akron akron center reproductive health argued november decided june akron ohio ordinance inter alia requires abortions performed first trimester pregnancy performed hospital prohibits physician performing abortion unmarried minor age unless obtains consent one parents unless minor obtains order jurisdiction abortion performed requires attending physician inform patient status pregnancy development fetus date possible viability physical emotional complications may result abortion availability agencies provide assistance information respect birth control adoption childbirth also inform particular risks associated pregnancy abortion technique employed prohibits physician performing abortion hours pregnant woman signs consent form requires physicians performing abortions ensure fetal remains disposed humane sanitary manner violation ordinance punishable misdemeanor respondents filed action federal district petitioners challenging ordinance district invalidated upheld appeals affirmed reversed held section unconstitutional pp state interest health regulation becomes compelling approximately end first trimester state regulation may upheld reasonably designed interest substantial portion second trimester state regulation departs accepted medical practice may upheld simply may reasonable remaining portion trimester rather state obligated make reasonable effort limit effect regulations period trimester health interest may furthered pp said lines drawn reasonable preventing performance abortions appropriate nonhospital setting akron imposed heavy unnecessary burden women access relatively inexpensive otherwise accessible safe abortion procedure section effect inhibiting vast majority abortions first trimester therefore unreasonably infringes upon woman constitutional right obtain abortion pp section unconstitutional making blanket determination minors age immature make abortion decision abortion never may minor best interests without parental approval circumstances ohio statute governing juvenile proceedings mention minors abortions suggest ohio juvenile authority inquire minor maturity emancipation applied juvenile proceedings reasonably susceptible construed create opportunity evaluations maturity pregnant minors pp sections unconstitutional pp validity informed consent requirement rests state interest protecting pregnant woman health mean state unreviewable authority decide information woman must given chooses abortion state may adopt regulations designed influence woman informed choice abortion childbirth pp section attempts extend state interest ensuring informed consent beyond permissible limits intrudes upon discretion pregnant woman physician state may require physician make certain patient understands physical emotional implications abortion goes far beyond merely describing general subject matter relevant informed consent insisting upon recitation lengthy inflexible list information section unreasonably placed obstacles path physician pp respect requirement attending physician must inform woman specified information unreasonable state insist physician competent provide information counseling relevant informed consent pp section unconstitutional akron failed demonstrate legitimate state interest furthered arbitrary inflexible waiting period evidence abortion procedure performed safely appear state legitimate concern woman decision informed reasonably served requiring delay matter course pp section violates due process clause failing give physician fair notice contemplated conduct forbidden pp together akron center reproductive health et al city akron et also certiorari powell delivered opinion burger brennan marshall blackmun stevens joined filed dissenting opinion white rehnquist joined post alan segedy argued cause petitioner respondent briefs robert pritt segedy robert destro filed brief seguin et respondents rule support petitioner respondent solicitor general lee argued cause amicus curiae brief assistant attorney general mcgrath deputy solicitor general geller stephan landsman argued cause respondents petitioners briefs janet benshoof suzanne lynn nan hunter lois lipton gordon fn briefs amici curiae urging reversal filed delores horan feminists life lynn wardle families foundation et al briefs amici curiae urging affirmance filed bruce ennis donald bersoff american psychological association sylvia law nadine taub ellen winner committee abortion rights sterilization abuse et al briefs amici curiae filed carolyn cox lynn bregman american college obstetricians gynecologists et al david hopkins american public health association dennis horan victor rosenblum patrick trueman thomas marzen americans life california women lawyers et al charles rice catholic league religious civil rights rhonda copelon certain religious organizations jack bierig college american pathologists ronald suster lawyers life alan ernest legal defense fund unborn children judith levin national abortion federation jack greenberg james nabrit iii judith reed naacp legal defense educational fund phyllis segal judith avner jemera rone national organization women et al eve paul dara klassel planned parenthood federation america et al james arthur gleason womankind nancy reardan women lawyers sacramento et al susan frelich appleton paul brest certain law professors justice powell delivered opinion litigation must decide constitutionality several provisions ordinance enacted city akron ohio regulate performance abortions today also review abortion regulations enacted state missouri see planned parenthood assn kansas city ashcroft post state virginia see simopoulos virginia post cases come us decade held roe wade right privacy grounded concept personal liberty guaranteed constitution encompasses woman right decide whether terminate pregnancy legislative responses decision required us several occasions today define limits state authority regulate performance abortions arguments continue made cases well erred interpreting constitution nonetheless doctrine stare decisis perhaps never entirely persuasive constitutional question doctrine demands respect society governed rule law respect today reaffirm roe wade february city council akron enacted ordinance entitled regulation abortions ordinance sets forth provisions regulate performance abortions see akron codified ordinances ch issue case section requires abortions performed first trimester pregnancy performed hospital ii section sets forth requirements notification consent parents abortions may performed unmarried minors iii section requires attending physician make certain specified statements patient insure consent abortion truly informed consent iv section requires waiting period time woman signs consent form time abortion performed section requires fetal remains disposed humane sanitary manner violation section ordinance punishable criminal misdemeanor provision invalidated severed remainder ordinance ordinance became effective may april lawsuit challenging virtually ordinance provisions filed district northern district ohio plaintiffs respondents three corporations operate abortion clinics akron physician performed abortions one clinics defendants petitioners city akron three city officials akron two individuals intervenors permitted intervene codefendants individual capacity parents unmarried minor daughters childbearing age supp april district preliminarily enjoined enforcement ordinance august hearing evidence district ruled merits found plaintiffs lacked standing challenge seven provisions ordinance none district invalidated four provisions including parental notice consent requiring disclosure facts concerning woman pregnancy fetal development complications abortion agencies available assist woman disposal fetal remains upheld constitutionality remainder ordinance including hospitalization abortions first trimester requiring disclosure particular risks woman pregnancy abortion technique employed waiting period parties appealed portion district judgment appeals sixth circuit affirmed part reversed part affirmed district decision hospitalization requirement constitutional also affirmed ruling unconstitutional appeals reversed district decision finding provisions unconstitutional three separate petitions certiorari filed light importance issues presented particular conflicting decisions whether state may require abortions performed hospital granted akron plaintiffs petitions denied intervenors petition seguin akron center reproductive health participated respondents rule reverse judgment appeals upholding akron hospitalization requirement affirm remainder decision invalidating provisions parental consent informed consent waiting period disposal fetal remains ii roe wade held right privacy founded fourteenth amendment concept personal liberty restrictions upon state action broad enough encompass woman decision whether terminate pregnancy although constitution specifically identify right history constitutional adjudication leaves doubt full scope liberty guaranteed due process clause found limited precise terms specific guarantees elsewhere provided constitution poe ullman harlan dissenting dismissal appeal central among protected liberties individual freedom personal choice matters marriage family life roe stewart concurring see eisenstadt baird loving virginia griswold connecticut pierce society sisters meyer nebraska decision roe based firmly essential element personal liberty also recognized abortion medical procedure full vindication woman fundamental right necessarily requires physician given room needs make best medical judgment doe bolton see whalen roe physician exercise medical judgment encompasses assisting woman decisionmaking process implementing decision choose abortion see colautti franklin time roe acknowledged woman fundamental right unqualified must considered important state interests abortion roe restrictive state regulation right choose abortion fundamental rights subject searching judicial examination must supported compelling state interest recognized two interests may justify state regulation abortions first state important legitimate interest protecting potentiality human life although interest exists throughout course woman pregnancy beal doe becomes compelling viability point fetus capability meaningful life outside mother womb roe supra see planned parenthood