18 Equality, Race, Sex, Class, and Contested Facts 18 Equality, Race, Sex, Class, and Contested Facts

In the aftermath of Roe, anti-abortion forces initially sought to pass a constitutional amendment that would recognize fetal personhood and ban all abortions nationwide. But while fighting for this amendment, anti-abortion groups also pushed more incremental restrictions designed to limit access to abortion such as bans on Medicaid reimbursement for abortion for low-income abortions. The success of anti-abortion incrementalism intensified skepticism of the Roe decision among progressives, who questioned the reasoning, timing, and sweeping of the 1973 decision. We will study the narrowing of abortion rights and the growing criticism of Roe from supporters of abortion rights. We will examine the complex reasons for the ongoing polarization of abortion rights. The conflict seemed to have come to a head in 1992 when a conservative supermajority looked ready to dismantle Roe in Planned Parenthood v. Casey. 505 U.S. 833 (1992) (plurality decision) We will read the Casey decision and then study how it further encouraged efforts to rethink the relationship between constitutional equality and abortion. Anti-abortion groups began stressing that abortion did not facilitate equality for women and people who can get pregnant--either because these groups had already achieved or could achieve equality without abortion or because abortion actually harmed them. By contrast, a growing reproductive justice  movement led by people of color connected issues of reproductive health to questions of racial and social justice.

18.1 Maher v. Roe 18.1 Maher v. Roe

MAHER, COMMISSIONER OF SOCIAL SERVICES OF CONNECTICUT v. ROE et al.

No. 75-1440.

Argued January 11, 1977

Decided June 20, 1977

*465Powell, J., delivered the opinion of the Court, in which BuRGER, C. J., and Stewart, White, Rehnquist, and Stevens, JJ., joined. Burger, C. J., filed a concurring statement, post, p. 481. Brennan, J., filed a dissenting opinion, in which Marshall and Blackmun, JJ., joined, post, p. 482. Marshall, J., filed a dissenting opinion, ante, p. 454. Blackmun, J., filed a dissenting opinion, in which Brennan and Marshall, JJ., joined, ante, p. 462.

Edmund C. Walsh, Assistant Attorney General of Connecticut, argued the cause for appellant. With him on the brief was Carl R. Ajello, Attorney General.

Lucy V. Katz argued the cause for appellees. With her on the brief were Kathryn Emmett and Catherine Roraback.*

Mr. Justice Powell

delivered the opinion of the Court.

In Beal v. Doe, ante, p. 438, we hold today that Title XIX of the Social Security Act does not require the funding of nontherapeutic abortions as a condition of participation in the *466joint federal-state Medicaid program established by that statute. In this case, as a result of our decision in Beal, we must decide whether the Constitution requires a participating State to pay for nontherapeutic abortions when it pays for childbirth.

I

A regulation of the Connecticut Welfare Department limits state Medicaid benefits for first trimester abortions1 to those that are “medically necessary,” a term defined to include psychiatric necessity. Connecticut Welfare Department, Public Assistance Program Manual, Yol. 3, c. Ill, §275 (1975).2 Connecticut enforces this limitation through a system of prior authorization from its Department of Social Services. In order to obtain authorization for a first trimester abortion, the hospital or clinic where the abortion is to be performed must submit, among other things, a certificate from the patient’s attending physician stating that the abortion is medically necessary.

This attack on the validity of the Connecticut regulation *467was brought against appellant Maher, the Commisioner of Social Services, by appellees Poe and Roe, two indigent women who were unable to obtain a physician's certificate of medical necessity.3 In a complaint filed in the United States District Court for the District of Connecticut, they challenged the regulation both as inconsistent with the requirements of Title XIX of the Social Security Act, as added, 79 Stat. 343, as amended, 42 U. S. C. § 1396 et seq. (1970 ed. and Supp. V), and as violative of their constitutional rights, including the Fourteenth Amendment’s guarantees of due process and equal protection. Connecticut originally defended its regulation on the theory that Title XIX of the Social Security Act prohibited the funding of abortions that were not medically necessary. After certifying a class of women unable to obtain Medicaid assistance for abortions because of the regulation, the District Court held that the Social Security Act not only allowed state funding of nontherapeutic abortions but also required it. Roe v. Norton, 380 F. Supp. 726 (1974). On appeal, the Court of Appeals for the Second Circuit read the Social Security Act to allow, but not to require, state funding of such abortions. 522 F. 2d 928 (1975). Upon remand for consideration of the constitutional issues raised in the complaint, a three-judge District Court was convened. That court invalidated the Connecticut regulation. 408 F. Supp. 660 (1975).

*468Although it found no independent constitutional right to a state-financed abortion, the District Court held that the Equal Protection Clause forbids the exclusion of nontherapeutic abortions from a state welfare program that generally subsidizes the medical expenses incident to pregnancy and childbirth. The court found implicit in Roe v. Wade, 410 U. S. 113 (1973), and Doe v. Bolton, 410 U. S. 179 (1973), the view that “abortion and childbirth, when stripped of the sensitive moral arguments surrounding the abortion controversy, are simply two alternative medical methods of dealing with pregnancy . . . 408 F. Supp., at 663 n. 3. Relying also on Shapiro v. Thompson, 394 U. S. 618 (1969), and Memorial Hospital v. Maricopa County, 415 U. S. 250 (1974), the court held that the Connecticut program “weights the choice of the pregnant mother against choosing to exercise her constitutionally protected right” to a nontherapeutic abortion and “thus infringes upon a fundamental interest.” 408 F. Supp., at 663-664. The court found no state interest to justify this infringement. The State’s fiscal interest was held to be “wholly chimerical because abortion is the least expensive medical response to a pregnancy.” Id., at 664 (footnote omitted). And any moral objection to abortion was deemed constitutionally irrelevant:

“The state may not justify its refusal to pay for one type of expense arising from pregnancy on the basis that it morally opposes such an expenditure of money. To sanction such a justification would be to permit discrimination against those seeking to exercise a constitutional right on the basis that the state simply does not approve of the exercise of that right.” Ibid.

The District Court enjoined the State from requiring the certificate of medical necessity for Medicaid-funded abortions.4 *469The court also struck down the related requirements of prior written request by the pregnant woman and prior authorization by the Department of Social Services, holding that the State could not impose any requirements on Medicaid payments for abortions that are not “equally applicable to medicaid payments for childbirth, if such conditions or requirements tend to discourage a woman from choosing an abortion or to delay the occurrence of an abortion that she has asked her physician to perform.” Id., at 665. We noted probable jurisdiction to consider the constitutionality of the Connecticut regulation. 428 U. S. 908 (1976).

II

The Constitution imposes no obligation on the States to pay the pregnancy-related medical expenses of indigent women, or indeed to pay any of the medical expenses of indigents.5 But when a State decides to alleviate some of the *470hardships of poverty by providing medical care, the manner in which it dispenses benefits is subject to constitutional limitations. Appellees’ claim is that Connecticut must accord equal treatment to both abortion and childbirth, and may not evidence a policy preference by funding only the medical expenses incident to childbirth. This challenge to the classifications established by the Connecticut regulation presents a question arising under the Equal Protection Clause of the Fourteenth Amendment. The basic framework of analysis of such a claim is well settled:

“We must decide, first, whether [state legislation] operates to the disadvantage of some suspect class or impinges upon a fundamental right explicitly or implicitly protected by the Constitution, thereby requiring strict judicial scrutiny. ... If not, the [legislative] scheme must still be examined to determine whether it rationally furthers some legitimate, articulated state purpose and therefore does not constitute an invidious discrimination . . . ” San Antonio School Dist. v. Rodriguez, 411 U. S. 1, 17 (1973).

Accord, Massachusetts Bd. of Retirement v. Murgia, 427 U. S. 307, 312, 314 (1976). Applying this analysis here, we think the District Court erred in holding that the Connecticut regulation violated the Equal Protection Clause of the Fourteenth Amendment.

A

This case involves no discrimination against a suspect class. An indigent woman desiring an abortion does not come within *471the limited category of disadvantaged classes so recognized by our cases. Nor does the fact that the impact of the' regulation falls upon those who cannot pay lead to a different conclusion. In a sense, every denial of welfare to an indigent creates a wealth classification as compared to nonindigents who are able to pay for the desired goods or services. But this Court has never held that financial need alone identifies a suspect class for purposes of equal protection analysis. See Rodriguez, supra, at 29; Dandridge v. Williams, 397 U. S. 471 (1970).6 Accordingly, the central question in this case is whether the regulation “impinges upon a fundamental right explicitly or implicitly protected by the Constitution.” The District Court read our decisions in Roe v. Wade, 410 U. S. 113 (1973), and the subsequent cases applying it, as establishing a fundamental right to abortion and therefore concluded that nothing less than a compelling state interest would justify Connecticut’s different treatment of abortion and childbirth. We think the District Court misconceived the nature and scope of the fundamental right recognized in Roe.

B

At issue in Roe was the constitutionality of a Texas law making it a crime to procure or attempt to procure an abortion, except on medical advice for the purpose of saving the life of the mother. Drawing on a group of disparate cases restricting governmental intrusion, physical coercion, and criminal prohibition of certain activities, we concluded that the Fourteenth Amendment’s concept of personal liberty *472affords constitutional protection against state interference with certain aspects of an individual's personal “privacy,” including a woman’s decision to terminate her pregnancy.7 I’d,, at 153.

The Texas statute imposed severe criminal sanctions on the physicians and other medical personnel who performed abortions, thus drastically limiting the availability and safety of the desired service. As Mr. Justice Stewart observed, “it is difficult to imagine a more complete abridgment of a constitutional freedom . . . .” Id., at 170 (concurring opinion). We held that only a compelling state interest would justify such a sweeping restriction on a constitutionally protected interest, and we found no such state interest during the first trimester. Even when judged against this demanding standard, however, the State's dual interest in the health of the pregnant woman and the potential life of the fetus were deemed sufficient to justify substantial regulation of abortions in the second and third trimesters. “These interests are separate and distinct. Each grows in substantiality as the woman approaches term and, at a point during pregnancy, each becomes ‘compelling.' ” Id., at 162-163. In the second trimester, the State’s interest in the health of the pregnant woman justifies state regulation reasonably related to that concern. Id., at 163. At viability, usually in the third trimester, the State's interest in the potential life of the fetus justifies prohibition with criminal penalties, except where the life or health of the mother is threatened. Id., at 163-164.

The Texas law in Roe was a stark example of impermissible interference with the pregnant woman’s decision to terminate her - pregnancy. In subsequent cases, we have invalidated *473other types of restrictions, different in form but similar in effect, on the woman’s freedom of choice. Thus, in Planned Parenthood of Central Missouri v. Danforth, 428 U. S. 52, 70-71, n. 11 (1976), we held that Missouri’s requirement of spousal consent was unconstitutional because it “granted [the husband] the right to prevent unilaterally, and for whatever reason, the effectuation of his wife’s and her physician’s decision to terminate her pregnancy.” Missouri had interposed an “absolute obstacle to a woman’s decision that Roe held to be constitutionally protected from such interference.” (Emphasis added.) Although a state-created obstacle need not be absolute to be impermissible, see Doe v. Bolton, 410 U. S. 179 (1973); Carey v. Population Services International, 431 U. S. 678 (1977), we have held that a requirement for a lawful abortion “is not unconstitutional unless it unduly burdens the right to seek an abortion." Bellotti v. Baird, 428 U. S. 132, 147 (1976). We recognized in Bellotti that “not all distinction between abortion and other procedures is forbidden” and that “[t]he constitutionality of such distinction will depend upon its degree and the justification for it.” Id., at 149-150. We therefore declined to rule on the constitutionality of a Massachusetts statute regulating a minor’s access to an abortion until the state courts had had an opportunity to determine whether the statute authorized a parental veto over the minor’s decision or the less burdensome requirement of parental consultation.

These cases recognize a constitutionally protected interest “in making certain kinds of important decisions” free .from governmental compulsion. Whalen v. Roe, 429 U. S. 589, 599-600, and nn. 24 and 26 (1977). As Whalen makes clear, the right in Roe v. Wade can be understood only by considering both the woman’s interest and the nature of the State’s interference with it. Roe did not declare an unqualified “constitutional right to an abortion,” as the District Court seemed to think. Rather, the right protects the woman from *474unduly burdensome interference with her freedom to decide whether to terminate her pregnancy. It implies no limitation on the authority of a State to make a value judgment favoring childbirth over abortion, and to implement that judgment by the allocation of public funds.

The Connecticut regulation before us is different in kind from the laws invalidated in our previous abortion decisions. The Connecticut regulation places no obstacles — absolute or otherwise — in the pregnant woman’s path to an abortion. An indigent woman who desires an abortion suffers no disadvantage as a consequence of Connecticut’s decision to fund childbirth; she continues as before to be dependent on private sources for the service she desires. The State may have made childbirth a more attractive alternative, thereby influencing the woman’s decision, but it has imposed no restriction on access to abortions that was not already there. The indigency that may make it difficult — and in some cases, perhaps, impossible — for some women to have abortions is neither created nor in any way affected by the Connecticut regulation. We conclude that the Connecticut regulation does not impinge upon the fundamental right recognized in Roe. 8

*475c

Our conclusion signals no retreat from Roe or the cases applying it. There is a basic difference between direct state interference with a protected activity and state encouragement of an alternative activity consonant with legislative policy.9 *476Constitutional concerns are greatest when the State attempts to..impose its.will by force of law; the State’s power to encourage, actions deemed to be in the public interest is necessarily far Jbrpader.

• This, distinction is implicit in two cases cited in Roe in support of the pregnant woman’s right under the Fourteenth Amendment, Meyer v. Nebraska, 262 U. S. 390 (1923), involved-' a ’Nebraska law making it criminal to teach foreign''languages to children who had not passed the eighth ’ gradé.' ‘ Id., at 396-397. Nebraska’s imposition of a .criminal .¡sanction on the providers of desired services makes Meyer closely analogous to Roe. In sustaining the. constitutional challenge brought by a teacher convicted under the law, the- Court held that the teacher’s “right thus to teach and the right of parents to engage him so to instruct their children’,’ were “within the liberty of the Amendment.” 262 U. S. at 400. In Pierce v. Society of Sisters, 268 U. S. 510 (1925), the. Court relied on Meyer to invalidate an Oregon criminal law requiring the parent or guardian of a child to sénd’ hiíírto a public school, thus precluding the choice of a private school.' Reasoning that the Fourteenth Amendment’s concept' of liberty “excludes any general power of the State to standardize, its children by forcing them to accept instruction from public teachers only,” the Court held that the law “unreasonably interfere [d] with the liberty of parents and guardians, to-direct the upbringing and education of children under their control;” 268 U. S., at 534 — 535.

Both’ case|. invalidated substantial restrictions on constitutionally protected liberty interests: in Meyer, the parent’s right to--.have.his child taught a particular foreign language; in Pierce', the.; parent’s right to choose private rather than public school 'education. But neither case denied to a State *477the policy choice of encouraging the preferred course of action. Indeed, in Meyer the Court was careful to state,,that-the power of the State “to prescribe a curriculum” that included English and excluded German in its free public schools “is not questioned.” 262 U. S., at 402. Similarly, Pierce casts no shadow over a State’s power to favor public .education, by funding it — a policy choice pursued in some . States for more than a century. See Brown v. Board of Education, 347 U. S. 483, 489 n. 4 (1954). Indeed, in Norwqod v. Harrison, 413 U. S. 465, 462 (1973), we explicitly rejected .the argument that Pierce established a “right of private or. parochial schools to share with public schools in state, largesse,” noting that “[i]t is one thing to say that a State ipay. not.prohibit the maintenance of private schools and quite another -to say that such schools must, as a matter of equal, protection, receive state aid.” Yet, were we to accept appellees’ argument, an indigent parent could challenge the state. spolicy ..of favoring public rather than private schools, or of preferring instruction in English rather than German, on grounds identical in principle to those advanced here. We think it abundantly clear that a State is not required to show a compelling interest for its policy choice to favor normal childbirth any more, than, a State must so justify its election to fund public but not private education.10

*478D

The question remains whether Connecticut’s regulation can be sustained under the less demanding test of rationality that applies in the absence of a suspect classification or the impingement of a fundamental right. This test requires that the distinction drawn between childbirth and nontherapeutic abortion by the regulation be “rationally related” to a “constitutionally permissible” purpose. Lindsey v. Normet, 405 U. S. 56, 74 (1972); Massachusetts Bd. of Retirement v. Murgia, 427 U. S., at 314. We hold that the Connecticut funding scheme satisfies this standard.

Roe itself explicitly acknowledged the State’s strong interest in protecting the potential life of the fetus. That interest exists throughout the pregnancy, “grow[ing] in substantiality as the woman approaches term.” 410 U. S., at 162-163. Because the pregnant woman carries a potential human being, she “cannot be isolated in her privacy. . . . [Her] privacy is no longer sole and any right of privacy she possesses must be measured accordingly.” Id., at 159. The State unquestionably has a “strong and legitimate interest in encouraging normal childbirth,” Beal v. Doe, ante, at 446, an interest honored over the' centuries.11 Nor can there be any question that the Connecticut regulation rationally furthers that interest. The medical costs associated with childbirth are substantial, and have increased significantly in recent years. As *479recognized by the District Court in this case, such costs are significantly greater than those normally associated with elective abortions during the first trimester. The subsidizing of costs incident to childbirth is a rational means of encouraging childbirth.

We certainly are not unsympathetic to the plight of an indigent woman who desires an abortion, but “the Constitution does not provide judicial remedies for every social and economic ill,” Lindsey v. Normet, supra, at 74. Our cases uniformly have accorded the States a wider latitude in choosing among competing demands for limited public funds.12 In Dandridge v. Williams, 397 U. S., at 485, despite recognition that laws and regulations allocating welfare funds involve “the most basic economic needs of impoverished human beings,” we held that classifications survive equal protection challenge when a “reasonable basis” for the classification is shown. As the preceding discussion makes clear, the state interest in encouraging normal childbirth exceeds this minimal level.

The decision whether to expend state funds for nonthera-peutic abortion is fraught with judgments of policy and value over which opinions are sharply divided. Our conclusion that the Connecticut regulation is constitutional is not based on a weighing of its wisdom or social desirability, for this Court does not strike down state laws “because they may be unwise, improvident, or out of harmony with a particular school of thought.” Williamson v. Lee Optical Co., 348 U. S. 483, 488 (1955), quoted in Dandridge v. Williams, supra, at 484. Indeed, when an issue involves policy choices as sensitive as those implicated by public funding of nontherapeutic abortions, the appropriate forum for their resolution in a democracy is the legislature. We should not forget that “legisla*480tures are ultimate guardians of the liberties and welfare of the people in quite as great a degree as the courts.” Missouri, K. & T. R. Co. v. May, 194 U. S. 267, 270 (1904) (Holmes, J.).13

In conclusion, we emphasize that our decision today does not proscribe government funding of nontherapeutic abortions. It is open to Congress to require provision of Medicaid benefits for such abortions as a condition of state participation in the Medicaid program. Also, under Title XIX as construed in Beal v. Doe, ante, p. 438, Connecticut is free — through normal democratic processes — to decide that such benefits should be provided. We hold only that the Constitution does not require a judicially imposed resolution of these difficult issues.

Ill

The District Court also invalidated Connecticut's requirements of prior written request by the pregnant woman and prior authorization by the Department of Social Services. Our analysis above rejects the basic premise that prompted invalidation of these procedural requirements. It is not unreasonable for a State to insist upon a prior showing of medical necessity to insure that its money is being spent only for authorized purposes. The simple answer to the argument that similar requirements are not imposed for other medical procedures is that such procedures do not involve the termination of a potential human life. In Planned Parenthood of Central Missouri v. Danforth, 428 U. S. 52 (1976), we held that the woman's written consent to an abortion was not an impermissible burden under Roe. We think that decision is controlling on the similar issue here.

*481The judgment of the District Court is reversed, and the case is remanded for further proceedings consistent with this opinion.

It is so ordered.

[For dissenting opinion of Me. Justice Marshall, see ante, p. 454.]

[For dissenting opinion of Mr. Justice Blackmun, see ante, p. 462.]

Mr. Chief Justice Burger,

concurring.

I join the Court’s opinion. Like the Court, I do not read any decision of this Court as requiring a State to finance a nontherapeutic abortion. The Court’s holdings in Roe v. Wade, 410 U. S. 113 (1973), and Doe v. Bolton, 410 U. S. 179 (1973), simply require that a State not create an absolute barrier to a woman’s decision to have an abortion. These precedents do not suggest that the State is constitutionally required to assist her in procuring it.

From time to time, every state legislature determines that, as a matter of sound public policy, the government ought to provide certain health and social services to its citizens. Encouragement of childbirth and child care is not a novel undertaking in this regard. Various governments, both in this country and in others, have made such a determination for centuries. In recent times, they have similarly provided educational services. The decision to provide any one of these services — or not to provide them — is not required by the Federal Constitution. Nor does the providing of a particular service require, as a matter of federal constitutional law, the provision of another.

Here, the State of Connecticut has determined that it will finance certain childbirth expenses. That legislative deter-*482initiation places no state-created barrier to a woman’s choice to procure an abortion, and it does not require the State to provide it. Accordingly, I concur in the judgment.

Mu. Justice Brennan,

with whom Mr. Justice Marshall and Mr. Justice Blackmun join, dissenting.

The District Court held:

“When Connecticut refuses to fund elective abortions while funding therapeutic abortions and prenatal and postnatal care, it weights the choice of the pregnant mother against choosing to exercise her constitutionally protected right to an elective abortion. . . . Her choice is affected not simply by the absence of payment for the abortion, but by the availability of public funds for childbirth if she chooses not to have the abortion. When the state thus infringes upon a fundamental interest, it must assert a compelling state interest.” Roe v. Norton, 408 F. Supp. 660, 663-664 (1975).

This Court reverses on the ground that “the District Court misconceived the nature and scope of the fundamental right recognized in Roe [v. Wade, 410 U. S. 113 (1973)],” ante, at 471, and therefore that Connecticut was not required to meet the “compelling interest” test to justify its discrimination against elective abortion but only “the less demanding test of rationality that applies in the absence of . . . the impingement of a fundamental right,” ante, at 477, 478. This holding, the Court insists, “places no obstacles — absolute or otherwise— in the pregnant woman’s path to an abortion”; she is still at liberty to finance the abortion from “private sources.” Ante, at 474. True, “the State may [by funding childbirth] have made childbirth a more attractive alternative, thereby influencing the woman’s decision, but it has imposed no restriction on access to abortions that was not already there.” Ibid. True, also, indigency “may make it difficult — and in some cases, *483perhaps impossible — for some women to have abortions,” but that regrettable consequence “is neither created nor in anyway affected by the Connecticut regulation.” Ibid.

But a distressing insensitivity to the plight of impoverished pregnant women is inherent in the Court’s analysis. The stark reality for too many, not just “some,” indigent pregnant women is that indigency makes access to competent licensed physicians not merely “difficult” but “impossible.” As a practical matter, many indigent women will feel they have no choice but to carry their pregnancies to term because the State will pay for the associated medical services, even though they would have chosen to have abortions if the State had also provided funds for that procedure, or indeed if the State had provided funds for neither procedure. This disparity in funding by the State clearly operates to coerce indigent pregnant women to bear children they would not otherwise choose to have, and just as clearly, this coercion can only operate upon the poor, who are uniquely the victims of this form of financial pressure. Mr. Justice Frankfurter’s words are apt:

“To sanction such a ruthless consequence, inevitably resulting from a money hurdle erected by the State, would justify a latter-day Anatole France to add one more item to his ironic comments on the 'majestic equality’ of the law. 'The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread’. . . .” Griffin v. Illinois, 351 U. S. 12, 23 (1956) (concurring opinion).

None can take seriously the Court’s assurance that its “conclusion signals no retreat from Roe [v. Wade] or the cases applying it,” ante, at 475. That statement must occasion great surprise among the Courts of Appeals and District Courts that, relying upon Roe v. Wade and Doe v. Bolton, 410 U. S. 179 (1973), have held that States are constitutionally required to fund elective abortions if they fund pregnancies carried to *484term. See Doe v. Rose, 499 F. 2d 1112 (CA10 1974); Wulff v. Singleton, 508 F. 2d 1211 (CA8 1974), rev’d and remanded on other grounds, 428 U. S. 106 (1976); Doe v. Westby, 383 F. Supp. 1143 (WDSD 1974), vacated and remanded (in light of Hagans v. Lavine, 415 U. S. 528 (1974)), 420 U. S. 968, on remand, 402 F. Supp. 140 (1975); Doe v. Wohlgemuth, 376 F. Supp. 173 (WD Pa. 1974), aff’d on statutory grounds sub nom. Doe v. Beal, 523 F. 2d 611 (CA3 1975), rev’d and remanded, ante, p. 438; Doe v. Rampton, 366 F. Supp. 189 (Utah 1973); Klein v. Nassau County Medical Center, 347 F. Supp. 496 (EDNY 1972), vacated and remanded (in light of Roe v. Wade and Doe v. Bolton, 412 U. S. 925 (1973)), on remand, 409 F. Supp. 731 (1976). Indeed, it cannot be gainsaid that today’s decision seriously erodes the principles that Roe and Doe announced to guide the determination of what constitutes an unconstitutional infringement of the fundamental right of pregnant women to be free to decide whether to have an abortion.

The Court’s premise is that only an equal protection claim is presented here. Claims of interference with enjoyment of fundamental rights have, however, occupied a rather protean position in our constitutional jurisprudence. Whether or not the Court’s analysis may reasonably proceed under the Equal Protection Clause, the Court plainly errs in ignoring, as it does, the unanswerable argument of appellees, and the holding of the District Court, that the regulation unconstitutionally impinges upon their claim of privacy derived from the Due Process Clause.

Roe v. Wade and cases following it hold that an area of privacy invulnerable to the State’s intrusion surrounds the decision of a pregnant woman whether or not to carry her pregnancy to term. The Connecticut scheme clearly impinges upon that area of privacy by bringing financial pressures on indigent women that force them to bear children they would not otherwise have. That is an obvious impairment of the *485fundamental right established by Roe v. Wade. Yet the Court concludes that “the Connecticut regulation does not impinge upon [that] fundamental right.” Ante, at 474. This conclusion is based on a perceived distinction, on the one hand, between the imposition of criminal penalties for the procurement of an abortion present in Roe v. Wade and Doe v. Bolton and the absolute prohibition present in Planned Parenthood of Central Missouri v. Danforth, 428 U. S. 52 (1976), and, on the other, the assertedly lesser inhibition imposed by the Connecticut scheme. Ante, at 472-474.

The last time our Brother Powell espoused the concept in an abortion case that “[t]here is a basic difference between direct state interference with a protected activity and state encouragement of an alternative activity consonant with legislative policy,” ante, at 475, the Court refused to adopt it. Singleton v. Wulff, 428 U. S. 106, 122 (1976). This was made explicit in Part II of our Brother Blackmun’s opinion for four of us and is implicit in our Brother Stevens’ essential agreement with the analysis of Part II-B. Id., at 121-122 (concurring in part). Part II-B stated:

“Mr. Justice Powell would so limit Doe and the other cases cited, explaining them as cases in which the State ‘directly interfered with the abortion decision’ and ‘directly interdicted the normal functioning of the physician-patient relationship by criminalizing certain procedures,’ [428 U. S.,] at 128. There is no support in the language of the cited cases for this distinction .... Moreover, a ‘direct interference’ or ‘interdiction’ test does not appear to be supported by precedent. . . . For a doctor who cannot afford to work for nothing, and a woman who cannot afford to pay him, the State’s refusal to fund an abortion is as effective an ‘interdiction’ of it as would ever be necessary. Furthermore, since the right ... is not simply the right to have an abortion, but the right to have abortions nondiscriminatorily funded, *486the denial of such funding is as complete an 'interdiction’ of the exercise of the right as could ever exist.” Id., at 118 n. 7.

We have also rejected this approach in other abortion cases. Doe v. Bolton, the companion to Roe v. Wade, in addition to striking down the Georgia criminal prohibition against elective abortions, struck down the procedural requirements of certification of hospitals, of approval by a hospital committee, and of concurrence in the abortion decision by two doctors other than the woman’s own doctor. None of these requirements operated as an absolute bar to elective abortions in the manner of the criminal prohibitions present in the other aspect of the case or in Roe, but this was not sufficient to save them from unconstitutionality. In Planned Parenthood, supra, we struck down a requirement for spousal consent to an elective abortion which the Court characterizes today simply as an “absolute obstacle” to a woman’s obtaining an abortion. Ante, at 473. But the obstacle was “absolute” only in the limited sense that a woman who was unable to persuade her spouse to agree to an elective abortion was prevented from obtaining one. Any woman whose husband agreed, or could be persuaded to agree, was free to obtain an abortion, and the State never imposed directly any prohibition of its own. This requirement was qualitatively different from the criminal statutes that the Court today says are comparable, but we nevertheless found it unconstitutional.

Most recently, also in a privacy case, the Court squarely reaffirmed that the right of privacy was fundamental, and that an infringement upon that right must be justified by a compelling state interest. Carey v. Population Services International, 431 U. S. 678 (1977). That case struck down in its entirety a New York law forbidding the sale of contraceptives to minors under 16 years old, limiting persons who could sell contraceptives to pharmacists, and forbidding ad*487vertisement and display of contraceptives. There was no New York law forbidding use of contraceptives by anyone, including minors under 16, and therefore no “absolute” prohibition against the exercise of the fundamental right. Nevertheless the statute was declared unconstitutional as a burden on the right to privacy. In words that apply fully to Connecticut’s statute, and that could hardly be more explicit, Carey stated: “ 'Compelling’ is of course the key word; where a decision as fundamental as that whether to bear or beget a child is involved, regulations imposing a burden on it may be justified only by compelling state interests, and must be narrowly drawn to express only those interests.” Id., at 686. Carey relied specifically upon Roe, Doe, and Planned Parenthood, and interpreted them in a way flatly inconsistent with the Court’s interpretation today: “The significance of these cases is that they establish that the same test must be applied to state regulations that burden an individual’s right to decide to prevent conception or terminate pregnancy by substantially limiting access to the means of effectuating that decision as is applied to state statutes that prohibit the decision entirely.” 431 U. S., at 688.

Finally, cases involving other fundamental rights also make clear that the Court’s concept of what constitutes an impermissible infringement upon the fundamental right of a pregnant woman to choose to have an abortion makes new law. We have repeatedly found that infringements of fundamental rights are not limited to outright denials of those rights. First Amendment decisions have consistently held in a wide variety of contexts that the compelling-state-interest test is applicable not only to outright denials but also to restraints that make exercise of those rights more difficult. See, e. g., Sherbert v. Verner, 374 U. S. 398 (1963) (free exercise of religion); NAACP v. Button, 371 U. S. 415 (1963) (freedom of expression and association), Linmark Associates v. Township of Willingboro, 431 U. S. 85 (1977) (freedom of expres*488sion). The compelling-state-interest test has been applied in voting cases, even where only relatively small infringements upon voting power, such as dilution of voting strength caused by malapportionment, have been involved. See, e. g., Reynolds v. Sims, 377 U. S. 533, 562, 566 (1964); Chapman v. Meier, 420 U. S. 1 (1975); Connor v. Finch, 431 U. S. 407 (1977). Similarly, cases involving the right to travel have consistently held that statutes penalizing the fundamental right to travel must pass muster under the compelling-state-interest test, irrespective of whether the statutes actually deter travel. Memorial Hospital v. Maricopa County, 415 U. S. 250, 257-258 (1974); Dunn v. Blumstein, 405 U. S. 330, 339-341 (1972); Shapiro v. Thompson, 394 U. S. 618 (1969). And indigents asserting a fundamental right of access to the courts have been excused payment of entry costs without being required first to show that their indigency was an absolute bar to access. Griffin v. Illinois, 351 U. S. 12 (1956); Douglas v. California, 372 U. S. 353 (1963); Boddie v. Connecticut, 401 U. S. 371 (1971).

Until today, I had not thought the nature of the fundamental right established in Roe was open to question, let alone susceptible of the interpretation advanced by the Court. The fact that the Connecticut scheme may not operate as an absolute bar preventing all indigent women from having abortions is not critical. What is critical is that the State has inhibited their fundamental right to make that choice free from state interference.

Nor does the manner in which Connecticut has burdened the right freely to choose to have an abortion save its Medicaid program. The Connecticut scheme cannot be distinguished from other grants and withholdings of financial benefits that we have held unconstitutionally burdened a fundamental right. Sherbert v. Verner, supra, struck down a South Carolina statute that denied unemployment compensation to a woman who for religious reasons could not *489work on Saturday, but that would have provided such compensation if her unemployment had stemmed from a number of other nonreligious causes. Even though there was no proof of indigency in that case, Sherbert held that “the pressure upon her to forgo [her religious] practice [was] unmistakable,” 374 U. S., at 404, and therefore held that the effect was the same as a fine imposed for Saturday worship. Here, though the burden is upon the right to privacy derived from the Due Process Clause and not upon freedom of religion under the Free Exercise Clause of the First Amendment, the governing principle is the same, for Connecticut grants and withholds financial benefits in a manner that discourages significantly the exercise of a fundamental constitutional right. Indeed, the case for application of the principle actually is stronger than in Verner since appellees are all indigents and therefore even more vulnerable to the financial pressures imposed by the Connecticut regulation.

Bellotti v. Baird, 428 U. S. 132, 147 (1976), held, and the Court today agrees, ante, at 473, that a state requirement is unconstitutional if it “unduly burdens the right to seek an abortion.” Connecticut has “unduly” burdened the fundamental right of pregnant women to be free to choose to have an abortion because the State has advanced no compelling state interest to justify its interference in that choice.

Although appellant does not argue it as justification, the Court concludes that the State's interest “in protecting the potential life of the fetus” suffices, ante, at 478.* Since only the first trimester of pregnancy is involved in this case, that justification is totally foreclosed if the Court is not overruling *490the holding of Roe v. Wade that “[w]ith respect to the State’s important and legitimate interest in potential life, the 'compelling’ point is at viability,” occurring at about the end of the second trimester. 410 U. S., at 163. The appellant also argues a further justification not relied upon by the Court, namely, that the State needs “to control the amount of its limited public funds which will be allocated to its public welfare budget.” Brief for Appellant 22. The District Court correctly held, however, that the asserted interest was “wholly chimerical” because the “state’s assertion that it saves money when it declines to pay the cost of a welfare mother’s abortion is simply contrary to undisputed facts.” 408 F. Supp., at 664.

Finally, the reasons that render the Connecticut regulation unconstitutional also render invalid, in my view, the requirement of a prior written certification by the woman’s attending physician that the abortion is “medically necessary,” and the requirement that the hospital submit a Request for Authorization of Professional Services including a “statement indicating the medical need for the abortion.” Brief for Appel-lees 2-3. For the same reasons, I would also strike down the requirement for prior authorization of payment by the Connecticut Department of Social Services.

18.2 Planned Parenthood v. Casey 18.2 Planned Parenthood v. Casey

PLANNED PARENTHOOD OF SOUTHEASTERN PENNSYLVANIA et al. v. CASEY, GOVERNOR OF PENNSYLVANIA, et al.

No. 91-744.

Argued April 22, 1992

Decided June 29, 1992*

*841O’Connor, Kennedy, and Soutee, JJ., announced the judgment of the Court and delivered the opinion of the Court with respect to Parts I, II, III, V-A, V-C, and VI, in which Blackmun and Stevens, JJ., joined, an opinion with respect to Part V-E, in which Stevens, J., joined, and an opinion with respect to Parts IV, V-B, and V-D. Stevens, J., filed an opinion concurring in part and dissenting in part, post, p. 911. Black-mun, J., filed an opinion concurring in part, concurring in the judgment in part, and dissenting in part, post, p. 922. Rehnquist, C. J., filed an opinion concurring in the judgment in part and dissenting in part, in which *842White, Scalia, and Thomas, JJ., joined, post, p. 944. Scalia, J., filed an opinion concurring in the judgment in part and dissenting in part, in which Rehnquist, C. J., and White and Thomas, JJ., joined, post, p. 979.

Kathryn Kolbert argued the cause for petitioners in No. 91-744 and respondents in No. 91-902. With her on the briefs were Janet Benshoof Lynn M. Paltrow, Rachael N. Pine, Steven R. Shapiro, John A. Powell, Linda J. Wharton, and Carol E. Tracy.

Ernest D. Preate, Jr., Attorney General of Pennsylvania, argued the cause for respondents in No. 91-744 and petitioners in No. 91-902. With him on the brief were John G. Knorr III, Chief Deputy Attorney General, and Kate L. Mershimer, Senior Deputy Attorney General.

Solicitor General Starr argued the cause for the United States as amicus curiae in support of respondents in No. 91-744 and petitioners in No. 91-902. With him on the brief were Assistant Attorney General Gerson, Paul J. Larkin, Jr., Thomas G. Hungar, and Alfred R. Moilin.

*843Justice O’Connor, Justice Kennedy, and Justice Sou-ter

announced the judgment of the Court and delivered the opinion of the Court with respect to Parts I, II, III, V-A, *844V-C, and VI, an opinion with respect to Part V-E,

in which Justice Stevens joins, and an opinion with respect to Parts IV, V-B, and V-D.

I

Liberty finds no refuge in a jurisprudence of doubt. Yet 19 years after our holding that the Constitution protects a woman’s right to terminate her pregnancy in its early stages, Roe v. Wade, 410 U. S. 113 (1973), that definition of liberty is still questioned. Joining the respondents as amicus curiae, the United States, as it has done in five other cases in the last decade, again asks us to overrule Roe. See Brief for Respondents 104-117; Brief for United States as Amicus Curiae 8.

At issue in these cases are five provisions of the Pennsylvania Abortion Control Act of 1982, as amended in 1988 and 1989. 18 Pa. Cons. Stat. §§3203-3220 (1990). Relevant portions of the Act are set forth in the Appendix. Infra, at 902. The Act requires that a woman seeking an abortion give her informed consent prior to the abortion procedure, and specifies that she be provided with certain information at least 24 hours before the abortion is performed. § 3205. For a minor to obtain an abortion, the Act requires the informed consent of one of her parents, but provides for a judicial bypass option if the minor does not wish to or cannot obtain a parent’s consent. § 3206. Another provision of the Act requires that, unless certain exceptions apply, a married woman seeking an abortion must sign a statement indicating that she has notified her husband of her intended abortion. §3209. The Act exempts compliance with these three requirements in the event of a “medical emergency,” which is defined in §3203 of the Act. See §§3203, 3205(a), 3206(a), 3209(c). In addition to the above provisions regulating the performance of abortions, the Act imposes certain reporting requirements on facilities that provide abortion services. §§ 3207(b), 3214(a), 3214(f).

*845Before any of these provisions took effect, the petitioners, who are five abortion clinics and one physician representing himself as well as a class of physicians who provide abortion services, brought this suit seeking declaratory and injunctive relief. Each provision was challenged as unconstitutional on its face. The District Court entered a preliminary injunction against the enforcement of the regulations, and, after a 3-day bench trial, held all the provisions at issue here unconstitutional, entering a permanent injunction against Pennsylvania’s enforcement of them. 744 F. Supp. 1323 (ED Pa. 1990). The Court of Appeals for the Third Circuit affirmed in part and reversed in part, upholding all of the regulations except for the husband notification requirement. 947 F. 2d 682 (1991). We granted certiorari. 502 U. S. 1056 (1992).

The Court of Appeals found it necessary to follow an elaborate course of reasoning even to identify the first premise to use to determine whether the statute enacted by Pennsylvania meets constitutional standards. See 947 F. 2d, at 687-698. And at oral argument in this Court, the attorney for the parties challenging the statute took the position that none of the enactments can be upheld without overruling Roe v. Wade. Tr. of Oral Arg. 5-6. We disagree with that analysis; but we acknowledge that our decisions after Roe cast doubt upon the meaning and reach of its holding. Further, The Chief Justice admits that he would overrule the central holding of Roe and adopt the rational relationship test as the sole criterion of constitutionality. See post, at 944, 966. State and federal courts as well as legislatures throughout the Union must have guidance as they seek to address this subject in conformance with the Constitution. Given these premises, we find it imperative to review once more the principles that define the rights of the woman and the legitimate authority of the State respecting the termination of pregnancies by abortion procedures.

After considering the fundamental constitutional questions resolved by Roe, principles of institutional integrity, *846and the rule of stare decisis, we are led to conclude this: the essential holding of Roe v. Wade should be retained and once again reaffirmed.

It must be stated at the outset and with clarity that Roe’s essential holding, the holding we reaffirm, has 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.

II

Constitutional protection of the woman’s decision to terminate her pregnancy derives from the Due Process Clause of the Fourteenth Amendment. It declares that no State shall “deprive any person of life, liberty, or property, without due process of law.” The controlling word in the cases before us is “liberty.” Although a literal reading of the Clause might suggest that it governs only the procedures by which a State may deprive persons of liberty, for at least 105 years, since Mugler v. Kansas, 123 U. S. 623, 660-661 (1887), the Clause has been understood to contain a substantive component as well, one “barring certain government actions regardless of the fairness of the procedures used to implement them.” Daniels v. Williams, 474 U. S. 327, 331 (1986). As Justice Brandéis (joined by Justice Holmes) observed, “[djespite arguments to the contrary which had seemed to me persuasive, it is settled that the due process clause of the Fourteenth *847Amendment applies to matters of substantive law as well as to matters of procedure. Thus all fundamental rights comprised within the term liberty are protected by the Federal Constitution from invasion by the States.” Whitney v. California, 274 U. S. 357, 373 (1927) (concurring opinion). “[TJhe guaranties of due process, though having their roots in Magna Carta’s ‘per legem ter rae’ and considered as procedural safeguards ‘against executive usurpation and tyranny/ have in this country ‘become bulwarks also against arbitrary legislation.’ ” Poe v. Ullman, 367 U. S. 497, 541 (1961) (Harlan, J., dissenting from dismissal on jurisdictional grounds) (quoting Hurtado v. California, 110 U. S. 516, 532 (1884)).

The most familiar of the substantive liberties protected by the Fourteenth Amendment are those recognized by the Bill of Rights. We have held that the Due Process Clause of the Fourteenth Amendment incorporates most of the Bill of Rights against the States. See, e. g., Duncan v. Louisiana, 391 U. S. 145, 147-148 (1968). It is tempting, as a means of curbing the discretion of federal judges, to suppose that liberty encompasses no more than those rights already guaranteed to the individual against federal interference by the express provisions of the first eight Amendments to the Constitution. See Adamson v. California, 332 U. S. 46, 68-92 (1947) (Black, J., dissenting). But of course this Court has never accepted that view.

It is also tempting, for the same reason, to suppose that the Due Process Clause protects only those practices, defined at the most specific level, that were protected against government interference by other rules of law when the Fourteenth Amendment was ratified. See Michael H. v. Gerald D., 491 U. S. 110, 127-128, n. 6 (1989) (opinion of Scalia, J.). But such a view would be inconsistent with our law. It is a promise of the Constitution that there is a realm of personal liberty which the government may not enter. We have vindicated this principle before. Marriage is mentioned nowhere in the Bill of Rights and interracial marriage was file-*848gal in most States in the 19th century, but the Court was no doubt correct in finding it to be an aspect of liberty protected against state interference by the substantive component of the Due Process Clause in Loving v. Virginia, 388 U. S. 1, 12 (1967) (relying, in an opinion for eight Justices, on the Due Process Clause). Similar examples may be found in Turner v. Safley, 482 U. S. 78, 94-99 (1987); in Carey v. Population Services International, 431 U. S. 678, 684-686 (1977); in Griswold v. Connecticut, 381 U. S. 479, 481-482 (1965), as well as in the separate opinions of a majority of the Members of the Court in that case, id., at 486-488 (Goldberg, J., joined by Warren, C. J., and Brennan, J., concurring) (expressly relying on due process), id., at 500-502 (Harlan, J., concurring in judgment) (same), id., at 502-507 (White, J., concurring in judgment) (same); in Pierce v. Society of Sisters, 268 U. S. 510, 534-535 (1925); and in Meyer v. Nebraska, 262 U. S. 390, 399-403 (1923).

Neither the Bill of Rights nor the specific practices of States at the time of the adoption of the Fourteenth Amendment marks the outer limits of the substantive sphere of liberty which the Fourteenth Amendment protects. See U. S. Const., Arndt. 9. As the second Justice Harlan recognized:

“[T]he full scope of the liberty guaranteed by the Due Process Clause cannot be found in or limited by the precise terms of the specific guarantees elsewhere provided in the Constitution. This ‘liberty’ is not a series of isolated points pricked out in terms of the taking of property; the freedom of speech, press, and religion; the right to keep and bear arms; the freedom from unreasonable searches and seizures; and so on. It is a rational continuum which, broadly speaking, includes a freedom from all substantial arbitrary impositions and purposeless restraints, . . . and which also recognizes, what a reasonable and sensitive judgment must, that certain interests require particularly careful scrutiny of the state needs asserted to justify their abridgment.” Poe v. *849UUman, supra, at 543 (opinion dissenting from dismissal on jurisdictional grounds).

Justice Harlan wrote these words in addressing an issue the full Court did not reach in Poe v. Ullman, but the Court adopted his position four Terms later in Griswold v. Connecticut, supra. In Griswold, we held that the Constitution does not permit a State to forbid a married couple to use contraceptives. That same freedom was later guaranteed, under the Equal Protection Clause, for unmarried couples. See Eisenstadt v. Baird, 405 U. S. 438 (1972). Constitutional protection was extended to the sale and distribution of contraceptives in Carey v. Population Services International, supra. It is settled now, as it was when the Court heard arguments in Roe v. Wade, that the Constitution places limits on a State’s right to interfere with a person’s most basic decisions about family and parenthood, see Carey v. Population Services International, supra; Moore v. East Cleveland, 431 U. S. 494 (1977); Eisenstadt v. Baird, supra; Loving v. Virginia, supra; Griswold v. Connecticut, supra; Skinner v. Oklahoma ex rel. Williamson, 316 U. S. 535 (1942); Pierce v. Society of Sisters, supra; Meyer v. Nebraska, supra, as well as bodily integrity, see, e. g., Washington v. Harper, 494 U. S. 210, 221-222 (1990); Winston v. Lee, 470 U. S. 753 (1985); Rochin v. California, 342 U. S. 165 (1952).

The inescapable fact is that adjudication of substantive due process claims may call upon the Court in interpreting the Constitution to exercise that same capacity which by tradition courts always have exercised: reasoned judgment. Its boundaries are not susceptible of expression as a simple rule. That does not mean we are free to invalidate state policy choices with which we disagree; yet neither does it permit us to shrink from the duties of our office. As Justice Harlan observed:

“Due process has not been reduced to any formula; its content cannot be determined by reference to any code. *850The best that can be said is that through the course of this Court’s decisions it has represented the balance which our Nation, built upon postulates of respect for the liberty of the individual, has struck between that liberty and the demands of organized society. If the supplying of content to this Constitutional concept has of necessity been a rational process, it certainly has not been one where judges have felt free to roam where unguided speculation might take them. The balance of which I speak is the balance struck by this country, having regard to what history teaches are the traditions from which it developed as well as the traditions from which it broke. That tradition is a living thing. A decision of this Court which radically departs from it eould not long survive, while a decision which builds on what has survived is likely to be sound. No formula could serve as a substitute, in this area, for judgment and restraint.” Poe v. Ullman, 367 U. S., at 542 (opinion dissenting from dismissal on jurisdictional grounds).

See also Rochin v. California, supra, at 171-172 (Frankfurter, J., writing for the Court) (“To believe that this judicial exercise of judgment could be avoided by freezing ‘due process of law’ at some fixed stage of time or thought is to suggest that the most important aspect of constitutional adjudication is a function for inanimate machines and not for judges”).

Men and women of good conscience can disagree, and we suppose some always shall disagree, about the profound moral and spiritual implications of terminating a pregnancy, even in its earliest stage. Some of us as individuals find abortion offensive to our most basic principles of morality, but that cannot control our decision. Our obligation is to define the liberty of all, not to mandate our own moral code. The underlying constitutional issue is whether the State can resolve these philosophic questions in such a definitive way that a woman lacks all choice in the matter, except perhaps *851in those rare circumstances in which the pregnancy is itself a danger to her own life or health, or is the result of rape or incest.

It is conventional constitutional doctrine that where reasonable people disagree the government can adopt one position or the other. See, e. g., Ferguson v. Skrupa, 372 U. S. 726 (1963); Williamson v. Lee Optical of Okla., Inc., 348 U. S. 483 (1955). That theorem, however, assumes a state of affairs in which the choice does not intrude upon a protected liberty. Thus, while some people might disagree about whether or not the flag should be saluted, or disagree about the proposition that it may not be defiled, we have ruled that a State may not compel or enforce one view or the other. See West Virginia Bd. of Ed. v. Barnette, 319 U. S. 624 (1943); Texas v. Johnson, 491 U. S. 397 (1989).

Our law affords constitutional protection to personal decisions relating to marriage, procreation, contraception, family relationships, child rearing, and education. Carey v. Population Services International, 431 U. S., at 685. Our cases recognize “the right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.” Eisenstadt v. Baird, supra, at 453 (emphasis in original). Our precedents “have respected the private realm of family life which the state cannot enter.” Prince v. Massachusetts, 321 U. S. 158, 166 (1944). These matters, involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy, are central to the liberty protected by the Fourteenth Amendment. At the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe, and of the mystery of human life. Beliefs about these matters could not define the attributes of personhood were they formed under compulsion of the State.

