In June 1986, the Governor of Missouri signed into law Missouri Senate Committee Substitute for House Bill No. 1596, which amended existing state law concerning unborn children and abortions.
The Act consisted of 20 provisions, five of which are before the Court. The preamble contains findings that the life of each human being begins at conception and that unborn children have protectable interests in life, health, and well-being. The Act requires that prior to performing an abortion on any woman whom a physician has reason to believe is 20 or more weeks pregnant, the physician ascertain whether the fetus is viable by performing such medical examinations and tests as are necessary to make a finding of the gestational age, weight, and lung maturity of the unborn child. The Act also prohibits the use of public employees and facilities to perform or assist abortions not necessary to save the mother's life and prohibits the use of public funds, employees, or facilities for encouraging or counseling a woman to have an abortion not necessary to save her life.
In July 1986, five health professionals employed by the State and two nonprofit corporations brought this class action in the United States District Court for the Western District of Missouri. The plaintiffs sought declaratory and injunctive relief on the ground that certain statutory provisions violated the First, Fourth, Ninth, and Fourteenth Amendments. The two nonprofit corporations are Reproductive Health Services, which offers family planning and gynecological services including abortion services up to 22 weeks gestational age, and Planned Parenthood of Kansas City, which provides abortion services up to 14 weeks gestational age. The individual plaintiffs are three physicians, one nurse, and a social worker, all public employees at public facilities who encourage and counsel pregnant women to have nontherapeutic abortions, with two of the physicians performing abortions.
Several weeks after the complaint was filed, the District Court temporarily restrained enforcement of several provisions of the Act. Following a 3-day trial in December 1986, the District Court declared seven provisions of the Act unconstitutional and enjoined their enforcement, including the preamble, the informed consent provision, the requirement that post-16-week abortions be performed only in hospitals, the mandated tests to determine viability, and the prohibition on the use of public funds, employees, and facilities to perform or assist nontherapeutic abortions.
The Court of Appeals for the Eighth Circuit affirmed, with one exception not relevant to this appeal. The Court of Appeals determined that Missouri's declaration that life begins at conception was an impermissible state adoption of a theory of when life begins. It held that the requirement that physicians perform viability tests was an unconstitutional legislative intrusion on a matter of medical skill and judgment. The Court of Appeals invalidated Missouri's prohibition on the use of public facilities and employees to perform or assist abortions not necessary to save the mother's life. It distinguished our decisions in Harris v. McRae, 448 U. S. 297 (1980), and Maher v. Roe, 432 U. S. 464 (1977), on the ground that there is a fundamental difference between providing direct funding to effect the abortion decision and allowing staff physicians to perform abortions at an existing publicly owned hospital. The Court of Appeals struck down the provision prohibiting the use of public funds for encouraging or counseling women to have nontherapeutic abortions, for the reason that this provision was both overly vague and inconsistent with the right to an abortion enunciated in Roe v. Wade.
The Supreme Court noted probable jurisdiction to consider the constitutionality of the Missouri statute.