central missouri danforth viability interest protecting potential life unborn child important state may proscribe abortions altogether except necessary preserve life health mother roe second state legitimate concern health women undergo abortions state may properly assert important interests safeguarding health maintaining medical standards held roe however health interest become compelling approximately end first trimester pregnancy time pregnant woman must permitted consultation physician decide abortion effectuate decision free interference state ibid mean state never may enact regulation touching woman abortion right first weeks pregnancy certain regulations significant impact woman exercise right may permissible justified important state health objectives danforth supra unanimously upheld two missouri statutory provisions applicable first trimester requiring woman provide informed written consent abortion physician keep certain records even though comparable requirements imposed medical procedures see decisive factor state met burden demonstrating regulations furthered important state concerns even minor regulations abortion procedure first trimester may interfere consultation woman choice abortion childbirth see approximately end first trimester pregnancy state may regulate abortion procedure extent regulation reasonably relates preservation protection maternal health roe state discretion regulate basis however permit adopt abortion regulations depart accepted medical practice rejected state attempt ban particular abortion procedure ban increased costs limited availability abortions without promoting important health benefits see danforth state requires licensing undertakes regulate performance abortions period health standards adopted must legitimately related objective state seeks accomplish doe iii section akron ordinance requires abortion performed upon pregnant woman subsequent end first trimester pregnancy must performed hospital hospital general hospital special hospital devoted gynecology obstetrics accredited joint commission accreditation hospitals american osteopathic association accreditation organizations requires compliance comprehensive standards governing wide variety health surgical services ordinance thus prevents performance abortions outpatient facilities part hospital district plaintiffs sought demonstrate hospitalization requirement serious detrimental impact woman ability obtain abortion akron reasonably related state interest health pregnant woman district reject argument rather found evidence convincing willing discard formulation roe line impermissible regulation permissible regulation appeals affirmed similar basis accepted plaintiffs argument akron hospitalization requirement reasonable health justification least part second trimester declined retreat bright line roe wade believe courts misinterpreted prior decisions hold unconstitutional roe wade held end first trimester pregnancy state interest becomes compelling may regulate abortion procedure extent regulation reasonably relates preservation protection maternal health noted example establish requirements relating facility procedure performed whether must hospital may clinic place status ibid companion case doe bolton invalidated georgia requirement abortions performed hospital licensed state board health accredited joint commission accreditation hospitals see recognized state legitimate health interests establishing abortions standards licensing facilities abortions may performed found however state must show shown doe order prove full resources licensed hospital rather appropriately licensed institution satisfy health interests ibid reaffirm today see supra state interest health regulation becomes compelling approximately end first trimester existence compelling state interest health however beginning inquiry state regulation may upheld reasonably designed state interest see doe roe hold always reasonable state adopt abortion regulation applies entire second trimester state necessarily must latitude adopting regulations general applicability sensitive area appears substantial portion second trimester state regulation depart accepted medical practice supra regulation may upheld simply may reasonable remaining portion trimester rather state obligated make reasonable effort limit effect regulations period trimester health interest furthered doubt hospitalization requirement places significant obstacle path women seeking abortion primary burden created requirement additional cost woman appeals noted testimony abortion costs twice much hospital clinic see abortion costs whereas abortion performed clinic costs moreover indicated abortions rarely performed akron hospitals ibid nine abortions performed akron hospitals year trial thus hospitalization requirement may force women travel find available facilities resulting financial expense additional health risk therefore apparent hospitalization requirement may significantly limit woman ability obtain abortion akron contend imposes insignificant burden women access abortion rather defends reasonable health regulation position strong support time roe wade hospitalization abortions recommended american public health association apha see roe american college obstetricians gynecologist acog see standards services ed since however safety abortions increased dramatically principal reason procedure widely successfully used abortions appeals found abundance evidence safest method performing trimester abortions today availability procedure interval approximately weeks pregnancy period abortion techniques generally used meant women desiring early abortion longer forced incur health risks waiting least week pregnancy purposes even significant factor experience indicates may performed safely outpatient basis appropriate nonhospital facilities evidence strong enough convinced apha abandon prior recommendation hospitalization abortions current data show abortions occurring second trimester safely performed dilatation evacuation procedure requirements abortions weeks gestation performed hospitals increase expense inconvenience woman without contributing safety procedure apha recommended program guide abortion services revised public health hereinafter apha recommended guide developments professional commentary supporting constitute impressive evidence least early weeks second trimester abortions may performed safely outpatient clinic hospital conclude therefore present medical knowledge roe supra convincingly undercuts akron justification requiring abortions performed hospital akron nonetheless urges fact midtrimester abortions may done minimally equipped clinic invalidate regulation brief respondents true state abortion regulation unconstitutional simply correspond perfectly cases asserted state interest lines drawn state regulation must reasonable said preventing performance abortions appropriate nonhospital setting akron imposed heavy unnecessary burden women access relatively inexpensive otherwise accessible safe abortion procedure section effect inhibiting vast majority abortions first weeks danforth therefore unreasonably infringes upon woman constitutional right obtain abortion iv turn next provision prohibiting physician performing abortion minor pregnant woman age unless obtains informed written consent one parents legal guardian unless minor obtains order jurisdiction abortion performed induced district invalidated provision establish procedure minor avoid parental veto abortion decision demonstrating decision fact informed rather requires cases minor informed consent either parental consent order appeals affirmed basis relevant legal standards dispute held state may impose blanket provision requiring consent parent person loco parentis condition abortion unmarried minor danforth supra bellotti baird bellotti ii majority indicated state interest protecting immature minors sustain requirement consent substitute either parental judicial see plurality opinion four justices white dissenting expressing approval absolute parental judicial consent requirement see also danforth supra stevens concurring part dissenting part bellotti ii plurality cautioned however state must provide alternative procedure whereby pregnant minor may demonstrate sufficiently mature make abortion decision despite immaturity abortion best interests decisions clear akron may make blanket determination minors age immature make decision abortion never may minor best interest without parental approval akron ordinance create expressly alternative procedure required bellotti ii akron contends ohio juvenile qualify jurisdiction within meaning assumed course juvenile proceedings construe ordinance manner consistent constitutional requirement determination minor ability make informed consent brief petitioner akron concludes courts invalidated face city relies bellotti baird bellotti decide whether state parental consent provisions unconstitutional applied mature minors holding instead abstention appropriate unconstrued state statute susceptible construction state judiciary might avoid whole part necessity federal constitutional adjudication least materially change nature problem quoting harrison naacp see also matheson refusing decide whether parental notice statute constitutional applied mature minors think abstention principle applied reasonable assume bellotti supra matheson supra state presented state statute specifically governing abortion consent procedures pregnant minors attempt construe statute consistently constitutional requirements suit however concerns municipal ordinance creates procedures making necessary determinations akron seeks invoke ohio statute governing juvenile proceedings statute neither mentions minors abortions suggests ohio juvenile authority inquire minor maturity emancipation circumstances think akron ordinance applied ohio juvenile proceedings reasonably susceptible construed create opportunity evaluations maturity pregnant minors bellotti ii supra plurality opinion therefore affirm appeals judgment unconstitutional akron ordinance provides abortion shall performed except informed written consent pregnant woman given freely without coercion furthermore order insure consent abortion truly informed consent woman must orally informed attending physician status pregnancy development fetus date