In 1992, Planned Parenthood of Southeastern Pennsylvania v. Casey upheld a central part of Roe v. Wade, saying that women were still allowed to make their own decisions, but it allowed for more government regulation and less privacy. As long as state restrictions did not create "undue burden" on a woman, they were permissible. Still, what exactly constitutes "undue burden" is debated.
"Before Casey, if a state tried to do something like make or have a 24-hour waiting period, the Supreme Court would likely have said -- and it did in some cases -- that's unduly interfering with her privacy," McClain said. "Casey basically says the woman is not isolated. The community has a profound interest in the fetus. As long as she gets to make the decision, the state can try to encourage her in favor of continuing the pregnancy."
McClain said that over the last 20 years, Casey has promoted the notion that women don't really understand what they're doing when they terminate their pregnancies. Therefore, if women understood abortions, they wouldn't go through with them.
"Forty years after Roe and 20 years after Casey, we're still at a point where women have a right to decide, but there's an awful lot of effort to get at a woman and tell her what to think about the pregnancy and what to do about the pregnancy … It's inconsistent with women's equality and autonomy and ability to make competent decisions."
Then, in 2007, the Supreme Court upheld a ban on "partial-birth abortions," which is not a medical term, but rather a procedure performed later in pregnancy that involves delivering the fetus and collapsing its skull. The ruling was particularly noteworthy because it did not include an exception that would make it legal to perform the procedure when a woman's health was in danger and there were no other medical options.
Supreme Court rulings aren't the only things that changed in the last four decades.
Rachel Jones, the Guttmacher Institute's lead abortion researcher, said abortion practices have generally changed with general trends in health care, which have seen less complicated procedures moving out of the hospital and into smaller clinics and practices, but the cost of the procedure has stayed down.
According to Guttmacher's most recent survey, a first trimester abortion cost $470 on average, Jones said.
"If you adjust for inflation, that isn't actually much of an increase over the last couple of decades," she said. "Interestingly, it's one of the only aspects of healthcare where we see that pattern, and it's because abortion providers pick up the slack."
In contrast, Americans United for Life president and CEO Charmaine Yoest said this week in a press release that the "big abortion industry" was "profit hungry." Yoest praised states with the most restrictions on abortion.
Sharing Abortion Stories
Women have started sharing their stories as part of Advocates for Youth's "1 in 3 Campaign," which comes from the Guttmacher finding that one in every three women will have an abortion in her lifetime.
Advocates for Youth, a more than 30-year-old nonprofit, was having a meeting about how to tackle abortion stigmas in 2011 when a few members told their abortion stories. Soon after, CEO Debra Hauser told her colleagues that, in fact, she had an abortion when she discovered she was pregnant shortly after her husband left her. At the time, she already had a six-month-old child.