In every region of the world, individuals and governments have grappled with the ethical, social, medical, and religious problems created by abortion. For most women in the world, abortions are available on demand within the first trimester, and this is particularly so in North America, Europe and Asia. After the first trimester abortion laws generally become more strict. In South America, Africa and Southeast Asia, abortions are generally illegal, with exceptions often recognized where the woman’s life in is danger, or in cases of rape.


Common Types of Abortion Procedures

First Trimester. The vast majority of abortions take place in the first trimester. Early in the first trimester, drugs such as RU-486 (mifepristone) may be used to terminate pregnancy. Otherwise, the most common type of first-trimester abortion is vacuum aspiration, also called suction curettage, in which the doctor uses suction to extract the embryo from the uterus.

Second Trimester. The most common abortion procedure in the second trimester is known as dilation and evacuation, or “D&E.” In essence, the doctor dilates the cervix, dismembers the fetus while still in the uterus, and then removes all of the parts. In one controversial variation of D&E, the fetus is removed intact or nearly intact through the cervix. Within the medical community this last procedure is referred to variously as “intact D&E,” “dilation and extraction,” “D&X,” or “intact D&X.” The fetus is killed while partly past the woman’s cervix, hence the procedure is often referred to as a “partial-birth abortion.”

The Test of Constitutionality under U.S. Law

In 1973, the U.S. Supreme Court first held that a right to have an abortion was protected by the U.S. Constitution, in Roe v. Wade. While the legal test articulated in Roe has since been jettisoned by the Court, its “essential holding” has been reaffirmed. That holding has been summarized as having three parts:

First is a recognition of the right of the woman to choose to have an abortion before viability and to obtain it without undue interference from the State. Before viability, the State’s interests are not strong enough to support a prohibition of abortion or the imposition of a substantial obstacle to the woman’s effective right to elect the procedure. Second is a confirmation of the State’s power to restrict abortions after fetal viability, if the law contains exceptions for pregnancies which endanger the woman’s life or health. And third is the principle that the State has legitimate interests from the outset of the pregnancy in protecting the health of the woman and the life of the fetus that may become a child. These principles do not contradict one another; and we adhere to each.

Specific Restrictions Ruled Upon by the Supreme Court

Spousal Notification. Applying the “substantial obstacle” standard described above, the Supreme Court overturned a state spouse-notification law in 1992.

Partial-Birth Abortions. The Partial-Birth Abortion Ban Act of 2003 states that a doctor who “knowingly performs a partial-birth abortion and thereby kills a human fetus” commits a crime punishable by imprisonment for up to two years. It defines “partial-birth abortion” as a procedure in which the doctor “delivers a living fetus” until some part of the fetus is “outside the body of the mother” and then “performs the overt act . . . that kills the partially delivered living fetus.” The law provides an exception where the woman’s life is in danger. Significantly, there is no broad exception where the procedure is deemed by the doctor to be in the interests of the health of the mother. Abortion opponents have claimed that such broad “health” exceptions are subject to abuse. The Act was upheld on April 18, 2007h by the United States Supreme Court in Gonzales v. Carhart. The Court held that the federal law was not void for vagueness, and that it did not impose a substantial obstacle for a woman seeking an abortion. The Court had previously struck down a more broadly-written partial-birth abortion law from Nebraska, in Stenberg v. Carhart. A key difference cited by the Court was that the Nebraska law was so broadly worded that it would have applied to standard D&E procedures as well as partial-birth abortions.

Waiting Periods. The Supreme Court in Casey upheld a 24-hour waiting period requirement of a Pennsylvania statute.

Parental Consent for Minors. In 1976, the court struck down a Missouri abortion law that required the consent in some instances of a woman’s parents. The Supreme Court in Casey upheld a parental consent provision for minors under a Pennsylvania statute.

Informed Consent. The Supreme Court in Casey upheld an informed consent requirement under a Pennsylvania statute. A South Dakota law requires doctors to tell women seeking an abortion that the procedure will “terminate the life of a whole, separate, unique, living human being.” That law is being challenged in the U.S. Court of Appeals for the 8th Circuit.

Spousal Consent. In 1976, the Court overturned a Missouri statute that required the written consent of a woman’s husband for an abortion.

Record-keeping. The Supreme Court upheld record-keeping requirements in Casey and in Danforth.

Public Funding, Facilities or Employees. In 1989, the court upheld states banning public funds for abortion and to prohibiting abortions at public facilities or by public employees.