possible viability physical emotional complications may result abortion availability agencies provide assistance information respect birth control adoption childbirth addition attending physician must inform particular risks associated pregnancy abortion technique employed information medical judgment relevant decision whether abortion carry pregnancy term district found unconstitutional related valid state interest maternal health see appeals concluded provisions unconstitutional see affirm danforth upheld missouri law requiring pregnant woman certif writing consent abortion consent informed freely given result coercion explained decision abort important often stressful one desirable imperative made full knowledge nature consequences woman one primarily concerned awareness decision significance may assured constitutionally state extent requiring prior written consent validity informed consent requirement thus rests state interest protecting health pregnant woman decision abortion implications far broader associated kinds medical treatment bellotti ii plurality opinion thus state legitimately may seek ensure made light attendant circumstances psychological emotional well physical might relevant patient colautti franklin mean however state unreviewable authority decide information woman must given chooses abortion remains primarily responsibility physician ensure appropriate information conveyed patient depending particular circumstances danforth recognition state interest ensuring information given justify abortion regulations designed influence woman informed choice abortion childbirth viewing city regulations light believe attempts extend state interest ensuring informed consent beyond permissible limits first fair say much information required designed inform woman consent rather persuade withhold altogether subsection requires physician inform patient unborn child human life moment conception requirement inconsistent holding roe wade state may adopt one theory life begins justify regulation abortions see moreover much detailed description anatomical physiological characteristics particular unborn child required subsection involve best speculation physician subsection begins dubious statement abortion major surgical procedure proceeds describe numerous possible physical psychological complications abortion parade horribles intended suggest abortion particularly dangerous procedure additional equally decisive objection intrusion upon discretion pregnant woman physician provision specifies litany information physician must recite woman regardless whether judgment information relevant personal decision example even physician believes risks outlined subsection nonexistent particular patient remains obligated describe danforth warned placing physician undesired uncomfortable straitjacket consistent interest ensuring informed consent state may require physician make certain patient understands physical emotional implications abortion akron gone far beyond merely describing general subject matter relevant informed consent insisting upon recitation lengthy inflexible list information akron unreasonably placed obstacles path doctor upon woman entitled rely advice connection decision whalen roe section presents different question provision attending physician must inform woman particular risks associated pregnancy abortion technique employed including providing least general description medical instructions followed subsequent abortion order insure safe recovery shall addition provide information medical judgment relevant decision whether abortion carry pregnancy term appeals also held however invalid required disclosure made attending physician found practice three plaintiff clinics counseling conducted persons doctor performs abortion determined akron justified requiring physician personally describe health risks akron challenges holding contrary cases emphasize importance relationship akron view view dissenting judge attending physician requirement seek ensure fact true relationship even woman goes abortion clinic kennedy concurring part dissenting part requiring physicians personally discuss abortion decision health risks consequences patient may cases add cost providing abortions though record suggest ethical physicians charge adhering typical element relationship yet roe subsequent cases stressed repeatedly central role physician consulting woman whether abortion determining abortion carried colautti franklin moreover left doubt ensure safety abortion procedure may mandate physicians perform abortions see connecticut menillo roe convinced however vital state need insisting physician performing abortion matter physician personally counsel patient absence request state interest ensuring woman consent informed unpressured critical factor whether obtains necessary information counseling qualified person identity person obtains akron intervenors strongly urge nonphysician counselors plaintiff abortion clinics trained qualified perform important function courts made findings however record us say woman consent abortion informed physician delegates counseling task another qualified individual holding suggest state powerless vindicate interest making certain important stressful decision abort made full knowledge nature consequences danforth imply physician may abdicate essential role person ultimately responsible medical aspects decision perform abortion state may define physician responsibility include verification adequate counseling provided woman consent informed addition state may establish reasonable minimum qualifications people perform primary counseling function see doe state may require medical facility possess staffing services necessary perform abortion safely light alternatives believe unreasonable state insist physician competent provide information counseling relevant informed consent affirm judgment appeals invalid vi akron ordinance prohibits physician performing abortion hours pregnant woman signs consent form district upheld provision ground furthered akron interest ensuring woman abortion decision made careful consideration facts applicable particular situation appeals reversed finding inflexible waiting period medical basis careful consideration abortion decision woman beyond state power require affirm appeals judgment district found mandatory waiting period increases cost obtaining abortion requiring woman make two separate trips abortion facility see plaintiffs also contend scheduling difficulties effective delay may longer hours delay cases increase risk abortion akron denies significant health risk created waiting period argues brief period delay opportunity reflection counseling received often beneficial pregnant woman find akron failed demonstrate legitimate state interest furthered arbitrary inflexible waiting period evidence suggesting abortion procedure performed safely convinced state legitimate concern woman decision informed reasonably served requiring delay matter course decision whether proceed abortion one important affor physician adequate discretion exercise medical judgment colautti franklin accordance ethical standards profession physician advise patient defer abortion thinks beneficial woman appropriate counseling prepared give written informed consent proceed abortion state may demand delay effectuation decision vii section akron ordinance requires physicians performing abortions insure remains unborn child disposed humane sanitary manner appeals found word humane impermissibly vague definition conduct subject criminal prosecution invalidated entire provision declining sever word humane order uphold requirement disposal sanitary see affirm judgment akron contends purpose simply preclude mindless dumping aborted fetuses onto garbage piles planned parenthood assn fitzpatrick supp ed quoting state characterization legislative purpose summarily aff sub nom franklin fitzpatrick far clear however provision limited intent phrase humane sanitary appeals noted suggest possible intent mandate sort decent burial embryo earliest stages formation level uncertainty fatal criminal liability imposed see colautti franklin supra fails give physician fair notice contemplated conduct forbidden harriss agree violates due process clause viii affirm judgment appeals invalidating sections akron regulations abortions ordinance deal parental consent informed consent waiting period disposal fetal remains remaining portion judgment sustaining akron requirement abortions performed hospital reversed ordered footnotes today however dissenting opinion rejects basic premise roe progeny dissent stops short arguing flatly roe overruled rather adopts reasoning practical purposes accomplish precisely result dissent ven assuming fundamental right terminate pregnancy situations state compelling interests maternal health potential human life present throughout pregnancy post emphasis original existence compelling interests turns largely unnecessary however dissent think even one numerous abortion regulations issue imposes sufficient burden limited fundamental right post require heightened scrutiny indeed dissent asserts regardless cost health regulation hospitalization requirement simply rise level official interference abortion decision post quoting harris mcrae supra white concurring dissent therefore hold requirement abortions performed general hospital impose unacceptable burden abortion decision requires great familiarity cost limited availability hospitals appreciate effect dissent views drive performance many abortions back underground free effective regulation often without attendance physician sum appears dissent uphold virtually abortion regulation test also appears even heightened scrutiny deemed appropriate dissent uphold virtually regulation state interest preserving potential human life see post arguing waiting period justified part abortion decision grave consequences fetus analysis wholly incompatible existence fundamental right recognized roe wade ordinance prefaced several findings whereas citizens akron entitled highest standard health care whereas abortion major surgical procedure result complications adequate equipment personnel required safe performance order insure highest standards care protection life health pregnant woman whereas abortion performed hospital special outpatient facility