*852These considerations begin our analysis of the woman’s interest in terminating her pregnancy but cannot end it, for this reason: though the abortion decision may originate within the zone of conscience and belief, it is more than a philosophic exercise. Abortion is a unique act. It is an act fraught with consequences for others: for the woman who must live with the implications of her decision; for the persons who perform and assist in the procedure; for the spouse, family, and society which must confront the knowledge that these procedures exist, procedures some deem nothing short of an act of violence against innocent human life; and, depending on one’s beliefs, for the life or potential life that is aborted. Though abortion is conduct, it does not follow that the State is entitled to proscribe it in all instances. That is because the liberty of the woman is at stake in a sense unique to the human condition and so unique to the law. The mother who carries a child to full term is subject to anxieties, to physical constraints, to pain that only she must bear. That these sacrifices have from the beginning of the human race been endured by woman with a pride that ennobles her in the eyes of others and gives to the infant a bond of love cannot alone be grounds for the State to insist she make the sacrifice. Her suffering is too intimate and personal for the State to insist, without more, upon its own vision of the woman’s role, however dominant that vision -has been in the course of our history and our culture. The destiny of the woman must be shaped to a large extent on her own conception of her spiritual imperatives and her place in society.

It should be recognized, moreover, that in some critical respects the abortion decision is of the same character as the decision to use contraception, to which Griswold v. Connecticut, Eisenstadt v. Baird, and Carey v. Population Services International afford constitutional protection. We have no doubt as to the correctness of those decisions. They support *853the reasoning in Roe relating to the woman’s liberty because they involve personal decisions concerning not only the meaning of procreation but also human responsibility and respect for it. As with abortion, reasonable people will have differences of opinion about these matters. One view is based on such reverence for the wonder of creation that any pregnancy ought to be welcomed and carried to full term no matter how difficult it will be to provide for the child and ensure its well-being. Another is that the inability to provide for the nurture and care of the infant is a cruelty to the child and an anguish to thé parent. These are intimate views with infinite variations, and their deep, personal character underlay our decisions in Griswold, Eisenstadt, and Carey. The same concerns are present when the woman confronts the reality that, perhaps despite her attempts to avoid it, she has become pregnant.

It was this dimension of personal liberty that Roe sought to protect, and its holding invoked the reasoning and the tradition of the precedents we have discussed, granting protection to substantive liberties of the person. Roe was, of course, an extension of those cases and, as the decision itself indicated, the separate States could act in some degree to further their own legitimate interests in protecting prenatal life. The extent to which the legislatures of the States might aet to outweigh the interests of the woman in choosing to terminate her pregnancy was a subject of debate both in Roe itself and in decisions following it.

While we appreciate the weight of the arguments made on behalf of the State in the cases before us, arguments which in their ultimate formulation conclude that Roe should be overruled, the reservations any of us may have in reaffirming the central holding of Roe are outweighed by the explication of individual liberty we have given combined with the force of stare decisis. We turn now to that doctrine.

*854hH I — I

A

The obligation to follow precedent begins with necessity, and a contrary necessity marks its outer limit. With Cardozo, we recognize that no judicial system could do society's work if it eyed each issue afresh in every case that raised it. See B. Cardozo, The Nature of the Judicial Process 149 (1921). Indeed, the very concept of the rule of law underlying our own Constitution requires such continuity over time that a respect for precedent is, by definition, indispensable. See Powell, Stare Decisis and Judicial Restraint, 1991 Journal of Supreme Court History 13,16. At the other extreme, a different necessity would make itself felt if a prior judicial ruling should come to be seen so clearly as error that its enforcement was for that very reason doomed.

Even when the decision to overrule a prior case is not, as in the rare, latter instance, virtually foreordained, it is common wisdom that the rule of stare decisis is not an “inexorable command,” and certainly it is not such in every constitutional case, see Burnet v. Coronado Oil & Gas Co., 285 U. S. 393, 405-411 (1932) (Brandéis, J., dissenting). See also Payne v. Tennessee, 501 U. S. 808, 842 (1991) (Souter, J., joined by Kennedy, J., concurring); Arizona v. Rumsey, 467 U. S. 203, 212 (1984). Rather, when this Court reexamines a prior holding, its judgment is customarily informed by a series of prudential and pragmatic considerations designed to test the consistency of overruling a prior decision with the ideal of the rule of law, and to gauge the respective costs of reaffirming and overruling a prior case. Thus, for example, we may ask whether the rule has proven to be intolerable simply in defying practical workability, Swift & Co. v. Wickham, 382 U. S. 111, 116 (1965); whether the rule is subject to a kind of reliance that would lend a special hardship to the consequences of overruling and add inequity to the cost of repudiation, e. g., United States v. Title Ins. & Trust *855Co., 265 U. S. 472, 486 (1924); whether related principles of law have so far developed as to have left the old rule no more than a remnant of abandoned doctrine, see Patterson v. McLean Credit Union, 491 U. S. 164, 173-174 (1989); or whether facts have so changed, or come to be seen so differently, as to have robbed the old rule of significant application or justification, e.g., Burnet, supra, at 412 (Brandéis, J., dissenting).

So in this case we may enquire whether Roe’s central rule has been found unworkable; whether the rule’s limitation on state power could be removed without serious inequity to those who have relied upon it or significant damage to the stability of the society governed by it; whether the law’s growth in the intervening years has left Roe’s central rule a doctrinal anachronism discounted by society; and whether Roe’s premises of fact have so far changed in the ensuing two decades as to render its central holding somehow irrelevant or unjustifiable in dealing with the issue it addressed.

1

Although Roe has engendered opposition, it has in no sense proven “unworkable,” see Garcia v. San Antonio Metropolitan Transit Authority, 469 U. S. 528, 546 (1985), representing as it does a simple limitation beyond which a state law is unenforceable. While Roe has, of course, required judicial assessment of state laws affecting the exercise of the choice guaranteed against government infringement, and although the need for such review will remain as a consequence of today’s decision, the required determinations fall within judicial competence.

2

The inquiry into reliance counts the cost of a rule’s repudiation as it would fall on those who have relied reasonably on the rule’s continued application. Since the classic case for weighing reliance heavily in favor of following the earlier rule occurs in the commercial context, see Payne v. Tennes*856see, supra,, at 828, where advance planning of great precision is most obviously a necessity, it is no cause for surprise that some would find no reliance worthy of consideration in support of Roe.

While neither respondents nor their amici in so many words deny that the abortion right invites some reliance prior to its actual exercise, one can readily imagine an argument stressing the dissimilarity of this case to one involving property or contract. Abortion is customarily chosen as an unplanned response to the consequence of unplanned activity or to the failure of conventional birth control, and except on the assumption that no intercourse would have occurred but for Roe’s holding, such behavior may appear to justify no reliance claim. Even if reliance could be claimed on that unrealistic assumption, the argument might run, any reliance interest would be de minimis. This argument would be premised on the hypothesis that reproductive planning could take virtually immediate account of any sudden restoration of state authority to ban abortions.

To eliminate the issue of relianee that easily, however, one would need to limit cognizable reliance to specific instances of sexual activity. But to do this would be simply to refuse to face the fact that for two decades of economic and social developments, people have organized intimate relationships and made choices that define their views of themselves and their places in society, in relianee on the availability of abortion in the event that contraception should fail. The ability of women to participate equally in the economic and social life of the Nation has been facilitated by their ability to control their reproductive lives. See, e. g., R. Petehesky, Abortion and Woman’s Choice 109, 138, n. 7 (rev. ed. 1990). The Constitution serves human values, and while the effect of reliance on Roe cannot be exactly measured, neither can the certain cost of overruling Roe for people who have ordered their thinking and living around that case be dismissed.

*8573

No evolution of legal principle has left Roe’s doctrinal footings weaker than they were in 1973. No development of constitutional law since the ease was decided has implicitly or explicitly left Roe behind as a mere survivor of obsolete constitutional thinking.

It will be recognized, of course, that Roe stands at an intersection of two lines of decisions, but in whichever doctrinal category one reads the case, the result for present purposes will be the same. The Roe Court itself placed its holding in the succession of cases most prominently exemplified by Griswold v. Connecticut, 381 U. S. 479 (1965). See Roe, 410 U. S., at 152-153. When it is so seen, Roe is clearly in no jeopardy, since subsequent constitutional developments have neither disturbed, nor do they threaten to diminish, the scope of recognized protection accorded to the liberty relating to intimate relationships, the family, and decisions about whether or not to beget or bear a child. See, e. g., Carey v. Population Services International, 431 U. S. 678 (1977); Moore v. East Cleveland, 431 U. S. 494 (1977).

Roe, however, may be seen not only as an exemplar of Griswold liberty but as a rule (whether or not mistaken) of personal autonomy and bodily integrity, with doctrinal affinity to cases recognizing limits on governmental power to mandate medical treatment or to bar its rejection. If so, our cases since Roe accord with Roe’s view that a State’s interest in the protection of life falls short of justifying any plenary override of individual liberty claims. Cruzan v. Director, Mo. Dept. of Health, 497 U. S. 261, 278 (1990); cf., e. g., Riggins v. Nevada, 504 U. S. 127, 135 (1992); Washington v. Harper, 494 U. S. 210 (1990); see also, e. g., Rochin v. California, 342 U. S. 165 (1952); Jacobson v. Massachusetts, 197 U. S. 11, 24-30 (1905).

Finally, one could classify Roe as sui generis. If the case is so viewed, then there clearly has been no erosion of its central determination. The original holding resting on the *858concurrence of seven Members of the Court in 1973 was expressly affirmed by a majority of six in 1983, see Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416 (Akron I), and by a majority of five in 1986, see Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747, expressing adherence to the constitutional ruling despite legislative efforts in some States to test its limits. More recently, in Webster v. Reproductive Health Services, 492 U. S. 490 (1989), although two of the present authors questioned the trimester framework in a way consistent with our judgment today, see id., at 518 (Rehnquist, C. J., joined by White and Kennedy, JJ.); id., at 529 (O’Connor, J., concurring in part and concurring in judgment), a majority of the Court either decided to reaffirm or declined to address the constitutional validity of the central holding of Roe. See Webster, 492 U. S., at 521 (Rehnquist, C. J., joined by White and Kennedy, JJ.); id., at 525-526 (O’Connor, J., concurring in part and concurring in judgment); id., at 537, 553 (Blackmun, J., joined by Brennan and Marshall, JJ., concurring in part and dissenting in part); id., at 561-563 (Stevens, J., concurring in part and dissenting in part).

Nor will courts building upon Roe be likely to hand down erroneous decisions as a consequence. Even on the assumption that the central holding of Roe was in error, that error would go only to the strength of the state interest in fetal protection, not to the recognition afforded by the Constitution to the woman’s liberty. The latter aspect of the decision fits comfortably within the framework of the Court’s prior decisions, including Skinner v. Oklahoma ex rel. Williamson, 316 U. S. 535 (1942); Griswold, supra; Loving v. Virginia, 388 U. S. 1 (1967); and Eisenstadt v. Baird, 405 U. S. 438 (1972), the holdings of which are “not a series of isolated points,” but mark a “rational continuum.” Poe v. Ullman, 367 U. S., at 543 (Harlan, J, dissenting). As we described in *859Carey v. Population Services International, supra, the liberty which encompasses those decisions

“includes ‘the interest in independence in making certain kinds of important decisions/ While the outer limits of this aspect of [protected liberty] have not been marked by the Court, it is clear that among the decisions that an individual may make without unjustified government interference are personal decisions ‘relating to marriage, procreation, contraception, family relationships, and child rearing and education/ ” 431 U. S., at 684-685 (citations omitted).

The soundness of this prong of the Roe analysis is apparent from a consideration of the alternative. If indeed the woman’s interest in deciding whether to bear and beget a child had not been recognized as in Roe, the State might as readily restrict a woman’s right to choose to carry a pregnancy to term as to terminate it, to further asserted state interests in population control, or eugenics, for example. Yet Roe has been sensibly relied upon to counter any such suggestions. E. g., Arnold v. Board of Education of Escambia County, Ala., 880 F. 2d 305, 311 (CA11 1989) (relying upon Roe and concluding that government officials violate the Constitution by coercing a minor to have an abortion); Avery v. County of Burke, 660 F. 2d 111, 115 (CA4 1981) (county agency inducing teenage girl to undergo unwanted sterilization on the basis of misrepresentation that she had sickle cell trait); see also In re Quinlan, 70 N. J. 10, 355 A. 2d 647 (relying on Roe in finding a right to terminate medical treatment), cert, denied sub nom. Garger v. New Jersey, 429 U. S. 922 (1976)). In any event, because Roe’s scope is confined by the fact of its concern with postconeeption potential life, a concern otherwise likely to be implicated only by some forms of contraception protected independently under Griswold and later cases, any error in Roe is unlikely to have serious ramifications in fixture cases.

*8604

We have seen how time has overtaken some of Roe’s factual assumptions: advances in maternal health care allow for abortions safe to the mother later in pregnancy than was true in 1973, see Akron I, supra, at 429, n. 11, and advances in neonatal care have advanced viability to a point somewhat earlier. Compare Roe, 410 U. S., at 160, with Webster, supra, at 515-616 (opinion of Rehnquist, C. J.); see Akron I, 462 U. S., at 457, and n. 5 (O’Connor, J., dissenting). But these facts go only to the scheme of time limits on the realization of competing interests, and the divergences from the factual premises of 1973 have no bearing on the validity of Roe’s central holding, that viability marks the earliest point at which the State’s interest in fetal life is constitutionally adequate to justify a legislative ban on nontherapeutic abortions. The soundness or unsoundness of that constitutional judgment in no sense turns on whether viability occurs at approximately 28 weeks, as was usual at the time of Roe, at 23 to 24 weeks, as it sometimes does today, or at some moment even slightly earlier in pregnancy, as it may if fetal respiratory capacity can somehow be enhanced in the future. Whenever it may occur, the attainment of viability may continue to serve as the critical fact, just as it has done since Roe was decided; which is to say that no change in Roe’s factual underpinning has left its central holding obsolete, and none supports an argument for overruling it.

5

The sum of the precedential enquiry to this point Shows Roe’s underpinnings unweakened in any way affecting its central holding. While it has engendered disapproval, it has not been unworkable. An entire generation has come of age free to assume Roe’s concept of liberty in defining the capacity of women to act in society, and to make reproductive decisions; no erosion of principle going to liberty or personal autonomy has left Roe’s central holding a doctrinal remnant; *861Roe portends no developments at odds with other precedent for the analysis of personal liberty; and no changes of fact have rendered viability more or less appropriate as the point at which the balance of interests tips. Within the bounds of normal stare decisis analysis, then, and subject to the considerations on which it customarily turns, the stronger argument is for affirming Roe’s central holding, with whatever degree of personal reluctance any of us may have, not for overruling it.

B

In a less significant case, stare decisis analysis could, and would, stop at the point we have reached. But the sustained and widespread debate Roe has provoked calls for some comparison between that case and others of comparable dimension that have responded to national controversies and taken on the impress of the controversies addressed. Only two such decisional lines from the past century present themselves for examination, and in each instance the result reached by the Court accorded with the principles we apply today.

The first example is that line of cases identified with Lochner v. New York, 198 U. S. 45 (1905), which imposed substantive limitations on legislation limiting economic autonomy in favor of health and welfare regulation, adopting, in Justice Holmes’s view, the theory of laissez-faire. Id., at 75 (dissenting opinion). The Lochner decisions were exemplified by Adkins v. Children’s Hospital of District of Columbia, 261 U. S. 525 (1923), in which this Court held it to be an infringement of constitutionally protected liberty of contract to require the employers of adult women to satisfy minimum wage standards. Fourteen years later, West Coast Hotel Co. v. Parrish, 300 U. S. 379 (1937), signaled the demise of Lochner by overruling Adkins. In the meantime, the Depression had come and, with it, the lesson that seemed unmistakable to most people by 1937, that the interpretation of contractual freedom protected in Adkins rested on funda*862mentally false factual assumptions about the capacity of a relatively unregulated market to satisfy minimal levels of human welfare. See West Coast Hotel Co., supra, at 399. As Justice Jackson wrote of the constitutional crisis of 1937 shortly before he came on the bench: “The older world of laissez faire was recognized everywhere outside the Court to be dead.” The Struggle for Judicial Supremacy 85 (1941). The facts upon which the earlier case had premised a constitutional resolution of social controversy had proven to be untrue, and history’s demonstration of their untruth not only justified but required the new choice of constitutional principle that West Coast Hotel announced. Of course, it was true that the Court lost something by its misperception, or its lack of prescience, and the Court-packing crisis only magnified the loss; but the clear demonstration that the facts of economic life were different from those previously assumed warranted the repudiation of the old law.

The second comparison that 20th century history invites is with the cases employing the separate-but-equal rule for applying the Fourteenth Amendment’s equal protection guarantee. They began with Plessy v. Ferguson, 163 U. S. 537 (1896), holding that legislatively mandated racial segregation in public transportation works no denial of equal protection, rejecting the argument that racial separation enforced by the legal machinery of American society treats the black race as inferior. The Plessy Court considered “the underlying fallacy of the plaintiff’s argument to consist in the assumption that the enforced separation of the two races stamps the colored race with a badge of inferiority. If this be so, it is not by reason of anything found in the act, but solely because the colored race chooses to put that construction upon it.” Id., at 551. Whether, as a matter of historical fact, the Justices in the Plessy majority believed this or not, see id., at 557, 562 (Harlan, J., dissenting), this understanding of the implication of segregation was the stated justification for the Court’s opinion. But this understanding of *863the facts and the rule it was stated to justify were repudiated in Brown v. Board of Education, 347 U. S. 483 (1954) (Brown I). As one commentator observed, the question before the Court in Brown was “whether discrimination inheres in that segregation which is imposed by law in the twentieth century in certain specific states in the American Union. And that question has meaning and can find an answer only on the ground of history and of common knowledge about the facts of life in the times and places aforesaid.” Black, The Lawfulness of the Segregation Decisions, 69 Yale L. J. 421, 427 (1960).

The Court in Brown addressed these facts of life by observing that whatever may have been the understanding in Plessy’s time of the power of segregation to stigmatize those who were segregated with a “badge of inferiority,” it was clear by . 1954 that legally sanctioned segregation had just such an effect, to the point that racially separate public educational facilities were deemed inherently unequal. 347 U. S., at 494-495. Society’s understanding of the facts upon which a constitutional ruling was sought in 1954 was thus fundamentally different from the basis claimed for the decision in 1896. While we think Plessy was wrong the day it was decided, see Plessy, supra, at 552-564 (Harlan, J., dissenting), we must also recognize that the Plessy Court’s explanation for its decision was so clearly at odds with the facts apparent to the Court in 1954 that the decision to reexamine Plessy was on this ground alone not only justified but required.

West Coast Hotel and Brown each rested on facts, or an understanding of facts, changed from those which furnished the claimed justifications for the earlier constitutional resolutions. Each case was comprehensible as the Court’s response to facts that the country could understand, or had come to understand already, but which the Court of an earlier day, as its own declarations disclosed, had not been able to perceive. As the decisions were thus comprehensible *864they were also defensible, not merely as the victories of one doctrinal school over another by dint of numbers (victories though they were), but as applications of constitutional principle to facts as they had not been seen by the Court before. In constitutional adjudication as elsewhere in life, changed circumstances may impose new obligations, and the thoughtful part of the Nation could accept each decision to overrule a prior ease as a response to the Court’s constitutional duty.

Because the cases before us present no such occasion it could be seen as no such response. Because neither the factual underpinnings of Roe’s central holding nor our understanding of it has changed (and because no other indication of weakened precedent has been shown), the Court could not pretend to be reexamining the prior law with any justification beyond a present doctrinal disposition to come out differently from the Court of 1973. To overrule prior law for no other reason than that would run counter to the view repeated in our eases, that a decision to overrule should rest on some special reason over and above the belief that a prior ease was wrongly decided. See, e. g., Mitchell v. W. T. Grant Co., 416 U. S. 600, 636 (1974) (Stewart, J., dissenting) (“A basic change in the law upon a ground no firmer than a change in our membership invites the popular misconception that this institution is little different from the two political branches of the Government. No misconception could do more lasting injury to this Court and to the system of law which it is our abiding mission to serve”); Mapp v. Ohio, 367 U. S. 643, 677 (1961) (Harlan, J., dissenting).

C

The examination of the conditions justifying the repudiation of Adkins by West Coast Hotel and Plessy by Brown is enough to suggest the terrible price that would have been paid if the Court had not overruled as it did. In the present cases, however, as our analysis to this point makes clear, the terrible price would be paid for overruling. Our analysis *865would not be complete, however, without explaining why-overruling Roe’s central holding would not only reach an unjustifiable result under principles of stare decisis, but would seriously weaken the Court’s capacity to exercise the judicial power and to function as the Supreme Court of a Nation dedicated to the rule of law. To understand why this would be so it is necessary to understand the source of this Court’s authority, the conditions necessary for its preservation, and its relationship to the country’s understanding of itself as a constitutional Republic.

The root of American governmental power is revealed most clearly in the instance of the power conferred by the Constitution upon the-Judiciary of the United States and specifically upon this Court. As Americans of each succeeding generation are rightly told, the Court cannot buy support for its decisions by spending money and, except to a minor degree, it cannot independently coerce obedience to its decrees. The Court’s power lies, rather, in its legitimacy, a product of substance and perception that shows itself in the people’s acceptance of the Judiciary as fit to determine what the Nation’s law means and to declare what it demands.

The underlying substance of this legitimacy is of course the warrant for the Court’s decisions in the Constitution and the lesser sources of legal principle on which the Court draws. That substance is expressed in the Court’s opinions, and our contemporary understanding is such that a decision without principled justification would be no judicial act at all. But even when justification is furnished by apposite legal principle, something more is required. Because not every conscientious claim of principled justification will be accepted as such, the justification claimed must be beyond dispute. The Court must take care to speak and act in ways that allow people to accept its decisions on the terms the Court claims for them, as grounded truly in principle, not as compromises with social and political pressures having, as such, no bearing on the principled choices that the Court is *866obliged to make. Thus, the Court’s legitimacy depends on making legally principled decisions under circumstances in which their principled character is sufficiently plausible to be accepted by the Nation.

The need for principled action to be perceived as such is implicated to some degree whenever this, or any other appellate court, overrules a prior case. This is not to say, of course, that this Court cannot give a perfectly satisfactory explanation in most cases. People understand that some of the Constitution’s language is hard to fathom and that the Court’s Justices are sometimes able to perceive significant facts or to understand principles of law that* eluded their predecessors and that justify departures from existing decisions. However upsetting it may be to those most directly affected when one judicially derived rule replaces another, the country can accept some correction of error without necessarily questioning the legitimacy of the Court.

In two circumstances, however, the Court would almost certainly fail to receive the benefit of the doubt in overruling prior cases. There is, first, a point beyond which frequent overruling would overtax the country’s belief in the Court’s good faith. Despite the variety of reasons that may inform and justify a decision to overrule, we cannot forget that such a decision is usually perceived (and perceived correctly) as, at the least, a statement that a prior decision was wrong. There is a limit to the amount of error that can plausibly be imputed to prior Courts. If that limit should be exceeded, disturbance of prior rulings would be taken as evidence that justifiable reexamination of principle had given way to drives for particular results in the short term. The legitimacy of the Court would fade with the frequency of its vacillation.

That first circumstance can be described as hypothetical; the second is to the point here and now. Where, in the performance of its judicial duties, the Court decides a ease in such a way as to resolve the sort of intensely divisive controversy reflected in Roe and those rare, comparable cases, its *867decision has a dimension that the resolution of the normal case does not carry. It is the dimension present whenever the Court’s interpretation of the Constitution calls the contending sides of a national controversy to end their national division by accepting a common mandate rooted in the Constitution.

The Court is not asked to do this very often, having thus addressed the Nation only twice in our lifetime, in the decisions of Brown and Roe. But when the Court does act in this way, its decision requires an equally rare precedential force to counter the inevitable efforts to overturn it and to thwart its implementation. Some of those efforts may be mere unprincipled emotional reactions; others may proceed from principles worthy of profound respect. But whatever the premises of opposition may be, only the most convincing justification under accepted standards of precedent could suffice to demonstrate that a later decision overruling the first was anything but a surrender to political pressure, and an unjustified repudiation of the principle on which the Court staked its authority in the first instance. So to overrule under fire in the absence of the most compelling reason to reexamine a watershed decision would subvert the Court’s legitimacy beyond any serious question. Cf. Brown v. Board of Education, 349 U. S. 294, 300 (1955) (Broten II) (“[I]t should go without saying that the vitality of th[e] constitutional principles [announced in Brown I,] cannot be allowed to yield simply because of disagreement with them”).

The country’s loss of confidence in the Judiciary would be underscored by an equally certain and equally reasonable condemnation for another failing in overruling unnecessarily and under pressure. Some cost will be paid by anyone who approves or implements a constitutional decision where it is unpopular, or who refuses to work to undermine the decision or to force its reversal. The price may be criticism or ostracism, or it may be violence. An extra price will be paid by those who themselves disapprove of the decision’s results *868when viewed outside of constitutional terms, but who nevertheless struggle to accept it, because they respect the rule of law. To all those who will be so tested by following, the Court implicitly undertakes to remain steadfast, lest in the end a price be paid for nothing. The promise of constancy, once given, binds its maker for as long as the power to stand by the decision survives and the understanding of the issue has not changed so fundamentally as to render the commitment obsolete. From the obligation of this promise this Court cannot and should not assume any exemption when duty requires it to decide a case in conformance with the Constitution. A willing breach of it would be nothing, less than a breach of faith, and no Court that broke its faith with the people could sensibly expect credit for principle in the decision by which it did that.

It is true that diminished legitimacy may be restored, but only slowly. Unlike the political branches, a Court thus weakened could not seek to regain its position with a new mandate from the voters, and even if the Court could somehow go to the polls, the loss of its principled character could not be retrieved by the casting of so many votes. Like the character of an individual, the legitimacy of the Court must be earned over time. So, indeed, must be the character of a Nation of people who aspire to live according to the rule of law. Their belief in themselves as such a people is not readily separable from their understanding of the Court invested with the authority to decide their constitutional cases and speak before all others for their constitutional ideals. If the Court’s legitimacy should be undermined, then, so would the country be in its very ability to see itself through its constitutional ideals. The Court’s concern with legitimacy is not for the sake of the Court, but for the sake of the Nation to which it is responsible.

The Court’s duty in the present cases is clear. In 1973, it confronted the already-divisive issue of governmental power *869to limit personal choice to undergo abortion, for which it provided a new resolution based on the due process guaranteed by the Fourteenth Amendment. Whether or not a new social consensus is developing on that issue, its divisiveness is no less today than in 1973, and pressure to overrule the decision, like pressure to retain it, has grown only more intense. A decision to overrule Roe’s essential holding under the existing circumstances would address error, if error there was, at the cost of both profound and unnecessary damage to the Court’s legitimacy, and to the Nation’s commitment to the rule of law. It is therefore imperative to adhere to the essence of Roe’s original decision, and we do so today.

IV

From what we have said so far it follows that it is a constitutional liberty of the woman to have some freedom to terminate her pregnancy. We conclude that the basic decision in Roe was based on a constitutional analysis which we cannot now repudiate. The woman’s liberty is not so unlimited, however, that from the outset the State cannot show its concern for the life of the unborn, and at a later point in fetal development the State’s interest in life has sufficient force so that the right of the woman to terminate the pregnancy can be restricted.

That brings us, of course, to the point where much criticism has been directed at Roe, a criticism that always inheres when the Court draws a specific rule from what in the Constitution is but a general standard. We conclude, however, that the urgent claims of the woman to retain the ultimate control over her destiny and her body, claims implicit in the meaning of liberty, require us to perform that function. Liberty must not be extinguished for want of a line that is clear. And it falls to us to give some real substance to the woman’s liberty to determine whether to carry her pregnancy to full term.

*870We conclude the line should be drawn at viability, so that before that time the woman has a right to choose to terminate her pregnancy. We adhere to this principle for two reasons. First, as we have said, is the doctrine of stare deci-sis. Any judicial act of line-drawing may seem somewhat arbitrary, but Roe was a reasoned statement, elaborated with great care. We have twice reaffirmed it in the face of great opposition. See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 759; Akron I, 462 U. S., at 419-420. Although we must overrule those parts of Thornburgh and Akron I which, in our view, are inconsistent with iBoe’s statement that the State has a legitimate interest in promoting the life or potential life of the unborn, see infra, at 882-883, the central premise of those cases represents an unbroken commitment by this Court to the essential holding of Roe. It is that premise which we reaffirm today.

The second reason is that the concept of viability, as we noted in Roe, is the time at which there is a realistic possibility of maintaining and nourishing a life outside the womb, so that the independent existence of the second life can in reason and all fairness be the object of state protection that now overrides the rights of the woman. See Roe v. Wade, 410 U. S., at 163. Consistent with other constitutional norms, legislatures may draw lines which appear arbitrary without the necessity of offering a justification. But courts may not. We must justify the lines we draw And there is no line other than viability which is more workable. To be sure, as we have said, there may be some medical developments that affect the precise point of viability, see supra, at 860, but this is an imprecision within tolerable limits given that the medical community and all those who must apply its discoveries will continue to explore the matter. The viability line also has, as a practical matter, an element of fairness. In some broad sense it might be said that a woman who fails to act before viability has consented to the State’s intervention on behalf of the developing child.

*871The woman’s right to terminate her pregnancy before viability is the most central principle of Roe v. Wade. It is a rule of law and a component of liberty we cannot renounce.

On the other side of the equation is the interest of the State in the protection of potential life. The Roe Court recognized the State’s “important and legitimate interest in protecting the potentiality of human life.” Roe, supra, at 162. The weight to be given this state interest, not the strength of the woman’s interest, was the difficult question faced in Roe. We do not need to say whether each of us, had we been Members of the Court when the valuation of the state interest came before it as an original matter, would have concluded, as the Roe Court did, that its weight is insufficient to justify a ban on abortions prior to viability even when it is subject to certain exceptions. The matter is not before us in the first instance, and coming as it does after nearly 20 years of litigation in Roe’s wake we are satisfied that the immediate question is not the soundness of Roe’s resolution of the issue, but the precedential force that must be accorded to its holding. And we have concluded that the essential holding of Roe should be reaffirmed.

Yet it must be remembered that Roe v. Wade speaks with clarity in establishing not only the woman’s liberty but also the State’s “important and legitimate interest in potential life.” Roe, supra, at 163. That portion of the decision in Roe has been given too little acknowledgment and implementation by the Court in its subsequent cases. Those eases decided that any regulation touching upon the abortion decision must survive strict scrutiny, to be sustained only if drawn in narrow terms to further a compelling state interest. See, e. g., Akron I, supra, at 427. Not all of the cases decided under that formulation can be reconciled with the holding in Roe itself that the State has legitimate interests in the health of the woman and in protecting the potential life within her. In resolving this tension, we choose to rely upon Roe, as against the later cases.

*872Roe established a trimester framework to govern abortion regulations. Under this elaborate but rigid construct, almost no regulation at all is permitted during the first trimester of pregnancy; regulations designed to protect the woman’s health, but not to further the State’s interest in potential life, are permitted during the second trimester; and during the third trimester, when the fetus is viable, prohibitions are permitted provided the life or health of the mother is not at stake. Roe, supra, at 163-166. Most of our cases since Roe have involved the application of rules derived from the trimester framework. See, e. g., Thornburgh v. American College of Obstetricians and Gynecologists, supra; Akron I, supra.

The trimester framework no doubt was erected to ensure that the woman’s right to choose not become so subordinate to the State’s interest in promoting fetal life that her choice exists in theory but not in fact. We do not agree, however, that the trimester approach is necessary to accomplish this objective. A framework of this rigidity was unnecessary and in its later interpretation sometimes contradicted the State’s permissible exercise of its powers.

Though the woman has a right to choose to terminate or continue her pregnancy before viability, it does not at all follow that the State is prohibited from taking steps to ensure that this choice is thoughtful and informed. Even in the earliest stages of pregnancy, the State may enact rules and regulations designed to encourage her to know that there are philosophic and social arguments of great weight that can be brought to bear in favor of continuing the pregnancy to full term and'that there are procedures and institutions to allow adoption of unwanted children as well as a certain degree of state assistance if the mother chooses to raise the child herself. “ ‘[T]he Constitution does not forbid a State or city, pursuant to democratic processes, from expressing a preference for normal childbirth.’” Webster v. Reproductive Health Services, 492 U. S., at 511 (opinion of *873the Court) (quoting Poelker v. Doe, 432 U. S. 519, 521 (1977)). It follows that States are free to enact laws to provide a reasonable framework for a woman to make a decision that has such profound and lasting meaning. This, too, we find consistent with Roe’s central premises, and indeed the inevitable consequence of our holding that the State has an interest in protecting the life of the unborn. .

We reject the trimester framework, which we do not consider to be part of the essential holding of Roe. See Webster v. Reproductive Health Services, 492 U. S., at 518 (opinion of Rehnquist, C. J.); id., at 529 (O’Connor, J., concurring in part and concurring in judgment) (describing the trimester framework as “problematic”). Measures aimed at ensuring that a woman’s choice contemplates the consequences for the ' fetus do not necessarily interfere with the right recognized in Roe, although those measures have been found to be inconsistent with the rigid trimester framework announced in that case. A logical reading of the central holding in Roe itself, and a necessary reconciliation of the liberty of the woman and the interest of the State in promoting prenatal life, require, in our view, that we abandon the trimester framework as a rigid prohibition on all previability regulation aimed at the protection of fetal life. The trimester framework suffers from these basic flaws: in its formulation it misconceives the nature of the pregnant woman’s interest; and in practice it undervalues the State’s interest in potential life, as recognized in Roe.

As our jurisprudence relating to all liberties save perhaps abortion has recognized, not every law which makes a right more difficult to exercise is, ipso facto, an infringement of that right. An example clarifies the point. We have held that not every ballot access limitation amounts to an infringement of the right to vote. Rather, the States are granted substantial flexibility in establishing the framework within which voters choose the candidates for whom' they *874wish to vote. Anderson v. Celebrezze, 460 U. S. 780, 788 (1983); Norman v. Reed, 502 U. S. 279 (1992).

The abortion right is similar. Numerous forms of state regulation might have the incidental effect of increasing the cost or decreasing the availability of medical care, whether for abortion or any other medical procedure. The fact that a law which serves a valid purpose, one not designed to strike at the right itself, has the incidental effect of making it more difficult or more expensive to procure an abortion cannot be enough to invalidate it. Only where state regulation imposes an undue burden on a woman’s ability to make this decision does the power of the State reach into the heart of the liberty protected by the Due Process Clause. See Hodgson v. Minnesota, 497 U. S. 417, 458-459 (1990) (O’Connor, J., concurring in part and concurring in judgment in part); Ohio v. Akron Center for Reproductive Health, 497 U. S. 502, 519-520 (1990) (Akron II) (opinion of Kennedy, J.); Webster v. Reproductive Health Services, supra, at 530 (O’Connor, J., concurring in part and concurring in judgment); Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 828 (O’Connor, J., dissenting); Simopoulos v. Virginia, 462 U. S. 506, 520 (1983) (O’Connor, J., concurring in part and concurring in judgment); Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476, 505 (1983) (O’Connor, J., concurring in judgment in part and dissenting in part); Akron I, 462 U. S., at 464 (O’Connor, J., joined by White and Rehnquist, JJ., dissenting); Bellotti v. Baird, 428 U. S. 132, 147 (1976) (Bellotti I).

For the most part, the Court’s early abortion cases adhered to this view. In Maher v. Roe, 432 U. S. 464, 473-474 (1977), the Court explained: “Roe did not declare an unqualified ‘constitutional right to an abortion,’ as the District Court seemed to think. Rather, the right protects the woman from unduly burdensome interference with her freedom to decide whether to terminate her pregnancy.” See *875also Doe v. Bolton, 410 U. S. 179, 198 (1973) (“[T]he interposition of the hospital abortion committee is unduly restrictive of the patient’s rights”); Bellotti I, supra, at 147 (State may not “impose undue burdens upon a minor capable of giving an informed consent”); Harris v. McRae, 448 U. S. 297, 314 (1980) (citing Maker, supra). Cf. Carey v. Population Services International, 431 U. S., at 688 (“[T]he same test must be applied to state regulations that burden an individual’s right to decide to prevent conception or terminate pregnancy by substantially limiting access to the means of effectuating that decision as is applied to state statutes that prohibit the decision entirely”).

These considerations of the nature of the abortion right illustrate that it is an overstatement to describe it as a right to decide whether to have an abortion “without interference from the State.” Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52, 61 (1976). All abortion regulations interfere to some degree with a woman’s ability to decide whether to terminate her pregnancy. It is, as a consequence, not surprising that despite the protestations contained in the original Roe opinion to the effect that the Court was not recognizing an absolute right, 410 U. S., at 154-155, the Court’s experience applying the trimester framework has led to the striking down of some abortion regulations which in no real sense deprived women of the ultimate decision. Those decisions went too far because the right recognized by Roe is a right “to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.” Eisenstadt v. Baird, 405 U. S., at 453. Not all governmental intrusion is of necessity unwarranted; and that brings us to the other basic flaw in the trimester framework: even in ftoe’s terms, in practice it undervalues the State’s interest in the potential life within the woman.

Roe v. Wade was express in its recognition of the State’s “important and legitimate interests] in preserving and pro-*876teeting the health of the pregnant woman [and] in protecting the potentiality of human life.” 410 U. S., at 162. The trimester framework, however, does not fulfill Roe’s own promise that the State has an interest in protecting fetal life or potential life. Roe began the contradiction by using the trimester framework to forbid any regulation of abortion designed to advance that interest before viability. Id., at 163. Before viability, Roe and subsequent cases treat all governmental attempts to influence a woman’s decision on behalf of the potential life within her as unwarranted. This treatment is, in our judgment, incompatible with the recognition that there is a substantial state interest in potential life throughout pregnancy. Cf. Webster, 492 U. S., at 519 (opinion of Rehnquist, C. J.); Akron I, supra, at 461 (O’Connor, J., dissenting).

The very notion that the State has a substantial interest in potential life leads to the conclusion that not all regulations must be deemed unwarranted. Not all burdens on the right to decide whether to terminate a pregnancy will be undue. In our view, the undue burden standard is the appropriate means of reconciling the State’s interest with the' woman’s constitutionally protected liberty.

The concept of an undue burden has been utilized by the Court as well as individual Members of the Court, including two of us, in ways that could be considered inconsistent. See, e. g., Hodgson v. Minnesota, supra, at 459-461 (O’CONNOR, J., concurring in part and concurring in judgment); Akron II, supra, at 519-520 (opinion of Kennedy, J.); Thornburgh v. American College of Obstetricians and Gynecologists, supra, at 828-829 (O’Connor, J., dissenting); Akron I, supra, at 461-466 (O’Connor, J., dissenting); Harris v. McRae, supra, at 314; Maher v. Roe, supra, at 473; Beal v. Doe, 432 U. S. 438, 446 (1977); Bellotti I, supra, at 147. Because we set forth a standard of general application to which we intend to adhere, it is important to clarify what is meant by an undue burden.

*877A finding of an undue burden is a shorthand for the conclusion that a state regulation has the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus. A statute with this purpose is invalid because the means chosen by the State to further the interest in potential life must be calculated to inform the woman’s free choice, not hinder it. And a statute which, while furthering the interest in potential life or some other valid state interest, has the effect of placing a substantial obstacle in the path of a woman’s choice cannot be considered a permissible means of sérving its legitimate ends. To the extent that the opinions of the Court or of individual Justices use the undue burden standard in a manner that is inconsistent with this analysis, we set out what in our view should be the controlling standard. Cf. McCleskey v. Zant, 499 U. S. 467, 489 (1991) (attempting “to define the doctrine of abuse of the writ with more precision” after acknowledging tension among earlier cases). In our considered judgment, an undue burden is an unconstitutional burden. See Akron II, 497 U. S., at 519-520 (opinion of Kennedy, J.). Understood another way, we answer the question, left open in previous opinions discussing the undue burden formulation, whether a law designed to further the State’s interest in fetal life which imposes an undue burden on the woman’s decision before fetal viability could be constitutional. See, e. g., Akron I, 462 U. S., at 462-463 (O’Connor, J., dissenting). The answer is no.

Some guiding principles should emerge. What is at stake is the woman’s right to make the ultimate decision, not a right to be insulated from all others in doing so. Regulations which do no more than create a structural mechanism by which the State, or the parent or guardian of a minor, may express profound respect for the life of the unborn are permitted, if they are not a substantial obstacle to the woman’s exereise of the right to choose. See infra, at 899-900 (addressing Pennsylvania’s parental consent requirement). *878Unless it has that effect on her right of choice, a state measure designed to persuade her to choose childbirth over abortion will be upheld if reasonably related to that goal.' Regulations designed to foster the health of a woman seeking an abortion are valid if they do not constitute an undue burden.

Even when jurists reason from shared premises, some disagreement is inevitable. Compare Hodgson, 497 U. S., at 482-497 (Kennedy, J., concurring in judgment in part and dissenting in part), with id., at 458-460 (O’Connor, J., concurring in part and concurring in judgment in part). That is to be expected in the application of any legal standard which must accommodate life’s complexity. We do not expect it to be otherwise with respect to the undue burden standard. We give this summary:

(a) To protect the central right recognized by Roe v. Wade while at the same time accommodating the State’s profound interest in potential life, we will employ the undue burden analysis as explained in this opinion. An undue burden exists, and therefore a provision of law is invalid, if its purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.

(b) We reject the rigid trimester framework of Roe v. Wade. To promote the State’s profound interest in potential life, throughout pregnancy the State may take measures to ensure that the woman’s choice is informed, and measures designed to advance this interest will not be invalidated as long as their purpose is to persuade the woman to choose childbirth over abortion. These measures must not be an undue burden on the right.

(c) As with any medical procedure, the State may enact regulations to further the health or safety of a woman seeking an abortion. Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.

*879(d) Our adoption of the undue burden analysis does not disturb the central holding of Roe v. Wade, and we reaffirm that holding. Regardless of whether exceptions are made for particular circumstances, a State may not prohibit any woman from making the ultimate decision to terminate her pregnancy before viability.

(e) We also reaffirm Roe’s holding that “subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.” Roe v. Wade, 410 U. S., at 164-165.

These principles control our assessment of the Pennsylvania statute, and we now turn to the issue of the validity of its challenged provisions.

V

The Court of Appeals applied what it believed to be the undue burden standard and upheld each' of the provisions except for the husband notification requirement. We agree generally with this conclusion, but refine the undue burden analysis in accordance with the principles articulated above. We now consider the separate statutory sections at issue.

A

Because it is central to the operation of various other requirements, we begin with the statute’s definition of medical emergency. Under the statute, a medical emergency is

“[t]hat condition which, on the basis of the physician’s good faith clinical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible impairment of a major bodily function.” 18 Pa. Cons. Stat. §3208 (1990).

*880Petitioners argue that the definition is too narrow, contending that it forecloses the possibility of an immediate abortion despite some significant health risks. If the contention were correct, we would be required to invalidate the restrictive operation of the provision, for the essential holding of Roe forbids a State to interfere with a woman’s choice to undergo an abortion procedure if continuing her pregnancy would constitute a threat to her health. 410 U. S., at 164. See also Harris v. McRae, 448 U. S., at 316.

The District Court found that there were three serious conditions which would not be covered by the statute: pre-eclampsia, inevitable abortion, and premature ruptured membrane. 744 F. Supp., at 1378. Yet, as the Court of Appeals observed, 947 F. 2d, at 700-701, it is undisputed that under some circumstances each of these conditions could lead to an illness with substantial and irreversible consequences. While the definition could be interpreted in an unconstitutional manner, the Court of Appeals construed the phrase “serious risk” to include those circumstances. Id., at 701. It stated: “[W]e read the medical emergency exception as intended by the Pennsylvania legislature to assure that compliance with its abortion regulations would not in any way pose a significant threat to the life or health of a woman.” Ibid. As we said in Brockett v. Spokane Arcades, Inc., 472 U. S. 491, 499-500 (1985): “Normally, ... we defer to the construction of a state statute given it by the lower federal courts.” Indeed, we have said that we will defer to lower court interpretations of state law unless they amount to “plain” error. Palmer v. Hoffman, 318 U. S. 109, 118 (1943). This “ ‘reflects] our belief that district courts and courts of appeals are better schooled in and more able to interpret the laws of their respective States.’” Frisby v. Schultz, 487 U. S. 474, 482 (1988) (citation omitted). We adhere to that course today, and conclude that, as construed by the Court of Appeals, the medical emergency definition imposes no undue burden on a woman’s abortion right.

*881B

We next consider the informed consent requirement. 18 Pa. Cons. Stat. §3205 (1990). Except in a medical emergency, the statute requires that at least 24 hours before performing an abortion a physician inform the woman of the nature of the procedure, the health risks of the abortion and of childbirth, and the “probable gestational age of the unborn child.” The physician or a qualified nonphysician must inform the woman of the availability of printed materials published by the State describing the fetus and providing information about medical assistance for childbirth, information about child support from the father, and a list of agencies which provide adoption and other services as alternatives. to abortion. An abortion may not be performed unless the woman certifies in writing that she has been informed of the availability of these printed materials and has been provided them if she chooses to view them.

Our prior decisions establish that as with any medical procedure, the State may require a woman to give her written informed consent to an abortion. See Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 67. In this respect, the statute is unexceptional. Petitioners challenge the statute’s definition of informed consent because it includes the provision of specific information by the doctor and the mandatory 24-hour waiting period. The conclusions reached by a majority of the Justices in the separate opinions filed today and the undue burden standard adopted in this opinion require us to overrule in part some of the Court’s past decisions, decisions driven by the trimester framework’s prohibition of all previability regulations designed to further the State’s interest in fetal life.

In Akron I, 462 U. S. 416 (1983), we invalidated an ordinance which required that a woman seeking an abortion be provided by her physieian with specific information “designed. to influence the woman’s informed choice between abortion or childbirth.” Id., at 444. As we later described *882the Akron I holding in Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 762, there were two purported flaws in the Akron ordinance: the information was designed to dissuade the woman from having an abortion and the ordinance imposed “a rigid requirement that a specific body of information be given in all cases, irrespective of the particular needs of the patient. . . .” Ibid.

To the extent Akron I and Thornburgh find a constitutional violation when the government requires, as it does here, the giving of truthful, nonmisleading information about the nature of the procedure, the attendant health risks and those of childbirth, and the “probable gestational age” of the fetus, those eases go too far, are inconsistent with Roe’s acknowledgment of an important interest in potential life, and are overruled. This is clear even on the very terms of Akron I and Thornburgh. Those decisions, along with Dan-forth, recognize a substantial government interest justifying a requirement that a woman be apprised of the health risks of abortion and childbirth. E. g., Danforth, supra, at 66-67. It cannot be questioned that psychological well-being is a facet of health. Nor can it be doubted that most women considering an abortion would deem the impact on the fetus relevant, if not dispositive, to the decision. In attempting to ensure that a woman apprehend the full consequences of her decision, the State furthers the legitimate purpose of reducing the risk that a woman may elect an abortion, only to discover later, with devastating psychological consequences, that her decision was not fully informed. If the information the State requires to be made available to the woman is truthful and not misleading, the requirement may be permissible.

We also see no reason why the State may not require doctors to inform a woman seeking an abortion of the availability of materials relating to the consequences to the fetus, even when those consequences have no direct relation to her health. An example illustrates the point. We would think *883it constitutional for the State to require that in order for there to he informed consent to a kidney transplant operation the recipient must be supplied with information about risks to the donor as well as risks to himself or herself. A requirement that the physician make available information similar to that mandated by the statute here was described in Thornburgh as “an outright attempt to wedge the Commonwealth’s message discouraging abortion into the privacy of the informed-consent dialogue between the woman and her physician.” 476 U. S., at 762. We conclude, however, that informed choice need not be defined in such narrow terms that all considerations of the effect on the fetus are made irrelevant. As we have made clear, we depart from the holdings of Akron I and Thornburgh to the extent that we permit a State to further its legitimate goal of protecting the life of the unborn by enacting legislation aimed at ensuring a decision that is mature and informed, even when in so doing the State expresses a preference for childbirth over abortion. In short, requiring that the woman be informed of the availability of information relating to fetal development and the assistance available should she decide to carry the pregnancy to full term is a reasonable measure to ensure an informed choice, one which might cause the woman to choose childbirth over abortion. This requirement cannot be considered a substantial obstacle to obtaining an abortion, and, it follows, there is no undue burden.

Our prior cases also suggest that the “straitjacket,” Thornburgh, supra, at 762 (quoting Danforth, supra, at 67, n. 8), of particular information which must be given in each ease interferes with a constitutional right of privacy between a pregnant woman and her physician. As a preliminary matter, it is worth noting that the statute now before us does not require a physician to comply with the informed consent provisions “if he or she can demonstrate by a preponderance of the evidence, that he or she reasonably believed that furnishing the information would have resulted in a severely *884adverse effect on the physical or mental health of the patient/’ 18 Pa. Cons. Stat. § 3205 (1990). In this respect, the statute does not prevent the physician from exercising his or her medical judgment.

Whatever constitutional status the doctor-patient relation may have as a general matter, in the present context it is derivative of the woman’s position. The doctor-patient relation does not underlie or override the two more general rights under which the abortion right is justified: the right to make family decisions and the right to physical autonomy. On its own, the doctor-patient relation here is entitled to the same solicitude it receives in other contexts. Thus, a requirement that a doctor give a woman certain information as part of obtaining her consent to an abortion is, for constitutional purposes, no different from a requirement that a doctor give certain specific'information about any medical procedure.

All that is left of petitioners’ argument is an asserted First Amendment right of a physician not to provide information about the risks of abortion, and childbirth, in a manner mandated by the State. To be sure, the physician’s First Amendment rights not to speak are implicated, see Wooley v. Maynard, 430 U. S. 705 (1977), but only as part of the practice of medicine, subject to reasonable licensing and regulation by the State, cf. Whalen v. Roe, 429 U. S. 589, 603 (1977). We see no constitutional infirmity in the requirement that the physician provide the information mandated by the State here.

