Roe v. Wade at a Crossroads: Can It Prevail for the Common Good?

Photograph Source: John Stephen Dwyer – CC BY-SA 3.0

The recent passage of the Texas law banning abortion as early as 6 weeks, or just 14 days after a missed period when most women don’t even know they are pregnant, has precipitated a crisis for many women in that state and neighboring states in helping them to gain access to urgently needed abortion services. The stakes are now much higher as the conservative U.S. Supreme Court is planning to consider the legality of Roe v. Wade during this term’s schedule. Amidst the current debate on this issue, filled with disinformation and heated rhetoric, there is a need to pause and examine the real stakes involved. This article has two goals: (1) to bring brief historical perspective to this issue; and (2) to outline some of the important reasons why Roe v. Wade must be preserved as the law of the land.

Brief Historical Perspective

The recently enacted Texas law banning abortion after 6 weeks gestation, even in cases of rape and incest, represents the latest battle in the long war on women being waged by conservative Republicans in this country against women’s reproductive rights. Roe v. Wade, adopted in 1973, was a break-through law ensuring that women could terminate their pregnancy at any point up to “viability”, about 24 weeks. States could restrict or prohibit abortion after that time, but exceptions must be made to preserve “the life or health of the woman.”

Conservatives have sought to limit Roe v. Wade on many occasions since then.  The Hyde amendment, passed in 1977, banned federal funding from covering abortion services, and has been a budget rider on federal spending bills since then. The Partial Birth Abortion Ban was enacted in 2003, during the presidency of George W. Bush, permitting abortion only as a last resort to save the mother’s life, or if the fetus was already dead.

In 2017, soon after entering office, former President Trump issued a global gag rule prohibiting international organizations from receiving U. S. family planning funding if they provide, counsel, refer or lobby for abortion services.1 Former Vice President Pence vowed his intention to end taxpayer funding of abortion and abortion providers.2 At the state level, Texas closed most of its abortion clinics and ended Medicaid funding for Planned Parenthood.

Texas has been enforcing its new 2021 law, which also empowers anyone—friends, neighbors, even family members— to report instances of a woman having an abortion and be rewarded by a $10,000 finding fee—a kind of unconstitutional vigilante law. Texas women managing to get to neighboring states for the procedure have flooded abortion facilities in neighboring states.

The U. S. Supreme Court (SCOTUS) plans to take up the Roe v. Wade case during its new term in the form of the Mississippi case, which has passed a law similar to that of Texas, except establishing a 15-week gestation time instead of 6-week. This has already raised widespread concerns, since SCOTUS is already perceived as a right-leaning Court after conservative jurists were appointed by the Trump administration. It had declined to block the new Texas abortion law after it had been enacted.

We already know that anti-abortion laws are deeply unpopular among Americans.3

+ A new poll in October 2021 from the PS Newshour, NPR and Marist, found that

+ 74 percent of Americans oppose a law that allows private citizens to sue abortion

+ providers or others who provide any assistance; that majority includes 90 percent of

+ Democrats, 57 percent of Republicans, and 74 percent of Independents.

+ Gallup, which has tracked views on abortion since 1975, published a poll in May 2021

+  that found 32 percent of respondents think abortion should be legal under all

+ circumstances, 48 percent support abortion under certain circumstances, and 19

+ percent think it should be illegal under all circumstances.

+ A May 2021 Pew Research Center poll found that 59 percent of U. S. adults think that abortion should be legal in all or most cases, and 39 percent think it should be illegal in all or most cases.

In October 2021, the Biden administration reversed Trump’s contentious policy that barred organizations that provide abortion referrals from receiving federal family planning money.4 This will improve access to reproductive health care, which had been reduced by almost one-half overall across the country by Trump’s 2017 gag rule and by 90-100 percent in 10 states.5

In Defense of Roe v. Wade

These are reasons that compel us to make sure that Roe v. Wade remains to defend  women’s reproductive rights, as about one-half of the U. S. population.

The prevalence of unintended pregnancy is higher than many might think.

+ By age 45, the average female will have had 1.4 unintended pregnancies; about four in ten of them will have had an induced abortion.6

+ 58 percent of women with unintended pregnancies get pregnant while using one or another form of birth control.7

+ 39 states have parental notification laws, which have led to an increase in late trimester abortions. 8

+ Other obstacles to abortion include mandated waiting periods, spousal notification laws, and regulation of abortion facility locations.9

+ Both patients and providers often face harassment by individuals and organized groups.10

+ Rape is a very under-reported crime with a lifetime prevalence of up to 25 percent,11 with about a 25 percent chance of pregnancy.12

+ Rates of teen pregnancy in the U. S. are three to ten times higher than those among the industrialized countries of Western Europe.13

The decision whether or not to have an abortion is a personal choice that all women should be able to make themselves.

Eleanor Cooney, author of an excellent chapter, The Way It Was, in the 2013 book, Public Health and Social Justice, brings us this important insight concerning the universality of  women facing the need for an abortion:

Women of all kinds seek and have always sought abortion: married, single, in their twenties, thirties, and forties, teenagers. Some have no children, some are churchgoers, atheists, agnostics. They are morally upright pillars of the community, they are prostitutes. They’re promiscuous, they’re monogamous, they’re recent virgins. They get pregnant under all kinds of circumstances: consensual sex, nonconsensual sex, sex that falls somewhere between consensual and nonconsensual. Some are drunk or using drugs, some never even touch an aspirin. Some use no birth control, some use birth control that fails.14  

Family planning, together with Roe v. Wade, provide better outcomes for women and society.

