The Importance of Doe v. Bolton

January 22, 2013 marks the 40th anniversary of the Roe v. Wade decision. All month, we’ll be running posts examining various aspects of this landmark ruling. If you’d like to contribute, let us know! 

Roe v. Wade wasn’t the only significant abortion decision released by the Supreme Court on January 22, 1973. The Court also ruled on the constitutionality of Georgia’s abortion laws, in the equally important but lesser-known case Doe v. Bolton, which the Court first heard in 1971.

The plaintiff, identified as “Mary Doe,” was nine weeks pregnant when she sued the state’s attorney general, Arthur Bolton, for the right to an abortion. At the time, Georgia allowed for abortion for state residents in cases of rape, severe fetal deformity, or the possibility that the mother could sustain a severe or fatal injury to her health. In its ruling, the Supreme Court found that the existence of the three conditions upon which abortion was allowed violated the Fourteenth Amendment and that the residency requirement violated the Privileges and Immunities Clause.

In Doe, the Court unambiguously favored the woman’s right to preserve her health over the government’s power to meddle. In an interview with Frontline, Jack Belkin, the editor of What Roe v. Wade Should Have Said, summarizes the Court’s opinion:

“…what the Supreme Court did in Doe v. Bolton was to say that where the state piles on procedures whose basic job is to slow down the process of getting an abortion or make it more difficult for women to get an abortion, those things are unconstitutional unless they have some clear relationship to preserving the woman’s health or good medical practice.

And the Court said … that the things that Georgia did, the impositions they made, weren’t the sort of impositions they made for any other kind of surgery, no matter how dangerous or life-threatening. There seemed to be special rules basically designed to impede and slow down the ability of women to get abortions if they were medically indicated, and so the Supreme Court said, ‘You can’t do that.’”

In his book The Nine, Jeffrey Toobin quotes Justice Harry Blackmun’s majority opinion in Doe. Blackmun wrote that the decision to have an abortion “may be exercised in the light of all factors— physical, emotional, psychological, familial, and the woman’s age—relevant to the well-being of the patient.”

And herein lies Doe’s importance. Given that four decades on, the idea that pregnancy can have an adverse affect on a woman’s mental or emotional health is still controversial in some areas, the Court’s inclusion of these factors as legitimate considerations is indeed groundbreaking. Doe’s expansive view of “health” is even more important when you consider that this opinion is meant to be read together with Roe, which requires that even states that restrict abortion in the second and third trimesters of pregnancy must make exceptions “for the preservation of the life or health of the mother.” Allowing a woman to have an abortion if her mental or emotional health was at risk shows a holistic and realistic view of the strains and stresses that a pregnancy—whether wanted or not—can put on a woman; it acknowledges that a person’s mental and emotional health should be given equal weight along with the more easily understood physical risks of a pregnancy.

Doe and Roe have one other commonality: plaintiffs who, in the years after their cases, spoke out against legal abortion. Sandra Cano, aka “Mary Doe,” has become a anti-choice activist, even asking the Supreme Court to reverse its decision in Doe (the Court declined to do so). In a 2003 article, Cano claims that she was “used” by attorneys who wanted to challenge the state’s abortion laws; she ended up leaving Georgia for a number of months during her pregnancy, and by the time she returned it was too late to have an abortion.

Whether Cano, like Norma McCorvey, actually wanted to have an abortion seems destined to be a matter of debate; for as staunchly as these women have subsequently claimed that they either didn’t understand the cases they were involved in, or were misled by their attorneys, others involved in their cases have been equally firm that the women participated out of their own free will, and did want to obtain abortions. What isn’t a matter of debate, however, is that the cases that bear their pseudonyms have given millions of women the right to make the choices that they feel are best for their lives, their families, and their health.

About Sarah:
Sarah's first book, Generation Roe: Inside the Future of the Pro-Choice Movement, will be out March 2013. For more information, follow her on Twitter @saraherdreich, or check out


  1. One more reason I can’t wait to read Generation Roe!!!

  2. I agree very much with the TIME article. The pro-choice movement has been losing steadily for the last 40 years. A new generation of feminists does not see an unborn baby as the enemy.

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