U.S. abortion history fraught with resistance, unequal access and violence

The debate around abortion through modern American history could fill bookshelves. We take a look at a few key moments since 1973's Roe v. Wade Supreme Court decision, a period marked by shifting attitudes, unequal access and instances of deadly violence.

Years since Roe v. Wade decision in 1973 have seen vocal opposition and occasional violence

Pro-choice activists are seen outside of the U.S. Supreme Court in Washington on June 15. (Mandel Ngan/AFP/Getty Images)

In a watershed ruling, the U.S. Supreme Court has overturned the pivotal 1973 Roe v. Wade ruling that recognized a woman's constitutional right to an abortion and legalized it nationwide.

The ruling on the case before the court, Dobbs v. Jackson Women's Health Organization, centred on a Mississippi law banning abortion after 15 weeks. You can read about the 6-3 opinion delivered by Justice Samuel Alito and the potential effects here.

Since 1973's Roe v. Wade decision and leading up to the Dobbs ruling, the abortion issue has been marked by debates around regulation of the medical procedure, access to it and shifting public opinion, as well as occasional instances of deadly violence.

While entire bookshelves can be filled with texts on abortion in modern American history, here are just a few notable events and themes.

Shifting attitudes

Nearly all U.S. states in August 1962 outlawed abortion entirely or in all but the most exceptional circumstances, usually involving risk to a pregnant woman's life or health. That's when Sherri Finkbine, a host of the Phoenix version of the children's television show Romper Room, travelled to Sweden to have an abortion. 

Finkbine, a mother of four, had unwittingly taken a medication containing thalidomide, which at the time was already being linked to birth defects and infant death. She took her story public as a warning to others who may have taken the drug, in a newspaper story that only identified her as a Phoenix housewife. Her name was revealed in a later lawsuit filed by a local hospital administrator. 

Sherri Finkbine and her then-husband, Robert, are shown arriving in Sweden on Aug. 7, 1962. Finkbine's case received national attention and revealed attitudes about abortion. (Express Newspapers/Getty Images)

A decade before Roe v. Wade, the case was seen as revealing changing attitudes concerning a woman's right to choose to terminate a pregnancy in certain circumstances, with 52 per cent of respondents telling a Gallup survey at the time that Finkbine was doing the right thing, and 32 per cent opposed to her decision.

But Finkbine paid a price, losing her job and enduring death threats. She eventually gave birth again and was a great-grandmother by the time she told the Arizona Republic in 2016 that she didn't regret her decision 54 years earlier.

"Just pondering whether to do it or not is a mental anguish," she said. "That is punishment."

Evolving opposition

Polling conducted by the Pew Research Center in April of this year indicated that 80 per cent of self-identified Democrats or those who lean Democrat agreed that abortion should be legal in all or most cases, compared to 38 per cent of those identifying as Republicans or leaning Republican.

Evangelical Protestants, largely white and overwhelmingly Republican, account for much of that disparity. Around 74 per cent of white evangelicals, according to Pew, say abortion should be illegal in all or most cases, while 60 per cent of white, mainline Protestants, who do not consider themselves evangelical, say abortion should be legal in all or most cases. (Black Protestants as a group support legalized abortion at a slightly higher level than that.)

Anti-abortion demonstrators during the March for Life are shown on Pennsylvania Avenue in Washington on Jan. 24, 2000. (Mark Wilson/Getty Images)

This wasn't the case when the Roe v. Wade opinion was delivered in January 1973. In that opinion, the court ruled that states could not ban abortion, as a woman's decision to terminate her pregnancy was protected under the right to privacy that flows from the 14th Amendment of the U.S. Constitution.

It was a Catholic woman named Nellie Gray who started the still-ongoing March for Life rallies against abortion. And it was Catholic religious leaders who objected most vociferously to the ruling. At the time, Cardinal Patrick O'Boyle called the Supreme Court opinion a "catastrophe for America" and said the court had "embraced a policy of death."

By contrast, the 1971 pre-Roe resolution of the Southern Baptist Convention — the most influential evangelical organization — allowed for "the possibility of abortion under such conditions as rape, incest, clear evidence of severe fetal deformity, and carefully ascertained evidence of the likelihood of damage to the emotional, mental, and physical health of the mother." 

When the Roe opinion came down, the organization's Baptist Press news service concluded that "religious liberty, human equality and justice are advanced by the Supreme Court abortion decision."

Jerry Falwell is shown at a Jan. 8, 2006, rally in Philadelphia. Sponsored by the Family Research Council, the rally was held in support of the Bush administration nomination of Samuel Alito for the Supreme Court. (Jeff Fusco/Getty Images)

But by the 1980s, religious groups and leaders, such as televangelist Jerry Falwell and religious broadcaster Pat Robertson, were publicly railing against what they saw as liberal trends, such as abortion rights and burgeoning gay rights. 

