fetus

The Pennsylvania Abortion Control Act of 1982, as amended in 1988 and 1989, established several requirements governing the performance of abortions within the Commonwealth. The Act required a woman seeking an abortion to provide informed consent after receiving specific information from a physician or counselor at least twenty-four hours before the procedure. It mandated that a minor obtain the informed consent of one parent, subject to a judicial bypass option. It further required a married woman to sign a statement confirming that she had notified her husband of her planned abortion, unless certain exceptions applied. The Act also imposed reporting obligations on facilities providing abortion services and defined a medical emergency exception to the various requirements. Before any of these provisions took effect, the petitioners brought suit in the United States District Court for the Eastern District of Pennsylvania. The petitioners were five abortion clinics and one physician representing himself as well as a class of physicians who provide abortion services. They sought declaratory and injunctive relief and challenged each provision as unconstitutional on its face. The District Court entered a preliminary injunction. After conducting a three-day bench trial, the District Court held all the provisions unconstitutional and entered a permanent injunction against their enforcement by Pennsylvania. The Court of Appeals for the Third Circuit affirmed in part and reversed in part. It adopted the District Court's factual findings and legal analysis except with respect to the spousal notification requirement. The Court of Appeals upheld the spousal notification requirement as constitutional and applied the undue burden standard in evaluating the provisions. The Supreme Court granted certiorari to consider the constitutionality of the challenged provisions of the Pennsylvania statute.

In 1999 the Nebraska Legislature enacted a statute that prohibits any partial birth abortion. The statute defines partial birth abortion as an abortion procedure in which the person performing the abortion partially delivers vaginally a living unborn child before killing the unborn child and completing the delivery. The statute provides an exception only when the procedure is necessary to save the life of the mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself. Violation of the statute is a Class III felony carrying a prison term of up to twenty years, a fine of up to twenty-five thousand dollars, and automatic revocation of the physician's license to practice medicine in Nebraska. Dr. Leroy Carhart is a Nebraska physician who performs abortions in a clinical setting. He brought suit in federal district court seeking a declaration that the Nebraska statute violates the Federal Constitution and an injunction forbidding its enforcement. After a trial on the merits during which both sides presented several expert witnesses, the District Court held the statute unconstitutional. The Eighth Circuit affirmed the judgment of the District Court. The evidence at trial addressed several abortion procedures used after the first trimester. The most common second-trimester method is dilation and evacuation, or D&E, in which the cervix is dilated and instruments are used to remove fetal tissue, often requiring dismemberment. A variation known as intact D&E or D&X involves removing the fetus intact, usually after collapsing the skull, and is used after approximately sixteen weeks of gestation. Dr. Carhart testified that he attempts to use the intact D&E procedure in the 10 to 20 cases a year that present to Dr. Carhart because it reduces the risk of injury from sharp bone fragments, minimizes instrument passes, and lowers the chance of leaving retained tissue. The District Court found that the banned procedure is sometimes safer than other methods for women undergoing abortions between twelve and twenty weeks of gestation. It credited testimony that the intact D&E procedure reduces operating time, blood loss, risk of infection, complications from bony fragments, and instrument-inflicted damage to the uterus and cervix. The court also noted that a select panel of the American College of Obstetricians and Gynecologists had concluded the procedure may be the best or most appropriate in particular circumstances. The Court of Appeals accepted these findings. The Supreme Court granted certiorari to review the judgment of the Court of Appeals.

In July 2013 the Texas Legislature enacted House Bill 2. The bill contained an admitting-privileges requirement for physicians performing abortions and a surgical-center requirement for abortion facilities. Before the law took effect a group of Texas abortion providers filed the Abbott case seeking facial invalidation of the admitting-privileges provision. The district court initially enjoined the provision but the Fifth Circuit vacated the injunction and later upheld the requirement on the basis of evidence presented before enforcement. On April 6 2014 petitioners a group of abortion providers that included some Abbott plaintiffs filed this suit in federal district court. They sought as-applied relief against the admitting-privileges requirement for facilities in McAllen and El Paso and a statewide injunction against the surgical-center requirement claiming violations of the Fourteenth Amendment. The district court held a four-day bench trial and received stipulations expert depositions and testimony. It found that the number of facilities providing abortions dropped in half from about 40 to about 20 after the admitting-privileges requirement began to be enforced. It found that the number of women of reproductive age living more than 50 miles from a clinic doubled. The number living more than 100 miles away increased by 150 percent. The number living more than 150 miles away increased by more than 350 percent. The number living more than 200 miles away increased by about 2,800 percent. It found that the number of facilities would drop to seven or eight if the surgical-center provision took effect. It found that before H. B. 2's passage abortion was an extremely safe procedure with very low rates of complications and virtually no deaths. It found that abortion was safer than many more common procedures not subject to the same level of regulation. It found that the cost of compliance with the surgical-center requirement would most likely exceed 1.5 million dollars to 3 million dollars per clinic. On the basis of these findings the district court enjoined enforcement of both provisions. The Fifth Circuit reversed in significant part holding that res judicata barred the challenges and that both requirements were constitutional. The case reached the Supreme Court.

Mississippi's Gestational Age Act provides that, except in a medical emergency or in the case of a severe fetal abnormality, a person shall not intentionally or knowingly perform or induce an abortion of an unborn human being if the probable gestational age of the unborn human being has been determined to be greater than fifteen weeks. The Mississippi Legislature made findings about prenatal development and the risks and nature of dilation-and-evacuation procedures used after 15 weeks. Jackson Women's Health Organization, an abortion clinic, and one of its doctors filed suit in Federal District Court challenging the statute. They alleged that the law violated this Court's precedents establishing a constitutional right to abortion. The District Court granted summary judgment for the respondents and permanently enjoined enforcement of the law. The Fifth Circuit affirmed the District Court's decision. Petitioners defended the statute before this Court, arguing that Roe and Casey were wrongly decided. The Supreme Court granted certiorari to consider whether all pre-viability prohibitions are unconstitutional and whether Roe and Casey should be overruled.