The Pennsylvania statute also requires us to reconsider the holding in Akron I that the State may not require that a physician, as opposed to a qualified assistant, provide information relevant to a woman’s informed consent. 462 U. S., at 448. Since there is no evidence on this record that requiring a doctor to give the information as provided by the statute would amount in practical terms to a substantial obstacle to a woman seeking an abortion, we conclude that it is not *885an undue burden. Our eases reflect the fact that the Constitution gives the States broad latitude to decide that particular functions may be performed only by licensed professionals, even if an objective assessment might suggest that those same tasks could be performed by others. See Williamson v. Lee Optical of Okla., Inc., 348 U. S. 483 (1955). Thus, we uphold the provision as a reasonable means to ensure that the woman’s consent is informed.

Our analysis of Pennsylvania’s 24-hour waiting period between the provision of the information deemed necessary to informed consent and the performance of an abortion under the undue burden standard requires us to reconsider the premise behind the decision in Akron I invalidating a parallel requirement. In Akron I we said: “Nor are we convinced that the State’s legitimate concern that the woman’s decision be informed is reasonably served by requiring a 24-hour delay as a matter of course.” 462 U. S., at 450. We consider that conclusion to be wrong. The idea that important decisions will be more informed and deliberate if they follow some period of reflection does not strike us as unreasonable, particularly where the statute directs that important information become part of the background of the decision. The statute, as construed by the Court of Appeals, permits avoidance of the waiting period in the event of a medical emergency and the record evidence shows that in the vast majority of cases, a 24-hour delay does not create any appreciable health risk. In theory, at least, the waiting period is a reasonable measure to implement the State’s interest in protecting the life of the unborn, a measure that does not amount to an undue burden.

Whether the mandatory 24-hour waiting period is nonetheless invalid because in practice it is a substantial obstacle to a woman’s choice to terminate her pregnancy is a closer question. The findings of fact by the District Court indicate that because of the distances many women must travel to reach an abortion provider, the practical effect will often be *886a delay of much more than a day because the waiting period requires that a woman seeking an abortion make at least two visits to the doctor. The District Court also found that in many instances this will increase the exposure of women seeking abortions to “the harassment and hostility of antiabortion protestors demonstrating outside a clinic.” 744 F. Supp., at 1351. As a result, the District Court found that for those women who have the fewest financial resources, those who must travel long distances, and those who have difficulty explaining their whereabouts to husbands, employers, or others, the 24-hour waiting period will be “particularly burdensome.” Id., at 1352.

These findings are troubling in some respects, but they do not demonstrate that the waiting period constitutes an undue burden. We do not doubt that, as the District Court held, the waiting period has the effect of “increasing the cost and risk of delay of abortions,” id., at 1378, but the District Court did not conclude that the increased costs and potential delays amount to substantial obstacles. Rather, applying the trimester framework’s strict prohibition of all regulation designed to promote the State’s interest in potential life before viability, see id., at 1374, the District Court concluded that the waiting period does not further the state “interest in maternal health” and “infringes the physician’s discretion to exercise sound medical judgment,” id., at 1378. Yet, as we have stated, under the undue burden standard a State is permitted to enact persuasive measures which favor childbirth over abortion, even if those measures do not further a health interest. And while the waiting period does limit a physician’s discretion, that is not, standing alone, a reason to invalidate it. In light of the construction given the statute’s definition of medical emergency by the Court of Appeals, and the District Court’s findings, we cannot say that the waiting period imposes a real health risk.

We also disagree with the District Court’s conclusion that the “particularly burdensome” effects of the waiting period *887on some women require its invalidation. A particular burden is not of necessity a substantial obstacle. Whether a burden falls on a particular group is a distinct inquiry from whether it is a substantial obstacle even as to the women in that group. And the District Court did not conclude that the waiting period is such an obstacle even for the women who are most burdened by it. Hence, on the record before us, and in the context of this facial challenge, we are not convinced that the 24-hour waiting period constitutes an undue burden.

We are left with the argument that the various aspects of the informed consent requirement are unconstitutional because they place barriers in the way of abortion on demand. Even the broadest reading of Roe, however, has not suggested that there is a constitutional right to abortion on demand. See, e. g., Doe v. Bolton, 410 U. S., at 189. Rather, the right protected by Roe is a right to decide to terminate a pregnancy free of undue interference by the State. Because the informed consent requirement facilitates the wise exercise of that right, it cannot be classified as an interference with the right Roe protects. The informed consent requirement is not an undue burden on that right.

C

Section 8209 of Pennsylvania’s abortion law provides, except in eases of medical emergency, that no physician shall perform an abortion on a married woman without receiving a signed statement from the woman that she has notified her spouse that she is about to undergo an abortion. The woman has the option of providing an alternative signed statement certifying that her husband is not the man who impregnated her; that her husband could not be located; that the pregnancy is the result of spousal sexual assault which she has reported; or that the woman believes that notifying her husband will cause him or someone else to inflict bodily injury upon her. A physician who performs an abortion on *888a married woman without receiving the appropriate signed statement will have his or her license revoked, and is liable to the husband for damages.

The District Court heard the testimony of numerous expert witnesses, and made detailed findings of fact regarding the effect of this statute. These included:

“273. The vast majority of women consult their husbands prior to deciding to terminate their pregnancy....
“279. The ‘bodily injury’ exception could not be invoked by a married woman whose husband, if notified, would, in her reasonable belief, threaten to (a) publicize her intent to have an abortion to family, friends or acquaintances; (b) retaliate against her in future child custody or divorce proceedings; (e) inflict psychological intimidation or emotional harm upon her, her children or other persons; (d) inflict bodily harm on other persons such as children, family members or other loved ones; or (e) use his control over finances to deprive of necessary monies for herself or her children....
“281. Studies reveal that family violence occurs in two million families in the United States.. This figure, however, is a conservative one that substantially understates (because battering is usually not reported until it reaches life-threatening proportions) the actual number of families affected by domestic violence. In fact, researchers estimate that one of every two women will be battered at some time in their life....
“282. A wife may not elect to notify her husband of her intention to have an abortion for a variety of reasons, including the husband’s illness, concern about her own health, the imminent failure of the marriage, or the husband’s absolute opposition to the abortion. ...
“283. The required filing of the spousal consent form would require plaintiff-clinics to change their counseling *889procedures and force women to reveal their most intimate decision-making on pain of criminal sanctions. The confidentiality of these revelations could not be guaranteed, since the woman’s records are not immune from subpoena....
“284. Women of all class levels, educational backgrounds, and racial, ethnic and religious groups are battered....
“285. Wife-battering or abuse can take on many physical and psychological forms. The nature and scope of the battering can cover a broad range of actions and be gruesome and torturous....
“286. Married women, victims of battering, have been killed in Pennsylvania and throughout the United States....
“287. Battering can often involve a substantial amount of sexual abuse, including marital rape and sexual mutilation....
“288. In a domestic abuse situation, it is common for the battering husband to also abuse the children in an attempt to coerce the wife....
“289. Mere notification of pregnancy is frequently a flashpoint for battering and violence within the family. The number of battering incidents is high during the pregnancy and often the worst abuse can be associated with pregnancy. . . . The battering husband may deny parentage and use the pregnancy as an excuse for abuse....
“290. Secrecy typically shrouds abusive families. Family members are instructed not to tell anyone, especially police or doctors, about the abuse and violence. Battering husbands often threaten their wives or her children with further abuse if she tells an outsider of the violence and tells her that nobody will believe her. A battered woman, therefore, is highly unlikely to disclose *890the violence against her for fear of retaliation by the abuser....
“291. Even when confronted directly by medical personnel or other helping professionals, battered women often will not admit to the battering because they have not admitted to themselves that they are battered.. . .
“294. A woman in a shelter or a safe house unknown to her husband is not ‘reasonably likely’ to have bodily harm inflicted upon her by her batterer, however her attempt to notify her husband pursuant to section 3209 could accidentally disclose her whereabouts to her husband. Her fear of future ramifications would be realistic under, the circumstances.
“295. Marital rape is rarely discussed with others or reported to law enforcement authorities, and of those reported only few are prosecuted....
“296. It is common for battered women to have sexual intercourse with their husbands to avoid being battered. While this type of coercive sexual activity would be spousal sexual assault as defined by the Act, many women may not consider it to be so and others would fear disbelief....
“297. The marital rape exception to section 3209 cannot be claimed by women who are victims of coercive sexual behavior other than penetration. The 90-day reporting requirement of the spousal sexual assault statute, 18 Pa. Con. Stat. Ann. § 3218(c), further narrows the class of sexually abused wives who can claim the exception, since many of these women may be psychologically unable to discuss or report the rape for several years after the incident. . ..
“298. Because of the nature of the battering relationship, battered women are unlikely to avail themselves of the exceptions to section 3209 of the Act, regardless of *891whether the section applies to them.” 744 F. Supp., at 1360-1362 (footnote omitted).

These findings are supported by studies of domestic violence. The American Medical Association (AMA) has published a summary of the recent research in this field, which indicates that in an average 12-month period in this country, approximately two million women are the victims of severe assaults by their male partners. In a 1985 survey, women reported that nearly one of every eight husbands had assaulted their wives during the past year. The AMA views these figures as “marked underestimates,” because the nature of these incidents discourages women from reporting them, and because surveys typically exclude the very poor, those who do not speak English well, and women who are homeless or in institutions or hospitals when the survey is conducted. According to the AMA, “[researchers on family violence agree that the true incidence of partner violence is probably double the above estimates; or four million severely assaulted women per year. Studies on prevalence suggest that from one-fifth to one-third of all women will be physically assaulted by a partner or ex-partner during their lifetime.” AMA Council on Scientific Affairs, Violence Against Women 7 (1991) (emphasis in original). Thus on an average day in the United States, nearly 11,000 women are severely assaulted by their male partners. Many of these incidents involve sexual assault. Id., at 3-4; Shields & Hanneke, Battered Wives’ Reactions to Marital Rape, in The Dark Side of Families: Current Family Violence Research 131, 144 (D. Finkelhor, R. Gelles, G. Hataling, & M. Straus eds. 1983). In families where wifebeating takes. place, moreover, child abuse is often present as well. Violence Against Women, supra, at 12.

Other studies fill in the rest of this troubling picture. Physical violence is only the most visible form of abuse. Psychological abuse, particularly forced social and economic isolation of women, is also eommon. L. Walker, The Bat*892tered Woman Syndrome 27-28 (1984). Many victims of domestic violence remain with their abusers, perhaps because they perceive no superior alternative. Herbert, Silver, & Ellard, Coping with an Abusive Relationship: I. How and Why do Women Stay?, 53 J. Marriage & the Family 311 (1991). Many abused women who find temporary refuge in shelters return to their husbands, in large part because they have no other source of income. Aguirre, Why Do They Return? Abused Wives in Shelters, 30 J. Nat. Assn, of Social Workers 350, 352 (1985). Returning to one’s abuser can be dangerous. Recent Federal Bureau of Investigation statistics disclose that 8.8 percent of all homicide victims in the United States are killed by their spouses. Mercy & Saltz-man, Fatal Violence Among Spouses in the United States, 1976-85, 79 Am. J. Public Health 595 (1989). Thirty percent of female homicide victims are killed by their male partners. Domestic Violence: Terrorism in the Home, Hearing before the Subcommittee on Children, Family, Drugs and Alcoholism of the Senate Committee on Labor and Human Resources, 101st Cong., 2d Sess., 3 (1990).

The limited research that has been conducted with respect to notifying one’s husband about an abortion, although involving samples too small to be representative, also supports the District Court’s findings of fact. The vast majority of women notify their male partners of their decision to obtain an abortion. In many cases in which married women do not notify their husbands, the pregnancy is the result of an extramarital affair. Where the husband is the father, the primary reason women do not notify their husbands is that the husband and wife are experiencing marital difficulties, often accompanied by incidents of violence. Ryan & Plutzer, When Married Women Have Abortions: Spousal Notification and Marital Interaction, 51 J. Marriage & the Family 41, 44 (1989).

This information and the District Court’s findings reinforce what common sense would suggest. In well-*893functioning marriages, spouses discuss important intimate decisions such as whether to bear a child. But there are millions of women in this country who are the victims of regular physical and psychological abuse at the hands of their husbands. Should these women become pregnant, they may have very good reasons for not wishing to inform their husbands of their decision to obtain an abortion. Many may have justifiable fears of physical abuse, but may be no less fearful of the consequences of reporting prior abuse to the Commonwealth of Pennsylvania. Many may have a reasonable fear that notifying their husbands will provoke further instances of child abuse; these women are not exempt from § 3209’s notification requirement. Many may fear devastating forms of psychological abuse from their husbands, including verbal harassment, threats of future violence, the destruction of possessions, physical confinement to the home, the withdrawal of financial support, or the disclosure of the abortion to family and friends. These methods of psychological abuse may act as even more of a deterrent to notification than the possibility of physical violence, but women who are the victims of the abuse are not exempt from § 8209’s notifi-. cation requirement. And many women who are pregnant as a result of sexual assaults by their husbands will be unable to avail themselves of the exception for spousal sexual assault, § 3209(b)(3), because the exception requires that the woman have notified law enforcement authorities within 90 days of the assault, and her husband will be notified of her report once an investigation begins, § 3128(c). If anything in this field is certain, it is that victims of spousal sexual assault are extremely reluctant to report the abuse to the government; hence, a great many spousal rape victims will not be exempt from the notification requirement imposed by §3209.

The spousal notification requirement is thus likely to prevent a significant number of women from obtaining an abortion. It does not merely make abortions a little more difficult or expensive to obtain; for. many women, it will impose *894a substantial obstacle. We must not blind ourselves to the fact that the significant number of women who fear for their safety and the safety of their children are likely to be deterred from procuring an abortion as surely as if the Commonwealth had outlawed abortion in all cases.

Respondents attempt to avoid the conclusion that § 3209 is invalid by pointing out that it imposes almost no burden at all for the vast majority of women seeking abortions. They begin by noting that only about 20 percent of the women who obtain abortions are married. They then note that of these women about 95 percent notify their husbands of their own volition. Thus, respondents argue, the effects of § 3209 are felt by only one percent of the women who obtain abortions. Respondents argue that since some of these women will be able to notify their husbands without adverse consequences or will qualify for one of the exceptions, the statute affects fewer than one percent of women seeking abortions. For this reason, it is asserted, the statute cannot be invalid on its face. See Brief for Respondents 83-86. We disagree with respondents’ basic method of analysis.

The analysis does not end with the one percent of women upon whom the statute operates; it begins there. Legislation is measured for consistency with the Constitution by its impact on those whose conduct it affects. For example, we would not say that a law which requires a newspaper to print a candidate’s reply to an unfavorable editorial is valid on its face because most newspapers would adopt the policy even absent the law. See Miami Herald Publishing Co. v. Tornillo, 418 U. S. 241 (1974). The proper focus of constitutional inquiry is the group for whom the law is a restriction, not the group for whom the law is irrelevant.

Respondents’ argument itself gives implicit recognition to this principle, at one of its critical points. Respondents speak of the one percent of women seeking abortions who are married and would choose not to notify their husbands of their plans. By selecting as the controlling class women *895who wish to obtain abortions, rather than all women or all pregnant women, respondents in effect concede that §3209 must be judged by reference to those for whom it is an actual rather than an irrelevant restriction. Of course, as we have said, §3209’s real target is narrower even than the class of women seeking abortions identified by the State: it is married women seeking abortions who do not wish to notify their husbands of their intentions and who do not qualify for one of the statutory exceptions to the notice requirement. The unfortunate yet persisting conditions we document above will mean that in a large fraction of the cases in which §3209 is relevant, it will operate as a substantial obstacle to a woman’s choice to undergo an abortion. It is an undue burden, and therefore invalid.

This conclusion is in no way inconsistent with our decisions upholding parental notification or consent requirements. See, e. g., Akron II, 497 U. S., at 510-519; Bellotti v. Baird, 443 U. S. 622 (1979) (Bellotti II); Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 74. Those enactments, and our judgment that they are constitutional, are based on the quite reasonable assumption that minors will benefit from consultation with their parents and that children will often not realize that their parents have their best interests at heart. We cannot adopt a parallel assumption about adult women.

We recognize that a husband has a “deep and proper concern and interest ... in his wife’s pregnancy and in the growth and development of the fetus she is' carrying.” Dan-forth, supra, at 69. With regard to the children he has fathered and raised, the Court has recognized his “cognizable and substantial” interest in their custody. Stanley v. Illinois, 405 U. S. 645, 651-652 (1972); see also Quilloin v. Walcott, 434 U. S. 246 (1978); Caban v. Mohammed, 441 U. S. 380 (1979); Lehr v. Robertson, 463 U. S. 248 (1983). If these cases concerned a State’s ability to require the mother to notify the father before taking some action with respect to a living *896child raised by both, therefore, it would be reasonable to conclude as a general matter that the father’s interest in the welfare of the child and the mother’s interest are equal.

Before birth, however, the issue takes on a very different cast. It is an inescapable biological fact that state regulation with respect to the child a woman is carrying will have a far greater impact on the mother’s liberty than on the father’s. The effect of state regulation on a woman’s protected liberty is doubly deserving of scrutiny in such a case, as the State has touched not only upon the private sphere of the family but upon the very bodily integrity of the pregnant woman. Cf. Cruzan v. Director, Mo. Dept. of Health, 497 U. S., at 281. The Court has held that “when the wife and the husband disagree on this decision, the view of only one of the two marriage partners can prevail. Inasmuch as it is the woman who physically bears the child and who is the more directly and immediately affected by the pregnancy, as between the two, the balance weighs in her favor.” Danforth, supra, at 71. This conclusion rests upon the basic nature of marriage and the nature of our Constitution: “[T]he marital couple is not an independent entity with a mind and heart of its own, but an association of two individuals each with a separate intellectual and emotional makeup. If the right of privacy means anything, it is the right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.” Eisenstadt v. Baird, 405 U. S., at 453 (emphasis in original). The Constitution protects individuals, men and women alike, from unjustified state interference, even when that interference is enacted into law for the benefit of their spouses.

There was a time, not so long ago, when a different understanding of the family and of the Constitution prevailed. In Bradwell v. State, 16 Wall. 130 (1873), three Members of this *897Court reaffirmed the common-law principle that “a woman had no legal existence separate from her husband, who was regarded as her head and representative in the social state; and, notwithstanding some recent modifications of this civil status, many of the special rules of law flowing from and dependent upon this cardinal principle still exist in foil force in most States.” Id., at 141 (Bradley, X, joined by Swayne and Field, JX, concurring in judgment). Only one generation has passed since this Court observed that “woman is still regarded as the center of home and family life,” with attendant “special responsibilities” that precluded full and independent legal status under the Constitution. Hoyt v. Florida, 368 U. S. 57, 62 (1961). These views, of course, are no longer consistent with our understanding of the family, the individual, or the Constitution.

In keeping with our rejection of the common-law understanding of a woman’s role within the family, the Court held in Danforth that the Constitution does not permit a State to require a married woman to obtain her husband’s consent before undergoing an abortion. 428 U. S., at 69. The principles that guided the Court in Danforth should be our guides today. For the great many women who are victims of abuse inflicted by their husbands, or whose children are the victims of such abuse, a spousal notice requirement enables the husband to wield an effective veto over his wife’s decision. Whether the prospect of notification itself deters such women from seeking abortions, or whether the husband, through physical force or psychological pressure or economic coercion, prevents his wife from obtaining an abortion until it is too late, the notice requirement will often be tantamount to the veto found unconstitutional in Danforth. The women most affected by this.law — those who most reasonably fear the consequences of notifying their husbands that they are pregnant — are in the gravest danger.

*898The husband’s interest in the life of the child his wife is carrying does not permit the State to empower him with this troubling degree of authority over his wife. The contrary view leads to consequences reminiscent of the common law. A husband has no enforceable right to require a wife to advise him before she exercises her personal choices. If a husband’s interest in the potential life of the child outweighs a wife’s liberty, the State could require a married woman to notify her husband before she uses a postfertilization contraceptive. Perhaps next in line would be a statute requiring pregnant married women to notify their husbands before engaging in conduct causing risks to the fetus. After all, if the husband’s interest in the fetus’ safety is a sufficient predicate for state regulation, the State could reasonably conclude that pregnant wives should notify their husbands before drinking alcohol or smoking. Perhaps married women should notify their husbands before using contraceptives or before undergoing any type of surgery that may have complications affecting the husband’s interest in his wife’s reproductive organs. And if a husband’s interest justifies notice in any of these cases, one might reasonably argue that it justifies exactly what the Danforth Court held it did not justify — a requirement of the husband’s consent as well. A State may not give to a man the kind of dominion over his wife that parents exercise over their children.

Section 3209 embodies a view of marriage consonant with the common-law status of married women but repugnant to our present understanding of marriage and of the nature of the rights secured by the Constitution. Women do not lose their constitutionally protected liberty when they marry. The Constitution protects all individuals, male or female, married or unmarried, from the abuse of governmental power, even where that power is employed for the supposed benefit of a member of the individual’s family. These considerations confirm our conclusion that § 3209 is invalid.

*899D

We next consider the parental consent provision. Except in a medical emergency, an unemancipated young woman under 18 may not obtain an abortion unless she and one of her parents (or guardian) provides informed consent as defined above. If neither a parent nor a guardian provides consent, a court may authorize the performance of an abortion upon a determination that the young woman is mature and capable of giving informed consent and has in fact given her informed consent, or that an abortion would be in her best interests.

We have been over most of this ground before. Our cases establish, and we reaffirm today, that a State may require a minor seeking an abortion to obtain the consent of a parent or guardian, provided that there is an adequate judicial bypass procedure. See, e. g., Akron II, 497 U. S., at 510-519; Hodgson, 497 U. S., at 461 (O’Connor, J., concurring in part and concurring in judgment in part); id., at 497-501 (Kennedy, J., concurring in judgment in part and dissenting in part); Akron I, 462 U. S., at 440; Bellotti II, 443 U. S., at 643-644 (plurality opinion). Under these precedents, in our view, the one-parent consent requirement and judicial bypass procedure are constitutional.

The only argument made by petitioners respecting this provision and to which our prior decisions do not speak is the contention that the parental consent requirement is invalid because it requires informed parental consent. For the most part, petitioners’ argument is a reprise of their argument with respect to the informed consent requirement in general, and we reject it for the reasons given above. Indeed, some of the provisions regarding informed consent have particular force with respect to minors: the waiting period, for example, may provide the parent or parents of a pregnant young woman the opportunity to consult with her in private, and to discuss the consequences of her decision in *900the context of the values and moral or religious principles of their family. See Hodgson, supra, at 448-449 (opinion of Stevens, J.).

E

Under the recordkeeping and reporting requirements of the statute, every facility which performs abortions is required to file a report stating its name and address as well as the name and address of any related entity, such as a controlling or subsidiary organization. In the case of state-funded institutions, the information becomes public.

For each abortion performed, a report must be filed identifying: the physician (and the second physician where required); the facility; the referring physician or agency; the woman’s age; the number of prior pregnancies and prior abortions she has had;'gestational age; the type of abortion procedure; the date of the abortion; whether there were any pre-existing medical conditions which would complicate pregnancy; medical complications with the abortion; where applicable, the basis for the determination that the abortion was medically necessary; the weight of the aborted fetus; and whether the woman was married, and if so, whether notice was provided or the basis for the failure to give notice. Every abortion facility must also file quarterly reports showing the number of abortions performed broken down by trimester. See 18 Pa. Cons. Stat, §§ 3207, 8214 (1990). In all events, the identity of each woman who has had an abortion remains confidential.

In Danforth, 428 U. S., at 80, we held that recordkeeping and reporting provisions “that are reasonably directed to the preservation of maternal health and that properly respect a patient’s confidentiality and privacy are permissible.” We think that under this standard, all the provisions at issue here, except that relating to spousal notice, are constitutional. Although they do not relate to the State’s interest in informing the woman’s choice, they do relate to health. The collection of information with respect to actual patients *901is a vital element of medical research, and so it cannot be said that the requirements serve no purpose other than to make abortions more difficult. Nor do we find that the requirements impose a substantial obstacle to a woman’s choice. At most they might increase the cost of some abortions by a slight amount. While at some point increased cost could become a substantial obstacle, there is no such showing on the record before us.

Subsection (12) of the reporting provision requires the re-, porting of, among other things, a married woman’s “reason for failure to provide notice” to her husband. § 3214(a)(12). This provision in effeet requires women, as a condition of obtaining an abortion, to provide the Commonwealth with the precise information we have already recognized that many women have pressing reasons not to reveal. Like the spousal notice requirement itself, this provision places an undue burden on a woman’s choice, and must be invalidated for that reason.

VI

Our Constitution is a covenant running from the first generation of Americans to us and then to future generations. It is a coherent succession. Each generation must learn anew that the Constitution’s written terms embody ideas and aspirations that must survive more ages than one. We accept our responsibility not to retreat from interpreting the full meaning of the covenant in light of all of our precedents. We invoke it once again to define the freedom guaranteed by the Constitution’s own promise, the promise of liberty.

* * *

The judgment in No. 91-902 is affirmed. The judgment in No. 91-744 is affirmed in part and reversed in part, and the case is remanded for proceedings consistent with this opinion, including consideration of the question of severability.

It is so ordered.

*902APPENDIX TO OPINION OF O’CONNOR, KENNEDY, AND SOUTER, JJ.

Selected Provisions of the 1988 and 1989 Amendments to the Pennsylvania Abortion Control Act of 1982

18 PA. CONS. STAT. (1990).

Ҥ3203. Definitions.

“ ‘Medical emergency.’ That condition which, on the basis of the physician’s good faith clinical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible impairment of major bodily function.”

Ҥ3205. Informed consent.

“(a) General rule. — No abortion shall be performed or induced except with the voluntary and informed consent of the woman upon whom the abortion is to be performed or induced. Except in the case of a medical emergency, consent to an abortion is voluntary and informed if and only if:

“(1) At least 24 hours prior to the abortion, the physician who is to perform the abortion or the referring physician has orally informed the woman of:
“(i) The nature of the proposed procedure or treatment and of those risks and alternatives to the procedure or treatment that a reasonable patient would consider material to the decision of whether or not to undergo the abortion.
“(ii) The probable gestational age of the unborn child at the time the abortion is to be performed.
“(iii) The medical risks associated with carrying her child to term.
“(2) At least 24 hours prior to the abortion, the physician who is to perform the abortion or the referring physician, or a qualified physician assistant, health care practitioner, technician or social worker to whom the re*903sponsibility has been delegated by either physician, has informed the pregnant woman that:
“(i) The department publishes printed materials which describe the unborn child and list agencies which offer alternatives to abortion and that she has a right to review the printed materials and that a copy will be provided to her free of charge if she chooses to review it.
“(ii) Medical assistance benefits may be available for prenatal care, childbirth and neonatal care, and that more detailed information on the availability of such assistance is contained in the printed materials published by the department.
“(iii) The father of the unborn child is liable to assist in the support of her child, even in instances where he has offered to pay for the abortion. In the case of rape, this information may be omitted.
“(3) A copy of the printed materials has been provided to the woman if she chooses to view these materials.
“(4) The pregnant woman certifies in writing, prior to the abortion, that the information required to be provided under paragraphs (1), (2) and (3) has been provided.

“(b) Emergency. — Where a medical emergency compels the performance of an abortion, the physician shall inform the woman, prior to the abortion if possible, of the medical indications supporting his judgment that an abortion is necessary to avert her death or to avert substantial and irreversible impairment of major bodily function.

“(e) Penalty. — Any physician who violates the provisions of this section is guilty of ‘unprofessional conduct’ and his license for the practice of medicine and surgery shall be subject to suspension or revocation in accordance with procedures provided under the act of October 5,1978 (P. L. 1109, No. 261), known as the Osteopathic Medical Practice Act, the *904act of December 20, 1985 (P. L. 457, No. 112), known as the Medical Practice Act of 1985, or their successor acts. Any physician who performs or induces an abortion without first obtaining the certification required by subsection (a)(4) or with knowledge or reason to know that the informed consent of the woman has not been obtained shall for the first offense be guilty of a summary offense and for each subsequent offense be guilty of a misdemeanor of the third degree. No physician shall be guilty of violating this section for failure to furnish the information required by subsection (a) if he or she can demonstrate, by a preponderance of the evidence, that he or she reasonably believed that furnishing the information would have resulted in a severely adverse effect on the physical or mental health of the patient.

“(d) Limitation on civil liability. — Any physician who complies with the provisions of this section may not be held civilly liable to his patient for failure to obtain informed consent to the abortion within the meaning of that term as defined by the act of October 15, 1975 (P. L. 390, No. Ill), known as the Health Care Services Malpractice Act.”

Ҥ 3206. Parental consent.

“(a) General rule. — Except in the case of a medical emergency or except as provided in this section, if a pregnant woman is less than 18 years of age and not emancipated, or if she has been adjudged an incompetent under 20 Pa. C. S. §5511 (relating to petition and hearing; examination by court-appointed physician), a physician shall not perform an abortion upon her unless, in the case of a woman who is less than 18 years of age, he first obtains the informed consent both of the pregnant woman and of one of her parents; or, in the case of a woman who is incompetent, he first obtains the informed consent of her guardian. In deciding whether to grant such consent, a pregnant woman’s parent or guardian shall consider only their child’s or ward’s best interests. In the case of a pregnancy that is the result of incest, where *905the father is a party to the incestuous act, the pregnant woman need only obtain the consent of her mother.

“(b) Unavailability of parent or guardian. — If both parents have died or are otherwise unavailable to the physician within a reasonable time and in a reasonable manner, consent of the pregnant woman’s guardian or guardians shall be sufficient. If the pregnant woman’s parents are divorced, consent of the parent having custody shall be sufficient. If neither any parent nor a legal guardian is available to the physician within a reasonable time and in a reasonable manner, consent of any adult person standing in loco parentis shall be sufficient.

“(c) Petition to the court for consent. — If both of the parents or guardians of the pregnant woman refuse to consent to the performance of an abortion or if she elects not to seek the consent of either of her parents or of her guardian, the court of common pleas of the judicial district in which the applicant resides or in which the abortion is sought shall, upon petition or motion, after an appropriate hearing, authorize a physician to perform the abortion if the court determines that the pregnant woman is mature and capable of giving informed consent to the proposed abortion, and has, in fact, given such consent.

“(d) Court order. — If the court determines that the pregnant woman is not mature and capable of giving informed consent or if the pregnant woman does not claim to be mature and capable of giving informed consent, the court shall determine whether the performance of an abortion upon her would be in her best interests. If the court determines that the performance of an abortion would be in the best interests of the woman, it shall authorize a physician to perform the abortion.

“(e) Representation in proceedings. — The pregnant woman may participate in proceedings in the court on her own behalf and the court may appoint a guardian ad litem to assist her. The court shall, however, advise her that she has *906a right to court appointed counsel, and shall provide her with such counsel unless she wishes to appear with private counsel or has knowingly and intelligently waived representation by counsel.”

Ҥ3207. Abortion facilities.

“(b) Reports. — Within 30 days after the effective date of this chapter, every facility at which abortions are performed shall file, and update immediately upon any change, a report with the department, containing the following information:

“(1) Name and address of the facility.
“(2) Name and address of any parent, subsidiary or affiliated organizations, corporations or associations.
“(3) Name and address of any parent, subsidiary or affiliated organizations, corporations or associations having contemporaneous commonality of ownership, beneficial interest, directorship or offieership with any other facility.

The information contained in those reports which are filed pursuant to this subsection by facilities which receive State-appropriated funds during the 12-ealendar-month period immediately preceding a request to inspect or copy such reports shall be deemed public information. Reports filed by facilities which do not receive State-appropriated funds shall only be available to law enforcement officials, the State Board of Medicine and the State Board of Osteopathic Medicine for use in the performance of their official duties. Any facility failing to comply with the provisions of this subsection shall be assessed by the department a fine of $500 for each day it is in violation hereof.”

Ҥ 3208. Printed information.

“(a) General rule. — The department shall cause to be published in English, Spanish and Vietnamese, within 60 days after this chapter becomes law, and shall update on an annual basis, the following easily comprehensible printed materials:

*907“(1) Geographically indexed materials designed to inform the woman of public and private agencies and services available to assist a woman through pregnancy, upon childbirth and while the child is dependent, including adoption agencies, which shall include a comprehensive list of the agencies available, a description of the services they offer and a description of the manner, including telephone numbers, in which they might be contacted, or, at the option of the department, printed materials including a toll-free 24-hour a day telephone number which may be called to obtain, orally, such a list and description of agencies in the locality of the caller' and of the services they offer. The materials shall provide information on the availability of medical assistance benefits for prenatal care, childbirth and neonatal care, and state that it is unlawful for any individual to coerce a woman to undergo abortion, that any physician who performs an abortion upon a woman without obtaining her informed consent or without according her a private medical consultation may be liable to her for damages in a civil action at law, that the father of a child is liable to assist in the support of that child, even in instances where the father has offered to pay for an abortion and that the law permits adoptive parents to pay costs of prenatal care, childbirth and neonatal care.
“(2) Materials designed to inform the woman of the probable anatomical and physiological characteristics of the unborn child at two-week gestational increments from fertilization to full term, including pictures representing the development of unborn children at two-week gestational increments, and any relevant information on the possibility of the unborn child’s survival; provided that any such pictures or drawings must contain the dimensions of the fetus and must be realistic and appropriate for the woman’s stage of pregnancy. The materials shall be objective, non-judgmental and designed *908to convey only accurate scientific information about the unborn child at the various gestational ages.' The material shall also contain objective information describing the methods of abortion procedures commonly employed, the medical risks commonly associated with each such procedure, the possible detrimental psychological effects of abortion and the medical risks commonly associated with each such procedure and the medical risks commonly associated with carrying a child to term.

“(b) Format. — The materials shall be printed in a typeface large enough to be clearly legible.

“(e) Free distribution. — The materials required under this section shall be available at no cost from the department upon request and in appropriate number to any person, facility or hospital.”

Ҥ3209. Spousal notice.

“(a) Spousal notice required. — In order to further the Commonwealth’s interest in promoting the integrity of the marital relationship and to protect a spouse’s interests in having children within marriage and in protecting the prenatal life of that spouse’s child, no physician shall perform an abortion on a married woman, except as provided in subsections (b) and (c), unless he or she has received a signed statement, which need not be notarized, from the woman upon whom the abortion is to be performed, that she has notified her spouse that she is about to undergo an abortion. The statement shall bear a notice that any false statement made therein is punishable by law.

“(b) Exceptions. — The statement certifying that the notice required by subsection (a) has been given need not be furnished where the woman provides the physician a signed statement certifying at least one of the following:

“(1) Her spouse is not the father of the child.
“(2) Her spouse, after diligent effort, could not be located.
*909“(3) The pregnancy is a result of spousal sexual assault as described in section 3128 (relating to spousal sexual assault), which has been reported to a law enforcement agency having the requisite jurisdiction.
“(4) The woman has reason to believe that the furnishing of notice to her spouse is likely to result in the infliction of bodily injury upon her by her spouse or by another individual.

Such statement need not be notarized, but shall bear a notice that any false statements made therein are punishable by law.

“(c) Medical emergency. — The requirements of subsection (a) shall not apply in case of a medical emergency.

“(d) Forms. — The department shall cause to be published, forms which may be utilized for purposes of providing the signed statements required by subsections (a) and (b). The department shall distribute an adequate supply of such forms to all abortion facilities in this Commonwealth.

“(e) Penalty; civil action. — Any'physician who violates the provisions of this section is guilty of 'unprofessional conduct,’ and his -or her license for the practice of medicine and surgery shall be subject to suspension or revocation in accordance with procedures provided under the act of October 5, 1978 (P. L. 1109, No. 261), known as the Osteopathic Medical Practice Act, the act of December 20, 1985 (P. L. 457, No. 112), known as the Medical Practice Act of 1985, or their successor acts. In addition, any physician who knowingly violates the provisions of this section shall be civilly liable to the spouse who is the father of the aborted child for any damages caused thereby and for punitive damages in the amount of $5,000, and the court shall award a prevailing plaintiff a reasonable attorney fee as part of costs.”

Ҥ3214. Reporting.

“(a) General rule. — For the purpose of promotion of maternal health and life by adding to the sum of medical and *910public health knowledge through the compilation of relevant data, and to promote the Commonwealth’s interest in protection of the unborn child, a report of each abortion performed shall be made to the department on forms prescribed by it. The report forms shall not identify the individual patient by name and shall include the following information:

“(1) Identification of the physician who performed the abortion, the concurring physician as required by section 3211(c)(2) (relating to abortion on unborn child of 24 or more weeks gestational age), the second physician as required by section 3211(c)(5) and the facility where the abortion was performed and of the referring physician, agency or service, if any.
“(2) The county and state in which the woman resides.
“(3) The woman’s age.
“(4) The number of prior pregnancies and prior abortions of the woman.
“(5) The gestational age of the unborn child at the time of the abortion.
“(6) The type of procedure performed or prescribed and the date of the abortion.
“(7) Pre-existing medical conditions of the woman which would complicate pregnancy, if any, and if known, any medical complication which resulted from the abortion itself.
“(8) The basis for the medical judgment of the physician who performed the abortion that the abortion was necessary to prevent either the death of the pregnant woman or the substantial and irreversible impairment of a major bodily function of the woman, where an abortion has been performed pursuant to section 3211(b)(1).
“(9) The weight of the aborted child for any abortion performed pursuant to section 3211(b)(1).
“(10) Basis for any medical judgment that a medical emergency existed which excused the physician from compliance with any provision of this chapter.
*911“(11) The information required to be reported under section 3210(a) (relating to determination of gestational age).
“(12) Whether the abortion was performed upon a married woman and, if so, whether notice to her spouse was given. If no notice to her spouse was given, the report shall also indicate the reason for failure to provide notice.

“(f) Report by facility. — Every facility in which an abortion is performed within this Commonwealth during any quarter year shall file with the department a report showing the total number of abortions performed within the hospital or other facility during that quarter year. This report shall also show the total abortions performed in each trimester of pregnancy. Any report shall be available for public inspection and copying only if the facility receives State-appropriated funds within the 12-calendar-month period immediately preceding the filing of the report. These reports shall be submitted on a form prescribed by the department which will enable, a facility to indicate whether or not it is receiving State-appropriated funds. If the facility indicates on the form that it is not receiving State-appropriated funds, the department shall regard its report as confidential unless it receives other evidence which causes it to conclude that the facility receives State-appropriated funds.”

Justice Stevens,

concurring in part and dissenting in part.

The portions of the Court’s opinion that I have joined are more important than those with which I disagree. I shall therefore first comment on significant areas of agreement, and then explain the limited character of my disagreement.

*912f-H

The Court is unquestionably correct in concluding that the doctrine of stare decisis has controlling significance in a case of this kind, notwithstanding an individual Justice’s concerns about the merits.1 The central holding of Roe v. Wade, 410 U. S. 113 (1973), has been a “part of our law” for almost two decades. Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52, 101 (1976) (Stevens, J., concurring in part and dissenting in part). It was a natural sequel to the protection of individual liberty established in Griswold v. Connecticut, 381 U. S. 479 (1965). See also Carey v. Population Services International, 431 U. S. 678, 687, 702 (1977) (White, J., concurring in part and concurring in result). The societal costs of overruling Roe at this late date would be enormous. Roe is an integral part of a correct understanding of both the concept of liberty and the basic equality of men and women.

Stare decisis also provides a sufficient basis for my agreement with the joint opinion’s reaffirmation of Roe’s post-viability analysis. Specifically, I accept the proposition that “[i]f the State is interested in protecting fetal life after viability, it may go so far as to proscribe abortion during that period, except when it is necessary to preserve the life or health of the mother.” 410 U. S., at 163-164; see ante, at 879.

I also accept what is implicit in the Court’s analysis, namely, a reaffirmation of Roe’s explanation oí-why the State’s obligation to protect the life or health of the mother *913must take precedence over any duty to the unborn. The Court in Roe carefully considered, and rejected, the State’s argument “that the fetus is a ‘person’ within the language and meaning of the Fourteenth Amendment.” 410 U. S., at 156. After analyzing the usage of “person” in the Constitution, the Court concluded that that word “has application only postnatally.” Id., at 157. Commenting on the contingent property interests of the unborn that are generally represented by guardians ad litem, the Court noted: “Perfection of the interests involved, again, has generally been contingent upon live birth. In short, the unborn have never been recognized in the law as persons in the whole sense.” Id., at 162. Accordingly, an abortion is not “the termination of life entitled to Fourteenth Amendment protection.” Id., at 159. From this holding, there was no dissent, see id., at 173; indeed, no Member of the Court has ever questioned this fundamental proposition. Thus, as a matter of federal constitutional law, a developing organism that is not yet a “person” does not have what is sometimes described as a “right to life.”2 This has been and, by the Court’s holding today, *914remains a fundamental premise of our constitutional law governing reproductive autonomy.

II

My disagreement with the joint opinion begins with its understanding of the trimester framework established in Roe. Contrary to the suggestion of the joint opinion, ante, at 876, it is not a “contradiction” to recognize that the State may have a legitimate interest in potential human life and, at the same time, to conclude that that interest does not justify the regulation of abortion before viability (although other interests, such as maternal health, may). The fact that the State’s interest is legitimate does not tell us when, if ever, that interest outweighs the pregnant woman’s interest in personal liberty. It is appropriate, therefore, to consider more carefully the nature of the interests at stake.

First, it is clear that, in order to be legitimate, the State’s interest must be secular; consistent with the First Amendment the State may not promote a theological or sectarian interest. See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747, 778 (1986) (Stevens, J., concurring); see generally Webster v. Reproductive Health Services, 492 U. S. 490, 563-572 (1989) (Stevens, J., concurring in part and dissenting in part). Moreover, as discussed above, the state interest in potential human life is not an interest in loco parentis, for the fetus is not a person.

Identifying the State’s interests — which the States rarely articulate with any precision — makes clear that the interest in protecting potential life is not grounded in the Constitution. It is, instead, an indirect interest supported by both humanitarian and pragmatic concerns. Many of our citizens believe that any abortion reflects an unacceptable disrespect for potential human life and that the performance of more *915than a million abortions each year is intolerable; many find third-trimester abortions performed when the fetus is approaching personhood particularly offensive. The State has a legitimate interest in minimizing such offense. The State may also have a broader interest in expanding the population,3 believing society would benefit from the services of additional productive citizens — or that the potential human lives might include the occasional Mozart or Curie. These are the kinds of concerns that comprise the State’s interest in potential human life.

In counterpoise is the woman’s constitutional interest in liberty. One aspect of this liberty is a right to bodily integrity, a right to control one’s person. See, e. g., Rochin v. California, 342 U. S. 165 (1952); Skinner v. Oklahoma ex rel. Williamson, 316 U. S. 535 (1942). This right is neutral on the question of abortion: The Constitution would be equally offended by an absolute requirement that all women undergo abortions as by an absolute prohibition on abortions. “Our whole constitutional heritage rebels at the thought of giving government the power to control men’s minds.” Stanley v. Georgia, 394 U. S. 557, 565 (1969). The same holds true for the power to control women’s bodies.

The woman’s constitutional liberty interest also involves her freedom to decide matters of the highest privacy and the most personal nature. Cf. Whalen v. Roe, 429 U. S. 589, *916598-600 (1977). A woman considering abortion faces “a difficult choice having serious and personal consequences of major importance to her own future — perhaps to the salvation of her own immortal soul.” Thornburgh, 476 U. S., at 781. The authority to make such traumatic and yet empowering decisions is an element of basic human dignity. As the joint opinion so eloquently demonstrates, a woman’s decision to terminate her pregnancy is nothing less than a matter of conscience.

Weighing the State’s interest in potential life and the woman’s liberty interest, I agree with the joint opinion that the State may “ ‘ “expres[s] a preference for normal childbirth,”’” that the State may take steps to ensure that a woman’s choice “is thoughtful and informed,” and that “States are free to enact laws to provide a reasonable framework for a woman to make a decision that has such profound and lasting meaning.” Ante, at 872-873. Serious questions arise, however, when a State attempts to “persuade the woman to choose childbirth over abortion.” Ante, at 878. Decisional autonomy must limit the State’s power to inject into a woman’s most personal deliberations its own views of what is best. The State may promote its preferences by funding childbirth, by creating and maintaining alternatives to abortion, and by espousing the virtues of family; but it must respect the individual’s freedom to make such judgments.

This theme runs throughout our decisions concerning reproductive freedom. In general, Roe’s requirement that restrictions on abortions before viability be justified by the State’s interest in maternal health has prevented States from interjecting regulations designed to influence a woman’s decision. Thus, we have upheld regulations of abortion that are not efforts to sway or direct a woman’s choice, but rather are efforts to enhance the deliberative quality of that decision or are neutral regulations on the health aspects of her decision. We have, for example, upheld regulations re*917quiring written informed consent, see Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52 (1976); limited rec-ordkeeping and reporting, see ibid.; and pathology reports, see Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476 (1983); as well as various licensing and qualification provisions, see, e. g., Roe, 410 U. S., at 150; Simopoulos v. Virginia, 462 U. S. 506 (1983). Conversely, we have consistently rejected state efforts to prejudice a woman’s choice, either by limiting the information available to her, see Bigelow v. Virginia, 421 U. S. 809 (1975), or by “requiring] the delivery of information designed ‘to influence the woman’s informed choice between abortion or childbirth.’ ” Thornburgh, 476 U. S., at 760; see also Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416, 442-449 (1983).

In my opinion, the principles established in this long line of eases and the wisdom reflected in Justice Powell’s opinion for the Court in Akron (and followed by the Court just six years ago in Thornburgh) should govern our decision today. Under these principles, Pa. Cons. Stat. § § 3205(a)(2)(i) — (iii) (1990) of the Pennsylvania statute are unconstitutional. Those sections require a physician or counselor to provide the woman with a range of materials clearly designed to persuade her to choose not to undergo the abortion. While the Commonwealth is free, pursuant to § 3208 of the Pennsylvania law, to produce and disseminate such material, the Commonwealth may not inject such information into the woman’s deliberations just as she is weighing such an important ehoice.

Under this same analysis, §§ 3205(a)(l)(i) and (iii) of the Pennsylvania statute are constitutional. Those sections, which require the physician to inform a woman of the nature and risks of the abortion procedure and the medical risks of carrying to term, are neutral requirements comparable to those imposed in other medical procedures. Those sections indicate no effort by the Commonwealth to influence the *918woman’s choice in any way. If anything, such requirements enhance, rather than skew, the woman’s decisionmaking.

I — I HH

The 24-hour waiting period required by §§ 3205(a)(l)-(2) of the Pennsylvania statute raises even more serious concerns. Such a requirement arguably furthers the Commonwealth’s interests in two ways, neither of which is constitutionally permissible.

First, it may be argued that the 24-hour delay is justified by the mere fact that it is likely to reduce the number of abortions, thus furthering the Commonwealth’s interest in potential life. But such an argument would justify any form of coercion that placed an obstacle in the woman’s path. The Commonwealth cannot further its interests by simply wearing down the ability of the pregnant woman to exercise her constitutional right.

Second, it can more reasonably be argued that the 24-hour delay furthers the Commonwealth’s interest in ensuring that the woman’s decision is informed and thoughtful. But there is no evidence that the mandated delay benefits women or that it is necessary to enable the physician to convey any relevant information to the patient. The mandatory delay thus appears to rest on outmoded and unacceptable assumptions about the decisionmaking capacity of women. While there are well-established and consistently maintained reasons for the Commonwealth to view with skepticism the ability of minors to make decisions, see Hodgson v. Minnesota, 497 U. S. 417, 449 (1990),4 none of those reasons applies to an *919adult woman’s decisionmaking ability. Just as we have left behind the belief that a woman must consult her husband before undertaking serious matters, see ante, at 895-898, so we must reject the notion that a woman is less capable of deciding matters of gravity. Cf. Reed v. Reed, 404 U. S. 71 (1971).

In the alternative, the delay requirement may be premised on the belief that the decision to terminate a pregnancy is presumptively wrong. This premise is illegitimate. Those who disagree vehemently about the legality and morality of abortion agree about one thing: The decision to terminate a pregnancy is profound and difficult. No person undertakes such a decision lightly — and States may not presume that a woman has failed to reflect adequately merely because her conclusion differs from the State’s preference. A woman who has, in the privacy of her thoughts and conscience, weighed the options and made her decision cannot be forced to reconsider all, simply because the State believes she has come to the wrong conclusion.5

*920Part of the constitutional liberty to choose is the equal dignity to which each of us is entitled. A woman who decides to terminate her pregnancy is entitled to the same respect as a woman who decides to carry the fetus to term. The mandatory waiting period denies women that equal respect.

IV

In my opinion, a correct application of the “undue burden” standard leads to the same conclusion concerning the constitutionality of these requirements. A state-imposed burden on the exercise of a constitutional right is measured both by its effects and by its character: A burden may be “undue” either because the burden is too severe or because it lacks a legitimate, rational justification.6

The 24-hour delay requirement fails both parts of this test. The findings of the District Court establish the severity of *921the burden that the 24-hour delay imposes on many pregnant women. Yet even in those cases in which the delay is not especially onerous, it is, in my opinion, “undue” because there is no evidence that such a delay serves a useful and legitimate purpose. As indicated above, there is no legitimate reason to require a woman who has agonized over her decision to leave the clinic or hospital and return again another day. While a general requirement that a physician notify her patients about the risks of a proposed medical procedure is appropriate, a rigid requirement that all patients wait 24 hours or (what is true in practice) much longer to evaluate the significance of information that is either common knowledge or irrelevant is an irrational and, therefore, “undue” burden.

