. Strange lawsuit from 2014 that identified a near-total ban as adding a financial burden to women and their need to access abortion services. As a result of this need, women are more likely to take unsafe measures to end pregnancies. Judge Thompson lifted the injunction after the Supreme Court overturned Roe v. Wade on June 24, 2022, allowing the law to go into effect.
Statistics
Between 1972 and 1974, Alabama had an illegal abortion mortality rate of 0.1 and 0.9 per million women aged 15–44. In 1990, 456,000 women in the state faced the risk of an unintended pregnancy. In 2010, the state had nine publicly-funded abortions, none of which were federally or state funded.