offering maximum safeguards life health pregnant woman whereas finding council point time union sperm egg least blastocyst stage birth infant point say unborn child human life changes occurring implantation embryo fetus child mature adult merely stages development maturation whereas traditionally physician responsible welfare pregnant woman unborn child situations conflict may arise pregnant woman health interests welfare unborn child resolution conflicts inducing abortion way implies physician adversary relationship towards unborn child whereas council therefore wishes affirm destruction unborn child primary purpose abortion consequently council recognizes continuing obligation part physician towards survival viable unborn child obligation discharged without additional hazard health pregnant woman whereas council extensive public hearings investigations concludes enactment ordinance reasonable prudent action significantly contribute preservation public life health safety morals welfare akron ordinance abortion hospital person shall perform induce abortion upon pregnant woman subsequent end first trimester pregnancy unless abortion performed hospital notice consent physician shall perform induce abortion upon unmarried pregnant woman age years without first given least hours actual notice one parents legal guardian minor pregnant woman intention perform abortion parent guardian reached reasonable effort find without first given least hours constructive notice one parents legal guardian minor pregnant woman certified mail last known address one parents guardian computed time mailing unless abortion ordered jurisdiction minor pregnant woman physician shall perform induce abortion upon minor pregnant woman age fifteen years without first obtained informed written consent minor pregnant woman accordance section chapter first obtained informed written consent one parents legal guardian accordance section chapter minor pregnant woman first obtained order jurisdiction abortion performed induced informed consent abortion otherwise permitted law shall performed induced informed written consent pregnant woman one parents legal guardian whose consent required accordance section chapter given freely without coercion order insure consent abortion truly informed consent abortion shall performed induced upon pregnant woman one parents legal guardian whose consent required accordance section chapter orally informed attending physician following facts signed consent form acknowledging parent legal guardian applicable informed follows according best judgment attending physician pregnant number weeks elapsed probable time conception unborn child based upon information provided time last menstrual period history physical examination appropriate laboratory tests unborn child human life moment conception described detail anatomical physiological characteristics particular unborn child gestational point development time abortion performed including limited appearance mobility tactile sensitivity including pain perception response brain heart function presence internal organs presence external members unborn child may viable thus capable surviving outside womb weeks elapsed time conception attending physician legal obligation take reasonable steps preserve life health viable unborn child abortion abortion major surgical procedure result serious complications including hemorrhage perforated uterus infection menstrual disturbances sterility miscarriage prematurity subsequent pregnancies abortion may leave essentially unaffected may worsen existing psychological problems may result severe emotional disturbances numerous public private agencies services available provide birth control information physician provide list agencies services available requests numerous public private agencies services available assist pregnancy birth child chooses abortion whether wishes keep child place adoption physician provide list agencies services available requests time attending physician provides information required paragraph section shall least orally inform pregnant woman one parents legal guardian whose consent required accordance section chapter particular risks associated pregnancy abortion technique employed including providing least general description medical instructions followed subsequent abortion order insure safe recovery shall addition provide information medical judgment relevant decision whether abortion carry pregnancy term attending physician performing inducing abortion shall provide pregnant woman one parents legal guardian signing consent form applicable duplicate copy consent form signed one parents legal guardian applicable accordance paragraph section waiting period physician shall perform induce abortion upon pregnant woman hours elapsed time pregnant woman one parents legal guardian whose consent required accordance section chapter signed consent form required section chapter physician certifies writing time elapsed disposal remains physician shall perform induce abortion upon pregnant woman shall insure remains unborn child disposed humane sanitary manner severability provision chapter construed law invalid illegal unconstitutional otherwise unenforcible invalidity illegality unconstitutionality unenforcibility shall extend provision provisions chapter compare planned parenthood assn kansas city ashcroft supplemented invalidating hospital requirement simopoulos commonwealth upholding hospital requirement numerous require abortions performed hospitals see brief americans life amicus curiae simopoulos virginia listing addition repeatedly recognized view unique status children law significant interest certain abortion regulations aimed protecting children present case adult planned parenthood central missouri danforth see carey population services international plurality opinion right privacy includes independence making certain kinds important decisions whalen roe recognized many minors less capable adults making important decision see bellotti baird bellotti ii plurality opinion danforth supra stevens concurring part dissenting part accordingly held legitimate interest encouraging parental involvement minor children decision abortion see matheson parental notice bellotti ii supra plurality opinion parental consent majority however indicated state parental interests must give way constitutional right mature minor immature minor whose best interests contrary parental involvement see matheson powell concurring marshall dissenting plurality bellotti ii concluded state choosing encourage parental involvement must provide alternative procedure minor may demonstrate mature enough make decision abortion best interest see bellotti ii supra roe identified end first trimester compelling point time according medical literature available mortality abortion may less mortality normal childbirth substantial evidence developments past decade particularly development much safer method performing abortions see infra extended period abortions safer childbirth see lebolt grimes cates mortality abortion childbirth populations comparable abortion may safer childbirth gestational ages weeks think prudent however retain roe identification beginning second trimester approximate time state interest maternal health becomes sufficiently compelling justify significant regulation abortion note medical evidence suggests approximately end first trimester state interest maternal health served regulations restrict manner abortions performed licensed physician see american college obstetricians gynecologists acog standards services ed hereinafter acog standards uncomplicated abortions generally may performed physician office outpatient clinic weeks first day last menstrual period acog technical bulletin methods abortion regardless advances abortion technology midtrimester terminations likely remain hazardous expensive emotionally disturbing women earlier abortions roe trimester standard thus continues provide reasonable legal framework limiting state authority regulate abortions state adopts health regulation governing performance abortions second trimester determinative question whether reasonable medical basis regulation see roe comparison abortion childbirth mortality rates may relevant state employs health rationale justification complete prohibition abortions certain circumstances see danforth supra invalidating state ban saline abortions method safer respect maternal mortality even continuation pregnancy normal childbirth course state retains interest ensuring validity roe factual assumption first trimester abortion safe woman normal childbirth term assumption holds true abortion performed medically competent personnel conditions insuring maximum safety woman connecticut menillo per curiam basis example permissible impose criminal sanctions performance abortion nonphysician ibid example concluded recordkeeping abused overdone useful state interest protecting health female citizens may resource relevant decisions involving medical experience judgment see infra discussing state interest requiring informed consent examples permissible state regulation area requirements qualifications person perform abortion licensure person facility procedure performed whether must hospital may clinic place status licensing facility like roe supra akron ordinance define first trimester elsewhere suggests age fetus measured date conception see physician must inform woman number weeks elapsed since conception physician must inform woman fetus may viable weeks conception average pregnancy lasts approximately weeks time conception commonly measured weeks beginning woman last menstrual period methods may deviation either way approximate nature measurements certain method delineating trimesters frequently first trimester estimated weeks following conception weeks following last menstrual period need attempt draw precise line purposes analysis identified compelling point state interest health approximately end first trimester roe unless otherwise indicated references opinion gestational age based time beginning last menstrual period joint commission accreditation hospitals jcah example established guidelines following services dietetic emergency home care nuclear medicine pharmaceutical professional library rehabilitation social work special care see generally jcah