Nearly 50 Years Post-Roe v. Wade and Nearing its End: What Is the Evidence that Abortion Advances Women’s Health and Equality?


There is a realistic possibility that the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, or another near term case, will curb or deny the existence of the federal constitutional right of abortion announced in Roe v. Wade and reaffirmed in Planned Parenthood v. Casey. In preparation for this moment, advocates of legal abortion have been passing laws at the state level to secure a right to abortion under circumstances similar to those protected in Roe and Casey––abortion for any reason, throughout pregnancy––on the grounds that abortion promotes women’s health and their social and economic equality. Women’s health and equality are foundational, respectively, to the holdings in Roe and Casey.

Pro-choice advocates have had nearly fifty years to investigate the effects of legal abortion on women’s lives. Undoubtedly, they would like to put to rest the question of whether abortion is a benefit to women. The leading medical associations and journals are openly pro-choice, and they would produce convincing evidence of abortion’s salutary effects if they could. Strikingly, however, while current abortion rights statutes are premised on these claims, their pro-choice supporters have not provided evidence to support them. Instead, pro-choice interest groups and legislators offer conclusory observations with no data, or poorly reasoned or researched studies, and they fail to grapple with significant empirical scholarship that indicates many women suffer harm as a result of their abortion. Furthermore, women’s social and economic progress—in areas ranging from employment to education to entrepreneurship to other outcomes—has proceeded independently of their recourse to abortion. And an important body of literature suggests that unlinking sex from childbearing has disadvantaged women in the realms of relationships with men, marriage, childbearing, and workplace accommodations for mothers.

This Article will set forth the evidence complicating and sometimes contradicting the narrative dominating current state legislative efforts to codify Roe: that abortion advances women’s health and their social and economic equality. It concludes that this lack of evidence, combined with the insistence nevertheless that abortion importantly promotes women’s health and equality, are themselves threats to women’s health and progress. Advocates of women’s welfare should exhibit a far greater amount of curiosity about the effects upon women of a procedure performed over 60 million times since Roe v. Wade. They should not promote the notion that children are women’s private “burden,” such that public and private actors are under no obligation to extend accommodations to women with children.