## Facts

- Pennsylvania enacted the Abortion Control Act of 1982 regulating abortion counseling, reporting, and certain post-viability procedures.
- The Act required physicians, at least 24 hours before an abortion, to provide specified information including the physician’s identity, medical risks of abortion and childbirth, asserted “detrimental” effects, potential public benefits, paternal support obligations, and availability of state-prepared materials describing fetal development and alternatives.
- The Act mandated distribution of state-produced printed materials describing fetal development at two-week gestational increments and listing agencies that would assist the woman in carrying the pregnancy to term and after birth.
- The Act imposed detailed reporting duties on physicians, including demographic information, identities of providers, bases for emergency and nonviability determinations, and method of payment, with public access to nonidentifying versions.
- For abortions after the first trimester, physicians had to report the basis for any determination that the fetus was not viable.
- For post-viability abortions, the Act required use of the method offering the best opportunity for the fetus to be born alive unless it posed a significantly greater risk to the woman, and required a second physician to be present to attempt to preserve fetal life and health.
- Physicians and related providers sued state officials seeking declaratory and injunctive relief; the Third Circuit enjoined enforcement of multiple provisions, and the Supreme Court reviewed.

## Issues

1. Whether the Act’s informed-consent and state-authored materials requirements unconstitutionally interfered with the pre-viability abortion decision and the physician–patient relationship.
2. Whether the Act’s reporting and disclosure regime impermissibly threatened privacy and deterred women and physicians from seeking or providing abortions.
3. Whether the post-viability method and second-physician requirements unconstitutionally subordinated maternal life or health to legislative preference for fetal survival.

## Decision

- The Supreme Court, in a 5–4 opinion by Justice Blackmun, affirmed the judgment enjoining enforcement of the challenged provisions.
- The Court held that the informed-consent and printed-materials provisions were unconstitutional because they compelled delivery of nonneutral, state-directed content intended to discourage abortion and intruded into the physician–patient dialogue.
- The Court invalidated the reporting provisions as excessively intrusive and as posing risks of identification and deterrence not justified by the asserted interest in statistics.
- The Court struck down the post-viability method and second-physician requirements because they pressured physicians to prioritize fetal survival under a standard that could increase risks to the woman and could delay care.
- Justice Stevens concurred, emphasizing that compelled, value-laden counseling also raised compelled-speech concerns.
- Dissents argued the Act was permissible regulation and criticized the Court’s strict application of the governing framework; Justice O’Connor advocated an “undue burden” approach.

## Legal Principles

- Before viability, the abortion decision is protected by the Due Process Clause and must remain primarily within the medical judgment of the pregnant patient and her attending physician.
- The State may regulate to protect maternal health and potential life, but may not structure “informed consent” to deliver ideological advocacy or to deter the abortion choice by commandeering the physician’s counseling.
- Reporting requirements related to abortion may be unconstitutional if they are sufficiently detailed or accessible to create risks of patient identification or deterrence that outweigh asserted governmental interests.
- After viability, the State has greater regulatory authority, but regulations cannot require standards or procedures that unnecessarily endanger the woman’s life or health by favoring fetal survival over maternal safety.

## Conclusion

The Court invalidated major components of Pennsylvania’s abortion statute because they were designed to discourage abortion and to shift clinical decision-making away from patient and physician judgment, including by mandating state-scripted counseling, imposing intrusive reporting, and requiring post-viability practices that could increase risks to the woman.


Thornburgh v. Am. Coll. of Obstetricians & Gynecologists, 476 U.S. 747 (1986)