Family planning clinics, under pressure by conservatives over many years, have been closed in many states. That has put some 61 million women at risk for an unintended pregnancy during their childbearing years (15-44). In order to avoid such an unplanned pregnancy, they have to depend on contraceptive use for about three decades. Improved birth control and access to family planning clinics led to a decline of the U. S. abortion rate to a new low in 2014. The Guttmacher Institute has called attention to the crucial importance of contraceptive use in these words:

The ability to delay and space childbearing is crucial to women’s social and economic advancement. Women’s ability to obtain and effectively use contraceptives has a  positive impact on their education and workforce participation, as well as on subsequent outcomes related to income, family stability, mental health and happiness, and children’s  well being.15

Opponents of family planning clinics, however, fail to recognize that 97 percent of Planned Parenthood services are for such preventive services as breast exams, screening for cervical cancer and sexually transmitted infections, with only 3 percent for abortion. They also fail to appreciate that family planning services are decreasing the number of abortions. Dr. Hal Lawrence, as CEO of the American College of Obstetricians and Gynecologists, has observed:

The strange thing about this is that people who want to decrease the number of abortions are taking away access to the very services that help prevent them.16

With this long-term issue about women’s reproductive care, international comparisons are poor. The U.S. ranks # 46 in the world in maternal death rates.17

Preserving access to abortion is a rational and moral approach to a common situation, benefiting the persons involved and society.

Preserving Roe v. Wade is a completely rational policy that retains the ability for women to choose a safe way to avoid unintended pregnancies. It is also a moral imperative as a way to avoid preventable outcomes of unintended pregnancies continuing to term, delivery, and new mothers and infants unprepared and unable to support themselves. Sister Joan Chichester, O. S. B., a Catholic nun, sums up the hypocrisy of the “pro-life” movement in these compelling words:

I do not believe that just because you’re opposed to abortion that that makes you pro-life. In fact, I think in many cases, your morality is deeply lacking if all you want is a child born but not a child fed, not a child educated, not a child housed. And why would I think that you don’t? Because you don’t want any tax money to go there. That’s not pro-life. That’s pro-birth. We need a much broader conversation on what the morality of pro-life is.18

Robin Marty, author of the 2021 book, The New Handbook for a Post-Roe America and her colleague, Leah Torres at West Alabama Women’s Center, are spot on with this observation:

Abortion has always existed. Legal or not, it will continue to exist. Texas is playing a dangerous constitutional game—and using pregnant people as collateral.19


Based on the above, we have to hope that facts and caring will prevail when SCOTUS considers how to proceed with Roe v. Wade. Their ruling will help to determine who we are as a society and hopefully confirm that we are pro-choice, pro-woman and pro-child, not the cruel conservative concept of pro-life as it has promulgated.


1) Adelman, L. In first executive actions since historic Women’s March, Trump moves to restrict access to reproductive health care worldwide. Planned Parenthood Federation of America, January 23, 2017.

2) Hackman, M. Pence vows support at antiabortion rally. Wall Street Journal, January 28-29, 2017.

3) Jones, C. Where Americans stand on abortion restrictions as a new Supreme Court term opens. PBS NEWS HOUR, October 4, 2021.

4) Weiland, M. Biden officials end ban on abortion referrals at federally funded clinics. New York Times, October 4, 2021.

5) Todd, C. Biden just reversed a Trump-era domestic gag rule on abortion. Self, October 5, 2021.

6) Henshaw, SK. Unintended pregnancy in the United States. Family Planning Perspectives, 1998: 30: pp. 24-29.

7) Grimes, DA. A 26-year-old woman seeking an abortion. JAMA 1999, 282 (12), pp. 1169-1175.

8) Hampton, HL. Care of the woman who has been raped. New Engl J Med 1995: 332 (4): pp. 234-237.

9) Lacayo, R. What can a kid decide? Time, 2000: p. 32.

10) NARAL report: Access to safe abortions increasingly difficult. The Nation’s Health, 2001 (April): p. 11.

11) Ibid # 7.

12) Council on Scientific Affairs Report: Violence against women. JAMA, 1992, 267 (23): pp. 3184-3189.

13) Population action report: Study ranks global reproductive health. The Nation’s Health, 2001, p. l7.

14) Cooney, E. The Way It Was. In Public Health and Social Justice. Donohoe, MT (Ed), 2013, p. 250.

15) Dreweke, J. Anti-choice Republicans likely to ignore key reason for abortion rate decline. Guttmacher Institute, January 17, 2017.

16) Lawrence, H. As quoted in Corbett, J. ‘Crisis no one is talking about’: GOP threatens  health care of 26 million people. Common Dreams, February 2, 2018.

17) West, E. Why single-payer is a feminist issue. Truthout, January 21, 2018.

18) Salzillo, L. Catholic nun explains pro-life in a way that will stun many (especially Republican lawmakers). Daily Kos, July 30, 2015.

19) Marty, R, Torres L. Abortion after the Texas law. Time, October11/18, 2021, p. 32.

John Geyman, M.D. is professor emeritus of Family Medicine at the University of Washington School of Medicine in Seattle, where he served as Chairman of the Department of Family Medicine from 1976 to 1990. His most recent publications are Struggling and Dying under TrumpCare: How We Can Fix this Fiasco (2019) and a pamphlet, Common Sense: The Case For and Against Medicare for All, Leading Issue in the 2020 Elections (2019).