Planned Parenthood of Central Missouri v. Danforth 1976

Appellants: Planned Parenthood of Central Missouri, David Hall, M.D., and Michael Freiman, M.D.

Appellee: John C. Danforth, Attorney General of Missouri

Appellants' Claim: That a Missouri abortion law was too restrictive on many aspects of the abortion process thus violating the patients' constitutional rights.

Chief Lawyers for Appellants: Frank Susman

Chief Lawyers for Appellees: John C. Danforth

Justices of the Court: Harry A. Blackmun, William J. Brennan, Jr., Thurgood Marshall, Lewis F. Powell, Jr.

Justices Dissenting: Chief Justice Warren E. Burger, William H. Rehnquist, John Paul Stevens, Byron R. White

Date of Decision: July 1, 1976

Decision: Ruled in favor of Danforth on some state requirements including provisions defining viability of the fetus, requiring a written consent by the pregnant women before an abortion, and keeping detailed medical records by abortion clinics. On other parts of the law, the Court ruled in favor of Planned Parenthood striking down Missouri's requirement for a husband's consent and, for unmarried minors, parental consent before receiving an abortion, prohibition of the saline amniocentesis abortion procedure, and requirement for physicians to preserve the fetus' life after an abortion.

Planned Parenthood of Central Missouri v. Danforth was just the sort of case the Supreme Court expected on the heels of the landmark Roe v. Wade decision legalizing abortion. The case presented many "logical [reasonable]" questions following the earlier ruling.

Decided in 1973 Roe v. Wade had been the most important and controversial legal victory for women since achieving the right to vote. Roe established a "right to privacy" involving "a woman's decision whether or not to terminate [end] her pregnancy." However, in Roe the Supreme Court "emphatically rejected" the idea that "the woman's right is absolute [unlimited] and that she is entitled to terminate her pregnancy at whatever time in whatever way and for whatever reason she alone chooses." Instead, the Court sought to balance a woman's privacy rights against a state's interest in protecting life, in this case the unborn child. The Court provided in Roe a balancing formula of acceptable action based on the three stages of pregnancy: (1) during the first three stages of pregnancy the state could not interfere at all in a decision to abort; (2) the next three months of pregnancy (fourth through the sixth month) the state could reasonably regulate the way abortions are done to protect maternal [the mother's] health; and, (3) the last three months of pregnancy (seventh through the ninth month), a stage when the fetus (unborn child) is viable (able to live on its own or with medical help), the state may greatly restrict the mother's decision to have an abortion unless it is necessary "for the life or health of the mother."

Missouri Tackles Abortion Procedures

With the Roe decision, strict anti-abortion laws in many states quickly became unconstitutional, including a 1969 Missouri abortion law. However, with the Court recognizing through its balancing formula that states still held an interest in protecting an unborn child, many states began enacting new, revised abortion laws. These new laws, while not directly violating the decisions in Roe, attempted to place some restrictions on abortion. In June of 1974 the Missouri General Assembly passed a new abortion act, House Bill 1211, and the governor signed it into law. The new Missouri law placed a number of requirements on the abortion procedure, and outlawed certain practices.

Within three days of House Bill 1211's passage, Planned Parenthood of Central Missouri and two physicians who regularly performed abortions, David Hall and Michael Freiman, challenged the law in the U.S. Court for the Eastern District of Missouri. The action was brought on behalf of all licensed physicians involved with abortions and their patients desiring to terminate pregnancy within Missouri. John C. Danforth, Attorney General of Missouri, argued the case for the state of Missouri in support of the new abortion law. Being contested in the suit was the constitutionality of several provisions (parts or sections of the law). The provisions concerned various issues including the definition of viability, required consent before an abortion, use of a procedure called saline amniocentesis, record keeping by clinics, and the professional care given to an aborted fetus.

The District Court found in favor of the state of Missouri in all but one of the contested issues. Planned Parenthood and the two doctors then took their case to the U.S. Supreme Court. The Court agreed to hear the case so it could clear up questions concerning abortion procedures.

A Complex Ruling

Justice Harry A. Blackmun, who had written the Court's decision in Roe v. Wade, again delivered the Court's opinion, this time in a complex eight-part decision. The Court upheld some parts of the Missouri law but struck down others.

First, the Court dismissed one part that declared if an infant survived the abortion it would be taken from its parents and made a state ward. Blackmun pointed out that neither Planned Parenthood nor the two suing physicians really had anything to do with such a situation and, therefore, could not appropriately challenge that part of the law.

Next, Blackmun turned to the law's definition of viability, "that stage of fetal development when the life of the unborn child may be continued indefinitely outside the womb by natural or artificial life-supportive systems." In Roe he had loosely defined "viable" as the point where the fetus could possibly live outside the mother's womb, using artificial aid if necessary. While stating that neither legislatures nor the courts should try to define what is essentially a technical medical concept, Blackmun nevertheless concluded Missouri's definition of viability was consistent with Roe and upheld the state's definition.

