Abortion

More than a generation after the 1973 Roe v. Wade U.S. Supreme Court decision that made abortion legal in the U.S., public debate on the subject continues to follow the well-worn path between condemnation and choice. Public attitudes do not.

Where advocates on both sides tend to lay out their arguments in terms of absolute moral rights and wrongs, the public seems to see conflicts and conditions. Solid majorities support a woman's right to choose abortion - if her reasons seem sound and if it's not too late in the pregnancy.

On an individual level, medical technology is making the issue more complex. In some respects, changing technology - such as the "abortion pill" and ultrasound-guided abortions available as early as eight days after conception – has made abortion both easier and more accepted. In other respects, new technology – such as ultrasound photos from the womb and developments making a fetus viable at earlier stages of pregnancy – has sparked new questions.

What will the Supreme Court do?

The high court stirred controversy on both sides of the abortion debate in 2007, when it upheld the Partial-Birth Abortion Ban Act of 2003, which sought to ban a particular kind of late-term abortion (often called "intact dilation and evacuation," or D&E). In the words of Justice Kennedy, "D&E is a procedure itself laden with the power to devalue human life," and therefore must be explicitly prohibited. Yet for those opposed to the ruling, as in the dissent of Justice Ginsberg, the decision represents a significant setback for women, reflecting "ancient notions about women's place in the family and under the Constitution--ideas that have long since been discredited."

Abortion opponents have been seeking to bring a case to the high court, hoping that the court might be open to changing or even overturning the Roe v. Wade decision. If the Supreme Court overturns the Roe decision, that doesn't mean abortion would automatically become illegal nationwide. Most legal experts think that issue would go back to the states, which would be free to permit, restrict or outlaw abortions as they please. Abortion would almost certainly be banned in some states, but just as likely would remain legal in others.

States are already permitted to place limits on abortions. Currently, 34 states require parental consent or notification before a minor has an abortion, and 24 states require a waiting period, according to the Guttmacher Institute. Opponents of abortion have long taken a piecemeal approach, in part because the public supports some restrictions. Abortion rights groups worry that even if abortion remains legal, it may become harder to get simply because there are fewer doctors and clinics willing to perform the procedure.

Abortion rate declining

More than one in five pregnancies ends in abortion, according to the National Center for Health Statistics. In recent years, the number and rate of abortions has leveled off after a decade of decline. There were 846,181 reported abortions in 2006, the most recent year for which there are statistics, compared to more than 1.4 million in 1990, according to the Centers for Disease Control and Prevention. Experts disagree on the possible causes for the decline, but usually cite more widespread use of reliable contraceptives, a decline in teen pregnancies and the overall aging of the population.

But the development of emergency contraception and the "abortion pill" have also changed the situation. While they're often lumped together in the policy debate, emergency contraception, which prevents fertilization or ovulation if taken within 72 hours after unprotected sex, is different from mifepristone, a drug that induces an abortion.

Doctors have for years used high doses of birth control pills as a form of emergency contraception, but in 1998 the Food and Drug Administration approved the first product specifically marketed for that purpose. The so-called "morning after" pill was approved in 2009 as an over-the-counter product for those older than age 17. A second emergency contraceptive, effective up to five days after unprotected sex, was approved for prescription use in 2010. The FDA approved mifepristone, also known as RU-486, in 2000. CDC statistics, however, show that the vast majority of reported abortions are still done by surgery in a doctor's office or clinic.

The public divided

Views on abortion overall haven't changed much since the 1970s. Only a minority of Americans actually holds strict pro-life or pro-choice views, and there is relatively little difference in attitudes between men and women on this issue. For much of the public, time and circumstance appear to be the important factors.

Polls find that two-thirds of Americans say abortion should be legal during the first trimester, but that drops to 8 percent in the third trimester. When the woman's health or life is endangered, or when the pregnancy was caused by rape or incest, more than three-quarters of the public favor the option of abortion. But support falls to 34 percent when the reasons for having an abortion are economic (for example, if a family cannot afford more children). There is broad support for laws requiring waiting periods, or, for minors, parental consent.

In surveys, people often make a distinction between what's right for them and what they want written into law. Nearly six out of 10 say Roe v. Wade should not be overturned, and a majority say the government should not get involved in the abortion issue. What's more, a Public Agenda survey found more than half say deeply religious politicians who have to vote on the issue should be willing to compromise. (Additional context can be found in Public Agenda's report on religion and public life.)

Choicework

For more detail on how society could address this issue, visit our Discussion Guide which sets out three alternative approaches. The points of view are drawn both from what the experts say about an issue and from what the public thinks about it, based on surveys and focus groups. We call this section "Choicework." Each point of view comes with the arguments for and against, along with some potential costs and tradeoffs.