The counseling provisions are similarly infirm. Whenever government commands private citizens to speak or to listen, careful review of the justification for that command is particularly appropriate. In these eases, the Pennsylvania statute directs that counselors provide women seeking abortions with information concerning alternatives to abortion, the availability of medical assistance benefits, and the possibility of child-support payments. §§ 3205(a)(2)(i) — (iii). The statute requires that this information be given to all women seeking abortions, including those for whom such information is clearly useless, such as those who are married, those who have undergone the procedure in the past and are fully aware of the options, and those who are fully convinced that abortion is their only reasonable option. Moreover, the statute requires physicians to inform all of their patients of “[t]he probable gestational age of the unborn child.” §3205(a)(l)(ii). This information is of little decisional value in most cases, because 90% of all abortions are performed during the first trimester7 when fetal age has less relevance than when the fetus nears viability. Nor can the informa*922tion required by the statute be justified as relevant to any “philosophic” or “social” argument, ante, at 872, either favoring or disfavoring the abortion decision in a particular ease. In light of all of these facts, I conclude that the information requirements in §3205(a)(l)(ii) and §§ 3205(a)(2)(i)-(iii) do not serve a useful purpose and thus constitute an unnecessary— and therefore undue — burden on the woman’s constitutional liberty to decide to terminate her pregnancy.

Accordingly, while I disagree with Parts IV, V-B, and V-D of the joint opinion,8 I join the remainder of the Court’s opinion.

Justice Blackmun,

concurring in part, concurring in the judgment in part, and dissenting in part.

I join Parts I, II, III, V-A, V-C, and VI of the joint opinion of Justices O’Connor, Kennedy, and Souter, ante.

Three years ago, in Webster v. Reproductive Health Services, 492 U. S. 490 (1989), four Members of this Court appeared poised to “cas[t] into darkness the hopes and visions of every woman in this country” who had come to believe that the Constitution guaranteed her the right to reproductive choice. Id., at 557 (Blackmun, J., dissenting). See id., at 499 (plurality opinion of Rehnquist, C. J., joined by White and Kennedy, JJ.); id., at 532 (Scalia, J., concurring in part and concurring in judgment). All that remained between the promise of Roe and the darkness of the plurality was a single, flickering flame. Decisions since Webster gave little reason to hope that this flame would cast much light. See, e. g., Ohio v. Akron Center for Reproductive Health, 497 U. S. 502, 524 (1990) (Blackmun, J., dissenting). But now, just when so many expected the darkness to fall, the flame has grown bright.

*923I do not underestimate the significance of today’s joint opinion. Yet I remain steadfast in my belief that the right to reproductive choice is entitled to the full protection afforded by this Court before Webster. And I fear for the darkness as four Justices anxiously await the single vote necessary to extinguish the light.

I — i

Make no mistake, the joint opinion of Justices O’Connor, Kennedy, and Souter is an act of personal courage and constitutional principle. In contrast to previous decisions in which Justices O’Connor and Kennedy postponed reconsideration of Roe v. Wade, 410 U. S. 113 (1973), the authors of the joint opinion today join Justice Stevens and me in concluding that “the essential holding of Roe v. Wade should be retained and once again reaffirmed.” Ante, at 846. In brief, five Members of this Court today recognize that “the Constitution protects a woman’s right to terminate her pregnancy in its early stages.” Ante, at 844.

A fervent view of individual liberty and the force of stare decisis have led the Court to this conclusion. Ante, at 853. Today a majority reaffirms that the Due Process Clause of the Fourteenth Amendment establishes “a realm of personal liberty which the government may not enter,” ante, at 847— a realm whose outer limits cannot be determined by interpretations of the Constitution that focus only on the specific practices of States at the time the Fourteenth Amendment was adopted. See ante, at 848-849. Included within this realm of liberty is “The right of the individual, married or single, to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.’ ” Ante, at 851, quoting Eisenstadt v. Baird, 405 U. S. 438, 453 (1972) (emphasis in original). “These matters, involving the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy, are central to the *924liberty protected by the Fourteenth Amendment.” Ante, at 851 (emphasis added). Finally, the Court today recognizes that in the case of abortion, “the liberty of the woman is at stake in a sense unique to the human condition and so unique to the law. The mother who carries a child to full term is subject to anxieties, to physical constraints, to pain that only she must bear.” Ante, at 852.

The Court’s reaffirmation of Roe’s central holding is also based on the force of stare decisis. “[N]o erosion of principle going to liberty or personal autonomy has left Roe’s central holding a doctrinal remnant; Roe portends no developments at odds with other precedent for the analysis of personal liberty; and no changes of fact have rendered viability more or less appropriate as the point at which the balance of interests tips.” Ante, at 860-861. Indeed, the Court acknowledges that Roe’s limitation on state power could not be removed “without serious inequity to those who have relied upon it or significant damage to the stability of the society governed by it.” Ante, at 855. In the 19 years since Roe was decided, that case has shaped more than reproductive planning — “[a]n entire generation has come of age free to assume Roe’s concept of liberty in defining the capacity of women to act in society, and to make reproductive decisions.” Ante, at 860. The Court understands that, having “call[ed] the contending sides ... to end their national division by accepting a common mandate rooted in the Constitution,” ante, at 867, a decision to overrule Roe “would seriously weaken the Court’s capacity to exercise the judicial power and to function as the Supreme Court of a Nation dedicated to the rule of law.” Ante, at 865. What has happened today should serve as a model for future Justices and a warning to all who have tried to turn this Court into yet another political branch.

In striking down the Pennsylvania statute’s spousal notification requirement, the Court has established a framework *925for evaluating abortion regulations that responds to the social context of women facing issues of reproductive choice.1 In determining the burden imposed by the challenged regulation, the Court inquires whether the regulation’s “purpose or effect is to plaee a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.” Ante, at 878 (emphasis added). The Court reaffirms: “The proper focus of constitutional inquiry is the group for whom the law is a restriction, not the group for whom the law is irrelevant.” Ante, at 894. Looking at this group, the Court inquires, based on expert testimony, empirical studies, and common sense, whether “in a large fraction of the cases in which [the restriction] is relevant, it will operate as a substantial obstacle to a woman’s choice to undergo an abortion.” Ante, at 895. “A statute with this purpose is invalid because the means chosen by the State to further the interest in potential life must be calculated to inform the woman’s free choice, not hinder it.” Ante, at 877. And in applying its test, the Court remains sensitive to the unique role of women in the decisionmaking process. Whatever may have been the practice when the Fourteenth Amendment was adopted, the Court observes, “[w]omen do not lose their constitutionally protected liberty when they marry. The Constitution protects all individuals, male or female, married or unmarried, from the abuse of governmental power, even where that power is employed for the supposed benefit of a member of the individual’s, family.” Ante, at 898.2

*926Lastly, while I believe that the joint opinion errs in failing to invalidate the other regulations, I am pleased that the joint opinion has not ruled out the possibility that these regulations may be shown to impose an unconstitutional burden. The joint opinion makes clear that its specific holdings are based on the insufficiency of the record before it. See, e. g., ante, at 885-886. I am confident that in the future evidence will be produced to show that “in a large fraction of the cases in which [these regulations are] relevant, [they] will operate as a substantial obstacle to a woman’s choice to undergo an abortion.” Ante, at 895.

II

Today, no less than yesterday, the Constitution and decisions of this Court require that a State’s abortion restrictions be subjected to the strictest judicial scrutiny. Our precedents and the joint opinion’s principles require us to subject all non-de-minimis abortion regulations to strict scrutiny. Under this standard, the Pennsylvania statute’s provisions requiring content-based counseling, a 24-hour delay, informed parental consent, and reporting of abortion-related information must be invalidated.

A

The Court today reaffirms the long recognized rights of privacy and bodily integrity. As early as 1891, the Court held, “[n]o right is held more sacred, or is more carefully guarded by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others ... .” Union Pacific R. Co. v. Botsford, 141 U. S. 250, 251 (1891). Throughout this century, this Court also has held that the fundamental right of privacy protects citizens against governmental in-*927trusión in such intimate family matters as procreation, child-rearing, marriage, and contraceptive choice. See ante, at 847-849. These eases embody the principle that personal decisions that profoundly affeet bodily integrity, identity, and destiny should be largely beyond the reach of government. Eisenstadt, 405 U. S., at 453. In Roe v. Wade, this Court correctly applied these principles to a woman’s right to choose abortion.

State restrictions on abortion violate a woman’s right of privacy in two ways. First, compelled continuation of a pregnancy infringes upon a woman’s right to bodily integrity by imposing substantial physical intrusions and significant risks of physical harm. During pregnancy, women experience dramatic physical changes and a wide range of health consequences. Labor and delivery pose additional health risks and physical demands. In short, restrictive abortion laws force women to endure physical invasions far more substantial than those this Court has held to violate the constitutional principle of bodily integrity in other contexts. See, e. g., Winston v. Lee, 470 U. S. 753 (1985) (invalidating surgical removal of bullet from murder suspect); Rochin v. California, 342 U. S. 165 (1952) (invalidating stomach pumping).3

Further, when the State restricts a woman’s right to terminate her pregnancy, it deprives a woman of the right to make her own decision about reproduction and family planning — critical life choices that this Court long has deemed central to the right to privacy. The decision to terminate or continue a pregnancy has no less an impact on a woman’s life than decisions about contraception or marriage. 410 U. S., *928at 153. Because motherhood has a dramatic impact on a woman’s educational prospects, employment opportunities, and self-determination, restrictive abortion laws deprive her of basic control over her life.- For these reasons, “the decision whether or not to beget or bear a child” lies at “the very heart of this cluster of constitutionally protected choices.” Carey v. Population Services International, 431 U. S. 678, 685 (1977).

A State’s restrictions on a woman’s right to terminate her pregnancy also implicate constitutional guarantees of gender equality. State restrictions on abortion compel women to continue pregnancies they otherwise might terminate. By restricting the right to terminate pregnancies, the State conscripts women’s bodies into its service, forcing women to continue their pregnancies, suffer the pains of childbirth, and in most instances, provide years of maternal care. The State does not compensate women for their services; instead, it assumes that they owe this duty as a matter of course. This assumption — that women can simply be forced to accept the “natural” status and incidents of motherhood — appears to rest upon a conception of women’s role that -has triggered the protection of the Equal Protection Clause. See, e.g., Mississippi Univ. for Women v. Hogan, 458 U. S. 718, 724-726 (1982); Craig v. Boren, 429 U. S. 190, 198-199 (1976).4 The joint opinion recognizes that these assumptions about women’s place in society “are no longer consistent with our *929understanding of the family, the individual, or the Constitution.” Ante, at 897.

B

The Court has held that limitations on the right of privacy are permissible only if they survive “strict” constitutional scrutiny — that is, only if the governmental entity imposing the restriction can demonstrate that the limitation is both necessary and narrowly tailored to serve a compelling governmental interest. Griswold v. Connecticut, 381 U. S. 479, 485 (1965). We have applied this principle specifically in the context of abortion regulations. Roe v. Wade, 410 U. S., at 155.5

Roe implemented these principles through a framework that was designed “to ensure that the woman’s right to choose not become so subordinate to the State’s interest in promoting fetal life that her choice exists in theory but not in fact,” ante, at 872. Roe identified two relevant state interests: “an interest in preserving and protecting the health of the pregnant woman” and an interest in “protecting the potentiality of human life.” 410 U. S., at 162. With respect to the State’s interest in the health of the mother, “the ‘compelling’ point ... is at approximately the end of the first trimester,” because it is at that point that the mortality rate in abortion approaches that in childbirth. Id., at 163. With respect to the State’s interest in potential life, “the ‘compelling’ point is at viability,” because it is at that point that the *930fetus “presumably has the capability of meaningful life outside the mother’s womb.” Ibid. In order to fulfill the requirement of narrow tailoring, “the State is obligated to make a reasonable effort to limit the effect of its regulations to the period in the trimester during which its health interest will be furthered.” Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416, 434 (1983).

In my view, application of this analytical framework is no less warranted than when it was approved by seven Members of this Court in Roe. Strict scrutiny of state limitations on reproductive choice still offers the most secure protection of the woman’s right to make her own reproductive decisions, free from state coercion. No majority of this Court has ever agreed upon an alternative approach. The factual premises of the trimester framework have not been undermined, see Webster, 492 U. S., at 553 (Blackmun, J., dissenting), and the Roe framework is far more administra-ble, and far less manipulate, than the “undue burden” standard adopted by the joint opinion.

Nonetheless, three criticisms of the trimester framework continue to be uttered. First, the trimester framework is attacked because its key elements do not appear in the text of the Constitution. My response to this attack remains the same as it was in Webster:

“Were this a true concern, we would have to abandon most of our constitutional jurisprudence. [Tjhe ‘critical elements’ of countless constitutional doctrines nowhere appear in the Constitution’s text.... The Constitution makes no mention, for example, of the First Amendment’s ‘actual malice’ standard for proving certain libels, see New York Times Co. v. Sullivan, 376 U. S. 254 (1964). ... Similarly, the Constitution makes no mention of the rational-basis test, or the specific verbal formulations of intermediate and strict scrutiny by which this Court evaluates claims under the Equal Protection Clause. The reason is simple. Like the Roe framework, these *931tests or standards are not, and do not purport to be, rights protected by the Constitution. Rather, they are judge-made methods for evaluating and measuring the strength and scope of constitutional rights or for balancing the constitutional rights of individuals against the competing interests of government.” Id., at 548.

The second criticism is that the framework more closely resembles a regulatory code than a body of constitutional doctrine. Again, my answer remains the same as in Webster:

“[I]f this were a true and genuine concern, we would have to abandon vast areas of our constitutional jurisprudence. . . . Are [the distinctions entailed in the trimester framework] any finer, or more ‘regulatory,’ than the distinctions we have often drawn in our First Amendment jurisprudence, where, for example, we have held that a ‘release time’ program permitting public-school students to leave school grounds during school hours to receive religious instruction does not violate the Establishment Clause, even though a release-time program permitting religious instruction on school grounds does violate the Clause? Compare Zorach v. Clauson, 343 U. S. 306 (1952), with Illinois ex rel. Mc-Collum v. Board of Education of School Dist. No. 71, Champaign County, 333 U. S. 203 (1948)... . Similarly, in a Sixth Amendment case, the Court held that although an overnight ban on attorney-client communication violated the constitutionally guaranteed right to counsel, Geders v. United States, 425 U. S. 80 (1976), that right was not violated when a trial judge separated a defendant from his lawyer during a 15-minute recess after the defendant’s direct testimony. Perry v. Leeke, 488 U. S. 272 (1989).
“That numerous constitutional doctrines result in narrow differentiations between similar circumstances does *932not mean that this Court has abandoned adjudication in favor of regulation.” Id., at 549-550.

The final, and more genuine, criticism of the trimester framework is that it fails to find the State’s interest in potential human life compelling throughout pregnancy. No Member of this Court — nor for that matter, the Solicitor General, see Tr. of Oral Arg. 42 — has ever questioned our holding in Roe that an abortion is not “the termination of life entitled to Fourteenth Amendment protection.” 410 U. S., at 159. Accordingly, a State’s interest in protecting fetal life is not grounded in the Constitution. Nor, consistent with our Establishment Clause, can it be a theological or sectarian interest. See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747, 778 (1986) (Stevens, J., concurring). It is, instead, a legitimate interest grounded in humanitarian or pragmatic concerns. See ante, at 914-915 (Stevens, J., concurring in part and dissenting in part).

But while a State has “legitimate interests from the outset of the pregnancy in protecting the health of the worn an and the life of the fetus that may become a child,” ante, at 846, legitimate interests are not enough. To overcome the burden of strict scrutiny, the interests must be compelling. The question then is how best to accommodate the State’s interest in potential human life with the constitutional liberties of pregnant women. Again, I stand by the views I expressed in Webster:

“I remain convinced, as six other Members of this Court 16 years ago were convinced, that the Roe framework, and the viability standard in particular, fairly, sensibly, and effectively functions to safeguard the constitutional liberties of pregnant women while recognizing and accommodating the State’s interest in potential human life. The viability line reflects the biological facts and truths of fetal development; it marks that threshold moment prior to which a fetus cannot survive separate from the *933woman and cannot reasonably and objectively be regarded as a subject of rights or interests distinct from, or paramount to, those of the pregnant woman. At the same time, the viability standard takes account of the undeniable fact that as the fetus evolves into its postnatal form, and as it loses its dependence on the uterine environment, the State’s interest in the fetus’ potential human life, and in fostering a regard for human life in general, becomes compelling. As a practical matter, because viability follows ‘quickening’ — the point at which. a woman feels movement in her womb — and because viability occurs no earlier than 23 weeks gestational age, it establishes an easily applicable standard for regulating abortion while providing a pregnant woman ample time to exercise her fundamental right with her responsible physician to terminate her pregnancy.” 492 U. S., at 553-554.6

Roe’s trimester framework does not ignore the State’s interest in prenatal life. Like Justice Stevens, ante, at 916,

I agree that the State may take steps to ensure that a woman’s choice “is thoughtful and informed,” ante, at 872, and that “States are free to enact laws to provide a reasonable framework for a woman to make a decision that has such profound and lasting meaning.” Ante, at 873. But

“[sjerious questions- arise ... when a State attempts to persuade the woman to choose childbirth over abortion. Ante, at 878. Decisional autonomy must limit the State’s power to inject into a woman’s most personal deliberations its own views of what is best. The State may promote its preferences by funding childbirth, by creating and maintaining alternatives to abortion, and by espousing the virtues of family; but it must respect *934the individual’s freedom to make such judgments.” Ante, at 916 (Stevens, J., concurring in part and dissenting in part) (internal quotation marks omitted).

As the joint opinion recognizes, “the means chosen by the State to further the interest in potential life must be calculated to inform the woman’s free choice, not hinder it.” Ante, at 877.

In sum, .Roe’s requirement of strict scrutiny as implemented through a trimester framework should not be disturbed. No other approach has gained a majority, and no other is more protective of the woman’s fundamental right. Lastly, no other approach properly accommodates the woman’s constitutional right with the State’s legitimate interests.

C

Application of the strict scrutiny standard results in the invalidation of all the challenged provisions. Indeed, as this Court has invalidated virtually identical provisions in prior cases, stare decisis requires that we again strike them down.

This Court has upheld informed- and written-consent requirements only where the State has demonstrated that they genuinely further important health-related state concerns. See Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52, 65-67 (1976). A State may not, under the guise of securing informed consent, “require the delivery of information ‘designed to influence the woman’s informed choice between abortion or childbirth.’ ” Thornburgh, 476 U. S., at 760, quoting Akron, 462 U. S., at 443-444. Rigid requirements that a specific body of information be imparted to a woman in all cases, regardless of the needs of the patient, improperly intrude upon the discretion of the pregnant woman’s physician and thereby impose an “‘undesired and uncomfortable straitjacket.’ ” Thornburgh, 476 U. S., at 762, quoting Danforth, 428 U. S., at 67, n. 8.

Measured against these principles, some aspects of the Pennsylvania informed-consent scheme are unconstitutional. *935While it is unobjectionable for the Commonwealth to require that the patient be informed of the nature of the procedure, the health risks of the abortion and of childbirth, and the probable gestational age of the unborn child, compare Pa. Cons. Stat. §§3205(a)(i)-(iii) (1990) with Akron, 462 U. S., at 446, n. 37, I remain unconvinced that there is a vital state need for insisting that the information be provided by a physician rather than a counselor. Id., at 448. The District Court found that the physician-only requirement necessarily would increase costs to the plaintiff clinics, costs that undoubtedly would be passed on to patients. And because trained women counselors are often more understanding than physicians, and generally havé more time to spend with patients, see App. 366-387, the physician-only disclosure requirement is not narrowly tailored to serve the Commonwealth’s interest in protecting maternal health.

Sections 3205(a)(2)(i)~(iii) of the Act further requires that the physician or a qualified nonphysieian inform the woman that printed materials are available from the Commonwealth that describe the fetus and provide information about medical assistance for childbirth, information about child support from the father, and a list of agencies offering adoption and other services as alternatives to abortion. Thornburgh invalidated biased patient-counseling requirements virtually identical to the one at issue here. What we said of those requirements fully applies in these cases:

“[T]he listing of agencies in the printed Pennsylvania form presents serious problems; it contains names of agencies that well may be out of step with the needs of the particular woman and thus places the physician in an awkward position and infringes upon his or her professional responsibilities. Forcing the physician or counselor to present the materials and the list to the woman makes him or her in effect an agent of the State in treating the woman and places his or her imprimatur upon both the materials and the list. All this is, or *936comes close to being, state medicine imposed upon the woman, not the professional medical guidance she seeks, and it officially structures — as it obviously was intended to do — the dialogue between the woman and her physician.
“The requirements . . . that the woman be advised that medical assistance benefits may be available, and that the father is responsible for financial assistance in the support of the child similarly are poorly disguised elements of discouragement for the abortion decision. Much of this ..., for many patients, would be irrelevant and inappropriate. For a patient with a life-threatening pregnancy, the ‘information’ in its very rendition may be cruel as well as destructive of the physician-patient relationship. As any experienced social worker or other counselor knows, theoretical financial responsibility often does not equate with fulfillment.... Under the guise of informed consent, the Act requires the dissemination of information that is not relevant to such consent, and, thus, it advances no legitimate state interest.” 476 U' S., at 762-763 (citation omitted).

“This type of compelled information is the antithesis of informed consent,” id., at 764, and goes far beyond merely describing the general subject matter relevant to the woman’s decision. “That the Commonwealth does not, and surely would not, compel similar disclosure of every possible peril of necessary surgery or of simple vaccination, reveals the anti-abortion character of the statute and its real purpose.” Ibid.7

*937The 24-hour waiting period following the provision of the foregoing information is also clearly unconstitutional. The District Court found that the mandatory 24-hour delay could lead to delays in excess of 24 hours, thus increasing health risks, and that it would require two visits to the abortion provider, thereby increasing travel time, exposure to further harassment, and financial cost. Finally, the District Court found that the requirement would pose especially significant burdens on women living in rural areas and those women that have difficulty explaining their whereabouts. 744 F. Supp. 1328,1378-1379 (ED Pa. 1990). In Akron this Court invalidated a similarly arbitrary or inflexible waiting period because, as here, it fiirthered no legitimate state interest.8

As Justice Stevens insightfully concludes, the mandatory delay rests either on outmoded or unacceptable assumptions about the decisionmaking capacity of women or the belief that the decision to terminate the pregnancy is *938presumptively wrong. Ante, at 918-919. The requirement that women consider this obvious and slanted information for an additional 24 hours contained in these provisions will only influence the womán’s decision in improper ways. The vast majority of women will know this information — of the few that do not, it is less likely that their minds will be changed by this information than it will be either by the realization that the State opposes their choice or the need once again to endure abuse and harassment on return to the clinic.9

Except in the case of a medical emergency, § 3206 requires a physician to obtain the informed consent of a parent or guardian before performing an abortion on an unemanci-pated minor or an incompetent woman. Based on evidence in the record, the District Court concluded that, in order to fulfill the informed-consent requirement, generally accepted medical principles would require an in-person visit by the parent to the facility. 744 F. Supp., at 1382. Although the Court “has recognized that the State has somewhat broader authority to regulate the activities of children than of adults,” the State nevertheless must demonstrate that there is a “significant state interest in conditioning an abortion... that is not present in the case of an adult.” Danforth, 428 U. S., at 74-75 (emphasis added). The requirement of an in-person visit would carry with it the risk of a delay of several days or possibly weeks, even where the parent is willing to consent. While the State has an interest in encouraging parental involvement-in the minor’s abortion decision, §3206 is not narrowly drawn to serve that interest.10

*939Finally, the Pennsylvania statute requires every facility performing abortions to report its activities to the Commonwealth. Pennsylvania contends that this requirement is valid under Danforth, in which this Court held that record-keeping and reporting requirements that are reasonably directed to the preservation of maternal health and that properly respect a patient’s confidentiality are permissible. Id., at 79-81. The Commonwealth attempts to justify its required reports on the ground that the public has a right to know how its tax dollars are spent. A regulation designed to inform the public about public expenditures does not further the Commonwealth’s interest in protecting maternal health. Accordingly, such a regulation cannot justify a legally significant burden on a woman’s right to obtain an abortion.

The confidential reports concerning the identities and medical judgment of physicians involved in abortions at first glance may seem valid, given the Commonwealth’s interest in maternal health and enforcement of the Act. The District Court found, however, that, notwithstanding the confidentiality protections, many physicians, particularly those who have previously discontinued performing abortions because of harassment, would refuse to refer patients to abortion clinics if their names were to appear on these reports. 744 F. Supp., at 1392. The Commonwealth has failed to show that the name of the referring physician either adds to the pool of scientific knowledge concerning abortion or is reasonably related to the Commonwealth’s interest in maternal health. I therefore agree with the District Court’s conclusion that the confidential reporting requirements are uneon-*940stitutional insofar as they require the name of the referring physician and the basis for his or her medical judgment.

In sum, I would affirm the judgment in No. 91-902 and reverse the judgment in No. 91-744 and remand the eases for further proceedings.

Ill

At long last, The ChieF Justice and those who have joined him admit it. Gone are the contentions that the issue need not be (or has not been) considered. There, on the first page, for all to see, is what was expected: “We believe that Roe was wrongly decided, and that it can and should be overruled consistently with our traditional approach to stare de-cisis in constitutional cases.” Post, at 944. If there is much reason to applaud the advances made by the joint opinion today, there is far more to fear from The ChieF Justice’s opinion.

The ChieF Justice’s criticism of Roe follows from his stunted conception of individual liberty. While recognizing that the Due Process Clause protects more than simple physical liberty, he then goes on to construe this Court’s personal-liberty cases as establishing only a laundry list of particular rights, rather than a principled account of how these particular rights are grounded in a more general right of privacy. Post, at 951. This constricted view is reinforced by The Chief Justice’s exclusive reliance on tradition as a source of fundamental rights. He argues that the record in favor of a right to abortion is no stronger than the record in Michael H. v. Gerald D., 491 U. S. 110 (1989), where the plurality found no fundamental right to visitation privileges by an adulterous father, or in Bowers v. Hardwick, 478 U. S. 186 (1986), where the Court found no fundamental right to engage in homosexual sodomy, or in a ease involving the “ ‘firing [of] a gun . . . into another person’s body.’” Post, at 951-952. In The Chief Justice’s world, a woman considering whether to terminate a pregnancy is entitled to no more protection than adulterers, murderers, and so-called sexual *941deviates.11 Given The ChieF Justice’s exclusive reliance on tradition, people using contraceptives seem the next likely candidate for his list of outcasts.

Even more shocking than The Chief Justice’s cramped notion of individual liberty is his complete omission of any discussion of the effects that compelled childbirth and motherhood have on women’s lives. The only expression of concern with women’s health is purely instrumental — for The CHIEF Justice, only women’s 'psychological health is a concern, and only to the extent that he assumes that every woman who decides to have an abortion does so without serious consideration of the moral implications of her decision. Post, at 967-968. In short, The Chief Justice’s view of the State’s compelling interest in maternal health has less to do with health than it does with compelling women to be maternal.

Nor does. The Chief Justice give any serious consideration to the doctrine of stare decisis. For The Chief Justice, the facts, that gave rise to Roe are surprisingly simple: “women become pregnant, there is a point somewhere, depending on medical technology, where a fetus becomes viable, and women give birth to children.” Post, at 965. This characterization of the issue thus allows The Chief Justice quickly to discard the joint opinion’s reliance argument by asserting that “reproductive planning could take virtually immediate account of” a decision overruling Roe. Post, at 956 (internal quotation marks omitted).

The Chief Justice’s narrow conception of individual liberty and stare decisis leads him to propose the same standard of review proposed by the plurality in Webster. “States may regulate abortion procedures in ways rationally related to a legitimate state interest. Williamson v. Lee Optical of Oklahoma, Inc., 348 U. S. 483, 491 (1955); cf. Stanley v. Illinois, 405 U.S. 645, 651-653 (1972).” Post, at 966. The *942CHIEF Justice then further weakens the test by providing an insurmountable requirement for facial challenges: Petitioners must “‘show that no set of circumstances exists under which the [provision] would be valid.’ ” Post, at 973, quoting Ohio v. Akron Center for Reproductive Health, 497 U. S., at 514. In short, in his view, petitioners must prove that the statute cannot constitutionally be applied to anyone. Finally, in applying his standard to the spousal-notification provision, The Chief Justice contends that the record lacks any “hard evidence” to support the joint opinion’s contention that a “large fraction” of women who prefer not to notify their husbands involve situations of battered women and unreported spousal assault. Post, at 974, n. 2. Yet throughout the explication of his standard, The Chief Justice never explains what hard evidence is, how large a fraction is required, or how a battered woman is supposed to pursue an as-applied challenge.

Under his standard, States can ban abortion if that ban is rationally related to a legitimate state interest — a standard which the United States calls “deferential, but not toothless.” Yet when' pressed at oral argument to describe the teeth, the best protection that the Solicitor General could offer to women was that a prohibition, enforced by criminal penalties, with no exception for the life of the mother, “could raise very serious questions.” Tr. of Oral Arg. 48. Perhaps, the Solicitor General offered, the failure to include an exemption for the life of the mother would be “arbitrary and capricious.” Id., at 49. If, as The Chief Justice contends, the undue burden test is made out of whole cloth, the so-called “arbitrary and capricious” limit is the Solicitor General’s “new clothes.”

Even if it is somehow “irrational” for a State to require a woman to risk her life for her child, what protection is offered for women who become pregnant through rape or incest? Is there anything arbitrary or capricious about a *943State’s prohibiting the sins of the father from being visited upon his offspring?12

But, we are reassured, there is always the protection of the democratic process. While there is much to be'praised about our democracy, our country since its founding has recognized that there are certain fundamental liberties that are not to be left to the whims of an election. A woman’s right to reproductive choice is one of those fundamental liberties. Accordingly, that liberty need not seek refuge at the ballot box.

IV

In one sense, the Court’s approach is worlds apart from that of The Chief Justice and Justíce Scalia. And yet, in another sense, the distance between the two approaches is short — the distance is but a single vote.

I am 83 years old. I cannot remain on this Court forever, and when I do step down, the confirmation process for my successor well may focus on the issue before us today. That, I regret, may be exactly where the choice between the two worlds will be made.

*944ChieF Justice Rehnquist,

with whom Justice White, Justice Scalia, and Justice Thomas join,

concurring in the judgment in part and dissenting in part.

The joint opinion, following its newly minted variation on stare decisis, retains the outer shell of Roe v. Wade, 410 U. S. 113 (1973), but beats a wholesale retreat from the substance of that case. We believe that Roe was wrongly decided, and that it can and should be overruled consistently with our traditional approach to stare decisis in constitutional cases. We would adopt the approach of the plurality in Webster v. Reproductive Health Services, 492 U. S. 490 (1989), and uphold the challenged provisions of the Pennsylvania statute in their entirety.

I

In ruling on this litigation below, the Court of Appeals for the Third Circuit first observed that “this appeal does not directly implicate Roe; this case involves the regulation of abortions rather than their outright prohibition.” 947 F. 2d 682, 687 (1991). Accordingly, the court directed its attention to the question of the standard of review for abortion regulations. In attempting to settle on the correct standard, however, the court confronted the confused state of this Court’s abortion jurisprudence. After considering the several opinions in Webster v. Reproductive Health Services, supra, and Hodgson v. Minnesota, 497 U. S. 417 (1990), the Court of Appeals concluded that Justice O’Connor’s “undue burden” test was controlling, as that was the narrowest ground on which we had upheld recent abortion regulations. 947 F. 2d, at 693-697 (“When a fragmented court decides a case and no single rationale explaining the result enjoys the assent of five Justices, the holding of the Court may be viewed as that position taken by those Members who concurred in the judgments on the narrowest grounds” (quoting Marks v. United States, 430 U. S. 188, 193 (1977) (internal quotation marks omitted))). Applying this standard, the Court of Appeals upheld all of the challenged regulations except the one *945requiring a woman to notify her spouse of an intended abortion.

In arguing that this Court should invalidate each of the provisions at issue, petitioners insist that we reaffirm our decision in Roe v. Wade, supra, in which we held unconstitutional a Texas statute making it a crime to procure an abortion except to save the life of the mother.1 We agree with the Court of Appeals that our decision in Roe is not directly implicated by the Pennsylvania statute, which does not prohibit, but simply regulates, abortion. But, as the Court of Appeals found, the state of our post-ftoe decisional law dealing with the regulation of abortion is confusing and uncertain, indicating that a reexamination of that line of eases is in order. Unfortunately for those who must apply this Court’s decisions, the reexamination undertaken today leaves the Court no less divided than beforehand. Although they reject the trimester framework that formed the underpinning of Roe, Justices O’Connor, Kennedy, and Souter adopt a revised undue burden standard to analyze the challenged regulations. We conclude, however, that such an outcome is an unjustified constitutional compromise, one which leaves the Court in a position to closely scrutinize all types of abortion regulations despite the fact that it lacks the power to do so under the Constitution.

In Roe, the Court opined that the State “does have an important and legitimate interest in preserving and protecting the health of the pregnant woman, . . . and that it has still another important and legitimate interest in protecting *946the potentiality of human life.” 410 U. S., at 162 (emphasis omitted). In the companion case of Doe v. Bolton, 410 U. S. 179 (1973), the Court referred to its conclusion in Roe “that a pregnant woman does not have an absolute constitutional right to an abortion on her demand.” 410 U. S., at 189. But while the language and holdings of these cases appeared to leave States free to regulate abortion procedures in a variety of ways, later decisions based on them have found considerably less latitude for such regulations than might have been expected.

For example, after Roe, many States have sought to protect their young citizens by requiring that a minor seeking an abortion involve her parents in the decision. Some States have simply required notification of the parents, while others have required a minor to obtain the consent of her parents. In a number of decisions, however, the Court has substantially limited the States in their ability to impose such requirements. With regard to parental notice requirements, we initially held that a State could require a minor to notify her parents before proceeding with an abortion. H. L. v. Matheson, 460 U. S. 398, 407-410 (1981). Recently, however, we indicated that a State’s ability to impose a notice requirement actually depends on whether it requires notice of one or both parents. We concluded that although the Constitution might allow a State to demand that notice be given to one parent prior to an abortion, it may not require that similar notice be given to two parents, unless the State incorporates a judicial bypass procedure in that two-parent requirement. Hodgson v. Minnesota, supra.

We have treated parental consent provisions even more harshly. Three years after Roe, we invalidated a Missouri regulation requiring that an unmarried woman under the age of 18 obtain the consent of one of her parents before proceeding with an abortion. We held that our abortion jurisprudence prohibited the State from imposing such a “blanket provision ... requiring the consent of a parent.” Planned Parenthood *947of Central Mo. v. Danforth, 428 U. S. 52, 74 (1976). In Bellotti v. Baird, 443 U. S. 622 (1979), the Court struck down a similar Massachusetts parental consent statute. A majority of the Court indicated, however, that a State could constitutionally require parental consent, if it alternatively allowed a pregnant minor to obtain an abortion without parental consent by showing either that she was mature enough to make her own decision, or that the abortion would be in her best interests. See id., at 643-644 (plurality opinion); id., at 656-657 (White, J., dissenting). In light of Bellotti, we have upheld one parental consent regulation which incorporated a judicial bypass option we viewed as sufficient, see Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476 (1983), but have invalidated another because of our belief that the judicial procedure did not satisfy the dictates of Bellotti, see Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416, 439-442 (1983). We have never had occasion, as we have in the parental notice context, to further parse our parental consent jurisprudence into one-parent and two-parent components.

In Roe, the Court observed that certain States recognized the right of the father to participate in the abortion decision in certain circumstances. Because neither Roe nor Doe involved the assertion of any paternal right, the Court expressly stated that the case did not disturb the validity of regulations that protected such a right. Roe v. Wade, supra, at 165, n. 67. But three years later, in Danforth, the Court extended its abortion jurisprudence and held that a State could not require that.a woman obtain the consent of her spouse before proceeding with an abortion. Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 69-71.

States have also regularly tried to ensure that a woman’s decision to have an abortion is an informed and well-considered one. In Danforth, we upheld a requirement that a woman sign a consent form prior to her abortion, and observed that “it is desirable and imperative that [the decision] *948be made with full knowledge of its nature and consequences.” Id., at 67. Since that case, however, we have twice invalidated state statutes designed to impart such knowledge to a woman seeking an abortion. In Akron, we held unconstitutional a regulation requiring a physician to inform a woman seeking an abortion of the status of her pregnancy, the development of her fetus, the date of possible viability, the complications that could result from an abortion, and the availability of agencies providing assistance and information with respect to adoption and childbirth. Akron v. Akron Center for Reproductive Health, supra, at 442-445. More recently, in Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747 (1986), we struck down a more limited Pennsylvania regulation requiring that a woman be informed of the risks associated with the abortion procedure and the assistance available to her if she decided to proceed with her pregnancy, because we saw the compelled information as “the antithesis of informed consent.” Id., at 764. Even when a State has sought only to provide information that, in our view, was consistent with the Roe framework, we concluded that the State could not require that a physician furnish the information, but instead had to alternatively allow nonphysician counselors to provide it. Akron v. Akron Center for Reproductive Health, 462 U. S., at 448-449. In Akron as well, we went further and held that a State may not require a physician to wait 24 hours to perform an abortion after receiving the consent of a woman. Although the State sought to ensure that the' woman’s decision was carefully considered, the Court concluded that the Constitution forbade the State to impose any sort of delay. Id., at 449-451.

We have not allowed States much leeway to regulate even the actual abortion procedure. Although a State can require that second-trimester abortions be performed in outpatient clinics, see Simopoulos v. Virginia, 462 U. S. 506 (1983), we concluded in Akron and Ashcroft that a State could not *949require that such abortions be performed only in hospitals. See Akron v. Akron Center for Reproductive Health, supra, at 437-439; Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, supra, at 481-482. Despite the fact that Roe expressly allowed regulation after the first trimester in furtherance of maternal health, “‘present medical knowledge,’” in our view, could not justify such a hospitalization requirement under the trimester framework. Akron v. Akron Center for Reproductive Health, supra, at 437 (quoting Roe v. Wade, supra, at 163). And in Danforth, the Court held that Missouri could not outlaw the saline amniocentesis method of abortion, concluding that the Missouri Legislature had “failed to appreciate and to consider several significant facts” in making its decision. 428 U. S., at 77.

Although Roe allowed state regulation after the point of viability to protect the potential life of the fetus, the Court subsequently rejected attempts to regulate in this manner. In Colautti v. Franklin, 439 U. S. 379 (1979), the Court struck down a statute that governed the determination of viability. Id., at 390-397. In the process, we made clear that the trimester framework incorporated only one definition of viability — ours—as we forbade States to decide that a certain objective indicator — “be it weeks of gestation or fetal weight or any other single factor” — should govern the definition of viability. Id., at 389. In that same case, we also invalidated a regulation requiring a physician to use the abortion technique offering the best chance for fetal survival when performing postviability abortions. See id., at 397-401; see also Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 768-769 (invalidating a similar regulation). In Thornburgh, the Court struck down Pennsylvania’s requirement that a second physician be present at postviability abortions to help preserve the health of the unborn child, on the ground that it did not incorporate a sufficient medical emergency exception. Id., at 769-771. Regulations governing the treatment of aborted fetuses have *950met a similar fate. In Akron, we invalidated a provision requiring physicians performing abortions to “insure that the remains of the unborn child are disposed of in a humane and sanitary manner.” 462 U. S., at 451 (internal quotation marks omitted).

Dissents in these cases expressed the view that the Court was expanding upon Roe in imposing ever greater restrictions on the States. See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 783 (Burger, C. J., dissenting) (“The extent to which the Court has departed from the limitations expressed in Roe is readily apparent”); id., at 814 (White, J., dissenting) (“[T]he majority indiscriminately strikes down statutory provisions that in no way contravene the right recognized in Roe”). And, when confronted with state regulations of this type in past years, the Court has become increasingly more divided: The three most recent abortion cases have not commanded a Court opinion. See Ohio v. Akron Center for Reproductive Health, 497 U. S. 502 (1990); Hodgson v. Minnesota, 497 U. S. 417 (1990); Webster v. Reproductive Health Services, 492 U. S. 490 (1989).

The task of the Court of Appeals in the present eases was obviously complicated by this confusion and uncertainty. Following Marks v. United States, 480 U. S. 188 (1977), • it concluded that in light of Webster and Hodgson, the strict scrutiny standard enunciated in Roe was no longer applicable, and that the “undue burden” standard adopted by Justice O’Connor was the governing principle. This state of confusion and disagreement warrants reexamination of the “fundamental right” accorded to a woman’s decision to abort a fetus in Roe, with its concomitant requirement that any state regulation of abortion survive “strict scrutiny.” See Payne v. Tennessee, 501 U. S. 808, 827-828 (1991) (observing that reexamination of constitutional decisions is appropriate when those decisions have generated uncertainty and failed to provide clear guidance, because “correction through legis*951lative action is practically impossible” (internal quotation marks omitted)); Garcia v. San Antonio Metropolitan Transit Authority, 469 U. S. 528, 546-547, 557 (1985).

We have held that a liberty interest protected under the Due Process Clause of the Fourteenth Amendment will be deemed fundamental if it is “implicit in the concept of ordered liberty.” Palko v. Connecticut, 302 U. S. 319, 325 (1937). Three years earlier, in Snyder v. Massachusetts, 291 U. S. 97 (1934), we referred to a “principle of justice so rooted in the traditions and conscience of our people as to be ranked as fundamental.” Id., at 105; see also Michael H. v. Gerald D., 491 U. S. 110, 122 (1989) (plurality opinion) (citing the language from Snyder). These expressions are admittedly not precise, but our decisions implementing this notion of “fonda-mental” rights do not afford any more elaborate basis on which to base such a classification.

In construing the phrase “liberty” incorporated in the Due Process Clause of the Fourteenth Amendment, we have recognized that its meaning extends beyond freedom from physical restraint. In Pierce v. Society of Sisters, 268 U. S. 510 (1925), we held that it included a parent’s right to send a child to private school; in Meyer v. Nebraska, 262 U. S. 390 (1923), we held that it included a right to teach a foreign language in a parochial school. Building on these cases, we have held that the term “liberty” includes a right to marry, Loving v. Virginia, 388 U. S. 1 (1967); a right to procreate, Skinner v. Oklahoma ex rel. Williamson, 316 U. S. 535 (1942); and a right to use contraceptives, Griswold v. Connecticut, 381 U. S. 479 (1965); Eisenstadt v. Baird, 405 U. S. 438 (1972). But a reading of these opinions makes clear that they do not endorse any all-encompassing “right of privacy.”

In Roe v. Wade, the Court recognized a “guarantee of personal privacy” which “is broad enough to encompass a woman’s decision whether or not to terminate her pregnancy.” 410 U S., at 152-153. We are now of the view that, in terming this right fundamental, the Court in Roe read the earlier *952opinions upon which it based its decision much too broadly. Unlike marriage, procreation, and contraception, abortion “involves the purposeful termination of a potential life.” Harris v. McRae, 448 U. S. 297, 325 (1980). The abortion decision must therefore “be recognized as sui generis, different in kind from the others that the Court has protected under the rubric of personal or family privacy and autonomy.” Thornburgh v. American College of Obstetricians and Gynecologists, supra, at 792 (White, J., dissenting). One cannot ignore the fact that a woman is not isolated in her pregnancy, and that the decision to abort necessarily involves the destruction of a fetus. See Michael H. v. Gerald D., supra, at 124, n. 4 (To look “at the act which is assertedly the subject of a liberty interest in isolation from its effect upon other people [is] like inquiring whether there is a liberty interest in firing a gun where the case at hand happens to involve its discharge into another person’s body”).

Nor do the historical traditions of the American people support the view that the right to terminate one’s pregnancy is “fundamental.” The common - law which we inherited from England made abortion after “quickening” an offense. At the time of the adoption of the Fourteenth Amendment, statutory prohibitions or restrictions on abortion were commonplace; in 1868, at least 28 of the then-87 States and 8 Territories had statutes banning or limiting abortion. J. Mohr, Abortion in America 200 (1978). By the turn of the century virtually every State had a law prohibiting or restricting abortion on its books. By the middle of the present century, a liberalization trend had set in. But 21 of the restrictive abortion laws in effect in 1868 were still in effect in 1973 when Roe was decided, and an overwhelming majority of the States prohibited abortion unless necessary to preserve the life or health of the mother. Roe v. Wade, 410 U. S., at 139-140; id., at 176-177, n. 2 (Rehnquist, J., dissenting). On this record, it can scarcely be said that any deeply rooted tradition of relatively unrestricted abortion in our his*953tory supported the classification of the right to abortion as “fundamental” under the Due Process Clause of the Fourteenth Amendment.

We think, therefore, both in view of this history and of our decided cases dealing with substantive liberty under the Due Process Clause, that the Court was mistaken in Roe when it classified a woman's decision to terminate her pregnancy as a “fundamental right” that could be abridged only in a manner which withstood “strict scrutiny.” In so concluding, we repeat the observation made in Bowers v. Hardwick, 478 U. S. 186 (1986):

“Nor are we inclined to take a more expansive view of our authority to discover new fundamental rights imbedded in the Due Process Clause. The Court is most vulnerable and comes nearest to illegitimacy when it deals with judge-made constitutional law having little ■ or no cognizable roots in the language or design of the Constitution.” Id., at 194.

We believe that the sort of constitutionally imposed abortion code of the type illustrated by our decisions following Roe is inconsistent “with the notion of a Constitution cast in general terms, as ours is, and usually speaking in general principles, as ours does.” Webster v. Reproductive Health Services, 492 U. S., at 518 (plurality opinion). The Court in Roe reached too far when it analogized the right to abort a fetus to the rights involved in Pierce, Meyer, Loving, and Griswold, and thereby deemed the right to abortion fundamental.

II

The joint opinion of Justices O’Connor, Kennedy, and Souter cannot bring itself to say that Roe was correct as an original matter, but the authors are of the view that “the immediate question is not the soundness of Roe’s resolution of the issue, but the precedential force that must be aceorded to its holding.” Ante, at 871. Instead of claiming that Roe *954was correct as a matter of original constitutional interpretation, the opinion therefore contains an elaborate discussion of stare decisis. This discussion of the principle of stare decisis appears to be almost entirely dicta, because the joint opinion does not apply that principle in dealing with Roe. Roe decided that a woman had a fundamental right to an abortion. The joint opinion rejects that view. Roe decided that abortion regulations were to be subjected to “strict scrutiny” and could be justified only in the light of “compelling state interests.” The joint opinion rejects that view. Ante, at 872-873; see Roe v. Wade, supra, at 162-164. Roe analyzed abortion regulation under a rigid trimester framework, a framework which has guided this Court’s decisionmaking for 19 years. The joint opinion rejects that framework. Ante, at 873.

Stare decisis is defined in Black’s Law Dictionary as meaning “to abide by, or adhere to, decided cases.” Black’s Law Dictionary 1406 (6th ed. 1990). Whatever the “central holding” of Roe that is left after the joint opinion finishes dissecting it is surely not the result of that principle. While purporting to adhere to precedent, the joint opinion instead revises it. Roe continues to exist, but only in the way a storefront on a western movie set exists: a mere facade to give the illusion of reality. Decisions following Roe, such as Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416 (1983), and Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747 (1986), are frankly overruled in part under the “undue burden” standard expounded in the joint opinion. Ante, at 881-884.

In our view, authentic principles of stare decisis do not require that any portion of the reasoning in Roe be kept intact. “Stare decisis is not... a universal, inexorable command,” especially in eases involving the interpretation of the Federal Constitution. Burnet v. Coronado Oil & Gas Co., 285 U. S. 393, 405 (1932) (Brandéis, J., dissenting). Erroneous decisions in such constitutional cases are uniquely durable, because correction through legislative action, save for *955constitutional amendment, is impossible. It is therefore our duty to reconsider constitutional interpretations that “depart] from a proper understanding” of the Constitution. Garcia v. San Antonio Metropolitan Transit Authority, 469 U. S., at 557; see United States v. Scott, 437 U. S. 82, 101 (1978) (“ ‘[I]n cases involving the Federal Constitution, . . . [t]he Court bows to the lessons of experience and the force of better reasoning, recognizing that the process of trial and error, so fruitful in the physical sciences, is appropriate also in the judicial function’” (quoting Burnet v. Coronado Oil & Gas Co., supra, at 406-408 (Brandeis, J., dissenting))); Smith v. Allwright, 321 U. S. 649, 665 (1944). Our constitutional watch does not cease merely because we have spoken before on an issue; when it becomes clear that a prior constitutional interpretation is unsound we are obliged to reexamine the question. See, e. g., West Virginia Bd. of Ed. v. Barnette, 319 U. S. 624, 642 (1943); Erie R. Co. v. Tompkins, 304 U. S. 64, 74-78 (1938).

The joint opinion discusses several stare decisis factors which, it asserts, point toward retaining a portion of Roe. Two of these factors are that the main “factual underpinning” of Roe has remained the same, and that its doctrinal foundation is no weaker now than it was in 1973. Ante, at 857-860. Of course, what might be called the basic facts which gave rise to Roe have remained the same — women become pregnant, there is a point somewhere, depending on medical technology, where a fetus becomes viable, and women give birth to children. But this is only to say that the same facts which gave rise to Roe will continue to give rise to similar cases. It is not a reason, in and of itself, why those cases must be decided in the same incorrect manner as was the first case to deal with the question. And surely there is no requirement, in considering whether to depart from stare decisis in a constitutional case, that a decision be more wrong now than it was at the time it was rendered. If that were true, the most outlandish constitutional decision could sur*956vive forever, based simply on the fact that it was no more outlandish later than it was when originally rendered.