Three Consent Issues

Blackmun next tackled three separate consent issues in the Missouri law. First, Blackmun found constitutional the requirement that a woman must provide written consent (agreement) to the abortion before undergoing it. Blackmun reasoned abortion was a very stressful operation. Requiring written consent from the woman showed she was in control of the decision.

Secondly, Blackmun ruled that spousal consent (husband must agree to the abortion) was unconstitutional. When it comes to making the final decision about having an abortion, Blackmun concluded that "the woman who physically bears the child" should be the one to decide.

Thirdly, Blackmun found unconstitutional the requirement of parental consent for an unmarried minor's (under eighteen years of age) abortion during the first twelve weeks of pregnancy. Blackmun reasoned that constitutional rights do not "magically" appear when one turns eighteen. Furthermore, Blackmun believed the parent consent requirement "providing the parent with absolute power" would not necessarily "serve to strengthen the family unit" as argued by the state.

Three More Issues

The Missouri law prohibited use of saline amniocentesis, the injection of a saline (salt solution) fluid into the sac surrounding the fetus. The fluid causes the fetus to be almost immediately rejected by the mother's body. Blackmun denied this restriction because the procedure was the most commonly used abortion procedure and provided a high degree of safety for the mother. Blackmun stressed that termination of pregnancy by other available means was "more dangerous to the woman's health than the method outlawed."

Two sections of the law required detailed record keeping of all abortions performed. The law required these records be kept seven years. Blackmun agreed that these requirements were "reasonably directed to the preservation of maternal [the mother's] health. . . " He, therefore, allowed both.

HOW THE ABORTION DEBATE HAS CHANGED

A t the beginning of the twenty-first century, the 1973 decision of Roe v. Wade legalizing abortion in the early stages of pregnancy before the unborn fetus could likely survive outside the womb still stood. Abortion debates remained as passionate as ever but generally concerned a "grab bag" of secondary issues and efforts by states to whittle away at a woman's access to abortion. The various issues at the state level included: requiring waiting periods and counseling for women seeking abortions, requiring parental consent, providing money for contraceptive education and family planning, and setting rules for protestors who attempt to blockade abortion clinics. Possibly the most emotional of all was the banning of "partial-birth abortion" which makes illegal certain abortion procedures performed during the last six months of pregnancy.

Congress likewise passed legislation prohibiting federal funding for abortions for various groups such as poor women enrolled in Medicaid, Native American women covered by Indian Health Services, and women in federal prisons, the military, and the Peace Corps. Meanwhile, technological developments have entered the abortion debates. For example, the new French-developed drug RU-486 with the scientific name of mifepristone, also known as the "morning after pill," induces abortion without surgical procedure. The Feminist Majority Foundation waged a nationwide campaign urging its approval. U.S. clinics began testing the drug by 1998.

Lastly, Blackmun declared unconstitutional the law's requirement that physicians provide professional care to the fetus as if it was "intended to be born and not aborted" or face manslaughter charges.

Building on Abortion Law

Looking at many facets of abortion procedures, the Court found constitutional the provisions of the law dealing with the term viability, written consent of the woman having the abortion, and extensive record keeping by clinics. The Court decided four other parts were unconstitutional: (1) requirements for husband consent; (2) requirements for parental consent of an unmarried minor; (3) prohibition of the saline amniocentesis medical procedure; and, (4) requiring professional care of the aborted fetus under the threat of manslaughter against the doctor.

Most important was the decisions concerning consent. The Court's position on parental consent later shifted some. In Belotti v. Baird (1979) the Court again struck down a state law requiring consent of both parents or the court. The Court found the law unconstitutional because it took away a minor's ability to choose regardless of her best interests, or ability to make informed decisions. But, in H.L.V. Matheson (1981) and Hodgson v. Minnesota (1990), the Court upheld laws requiring a physician to notify parents of a minor before performing an abortion. The Court reasoned the laws required only notification rather than consent and were in the best interest of the minor.

In Planned Parenthood of Southeastern Pennsylvania v. Casey (1992) the Court placed strong restrictions on minors by requiring that they obtain informed consent from at least one parent or a court before receiving an abortion. In Casey, the Court still refused to require husband notification.

Suggestions for further reading

Boyle, Mary. Re-Thinking Abortion: Psychology, Gender, Power, and the Law. New York: Routledge, 1997.

Graber, Mark A. Rethinking Abortion: Equal Choice, the Constitution and Reproductive Politics. Princeton, NJ: Princeton University Press, 1999.

Rein, Mei Ling, Siegel, Mark A., and Nancy R. Jacobs, eds. Abortion: An Eternal Social and Moral Issue. Buffalo, NY: Information Plus, 1998.