accreditation manual hospitals edition akron ordinance distinguishes hospitals outpatient clinics section provides even abortions must performed hospital abortion facility abortion facility defined clinic physician office place facility abortions performed hospital appeals believed bound indiana women services bowen supp nd ind summarily aff sub nom indiana women services orr indiana hospitalization requirement upheld although district case found roe render constitutionality second trimester regulations subject either availability abortions improvements medical techniques skills also rested decision alternative ground plaintiffs failed provide evidence support theory unreasonable require hospitalization dilatation evacuation abortions performed early second trimester see summary affirmance therefore binding precedent hospitalization issue see illinois state board elections socialist workers party also found additional requirement licensed hospital accredited jcah based differences reasonably related purposes act found doe quoting morey doud concluded event georgia hospital requirement invalid applied abortions national statistics indicate similar cost difference average clinic charged abortion whereas average hospital charge hospital charge include physician fee ran high see rosoff availability abortion services published abortion perspectives decade experience berger brenner keith eds hereinafter abortion akron situation unique many areas country hospitals perform abortions see planned parenthood assn kansas city ashcroft abortions available one hospital missouri wolfe stumbo supp wd elective abortion performed kentucky hospitals margaret edwards supp ed la hospitals louisiana perform abortions first trimester ratio abortions country fell deaths per abortions per see tyler cates schulz selik smith induced abortion published abortion time roe decided procedure used perform abortions instillation procedures primary means performing abortion development generally performed approximately week pregnancy time amniotic sac small see grimes cates dilatation evacuation published abortion see also planned parenthood assn kansas city ashcroft supra discussing testimony willard cates chief federal abortion surveillance national centers disease control abortions safely performed outside hospitals week apha recommended guide outpatient safer abortion procedures second trimester trial akron relied largely former position various medical organizations concerning hospitalization second trimester see revised position acog occur trial akron also argues safety nonhospital abortions depends adherence minimum standards adopted acog surgical facilities see acog standards evidence plaintiffs clinics operate manner issue litigation whether clinics meet standards prescribed city rather akron gone much banning abortions clinics regulation reasonably city interest promoting health continue hold doe bolton state may end first trimester adopt standards licensing facilities abortions may performed long standards legitimately related objective state seeks accomplish includes standards designed correct deficiencies akron reasonably believes exist clinics present operation city thus implies hospital requirement may sustained reasonable applied later abortions instillation abortions hold today state circumstances may require abortions performed hospital abortions performed much safer point development fetus performed instillation methods see cates grimes morbidity mortality published abortion evidence us need hospitalization concerns method performed early weeks second trimester see abortions weeks abortions weeks performed method see department health human services centers disease control abortion surveillance annual summary table appeals upheld notification requirement see validity ruling challenged primary holding matheson pregnant minor questioned utah abortion consent requirement ground impermissibly applied mature emancipated minors lacked standing raise argument since alleged member class mature emancipated standing problem exists however physician plaintiff subject potential criminal liability failure comply requirements standing raise claims minor patients see danforth doe bolton bellotti ii plurality opinion ohio juvenile jurisdiction child alleged juvenile traffic offender delinquent unruly abused neglected dependent ohio rev code ann supp category arguably encompass pregnant minor desiring abortion neglected child category neglected child defined one hose parents guardian custodian neglects refuses provide proper necessary subsistence education medical surgical care care necessary health morals well even assuming ohio courts construe provisions permitting minor obtain judicial approval proper necessary medical surgical care abortion parents refused provide care statute makes provision mature emancipated minor completely avoid hostile parental involvement demonstrating satisfaction capable exercising constitutional right choose abortion contrary statute requires minor parents notified petition filed requirement case mature minor seeking abortion unconstitutional see matheson powell concurring marshall dissenting particular emphasized state interest protecting immature minors promoting family integrity gives special interest ensuring abortion decision made understanding careful deliberation see matheson powell concurring stevens concurring judgment state always foreclosed asserting interest whether pregnancies end abortion childbirth maher roe harris mcrae upheld governmental spending statutes reimbursed indigent women childbirth abortion legislation interest preferring childbirth abortion permissible however add restriction access abortions already maher supra description must include limited appearance mobility tactile sensitivity including pain perception response brain heart function presence internal organs presence external members district found much evidence impossible determine many items unborn child sensitivity pain district found much evidence rather major surgical procedure physician required state abortion generally considered minor surgical procedure ibid section requires physician state hat abortion major surgical procedure result serious complications including hemorrhage perforated uterus infection menstrual disturbances sterility miscarriage prematurity subsequent pregnancies abortion may leave essentially unaffected may worsen existing psychological problems may result severe emotional disturbances akron made little effort defend constitutionality argues remaining four subsections provision valid severable four subsections require patient informed attending physician fact pregnant gestational age fetus availability information birth control adoption availability assistance pregnancy childbirth information extent accurate certainly objectionable probably routinely made available patient persuaded however sever provisions remainder require information given orally attending physician much given qualified person assisting physician see infra suggest appropriate counseling consists simply recital pertinent medical facts contrary clear needs patients information opportunity discuss abortion decision vary considerably disputed individual counseling available persons desire need see national abortion federation standards hereinafter naf standards planned parenthood metropolitan washington guidelines operation maintenance evaluation first trimester outpatient abortion facilities opportunity may especially important minors alienated separated parents see apha recommended guide thus patients mere provision printed statement relevant information counseling consistent recognition critical role physician abortion procedure based model competent conscientious ethical physician see doe occasion case consider conduct physicians may depart model cf danforth stewart concurring cf acog standards counseling provided elsewhere physician performing abortion verify counseling taken place importance competent counselors dispute see apha recommended guide abortion counselors may highly skilled physicians well trained sympathetic individuals working appropriate supervision naf standards counselors must trained initially least following subjects sexual reproductive health abortion technology contraceptive technology counseling skills community resources referrals informed consent agency policies practices provision apply physician certifies writing emergency need abortion performed induced continuation pregnancy poses immediate threat grave risk life physical health pregnant woman acog recommends clinic allow sufficient time reflection prior making informed decision acog standards contrast mandatory waiting period standard recognizes time needed consideration decision varies depending particular situation patient much prior counseling received fitzpatrick district accepted pennsylvania contention statute governing humane disposal fetal remains designed prevent mindless dumping decision distinguishable statute impose criminal liability merely provided promulgation regulations implement disposal requirement see persuaded akron argument word humane severed statute uncertain meaning phrase humane sanitary leaves doubt whether city enacted word sanitary alone akron remains free course enact carefully drawn regulations legitimate interest proper disposal fetal remains justice justice white justice rehnquist join dissenting roe wade held right privacy founded fourteenth amendment concept personal liberty restrictions upon state action broad enough encompass woman decision whether terminate pregnancy parties cases asked validity holding address accordingly previous holding nonetheless apparent opinion neither sound constitutional theory need decide cases based application neutral principles accommodate analytical framework varies according stages pregnancy stages concomitant standards review differ according level medical technology available particular challenge state regulation occurs analysis akron regulations inconsistent methods analysis employed previous cases dealing abortion approach fundamental rights areas recent cases indicate regulation imposed lawful abortion unconstitutional unless unduly burdens right seek abortion maher roe quoting bellotti baird bellotti see also harris mcrae view unduly burdensome standard applied challenged