Nor does the joint opinion faithfully follow this alleged requirement. The opinion frankly concludes that Roe and its progeny were wrong in failing to recognize that the State’s interests in maternal health and in the protection of unborn human life exist throughout pregnancy. Ante, at 871-873. But there is no indication that these components of Roe are any more incorrect at this juncture than they were at its inception.

The joint opinion also points to the reliance interests involved in this context in its effort to explain why precedent must be followed for precedent’s sake. Certainly it is true that where reliance is truly at issue, as in the case of judicial decisions that have formed the basis for private decisions, “[Considerations in favor of stare decisis are at their acme.” Payne v. Tennessee, 501 U. S., at 828. But, as the joint opinion apparently agrees, ante, at 855-856, any traditional notion of reliance is not applicable here. The Court today cuts back on the protection afforded by Roe, and no one claims that this action defeats any reliance interest in the disavowed trimester framework. Similarly, reliance interests would not be diminished were the Court to go further and acknowledge the full error of Roe, as “reproductive planning could take virtually immediate account. of” this action. Ante, at 856.

The joint opinion thus turns to what can only be described as an unconventional — and unconvincing — notion of reliance, a view based on the surmise that the availability of abortion since Roe has led to “two deeades of economic and social developments” that would be undercut if the error of Roe were recognized. Ante, at 856. The joint opinion’s assertion of this fact is undeveloped and totally conclusory. In fact, one cannot be sure to what economic and social developments the opinion is referring. Surely it is dubious to suggest that women have reached their “places in society” in *957reliance upon Roe, rather than as a result of their determination to obtain higher education and compete with men in the job market, and of society’s increasing recognition of their ability to fill positions that were previously thought to be reserved only for men. Ante, at 856.

In the end, having failed to put forth any evidence to prove any true reliance, the joint opinion’s argument is based solely on generalized assertions about the national psyche, on a belief that the people of this country have grown accustomed to the Roe decision over the last 19 years and have “ordered their thinking and living around” it. Ante, at 856, As an initial matter, one might inquire how the joint opinion can view the “central holding” of Roe as so deeply rooted in our constitutional culture, when it so casually uproots and disposes of that same decision’s trimester framework. Furthermore, at various points in the past, the same could have been said about this Court’s erroneous decisions that the Constitution allowed “separate but equal” treatment of minorities, see Plessy v. Ferguson, 163 U. S. 537 (1896), or that “liberty” under the Due Process Clause protected “freedom of contract,” see Adkins v. Children’s Hospital of District of Columbia, 261 U. S. 525 (1923); Lochner v. New York, 198 U. S. 45 (1905). The “separate but equal” doctrine lasted 58 years after Plessy, and Lochner’s protection of contractual freedom lasted 32 years. However, the simple fact that a generation or more had grown used to these major decisions did not prevent the Court from correcting its errors in those cases, nor should it prevent us from correctly interpreting the Constitution here. See Brown v. Board of Education, 347 U. S. 483 (1954) (rejecting the “separate but equal” doctrine); West Coast Hotel Co. v. Parrish, 300 U. S. 379 (1937) (overruling Adkins v. Children’s Hospital, supra, in upholding Washington’s minimum wage law).

Apparently realizing that conventional stare decisis principles do not support its position, the joint opinion advances a belief that retaining a portion of Roe is necessary to protect *958the “legitimacy” of this Court. Ante, at 861-869. Because the Court must take care to render decisions “grounded truly in principle,” and not simply as political and social compromises, ante, at 865, the joint opinion properly declares it to be this Court’s duty to ignore the public criticism and protest that may arise as a result of a decision. New would quarrel with this statement, although it may be doubted that Members of this Court, holding their tenure as they do during constitutional “good behavior,” are at all likely to be intimidated by such public protests.

But the joint opinion goes on to state that when the Court “resolve[s] the sort of intensely divisive controversy reflected in Roe and those rare, comparable cases,” its decision is exempt from reconsideration under established principles of stare decisis in constitutional eases. Ante, at 866. This is so, the joint opinion contends, because in those “intensely divisive” cases the Court has “eall[ed] the contending sides of a national controversy to end their national division by accepting a common mandate rooted in the Constitution,” and must therefore take special care not to be perceived as “surrendering] to political pressure” and continued opposition. Ante, at 866, 867. This is a truly novel principle, one which is contrary to both the Court’s historical practice and to the Court’s traditional willingness to tolerate criticism of its opinions. Under this principle, when the Court has ruled on a divisive issue, it is apparently prevented from overruling that decision for the sole reason that it was incorrect, unless opposition to the original decision has died away.

The first difficulty with this principle lies in its assumption that cases that are “intensely divisive” can be readily distinguished from those that are not. The question of whether a particular issue is “intensely divisive” enough to qualify for special protection is entirely subjective and dependent on the individual assumptions of the Members of this Court. In addition, because the Court’s duty is to ignore public opinion and criticism on issues that come before it, its Members are *959in perhaps the worst position to judge whether a decision divides the Nation deeply enough to justify such uncommon protection. Although many of the Court’s decisions divide the populace to a large degree, we have not previously on that account shied away from applying normal rules of stare decisis when urged to reconsider earlier decisions. Over the past 21 years, for example, the Court has overruled in whole or in part 34 of its previous constitutional decisions. See Payne v. Tennessee, supra, at 828-830, and n. 1 (listing eases).

The joint opinion picks out and discusses two prior Court rulings that it believes are of the “intensely divisive” variety, and concludes that they are of comparable dimension to Roe. Ante, at 861-864 (discussing Lochner v. New York, supra, and Plessy v. Ferguson, supra). It appears to us very odd indeed that the joint opinion chooses as benchmarks two cases in which the Court chose not to adhere to erroneous constitutional precedent, but instead enhanced its stature by acknowledging and correcting its error, apparently in violation of the joint opinion’s “legitimacy” principle. See West Coast Hotel Co. v. Parrish, supra; Brown v. Board of Education, supra. One might also wonder how it is that the joint opinion puts these, and not others, in the “intensely divisive” category, and how it assumes that these are the only two lines of cases of comparable dimension to Roe. There is no reason to think that either Plessy or Lochner produced the sort of public protest when they were decided that Roe did. There were undoubtedly large segments of the bench and bar who agreed with the dissenting views in those cases, but surely that cannot be what the Court means when it uses the term “intensely divisive,” or many other cases would have to be added to the list. In terms of public protest, however, Roe, so far as we know, was unique. But just as the Court should not respond to that sort of protest by retreating from the decision simply to allay the concerns of the protesters, it should likewise not respond by determining to adhere to the *960decision at all costs lest it seem to be retreating under fire. Public protests should not alter the normal application of stare decisis, lest perfectly lawful protest activity be penalized by the Court itself.

Taking the joint opinion on its own terms, we doubt that its distinction between Roe, on the one hand, and Plessy and Lochner, on the other, withstands analysis. The joint opinion acknowledges that the Court improved its stature by overruling Plessy in Brown on a deeply divisive issue. And our decision in West Coast Hotel, which overruled Adkins v. Children’s Hospital, supra, and Lochner, was rendered at a time when Congress was considering President Franklin Roosevelt’s proposal to “reorganize” this Court and enable him to name six additional Justices in the event that any Member of the Court over the age of 70 did not elect to retire. It is difficult to imagine a situation in which the Court would face more intense opposition to a prior ruling than it did at that time, and, under the general principle proclaimed in the joint opinion, the Court seemingly should have responded to this opposition by stubbornly refusing to reexamine the Lochner rationale, lest it lose legitimacy by appearing to “overrule under fire.” Ante, at 867.

The joint opinion agrees that the Court’s stature would have been seriously damaged if in Brown and West Coast Hotel it had dug in its heels and refused to apply normal principles of stare decisis to the earlier decisions. But the opinion contends that the Court was entitled to overrule Plessy and Lochner in those eases, despite the existence of opposition to the original decisions, only because both the Nation and the Court had learned new lessons in the interim. This is at best a feebly supported, post hoc rationalization for those decisions.

For example, the opinion asserts that the Court could justifiably overrule its decision in Lochner only because the Depression had convinced “most people” that constitutional protection of contractual freedom contributed to an economy *961that failed to protect the welfare of all. Ante, at 861. Surely the joint opinion does not mean to suggest that people saw this Court’s failure to uphold minimum wage statutes as the cause of the Great Depression! In any event, the Loch-ner Court did not base its rule upon the policy judgment that an unregulated market was fundamental to a stable economy; it simple believed, erroneously, that “liberty” under the Due Process Clause protected the “right to make a contract.” Lochner v. New York, 198 U. S., at 53. Nor is it the case that the people of this Nation only discovered the dangers of extreme laissez-faire economies because of the Depression. State laws regulating maximum hours and minimum wages were in existence well before that time. A Utah statute of that sort enacted in 1896 was involved in our decision in Holden v. Hardy, 169 U. S. 366 (1898), and other States followed suit shortly afterwards, see, e. g., Muller v. Oregon, 208 U. S. 412 (1908); Bunting v. Oregon, 243 U. S. 426 (1917). These statutes were indeed enacted because of a belief on the part of their sponsors that “freedom of contract” did not protect the welfare of workers, demonstrating that that belief manifested itself more than a generation before the Great Depression. Whether “most people” had come to share it in the hard times of the 1930’s is, insofar as anything the joint opinion advances, entirely speculative. The crucial failing at that time was not that workers were not paid a fair wage, but that there was no work available at any wage.

When the Court finally recognized its error in West Coast Hotel, it did not engage in the post hoc rationalization that the joint opinion attributes to it today; it did not state that Lochner had been based on an economic view that had fallen into disfavor, and that it therefore should be overruled. Chief Justice Hughes in his opinion for the Court simply recognized what Justice Holmes had previously recognized in his Lochner dissent, that “[t]he Constitution does not speak of freedom of contract.” West Coast Hotel Co. v. Parrish, 300 U. S., at 391; Lochner v. New York, supra, at 75 (Holmes, *962J., dissenting) (“[A] constitution is not intended to embody a particular economic theory, whether of paternalism and the organic relation of the citizen to the State or of laissez faire”). Although the Court did acknowledge in the last paragraph of its opinion the state of affairs during the then-current Depression, the theme of the opinion is that the Court had been mistaken as a matter of constitutional law when it embraced “freedom of contract” 32 years previously.

The joint opinion also agrees that the Court acted properly in rejecting the doctrine of “separate but equal” in Brown. In fact, the opinion lauds Brown in comparing it to Roe. Ante, at 867. This is strange, in that under the opinion’s “legitimacy” principle the Court would seemingly have been forced to adhere to its erroneous decision in Plessy because of its “intensely divisive” character. To us, adherence to Roe today under the guise of “legitimacy” would seem to resemble more closely adherence to Plessy on the same ground. Fortunately, the Court did not choose that option in Brown, and instead frankly repudiated Plessy. The joint opinion concludes that such repudiation was justified only because of newly discovered evidence that segregation had the effect of treating one race as inferior to another. But it can hardly be argued that this was not urged upon those who decided Plessy, as Justice Harlan observed in his dissent that the law at issue “puts the brand of servitude and degradation upon a large class of our fellow-citizens, our equals before the law.” Plessy v. Ferguson, 163 U. S., at 562. It is clear that the same arguments made before the Court in Brown were made in Plessy as well. The Court in Brown simply recognized, as Justice Harlan had recognized beforehand, that the Fourteenth Amendment does not permit racial segregation. The rule of Brown is not tied to popular opinion about the evils of segregation; it is a judgment that the Equal Protection Clause does not permit racial segregation, no matter whether the public might come to believe that it is beneficial. On that ground it stands, and on that ground *963alone the Court was justified in properly concluding that the Plessy' Court had erred.

There is also a suggestion in the joint opinion that the propriety of overruling a “divisive” decision depends in part on whether “iftost people” would now agree that it should be overruled. Either the demise of opposition or its progression to substantial popular agreement apparently is required to allow the Court to reconsider a divisive decision. How such agreement would be ascertained, short of a public opinion poll, the joint opinion does not say. But surely even the suggestion is totally at war with the idea of “legitimacy” in whose name it is invoked. The Judicial Branch derives its legitimacy, not from following public opinion, but from deciding by its best lights whether legislative enactments of the popular branches of Government comport with the Constitution. The doctrine of stare decisis is an adjunct of this duty, and should be no more subject to the vagaries of public opinion than is the basic judicial task.

There are other reasons why the joint opinion’s discussion of legitimacy is unconvincing as well. In assuming that the Court is perceived as “surrendering] to political pressure” when it overrules a controversial decision, ante, at 867, the joint opinion forgets that there are two sides to any controversy. The joint opinion asserts that, in order to protect its legitimacy, the Court must refrain from overruling a controversial decision lest it be viewed as favoring those who oppose the decision. But a decision to adhere to prior precedent is subject to the same criticism, for in such a case one can easily argue that the Court is responding to those who have demonstrated in favor of the original decision. The decision in Roe has engendered large demonstrations, including repeated marches on this Court and on Congress, both in opposition to and in support of that opinion. A decision either way on Roe can therefore be perceived as favoring one group or the other. But this perceived dilemma arises only if one assumes, as the joint opinion does, that the Court *964should make its decisions with a view toward speculative public perceptions. If one assumes instead, as the Court surely did in both Brown and West Coast Hotel, that the Court’s legitimacy is enhanced by faithful interpretation of the Constitution irrespective of public opposition, such self-engendered difficulties may be put to one side.

Roe is not this Court’s only decision to generate conflict. Our decisions in some recent capital eases, and in Bowers v. Hardwick, 478 U. S. 186 (1986), have also engendered demonstrations in opposition. The joint opinion’s message to such protesters appears to be that they must cease their activities in order to serve their cause, because their protests will only cement in place a decision which by normal standards of stare decisis should be reconsidered. Nearly a century ago, Justice David J. Brewer of this Court, in an article discussing criticism of its decisions, observed that “many criticisms may be, like their authors, devoid of good taste, but better all sorts of criticism than no criticism at all.” Justice Brewer on “The Nation’s Anchor,” 57 Albany L. J. 166, 169 (1898). This was good advice to the Court then, as it is today. Strong and often misguided criticism of a decision should not render the decision immune from reconsideration, lest a fetish for legitimacy penalize freedom of expression.

The end result of the joint opinion’s paeans of praise for legitimacy is the enunciation of a brand new standard for evaluating state regulation of a woman’s right to abortion— the “undue burden” standard. As indicated above, Roe v. Wade adopted a “fundamental right” standard under which state regulations could survive only if they met the requirement of “strict scrutiny.” While we disagree with that standard, it at least had a recognized basis in constitutional law at the time Roe was decided. The same cannot be said for the “undue burden” standard, which is created largely out of whole cloth by the authors of the joint opinion. It is a standard which even today does not command the support of a majority of this Gourt. And it will not, we believe, re-*965suit in the sort of “simple limitation,” easily applied, which the joint opinion anticipates. Ante, at 855. In sum, it is a standard which is not built to last.

In evaluating abortion regulations under that standard, judges will have to decide whether they place a “substantial obstacle” in the path of a woman seeking an abortion. • Ante, at 877. In that this standard is based even more on a judge’s subjective determinations than was the trimester framework, the standard will do nothing to prevent “judges from roaming at large in the constitutional field” guided only by their personal views. Griswold v. Connecticut, 381 U. S., at 502 (Harlan, J., concurring in judgment). Because the undue burden standard is plucked from nowhere, the question of what is a “substantial obstacle” to abortion will undoubtedly engender a variety of conflicting views. For example, in the very matter before us now, the authors of the joint opinion would uphold Pennsylvania’s 24-hour waiting period, concluding that a “particular burden” on some women is not a substantial obstacle. Ante, at 887. But the authors would at the same time strike down Pennsylvania’s spousal notice provision, after finding that in a “large fraction” of cases the provision will be a substantial obstacle. Ante, at 895. And, while the authors conclude that the informed consent provisions do not constitute an “undue burden,” Justice Stevens would hold that they do. Ante, at 920-922.

Furthermore, while striking down the spousal notice regulation, the joint opinion would uphold a parental consent restriction that certainly places very substantial obstacles in the path of a minor’s abortion choice. The joint opinion is forthright in admitting that it draws this distinction based on a policy judgment that parents will have the best interests of their children at heart, while the same is not necessarily true of husbands as to their wives. Ante, at 895. This may or may not be a correct judgment, but it is quintessentially a legislative one. The “undue burden” inquiry does not in any way supply the distinction between parental consent and *966spousal consent which the joint opinion adopts. Despite the efforts of the joint opinion, the undue burden standard presents nothing more workable than the trimester framework which it discards today. Under the guise of the Constitution, this Court will still impart its own preferences on the States in the form of a complex abortion code.

The sum of the joint opinion’s labors in the name of stare decisis and “legitimacy” is this: Roe v. Wade stands as a sort of judicial Potemkin Village, which may be pointed out to passers-by as a monument to the importance of adhering to precedent. But behind the facade, an entirely new method of analysis, without any roots in constitutional law, is imported to decide the constitutionality of state laws regulating abortion. Neither stare decisis nor “legitimacy” are truly served by such an effort.

We have stated above our belief that the Constitution does not subject state abortion regulations to heightened scrutiny. Accordingly, we think that the correct analysis is that set forth by the plurality opinion in Webster. A woman’s interest in having an abortion is a form of liberty protected by the Due Process Clause, but States may regulate abortion procedures in ways rationally related to a legitimate state interest. Williamson v. Lee Optical of Oklahoma, Inc., 348 U. S. 483, 491 (1955); cf. Stanley v. Illinois, 405 U. S. 645, 651-653 (1972). With this rule in mind, we examine each of the challenged provisions.

Ill

'A

Section 3205 of the Act imposes certain requirements related to the informed consent of a woman seeking an abortion. 18 Pa. Cons. Stat. §3205 (1990). Section 3205(a)(1) requires that the referring or performing physician must inform a woman contemplating an abortion of (i) the nature of the procedure and the risks and alternatives that a reasonable patient would find material; (ii) the fetus’ probable ges*967tational age; and (iii) the medical risks involved in carrying her pregnancy to term. Section 3205(a)(2) requires a physician or a nonphysician counselor to inform the woman that (i) the state health department publishes free materials describing the fetus at different stages and listing abortion alternatives; (ii) medical assistance benefits may be available for prenatal, childbirth, and neonatal care; and (iii) the child’s father is liable for child support. The Act also imposes a 24-hour waiting period between the time that the woman receives the required information and the time that the physician is allowed to perform the abortion. See Appendix to opinion of O’Connor, Kennedy, and Souter, JJ., ante, at 902-904.

This Court has held that it is certainly within the province of the States to require a woman’s voluntary and informed consent to an abortion. See Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 760. Here, Pennsylvania seeks to further its legitimate interest in obtaining informed consent by ensuring that each woman “is aware not only of the reasons for having an abortion, but also of the risks associated with an abortion and the availability of assistance that might make the alternative of normal childbirth more attractive than it might otherwise appear.” Id., at 798-799 (White, J., dissenting).

We conclude that this provision of the statute is rationally related to the State’s interest in assuring that a woman’s consent to an abortion be a fully informed decision.

Section 3205(a)(1) requires a physician to disclose certain information about the abortion procedure and its risks and alternatives. This requirement is certainly no large burden, as the Court of Appeals found that “the record shows that the clinics, without exception, insist on providing this information to women before an abortion is performed.” 947 F. 2d, at 703. We are of the view that this information “elearly is related to maternal health and to the State’s legitimate purpose in requiring informed consent.” Akron v. *968Akron Center for Reproductive Health, Inc., 462 U. S., at 446. An accurate description of the gestational age of the fetus and of the risks involved in carrying a child to term helps to further both those interests and the State’s legitimate interest in unborn human life. See id., at 445-446, n. 37 (required disclosure of gestational age of the fetus “certainly is not objectionable”). Although petitioners contend that it is unreasonable for the State to require that a physician, as opposed to a nonphysician counselor, disclose this information, we agree with the Court of Appeals that a State “may rationally decide that physicians are better qualified than counselors to impart this information and answer questions about the medical aspects of the available alternatives.” 947 F. 2d, at 704.

Section 3205(a)(2) compels the disclosure, by a physician or a counselor, of information concerning the availability of paternal child support and state-funded alternatives if the woman decides to proceed with her pregnancy. Here again, the Court of Appeals observed that “the record indicates that most clinics already require that a counselor consult in person with the woman about alternatives to abortion before the abortion is performed.” Id., at 704-705. And petitioners do not claim that the information required to be disclosed by statute is in any way false or inaccurate; indeed, the Court of Appeals found it to be “relevant, accurate, and noninflammatory.” Id., at 705. We conclude that this required presentation of “balanced information” is rationally related to the State’s legitimate interest in ensuring that the woman’s consent is truly informed, Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 830 (O’Connor, J., dissenting), and in addition furthers the State’s interest in preserving unborn life. That the information might create some uncertainty and persuade some women to forgo abortions does not lead to the conclusion that the Constitution forbids the provision of such information. Indeed, it only demonstrates that this information might *969very well make a difference, and that it is therefore relevant to a woman’s informed choice. Cf. id., at 801 (White, J., dissenting) (“[T]he ostensible objective of Roe v. Wade is not maximizing the number of abortions, but maximizing choice”). We acknowledge that in Thornburgh this Court struck down informed consent requirements similar to the ones at issue here. See id., at 760-764. It is clear, however, that while the detailed framework of Roe led to the Court’s invalidation of those informational requirements, they “would have been sustained under any traditional standard of judicial review, ... or for any other surgical procedure except abortion.” Webster v. Reproductive Health Services, 492 U. S., at 517 (plurality opinion) (citing Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 802 (White, J., dissenting); id., at 783 (Burger, C. J., dissenting)). In light of our rejection of Roe’s “fundamental right” approach to this subject, we do not regard Thornburgh as controlling.

For the same reason, we do not feel bound to follow this Court’s previous holding that a State’s 24-hour mandatory waiting period is unconstitutional. See Akron v. Akron Center for Reproductive Health, Inc., supra, at 449-451. Petitioners are correct that such a provision will result in delays for some women that might not otherwise exist, therefore placing a burden on their liberty. But the provision in no way prohibits abortions, and the informed consent and waiting period requirements do not apply in the ease of a medical emergency. See 18 Pa. Cons. Stat. §§ 3205(a), (b) (1990). We are of the view that, in providing time for reflection and reconsideration, the waiting period helps ensure that a woman’s decision to abort is a well-considered one, and reasonably furthers the State’s legitimate interest in maternal health and in the unborn life of the fetus. It “is surely a small cost to impose to ensure that the woman’s decision is well considered in light of its certain and irreparable conse-*970quenees on fetal life, and the possible effects on her own.” 462 U. S., at 474 (O’Connor, J., dissenting).

B

In addition to providing her own informed consent, before an unemaneipated woman under the age of 18 may obtain an abortion she must either furnish the consent of one of her parents, or must opt for the judicial procedure that allows her to bypass the consent requirement. Under the judicial bypass option, a minor can obtain an abortion if a state court finds that she is capable of giving her informed consent and has indeed given such consent, or determines that an abortion is in her best interests. Records of these court proceedings are kept confidential. The Act directs the state trial court to render a decision within three days of the woman’s application, and the entire procedure, including appeal to Pennsylvania Superior Court, is to last no longer than eight business days. The parental consent requirement does not apply in the case of a medical emergency. 18 Pa. Cons. Stat. §3206 (1990). See Appendix to opinion of O’Connor, Kennedy, and Souter, JJ., ante, at 904-906.

This provision is entirely consistent with this Court’s previous decisions involving parental consent requirements. See Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476 (1983) (upholding parental consent requirement with a similar judicial bypass option); Akron v. Akron Center for Reproductive Health, Inc., supra, at 439-440 (approving of parental consent statutes that include a judicial bypass option allowing a pregnant minor to “demonstrate that she is sufficiently mature to make the abortion decision herself or that, despite her immaturity, an abortion would be in her best interests”); Bellotti v. Baird, 443 U. S. 622 (1979).

We think it beyond dispute that a State “has a strong and legitimate interest in the welfare of its young citizens, whose immaturity, inexperience, and lack of judgment may some*971times impair their ability to exercise their rights wisely.” Hodgson v. Minnesota, 497 U. S., at 444 (opinion of Stevens, J.). A requirement of parental consent to abortion, like myriad other restrictions placed upon minors in other contexts, is reasonably designed to further this important and legitimate state interest. In our view, it is entirely “rational and fair for the State to conclude that, in most instances, the family will strive to give a lonely or even terrified minor advice that is both compassionate and mature.” Ohio v. Akron Center for Reproductive Health, 497 U. S., at 520 (opinion of Kennedy, J.); see also Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 91 (Stewart, J., concurring) (“There can be little doubt that the State furthers a constitutionally permissible end by encouraging an unmarried pregnant minor to seek the help and advice of her parents in making the very important decision whether or not to bear a child”). We thus conclude that Pennsylvania’s parental consent requirement should be upheld.

C

Section 3209 of the Act contains the spousal notification provision. It requires that, before a physician may perform an abortion on a married woman, the woman must sign a statement indicating that she has notified her husband of her planned abortion. A woman is not required to notify her husband if (1) her husband is not the father, (2) her husband, after diligent effort, cannot be located, (3) the pregnancy is the result of a spousal sexual assault that has been reported to the authorities, or (4) the woman has reason to believe that notifying her husband is likely to result in the infliction of bodily injury upon her by him or by another individual. In addition, a woman is exempted from the notification requirement in the case of a medical emergency. 18 Pa. Cons. Stat. §3209 (1990). See Appendix to opinion of O’Connor, Kennedy, and Souter, JJ., ante, at 908-909.

*972We first emphasize that Pennsylvania has not imposed a spousal consent requirement of the type the Court struck down in Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 67-72. Missouri’s spousal consent provision was invalidated in that case because of the Court’s view that it unconstitutionally granted to the husband “a veto power exercisable for any reason whatsoever or for no reason at all.” Id., at 71. But the provision here involves a much less intrusive requirement of spousal notification, not consent. Such a law requiring only notice to the husband “does not give any third party the legal right to make the [woman’s] decision for her, or to prevent her from obtaining an abortion should she choose to have one performed.” Hodgson v. Minnesota, supra, at 496 (Kennedy, J., concurring in judgment in part and dissenting in part); see H. L. v. Matheson, 450 U. S., at 411, n. 17. Danforth thus does not control our analysis. Petitioners contend that it should, however; they argue that the real effect of such a notice requirement is to give the power to husbands to veto a woman’s abortion choice. The District Court indeed found that the notification provision created a risk that some woman who would otherwise have an abortion will be prevented from having one. 947 F. 2d, at 712. For example, petitioners argue, many notified husbands will prevent abortions through physical force, psychological coercion, and other types of threats. But Pennsylvania has incorporated exceptions in the notice provision in an attempt to deal with these problems. For instance, a woman need not notify her husband if the pregnancy is the result of a reported sexual assault, or if she has reason to believe that she would suffer bodily injury as a result of the notification. 18 Pa. Cons. Stat. § 3209(b) (1990). Furthermore, because this is a facial challenge to the Act, it is insufficient for petitioners to show that the notification provision “might operate unconstitutionally under some conceivable set of circumstances.” United States v. Salerno, 481 U. S. 739, 745 (1987). Thus, it is not enough for petition*973ers to show that, in some “worst ease” circumstances, the notice provision will operate as a grant of veto power to husbands. Ohio v. Akron Center for Reproductive Health, 497 U. S., at 514. Because they are making a facial challenge to the provision, they must “show that no set of circumstances exists under which the [provision] would be valid.” Ibid. (internal quotation marks omitted). This they have failed to do.2

*974The question before us is therefore whether the spousal notification requirement rationally furthers any legitimate state interests. We conclude that it does. First, a husband’s interests in procreation within marriage and in the potential life of his unborn child are certainly substantial ones. See Planned Parenthood of Central Mo. v. Danforth, 428 U. S., at 69 (“We are not unaware of the deep and proper concern and interest that a devoted and protective husband has in his wife’s pregnancy and in the growth and development of the fetus she is carrying”); id., at 93 (White, J., concurring in part and dissenting in part); Skinner v. Oklahoma ex rel. Williamson, 316 U. S., at 541. The State itself has legitimate interests both in protecting these interests of the father and in protecting the potential life of the fetus, and the spousal notification requirement is reasonably related to advancing those state interests. By providing that a husband will usually know of his spouse’s intent to have an abortion, the provision makes it more likely that the husband will participate in deciding the fate of his unborn child, a possibility that might otherwise have been denied him. This participation might in some cases result in a decision to proceed with the pregnancy. As Judge Alito observed in his dissent below, “[t]he Pennsylvania legislature eould have rationally believed that some married women are initially inclined to obtain an abortion without their husbands’ knowledge because of perceived problems — such as economic constraints, future plans, or the husbands’ previously expressed *975opposition — that may be obviated by discussion prior to the abortion.” 947 F. 2d, at 726 (opinion concurring in part and dissenting in part).

The State also has a legitimate interest in promoting “the integrity of the marital relationship.” 18 Pa. Cons. Stat. § 3209(a) (1990). This Court has previously recognized “the importance of the marital relationship in our society.” Planned Parenthood of Central Mo. v. Danforth, supra, at 69. In our view, the spousal notice requirement is a rational attempt by the State to improve truthful communication between spouses and encourage collaborative decisionmaking, and thereby fosters marital integrity. See Labine v. Vincent, 401 U. S. 532, 538 (1971) (“[T]he power to make rules to establish, protect, and strengthen family life” is committed to the state legislatures). Petitioners argue that the notification requirement does not further any such interest; they assert that the majority of wives already notify their husbands of their abortion decisions, and the remainder have excellent reasons for keeping their decisions a secret. In the first ease, they argue, the law is unnecessary, and in the second ease it will only serve to foster marital discord and threats of harm. Thus, petitioners see the law as a totally irrational means of furthering whatever legitimate interest the State might have. But, in our view, it is unrealistic to assume that every husband-wife relationship is either (1) so perfect that this type of truthful and important communication will take place as a matter of course, or (2) so imperfect that, upon notice, the husband will react selfishly, violently, or contrary to the best interests of his wife. See Planned Parenthood of Central Mo. v. Danforth, supra, at 103-104 (Stevens, J., concurring in part and dissenting in part) (making a similar point in the context of a parental consent statute). The spousal notice provision will admittedly be unnecessary in some circumstances, and possibly harmful in others, but “the existence of particular cases in which a feature of a statute performs no function (or is even counterpro-*976duetive) ordinarily does not render the statute unconstitutional or even constitutionally suspect.” Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S., at 800 (White, J., dissenting). The Pennsylvania Legislature was in a position to weigh the likely benefits of the provision against its likely adverse effects, and presumably concluded, on balance, that the provision would be beneficial. Whether this was a wise decision or not, we cannot say that it was irrational. We therefore conclude that the spousal notice provision comports with the Constitution. See Harris v. McRae, 448 U. S., at 325-326 (“It is not the mission of this Court or any other to decide whether the balance of competing interests ... is wise social policy”).

D

The Act also imposes various reporting requirements. Section 3214(a) requires that abortion facilities file a report on each abortion performed. The reports do not include the identity of the women on whom abortions are performed, but they do contain a variety of information about the abortions. For example, each report must include the identities of the performing and referring physicians, the gestational age of the fetus at the time of abortion, and the basis for any medical judgment that a medical emergency existed. See 18 Pa. Cons. Stat. §§ 3214(a)(1), (5), (10) (1990). See Appendix to opinion of O’Connor, Kennedy, and Souter, JJ., ante, at 909-911. The District Court found that these reports are kept completely confidential. 947 F. 2d, at 716. We further conclude that these reporting requirements rationally farther the State’s legitimate interests in advancing the state of medical knowledge concerning maternal health and prenatal life, in gathering statistical information with respect to patients, and in ensuring compliance with other provisions of the Act.

Section 3207 of the Act requires each abortion facility to file a report with its name and address, as well as the names *977and addresses of any parent, subsidiary, or affiliated organizations. 18 Pa. Cons. Stat. § 3207(b) (1990). Section 3214(f) further requires each facility to file quarterly reports stating the total number of abortions performed, broken down by trimester. Both of these reports are available to the public only if the facility received state funds within the preceding 12 months. See Appendix to opinion of O’Connor, Kennedy, and Souter, JJ., ante, at 906,911. Petitioners do not challenge the requirement that facilities provide this information. They contend, however, that the forced public disclosure of the information given by facilities receiving public funds serves no legitimate state interest. We disagree. Records relating to the expenditure of public funds are generally available to the public under Pennsylvania law. See Pa. Stat. Ann., Tit. 65, §§66.1, 66.2 (Purdon 1959 and Supp. 1991-1992). As the Court of Appeals observed, “[w]hen a state provides money to a private commercial enterprise, there is a legitimate public interest in informing taxpayers who the funds are benefiting and what services the funds are supporting.” 947 F. 2d, at 718. These reporting requirements rationally further this legitimate state interest.

E

Finally, petitioners challenge the medical emergency exception provided for by the Act. The existence of a medical emergency exempts compliance with the Act’s informed consent, parental consent, and spousal notice requirements. See 18 Pa. Cons. Stat. §§ 3205(a), 3206(a), 3209(c) (1990). The Act defines a "medical emergency” as

“[t]hat condition which, on the basis of the physician’s good faith clinical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial *978and irreversible impairment of major bodily function.” §3203.

Petitioners argued before the District Court that the statutory definition was inadequate because it did not cover three serious conditions that pregnant women can suffer— preeelampsia, inevitable abortion, and prematurely ruptured membrane. The District Court agreed with petitioners that the medical emergency exception was inadequate, but the Court of Appeals reversed this holding. In construing the medical emergency provision, the Court of Appeals first observed that all three conditions do indeed present the risk of serious injury .or death when an abortion is not performed, and noted that the medical profession’s uniformly prescribed treatment for each of the three conditions is an immediate abortion. See 947 F. 2d, at 700-701. Finding that “[t]he Pennsylvania legislature did not choose the wording of its medical emergency exception in a vacuum,” the court read the exception as intended “to assure that compliance with its abortion regulations would not in any way pose a significant threat to the life or health of a woman.” Id., at 701. It thus concluded that the exception encompassed each of the three dangerous conditions pointed to by petitioners.

We observe that Pennsylvania’s present definition of medical emergency is almost an exact copy of that State’s definition at the time of this Court’s ruling in Thornburgh, one which the Court made reference to with apparent approval. 476 U. S., at 771 (“It is clear that the Pennsylvania Legislature knows how to provide a medieal-emergency exception when it chooses to do so”).3 We find that the interpretation *979of the Court of Appeals in these eases is eminently reasonable, and that the provision thus should be upheld. When a woman is faced with any condition that poses a “significant threat to [her] life or health,” she is exempted from the Act’s consent and notice requirements and may proceed immediately with her abortion.

IV

For the reasons stated, we therefore would hold that each of the challenged provisions of the Pennsylvania statute is consistent with the Constitution. It bears emphasis that our conclusion in this regard does not carry with it any necessary approval of these regulations. Our task is, as always, to decide only whether the challenged provisions of a law comport with the United States Constitution. If, as we believe, these do, their wisdom as a matter of public policy is for the people of Pennsylvania to decide.

Justice Scalia,

with whom The ChieF Justice, Justice White, and Justice Thomas join,

concurring in the judgment in part and dissenting in part.

My views on this matter are unchanged from those I set forth in my separate opinions in Webster v. Reproductive Health Services, 492 U. S. 490, 532 (1989) (opinion concurring in part and concurring in judgment), and Ohio v. Akron Center for Reproductive Health, 497 U. S. 502, 520 (1990) (Akron II) (concurring opinion). The States may, if they wish, permit abortion on demand, but the Constitution does not require them to do so. The permissibility of abortion, and the limitations upon it, are to be resolved like most important questions in our democracy: by citizens trying to persuade one another and then voting. As the Court acknowledges, “where reasonable people disagree the government can adopt one position or the other.”. Ante, at 851. The Court is correct in adding the qualification that this “assumes a state of affairs in which the choice does not intrude upon a protected liberty,” ibid. — but the crucial part of that quali*980fication is the penultimate word. A State’s choice between two positions on which reasonable people can disagree is constitutional even when (as is often the ease) it intrudes upon a “liberty” in the absolute sense. Laws against bigamy, for example — with which entire societies of reasonable people disagree — intrude upon men and women’s liberty to marry and live with one another. But bigamy happens not to be a liberty specially “protected” by the Constitution.

That is, quite simply, the issue in these eases: not whether the power of a woman to abort her unborn child is a “liberty” in the absolute sense; or even whether it is a liberty of great importance to many women. Of course it is both. The issue is whether it is a liberty protected by the Constitution of the United States. I am sure it is not. I reach that conclusion not because of anything so exalted as my views concerning the “concept of existence, of meaning, of the universe, and of the mystery of human life.” Ibid. Rather, I reach it for the same reason I reach the conclusion that bigamy is not constitutionally protected — because of two simple facts: (1) the Constitution says absolutely nothing about it, and (2) the longstanding traditions of American society have permitted it to be legally proscribed.1 Akron II, supra, at 520 (Scalia, J., concurring).

*981The Court destroys the proposition, evidently meant to represent my position, that “liberty” includes “only those practices, defined at the most specific level, that were protected against government interference by other rules of law when the Fourteenth Amendment was ratified,” ante, at 847 (citing Michael H. v. Gerald D., 491 U. S. 110, 127, n. 6 (1989) (opinion of Scalia, J.)). That is not, however, what Michael H. says; it merely observes that, in defining “liberty,” we may not disregard a specific, “relevant tradition protecting, or denying protection to, the asserted right,” ibid. But the Court does not wish to be fettered by any such limitations on its preferences. The Court’s statement that it is “tempting” to acknowledge the authoritativeness of tradition in order to “cur[b] the discretion of federal judges,” ante, at 847, is of course rhetoric rather than reality; no government official is “tempted” to place restraints upon his own freedom of action, which is why Lord Acton did not say “Power tends to purify.” The Court’s temptation is in the quite opposite and more natural direction — towards systematically eliminating checks upon its own power; and it succumbs.

Beyond that brief summary of the essence of my position, I will not swell the United States Reports with repetition of what I have said before; and applying the rational basis test, I would uphold the Pennsylvania statute in its entirety. I must, however, respond to a few of the more outrageous arguments in today’s opinion, which it is beyond human nature to leave unanswered. I shall discuss each of them under a quotation from the Court’s opinion to which they pertain.

“The inescapable fact is that adjudication of substantive due process claims may call upon the Court *982in interpreting the Constitution to exercise that same capacity which by tradition courts always have exercised: reasoned judgment.” Ante, at 849.

Assuming that the question before us is to be resolved at such a level of philosophical abstraction, in such isolation from the traditions of American society, as by simply applying “reasoned judgment,” I do not see how that could possibly have produced the answer the Court arrived at in Roe v. Wade, 410 U. S. 113 (1973). Today’s opinion describes the methodology of Roe, quite accurately, as weighing against the woman’s interest the State’s “ 'important and legitimate interest in protecting the potentiality of human life.’” Ante, at 871 (quoting Roe, supra, at 162). But “reasoned judgment” does not begin by begging the question, as Roe and subsequent eases unquestionably did by assuming that what the State is protecting is the mere “potentiality of human life.” See, e. g., Roe, supra, at 162; Planned Parenthood of Central Mo. v. Danforth, 428 U. S. 52, 61 (1976); Colautti v. Franklin, 439 U. S. 379, 386 (1979); Akron v. Akron Center for Reproductive Health, Inc., 462 U. S. 416, 428 (1983) (Akron I); Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476, 482 (1983). The whole argument of abortion opponents is that what the Court calls the fetus and what others call the unborn child is a human life. Thus, whatever answer Roe came up with after conducting its “balancing” is bound to be wrong, unless it is correct that the human fetus is in some critical sense merely potentially human. There is of course no way to determine that as a legal matter; it is in fact a value judgment. Some societies have considered newborn children not yet human, or the incompetent elderly no longer so.

The authors of the joint opinion, of course, do not squarely contend that Roe, v. Wade was a correct application of “reasoned judgment”; merely that it must be followed, because of stare decisis. Ante, at 853, 861, 871. But in their exhaustive discussion of all the factors that go into the determi*983nation of when stare decisis should be observed and when disregarded, they never mention “how wrong was the decision on its face?” Surely, if “[t]he Court’s power lies ... in its legitimacy, a product of substance and perception,” ante, at 865, the “substance” part of the equation demands that plain error be acknowledged and eliminated. Roe was plainly wrong — even on the Court’s methodology of “reasoned judgment,” and even more so (of course) if the proper criteria of text and tradition are applied.

The emptiness of the “reasoned judgment” that produced Roe is displayed in plain view by the fact that, after more than 19 years of effort by some of the brightest (and most determined) legal minds in the country, after more than 10 eases upholding abortion rights in this Court, and after dozens upon dozens of amicus briefs submitted in these and other eases, the best the Court can do to explain how it is that the word “liberty” must be thought to include the right to destroy human fetuses is to rattle off a collection of adjectives that simply decorate a value judgment and conceal a political choice. The right to abort, we are told, inheres in “liberty” because it is among “a person’s most basic decisions,” ante, at 849; it involves a “most intimate and personal choie[ej,” ante, at 851; it is “central to personal dignity and autonomy,” ibid.; it “originate^] within the zone of conscience and belief,” ante, at 852; it is “too intimate and personal” for state interference, ibid.; it reflects “intimate views” of a “deep, personal character,” ante, at 858; it involves “intimate relationships” and notions of “personal autonomy and bodily integrity,” ante, at 857; and it concerns a particularly “ ‘important decisio[n],’” ante, at 859 (citation omitted).2 But it is *984obvious to anyone applying “reasoned judgment” that the same adjectives can be applied to many forms of conduct that this Court (including one of the Justices in today’s majority, see Bowers v. Hardwick, 478 U. S. 186 (1986)) has held are not entitled to constitutional protection — because, like abortion, they are forms of conduct that have long been criminalized in American society. Those adjectives might be applied, for example, to homosexual sodomy, polygamy, adult incest, and suicide, all of which are equally “intimate” and “deep[ly] personal” decisions involving “personal autonomy and bodily integrity,” and all of which can constitutionally be proscribed because it is our unquestionable constitutional tradition that they are proseribable. It is not reasoned judgment that supports the Court’s decision; only personal predilection. Justice Curtis’s warning is as timely today as it was 135 years ago:

“[W]hen a strict interpretation of the Constitution, according to the fixed rules which govern the interpretation of laws, is abandoned, and the theoretical opinions of individuals are allowed to control its meaning, we have no longer a Constitution; we are under the government of individual men, who for the time being have power to declare what the Constitution is, according to their own views of what it ought to mean.” Dred Scott v. Sandford, 19 How. 393, 621 (1857) (dissenting opinion).
“Liberty finds no refuge in a jurisprudence of doubt.” Ante, at 844.

One might have feared to encounter this august and sonorous phrase in an opinion defending the real Roe v. Wade, rather than the revised version fabricated today by the au*985thors of the joint opinion. The shortcomings of Roe did not include lack of clarity: Virtually all regulation of abortion before the third trimester was invalid. But to come across this phrase in the joint opinion — which calls upon federal district judges to apply an “undue burden” standard as doubtful in application as it is unprincipled in origin — is really more than one should have to bear.

The joint opinion frankly concedes that the amorphous concept of “undue burden” has been inconsistently applied by the Members of this Court in the few brief years since that “test” was first explicitly propounded by Justice O’Connor in her dissent in Akron I, 462 U. S. 416 (1983). See ante, at 876.3 Because the three Justices now wish to “set forth a standard of general application,” the joint opinion announces that “it is important to clarify what is meant by an undue burden.” Ibid. I certainly agree with that, but I do not agree that the joint'opinion succeeds in the announced endeavor. To the contrary, its efforts at clarifica*986tion make elear only that the standard is inherently manipulable and will prove hopelessly unworkable in practice.

The joint opinion explains that a state regulation imposes an “undue burden” if it “has the purpose or effect of placing a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus.” Ante, at 877; see also ante, at 877-879. An obstacle is “substantial,” we are told, if it is “calculated^] [not] to inform the woman’s free choice, [but to] hinder it.” Ante, at 877.4 This latter statement cannot *987possibly mean what it says. Any regulation of abortion that is intended to advance what the joint opinion concedes is the State’s “substantial” interest in protecting unborn life will be “calculated [to] hinder” a decision to have an abortion. It thus seems more accurate to say that the joint opinion would uphold abortion regulations only if they do not unduly hinder the woman’s decision. That, of course, brings us right back to square one: Defining an “undue burden” as an “undue hindrance” (or a “substantial obstacle”) hardly “clarifies” the test. Consciously or not, the joint opinion’s verbal shell game will conceal raw judicial policy choices concerning what is “appropriate” abortion legislation.

The ultimately standardless nature of the “undue burden” inquiry is a reflection of the underlying fact that the concept has no principled or coherent legal basis. As The ChieF Justice points out, Roe’s strict-scrutiny standard “at least had a recognized basis in constitutional law at the time Roe was decided,” ante, at 964, while “[t]he same cannot be said for the ‘undue burden’ standard, which is created largely out of whole cloth by the authors of the joint opinion,” ibid. The joint opinion is flatly wrong in asserting that “our jurisprudence relating to all liberties save perhaps abortion has recognized” the permissibility of laws that do not impose an “undue burden.” Ante, at 873. It argues that the abortion right is similar to other rights in that a law “not designed to strike at the right itself, [but which] has the incidental effect of making it more difficult or more expensive to [exercise the right,]” is not invalid. Ante, at 874. I agree, indeed I have *988forcefully urged, that a law of general applicability which places only an incidental burden on a fundamental right does not infringe that right, see R. A. V. v. St. Paul, 505 U. S. 377, 389-390 (1992); Employment Div., Dept. of Human Resources of Ore. v. Smith, 494 U. S. 872, 878-882 (1990), but that principle does not establish the quite different (and quite dangerous) proposition that a law which directly regulates a fundamental right will not be found to violate the Constitution unless it imposes an “undue burden.” It is that, of course, which is at issue here: Pennsylvania has consciously and directly regulated conduct that our cases have held is constitutionally protected. The appropriate analogy, therefore, is that of a state law requiring purchasers of religious books to endure a 24-hour waiting period, or to pay a nominal additional tax of 10. The joint opinion cannot possibly be correct in suggesting that we would uphold such legislation on the ground that it does not impose a “substantial obstacle” to the exercise of First Amendment rights. The “undue burden” standard is not at all the generally applicable principle the joint opinion pretends it to be; rather, it is a unique concept created specially for these cases, to preserve some judicial foothold in this ill-gotten territory. In claiming otherwise, the three Justices show their willingness to place all constitutional rights at risk in an effort to preserve what they deem the “central holding in Roe.” Ante, at 873.

The rootless nature of the “undue burden”, standard, a phrase plucked out of context from our earlier abortion decisions, see n. 3, supra, is further reflected in the fact that the joint opinion finds it necessary expressly to repudiate the more narrow formulations used in Justice O’Connor’s earlier opinions. Ante, at 876-877. Those opinions stated that a statute imposes an “undue burden” if it imposes “absolute obstacles or severe limitations on the abortion decision,” Akron I, 462 U. S., at 464 (dissenting opinion) (emphasis added); see also Thornburgh v. American College of Obstetricians and Gynecologists, 476 U. S. 747, 828 (1986) (dissent*989ing opinion). Those strong adjectives are conspicuously missing from the joint opinion, whose authors have for some unexplained reason now determined that a burden is “undue” if it merely imposes a “substantial” obstacle to abortion decisions. See, e. g., ante, at 895, 901. Justice O’Connor has also abandoned (again without explanation) the view she expressed in Planned Parenthood Assn. of Kansas City, Mo., Inc. v. Ashcroft, 462 U. S. 476 (1983) (dissenting opinion), that a medical regulation which imposes an “undue burden” could nevertheless be upheld if it “reasonably relate[s] to the preservation and protection of maternal health,” id., at 505 (citation and internal quotation marks omitted). In today’s version, even health measures will be upheld only “if they do not constitute an undue burden,” ante, at 878 (emphasis added). Gone too is Justice O’Connor’s statement that “the State possesses compelling interests in the protection of potential human life . . . throughout pregnancy,” Akron I, supra, at 461 (dissenting opinion) (emphasis added); see also Ashcroft, supra, at 505 (O’Connor, J., concurring in judgment in part and dissenting in part); Thornburgh, supra, at 828 (O’Con-nor, J., dissenting); instead, the State’s interest in unborn human life is stealthily downgraded to a merely “substantial” or “profound” interest, ante, at 876, 878. (That had to be done, of course, since designating the interest as “compelling” throughout pregnancy would have been, shall we say, a “substantial obstacle” to the joint opinion’s determined effort to reaffirm what it views as the “central holding” of Roe. See Akron I, 462 U. S., at 420, n. 1.) And “viability” is no longer the “arbitrary” dividing line previously decried by Justice O’Connor in Akron I, id., at 461; the Court now announces that “the attainment of viability may continue to serve as the critical fact,” ante, at 860.5 It is difficult to *990maintain the illusion that we are interpreting a Constitution rather than inventing one, when we amend its provisions so breezily.