The so-called Republican Revolution of the 1994 midterms that gave the party control of both houses of Congress saw lawmakers influenced by the vocal opposition to abortion rights reach Washington.

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By 2022, very few Republican politicians supported the right to terminate a pregnancy, with some at state levels not allowing exceptions for rape or incest —  a contrast to the situation in the 1980s, when a number of party members were pro-choice. 

For its part, the Southern Baptist Convention by 2003, said it renounced the statements of its organization some 30 years earlier, arguing that Roe was "fundamentally flawed" and "an act of injustice against innocent unborn children." Life began at conception, they and other Christian groups reasoned.

As for Catholics, while leadership is still opposed to abortion 50 years later, 56 per cent of the American Catholics who responded to the Pew survey this spring agreed that abortion should be legal in all or most cases.

Unequal access

In 1976, U.S. Congress enacted the Hyde Amendment, which barred the use of Medicaid funds for abortion services in nearly all cases. Some states have made up that gap with provisions in their social programs, but not at all.

Citing statistics regarding Medicaid enrolments, the pro-choice research group Guttmacher Institute said the amendment disproportionately affects Americans with fewer means, and those who are Black or Indigenous.

"On average, an abortion at 10 weeks costs around $550 [US], which could be someone's entire monthly rent payment, and the cost increases as a pregnancy progresses," the group said in a 2021 news release on the amendment.

U.S. President Joe Biden voted in favour of the amendment in 1977, when he was a Delaware senator. Biden, a practising Catholic, has struggled with the abortion issue through the years but pivoted during the 2020 presidential campaign.

"If I believe health care is a right, as I do, I can no longer support an amendment that makes that right dependent on someone's zip code," he said.

But so far, attempts by his administration to pass a government funding budget without the amendment have not passed Congress.

Deadly violence 

Roe v. Wade galvanized thousands of peaceful anti-abortion protesters, but some abortion clinics became targets for extremists. Some doctors who performed abortions were attacked at their homes.

Things turned deadly in the 1990s.

Two Florida physicians, David Gunn and John Britton, were fatally shot in 1993 and 1994, respectively. Paul Hill, who also killed Britton's bodyguard, was eventually sentenced to death and executed for Britton's death.

A young boy is seen among protesters outside Florida State Prison in Raiford, Fla., in September 2003, when former Presbyterian minister Paul Hill was executed for the shotgun murder of Dr. John Britton, an abortion doctor, and Britton's volunteer bodyguard, James Barrett. (Matt Stroshane/Getty Images)

A police officer working his second job as a security guard was killed and a nurse wounded in a 1998 bombing outside an Alabama clinic carried out by Eric Rudolph, who was also responsible for three other bombings, including one at the 1996 Olympics in Atlanta.

American anti-abortion extremist James Kopp was known to have entered Canada but never definitively connected to three non-fatal attacks on abortion providers in Winnipeg, Vancouver and Hamilton in the 1990s. He was convicted for the 1998 murder of abortion provider Barnett Slepian, near Buffalo, N.Y.

The ongoing threat was most illustrative in the case of Kansas physician George Tiller. Tiller's clinic was firebombed in 1986, he was injured in a shooting in 1993, and then gunned down in 2010 by an extremist.

Pushing the boundaries of 'undue burden'

The most consequential abortion ruling after Roe was 1992's Planned Parenthood v. Casey. The Supreme Court upheld the right to abortion in a 5-4 decision, again leaning heavily on the 14th Amendment.

But Casey, among its other impacts, introduced the concept of "undue burden" — specifying that states couldn't impose restrictions on abortion that reached that hotly debated standard.

The Jackson Women's Health Organization, the last abortion clinic in Mississippi, is shown in 2018. The clinic was at the centre of the case heard during the current session of the U.S. Supreme Court. (Brendan Smialowski/AFP/Getty Images)

Since Casey, some states have pushed the boundaries of what's an undue burden, introducing 24-hour wait periods, mandatory sonogram requirements, mandatory hospital admitting privileges for doctors and strict prescribing protocols for medication that can trigger pregnancy termination.

The number of U.S. clinics that perform abortions dropped to around 800, from an early 1990s peak of over 2,000 locations, according to the Guttmacher Institute.

The push by states to regulate abortion accelerated after the Trump presidency saw the confirmation of three conservatives to the top court, making the Supreme Court composition a 6-3 majority of justices nominated by Republican presidents.

Texas then upped the stakes by introducing a law in which individuals can sue abortion providers, seen as a new front in the effort to limit the procedure, while Mississippi appealed the legal challenge of its abortion ban all the way to the Supreme Court.