regulations throughout entire pregnancy without reference particular stage pregnancy involved particular regulation unduly burde fundamental right maher supra evaluation regulation limited determination regulation rationally relates legitimate state purpose irrespective may believe wise prudent policy difficult area constitution constitute us platonic guardians vest authority strike laws meet standards desirable social policy wisdom common sense plyler doe burger dissenting trimester approach adopted roe modified form employed analyze regulations cases supported legitimate useful framework accommodating woman right state interests decision today graphically illustrates trimester approach completely unworkable method accommodating conflicting personal rights compelling state interests involved abortion context indicates today state compelling interest maternal health changes medical technology changes health regulation must depart accepted medical practice ante applying standard holds safety abortions increased dramatically since roe decided ante omitted although regulation one requiring abortions performed hospitals strong support reasonable health regulation ante regulation longer stand according diligent research medical scientific literature dilation evacuation procedure used abortions widely successfully used abortions ante omitted medical literature relied indicates procedure may performed appropriate nonhospital setting least early weeks second trimester ante chooses period weeks gestation point procedures may performed safely nonhospital setting thereby invalidates akron hospitalization regulation difficult see despite purported adherence trimester approach adopted roe lines drawn decision blurred accepts technological advancement safety abortion procedure state may longer rely bright line separates permissible impermissible regulation longer free consider second trimester unit weigh risks posed abortion procedures throughout trimester rather state must continuously conscientiously study contemporary medical scientific literature order determine whether effect particular regulation depart accepted medical practice insofar particular procedures particular periods within trimester concerned assuming legislative bodies able engage exacting task difficult believe constitution requires prelude protecting health citizens even difficult believe without resources available bodies entrusted making legislative choices believes competent make inquiries revise standards every time american college obstetricians gynecologists acog similar group revises views appropriate medical procedure area indeed acog standards relies changed trial present cases acog changed standards recommended abortions performed hospital see today decision indicates medical technology changing change necessitate continued functioning nation ex officio medical board powers approve disapprove medical operative practices standards throughout planned parenthood central missouri danforth white concurring part dissenting part improvements medical technology inevitably move forward point state may regulate reasons maternal health different technological improvements move backward point viability state may proscribe abortions except necessary preserve life health mother viability weeks considered unusual edition hellman pritchard williams obstetrics relied roe understanding viability stated ttainment fetal weight fetal age approximately weeks gestation widely used criterion viability however recent studies demonstrated increasingly earlier fetal viability certainly reasonable believe fetal viability first trimester pregnancy may possible distant future indeed explicitly acknowledged roe left point viability flexible anticipated advancements medical skill colautti franklin recognized roe viability matter medical judgment skill technical ability preserved flexibility term danforth supra roe framework clearly collision course medical risks various abortion procedures decrease point state may regulate reasons maternal health moved forward actual childbirth medical science becomes better able provide separate existence fetus point viability moved back toward conception moreover clear trimester approach violates fundamental aspiration judicial decisionmaking application neutral principles sufficiently absolute give roots throughout community continuity significant periods time cox role american government roe framework inherently tied state medical technology exists whenever particular litigation ensues although legislatures better suited make necessary factual judgments area framework forces legislatures matter constitutional law speculate constitutes accepted medical practice given time without necessary expertise ability courts must pretend act science review boards examine legislative judgments adheres roe framework doctrine stare decisis demands respect society governed rule law ante although respect stare decisis challenged considered practice apply stare decisis rigidly constitutional nonconstitutional cases glidden zdanok although must mindful desirability continuity decision constitutional questions convinced former error never felt constrained follow precedent constitutional questions correction depends upon amendment upon legislative action throughout history freely exercised power reexamine basis constitutional decisions smith allwright omitted even assuming fundamental right terminate pregnancy situations justification law logic trimester framework adopted roe employed today basis stare decisis reasons stated framework clearly unworkable means balancing fundamental right compelling state interests indisputably implicated ii roe correctly realized state important interests areas health medical standards state legitimate interest seeing abortion like medical procedure performed circumstances insure maximum safety patient also recognized state another important legitimate interest protecting potentiality human life emphasis original agree completely state interests view point interests become compelling depend trimester pregnancy rather interests present throughout pregnancy never failed recognize state may properly assert important interests safeguarding health maintaining medical standards doubted long state statute within bounds reason assum character merely arbitrary fiat state must decide upon measures needful protection people purity extract tonic lynch nothing constitution limits state power require medical procedures done safely sendak arnold white dissenting mode procedure medical diagnostic procedures business judges parham roe framework however state interest maternal health become compelling onset second trimester pregnancy end first trimester mortality abortion may less mortality normal childbirth second trimester decision perform abortion must left medical judgment pregnant woman attending physician fallacy inherent roe framework apparent state compelling interest ensuring maternal safety abortion may dangerous childbirth simply follow state interest point justifies state regulation ensure abortions performed safely possible state interest potential human life likewise extant throughout pregnancy roe held although state important legitimate interest protecting potential life interest become compelling point fetus viable difficulty analysis clear potential life less potential first weeks pregnancy viability afterward stage pregnancy potential human life although refused resolve difficult question life begins chose point viability fetus capable life independent mother permit complete proscription abortion choice viability point state interest potential life becomes compelling less arbitrary choosing point viability point afterward accordingly believe state interest protecting potential human life exists throughout pregnancy iii although state possesses compelling interests protection potential human life maternal health throughout pregnancy every regulation state imposes must measured state compelling interests examined strict scrutiny acknowledged right roe wade understood considering woman interest nature state interference roe declare unqualified constitutional right abortion rather right protects woman unduly burdensome interference freedom decide whether terminate pregnancy maher individual justices repeatedly utilized unduly burdensome standard abortion cases requirement state interference infringe substantially heavily burden right heightened scrutiny applied novel jurisprudence restricted abortion context san antonio independent school district rodriguez observed apply strict judicial scrutiny legislation may said deprived infringed interfered free exercise fundamental personal right liberty impact regulation rise level appropriate strict scrutiny inquiry limited whether state law bears rational relationship legitimate state purposes even first amendment context required circumstances state laws infringe substantially protected conduct gibson florida legislative investigation committee significant encroachment upon personal liberty bates city little rock carey population services international eschewed notion state law meet exacting compelling state interest test whenever implicates sexual freedom rather required strict scrutiny standard employed necessary state law impos significant burden protected right burden individual right decide prevent conception terminate pregnancy substantially limiting access means effectuating decision emphasis added stressed even burdensome regulation may validated sufficiently compelling state interest finally griswold connecticut recognized law banning use contraceptives married persons maximum destructive impact marital relationship indeed today follows approach although use expression undue burden recognizes even significant obstacle justified reasonable regulation see ante undue burden required abortion cases represents required threshold inquiry must conducted require state justify legislative actions exacting compelling state interest standard test severe legislation rarely meet imposed courts deliberate restraint view respect properly accorded legislative judgments carey supra powell concurring part concurring judgment unduly burdensome standard particularly appropriate abortion context nature scope right involved privacy right involved abortion context said absolute roe roe declare