Because the portion of the joint opinion adopting and describing the undue burden test provides no more useful guidance than the empty phrases discussed above, one must turn to the 23 pages applying that standard to the present facts for further guidance. In evaluating Pennsylvania’s abortion law, the joint opinion relies extensively on the factual findings of the District Court, and repeatedly qualifies its conclusions by noting that they are contingent upon the record developed in these cases. Thus, the joint opinion would uphold the 24-hour waiting period contained in the Pennsylvania statute’s informed consent provision, 18 Pa. Cons. Stat. § 3205 (1990), because “the record evidence shows that in the vast majority of eases, a 24-hour delay does not create any appreciable health risk,” ante, at 885. The three Justices therefore conclude that “on the record before us,. .. we are not convinced that the 24-hour waiting period constitutes an undue burden.” Ante, at 887. The requirement that a doctor provide the information pertinent to informed consent would also be upheld because “there is no evidence on this record that [this requirement] would amount in practical terms to a substantial obstacle to a woman seeking- an abortion.” Ante, at 884. Similarly, the joint opinion would uphold the reporting requirements of the Act, §§3207, 3214, because “there is no . . . showing on the record before us” that these requirements constitute a “substantial obstacle” *991to abortion decisions. Ante, at 901. But at the same time the opinion pointedly observes that these reporting requirements may increase the costs of abortions and that “at some point [that fact] could become a substantial obstacle.” Ibid. Most significantly, the joint opinion’s conclusion that the spousal notice requirement of the Act, see § 3209, imposes an “undue burden” is based in large measure on the District Court’s “detailed findings of fact,” which the joint opinion sets out at great length, ante, at 888-891.

I do not, of course, have any objection to the notion that, in applying legal principles, one should rely only upon the facts that are contained in the record or that are properly subject to judicial notice.6 But what is remarkable about the joint opinion’s fact-intensive analysis is that it does not result in any measurable clarification of the “undue burden” standard. Rather, the approach of the joint opinion is, for the most part, simply to highlight certain facts in the record that apparently strike the three Justices as particularly significant in establishing (or refuting) the existence of an undue burden; after describing these facts, the opinion then simply announces that the provision either does or does not impose a “substantial obstacle” or an “undue burden.” See, e. g., ante, at 880, 884-885, 887, 893-894, 895, 901. We do not know whether the same conclusions could have been reached on a different record, or in what respects the record would have had to differ before an opposite conclusion would have been *992appropriate. The inherently standardless nature of this inquiry invites the district judge to give effect to his personal preferences about abortion. By finding and relying upon the right facts, he can invalidate, it would seem, almost any abortion restriction that strikes him as “undue” — subject, of course, to the possibility of being reversed by a court of appeals or Supreme Court that is as unconstrained in reviewing his decision as he was in making it.

To the extent I can discern any meaningful content in the “undue burden” standard as applied in the joint opinion, it appears' to be that a State may not regulate abortion in such a way as to reduce significantly its incidence. The joint opinion repeatedly emphasizes that an important factor in the “undue burden” analysis is whether the regulation “prevent[s] a significant number of women from obtaining an abortion,” ante, at 893; whether a “significant number of women . . . are likely to be deterred from procuring an abortion,” ante, at 894; and whether the regulation often “deters” women from seeking abortions, ante, at 897. We are not told, however, what forms of “deterrence” are impermissible or what degree of success in deterrence is too much to be tolerated. If, for example, a State required a woman to read a pamphlet describing, with illustrations, the facts of fetal development before she could obtain an abortion, the effect of such legislation might be to “deter” a “significant number of women” from procuring abortions, thereby seemingly allowing a district judge to invalidate it as an undue burden. Thus, despite flowery rhetoric about the State’s “substantial” and “profound” interest in “potential human life,” and criticism of Roe for undervaluing that interest, the joint opinion permits the State to pursue that interest only so long as it is not too successful. As Justice Blackmun recognizes (with evident hope), ante, at 926, the “undue burden” standard may ultimately require the invalidation of each provision upheld today if it can be shown, on a better record, that the State is too effectively “expressing] a pref-*993erenee for childbirth over abortion,” ante, at 883. Reason finds no refuge in this jurisprudence of confusion.

“While we appreciate the weight of the arguments . . . that Roe should be overruled, the reservations any of us may have in reaffirming the central holding of Roe are outweighed by the explication of individual liberty we have given combined with the force of stare decisis.” Ante, at 853.

The Court’s reliance upon stare decisis ean best be described as contrived. It insists upon the necessity of adhering not to all of Roe, but only to what it calls the “central holding.” It seems to me that stare decisis ought to be applied even to the doctrine of stare decisis, and I confess never to have heard of this new, keep-what-you-want-and-throwaway-the-rest version. I wonder whether, as applied to Marbury v. Madison, 1 Cranch 137 (1803), for example, the new version of stare decisis would be satisfied if we allowed courts to review the constitutionality of only those statutes that (like the one in Marbury) pertain to the jurisdiction of the courts.

I am certainly not in a good position to dispute that the Court has saved the “central holding” of Roe, since to do that effectively I would have to know what the Court has saved, which in turn would require me to understand (as I do not) what the “undue burden” test means. I must confess, however, that I have always thought, and I think a lot of other people have always thought, that the arbitrary trimester framework, which the Court today discards, was quite as central to Roe as the arbitrary viability test, which the Court today retains. It seems particularly ungrateful to carve the trimester framework out of the core of Roe, since its very rigidity (in sharp contrast to the utter indeterminability of the “undue burden” test) is probably the only reason the Court is able to say, in urging stare decisis, that Roe “has in no sense proven ‘unworkable/ ” ante, at 855. I suppose the *994Court is entitled to call a “central holding” whatever it wants to call a “central holding” — which is, come to think of it, perhaps one of the difficulties with this modified version of stare decisis. I thought I might note, however, that the following portions of Roe have not been saved:

• Under Roe, requiring that a woman seeking an abortion be provided truthful information about abortion before giving informed written consent is unconstitutional, if the information is designed to influence her choice. Thornburgh, 476 U. S., at 759-765; Akron I, 462 U. S., at 442-445. Under the joint opinion’s “undue burden” regime (as applied today, at least) such a requirement is constitutional. Ante, at 881-885.

• Under Roe, requiring that information be provided by a doctor, rather than by nonphysieian counselors, is unconstitutional. Akron I, supra, at 446-449. Under the “undue burden” regime (as applied today, at least) it is not. Ante, at 884-885.

• Under Roe, requiring a 24-hour waiting period between the time the woman gives her informed consent and the time of the abortion is unconstitutional. Akron I, supra, at 449-451. Under the “undue burden” regime (as applied today, at least) it is not. Ante, at 885-887.

• Under Roe, requiring detailed reports that include demographic data about each woman who seeks an abortion and various information about each abortion is unconstitutional. Thornburgh, supra, at 765-768. Under the “undue burden” regime (as applied today, at least) it generally is not. Ante, at 900-901.

“Where, in the performance of its judicial duties, the Court decides a case in such a way as to resolve the sort of intensely divisive controversy reflected in Roe ..., its decision has a dimension that the resolution of the normal case does not carry. It is the dimension present whenever the Court’s interpretation of the Constitution calls the contending sides of a *995national controversy to end their national division by accepting a common mandate rooted in the Constitution.” Ante, at 866-867.

The Court’s description of the place of Roe in the social history of the United States is unrecognizable. Not only did Roe not, as the Court suggests, resolve the deeply divisive issue of abortion; it did more than anything else to nourish it, by elevating it to the national level where it is infinitely more difficult to resolve. National politics were not plagued by abortion protests, national abortion lobbying, or abortion marches on Congress before Roe v. Wade was decided. Profound disagreement existed among our citizens over the issue — as it does over other issues, such as the death penalty — but that disagreement was being worked out at the state level. As with many other issues, the division of sentiment within each State was not as closely balanced as it was among the population of the Nation as a whole, meaning not only that more people would be satisfied with the results of state-by-state resolution, but also that those results would be more stable. Pr e-Roe, moreover, political compromise was possible.

Roe’s mandate for abortion on demand destroyed the compromises of the past, rendered compromise impossible for the future, and required the entire issue to be resolved'uniformly, at the national level. At the same time, Roe created a vast new class of abortion consumers and abortion proponents by eliminating the moral opprobrium that had attached to the act. (“If the Constitution guarantees abortion, how can it be bad?” — not an accurate line of thought, but a natural one.) Many favor all of those developments, and it is not for me to say that they are wrong. But to portray Roe as the statesmanlike “settlement” of a divisive issue, a jurisprudential Peace of Westphalia that is worth preserving, is nothing less than Orwellian. Roe fanned into life an issue that has inflamed our national polities in general, and has obscured with its smoke the selection of Justices to this Court *996in particular, ever since. And by keeping us in the abortion-umpiring business, it is the perpetuation of that disruption, rather than of any Pax Boeana, that the Court’s new majority decrees.

“[T]o overrule under fire . . . would subvert the Court’s legitimacy....
“... To all those who will be ... tested by following, the Court implicitly undertakes to remain steadfast .... The promise of constancy, once given, binds its maker for as long as the power to stand by the decision survives and ... the commitment [is not] obsolete....
“[The American people’s] belief in themselves as ... a people [who aspire to live according to the rule of law] is not readily separable from their understanding of the Court invested with the authority to decide their constitutional cases and speak before all others for their constitutional ideals. If the Court’s legitimacy should be undermined, then, so would the country be in its very ability to see itself through its constitutional ideals.” Ante, at 867-868.

The Imperial Judiciary lives. It is instructive to compare this Nietzschean vision of us uneleeted, life-tenured judges— leading a Yolk who will be “tested by following,” and whose very “belief in themselves” is mystically bound up in their “understanding” of a Court that “speak[s] before all others for their constitutional ideals” — with the somewhat more modest role envisioned for these lawyers by the Founders.

“The judiciary . . . has ... no direction either of the strength or of the wealth of the society, and can take no active resolution whatever. It may truly be said to have neither Force nor Will, but merely judgment....” The Federalist No. 78, pp. 393-394 (G. Wills ed. 1982).

Or, again, to compare this ecstasy of a Supreme Court in which there is, especially on controversial matters, no *997shadow of change or hint of alteration (“There is a limit to the amount of error that can plausibly be imputed to prior Courts,” ante, at 866), with the more democratic views of a more humble man:

“[Tjhe candid citizen must confess that if the policy of the Government upon vital questions affecting the whole people is to be irrevocably fixed by decisions of the Supreme Court,... the people will have ceased to be their own rulers, having to that extent practically resigned their Government into the hands of that eminent tribunal.” A. Lincoln, First Inaugural Address (Mar. 4,1861), reprinted in Inaugural Addresses of the Presidents of the United States, S. Doc. No. 101-10, p. 139 (1989).

It is particularly difficult, in the circumstances of the present decision, to sit still for the Court’s lengthy lecture upon the virtues of “constancy,” ante, at 868, of “remaining] steadfast,” ibid., and adhering to “principle,” ante, passim. Among the five Justices who purportedly adhere to Roe, at most three agree upon the principle that constitutes adherence (the joint opinion’s “undue burden” standard) — and that principle is inconsistent with Roe. See 410 U. S., at 154-156.7 To make matters worse, two of the three, in order thus to remain steadfast, had to abandon previously stated positions. See n. 4, supra; see supra, at 988-990. . It is beyond me how the Court expects these accommodations to be accepted “as grounded truly in principle, not as compromises with social and political pressures having, as such, no bearing on the principled choices that the Court is obliged to make.” Ante, at 865-866. The only principle the Court “adheres” *998to, it seems to me, is the principle that the Court must be seen as standing by Roe. That is not a principle of law (which is what I thought the Court was talking about), but a principle of Realpolitik — and a wrong one at that.

I cannot agree with, indeed I am appalled by, the Court’s suggestion that the decision whether to stand by an erroneous constitutional decision must be strongly influenced— against overruling, no less — by the substantial and continuing public opposition the decision has generated. The Court’s judgment that any other course would “subvert the Court’s legitimacy” must be another consequence of reading the error-filled history book that described the deeply divided country brought together by Roe. In my history book, the Court was covered with dishonor and deprived of legitimacy by Dred Scott v. Sandford, 19 How. 393 (1857), an erroneous (and widely opposed) opinion that it did not abandon, rather than by West Coast Hotel Co. v. Parrish, 300 U. S. 379 (1937), which produced the famous “switch in time” from the Court’s erroneous (and widely opposed) constitutional opposition to the social measures of the New Deal. (Both Dred Scott and one line of the cases resisting the New Deal rested upon the concept of “substantive due process” that the Court praises and employs today. Indeed, Dred Scott was “very possibly the first application of substantive due process in the Supreme Court, the original precedent for Lochner v. New York and Roe v. Wade.” D. Currie, The Constitution in the Supreme Court 271 (1985) (footnotes omitted).)

But whether it would “subvert the Court’s legitimacy” or not, the notion that we would decide a ease differently from the way we otherwise would have in order to show that we can stand firm against public disapproval is frightening. It is a bad enough idea, even in the head of someone like me, who believes that the text of the Constitution, and our traditions, say what they say and there is no fiddling with them. But when it is in the mind of a Court that believes the Con*999stitution has an evolving meaning, see ante, at 848; that the Ninth Amendment’s reference to “othe[r]” rights is not a disclaimer, but a charter for action, ibid.; and that the function of this Court is to “speak before all others for [the people’s] constitutional ideals” unrestrained by meaningful text or tradition — then the notion that the Court must adhere to a decision for as long as the decision faces “great opposition” and the Court is “under fire” acquires a character of almost ezarist arrogance. We are offended by these marchers who descend upon us, every year on the anniversary of Roe, to protest our saying that the Constitution requires what our society has never thought the Constitution requires. These people who refuse to be “tested by following” must be taught a lesson. We have no Cossacks, but at least we can stubbornly refuse to abandon an erroneous opinion that we might otherwise change — to show how little they intimidate us.

Of course, as The Chief Justice points out, we have been subjected to what the Court calls “‘political pressure’” by both sides of this issue. Ante, at 963. Maybe today’s decision not to overrule Roe will be seen as buckling to pressure from that direction. Instead of engaging in the hopeless task of predicting public perception — a job not for lawyers but for political campaign managers — the Justices should do what is legally right by asking two questions: (1) Was Roe correctly decided? (2) Has Roe succeeded in producing a settled body of law? If the answer to both questions is no, Roe should undoubtedly be overruled.

In truth, I am as distressed as the Court is — and expressed my distress several years ago, see Webster, 492 U. S., at 535 — about the “political pressure” directed to the Court: the marches, the mail, the protests aimed at inducing us to change our opinions. How upsetting it is, that so many of our citizens (good people, not lawless ones, on both sides of this abortion issue, and on various sides of other issues as well) think that we Justices should properly take into ac*1000count their views, as though we were engaged not in ascertaining an objective law but in determining some kind of social consensus. The Court would profit, I think, from giving less attention to the fact of this distressing phenomenon, and more attention to the cause of it. That cause permeates today’s opinion: a new mode of constitutional adjudication that relies not upon text and traditional practice to determine the law, but upon what the Court calls “reasoned judgment,” ante, at 849, which turns out to be nothing but philosophical predilection and moral intuition. All manner of “liberties,” the Court tells us, inhere in the Constitution and are enforceable by this Court — notjust those mentioned in the text or established in the traditions of our society. Ante, at 847-849. Why even the Ninth Amendment — which says only that “[t]he enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people” — is, despite our contrary understanding for almost 200 years, a literally boundless source of additional, unnamed, unhinted-at “rights,” definable and enforceable by us, through “reasoned judgment.” Ante, at 848-849.

What makes all this relevant to the bothersome application of “political pressure” against the Court are the twin facts that the American people love democracy and the American people are not fools. As long as this Court thought (and the people thought) that we Justices were doing essentially lawyers’ work up here — reading text and discerning our society’s traditional understanding of that text — the public pretty much left us alone. Texts and traditions are facts to study, not convictions to demonstrate about. But if in reality our process of constitutional adjudication consists primarily of making value judgments; if we can ignore a long and clear tradition clarifying an ambiguous text, as we did, for example, five days ago in declaring unconstitutional invocations and benedictions at public high school graduation ceremonies, Lee v. Weisman, 505 U. S. 577 (1992); if, as I say, our pronouncement of constitutional law rests primarily on value *1001judgments, then a free and intelligent people’s attitude towards us can be expected to be (ought to be) quite different. The people know that their value judgments are quite as good as those taught in any law school — maybe better. If, indeed, the “liberties” protected by the Constitution are, as the Court says, undefined and unbounded, then the people should demonstrate, to protest that we do not implement their values instead of ours. Not only that, but confirmation hearings for new Justices should deteriorate into question- and-answer sessions in which Senators go through a list of their constituents’ most favored and most disfavored alleged constitutional rights, and seek the nominee’s commitment to support or oppose them. Value judgments, after all, should be voted on, not dictated; and if our Constitution has somehow accidently committed them to the Supreme Court, at least we can have a sort of plebiscite each time a new nominee to that body is put forward. Justice Blackmun not only regards this prospect with equanimity, he solicits it. Ante, at 943.

* * *

There is a poignant aspect to today’s opinion. Its length, and what might be called its epic tone, suggest that its authors believe they are bringing to an end a troublesome era in the history of our Nation and of our Court. “It is the dimension” of authority, they say, to “eal[l] the contending sides of national controversy to end their national division by accepting a common mandate rooted in the Constitution.” Ante, at 867.

There comes vividly to mind a portrait by Emanuel Leutze that hangs in the Harvard Law School: Roger Brooke Taney, painted in 1859, the 82d year of his life, the 24th of his Chief Justiceship, the second after his opinion in Dred Scott. He is all in black, sitting in a shadowed red armchair, left hand resting upon a pad of paper in his lap, right hand hanging limply, almost lifelessly, beside the inner arm of the chair. He sits facing the viewer and staring straight out. There *1002seems to be on his face, and in his deep-set eyes, an expression of profound sadness and disillusionment. Perhaps he always looked that way, even when dwelling upon the happiest of thoughts. But those of us who know how the lustre of his great Chief Justiceship came to be eclipsed by Dred Scott cannot help believing that he had that ease — its already apparent consequences for the Court and its soon-to-be-played-out consequences for the Nation — burning on his mind. I expect that two years earlier he, too, had thought himself “eall[ing] the contending sides of national controversy to end their national division by accepting a common mandate rooted in the Constitution.”

It is no more realistic for us in this litigation, than it was for him in that, to think that an issue of the sort they both involved — an issue involving life and death, freedom and subjugation — can be “speedily and finally settled” by the Supreme Court, as President James Buchanan in his inaugural address said the issue of slavery in the territories would be. See Inaugural Addresses of the Presidents of the United States, S. Doc. No. 101-10, p. 126 (1989). Quite to the contrary, by foreclosing all democratic outlet for the deep passions this issue arouses, by banishing the issue from the political forum that gives all participants, even the losers, the satisfaction of a fair hearing and an honest fight, by continuing the imposition of a rigid national rule instead of allowing for regional differences, the Court merely prolongs and intensifies the anguish.

We should get out of this area, where we have no right to be, and where we do neither ourselves nor the country any good by remaining.

18.3 Brief of Sandra Cano, the Former “Mary Doe” of Doe v. Bolton, and 180 Women Injured by Abortion as Amici Curiae in Support of Petitioner, Gonzales v. Carhart 18.3 Brief of Sandra Cano, the Former “Mary Doe” of Doe v. Bolton, and 180 Women Injured by Abortion as Amici Curiae in Support of Petitioner, Gonzales v. Carhart

