Donald Trump and abortion: How do states have a say in a woman's decision?

Donald Trump backed off of a statement he made on abortion Wednesday night after he was roundly criticized for saying women who undergo an abortion should face "some form of punishment" should the practice be outlawed.

Trump's campaign, a few hours after the Republican frontrunner for president talked with MSNBC’s Chris Matthews, walked back his statement saying what Trump meant to say was that doctors who perform the abortions should be punished, if all abortions were illegal. 

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"If Congress were to pass legislation making abortion illegal and the federal courts upheld this legislation, or any state were permitted to ban abortion under state and federal law, the doctor or any other person performing this illegal act upon a woman would be held legally responsible, not the woman," Trump said in the statement. "The woman is a victim in this case as is the life in her womb. My position has not changed -- like Ronald Reagan, I am pro-life with exceptions."

Since Roe v Wade guarantees a woman’s right to an abortion in the first trimester of her pregnancy, the question Matthews asked was, at least in part, a hypothetical one. But what are the laws concerning abortions and how do states have a say in a woman’s decision?

Here’s a quick look at the laws surrounding abortion in America.

The federal level

In 1973, the U.S. Supreme Court ruled in Roe v. Wade that a woman has the right to have an abortion during her first trimester of pregnancy per her right to privacy protected by the Fourteenth Amendment to the Constitution. The decision gave states the right to intervene in the second trimester  with respect to  the mother's health. The practice could be banned outright during the third trimester.

The state level

While all state restrictions on abortions were nullified after Roe v. Wade and its companion case, Doe v. Bolton, states have been able to pass laws regulating when and under what circumstances a woman can have  an abortion that do not legally  conflict with the Supreme Court's decision.

For instance, 38 states require that a licensed physician perform an abortion. Forty-three states ban abortions for women who are past a certain period in the last trimester – except when necessary to save the life of the mother.

Here are some of the restrictions placed by states on abortion services

 Eighteen states require not one but two doctors to perform an abortion if the woman is past a certain point in her pregnancy.

Partial-birth abortion – a procedure which partially delivers a fetus before aborting it -- is prohibited in 19 states.

Seventeen states require that women be counseled prior to an abortion; 12 of those states require the conversation to include the ability of the fetus to feel pain.

Forty-five  states allow individual health care providers to refuse to pay for abortions; 25 states restrict coverage of abortion in healthcare exchange plans.

Forty-two states allow institutions to refuse to perform abortions; 16 of those states say only private of religious institutions may refuse to perform abortions.

Twenty-one states restrict abortion coverage for public employees.

In 2010–2011, the median charge for an abortion in the United States was $495 at 10 weeks’ gestation; at 20 weeks, it was $1,350. 

Twenty-eight states require a woman seeking an abortion to wait a specified period of time, usually 24 hours, between when she receives counseling and when the procedure is performed.  

Thirty-eight states require some type of parental involvement in a minor’s decision to have an abortion; twenty-five states require one or both parents to consent to the procedure, while 13 require that one or both parents be notified.

Some statistics on abortion in the United States

There are 1.1 million abortions performed each year in the United States.

Nearly 1 in 4 pregnancies end in abortion.

Half  of all  women seeking an abortion have had at least one previous abortion.

The U.S. abortion rate is among the highest of developed countries.

Half  of all abortions performed in the United States are on women younger than 25; 18 percent are teenagers.

It is estimated that a third of all American women have had an abortion by age 45. 

White women account for 36 percent of all abortions performed; 30 percent for black women and 25 percent for Hispanic women.

Protestants account for 37 percent of woman seeking abortions; Catholics 28 percent.

In September 2000, the U.S. Food and Drug Administration approved the drug mifepristone as an alternative to surgical abortion.

Since the Roe v Wade Supreme Court decision in 1973, states have place 1,074 restrictions on abortion services. One quarter of those restrictions were enacted between 2011 and 2015.

Sources:;;; Kaiser Family Foundation  

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