unqualified constitutional right abortion maher rather roe right intended protect state action drastically limiting availability safety desired service imposition absolute obstacle abortion decision danforth official interference coercive restraint imposed abortion decision harris white concurring state regulation may inhibit abortions degree require find regulation invalid see matheson abortion cases demonstrate undue burden found part situations involving absolute obstacles severe limitations abortion decision roe invalidated texas statute criminalized abortions except necessary save life mother danforth invalidated state prohibition abortion saline amniocentesis ban effect inhibiting vast majority abortions first weeks today acknowledges regulation danforth effectively represented complete prohibition abortions certain circumstances ante emphasis added danforth also invalidated state regulations requiring parental spousal consent prerequisite abortion consent requirements effectively impermissibly delegated veto power parents spouses first trimester pregnancy bellotti bellotti baird bellotti ii concerned effective parental veto abortion decision determining whether state imposes undue burden must keep mind concerned extremely sensitive issues one involved appropriate forum resolution democracy legislature forget legislatures ultimate guardians liberties welfare people quite great degree courts missouri may holmes maher omitted mean determining whether regulation imposes undue burden roe right defer judgments made state legislatures point rather face complex problem many hard questions easy answers well pay careful attention branches government addressed problem columbia broadcasting system democratic national committee must always mindful constitution compel state statutes encourage facilitate abortions contrary state action encouraging childbirth except urgent circumstances rationally related legitimate governmental objective protecting potential life harris mcrae accord maher roe supra matheson supra omitted iv section akron ordinance requires abortions performed hospitals holds requirement imposes significant obstacle form increased costs decreased availability abortions ante rejects argument offered state requirement reasonable health regulation roe see ante reasons stated find justification trimester approach used analyze restriction apply unduly burdensome test find hospitalization requirement impose undue burden decision reliance increased abortion costs decreased availability misplaced city akron points evidence case show two akron hospitals performed abortions denied abortion woman permit abortion procedure see reply brief petitioner addition evidence presented hospitals nearby areas provide abortions almost state regulation including licensing requirements allow see ante inevitably necessarily entails increased costs abortion simopoulos virginia post upholds state stringent licensing requirements clearly involve greater cost state licensing scheme unreasonable means furthering state compelling interest preserving maternal health post although acknowledges indisputably correct notion simopoulos inexplicably refuses apply case health regulation hospitalization requirement simply rise level official interference abortion decision see harris supra white concurring factors may legitimately considered state go well beyond various medical organizations say physical safety particular procedure indeed factors physical emotional psychological familial woman age relevant patient doe bolton acog standards upon relies state egardless advances abortion technology midtrimester terminations likely remain hazardous expensive emotionally disturbing woman early abortions american college obstetricians gynecologists technical bulletin methods midtrimester abortion hospitalization requirement impose undue burden necessary apply exacting standard review regulation rational relation valid state objective ensuring health welfare citizens see williamson lee optical section akron ordinance provides physician shall perform abortion minor years age unless minor gives written consent physician first obtains informed written consent parent guardian unless minor first obtains order jurisdiction abortion performed induced despite fact regulation yet construed state courts holds regulation unconstitutional reasonably susceptible construed create opportunity evaluations maturity pregnant minors ante quoting bellotti ii plurality opinion believe abstained declaring ordinance unconstitutional bellotti abstained deciding whether state parental consent provision unconstitutional applied mature minors recognized respected rule abstention proper unconstrued state statute susceptible construction state judiciary might avoid whole part necessity federal constitutional adjudication least materially change nature problem quoting harrison naacp acknowledging force abstention doctrine see ante nevertheless declines apply instead speculates state juvenile might inquire minor maturity ability decide abortion deciding whether minor provided surgical care necessary health morals well ante quoting ohio rev code ann ultimately rejects possible interpretation state law however filing petition juvenile requires parental notification unconstitutional condition insofar mature minors concerned assuming arguendo correct holding parental notification requirement unconstitutional applied mature minors see reason assume akron ordinance state juvenile statute compel state judges notify parents mature minor notification contrary minor best interests reason believe state courts construe consent requirement impose type parental judicial veto abortion decisions mature minors light complete lack knowledge akron ordinance operate akron ordinance state juvenile statute interact scrupulous regard rightful independence state governments counsels unnecessary interference federal courts proper validly administered state concerns course essential balanced working federal system harrison naacp supra quoting matthews rodgers invalidates provisions akron ordinance although finds subsections certainly objectionable ante refuses sever provisions subsections city requires acceptable information provided attending physician much given qualified person assisting physician ibid despite fact finds properly leaves precise nature amount disclosure physician discretion medical judgment ante also finds unconstitutional requires disclosure made attending physician rather qualified persons work abortion clinics approved provisions past even though physician required deliver certain information patient danforth upheld state requirement decision abort indeed important often stressful one desirable imperative made full knowledge nature consequences matheson noted state statute case required patient advised minimum available adoption services fetal development foreseeable complications risks abortion see utah code ann planned parenthood central mo danforth rejected constitutional attack written consent provisions indeed held provision unduly burde right seek abortion bellotti validity subsections appears city akron conceded unconstitutionality see brief city akron reply brief city akron pp view remaining subsections separable subsections conceded unconstitutional section contains separability clause creates presumption divisibility places burden litigant escape operation carter carter coal opinion cardozo akron center failed show severance subsections create program quite different one legislature actually adopted sloan lemon remainder impose undue burden drastic limitation abortion decision city akron merely attempting ensure decision abort made light knowledge city deems relevant informed choice regulations impermissibly affect privacy right fourteenth amendment section akron ordinance requires waiting period signing consent form actual performance abortion except cases emergency see invalidated requirement affected abortion decisions first trimester pregnancy affirms decision ground affects early abortions akron failed demonstrate legitimate state interest furthered arbitrary inflexible waiting period ante accepts arguments made akron center waiting period increases costs obtaining abortion requiring pregnant woman make two trips clinic increases risks abortion delay scheduling difficulties decision whether proceed left physician discretion exercise medical judgment ibid quoting colautti certainly difficult understand believes relationship able accommodate interest state maternal physical mental light fact record case shows relationship nonexistent see kennedy concurring part dissenting part also interesting note american college obstetricians gynecologists recommends rior abortion woman access special counseling explores options management unwanted pregnancy examines risks allows sufficient time reflection prior making informed decision acog standards services waiting period apply cases medical emergency therefore physician determine waiting period increase risks significantly need require woman wait concern respect simply misplaced although waiting period may impose additional cost abortion decision increased cost unduly burden availability abortions impose absolute obstacle access abortions state required abortion statutes minimize costs abortions matheson assuming arguendo additional costs impose undue burden abortion decision state compelling interests maternal physical mental health protection fetal life clearly justify waiting period acknowledged danforth decision abort stressful one waiting period reasonably relates state interest ensuring woman make serious decision undue haste decision also grave consequences fetus whose life state compelling interest protect preserve medical procedure involves purposeful termination potential life harris waiting period surely small cost impose ensure woman decision well considered light certain irreparable consequences fetal life possible effects finally akron ordinance requires ny physician shall perform induce abortion upon pregnant woman shall insure remains unborn child disposed humane sanitary manner finds provision void vagueness disagree planned parenthood assn fitzpatrick supp ed summarily aff sub nom franklin fitzpatrick district upheld humane disposal provision vagueness attack light state representation intent act preclude