Brief of Sandra Cano, the Former “Mary Doe” of Doe v. Bolton, and 180 Women Injured by Abortion as Amici Curiae in Support of Petitioner
Linda Boston Schlueter
Counsel of Record
State Bar Card No.: 24000127
Supreme Court Admission: 1976
Allan E. Parker, Jr.
State Bar Card No.: 15505500
Supreme Court Admission: 1994
Richard Clayton Trotter
State Bar Card No.: 20240500
Supreme Court Admission: 1988
8122 Datapoint Drive
Suite 812
San Antonio, Texas 78229
Telephone: 210-614-7157
Counsel for Amici Curiae
Sandra Cano and
post-abortive women
*i TABLE OF CONTENTS
TABLE OF CONTENTS
i
TABLE OF AUTHORITIES
ii
STATEMENT OF INTEREST OF THE AMICI CURIAE
1
SUMMARY OF THE ARGUMENT
5
ARGUMENT
6
I. THE “HEALTH” EXCEPTION IS NOT A PER SE REQUIREMENT AND THIRTY-THREE YEARS OF REAL LIFE EXPERIENCE DEMONSTRATES THAT IT SHOULD BE ABANDONED BECAUSE THE “HEALTH” EXCEPTION IN FACT CREATES SERIOUS ADVERSE CONSEQUENCES TO WOMEN'S HEALTH
6
II. CONGRESS CORRECTLY OMITTED THE “HEALTH” EXCEPTION CONSIDERING THE SIGNIFICANT FACTUAL FINDINGS THAT THE PARTIAL-BIRTH ABORTION PROCEDURE IS NEVER MEDICALLY NECESSARY TO PRESERVE THE MOTHER'S HEALTH AND POSES SERIOUS ADVERSE CONSEQUENCES TO A WOMAN'S HEALTH
11
A. Deference Should Be Given to Congressional Findings
11
B. Recent State Legislative Findings Also Support Congress' Findings of the Serious Physical, Emotional, and Psychological Harm to Women
14
*ii C. The Real Life Experiences of Post-abortive Women Demonstrate that Abortion Hurts Women, and Therefore, Congress Correctly Banned the Partial-Birth Abortion Procedure
21
III. THIS CASE DEMONSTRATES ABORTION ISSUES ARE VERY COMPLEX ISSUES THAT ARE FACT BOUND AND INVOLVE NATIONAL AND STATE POLICY THAT ARE BEST LEFT TO THE LEGISLATIVE BRANCHES OF GOVERNMENT, AND THEREFORE, CONGRESS' EXCLUSION OF THE HEALTH EXCEPTION SHOULD BE UPHELD
26
CONCLUSION
30
APPENDIX
Appendix A: Affidavit of Sandra Cano, the “Doe” of Doe v. Bolton
App. 1
Appendix B: Affidavit excerpts of post-abortive women
App. 11
*iii TABLE OF AUTHORITIES
Cases
27
passim
26
12
12
12
McCorvey v. Hill, 2003 U.S. Dist. LEXIS 12986 (N.D. Tex. 2003)
28
28
27
12
8, 21, 25
27
Planned Parenthood v. Taft, 439 F.3d 304 (6th Cir. 2006)
10
passim
9, 27
12
11
6, 8
12
21
Statutes
Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531
passim
Women's Right to Know Act of 2003, Tex. Health & Safety Code § 171.001 et seq. (2003)
14
Rules
27
Other
“The Aftereffects of Abortion,” www.afterabortion.info/complic.html
22
27
FDA Breast Implant Consumer Handbook - 2004, www.fda.gov/cdrh/breastimplants/handbook2004
9
*v Report of the South Dakota Task Force to Study Abortion (December 2005), available at www.ivotemyvalues.com/pdf/contentmgmt/Task_Force_Report.pdf
16, 17, 20, 22
Texas Dep't of Health, “Woman's Right To Know” booklet available at www.dshs.state.tx.us/wrtk/pdf/booklet.pdf
14, 15
Willke & Willke, Abortion 50 (Hayes Pub. Co. 2003)
19
*1 STATEMENT OF INTEREST OF THE AMICI CURIAE
Consent to file this amicus brief was given by both parties. This brief supporting Petitioner was prepared by counsel for amici.1
At the heart of this case is the future of the “health” exception articulated in Roe v. Wade and Doe v. Bolton. Amici Sandra Cano is the “Doe” of Doe v. Bolton. It was Doe v. Bolton which provided for the health exception and led to partial-birth abortion and abortion on demand. While it is unusual for a successful litigant to file an amicus brief opposing the health exception which was the heart of her case, Mrs. Cano in fact never wanted an abortion in Doe v. Bolton and fraud was perpetrated on the Court. Her Affidavit is Appendix A. In addition, the three-doctor provision of the Georgia statute which provided actual verification and protection for women was struck down in Doe. Furthermore, the “health” exception has been broadly interpreted and thereby ultimately led to partial-birth abortion. Mrs. Cano supports Congress' position omitting the “health” exception and urges this Court to give deference to Congress and hold the ban on partial-birth abortion constitutional.
Other amici are 180 post-abortive women who have suffered the adverse emotional and psychological effects of abortion. Congress in its findings only discussed the physical health consequences of abortion. However, other health consequences not stated in Congress' findings would be helpful to the Supreme Court in making its decision. The women attest to the fact that there are adverse emotional and psychological health effects that have affected their lives. All of the women have used their *2 full name in the original Affidavits, but some have requested that only their initials be used publicly to protect their confidentiality.
Although the Supreme Court only made non-evidence based assumptions in Roe v. Wade and Doe v. Bolton because abortion was generally not legal or widespread, the post-abortive women amici provide this Court with their real life experiences and attest that abortion in practice hurts women's health. Post-abortive women were asked, “How has abortion affected you?” Some of the women's Affidavit testimony is in the brief with the complete answer to that question from the amici in Appendix B. The post-abortive women amici are:
D.Q. (Tennessee)
Myra J. Rasmussen (Tennessee)
Donna M. Razin (Florida)
C.R. (Georgia)
Cathy L. Moffat (Utah)
J.L.M. (Texas)
Dana Renee Nickles (Arkansas)
S.O. (Florida)
Kristen Pettibone (Georgia)
Mary A. Hill-Griffith (Florida)
Dana Nicole Landers (Florida)
Julie Thomas (Georgia)
S.T. (Tennessee)
Teresa Renee Zell (North Carolina)
Mary Ellen York (Michigan)
E.A.W. (Tennessee)
Lorene Elaine Woods (Tennessee)
J.S.W. (California)
Carolyn Weedin (Texas)
Darla Weaver (Texas)
B.J.W. (Colorado)
H.T. (Texas)
T.J.H. (California)
Caroline Burnett (Florida)
Deborah R. Paine (Georgia)
Rhonda Kay Plumb (Illinois)
Tami T. Rohrbacher (Wyoming)
Leslie Bowen (Florida)
Janice L. Bartlett (Florida)
Mary Catherine Coburn (Georgia)
Hemda Ben-Judah (Georgia)
Becky Abell (Oklahoma)
Muriel A. Ramos (Florida)
C.L.R. (Arizona)
Nancy M. Haberling (Ohio)
Beverly A. Green (Minnesota)
Jackie Lynn Garner (Oklahoma)
K.G. (California)
O.F. (Maryland)
Angela Eckstein (Ohio)
Mary J. Duncan (South Carolina)
Deborah L. Dowless (Virginia)
T.D. (Pennsylvania)
Darlene Crumbo (California)
*3 Jamie Renee Carter (West Virginia)
Cynthia Carney (Oklahoma)
Elizabeth Campbell (California)
Elvira T. Brand (Florida)
Paula S. Botos (Kentucky)
Kim Marie Blackowiak (Minnesota)
Loretta Bingham (Florida)
Pamela Berry (Texas)
Brandie M. Atwood (Arkansas)
Melody A. Athey (Kansas)
Paulette C. Heller (Tennessee)
J.M.H. (Texas)
Lori Harrington (Mississippi)
Diane M. Hanson (Colorado)
Kathleen Vaunae Hansel (California)
Deanna Hall (California)
M.J.H. (Tennessee)
Karen Sue Green (Texas)
Deborah Longford (Tennessee)
V.L. (Oklahoma)
Rose Lewis (California)
Jana M. Lewis (Montana)
S.A.L. (Oklahoma)
C.L. (California)
D.L. (Louisiana)
L.L. (California)
S.C.K. (California)
Carolyn Knapschaefer (Kentucky)
Marene M. Kissinger (California)
M.M.K (Tennessee)
Gale Denise Jones (Texas)
Donna A. Jones (Florida)
Kyra L. Janke (Texas)
Lori Crossman (Michigan)
Tammy Craven (North Carolina)
R.A.C. (Alabama)
Margaret Conway (Michigan)
Pamela T. Colip (California)
D.M. (Kansas)
April Miera (New Mexico)
Roxanne Mergenthaler (Montana)
Amy Lynn Meole (Connecticut)
Patricia A. Meixelsperger (Wisconsin)
S.B.M. (Arkansas)
Vanessa McDonald (Texas)
J.M.M. (Louisiana)
Debra Mays (Michigan)
Sandra Mauldin (Arkansas)
G.M. (New York)
Dana Mann (Ohio)
N.A.M. (Idaho)
S.M.L. (Virginia)
L.M.S. (Washington)
Marie Skurka (Louisiana)
Amy Susan Shatrick (Ohio)
Sebrina Seay (California)
D.M. (California)
Karyn Schneider (California)
Rose A. Sarcione (Missouri)
Sara Sarginson (Michigan)
Tammy Joe Rutthofsky (Michigan)
K.R. (Texas)
Rosa Maria Rosas (West Virginia)
Esther Monica Ripplinger (Oregon)
Kathy S. Rice (West Virginia)
Dorothy Rice (California)
*4 Melinda L. James (Mississippi)
L.M.J. (Michigan)
E.K.J. (Texas)
Nancy C. Sweitzer (Pennsylvania)
A.A.S. (Missouri)
P.S. (Virginia)
Brenda Hilliard Stockdale (Georgia)
Lori A. Stirrup (Texas)
Debra J. Storm (California)
M.H.S. (Ohio)
Judy Sullivan (New York)
Tracy A. Stalsberg (Wisconsin)
Natalie Ann South (Mississippi)
N.M. (Florida)
C.M.S. (North Carolina)
Judee Oris (New York)
M.E.M. (California)
D.M. (Texas)
LuAnn Morton (Colorado)
Kathleen Murz (Texas)
Maranda Music (Kentucky)
Leslie D. Musick (Tennessee)
Mary L. Neikam (Pennsylvania)
T.M.N. (Wisconsin)
Linda Newberry (Tennessee)
Deborah Peterson (New Hampshire)
Alison Phillips (Colorado)
Lauralee Peterson (Minnesota)
Dianne Pesares (Georgia)
Kelli R. Perkins (Kentucky)
J.A.P. (Texas)
Elizabeth C. Patchet (Wisconsin)
Debbie Otto (Montana)
Laurie A. Moore (Kentucky)
D.R. (California)
T.R. (Tennessee)
Janice K. Rathkey (Oregon)
Lynn F. Rasberry (Texas)
Angie Ramsey (Arkansas)
K.G.R. (Florida)
Regina Pulliam (Oklahoma)
Connie Pollner (Georgia)
Paisley Pryor (Florida)
D.S.P. (Florida)
Jana L. Phillips (Missouri)
Leslie A. Patterson (Oklahoma)
Joann L. Ostrowski (Pennsylvania)
K.O. (Arizona)
Kaye Peterson (Texas)
Karen M. Kowalewski (California)
M.M.P. (Minnesota)
M.L.M. (Tennessee)
Sherry Mae Morgan (Tennessee)
Camelia M. Murphy (Texas)
Tara L.K. Musico (Hawaii)
Diane K. Musselman (Pennsylvania)
Wendy Miller (Missouri)
Mary Ann Novak (Pennsylvania)
K.N. (Mississippi)
Kristene O'Dell (Texas)
Jeanette Parks (Arkansas)
Dianne Marie Donaudy (Georgia)
Tina C. Brock (Georgia)
Rhonda Arias (Texas)
Myra M. Myers (Texas)
Kathy Rutledge (Kentucky)
Karen Bodle (Pennsylvania)
Cynthia Collins (Louisiana)
Caron Strong (California)
*5 SUMMARY OF THE ARGUMENT
I
At the heart of this case is the future of the “health” exception established in Doe v. Bolton. The health exception has been broadly interpreted to even include the partial-birth abortion procedure which Congress has defined as “gruesome and inhumane.” This Court has recognized that the state may promote but not endanger a woman's health when it regulates the methods of abortion. But after thirty-three years of real life experiences, post-abortive women and Sandra Cano, “Doe” herself, now attest that abortion hurts women and endangers their physical, emotional, and psychological health. Therefore, the ban on partial-birth abortion which excludes a health exception should be held constitutional.
II
This Court should re-evaluate the health exception considering the extensive evidence that Congress heard and its findings of fact. Congress found that the partialbirth abortion procedure is never medically necessary to preserve the health of the mother and, in fact, poses serious risks to the long-term health of women. Numerous state legislatures are currently holding hearings and also are finding the long-term negative health effects of abortion. The sworn Affidavit evidence of post-abortive women also demonstrates that abortion hurts women physically, emotionally, and psychologically. This Court now has the benefit of fact-finding by Congress and the states as well as the real life experience of post-abortive women and therefore should give deference to those findings and exclude a health exception.
*6 III
This case demonstrates the need to examine the underlying assumptions of a “health” exception. This case also demonstrates that the health exception involves complex physical, emotional, and psychological health issues. Such issues are best left to fact-finders and policy makers in the federal and/or the state legislative branches. Therefore, this Court should give deference to Congress' findings of fact and hold the partial-birth abortion ban constitutional.
ARGUMENT
I. THE “HEALTH” EXCEPTION IS NOT A PER SE REQUIREMENT AND THIRTY-THREE YEARS OF REAL LIFE EXPERIENCE DEMONSTRATES THAT IT SHOULD BE ABANDONED BECAUSE THE “HEALTH” EXCEPTION IN FACT CREATES SERIOUS ADVERSE CONSEQUENCES TO WOMEN'S HEALTH.
The health exception has been defined so broadly that it allows abortion on demand and the partial-birth abortion procedure which Congress defined as “gruesome and inhumane.”2 In a precursor to Roe v. Wade, this Court had an opportunity to analyze the word “health” in the District of Columbia abortion statute.3 This Court stated that the general usage and modern understanding of the term “health” includes both psychological and physical wellbeing.4
In Roe v. Wade, the Court did not focus on the health exception as it did in Doe v. Bolton. However, the Court made the following observation: “Maternity, or additional *7 offspring, may force upon the woman a distressful life and future. Psychological harm may be imminent.”5
In Doe, the Court stated that the health exception could be judged “ … in light of all factors - physical, emotional, psychological, familial, and the woman's age relevant to the well-being of the patient.”6 In his concurring opinion, Chief Justice Burger recognized that the term health was used “in its broadest medical context.”7 At the time, he believed that the decision would not have the sweeping effect that the dissenting Justices forewarned because physicians would observe the standards of their profession and only act after careful deliberation concerning judgments of life and health.8 He also believed that the Court rejected “any claim that the Constitution requires abortions on demand.”9 Unfortunately, Chief Justice Burger's assumptions have not been realized in the thirty-three years of real life experiences of the post-abortive women. Because of the broad definition of health and the fact that “health” is determined solely by one woman and one abortionist profiting from the abortion, America in effect has abortion on demand and partial-birth abortion. Furthermore, there is not a careful or narrow view of “health” and abortionists and women do not have a normal doctor-patient relationship as the post-abortive women attest.10
*8 The broad interpretation of “health” is certainly evident in Justice Douglas' concurring opinion.11 Justice Douglas elaborated on the meaning of health with a very broad definition. He stated: “Elaborate argument is hardly necessary to demonstrate that childbirth may deprive a woman of her preferred lifestyle and force upon her a radically different and undesired future.”12
Justice Douglas expanded the definition of “health” to include “hardships” by stating:
The vicissitudes of life produce pregnancies which may be unwanted, or which may impair ‘health’ in the broad Vuitch sense of the term, or which may imperil the life of the mother, or which in the full setting of the case may create such suffering, dislocations, misery, or tragedy as to make an early abortion the only civilized step to take. These hardships may be properly erabraced in the ‘health’ factor of the mother as appraised by a person of insight.
In Casey, this Court stated that “psychological well-being is a facet of health.”13 This Court also stated that there could be “devastating psychological consequences” if a woman's decision was not fully informed and truthful, not misleading.14 The post-abortive women amici attest to the “psychological consequences” that they experienced when they were not fully informed of the physical and psychological consequences of abortion and the information they were given by the abortionist or the abortion facility staff was in fact misleading.15
*9 In Stenberg v. Carhart,16 this Court held that the Nebraska statute violated the Constitution because it lacked the health exception. But this Court also cautioned that “a State may promote but not endanger a woman's health when it regulates the methods of abortion.”17 This Court indicated that it had invalidated statutes that in the process of regulating the methods of abortion had imposed significant health risks.18 It is not, however, the method of abortion that creates the health risk, it is the abortion itself. Congress found that “partial-birth abortion is never necessary to preserve the health of a woman” but “poses significant health risks to a woman …”19 Thus, the State would actually be endangering the woman's health by allowing partial-birth abortion. In other procedures such as silicone breast implants, a woman and her doctor cannot make that surgery choice because the federal Food and Drug Administration placed a moratorium on the device due to the health risks that were involved.20 Therefore, they should not be able to “choose” abortion which is a more dangerous and risky procedure.
In the most recent decision concerning the health exception, the Court of Appeals for the Sixth Circuit found *10 that the health exception is not a per se requirement.21 In that case, the Ohio statute prohibited the use of RU-486 for the purpose of inducing an abortion unless certain criteria were met.22 Challenges were made to the statute including that it lacked the constitutionally mandated health exception.23 The district court held that the health exception was required, thus imposing a per se requirement.24 The Court of Appeals, however, stated this was erroneous and that no such blanket per se requirement has been imposed.25 The court concluded that the health exception is “constitutionally necessary where substantial medical authority indicates that a banned procedure would be safer than the other available procedures, not just when banning the procedure subjects a woman to risks from the pregnancy itself.”26
In the present case, Congress concluded after extensive hearings that the partial-birth abortion procedure is never medically necessary to preserve the health of the mother.27 In fact, Congress found that the partial-birth abortion procedure poses “serious risks to the long-term health of women and in some circumstances, their lives.”28 Thus, there is no per se requirement for inclusion of the health exception, and therefore, the ban on the partial-birth abortion procedure is constitutional.
*11 II. CONGRESS CORRECTLY OMITTED THE “HEALTH” EXCEPTION CONSIDERING THE SIGNIFICANT FACTUAL FINDINGS THAT THE PARTIAL-BIRTH ABORTION PROCEDURE IS NEVER MEDICALLY NECESSARY TO PRESERVE THE MOTHER'S HEALTH AND POSES SERIOUS ADVERSE CONSEQUENCES TO A WOMAN'S HEALTH.
This Court should re-evaluate the health exception considering the extensive evidence that Congress heard and its findings of fact. It is clear that Congress recognizes the problems with the health exception.29 In addition, one state has banned abortion based on the negative health consequences to women30 and several other state legislatures are considering or have considered similar legislation.31 The sworn Affidavit evidence of post-abortive women also attest that abortion hurts women physically, emotionally, and psychologically. In this case, the Court now has the benefit of fact-finding by Congress, the states, and real life experiences of post-abortive women as discussed below.
A. Deference Should Be Given to Congressional Findings.
As a co-equal branch of government, deference should be given to Congress' findings which were based on extensive hearings and evidence. Congressional findings should be given great deference.32 In Turner, this Court stated that “In reviewing the constitutionality of a statute, *12 ‘courts must accord substantial deference to the predictive judgments of Congress …’ ” and that its “sole obligation is ‘to assure that, in formulating its judgments, Congress has drawn reasonable inferences based on substantial evidence.”33 Congress has drawn “reasonable inferences based on substantial evidence” and the post-abortive women amici can attest based on their real life experiences that abortion hurts women physically, emotionally, and psychologically.34
Congressional findings should particularly be given deference in medical or health issues.35 Congress should make factual findings because it is “an institution better equipped to amass and evaluate the vast amounts of data bearing on such an issue.”36 Furthermore, the courts should not second-guess legislative judgments.37 By way of analogy, this Court was not willing to second-guess Congress' findings that child pornography is “armful to the physiological, emotional, and mental health of the child.”38 In fact, this Court noted that “sexually exploited children are unable to develop healthy affectionate relationships in *13 later life, have sexual dysfunctions …” and are “predisposed to self-destructive behavior such as drug and alcohol abuse or prostitution.”39 Post-abortive women also attest to similar problems.40 In this case, Congress' findings should not be second-guessed.
Congress made numerous findings concerning the partial-birth abortion procedure.41 The amici believe that Congress correctly found that (1) partial-birth abortion “is a gruesome and inhumane procedure that is never medically necessary and should be prohibited;”42 (2) “partialbirth abortion remains a disfavored procedure that is not only unnecessary to preserve the health of the mother, but in fact poses serious risks to the long-term health of women and in some circumstances, their lives;”43 (3) the overwhelming evidence after extensive congressional hearings “demonstrates that a partial-birth abortion is never necessary to preserve the health of a woman, poses significant health risks to a woman upon whom the procedure is performed and is outside the standard of medical care;”44 and, (4) Congress had substantial evidence to conclude that “a ban on partial-birth abortion is not required to contain a “health” exception, because the facts indicate that a partial-birth abortion is never necessary to preserve the health of a woman, poses serious risks to a woman's health, and lies outside the standard of medical care.”45 The amici support Congress' findings and urge this Court to give the congressional findings great deference because its findings were based on extensive hearings, a substantial record, and were “reasonable inferences based on substantial evidence.”
*14 B. Recent State Legislative Findings Also Support Congress' Findings of the Serious Physical, Emotional, and Psychological Harm to Women.
Prior to Roe and Doe, health issues like abortion were decided by the states who are able to hold hearings and determine whether the medical and scientific knowledge are more advanced to warrant a different legal conclusion. Recently, there are some important examples of states making determinations about the emotional and psychological health consequences of abortion.
In Texas, the Legislature passed the “Women's Right to Know” Act46 in 2003. As a result, the medical board of the Texas Department of Health held hearings and ultimately produced a booklet entitled “A Woman's Right to Know” which is to be distributed to women who are thinking about having an abortion.47 The booklet provides women with information concerning the unique DNA of the baby,48 calls the baby an “unborn child,”49 shows the growth and development of the child from four weeks gestation to thirty-eight weeks gestation,50 describes the procedure,51 and explains the physical, emotional, and psychological risks to women.52
Specifically, the Texas Department of Health's “Woman's Right to Know” booklet describes the partialbirth abortion procedure or dilatation and extraction (D&X) procedure which it states can be done after sixteen *15 weeks.53 The booklet lists the following possible side effects and risks:
• “A hole in the uterus (uterine perforation) or other damage to the uterus.
• Injury to the bowel or bladder.
• Incomplete removal of the unborn child, placenta, or contents of the uterus, requiring an additional operation.
• Infection.
• Complications from anesthesia such as respiratory problems, nausea and vomiting, headaches, or drug reactions.
• Inability to get pregnant due to infection or complication from an operation.
• A possible hysterectomy as a result of complication or injury during the procedure.
• Hemorrhage (heavy bleeding).
• Emergency treatment for any of the above problems, including the possible need to treat with an operation, medicines, or a blood transfusion.
• Rarely, death.”54
In addition, the Texas Department of Health notes in its booklet “A Woman's Right to Know” that Former Surgeon General C. Everett Koop and the Physician's Ad Hoc Coalition for Truth stated in 1996 that the partial-birth abortion procedure “ … is never medically necessary to protect a mother's health or her future fertility. On the contrary, this procedure can pose a significant threat to both.”55
*16 The Texas Department of Health's pamphlet warns of the “emotional side of an abortion.”56 It states:
Some women may feel guilty, sad, or empty, while others may feel relief that the procedure is over. Some women have reported serious psychological effects after their abortion, including depression, grief, anxiety, lowered self-esteem, regret, suicidal thoughts and behavior, sexual dysfunction, avoidance of emotional attachment, flashbacks, and substance abuse. These emotions may appear immediately after an abortion, or gradually over a longer period of time. These feelings may recur or be felt stronger at the time of another abortion, or a normal birth, or on the anniversary of the abortion.57
Currently, a number of state legislatures are considering removing or in some other way limiting abortion or the health exception.58 A notable example is South Dakota which has made substantial and detailed findings after extensive hearings. This led to the ban on abortion except to save the life of the mother.
In South Dakota, the Legislature enacted HB 1233 which created the South Dakota Task Force to Study Abortion [hereinafter Task Force]. The Task Force was specifically charged to study ten aspects of abortion including the physical and mental effects of abortion on women.59 It was also charged with preparing a report that *17 detailed its findings along with any proposals for additional legislation that the Task Force would deem advisable.60
In compliance with its charge, the Task Force initially met on August 1, 2005 and then scheduled four full days of hearings.61 “The Task Force heard live testimony of approximately fifty-five witnesses, including thirty-two experts, and considered the written reports and testimony from another fifteen experts” and the live testimony “was divided almost equally between witnesses who support the position that abortion is harmful to women and should be illegal and those who think it should be legal.”62 In addition, the Task Force received approximately 3,500 pages of written materials, studies, reports, and testimony.63 The Task Force noted that of particular significance were the Affidavits of almost 2,000 post-abortive women who provided statements about their real life experiences.64 The Task Force stated that “[o]f these post-abortive women, over 99% of them testified that abortion is destructive of *18 the rights, interests, and health of women and that abortion should not be legal.”65
After hearing all of the evidence from experts and post-abortive women, the Task Force stated:
Further, the Task Force finds that the pre-abortion counseling provided often does not prepare women who have abortions for the psychological outcomes they may experience after their abortions. In addition, women who receive little or no information about possible emotional health risks of this procedure may significantly compromise their mental health and the quality of their lives for years to come. Due to the very limited information disclosed by abortion providers, women are not fully aware that abortion carries with it the potential to damage their physical, emotional, interpersonal, and spiritual well-being.66
The Task Force also addressed the issue of the psychological consequences of terminating the life of the child. The Task Force stated:
Perhaps worse, the pregnant mother is not told prior to her abortion that the procedure will terminate the life of a human being. The psychological consequences can be devastating when that woman learns, subsequent to the abortion, that this information was withheld - information that would have resulted in her declining to submit to an abortion. Her anger at being deceived and being prevented from making an informed decision for herself is exacerbated by her realization that she was implicated in the killing of her own child in utero. Aside from the injustice of her being deprived of making her own informed decision (see Section II-D), the psychological harm of *19 knowing she killed her child is often devastating.67
In addition, the Task Force found that:
… it is simply unrealistic to expect that a pregnant mother is capable of being involved in the termination of the life of her own child without risk of suffering significant psychological trauma and distress. To do so is beyond the normal, natural, and healthy capability of a woman whose natural instincts are to protect and nurture her child.68
The Task Force heard testimony from Dr. Vincent Rue, Ph.D., who is a psychotherapist, professor, and was special consultant to then-U.S. Surgeon General Dr. C. Everett Koop on abortion morbidity. The Task Force stated: “In 1981, Dr. Rue provided the first clinical evidence of post-abortion trauma, identifying this psychological condition as ‘Post-abortion Syndrome’ in testimony before the U.S. Congress.”69 The Task Force heard evidence that individuals with Post-abortion Syndrome “experience symptoms of avoidance (efforts to escape from reminders of the event), intrusion (unwanted thoughts, nightmares, and flashbacks related to the event), and arousal (exaggerated startle reflex, sleep disturbance, irritability) for a month or more following exposure to a traumatic event.”70 Although for some women, the initial response is one of relief, many women later avoid the problem through repression and denial, usually for years - “5 years is common, 10 or 20 is not unusual.”71
The Task Force found the following mental health outcomes:
*20 1. “Based on methodological improvements characterizing these studies, prior works indicating that abortion is an emotionally benign medical procedure for most women are invalid and little reliance can be placed upon them;
2. In all the analyses conducted, women with a history of abortion were never found to be at a lower risk for mental health problems than their peers with no abortion experience;
3. Women with a history of induced abortion are at a significantly higher risk for the following problems: a) inpatient and outpatient psychiatric claims, particularly adjustment disorders, bipolar disorder, depressive psychosis, neurotic depression, and schizophrenia; b) substance use generally, and specifically during a subsequent pregnancy; and c) clinically significant levels of depression, anxiety, and parenting difficulties;
4. When compared to unintended pregnancies carried to term and other forms of perinatal loss, abortion poses more significant mental health risks; and
5. Cross-cultural data call into question the oftenvoiced view that psychological problems associated with abortion are socially constructed, as women living in a culture where abortion is normative and a much less volatile social issue, have been found to also suffer psychological effects of abortion.”72
Based on all of the evidence the Task Force concluded “that to fully protect the rights, interests, and health of the mother and the life of her unborn child, a ban on abortions is required.”73 It is the real life experience of the post-abortive women amici that abortion hurts women *21 emotionally and psychologically, and therefore, abortion should be banned to protect the health of the mother.
C. The Real Life Experiences of Postabortive Women Demonstrate that Abortion Hurts Women, and Therefore, Congress Correctly Banned the Partial-Birth Abortion Procedure.
While Congress, in this case, focused on the physical consequences of abortion, the amici's real life experiences concur with Congress' findings that there are harmful and negative physical consequences to abortion. Abortion also has negative psychological effects on women. In Planned Parenthood v. Casey,74 the Court placed abortion in the range of choices that are “central to personal dignity and autonomy, are central to the liberty protected by the Fourteenth Amendment.”75
The Court of Appeals for the Fifth Circuit recently cited testimony that abortion as practiced is “almost always a negative experience for the patient…”76 In Bell, the court struck down Texas abortion facility regulations that required Texas abortions to be done in a manner that enhanced women's “self-esteem” and “dignity.”77 Contrary to the non-evidence-based assumption in Casey, the decision in Bell and the Women's Affidavits refute the assumption that abortion enhances female dignity, self-esteem, and autonomy.78
*22 Dr. David Reardon, one of the world's leading experts on the effects of abortion on women, further demonstrates the devastating psychological consequences of abortion. Dr. Reardon states that following temporary feelings of relief, there is emotional “paralysis” or post-abortion “numbness,” guilt and remorse, nervous disorders, sleep disturbances, sexual dysfunction, depression, loss of selfesteem, self-destructive behavior such as suicide, thoughts of suicide, and alcohol and drug abuse, chronic problems with relationships, dramatic personality changes, anxiety attacks, difficulty grieving, increased tendency toward violence, chronic crying, difficulty concentrating, flashbacks, and difficulty in bonding with later children.79
The real life experiences of the post-abortive women also confirm what the research has discovered. The women were asked: How has abortion affected you? Typical responses from their sworn Affidavits80 which are located at Appendix B included depression,81 suicidal *23 thoughts,82 flashbacks,83 alcohol and/or drug use,84 promiscuity,85 *24 guilt,86 and secrecy,87 Each of them made the “choice” to abort their baby, and they have regretted their “choices.”88 *25 The emotional and psychological pain does not go away,89 and therefore, abortion is a short term solution with long term negative consequences.
Congress' findings, the findings of the South Dakota Task Force on Abortion, and sworn Affidavits of the women in Appendix B are only the tip of the abortion iceberg. Care Net90 and other pregnancy resource centers attest that their organizations had over 100,000 women in post-abortion recovery programs in 2004 alone. It is estimated that there are more than one million abortions each year. If even 1 in 10 women suffer from negative psychological consequences of abortion, then Congress and the state legislatures should hold hearings, make factual findings, and pass legislation concerning abortion. Congress and the state legislatures should be allowed to protect women's health from the negative physical and psychological effects of abortion.
Failing to allow the federal and state legislative branches to hear the evidence concerning abortion only prolongs the anguish and debate that has divided this country. Although Justice O'Connor called “the contending sides of a national controversy to end their national division by accepting a common mandate” which she alleged was rooted in the Constitution,91 this has not been the case. Justice Scalia recognized what has become the national reality:
Quite to the contrary, by foreclosing all democratic outlet for the deep passions this issue *26 arouses, by banishing the issue from the political forum that gives all participants, even the losers, the satisfaction of a fair hearing and an honest fight, by continuing the imposition of a rigid national rule instead of allowing for regional differences, the Court merely prolongs and intensifies the anguish.92
The post-abortive women amici urge this Court to end its “rigid national rule” and allow the federal and state legislative branches of government to determine the health facts about abortion. Congress and state legislatures should be allowed to protect women by holding hearings, making findings of fact, and enacting legislation based on the evidence.
III. THIS CASE DEMONSTRATES ABORTION ISSUES ARE VERY COMPLEX ISSUES THAT ARE FACT BOUND AND INVOLVE NATIONAL AND STATE POLICY THAT ARE BEST LEFT TO THE LEGISLATIVE BRANCHES OF GOVERNMENT, AND THEREFORE, CONGRESS' EXCLUSION OF THE HEALTH EXCEPTION SHOULD BE UPHELD.
Prior to Roe v. Wade93 and Doe v. Bolton,94 health issues such as abortion were traditionally state issues.95 The Roe Court noted that the Texas statute was “typical of *27 those that have been in effect in many States for approximately a century”96 and traced the history of abortion and referenced the state statutes pertaining to abortion.97 The Roe and Doe Court, however, constitutionalized the right to abortion and thereby overturned the abortion laws in all fifty states.98 In addition, the federal courts were empowered to strike down state or federal abortion laws that prohibited or regulated abortions.99 This became evident in Stenberg v. Carhart100 where the Court invalidated the laws in Nebraska as well as those in twenty-nine other states that prohibited the partial-birth abortion procedure. It is also true in this case where federal courts in California,101 Nebraska,102 and New York103 enjoined Congress' Partial-Birth Abortion Ban Act of 2003.104
Because the Roe Court recognized a constitutional right to abortion, it also removed the abortion debate from the legislative and political process. In 2003, Norma McCorvey, the “Roe” of Roe v. Wade, filed a Rule 60105 Motion to vacate that 1973 decision because of significant changes in the factual and legal conditions which make *28 the decision no longer just or equitable.106 At the Court of Appeals for the Fifth Circuit,107 Judge Edith Jones reviewed McCorvey's legally sufficient and compelling evidence consisting of 5,347 pages of post-abortive women's affidavits, medical experts, and former abortion clinic personnel. Judge Jones correctly stated in her concurring opinion the importance of the Supreme Court re-evaluating Roe and expressed her fervent hope that this Court would acknowledge the developments and re-evaluate Roe.108 Judge Jones summarized the evidence including evidence of the long-term emotional and psychological damage which is currently in issue with the health exception and the “perverse result”109 that an issue that affects millions of women and unborn babies cannot be heard or meaningfully debated:
At the same time, because the Court's rulings have rendered basic abortion policy beyond the power of our legislative bodies, the arms of representative government may not meaningfully debate McCorvey's evidence. The perverse result of the Court's having determined through constitutional adjudication this fundamental social policy, which affects over a million women and unborn babies each year, is that the facts no longer matter 110
Judge Jones concluded:
One may fervently hope that the Court will someday acknowledge such developments and re-evaluate Roe and Casey accordingly. That the Court's constitutional decision making leaves our *29 nation in a position of willful blindness to evolving knowledge should trouble any dispassionate observer …111
Furthermore, in 1973 when the Supreme Court decided Roe v. Wade and Doe v. Bolton, abortion was illegal in most states and relatively rare.112 No evidence existed then regarding how widespread legalized abortion would actually affect women. The Court assumed that abortion would be good for women and made many non-evidence-based assumptions. The Court assumed abortion was like other medical procedures and as safe as childbirth because the long-term effects of abortion on women were unknown at the time.113 Based on the little evidence before it, a single affidavit from Norma McCorvey, the “Roe” of Roe v. Wade, the Court knew that unwanted pregnancies could put pressure on women and that women needed help and compassion in such situations.114 The Court had no evidence or experience on whether abortion would in fact help or hurt women in the long run.
The evidence from post-abortive women now shows that abortion is merely a short-term “solution” with longterm negative physical and psychological consequences. Thus, deference should be given to Congress' factual findings and its ban on partial-birth abortion should be held constitutional. Sandra Cano and the post-abortive women amici urge this Court to uphold the ban on partial-birth abortion and the exclusion of the health exception.
*30 CONCLUSION
For the foregoing reasons and those in Petitioner's brief on the merits, Congress' ban on partial-birth abortion should be upheld.
*1A TABLE OF CONTENTS
Page
Appendix A: Affidavit of Sandra Cano, the “Doe” of Doe v. Bolton ... App. 1
Appendix B: Affidavit excerpts of post-abortive women ... App. 11
*2A APPENDIX A
IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF GEORGIA ATLANTA DIVISION
Sandra Cano, formerly known as MARY DOE, Plaintiff,
v.
ARTHUR BOLTON, Attorney General of the State of Georgia Through His Official Successor in Office, THURBERT E. BAKER; LEWIS R. SLATON, as District Attorney of Fulton County, Georgia Through His Official Successor in Office, PAUL L. HOWARD, JR.; And HERBERT T. JENKINS, as Chief of Police of the City of Atlanta Through His Official Successor in Office, RICHARD PENNINGTON, Defendants.
CIVIL ACTION NO. 13676
AFFIDAVIT OF SANDRA CANO
STATE OF GEORGIA
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF FULTON
BEFORE ME, the undersigned authority, on this day personally appeared SANDRA CANO, who after being duly sworn upon his [sic] oath deposed and said as follows:
*3a “1. My name is Sandra Cano, and I reside in Georgia. I am competent to make this Affidavit. I have personal knowledge of the facts stated herein and the following is true and correct.
2. In 1973, I was the woman designated as ‘Mary Doe’, the Plaintiff in Doe v. Bolton, 410 U.S. 179 (1973), the companion case to Roe v. Wade, 410 U.S. 113 (1973). Although the courts understood that ‘Mary Doe’ was not my real name, what the courts did not know was that, contrary to the facts recited in my 1970 Affidavit, I neither wanted nor sought an abortion. I was nothing but a symbol in Doe v. Bolton with my experience and circumstances discounted and misrepresented. During oral arguments before the United States Supreme Court one of the Justices stated that it did not matter whether I was a real or fictitious person. This is where the Court was so very wrong. It did matter. I was a real person, and I did not want an abortion.
3. Abortion is just like Doe v. Bolton. It discounts the real experiences of the mothers. It misrepresents that abortion is for them. Just as Mary Does' true desires were hidden from the courts by those promoting abortion, so, too, have the real facts about abortion been hidden. Today, this Court will know the real truth about the real woman who was used to deceive, not only the courts, but the women of this nation about the reality of abortion.
4. ‘Sandra Race Bensing’ was my real name in 1970. I was twenty-two years old and pregnant with my fourth child when I first met the Doe v. Bolton attorney, Margie Pitts Haines. I had gone to legal aid to get a divorce and to find an attorney to help me regain custody of my two children. My *4a husband was not supporting us, and we had to live at the Salvation Army. At times we lived with my mother, but my stepfather did not want us there. I loved my children, but I could not care for them financially.
5. I was a trusting person and did not read the papers placed in front of me by my lawyer. I truly thought Margie Pitts Haines was having me sign divorce papers. I did not even suspect that the papers related to abortion until one afternoon when my mother and my lawyer told me that my suitcase was packed to go to a hospital, and that they had scheduled an abortion for the next day. They advised me that my doctor, Dr. Donald Block, was going to perform an abortion. I told both my mother and my lawyer that I would not have an abortion. Not then. Not ever. They persisted in their demands upon me.
6. When the demand for an abortion persisted, I fled to Oklahoma and stayed at the home of my ex-husband's grandmother. I remained in Oklahoma until my mother and lawyer assured me that they would cease their pressuring me to have an abortion. I was relieved that the ordeal was ended. Because they promised never to force me to have an abortion, I returned to Georgia.
7. My lawyer sent me a plane ticket so I could fly from Oklahoma to Georgia. She wanted me to be in a courtroom with other pregnant mothers. The night before I went to court, my mother and my lawyer expressed concern that I would leave again, and so they had me stay at the apartment of a legal-aid lawyer. Before the court appearance, I was told by my lawyer not to say anything in court. As a result, I never did say anything in court.
*5a 8. My predicament made it difficult for me to take care of my children, but I didn't need an abortion. I needed help, but all of the people around me - my husband, my mother and my lawyer - refused to help me with my children.
9. Instead of real help, my mother, stepfather and my lawyer persisted in their demands that I have an abortion. Those demands were made for themselves so they would not be burdened. It was, in my mind, a demand for what they thought was the easiest way for them to get out from under any obligation to help my new baby and me. But the abortion was not in my interest. I was the mother of a baby for whom I was responsible. I had a natural desire to have my baby and to raise her. I carried my child to full term and gave birth. Because no one would help me I felt compelled to surrender my rights and give my baby up for adoption.
10. One day in 1973, my mother and stepfather called me into their bedroom. Their television was on. They shouted to me excitedly, “Look! You won! You won!” Margie Pitts Haines was on television and the story reported that the United States Supreme Court had made abortion legal. At that time, I did not fully comprehend what my role was in the Court's decision in Doe v. Bolton.
11. Over the years, I gained a greater and greater sense that I was wrongfully used in Doe v. Bolton. A number of years ago, I decided that I wanted to see my file in the case so I could see what was said about me. I went to the courthouse to see my records which were under seal. An attorney, Wendell Bird, agreed to represent me and he asked that my records in my case be unsealed. I produced my driver's license, my *6a birth certificate, and my marriage certificate. The attorney who represented me in Doe v. Bolton, Margie Pitts Hames, tried to stop me from getting my own records, and I did not understand why.
12. It was only when I first saw the opened records in Doe v. Bolton that I understood why Margie didn't want me to see them. The records stated that I applied for an abortion, was turned down, and, as a result, sued the state of Georgia. According to the records, I had applied for an abortion through a panel of nine doctors and nurses at a state-funded hospital, Grady Memorial Hospital. That was a false statement. After reading the court records, I contacted the hospital and tried to obtain my records. At first I was told there were records, but when my new attorney sent his legal assistant to review the records, we were told that they did not exist. The hospital said they didn't have any records. I never sought an abortion there or anywhere else.
13. At times, I have been forced to reflect upon the events that led up to that day in 1973 when my mother and stepfather told me about the Supreme Court decision in Doe v. Bolton. In 1970, my life was a mess. I was having my fourth child, but no responsible husband or real place to live. I was uneducated. When I came back from Oklahoma, I was so relieved that no one was going to pressure me to have an abortion that I took part in a court proceeding without understanding what was really happening. I was used wrongly, but I didn't inquire enough. In retrospect, there were big signs which revealed what was happening.
*7a 14. Once a television man came to Margie's office and I was asked what I thought of abortion. I told him that, “I don't believe in abortion and I don't want an abortion.” I also said I didn't care if anyone else had an abortion, that it wasn't my business. All I cared about, at that time, was that I didn't want an abortion. I was not thinking of the other women. I did not understand that I was involved in a case that sought to legalize abortion. I was naive. In retrospect, perhaps, I could have discovered what was going on. But I was in a crisis. I depended on my mother's help. My lawyer became upset with me because I would never say to anyone that I would have an abortion. I should have, perhaps, understood what was happening, but I was simply attempting to survive. I remember Margie debating me. She claimed we were involved in a liberation right. She said women were entitled to equal pay for equal work, and I agreed. I never saw the pleading filed in court.
15. Many years later, when I saw the unsealed records in my case, I could not believe what the certification filed in my name said. I am certain the signature on the affidavit that said I wanted an abortion was not mine. I never saw that affidavit until the records were unsealed. If it was my signature, it was obtained without my knowing the contents of the affidavit. I had fled to Oklahoma to avoid an abortion. My lawyer knew I would never say I wanted one. The only reason I went to a lawyer was to get my children back. My predicament was used to argue that my new baby's life should be terminated.
16. I have often rethought how my involvement in Doe v. Bolton came about. Over the years it has haunted me. I never had an abortion, but I know *8a what it is like to feel responsible for one. I know what it is like to feel like a mother who helped terminate the life of her own child. After Doe v. Bolton was decided and I was told about my involvement, I felt responsible for the experiences to which the mothers and babies were being subjected. In a way, I felt that I was involved in the abortions - that I was somehow responsible for the lives of the children and the horrible experiences of their mothers. I have felt that experience that the death of a child is my fault; the helplessness the mother feels as events occur around her without any power to stop them; and the guilt that is associated with being told by the courts and society that the child's death was performed for the mother and only the mother.
17. This last assertion - that abortion is performed for the mother - is the cruelest misrepresentation of all. My own circumstance, the one used to justify legal abortion in the first place, is a perfect example of this reality. There are many doctors, and clinics and others who were plaintiffs in Doe v. Bolton. As Mary Doe, I was the only pregnant mother who was a plaintiff. All of these other people - the doctors, nurses and clinics were using the Court to do what they thought was in my interest. They pressured the Court claiming I need the right to terminate the life of my own child. It was their solution, not mine. They claimed they did it out of compassion for me. But it was a false compassion. A true compassion would result in the fathers living up to their responsibilities. A true compassion, once a mother is in the predicament that the child's father abandoned her, would advise her how to get help and would provide her help. Unfortunately, the legal right to an abortion was sought in my *9a case because others thought it was too hard for them to give me real help. The abortion was sought for them, not for me.
18. But no matter how hard life happens to be, no one has the right to kill a baby - especially the baby's mother. She is the trustee of her child's life. She, of all people, has the sacred duty to protect the child. But the child's interests are not at odds with her own. They are in concert with one another. The mother derives a great benefit from her relationship with her child. It is as beneficial to her as it is the child. It is never in the interest of a mother to terminate the life of her own child.
19. I have been forced to live with the consequence of this false compassion for too long for me not to bring to the attention of the Court the fact that abortion is not in a woman's interest, and the fact that legalization of abortion began with manipulations and misrepresentations. Too many women who lost their children through abortion have told me of their emptiness, their sadness, the void in their lives, and how others forced them to have abortions and then blamed the abortion on the mother.
20. The experience of Doe v. Bolton must be understood and accounted for, not simply to correct the record in my own case, but to correct the law of abortion in general: abortion is not in the interest of a mother. It is a false solution imposed upon a mother by others.
20. Doe v. Bolton and my circumstanced [sic] were misused. Doe v. Bolton was a fraud upon the court. Doe v. Bolton was a secret case about abortion, which is a secret procedure. This secretiveness *10a allows others to prevail upon the mother and others Can act against her interest. Women have told me how they were forced to have an abortion against their will. If it was alleged that I spoke for other women in Doe v. Bolton, then I gladly speak for other women in this case to say that abortion is too coercive by nature; too much the will of others; too much the will of a society which finds abortion more convenient for it than a commitment to the well being of the mother and the child.
22. The real experiences of the women must be known and taken into consideration by the court. Abortion is too much what others would like a woman to do, rather than what is in her interest and what she really wants.
23. Others told the court that I wanted an abortion. The law has developed, in part, based upon what my lawyer claimed I wanted, and that abortion was in my interest. I feel I have the duty to tell this Court the truth about what I really thought then, and what I think now. As the Plaintiff in Doe v. Bolton, I have a very substantial interest in the litigation before this court in the matter of Roe v. Wade and I can provide the court a unique perspective of the Doe v. Bolton case not available from any other source.
24. In the 1970s the people closest to me successfully manipulated my circumstances to justify abortion and wanted me to have an abortion, but I refused. Today this Court has the opportunity to review, not just the real facts surrounding the Roe v. Wade and Doe v. Bolton, the original abortion decisions, but the opportunity to review the testimony of hundreds of women who have real, *11a true, experiences with abortion and not perpetuate the Doe v. Bolton fraud upon the Court.
Further Affiant sayeth not.”
/s/ Sandra Cano
Sandra Cano a.k.a. Mary Doe of Doe v. Bolton
SWORN TO AND SUBSCRIBED BEFORE ME, the undersigned authority, on this 12th day of Aug., 2003.
/s/ Justin [Illegible]
NOTARY PUBLIC IN AND FOR THE STATE OF GEORGIA
My commission expires:
Notary Public, Fulton County, Georgia
My Commission Expiers Oct. 18, 2005
*1AA APPENDIX B
Relevant Portion of 178 Sworn Affidavits of Post Abortive Women of the approximately 2,000 on file with The Justice Foundation
AFFIDAVIT
***
The State of Tennessee
***
D.Q.
How has abortion affected you? It has completely messed up my life. It was not the best way to start out in marriage. I was depressed, didn't want my husband to touch me, felt guilty, had suicidal thoughts, cried a lot, terribly depressed!
***
AFFIDAVIT
***
The State of Tennessee
***
Myra J. Rasmussen
How has abortion affected you? Too many ways to write! - It ended, or attributed to my divorce from the father. I'm overly concerned and worried about my living children. I've had nightmares for years. I'm worried that I may develop breast cancer. The loss of relationship with *2aa my aborted child can never be replaced. I've had problems with eating disorders and depression. It took me 18 years to reconcile my relationship with God which had previously been very important to me. It forever altered my life.
AFFIDAVIT
***
The State of Florida
***
Donna M. Razin
How has abortion affected you? Deep regret - initially I was suicidal - as the years have progressed I have developed a heightened level of bitterness and anger and self-hate. I feared God, have not been able to attend church because of my fear of God, unforgiveness, shame, guilt, condemnation, inability to bond and fit in with other women, inability to be intimate. The deep emotional scars were a large contributing factor in my divorce - a very, very catastrophic choice! Great sense of loss and grief.
***
AFFIDAVIT
***
The State of Georgia
***
C.R.
HOW HAS ABORTION AFFECTED YOU? YES. I FEEL EMOTIONALLY SCARRED. YEARS WENT BY OF HIDING IT. THEN SOMETHING *3AA STARTED TRIGGERING FLASHBACKS. CHILDREN'S BIRTHDAYS BRING ON EXTREME SADNESS. CHRISTMAS TIME BRINGS ON TIMES OF DEPRESSION, REGRET, AND WONDERING WHAT WOULD MY CHILDREN HAVE BEEN LIKE. COULD THEY HAVE MADE A DIFFERENCE IN THE WORLD. WHY COULDN'T I HAVE GIVEN THEM A CHANCE AT LIFE LIKE MY MOTHER GAVE ME! NO ONE EVER SHOWED ME THE STAGES OF PREGNANCY. IF SOMEONE HAD, I WOULDN'T HAVE WENT THROUGH IT. IF I WOULD HAVE KNOWN THE EMOTIONAL EFFECTS THAT WAS YEARS LATER, I WOULD HAVE RECONSIDERED.
***
AFFIDAVIT
***
The State of Utah
***
Cathy L. Moffat
How has abortion affected you? Depression, low-self esteem, guilt, condemnation, and shame, sleepless nights, nightmares and torment, thoughts of self-hate and suicide, lost, confused, destroyed relationships throughout my life, unloved, unlovable, unable to trust God or anyone. Only God can heal this! Post-abortion ectopic pregnancy, fear of not being able to conceive and birth healthy babies, pain, unable to receive love and healing from God and others, worthlessness, strive and drive to perform to be loved and accepted, isolation - emotionally. Lost, confused, needy - shunned by others. I reach out to for help. In a state where I could not forgive myself. Psychologically damaged for the rest of your life (until God heals). I have regretted my choices the rest of my life. Grief, anxiety, regret, morbid *4aa obesity and health problems, scar tissue, blood clots. Damaged marriage. Abortion hurts women.
***
AFFIDAVIT
***
The State of Texas
***
J.L.M.
How has abortion affected you? 11 years later I am obviously still affected. Initially, I suffered from depression, alcohol use increased, increased promiscuity, due to my lowered self-esteem. My grades suffered in college. Relationships were difficult. I had nightmares, flashbacks, and grief. Now with a 6 year old son, I am overly protective to a fault. His relationship with his father is damaged because of my own fears of losing my son. I feel God could still punish me by taking this child away. It's mired my motivation and hindered my career (ironically since my reasoning in part to have an abortion was so my career wouldn't be hindered.) It has cut the soul out of my entire life.
***
AFFIDAVIT
***
The State of Arkansas
***
*5aa Dana Renee Nickles
How has abortion affected you? In the beginning I thought I was doing the right thing. Only afterwards did I realize the TRUTH! My conscience was seared, my heart was broken. I lived in a state of depression looking at drugs as the answer to my problem. And the problem - I had killed my child? See you don't realize what happens to yourself until it's too late, you've already done it and there's no turning back. I can't turn back time - if I could - I WOULDN'T HAVE AN ABORTION!! I was emotionally torn apart. I didn't know what happiness was, confusion, my best friend! I built a wall around myself with bricks of denial. Shutting EVERYONE out!! I hated myself. Thinking of suicide MANY, MANY times, I could not live with myself.
***
AFFIDAVIT
***
The State of Florida
***
S.O.
How has abortion affected you? For twenty-eight years, I have mourned, gone thru depression around Victoria's birthdate, became angry as the years passed. My sleep pattern changed. I'm up and down all night. I became promiscuous, in and out of relationships, choosing men beneath my standards to make myself feel better, though I love people, over the years I became more anti-social as I felt I wasn't good enough to be around others, I *6aa would start educational classes and never completed them. I felt like people were trying to get too close to my personal life …
***
AFFIDAVIT
***
The State of Georgia
***
Kristen Pettibone
How has abortion affected you? My abortion devastated me. I lost respect for my boyfriend, respect for myself. I became an alcoholic, dabbled in drugs to forget what I had done! I had relationships with men who disrespected me because I felt I didn't deserve better. I had nightmares, night sweats, and even now go through periods of depression and crying.
***
AFFIDAVIT
***
The State of Florida
***
Mary A. Hill-Griffith
How has abortion affected you? It devastated my life. Immediately after abortion 1-2 days after hemorrhaging to death requiring emergency D&C, mental health problems/nervous *7aa breakdown/psychosis/suicidal/low-serf esteem/difficulty parenting child. I did have alcoholism/faith damage/social damage changing my views of society as hate-filled cold, and uncaring/loss of my child's life/bitter heartbreak to not be able to undo the effects of abortion.
***
AFFIDAVIT
***
The State of Florida
***
Dana Nicole Landers
How has abortion affected you? For years my abortion decision led me down a self-destructive path even until the point of wanting to die. I went from an honor roll student in high school to a drug addict. I suffered from depression, anger, guilt, regret, and denial just to name a few. It was not until I admitted that the abortion was murder that I was actually able to begin the healing process. I had to be able to grief the loss of my unborn child in a society that had convinced me that he/she was just a piece of tissue.
***
AFFIDAVIT
***
The State of California
***
*8AA T.J.H.
How has abortion affected you? Lots of emotional difficulties - stress, anxiety, some depression, deep sense of loss and guilt/secrecy, some physical female problems, fear that I won't be able to conceive/carry a baby in the future/destroyed my relationship with the father.
***
AFFIDAVIT
***
The State of Florida
***
Caroline Burnett
How has abortion affected you? It took my innocence. Robbed me of self-worth. Really made me numb. Alcohol use. Suicidal thoughts. Depression, anxiety. Unbelievable guilt. Shut my emotions down. I thought it would be over after one day but fifteen years later, I'm still haunted by the memories and the tremendous guilt of, now when I understand, having robbed my children of life. I still feel like I'm going to vomit when certain thoughts surface.
***
AFFIDAVIT
***
The State of Georgia
***
*9aa Deborah R. Paine
How has abortion affected you? The abortions caused me to feel worthless, ashamed, angry, profound sadness. I was driven to perfectionism to try and make myself feel worthy of the air I breathed and space I occupied. I turned to 11 years of alcohol and drug addiction to cope with the regret. In my need to punish myself, I had a tubal ligation (sterilization). So I am childless. After killing my children, I did not deserve to be a mother.
***
AFFIDAVIT
***
The State of Illinois
***
Rhonda Kay Plumb
How has abortion affected you? I have been through a lot. It has been 9 years I have been grieving for my baby that they killed. I have had counseling. Have previously went through drinking and am on daily medications like Paxil and Xanax. Every day of my life I think of my baby. They were so cold at the clinic. When my parents found out, they called the clinic to see if I was there and said they were on their way. They put me in front of the line before everyone else so I could be done before my parents came.
***
*10AA AFFIDAVIT
***
The State of Wyoming
***
Tami T. Rohrbacher
How has abortion affected you? Suicidal - severe problems with reproductive organs, scarring, bleeding, infertility, depression, pain. Stripped my self-esteem - my rights and liberties have - I have never suffered so much pain before I suffer for the loss of my daughter but also for the loss of my dignity.
***
AFFIDAVIT
***
The State of Florida
***
Leslie Bowen
How has abortion affected you? My abortions have had a traumatic effect. Such as drug/alcohol use, nightmares, depression, suicidal thoughts/attempts, feelings of emptiness. Guilt, shame, self-destructive behaviors, sexual dysfunction, and physical complications.
***
*11AA AFFIDAVIT
***
The State of Georgia
***
Connie Ambrecht
How has abortion affected you? Guilt felt for years, unforgivable action.
***
AFFIDAVIT
***
The State of Georgia
***
Mary Catherine Coburn
How has abortion affected you? I felt like I spent the next two years of my life in a hole. I felt so much shame and guilt that it physically made me sick, especially since my boyfriend was the only other person that knew. I am a daughter of a pastor so I felt that I had to keep quiet. It took another year of my life to really begin to understand what I had done and grieve for my child's death. It was then that I really began to receive forgiveness from Jesus Christ. My abortion has changed my life. Not a day goes by that I do not think about my child.
***
*12AA AFFIDAVIT
***
The State of Florida
***
Janice L. Bartlett
How has abortion affected you? Devalued, dehumanized me. Took away my dignity and self-worth. Suffered from shame and guilt. Became depressed and even attempted suicide. Also led to use of alcohol, drugs, and sexual promiscuity.
***
AFFIDAVIT
***
The State of Georgia
***
Hemda Ben-Judah
How has abortion affected you? I have lived with guilt for many years. I am convinced I am forgiven. But pain comes daily. I have lied about it, kept it from some family members. Lied to myself that I had no pain that I was OK. And yet inside I was weeping for my child regretting, regretting what I had done. I have been an emotional rollercoaster, cried when I didn't know what I was crying for. Please when you read this know that there must be a change. We are still healing yet still I hurt. I am overly protective of my own children. And I dread the day I have to say to my little girls and boys that I killed their sibling.
*13aa ***
AFFIDAVIT
***
The State of Oklahoma
***
Becky Abell
How has abortion affected you? During the many years of denial of the abortion, I experienced horrendous bouts of anger, depression, panic attacks, thoughts of death (my death), fears. I was constantly at the doctor's office, trying to find a physical reason for my disordered life. I drank alcohol secretly. I avoided anything to do with babies. Five years after my abortion, I married and gave birth to my son. It was during that pregnancy I realized I had destroyed a life through abortion. My downward spiral began. I was an overprotective mother. I “overdid” everything - to compensate for what I had done.
***
AFFIDAVIT
***
The State of Florida
***
Muriel A. Ramos
How has abortion affected you? It made my life go into a downward spiral from emotional and spiritual pain to absolute symptoms of ill health. Almost a decade later, I *14aa gave birth and the physical problems were better. However, the reality of the abortion was exasperated. I was forever changed in an unhealthy way from that legal choice I made, however misinformed that I was.
***
AFFIDAVIT
***
The State of Arizona
***
C. L. R.
How has abortion affected you? My abortion immediately led to hopelessness, promiscuity, and drinking binges. I could not escape the pain and guilt. I've been through 19 years of intermittent counseling. I had trouble bonding with my baby after he was born. I've dealt with anxiety, depression, anger, and insomnia, and have been prescribed as many as ten different psychotropic medications.
***
AFFIDAVIT
***
The State of Georgia
***
*15aa Julie Thomas
How has abortion affected you? Spiritually, emotionally, physically and mentally. I could not forgive myself, consumed with guilt and shame. Don't deserve happiness. Depression on years on medication. Have depression related physical illness. Cannot have long-term relationships. Could not get close to God as I didn't feel worthy.
***
AFFIDAVIT
***
The State of Tennessee
***
S.T.
How has abortion affected you? Depression and flashbacks after the abortion. I had no self-worth. I turned to drugs and alcohol and relationships with no meaning. After I married and had a miscarriage, the guilt was horrible. I blamed myself for the miscarriage because I was a horrible mother to have had an abortion. Having the D&C after my miscarriage brought back horrible memories of the abortion.
***
AFFIDAVIT
***
The State of North Carolina
***
*16aa Teresa Renee Zell
How has abortion affected you? Depression, nightmares, hospitalizations, suicidal thoughts and actions, guilt, anger at myself and those who forced the abortion, fear, eating disorder, alcoholism, low-self esteem, anxiety, stress. I used to have thoughts of finding the father and killing him slowly and painfully and making him hurt like I hurt. If I thought I could win I would sue him for all the pain and mental suffering he has caused me!!! Abortion made my bi-polar disorder worse!
***
AFFIDAVIT
***
The State of Michigan
***
Mary Ellen York
How has abortion affected you? I was affected dramatically by my abortion. For years, I couldn't even look at a baby and when I heard the word “abortion” I would just cringe. I suffered depression and I didn't like myself very much. Feelings of guilt. I found it very hard to forgive myself. It took my life from me.
***
*17AA AFFIDAVIT
***
The State of Tennessee
***
E.A.W.
How has abortion affected you? The first one must not have affected me much as I went and had another two years later! After the second, I was sick (mentally and physically) for a long time. I remember extreme nervousness and anxiety with many psychosomatic “illnesses.” I was a miserable wreck. Drugs and promiscuity didn't help. So I left MA and went back to AZ. Basically, I just endured and lived with gritting my teeth all the time.
***
AFFIDAVIT
***
The State of Tennessee
***
Lorene Elaine Woods
How has abortion affected you? For three years I cried uncontrollably - weight loss, insomnia, panic attacks, fear of punishment from God and the worst was the uncontrollable jerking in my sleep. I still have that problem.
***
*18AA AFFIDAVIT
***
The State of California
***
J.S.W.
How has abortion affected you? A sense of loss of something precious. Guilt, shame, feelings of being a really horrible person.
***
AFFIDAVIT
***
The State of Texas
***
Carolyn Weedin
How has abortion affected you? My life is worthless to me. There is nothing in it. Shame, guilt, regret, is hard to live with. I am 50 years old now.
***
AFFIDAVIT
***
The State of Texas
***
*19aa Darla Weaver
How has abortion affected you? From 1983 until this year, 2002, I have suffered from post-abortion stress. I originally became out of control with alcohol, drugs and immoral relationships. Twice I tried to commit suicide! Later I withdrew and had trouble in all relationships being controlling and overly emotional. I have grieved silently, too ashamed to say I chose to kill my first child and too angry to love my own father any more. I can drive down the street and flashback to the abortion table.
***
AFFIDAVIT
***
The State of Colorado
***
B.J.W.
How has abortion affected you? Drug and alcohol abuse, broken relationships, attempted suicides, depression, physical and mental illness. Became a loner. Self-hatred, guilt and shame.
***
*20AA AFFIDAVIT
***
The State of Texas
***
H.T.
How has abortion affected you? Factor in several years of drug and alcohol abuse, development of bulimia. Experienced major clinical depression during and after birth of oldest living child after I learned how abortions were performed and more about fetal development. Years of nightmares, guilt, and regret.
***
AFFIDAVIT
***
The State of Texas
***
B.T.
How has abortion affected you? Shortly after the first abortion, I began to experience high levels of anxiety and depression which resulted in hospitalization. I numbed my negative emotions with lots of “partying” for many years after the hospitalization which led to another abortion. When I tried to give up the “party” lifestyle, the anxiety and depression were worse than ever. Years of struggle with negative emotions followed; guilt, shame, low self-esteem, anger/rage, anxiety, and depression to name a few.
***
*21AA AFFIDAVIT
***
The State of West Virginia
***
Jamie Renee Carte
How has abortion affected you? The shame of this sin, let's call it what it is, murder of my own child has had a lifelong effect. At first, anger that soon turned to rage overtook my life. I came against everyone. The secrets and hiding of it all lasted for years. When I am in the presence of babies or small children, I begin to feel uncomfortable.
***
AFFIDAVIT
***
The State of Oklahoma
***
Cynthia Carney
How has abortion affected you? Emotionally, physically, and psychologically. For 23 years, I went into crying spells, depression, suicidal thoughts. Emotionally it devastated me.
***
*22AA AFFIDAVIT
***
The State of California
***
Elizabeth Campbell
How has abortion affected you? I suffered from depression, migraine headaches, low-self-esteem. No self-worth. Was in an emotionally abusive relationship for 11 years until my divorce. I have a very difficult time trusting people and make very few friends. Overweight - thin - abortions. Overprotective parent to the point of smothering my children.
***
AFFIDAVIT
***
The State of Florida
***
Elvira T. Brand
***
HOW HAS YOUR ABORTION AFFECTED YOU? FOR YEARS I HAVE CARRIED TREMENDOUS GUILTY. IN THE FIRST INSTANCE I ENGAGED IN DANGEROUS ACTIVITIES AND DIDN'T CARE ABOUT MY FUTURE. AFTER THE SECOND, I FELT LIKE A WEAK, WORTHLESS INDIVIDUAL. I HAD NO ONE TO TALK TO ABOUT MY PAIN.
*23AA AFFIDAVIT
***
The State of Kentucky
***
Paula S. Botos
How has abortion affected you? My abortion led to a life of depression and anxiety. I really thought that I could forget about what I had done. I knew deep down that it was wrong but I turned to do things that I shouldn't have done. I hurt emotionally for 8 years. I felt worthless. I tried to cover my “lie” with drugs and turning to men.
***
AFFIDAVIT
***
The State of Minnesota
***
Kim Marie Blackowiak
How has abortion affected you? Yes, I was extremely sad, depressed, and suicidal after my abortion. After my abortion, I used drugs and alcohol frequently to numb the feelings.
***
*24AA AFFIDAVIT
***
The State of Florida
***
Loretta Bingham
How has abortion affected you? Even though I knew what I was doing, I suffered terrible grief and sadness afterwards. After the second one, I was called back into the clinic because they thought they hadn't gotten all the baby out of me. In my mind, I kept seeing an infant with its arms and legs pulled off. Twenty years later - it still hurts!
***
AFFIDAVIT
***
The State of Texas
***
Pamela Berry
How has abortion affected you? I immediately got involved with drugs and alcohol. I had nightmares of babies crying. I was extremely promiscuous and yet hated sex. After I got married, miscarried and it sent me into a deep depression feeling God was punishing me. I tried to commit suicide by an overdose of pain medication but God intervened.
***
*25AA AFFIDAVIT
***
The State of Arkansas
***
Brandie M. Atwood
How has abortion affected you? Abortion turned a 14-year-old school girl into a suicidal teenager that lived with feelings of guilt, rejection, and helplessness. When I got married and became pregnant, I cried constantly over the baby I killed. I was an emotional wreck throughout that pregnancy. Everyday that I was pregnant I kept thinking of the baby I aborted; how old would it be, was it a boy or girl? The abortion I had in 1987 affected me negatively and came out (or manifested itself) as lots of bad decisions throughout my teenage years.
***
AFFIDAVIT
***
The State of Kansas
***
Melody A. Athey
How has abortion affected you? I repressed any memory of the experience for 25 years. My whole lifestyle changed after my abortion. I started drinking heavily and married an alcoholic. Shortly after, I tried suicide once and considered it several times. I had repeated periods of depression especially around the anniversary date of my abortion. The guilt I felt was overwhelming.
*26aa ***
AFFIDAVIT
***
The State of Tennessee
***
Paulette C. Heller
How has abortion affected you? I have fought self-hate, suicide, depression and sickness. At 40, I had to have a total hysterectomy. The man who was the father of the baby agreed for the abortion. We eventually got married. But after a stormy six years and three children later, we divorced. We had all girls and he is plagued the with guilt of killing his possible only son. We have tried to forgive each other.
***
AFFIDAVIT
***
The State of Texas
***
J.M.H.
How has abortion affected you? Depression, shame, guilt, emptiness, anger, longing, horror. All of which has rendered me useless at times. Uncontrollable weeping and insomnia.
***
*27AA AFFIDAVIT
***
The State of California
***
Lisa Hartman
How has your abortion affected you? I had post-abortion trauma. I had night terrors, murderous thoughts, suicidal thoughts, depression, severe anxiety, fear that lasted 10 years. It handicapped my life. It nearly destroyed my life. I was in the fetal position for approximately six months immediately following the abortion. It was as if they took part of my soul.
***
AFFIDAVIT
***
The State of Mississippi
***
Lori Harrington
How has abortion affected you? I was pregnant again within three months (same father). We were married - had our beautiful Karl. I became a Christian, 19 months after Kati, we had Mary Kelly and it began to make me crazy. I didn't understand myself and had a terrible rage toward my husband who never let me talk about the abortion. I had an affair with another man then plummeted into a deep, deep depression, despair.
***
*28AA AFFIDAVIT
***
The State of Colorado
***
Diane M. Hanson
How has abortion affected you? It changed my life, how I viewed myself, it took away my self-worth. It was devastating and caused several years of intense pain and sorrow. The hardest part was knowing “it was my choice” that caused my baby's death and I couldn't do anything to change that or make it better!
***
AFFIDAVIT
***
The State of California
***
Kathleen Vaunae Hansel
How has abortion affected you? Resulted in depression, insomnia, nightmares, inability to make decisions regarding our two living children. It almost destroyed our marriage. I experienced extreme anger toward my spouse, myself, and my mother who had exerted a great amount of guilt on me. She felt I should abort as not to place an undue amount of stress on my husband.
***
*29AA AFFIDAVIT
***
The State of California
***
Deanna Hall
How has abortion affected you? When I woke up in recovery, I immediately knew the horror of what I had done. I knew I stood alone before God and the guilt was overwhelming. There was grief, sorrow and years before I could accept God's forgiveness because I couldn't forgive myself. I am a murderer and no one accused me of it, except myself and my sin. I will carry the sorrow the rest of my life.
***
AFFIDAVIT
***
The State of Tennessee
***
M.J.H.
How has abortion affected you? I had ten years of depression, anxiety, and panic attacks that I had trouble understanding. I did not understand what was causing me to be literally ill. I eventually learned of post-abortion syndrome. I was apprehensive at first but agreed to see a counselor. Through this process, I discovered that I was so full of guilt, shame, regret, unforgiveness, and sadness *30aa that I was unable to cope with day-to-day life. Those ten years of my life were spent in anguish due to a decision that I had made based upon misinformation and untruths.
***
AFFIDAVIT
***
The State of Texas
***
Karen Sue Green
How has abortion affected you? Until healing began, I had over 25 years of nightmares, flashbacks, anxiety, guilt, regret, grief.
***
AFFIDAVIT
***
The State of Ohio
***
Nancy M. Haberling
How has abortion affected you? It has given me low self-esteem, emotional problems and recently I divorced my husband because he made the statement that he did not know how I got away with murder after all these years. I have no self-respect for myself. I also don't trust men. I suffer from depression.
***
*31AA AFFIDAVIT
***
The State of Minnesota
***
Beverly A. Green
How has abortion affected you? I went into a black tunnel for years. Started using drugs, drinking, more promiscuity, very insecure, hated myself - the list goes on ….
***
AFFIDAVIT
***
The State of Oklahoma
***
Jackie Lynn Garner
How has abortion affected you? For many years, I tried to put it out of my mind to the point I still can't remember the date or clinic name. What I have never forgotten is the shame, anger, and sadness that gripped my life because of my abortion. I could not have healthy relationships with men, and to this day my sexual relationship with my husband suffers. I will always regret falling for the mistaken social belief that abortion was a quick and painless resolution to my unplanned pregnancy. Every time I fill out a new patient form at a doctor's office, I am reminded that I killed my child.
*32aa ***
AFFIDAVIT
***
The State of California
***
K.G.
How has abortion affected you? It was almost nine years ago and there is not a day that goes by that I don't think about it. About a month after I started having severe panic attacks because I felt like something bad would happen to me because I did something horrible. With the birth of each of my three children, I suffer from extreme guilt and sadness about the baby that I didn't give a chance at life.
***
AFFIDAVIT
***
The State of Maryland
***
O.F.
How has abortion affected you? It destroyed my life, my baby's and my husband's. We are the walking wounded … forever. We will NEVER be able to recover. Ever. My husband became suicidal as I did. We will always blame each other and never be guilt free.
***
*33AA AFFIDAVIT
***
The State of Ohio
***
Angela Eckstein
How has abortion affected you? There isn't near enough room here to adequately explain it. I felt alone, afraid, in trouble (punished), after a few years and having never discussed it, I dealt with a lot of depression, failed relationships (even with my own children).
***
AFFIDAVIT
***
The State of South Carolina
***
Mary J. Duncan
HOW HAS ABORTION AFFECTED YOU? EVEN AFTER 19 YEARS, I STILL CRY TEARS OF GRIEF OVER THE DEATH OF MY SON THROUGH A THERAPEUTIC ABORTION. I DID TELL GOD AT THE TIME THAT HE COULD TAKE ME HOME AS WELL IF HE WOULD. IT TOOK ME FIFTEEN YEARS FOR ME TO HAVE A MEMORIAL SERVICE FOR MICHAEL ELWOOD DUNCAN.
***
*34AA AFFIDAVIT
***
The State of Virginia
***
Deborah L. Dowless
How has abortion affected you? I did have a severe nervous breakdown.
***
AFFIDAVIT
***
The State of Pennsylvania
***
T.D.
How has abortion affected you? Every day of my life, I think about who my children would be today. Also, I have been drinking alcohol nearly every day of my life since the abortions. I have kept this dark secret to myself. I feel so much shame and I hate myself. If my parents were informed, their two grandchildren would be alive right now. P.S. My twelve year old daughter has just read this form and I am wanting to die. Right now.
***
*35AA AFFIDAVIT
***
The State of California
***
Darlene Crumbo
How has abortion affected you? It's been a deep, dark secret for 20 years. The unforgivable sin. I turned to drugs and alcohol for 10 years. I had low self-esteem because I couldn't forgive myself. I've had a weight problem for 20 years. I'm very protective of my only child because I lost one. I don't want to lose another. It hurts so bad to think of the child I could have had. To think of the baby that was sucked out of me like a vacuum cleaner.
***
AFFIDAVIT
***
The State of Michigan
***
Lori Crossman
How has abortion affected you? It devastated me emotionally, mentally, and spiritually. I cannot go back and reverse my “choices” - I cannot get my children back. They are dead because abortion was legal and easy to access.
***
*36AA AFFIDAVIT
***
The State of North Carolina
***
Tammy Craven
How has abortion affected you? It's been over 10 years since my baby's due date and not a day goes by that I don't think of him. For a long time, I was bitter and angry towards everyone in my life. I blocked out a lot of what really happened until about the last year and a half.
***
AFFIDAVIT
***
The State of Alabama
***
R.A.C.
How has abortion affected you? Severe depression, crying. I don't want to be around babies because I am ashamed of what I did.
***
AFFIDAVIT
***
The State of Michigan
***
*37aa Margaret Conway
How has abortion affected you? Shortly afterward I experienced months of the deepest darkest depression you can imagine. Something I have never experienced before or since. Then I had horrible confusion and thoughts of suicide. It was the worst time of my life. I still feel unforgivable.
***
AFFIDAVIT
***
The State of California
***
Pamela T. Colip
How has abortion affected you? I tried to hurt myself afterward. I will never forget the physical pain during the abortion (even though they gave me something to knock) me out and the emotional scars afterward, and guilt, have haunted me always. I regret with all my heart having killed my child.
***
AFFIDAVIT
***
The State of Kansas
***
*38AA D.M.
How has abortion affected you? I knew immediately afterward that I had done something terrible and irreversible. I've suffered guilt and shame. In the immediate years following, I went through eating disorders, destructive relationships, anxiety problems. I feel it caused me to have problems bonding with my first baby and feeling natural maternal feelings.
***
AFFIDAVIT
***
The State of New Mexico
***
April Micra
How has abortion affected you? Two weeks after the abortion, my emotions went crazy. I started having dreams about the baby calling me mom. I felt like a loser because I took my baby's life. I wanted to die, because I felt like why should I be alive if I took an innocent life that didn't ask to be born or killed. My uterus has never been the same after the abortion.
***
AFFIDAVIT
***
The State of Montana
***
*39aa Roxanne Mergenthaler
How has abortion affected you? I became psychologically numbed after my first abortion. I was suicidal to begin with then blocked it out and ending up blocking out all of my emotions. I suffer from post-abortion syndrome still, the only healing has been through a bible study, and that has helped. I have two atonement children (not consciously); I've had a hard time bonding with my first child because I got pregnant with her only two months after my abortion.
***
AFFIDAVIT
***
The State of Connecticut
***
Amy Lynn Meole
How has abortion affected you? The moment it was over, I started a downward spiral into depression. I cried constantly. I felt ashamed and so guilty. I knew I had just killed a life. Eventually my attitude toward sin became “I just don't care” because how could I do anything worse than this. My life suffered more consequences just because of that fact as well as the life of my husband.
***
***
*40aa The State of Wisconsin
***
Patricia A. Meixelsperger
How has abortion affected you? Almost did not finish college - drank - stopped classes - .65 grade average the next semester in school. Rebounded into very bad relationships and bad bad marriage. Physical, emotional toll was bad for 12 years. Before I began to understand, I was in total denial and it was destroying me.
***
AFFIDAVIT
***
The State of Arkansas
***
S. B. M.
How has abortion affected you? It is with me EVERYDAY - almost 20 years later! For years, I was in denial, but I was bound by shame and guilt. It is the unspeakable deed and harms a woman deep to her core - As a woman, nurturer, child of God … it distorts the image of my life.
***
AFFIDAVIT
***
The State of Texas
***
*41aa Vanessa McDonald
How has abortion affected you? When I aborted my child 6 years ago, I wish I had known how much misery I would live in because of it. I killed my own baby - I should have been the one person in the whole world to protect and love her. I think about her every day and wish I had chosen to have her and know this precious baby. I am now overprotective of my 1-year-old little girl. I overcompensate because of my loss.
***
AFFIDAVIT
***
The State of Louisiana
***
J. M. M.
How has abortion affected you? It caused me to be very shameful and emotional damage. I felt like a sneak, a cheater, a deceiver, and a lying tramp.
***
AFFIDAVIT
***
The State of Michigan
***
*42aa Debra Mays
How has abortion affected you? Initially I was numb and remained in shock from October 1985 until 1989 and I did anything to feel again. I was fighting with my friends more and lost many of them. I became more sexually active - anything to feel again. Then when the hurt surfaced, I drank alcohol - anything to cover the pain. Currently, I have gone through a grieving and healing process and there is still not a day that goes by that I don't regret my decision. It is the deepest loss a woman can ever know.
***
AFFIDAVIT
***
The State of Arkansas
***
Sandra Mauldin
How has abortion affected you? It has shattered my life beyond what I could ever sufficiently put into words. After the abortion, I became an alcoholic and ended up in the psychiatric ward of a mental hospital. I lived a promiscuous lifestyle and did not care if I lived or died. My life changed when God spared me from dying from a drug and alcohol overdose. Since then I have been living as a born-again Christian. Even so, I still suffered from what I later found out was post-abortion stress syndrome. The only reason I have chose to live and fight through this is the hope that God will use me to expose the atrocity of abortion and *43aa prevent another person from choosing the awful “choice” of abortion.
***
AFFIDAVIT
***
The State of New York
***
G.M.
How has abortion affected you? I feel guilty and empty after all the years. I am still sorry I had it done. I am depressed most of the time.
***
AFFIDAVIT
***
The State of Ohio
***
Dana Mann
How has abortion affected you? It was awful for a very long time. The guilt, anger, and emptiness were almost unspeakable. Many times, I wanted to commit suicide.
***
*44AA AFFIDAVIT
***
The State of Idaho
***
N.A.M.
How has abortion affected you? Terribly. I had brief psychotic episodes the first couple of days. Every time I turned the light off at night, I immediately saw the abortion doctor coming at me with utensils to kill me. When I turned on the light, he disappeared. This was not a dream, but something that my mind made real to my eyes. I slept with the light on for 2 weeks. I was emotionally numb, unable to feel or cry. Later, I began having dreams that I had murdered someone and was exceedingly fearful of discovery. Guilt and grief weighed heavily upon me as I later regretted my decision. I rarely look at a child that I don't painfully remember the brutal way that mine died.
****
AFFIDAVIT
***
The State of Virginia
***
S. M. L.
How has abortion affected you? My abortion has affected every day of my life since that time. It, the actual period of time when I was pregnant and the abortion and recovery, is a blur in my mind. In order to fill this affidavit out I come to realize how much of it I have blocked in *45aa order to survive. I have such a sense of loss and shame, even though God has forgiven me for this and all of my other sins. I suffer from endometriosis, which I believe is a direct physical result of my abortion. I grieve for my other child who never had a chance to live.
***
AFFIDAVIT
***
The State of Tennessee
***
Deborah Langford
How has abortion affected you? Mentally I feel like a murderer. I have been so unhappy and went through four marriages. Back to my first husband.
***
AFFIDAVIT
***
The State of Oklahoma
***
V.L.
How has abortion affected you? I spent years in a depression unable to cope well with everyday life. It has hindered my bonding with my children. I lost all desire to do anything productive. I could not concentrate on school, eventually I flunked out. I became suicidal because of the guilt. I could not be around babies.
*46aa ***
AFFIDAVIT
***
The State of California
***
Rose Lewis
Haw has abortion affected you? I've lost memory of timing of them. The two events are difficult to differentiate. I always want another child. I suffer returning bouts of depression. There is always an unexplained emptiness in me. I struggled with addictive behavior. I feel emptiness and often worthlessness and often anger that I don't know what to do with. I expect too much from others. Feel victimized. Was very promiscuous and drank often. Lowered self-worth. Question my existence - part of me feels numb, dead.
***
AFFIDAVIT
***
The State of Montana
***
Jana M. Lewis
How has abortion affected you? I have suffered a great loss and experienced huge regrets - my husband has also, though we don't discuss it; I have times of flashbacks and depression and panic. We have two beautiful kids and *47aa I look at them and think what might have been - would that baby have looked like “her” siblings, etc.? Tall, red-head?
***
AFFIDAVIT
***
The State of Oklahoma
***
S.A.L.
How has abortion affected you? The next day after, I went into a deep, dark, depression for over a year. I cried almost every day and for some time I turned to alcohol to ease the pain of the horrible guilt I felt. My life before then had been normal and mostly happy. I had almost made straight “A's” and was an honor society student. I was not prone to drinking alcohol or anything similar in high school. I had the abortion because I was afraid and insecure. It was the worst choice I ever made in my entire life. I deeply regret it.
***
AFFIDAVIT
***
The State of California
***
*48AA C.L.
How has abortion affected you? I was severely depressed, clinically suicidal immediately after and for periods over past 3 years. I have lived with regret and remorse every day of my life. I attempted to become pregnant with help of fertility drugs, etc., for over one and a half years, and cannot. It may be because of abortion. I am HAUNTED by the fact that it was temporary insanity that led me to that clinic and had they made me wait one day because of my emotional state, I'd be a mom.
***
AFFIDAVIT
***
The State of Louisiana
***
D.L.
How has abortion affected you? Deep emotional pain and suffering spiritual death. Affected many choices later made in life. Incredible guilt and sorrow.
***
*49AA AFFIDAVIT
***
The State of Kentucky
***
Carolyn Knapschaefer
How has abortion affected you? I nearly died after the abortion. My parents took me to a nearby hospital. By God's grace, I survived. Over time, I became very depressed and suicidal. Several relationships were destroyed. Two years after the abortion, I had a menstrual extraction - another name for an abortion. I rushed into that decision out of fear of the severe sickness I had with my first pregnancy. I nearly had a third abortion with my 13 yr. old daughter.
***
AFFIDAVIT
***
The State of California
***
Marene M. Kissinger
How has abortion affected you? The time spans almost 20 years. There was much drug abuse, promiscuity, and self-hatred. My last abortion in 1991, the reality of what I had done so many times hit me and almost killed me. The emotional and spiritual death I felt almost killed me physically. During my pregnancy with my son in 1992, it was a deadly struggle to deal with the pregnancy. Although participating in counseling I still feel a certain *50aa level of shame, I don't think that will ever go completely away. I will never forget the sound.
***
AFFIDAVIT
***
The State of Tennessee
***
M. M. K.
How has abortion affected you? Has caused tremendous guilt, shame, emotional trauma, when I realized what I had done. I have suffered from depression, bouts of crying, anger, great sorrow and grief. For a number of years, I suffered from “Anniversary Syndrome,” a type of depression around the time of conception, the date of the abortion and what would have been the estimated due date. I have also suffered from grief around Mother's Day. I have had low self-esteem. I “ran” from myself and from God for a number of years before I began to deal with this. It has affected my ability to relate well with others. It has interfered with intimacy with my husband. The depression, anger and emotional instability resulting from the abortion affected my ability to function properly on the job and almost caused me to lose a job. My first child, after the abortion, was breech presentation due, I believe, to the fact that there had been death (murder) in my womb. He was delivered by C-Section, which involves its own complications. I had difficulty forgiving myself and others who had any involvement with my decision to abort.
***
*51AA AFFIDAVIT
***
The State of Texas
***
Gale Denise Jones
How has abortion affected you? There isn't a day that goes by that I don't think about it. I look at my children now (2) and wonder what the other three would have been like. Sometimes I have crying spells where I cannot be consoled and once it passes I feel better, but the ache in my heart still remains. I have asked God to forgive me and I know He has but I can't forgive myself. I am easily motivated by guilt because of the way I feel about what I have done. I have had trouble with my uterus and have painful and long periods. I don't know if the abortions contributed to this but I can't imagine that they helped.
***
AFFIDAVIT
***
The State of Florida
***
Donna A. Jones
How has abortion affected you? Has affected many relationships with people in my life, both women and men. Suppressed emotions, did not allow myself to grieve over grandmothers death, could not feel or allow myself to cry. *52aa Deeply affected my marriage and intimacy with my husband. Used alcohol for many years to “numb.”
***
AFFIDAVIT
***
The State of Texas
***
Kyra L. Janke
How has abortion affected you? Oh - so much has happened - drugs - multiple husbands; boyfriends, low self esteem - STD's, and the real clincher - I haven't had anymore children.
***
AFFIDAVIT
***
The State of Mississippi
***
Melinda L. James
How has abortion affected you? I have been afflicted by calamity, grief, and sorrow. My nerves were wracked, my heart broken. My baby cannot grieve or feel sorrow. It is dead. The first time I felt it move was the last time I felt it move. Anti-abortion demonstrators chanted outside the clinic, screaming “don't kill your baby” throughout the whole hellish time. I felt I was trapped in a nightmare. It *53aa recurs. Please don't let this happen to any more humans. It is so wrong. It is so painful.
***
AFFIDAVIT
***
The State of Michigan
***
L. M. J.
How has abortion affected you? I have carried this “secret sin” for 18 years. I take full responsibility for my poor decision regarding abortion. Had I known when I finally ‘grew up’ that I would be so psychologically damaged and suffered from so much pain and grief, I would have never gone through it. I grieve for my children still.
***
AFFIDAVIT
***
The State of Texas
***
E. K. J.
How has abortion affected you? For many years, I struggled with tremendous guilt and depression over what I had done. I had realized that I had killed my child. As I went through 5 years of infertility before having my daughter, I wondered if perhaps something had happened during *54aa my abortion which would not allow me to ever have children. The day of the abortion stands out as the loneliest, most grief-filled day I have ever known.
***
AFFIDAVIT
***
The State of Pennsylvania
***
Nancy C. Sweitzer
How has abortion affected you? I have had trouble conceiving a child now. I am 40 now and I have no children. Because of a first trimester abortion, I experienced physical pain when the doctor dilated me and scraped me. Directly after the abortion, I experienced emotional pain, depression. I had no desire to do anything by regress back into a child, quit college, and stayed at home with morn and dad. I was a shell of a person.
***
AFFIDAVIT
***
The State of Missouri
***
A.A.S.
How has abortion affected you? I was emotionally distraught for a very long period after the abortion. I was *55aa extremely depressed. I had severe pain and bleeding for one week afterward. When I called the emergency number, they told me not to call back. I have had several surgeries in the past 15 years for endometriosis. I have had to hide my secret from loved ones. For a long time, I could not be in the presence of children or women who were pregnant.
***
AFFIDAVIT
***
The State of Virginia
***
P.S.
How has abortion affected you? It has taken away my life. I think of my children often and suffer post-traumatic stress disorder.
***
AFFIDAVIT
***
The State of Georgia
***
Brenda Hilliard Stockdale
How has abortion affected you? When I realized that I had allowed my child to die, I had tremendous grief, guilt, despair, and sorrow. I was over possessive of the children *56aa God allowed me to have after I got married. It changed my life forever.
***
AFFIDAVIT
***
The State of Texas
***
Lori A. Stirrup
How has abortion affected you? It has affected every relationship, every emotion, every idea. There isn't a day that goes by that I don't think of my children. Suicidal thoughts for a few years afterwards, an inability, an unwillingness to have a successful life. I did many things to medicate my pain, which led to a snowball effect of trying to medicate my pain. It built in me a deep distrust for everyone.
***
AFFIDAVIT
***
The State of California
***
Debra J. Storm
How has abortion affected you? I was left with psychological and physical scars and problems. I was suicidal. My *57aa marriage fell apart and we divorced. I had trouble forming normal bonding relationships. I began drinking and I was promiscuous. It left me unable to become pregnant.
***
AFFIDAVIT
***
The State of Ohio
***
M.H.S.
How has abortion affected you? I have been in depression and was depressed because of the abortions for years. With the Lord's help, I am working out the depression but I have relapses.
***
AFFIDAVIT
***
The State of New York
***
Judy Sullivan
How has abortion affected you? After I had my abortion, I experienced depression and shame that didn't go away as time passed. I didn't like myself and I couldn't love my family, as I should have. In fact, my relationships with everyone suffered. Ten years after I had my abortion, *58aa I took a post-abortion bible study, which helped me come to terms with what I had done.
***
AFFIDAVIT
***
The State of Wisconsin
***
Tracy A. Stalsberg
How has abortion affected you? The greatest way it affects me is in the overwhelming regret I feel and must live with for the rest of my life. In addition, I have suffered other emotional difficulties that I definitely contribute to my abortion experience. One area has been trying to deal with intense anger issues that come from feeling that I was incredibly deceived by the abortion industry. My life was changed forever, in a most horrible way, that day 15 years ago when I killed my own child and I can never take it back.
***
AFFIDAVIT
***
The State of Mississippi
***
*59aa Natalie Ann South
How has abortion affected you? At first, I cried all the time, felt lost and lonely like a part of me was ripped out. I wondered what he/she looked like, the color of eyes, how many fingers or toes, what color hair. I was devastated for years.
***
AFFIDAVIT
***
The State of Florida
***
N.M.
How has abortion affected you? I had many nightmares; emotional problems; guilt. It led to drinking and doing drugs as a result of these awful feelings.
***
AFFIDAVIT
***
The State of North Carolina
***
C.M.S.
How has abortion affected you? I feel guilty every day. I have to put it out of my mind to keep from being depressed. I feel guilt and regret always.
*60aa ***
AFFIDAVIT
***
The State of Washington
***
L.M.S.
How has abortion affected you? Guilt. Shame. Years (16 at least) of repeated bouts with serious, suicidal depression. After having married in 1989, became pregnant with our first child. We were ecstatic! Troubles developed. At 7 weeks, we were reassured by sonogram that baby was OK. I watched its little heart beat. At 8 weeks (May 1990), I miscarried our precious baby. Held in my hands and wept over our tiny fully formed baby and the lie I had believed - “blob of cells” - “not human” - in 1974. I knew myself to be a murderer, capable of the most heinous crime against the most innocent of humanity.
***
AFFIDAVIT
***
The State of Louisiana
***
Marie Skurka
How has abortion affected you? The abortion took place in 1985. I was able to suppress my feelings for about 11 years, but battled on and off with depression and struggled *61aa with low self-esteem. By 1996, I was drinking heavily and taking prescription diet pills in excess and I had reached the point of despair. I almost lost my mind. It frightened me to look in the mirror.
***
AFFIDAVIT
***
The State of Ohio
***
Amy Susan Shatrick
How has abortion affected you? Guilt. Guilt. Guilt. I always think of it on the anniversary. My baby would be 13 this August. I think of that every year. Unbelievable sadness. I drank heavily, suffered nightmares, bad relationships, shame. Cervical cancer, irregular pap smears. I can't believe I killed my first baby! No one wants to discuss it. It's my secret. I never hear about what abortion actually did to the fetus or mother. It's a lie that it is a good thing. It is a death sentence for baby and very possibly the mother physically, mentally, and spiritually.
***
*62AA AFFIDAVIT
***
The State of California
***
Sebrina Seay
How has abortion affected you? It changed my life; it has always made me ashamed that I could have participated in such an evil thing even if it wasn't my choice. I still went through it. I am 35 years old but I remember it being so fresh and it hurts. I have experienced a great loss and I'm still childless, but I believe God for my miracle even now.
***
AFFIDAVIT
***
The State of California
***
Gayle Schroeder
How has abortion affected you? I have never recovered and never will. I know God has forgiven me but I can't forgive myself. I feel dirty and unworthy. Not a day goes by that I see a child and wonder what ours would have been like. If Planned Parenthood would have told me there was other help or alternatives but never said anything. I still remember the sound of the vacuum at the abortion, but through it all, I want to turn something so terrible into something positive. I want to help others not to make the same mistake and overturn Roe v. Wade.
*63aa ***
AFFIDAVIT
***
The State of California
***
Karyn Schneider.
How has abortion affected you? It has been nine years since the abortion and honestly not one day has gone by when I haven't thought about what I did. I've suffered from depression, crying constantly, extreme agony, wishing I could have those moments back so that I could choose life - to choose my child over my selfishness. Absolutely no good has come of the choice I made killing my first child, struggling with fertility issues, longing for the one I had but then let go.
***
AFFIDAVIT
***
The State of Missouri
***
Rose A. Sarcione
How has abortion affected you? I was only 13 and in a training school for girls. Given to the system by a mother who did not want me. I knew from the pain it was not a pap, I hemorrhaged all night and was denied even an aspirin. I've had health, congenital problems since I was *64aa 18 so my child-bearing years were my early teens. I became a doormat after the abortion in all areas of my life. If so much could be taken from me without my permission. I've never had much fight in me. I felt like I deserved so little. Abusive relationships have been my life story. A haunting guilt has been my dark cloud.
***
AFFIDAVIT
***
The State of Michigan
***
Sara Sarginson
How has abortion affected you? It has ripped my whole life apart. I am no longer the happy person I once was. I really wish I was told of all the depression that has stricken my once happy joyous life. Every year around July and actually every day, I say good morning, I miss you; I love you to my child, Zacary. I wish this was never able to myself or anyone else for that matter. It has killed my child and me!
***
AFFIDAVIT
***
The State of Michigan
***
*65aa Tammy Joe Rutthofsky
How has abortion affected you? Physically - the pregnancy after my abortion was miscarried. Mentally - a lot of guilt and shame, anger, remorse. I was at a point of suicide from what I had done. After I was married and had my first son, I became abusive to him not feeling I deserved him since I killed my first child. Affected my marriage and my sexual abilities.
***
AFFIDAVIT
***
The State of Texas
***
K.R.
How has abortion affected you? When I had my abortion, I was 15 years old. To me at the time a fetus wasn't considered a child. Yet, at least that was the impression I was given. A few years later when I became a Christian I was old enough to realize that it was a real child that I had killed. It upset me very much. I cried a lot over it. I had a 2 year old son at the time so I knew what it meant to have and love a child. I knew God forgave me but it took a little while to forgive myself.
***
*66AA AFFIDAVIT
***
The State of West Virginia
***
Rosa Maria Rosas
How has abortion affected you? Total devastation, total sorrow, total shame total, regrets. I can't believe I actually had not one but two abortions. It is what I regret the most in my life. It is the worst thing I have ever done and there is no way to make retribution. I resigned myself to not being “worthy” of ever having children. When I again got pregnant in 1984, I couldn't enjoy my pregnancy and lived in guilt and fear of problems because I felt unworthy to have a child. I had toxemia and high blood pressure during pregnancy. I was stressed.
***
AFFIDAVIT
***
The State of Oregon
***
Esther Monica Ripplinger
How has abortion affected you? Frequent nightmares, overly protective of my son. I feared he might die. Unable to relax (even on vacation), depressed; I was prescribed medication. Substance abuse to numb emotional pain, thoughts of suicide. Unable to feel or cry, denial, loss of creativity, disrupted relationships and problems with making friends, racing thoughts, and preoccupation; *67aa inability to concentrate, distrust of decisions (mine). Disrupted intimacy. Increased anxiety during anniversary of abortion. Fear of vacuum cleaner.
***
AFFIDAVIT
***
The State of West Virginia
***
Kathy S. Rice
How has abortion affected you? Guilt. I had murdered an innocent little baby, I often wonder what he/she would be like today. I became pregnant from a date rape and did not want the baby at that time. But abortion was a big mistake, a wrong decision. I am sorry I chose abortion. I cannot forgive myself.
***
AFFIDAVIT
***
The State of California
***
Dorothy Rice
How has abortion affected you? I went into severe depression, with massive increase in drug and alcohol use and “casual” sexual activity. I have a very difficult time “connecting” with people; especially long-term. Difficulty *68aa with emotions - desensitized/super-sensitized. Caused a weakening in the ligament attaching my uterus and holding it up.
***
AFFIDAVIT
***
The State of California
***
D.R.
How has abortion affected you? I experienced great emotional, psychological, and physical and spiritual pain. Emotional pain of not rocking them in my arms, hearing their cries and laughter. I will never know if they looked like me or see my grandchildren or great grandchildren. I've cried many tears for many years. 15-20 years. That area as a mother has become incomplete. My last pregnancy ended in a 1988 miscarriage. I have been told by doctors that I have scar tissue. I have not been able to conceive a child since the miscarriage. I walked with unforgiveness for many years.
***
AFFIDAVIT
***
The State of Tennessee
***
*69AA T.R.
How has abortion affected you? After the abortion, I felt unworthy, sad, broken for many years I was self-destructive. No standards in my life. Drank, drugs, men, etc. I never forgot. I never told anyone until years later. It still affects me 19 years later. I am crying right now - and I remember that day so clearly. The date is stuck in my head forever.
***
AFFIDAVIT
***
The State of Oregon
***
Janice K. Rathkey
How has abortion affected you? I became numb over the years and engaged in all kinds of promiscuous behavior. I drank and did different kinds of drugs.
***
AFFIDAVIT
***
The State of Texas
***
Lynn F. Rasberry
How has abortion affected you? I now realize that this was sin and have gone to the Lord to ask for forgiveness. *70aa Unfortunately, 20 years has passed and I have not had another child. That one pregnancy was my only chance to bare children. This has caused me much agony and personal pain. I have had to deal with anger and relationship problems and was divorced after the abortion. I have not remarried and feel this also due to my abortion. I have had to deal with issues regarding my worth as a woman since I am not married and have no children. If I would have known the risks and complications from abortion both physical, emotional, and spiritual I would not have had an abortion.
***
AFFIDAVIT
***
The State of Arkansas
***
Angie Ramsey
How has abortion affected you? I became a drug addict, alcoholic, had eating disorders, guilt, anger, relationship problems, unforgiveness towards myself and my mother. Shame, nightmares, depression, a lot of confusion about why I felt the way I did. Also after second abortion, got tubal infection and was at E.R. within days after the abortion - very painful.
***
*71AA AFFIDAVIT
***
The State of Florida
***
K.G.R.
How has abortion affected you? Abortion has affected me emotionally, spiritually, and mentally. I became terribly depressed. I had suicidal thoughts because I knew and felt that since I killed my unborn child, why should I then have the privilege to live. To my knowledge, I haven't had any physical problems.
***
AFFIDAVIT
***
The State of Oklahoma
***
Regina Pulliam
How has abortion affected you? I have been having depressed feelings and guilt and I think about it often. I'm still scared and confused. And I think about it and say to myself how I wished I had never done it. I'm guilty of it and I wish it never happened. I say it and think over and over.
***
*72AA AFFIDAVIT
***
The State of Georgia
***
Connie Pollner
How has abortion affected you? Tremendous guilt, emotional problems, bulimia, grief.
***
AFFIDAVIT
***
The State of Florida
***
Paisley Pryor
How has abortion affected you? I regret the loss of my children. I wish I could have experienced the joy of my children when I was first blessed with them. I learned to value life when it became necessary to instill values in my growing children that I did not abort.
***
AFFIDAVIT
***
The State of Florida
***
*73AA D.S.P.
How has abortion affected you? Guilt, empty, sadness, depression, regret for having broke the commandment “Thou shall not kill.” I was 18 then and now 46. If I had known then what I know now, I would never have gone through with it. The shame had been unbearable. Since then I have had many medical problems, physical, emotional, mental, and spiritual. Two years ago, I gave that child of God a name not knowing if the baby was a boy or a girl. I named the child Amandrew (for Amanda and Andrew). God knows I'm sorry.
***
AFFIDAVIT
***
The State of Missouri
***
Jana L. Phillips
How has abortion affected you? Had difficulty getting pregnant, lots of female problems (nightmares frequently) mostly about my living children dying. I'm now on my third marriage, bad self-image, thought I was craving for feelings I had. Hated my mother for years. Lots of bitterness.
***
*74AA AFFIDAVIT
***
The State of Oklahoma
***
Leslie A. Patterson
How has abortion affected you? Grieved for loss of baby, eating problems, depression, didn't feel good about myself, shame and guilt.
***
AFFIDAVIT
***
The State of Pennsylvania
***
Joann L. Ostrowski
How has abortion affected you? For many years after that I suffered from depression, suicidal tendencies, low self-esteem, I ended up marrying the father of the baby and then divorcing him just two years into our marriage.
***
AFFIDAVIT
***
The State of Arizona
***
*75AA K.O.
How has abortion affected you? Suffered major guilt and depression from it. Wonder about the sex of my child. Inspired me to speak to others about it.
***
AFFIDAVIT
***
The State of Texas
***
Kaye Peterson
How has abortion affected you? I believe it made me neurotically fearful of responsibility. I was just sad for 22 years.
***
AFFIDAVIT
***
The State of California
***
Karen M. Kowalewski
How has abortion affected you? I started feeling guilty almost immediately and felt very low self-esteem. I cried a lot and also started over-eating to fill the emptiness I felt. When my husband verbally or emotionally abused me, I allowed it because I felt I deserved it for killing my baby.
*76aa ***
AFFIDAVIT
***
The State of Minnesota
***
M.M.P.
How has abortion affected you? Extreme isolation, depression, anxiety, grief for someone who should be alive but is not because of my “choice.”
***
AFFIDAVIT
***
The State of New York
***
Judee Oris
How has abortion affected you? For many years - consumed with shame, grief, and heartache. I suffered from anxiety and panic attacks. From obsessive thoughts of killing my baby. Became afraid of the subject of abortion, fled the room where the topic was discussed; becoming ill at times. Thought I was going crazy.
***
*77AA AFFIDAVIT
***
The State of California
***
M.E.M.
How has abortion affected you? Repentance, seeking God's forgiveness, warning others of a mistake they can never undo. A fatal step into misery of regret.
***
AFFIDAVIT
***
The State of Texas
***
Mary Moorman
How has abortion affected you? I had a tremendous amount of guilt for a long time. Filling out this form makes the pain and guilt come back. I have taken two human lives. I have had many health problems, two miscarriages and a hysterectomy.
***
AFFIDAVIT
***
The State of Colorado
***
*78aa LuAnn Morton
How has abortion affected you? Low self-esteem. I hurt for many years in my heart. I felt like a murderer and a bad woman because I could not parent that child. I never told my best friend. She would have hated me. I cried for years.
***
AFFIDAVIT
***
The State of Texas
***
Kathleen Murz
How has abortion affected you? It has caused relationship problems, depression, anger, loneliness, lack of self-worth, guilt.
***
AFFIDAVIT
***
The State of Kentucky
***
Maranda Music
How has abortion affected you? Made me very sad, depressed, and angry at the world.
***
*79AA AFFIDAVIT
***
The State of Tennessee
***
Linda Newberry
How has abortion affected you? I became an alcoholic and drug addict.
***
AFFIDAVIT
***
The State of New Hampshire
***
Deborah Peterson
How has abortion affected you? From the day I walked out of the clinic after the abortion, I was never the same. It felt like part of me had died. I became gradually depressed - later becoming severe - I became anorexic, bulimic, severely depressed and suicidal. I hated being around children after this. I felt much guilt and shame.
***
*80AA AFFIDAVIT
***
The State of Colorado
***
Alison Phillips
How has abortion affected you? I miss my baby. I have separated emotionally from almost everyone who told me to have an abortion. I still have depression, some nightmares, and overwhelming regret. My life has forever changed. They told me once it was over I would go back to the same life as before, but I never have.
***
AFFIDAVIT
***
The State of Minnesota
***
Lauralee Peterson
How has abortion affected you? My abortion has given me 22 years of sorrow and regret. When I realized the development of my child and the fact that abortion stopped my child's beating heart, I was filled with anger and sorrow. At the age of 16, I was not mature enough to make such a decision. My other children also know they have a missing sibling.
***
*81AA AFFIDAVIT
***
The State of Georgia
***
Dianne Pesares
How has abortion affected you? It has left an emptiness and pain that never goes away.
***
AFFIDAVIT
***
The State of Kentucky
***
Kelli R. Perkins
How has abortion affected you? For a while, I pretended that nothing happened. Soon after though I began to suffer from post-abortion syndrome. I have had problems with guilt, rage, and depression. Even though five years have passed and I have a two-year-old son, the emotions resulting from my abortion are just as real and strong as they've ever been.
***
*82AA AFFIDAVIT
***
The State of Texas
***
J.A.P.
How has abortion affected you? I kept it a secret over 30 years with only a handful of people knowing most of who are now dead. I was and am embarrassed, remorseful, sad, and forgiven for the murder I allowed and sought for my baby whom they called my “fetus.” No counseling was given about after effects physically, mentally, socially, or spiritually. Everyone can talk about tonsils being removed, but it's a deep dark secret to have murdered your child. I felt I had been weak. I let down everyone including God, and felt there was no option.
***
AFFIDAVIT
***
The State of Wisconsin
***
Elizabeth C. Patchet
How has abortion affected you? Emotionally I have had a difficult time with grief, guilt, shame and regrets. The thought that I chose to kill two of my own children has been overwhelming. I am emotionally hardened as a result. In my last pregnancy I had placenta previa which was potentially life threatening to me and my child. *83aa Studies have shown that women who have had abortions have a greater risk of this (seven to fifteen times).
***
AFFIDAVIT
***
The State of Montana
***
Debbie Otto
How has abortion affected you? I'll never get over it as long as I live. It gave me a very low opinion of myself. I got pregnant again and married that man. It was a disaster except for my two beautiful daughters who are now 20 and 22 years old. I've never quit thinking about my other baby who would be 25 1/2 now. I've had nightmares and anniversary depression.
***
AFFIDAVIT
***
The State of Kentucky
***
Laurie A. Moore
How has abortion affected you? After I had my first abortion, I moved to the Detroit area where I began seeking psychiatric help. I was diagnosed several different times by several different psychiatrists. I was put on many *84aa anti-depressants, stimulants, etc. I have suffered from severe depression and have attempted suicide several times.
***
AFFIDAVIT
***
The State of Tennessee
***
M.L.M.
How has abortion affected you? Since I had my abortion, nothing in my life has gone right. I have suffered from depression, an ongoing sense of shame and a tremendous amount of anger due to the fact that I allowed myself to be coerced into having this awful procedure performed. It has also affected my ability to be a proper mother to my children.
***
AFFIDAVIT
***
The State of Tennessee
***
Sherry Mae Morgan
How has abortion affected you? Never did I think that I would be so devastated due to my mistake in having not one, but two abortions. I was truthful with my fiancé about my past. Later we married, only to have them brought up to my face for 15 years of marriage. My ex-husband now used *85aa it against me with our son right after our divorce. My son looks at me and states, “Mom, Dad told me that you are a baby killer.”
***
AFFIDAVIT
***
The State of Texas
***
Camelia M. Murphy
How has abortion affected you? I have suffered with low-self esteem, self-hatred, suicidal impulses, constant anxiety (especially about sex and about making decisions), marital problems, difficulty in bonding with my living children, guilt, shame, difficulty in daily functioning, feelings of isolation from others, feelings of inferiority, failure to progress in labor (resulting in two c-sections).
***
AFFIDAVIT
***
The State of Hawaii
***
Tara LK Musico
How has abortion affected you? It affected me in all aspects: mentally, emotionally, socially, and physically. Mentally, I had to deal with the fact I killed my child, yet think clearly, which was impossible to do for a while. *86aa Emotionally, I become more angry, depressed, and withdrawn. Socially, I did not want to be around others. Physically, I forced myself to lose weight, which was unhealthy for me. I have dealt with these feelings through counseling and much prayer.
***
AFFIDAVIT
***
The State of Pennsylvania
***
Diane K. Musselman
How has abortion affevected you? Let's say the last 32 years were filled with pain emotionally, low-self esteem, poor relationship with family and friends, never married and childless. Distant myself to children, aware of what I did each “likely birth date, October, feeling worthless - not being able to forgive myself to this day, makes learning to love myself very hard and know I am loved. The physical aspects are I have aberrations that have my intestines and uterus glued together and numerous infections. At age 20, I can say that abortion was responsible for my downward spiral of destructive lifestyle that I am only now at 53 putting back together.
***
*87AA AFFIDAVIT
***
The State of Missouri
***
Wendy Miller
How has abortion affected you? I get emotionally wrought when I let myself dwell on the fact that I took my child's life. I never had to tell my parents or get their permission, which allowed a young, self-centered, selfish young girl to take another human's life so she could continue on in her current lifestyle.
***
AFFIDAVIT
***
The State of Pennsylvania
***
Mary Ann Novak
How has abortion affected you? I “shut down” emotionally, refused any serious relationships because I knew where it would lead, did not want children, and erected “a wall” around myself to protect myself from any and all kind of intimacy. I also became “a runner.” Not only physically, but emotionally I have flashbacks of my old boyfriend when I'm with my husband.
***
*88AA AFFIDAVIT
***
The State of Mississippi
***
K.N.
How has abortion affected you? I tried to commit suicide. I hated myself. I was told by the media on TV and my friends that it was just a seed and some told me it was just a blob of blood and there was no way it could actually be a baby still I was at least three or four months into the pregnancy. My mother and my aunt took me to the clinic in Dallas, Texas. After I got back home (first I must say my mother was all for it before we left for Dallas). My mother told me she knew that I should not have ever done it. So that put more guilt on me. Just before we left, she told me that was the best thing to do.
***
AFFIDAVIT
***
The State of Texas
***
Kristene O'Dell
How has abortion affected you? I completely shut down. I was angry at myself and I felt that there was no hope for me to ever be considered a respectable member of society. I became an alcoholic. I have struggled with eating disorders. I also built so many walls around myself no one could get close to me.
*89aa ***
AFFIDAVIT
***
The State of Arkansas
***
Jeanette Parks
How has abortion affected you? The night I returned home, I woke up hearing a baby cry. My boyfriend said it was cats. This happened often and I was depressed. I didn't understand because I didn't believe it was a baby yet. On public TV, I saw an abortion and realized it was alive and I was guilty of murder. I became pregnant later and baby was killed in car accident I believed because of abortion.
***
AFFIDAVIT
***
The State of Oklahoma
***
Cynthia Carney
How has abortion affected you? Emotionally, physically, and psychologically. For 23 years, I went into crying spells, depression, suicidal thoughts. Emotionally it devastated me.
***
*90AA AFFIDAVIT
***
The State of Georgia
***
Dianne Marie Donaudy
How has abortion affected you? It affected me in so many ways I can't list them all. I lost trust in people - in love - in God. I looked into reincarnation in hopes that my child would return in another pregnancy. I felt hopeless inside and used “cocktail hour” to get through my life.
***
AFFIDAVIT
***
The State of Georgia
***
Tina C. Brock
How has abortion affected you? After my abortion, my life was very emotionally unstable. I had severe episodes of depression and found myself crying uncontrollably for no reasons. Thank god a few years ago I accepted that God had forgiven me for killing my baby or allowing doctors to kill my baby, and God has healed me of my depression.
***
*91AA AFFIDAVIT
***
The State of Texas
***
Rhonda Arias
How has abortion affected you? It has severed my sense of purpose. It made me feel worthless and ashamed. Loneliness and depression overwhelmed my life.
***
AFFIDAVIT
***
The State of Texas
***
Myra J. Myers
How has abortion affected you? The truth was that two months following the abortion I would lose my womb causing a gradual reduction in my estrogen production, leading to estrogen deprivation resulting in delayed depression dinting an early and hard menopause. An abortion, not a pregnancy, caused serious consequences. The truth was that the night before my abortion appointment I asked aloud, “God, is there anything wrong in what I am going to do. Man says it isn't even life. What do You say?” I didn't hear an audible response and assumed it was OK. However, in the morning, a clerk from the clinic called to let me know that the doctor had to cancel his appointments for that morning and asked me what I *92aa wanted to do. I did not remember the night before, I did not make the connection. I was not listening. I informed my husband and he asked about the next Saturday. So, I made another appointment and I became responsible for my child's death. Guilty of murder.
***
AFFIDAVIT
***
The State of Louisiana
***
Frieda Keeling
How has abortion affected you? Depression, nightmares - I dreamt my body was dismembered as my baby and I heard babies crying to be rescued. I could not have meaningful relationships. I did believe God would forgive me. Deep shame and remorse. I had trouble sleeping. I felt empty and destroyed. I gained weight and I had abusive relationships.
***
AFFIDAVIT
***
The State of Colorado
***
*93aa Andrea R. Sosebee
How has abortion affected you? Alcohol Abuse, low self-esteem, shame, guilt, workaholic. Baby calling mother outside window, poor relationships in marriage. Multiple marriages.
***
AFFIDAVIT
***
The State of Washington
***
Mary J. Perrin
How has abortion affected you? Immediately afterward, I fell into a state of extreme grief and depression. I contemplated suicide.
***
AFFIDAVIT
***
The State of Louisiana
***
Cynthia Collins
How has abortion affected you? Suffer Depression, guilt, miscarriage, and problems conceiving. Also, have *94aa Fibrocystic Disease, which I believe was related to abortion. Carried trauma into relationship with marriage. Was bedridden during subsequent full term pregnancies for total of seven months due to bleeding and concerned for weakened cervix.
***
AFFIDAVIT
***
The State of California
***
Caron Strong
How has abortion affected you? Anger, depression, nightmares - miscarriages. Very self-destructive. Nightmares still to present day - 2001. Pain and heartache that I didn't possibly know could exist - or that I could live through suicidal thoughts.
***
AFFIDAVIT
***
The State of Permsylvania
***
Karen Bodle
How has abortion affected you? I suffered a nervous breakdown and spent about 6 weeks in a mental hospital. I had 2 miscarriages after my abortion. I felt shame and *95aa Struggled with depression. I felt dirty on the inside. I believed that people would reject me if they knew I had an abortion. I had deep emotional pain and was not allowed to grieve the loss of my child.
***
AFFIDAVIT
***
The State of Kentucky
***
Kathy G. Rutledge
How has abortion affected you? The physical effects I suffered included violent premature labor and massive hemorrhaging from numerous fragments of decidual and placental tissue retained in my uterus for over a month requiring a second surgical procedure to remove and from which the second doctor stated I could have died. Long-range physical effects included cervical incompetence due to the cervical dilation device used during the abortion procedure causing two subsequent miscarriages in my mid 20's. Bed confinement following heavy bleeding from a prematurely opened cervix allowed me to finally give birth at age 29. Observation of the dead baby that was birthed caused devastating emotional and psychological complications. Suicidal thoughts afterwards caused me to seek professional and spiritual help to overcome the shame and horror that I had killed a real baby. I endured chronic depression and emotional dysfunction as a result of flashbacks and other post-abortive syndromes … The short-term relief of terminating an unwanted pregnancy is completely overshadowed by this traumatic delivery for which a *96aa woman cannot possibly prepare herself psychologically. I thought I could handle terminating a “fetus” when I made my decision, but I could not handle terminating the small dead baby I witnessed. Women need protection from life-long physical and emotional complications that are suffered even more acutely from mid-term and late abortions, and women need the truth about the life, not “fetal tissue”, they are carrying to make informed decisions.

