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To understand Whole Woman's Health v. Hellerstedt, you should know about the Supreme Court’s biggest decision on abortion. In the landmark 1973 Roe v. Wade ruling (which also came out of Texas), the Supreme Court held that the Constitution protects women’s right to make their own personal medical decisions about abortion — without interference from politicians.

In 1992, the Supreme Court made another landmark decision on abortion access in the case of Planned Parenthood of Southeastern Pennsylvania v. Casey. The case was about a suite of abortion restrictions in Pennsylvania — including that a woman tell her husband if she intends to have an abortion. In a victory for abortion access, the court reaffirmed a woman's right to access abortion under Roe v. Wade. However, the decision set a new standard for courts reviewing abortion restriction cases: Abortion restrictions are allowed so long as they do not constitute an "undue burden" to the woman.

The court said a restriction is an “undue burden” if it places — or is just designed to place —  a substantial obstacle in the path of a woman seeking an abortion. Since husbands could keep wives from getting abortions, the husband-may-I part of Pennsylvania’s anti-abortion law was struck down. But it left other types of abortion restrictions up for interpretation under the undue burden standard.

Flash-forward to 2013: Backward politicians in Texas introduced a package of anti-abortion restrictions known as HB2 that were so severe they inspired Wendy Davis to launch an epic filibuster lasting 11 hours. Thousands of activists rallied around her, but Texas Governor Rick Perry ignored them and signed this clinic shutdown law.

The battle over reproductive rights and women’s health care that was waged on June 25 [2013] was not a battle I chose. When I believe women’s health is in danger, I’m going to stand and fight to protect that.”

– Wendy Davis, Valley Morning Star, 11/6/13


Before Roe v. Wade, abortion was illegal in most states

Even before  some of the provisions of HB2 took effect in November 2013 , abortion providers across the state began  to close. The case before the Supreme Court was brought by the Center for Reproductive Rights (CRR) on behalf of several Texas abortion providers, including Whole Woman’s Health, and challenged two of the most burdensome, medically unnecessary provisions of HB2.

The Fifth Circuit Court of Appeals upheld the anti-abortion restrictions in 2015, finding that leaving millions of Texas women with only nine providers of safe and legal abortion (and forcing them to travel out of state or hundreds of miles) was not an undue burden. If that was not an undue burden, it’s hard to imagine what is — and that’s why the case ended up at the  Supreme Court.