mindless dumping aborted fetuses onto garbage piles district held different concerns implicated statute point determined require expensive burial ibid present cases city akron informed intent humane portion statute distinguished sanitary portion merely ensure fetuses dump ed garbage piles brief petitioner light fact city akron indicates intent require physicians provide decent burials fetuses humane vague term sanitary vagueness akron center question conclude statute void vagueness reasons set forth dissent judgment cases roe recognized state possesses important legitimate interests protecting maternal health potentiality human life separate distinct interests held grow substantiality woman approaches term point pregnancy becomes compelling state interest maternal health said become compelling approximately end first trimester time abortion decision effectuation must left medical judgment pregnant woman attending physician end first trimester state may regulate abortion procedure extent regulation reasonably relates preservation protection maternal health noted light present medical knowledge mortality abortion may less mortality normal childbirth first trimester pregnancy ibid state interest potential human life held become compelling viability defined point fetus potentially able live outside mother womb albeit artificial aid roe omitted based review contemporary medical literature placed viability weeks acknowledged point may occur early weeks viability reached state may according roe proscribe abortion altogether except necessary preserve life health mother see since roe held roe left point viability flexible anticipated advancements medical skill colautti franklin also identified state interest protection young familial integrity abortion context see matheson although purports retain trimester approach reasonable legal framework limiting state regulatory authority abortions ante expressly abandons roe view relative rates childbirth abortion mortality relevant determining whether regulations reasonably related maternal health instead decides health regulation must depart accepted medical practice upheld ante state must make reasonable effort limit effect regulations period trimester health interest furthered ante emphasis added holds summary affirmance indiana women services bowen supp nd ind aff sub nom indiana women services orr thought binding precedent hospitalization issue see ante although reads decided alternative ground plaintiffs failed prove safety abortions ante simply ignores fact district held even plaintiffs prove birth dangerous early second trimester abortions matter insofar constitutionality regulations concerned see emphasis added irrespective difficulty task legislatures superior factfinding capabilities certainly better able make necessary judgments courts one study shows infants born alive gestational age less weeks weight grams chance survival see phillip little polivy lucey neonatal mortality risk eighties importance birth age groups pediatrics another recent comparative study shows preterm infants weight grams less born one hospital rate survival kopelman smallest preterm infants reasons optimism new dilemmas diseases children infant weighing grams gestational age weeks birth thriving los angeles hospital attending physician stated infant chance survival washington post mar aborted fetus simopoulos virginia post weighed grams gestational age approximately weeks recent developments promise even greater success overcoming various respiratory immunological neonatal complications stand way increased fetal viability see beddis collins levy godfrey silverman new technique arterial oxygen tension preterm infants archives disease childhood absolutely question current era sustained progressive improvement outlook survival small premature infants stern intensive care infant danish med bull interestingly planned parenthood central missouri danforth upheld recordkeeping requirement well consent provision even though requirements imposed abortions although state impose comparable requirements medical procedures see danforth must understood retreat position ostensibly adopted roe state compelling interest regulation first trimester pregnancy justify restrictions imposed abortion decision example acog standards relies heavily analysis provide physicians performing abortions offices provide prompt emergency treatment hospitalization event complications see acog standards acog also prescribes certain equipment available office abortions see doubt state compelling interest ensure requirements met legitimate concern justify state regulation health reasons even first trimester pregnancy see bellotti baird bellotti state may impose undue burdens upon minor capable giving informed consent bellotti left open question whether judicial hearing unduly burden roe right adult woman see bellotti baird bellotti ii opinion powell state may unduly burden right seek abortion harris mcrae doctrine roe wade held maher protects woman unduly burdensome interference freedom decide whether terminate pregnancy severe criminal sanctions issue roe wade supra absolute requirement spousal consent abortion challenged planned parenthood central missouri danforth beal doe state interest protecting potential human life least approximately third trimester become sufficiently compelling justify unduly burdensome state interference carey population services international powell concurring part concurring judgment view roe griswold connecticut make clear compelling state interest standard invoked state regulation entirely frustrates heavily burdens exercise constitutional rights area see bellotti baird even though explicitly use unduly burdensome standard evaluating requirement planned parenthood central missouri danforth supra requirement abortions danforth upheld unduly burde right seek abortion bellotti supra case invalidated regulations undue burdens doe bolton decided day roe doe invalidated hospitalization requirement covered abortion also invalidated hospital accreditation requirement approval requirement concurrence requirement clearly based disapproval requirements fact state impose medical procedure apart abortion subsequent doe expressly rejected view differential treatment abortion requires invalidation regulations see danforth maher roe harris see also planned parenthood assn kansas city ashcroft post amicus curiae brief support city akron solicitor general argues adopt unduly burdensome standard accord heavy deference legislative judgment determining constitutes undue burden see brief amicus curiae unduly burdensome standard appropriate incorporates deference legislative judgment threshold stage analysis rather limited nature fundamental right recognized abortion cases although cases require pay careful attention legislative judgment invoke strict scrutiny see columbia broadcasting system democratic national committee appropriate weigh state interests threshold stage never required state regulation burdens abortion decision narrowly drawn express relevant state interest roe mentioned narrowly drawn legislative enactments never actually adopted standard roe analysis decision today fully endorses roe requirement burdensome health regulation appears call significant obstacle ante reasonably related state compelling interest see ante recognizes state necessarily must latitude adopting regulations general applicability sensitive area ante see also simopoulos virginia post nevertheless fails apply reasonably relates standard hospitalization requirement reasonably relates compelling interest protection preservation maternal health normal understanding reasonably relates signifies concludes regulation must fall appears substantial portion second trimester state regulation depart accepted medical practice ante difficult see concludes regulation depart accepted medical practice substantial portion second trimester light fact concludes abortions may performed safely outpatient clinic weeks weeks second trimester ante four weeks hardly substantial portion second trimester view decision yet held parental notification case mature minors unconstitutional although plurality opinion justice powell bellotti ii suggested state statute case unconstitutional inter alia failed provide minors opportunity go directly without first consulting notifying parents matheson held unemancipated immature minors constitutional right notify lieu notifying parents furthermore matheson expressly decide parental notification requirement unconstitutional state otherwise permitted mature minors make abortion decisions free parental judicial veto see section requires attending physician orally inform pregnant woman pregnant probable number weeks since conception unborn child human moment conception certain anatomical physiological characteristics unborn child may viable physician legal responsibility try save child abortion major surgical procedure result serious physical psychological complications various agencies exist provide pregnant woman information birth control various agencies exist assist woman pregnancy decide undergo abortion section requires attending physician inform woman risks associated particular pregnancy proposed abortion technique well furnish information physician deems relevant medical judgment danforth even view requirement legally significant impact abortions trigger roe doe proscriptions state interference decision seek abortion see recordkeeping requirements assuming arguendo decides danforth bellotti ii matheson incorrect provisions burden right seek abortion inexplicably refuses determine whether burden reasonably relates legitimate state interests ante quoting roe rather decides provision must justified vital state need upheld see ante say provisions may violate first amendment rights physician state requires communicate ideology see wooley maynard however appear akron center raised first amendment argument see brief akron center reproductive health pp reply brief akron center reproductive health pp basis analysis requirement charges dissent uphold virtually regulation ante requirement valid imposes small cost relevant factors taken consideration precisely reasoning justice powell employs upholding requirement planned parenthood assn kansas city ashcroft post report requirement imposes comparatively small additional cost post