In 2003, the Texas state legislature passed the Woman’s Right to Know Act, hereafter the Act, as Chapter 171 of the state’s Health and Safety Code. The Act sets requirements that physicians must follow during the informed consent process for abortion, or a medical procedure to terminate pregnancy, in Texas. Lawmakers amended the Act and added several additional regulations that restrict access to abortion in 2011, 2013, 2015, and 2017. For instance, the Act requires that physicians perform abortions after sixteen weeks of pregnancy in ambulatory surgical centers or hospitals and states that physicians must perform an ultrasound to view images, called sonograms, of a developing fetus inside a woman’s uterus before a woman may receive an abortion. The Act further requires practitioners and clinics to offer state-developed informational materials to women who seek an abortion. The Act placed several restrictions on abortion care in Texas, making it more difficult for women to access safe and legal abortion care, which opponents have challenged in courts.

In 2010, the Catholic Church excommunicated Margaret McBride, a nun and ethics board member at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. McBride was excommunicated latae sententiae, or automatically, for approving a therapeutic abortion, which is an abortion that is required to save a pregnant woman’s life. McBride approved an abortion for a woman who was twenty-seven years old, eleven weeks pregnant with her fifth child, and suffered from pulmonary hypertension, a life-threatening condition during pregnancy. Following McBride’s decision, St. Joseph’s lost its affiliation with the Catholic Church, which it had maintained since the late 1800s. Affiliation with the Catholic Church required that the hospital abide by Canon Law, which is the law of the Catholic Church. Under Canon Law, abortion is serious wrongdoing that could result in excommunication, as it did in the case of McBride. McBride’s excommunication illustrated the impact that affiliation of Catholicism with hospitals had on patients’ ability to receive comprehensive reproductive health care.

Evelyn Lorraine Rothman advocated for women’s reproductive rights and invented at-home kits for women’s health concerns in the late twentieth century in Los Angeles, California. Rothman provided women in the Los Angeles area with the means to perform self-examinations, pregnancy tests, and abortions on their own without assistance from a medical professional. Along with Carol Downer, Rothman cofounded the Federation of Feminist Health Centers in Los Angeles, California, and spent her career educating women on reproductive health. She also invented the Del-Em Kit, a menstrual extraction device that allowed women to perform very early abortions on their own and at home. Rothman’s activism educated women on female anatomy, provided an at-home option for early abortion before abortion became legal, and promoted women’s reproductive rights in the 1970s.

In 1976, the US Congress passed the Hyde Amendment, which banned the use of federal funding to pay for abortions through Medicaid. In 1976, Illinois Congressman Henry J. Hyde proposed the amendment to the Departments of Labor and Health, Education, and Welfare, Appropriation Act of 1977. In 1980, the US Supreme Court in Harris v. McRae (1980) upheld the constitutionality of the Hyde Amendment. Included annually in every Congressional appropriation act after the one passed in 1976, amended versions of the Hyde Amendment have restricted federal funding of abortion services for women participating in Medicaid.

On 30 June 1980, in a five to four decision, the US Supreme Court ruled in the Case Harris v. McRae that the Hyde Amendment of 1976 did not violate the US Constitution. The Hyde Amendment banned the use of federal funding to pay for any abortion services. The US Supreme Court's decision in Harris v. McRae overturned the decision of McRae v. Califano (1980), in which the US District Court for the Eastern District of New York had ruled that the funding restrictions established by the Hyde Amendment violated the US Constitution. After the US Supreme Court's ruling in Harris v. McRae, the Hyde Amendment continued to prohibit federal Medicaid funding for abortion services, limiting the funds available for low-income women seeking abortions.

In the case of Beal v. Doe, tried in 1977, the US Supreme Court ruled that states could constitutionally restrict money from Medicaid from funding elective abortions. After the 1973 case Roe v. Wade, in which the US Supreme Court had ruled women have the rights to terminate pregnancies within the first trimester, the state of Pennsylvania passed legislation that restricted the use of Medicaid funds for abortion procedures. In 1977, several Medicaid eligible women who were unable to receive coverage for a non-therapeutic abortion brought a case against Frank S. Beal, secretary of the Department of Public Welfare of Pennsylvania. The US Supreme Court decision in Beal v. Doe gave states the authority to place Medicaid restrictions on funding for non-therapeutic or elective abortions.

In 1914, Margaret Sanger published “Family Limitations,” a pamphlet describing six different types of contraceptive methods. At the time Sanger published the pamphlet, the federal Comstock Act of 1873 had made distributing contraceptive and abortion information through the US postal service illegal. The Comstock Act classified contraceptive information as obscene and limited the amount of information available to individuals about preventing pregnancies. In 1915, Sanger’s husband was charged with violating the Comstock Act for distributing “Family Limitations” and was sent to jail for 30 days. The case sparked many birth control activists to lobby for the repeal of the Comstock Act. By inciting controversy during a time when the Comstock Act limited contraception access, Sanger’s pamphlet “Family Limitations” increased women’s knowledge about various methods of preventing pregnancy.

In 1901, the Arizona Territorial Legislature codified territorial law that illegalized advertising, causing, or performing abortions anywhere in Arizona. The 1901 code, in conjunction with the federal Comstock Act, regulated the advertisement and accessibility of abortion services and contraceptives in Arizona. The Federal Comstock Act of 1873 had illegalized the distribution of material on contraceptives and abortions through the US Postal Services by labeling contraceptive and abortive material as obscene. After the passage of that federal law, many states and territories, including Arizona, enacted or codified state or territory-level anti-obscenity laws to augment the federal law's effects. Those laws became called Comstock laws, and Arizona's 1901 laws was its Comstock law. The Arizona Comstock law hindered Arizona women's access to abortion services until the mid twentieth century, when state and federal court decisions dismantled Comstock laws nationwide.

Jane Elizabeth Hodgson was a physician who advocated for abortion rights in the twentieth century in the United States. In November of 1970, Hodgson became the first physician in the U.S. to be convicted of performing an illegal abortion in a hospital. Hodgson deliberately performed the abortion to challenge the Minnesota State Statute 617.18, which prohibited non-therapeutic abortions. Following the legalization of abortion in the US Supreme Court case Roe v. Wade (1973), Hodgson focused on promoting accessible abortion, obstetric, and gynecological care throughout Minnesota. Her name also appears in the Supreme Court case Hodgson v. Minnesota (1990), which challenged the constitutionality of a Minnesota statute that required physicians to notify both parents forty-eight hours prior to a minor being allowed to undergoing an abortion. Hodgson’s career was centered around challenging the legal system to protect and promote reproductive rights for women, including access to abortion.

In the 1980s, researchers at the pharmaceutical company Roussel-Uclaf in Paris, France, helped develop a biological compound called mifepristone. When a woman takes it, mifepristone interferes with the function of hormones involved in pregnancy and it can therefore be used to terminate pregnancies. In 2000, the US Food and Drug Administration approved mifepristone, also called RU 486, as part of a treatment to induce abortions using drugs instead of surgery, a method called medication abortion. Women can receive medication abortions earlier in their pregnancies than surgical abortions, and medication abortions often result in less severe side-effects than their surgical counterparts. In that capacity, mifepristone has increased women’s access to abortions throughout the world.