Footnotes

Counsel for amici authored the brief in whole. The Justice Foundation is a nonprofit legal foundation that handles cases in landmark decisions. The Foundation is supported through private contributions of donors who have made the preparation and submission of this brief possible. No party contributed to the writing or finances of this brief.
Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531, subsec. (1).
Id. at 72.
Id. at 208 (Burger, C.J., concurring).
Id.
Id.
For example, H.T. (Texas) - “Experienced major clinical depression during and after birth of oldest living child after I learned how abortions were performed and more about fetal development.” App. B at 30. M.J.H. (Tennessee) - “I had ten years of depression, anxiety, and panic attacks that I had trouble understanding … Those ten years of my life were spent in anguish due to a decision that I had made based upon misinformation and untruths.” App. B at 39.
Doe v. Bolton, 410 U.S. 179, 209 (1973) (Douglas, J., concurring).
Id. at 214-15.
Id.
For example, C.R. (Georgia) - “No one ever showed me the stages of pregnancy. If someone had, I wouldn't have went through it. If I would have known the emotional effects that was years later, I would have reconsidered.” App. B at 12-13. Muriel A. Ramos (Florida) - “It made my life go into a downward spiral from emotional and spiritual pain to absolute symptoms of ill health…. However, the reality of the abortion was exasperated. I was forever changed in an unhealthy way from that legal choice I made, however misinformed that I was.” App. B at 23-24.
Id. at 931.
Id.
Partial-Birth Abortion Ban Act, 18 U.S.C. § 1531, § 2, subsec. (5).
On January 6, 1992, the FDA called for a moratorium on the use of silicone gel-filled breast implants. FDA Breast Implant Consumer Handbook - 2004, www.fda.gov/cdrh/breastimplants/handbook2004. The FDA found that the implants caused such problems as fibrous capsular contracture, silicone gel leakage and migration, infection, interference with early tumor detection, human carcinogenicity, and autoimmune disease.
Planned Parenthood v. Taft, 2006 U.S. App. LEXIS 4459 (6th Cir. 2006).
Id. at 5-6.
Id. at 8.
Id. at 10.
Id. at 10-11.
Id. at 22.
Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531, subsec. (1).
Id. at subsec. (2).
Partial-Birth Abortion Ban Act, 18 U.S.C. § 1531.
HB 1215, 2006 Leg., 81st Sess. (S.D. 2006).
For example, Alabama, Indiana, Georgia, Kentucky, Louisiana, Missouri, Michigan, Mississippi, Ohio, Oklahoma, Tennessee, and West Virginia.
See Appendix B where the relevant portions of post-abortive women amici Affidavits are provided.
See e.g., Jones v. United States, 463 U.S. 354, 365 (1983) (stating courts should “pay particular defense to reasonable legislative judgments” in a case where congressional findings that individuals acquitted by reason of insanity were likely to be dangerous); Marshall v. United States, 414 U.S. 417, 427 (1974) (stating “courts should be cautious not to rewrite legislation” in case where Congress determined that drug addicts were less likely to be rehabilitated); Lambert v. Yellowley, 272 U.S. 581, 294-95 (1926) (deferring to Congress that alcohol had no medicinal uses).
Walters v. Nat'l Ass'n of Radiation Survivors, 473 U.S. 305, 330 (1985) (rejecting procedural due process challenge on statutory limitation of fees paid to attorneys who represent veterans on veteran benefit claims).
Id.
Id. at n.9.
See Appendix B for the Affidavits of post-abortive women.
Partial-Birth Abortion BanAct, 18 U.S.C. § 1531, § 2.
Id. subsec. (1).
Id. at subsec. (2).
Id. at subsec. (5).
Id. at subsec. (13) (emphasis added).
The booklet is available through the Texas Department of Health or on its website at www.dshs.state.tx.us/wrtk/pdf/booklet.pdf.
“Women's Right to Know” booklet at 2.
Id.
Id. at 3-8.
Id. at 14-15.
Id. at 15-17.
Id. at 14.
Id. at 15.
Id.
Id. at 16.
Id.
For example, Alabama, Indiana, Georgia, Kentucky, Louisiana, Missouri, Michigan, Mississippi, Ohio, Oklahoma, Tennessee, and West Virginia.
Report of the South Dakota Task Force to Study Abortion (December 2005), available at www.ivotemyvalues.com/pdf/contentmgmt/ Task-Force-Report.pdf. The Task Force was to study (1) the practice of abortion since its legalization; (2) the body of knowledge concerning the development and behavior of the unborn child which has developed because of technological advances and medical experience since the legalization of abortion; (3) the societal, economic, and ethical impact and effects of legalized abortion; (4) the degree to which decisions to undergo abortions are voluntary and informed; (5) the effect and health risks that undergoing abortions has on the women, including the effects on the women's physical and mental health, including the delayed onset of cancer, and her subsequent life and socioeconomic experiences; (6) the nature of the relationship between a pregnant woman and her unborn child; (7) whether abortion is a workable method for the pregnant woman to waive her rights to a relationship with the child; (8) whether the unborn child is capable of experiencing physical pain; (9) whether the need exists for additional protections of the rights of pregnant women contemplating abortion; and, (10) whether there is any interest of the state or the mother or the child which would justify changing the laws relative to abortion. Id. at 6.
Id. at 6.
Id.
Id. at 6-7.
Id. at 7.
Id.
Id. (emphasis added).
Id. at 47.
Id.
Id. at 47-48.
Id. at 53.
Id. at 44.
Willke & Willke, Abortion 50 (Hayes Pub. Co. 2003).
Report of the South Dakota Task Force to Study Abortion 42-43 (December 2005), available at www.ivotemyvalues.com/pdf/contentmgmt/Task_ Force_Report.pdf.
Id. at 69.
Id.
Id.
For example, Tami T. Rohrbacher (Wyoming) - “Stripped my self-esteem …” App. B at 20. Cathy L. Moffat (Utah) - “Depression, lowself esteem, guilt, condemnation, and shame, sleepless nights, nightmares and torment, thoughts of self-hate and suicide, lost, confused, destroyed relationships throughout my life, unloved, unlovable …” App. B at 13-14. Teresa Renee Zell (North Carolina) - “Depression, nightmares, hospitalizations, suicidal thoughts and actions, guilt, anger at myself and those who forced the abortion, fear, eating disorder, alcoholism, low-self esteem, anxiety, stress.” App. B at 26. Camelia M. Murphy (Texas) - “I have suffered with low-self esteem, self-hatred, suicidal impulses, constant anxiety (especially about sex and about making decisions) …” App. B at 95.
“The Aftereffects of Abortion,” www.afterabortion.info/complic.html (calling abortion a public health issue and listing the physical and psychological effects of abortion).
In addition, approximately 2,000 similar Affidavits from post-abortive women were given to the Task Force on Abortion in South Dakota which provided evidence that led to that State's ban.
For example, Cynthia Carney (Oklahoma) - “For 23 years, I went into crying spells, depression, suicidal thoughts. Emotionally it devastated me.” App. B at 31. Elizabeth Campbell (California) - “i suffered from depression, migraine headaches, low-self-esteem. No self-worth …” App. B at 32. D.Q. (Tennessee) - “It has completely messed up my life. It was not the best way to start out in marriage. I was depressed, didn't want my husband to touch me, felt guilty, had suicidal thoughts, cried a lot, terribly depressed!” App. B at 11. S.O. (Florida) - “For twenty-eight years, I have mourned, gone thru depression around Victoria's birthdate, became angry as the years passed.” App. B at 15-16.
For example, Donna M. Razin (Florida) - “Deep regret - initially I was suicidal - as the years have progressed I have developed a heightened level of bitterness and anger and self-hate.” App. B at 12. Kim Marie Blackowiak (Minnesota) - “Yes, I was extremely sad, depressed, and suicidal after my abortion. After my abortion - I used drugs and alcohol frequently to numb the feelings.” App. B at 33. Brandie M. Atwood (Arkansas) - “Abortion turned a 14-year-old school girl into a suicidal teenager that lived with feelings of guilt, rejection, and helplessness.” App. B at 35.
For example, C.R. (Georgia) - “Yes. I feel emotionally scarred. Years went by of hiding it. Then something started triggering flash backs. Children's birthdays bring on extreme sadness. Christmas time brings on times of depression, regret, and wondering what would my children have been like. Could they have made a difference in the world. Why couldn't I have given them a chance at life like my mother gave me!” App. B at 12-13. S.T. (Tennessee) - “Depression and flashbacks after the abortion. I had no self-worth. I turned to drugs and alcohol and relationships with no meaning.” App. B at 25.
For example, J.L.M. (Texas) - “11 years later I am obviously still affected. Initially, I suffered from depression, alcohol use increased, increased promiscuity, due to my lowered self esteem. My grades suffered in college. Relationships were difficult. I had nightmares, flashbacks, and grief.” App. B at 14. Kristen Pettibone (Georgia) - “My abortion devastated me. I lost respect for my boyfriend, respect for myself. I became an alcoholic, dabbled in drugs to forget what I had done!” App. B at 16. Dana Nicole Landers (Florida) - “For years my abortion decision led me down a self-destructive path even until the point of wanting to die. I went from an honor roll student in high school to a drug addict. I suffered from depression, anger, guilt, regret, and denial just to name a few.” App. B at 17. Deborah R. Paine (Georgia) - “I turned to 11 years of alcohol and drug addiction to cope with the regret. In my need to punish myself, I had a tubal ligation (sterilization). So I am childless. After killing my children, I did not deserve to be a mother.” App. B at 19.
For example, Janice L. Bartlett (Florida) - “Devalued, dehumanized me. Took away my dignity and self-worth. Suffered from shame and guilt. Became depressed and even attempted suicide. Also led to use of alcohol, drugs, and sexual promiscuity.” App. B at 22. C.L.R. (Arizona) - “My abortion immediately led to hopelessness, promiscuity, and drinking binges. I could not escape the pain and guilt. I've been through 19 years of intermittent counseling.” App. B at 24. E.A.W. (Tennessee) - “Drugs and promiscuity didn't help.” App. B at 27. Beverly A. Green (Minnesota) - “I went into a black tunnel for years. Started using drugs, drinking, more promiscuity, very insecure, hated myself - the list goes on …” App. B at 41.
For example, Hemda Ben-Judah (Georgia) - “I have lived with guilt for many years.” App. B at 22. Connie Ambrecht (Georgia) - “Guilt felt for years …” App. B at 21. Mary Ellen York (Michigan) - “I was affected dramatically by my abortion. For years I couldn't even look at a baby and when I heard the word “abortion” I would just cringe. I suffered depression and I didn't like myself very much. Feelings of guilt. I found it very hard to forgive myself. It took my life from me.” App. B at 26. J.S.W. (California) - “Guilt, shame, feelings of being a really horrible person.” App. B at 28.
For example, T.J.H. (California) - “ … deep sense of loss and guilt/secrecy.” App. B at 18. Melody A. Athey (Kansas) - “I repressed any memory of the experience for 25 years. My whole lifestyle changed after my abortion. I started drinking heavily and married an alcoholic shortly after. I tried suicide once and considered it several times. I had repeated periods of depression especially around the anniversary date of my abortion. The guilt I felt was overwhelming.” App. B at 35.
For example, Cathy L. Moffat (Utah) - “I have regretted my choices the rest of my life.” App. B at 13-14. Diane M. Hanson (Colorado) - “It changed my life, how I viewed myself, it took away my selfworth. It was devastating and caused several years of intense pain and sorrow. The hardest part was knowing ‘it was my choice’ that caused my baby's death and I couldn't do anything to change that or make it better!” App. B at 38. Lori Crossman (Michigan) - “It devastated me emotionally, mentally, and spiritually. I cannot go back and reverse my “choices” - I cannot get my children back. They are dead because abortion was legal and easy to access.” App. B at 45. Dana Renee Nickles (Arkansas) - “In the beginning I thought I was doing the right thing. Only afterwards did I realize the TRUTH! My conscience was seared, my heart was broken. I lived in a state of depression looking at drugs as the answer to my problem. And the problem - I had killed my child! See you don't realize what happens to yourself until it's too late, you've already done it and there's no turning back. I can't turn back time - if I could - I WOULDN'T HAVE AN ABORTION!! I was emotionally torn apart.” App. B at 15.
For example, Caroline Burnett (Florida) - “It took my innocence. Robbed me of self-worth … I thought it would be over after one day but fifteen years later, I'm still haunted by the memories and the tremendous guilt of, now when I understand, having robbed my children of life.” App. B at 18.
Care Net was founded in 1975. In 1980, Care Net opened its first affiliated pregnancy center in Baltimore, Maryland. Its focus is to develop, equip, and promote more than 900 pregnancy centers across North America. See www.care-net.org.
Id. at 1002 (Scalia, J. dissenting).
Gibbons v. Ogden, 22 U.S. (9 Wheat.) 1, 204 (1824) recognized that under what was later called the state's “police power” the states could regulate “health laws of every description.” The Court stated “[T]hat immense mass of legislation which embraces everything within the territory of a state not surrendered to a general government; all of which can be most advantageously exercised by the states themselves. Inspection laws, quarantine laws, health laws of every description, as well as for regulating the internal commerce of a State … are component parts of this mass.” Id. at 203.
Id. at 132-145.
Id.
Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531.
McCorvey v. Hill, 2003 U.S. Dist. LEXIS 12986 (N.D. Tex. 2003).
Id. at 853.
Id. at 852.
Id. (emphasis added).
Id. at 583 (emphasis added).
Id. at 149-50.
Id. at 153.
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