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The First Amendment protects freedoms of speech and expression, while the Fourteenth Amendment guarantees liberty and equal protection under the law. Together, these constitutional principles have been central in cases about abortion, especially where compelled speech and bodily autonomy intersect.

This topic is especially urgent in the post-Dobbs era, where Roe v. Wade and Casey were overturned, removing federal protections for abortion and giving more power to individual states. However, previous rulings like Planned Parenthood v. Casey established that access to abortion is part of the liberty protected by the Due Process Clause.

At the same time, free speech issues arise when states attempt to compel or suppress speech. For example, requiring doctors or clinics to share certain information, or prohibiting speech in protest zones. Understanding these tensions helps us evaluate whether First Amendment protections support or hinder access to reproductive care, and how these legal frameworks have evolved in response to political and cultural pressures.

This led to fragmentation across the nation, where some states had abortion bans and others had more protections for reproductive rights. This contributes to the main discussion of how rights are protected and courts find middle ground between collective governance and individual rights. Giving power back to the states meant access to abortion depends on a woman’s residence. This may be worrisome for someone who wants to get an abortion but is unable to because of the specific state decisions on reproductive rights. As a result, that person may have to travel far just to access specific reproductive care that is legal in another state. It displays how reproductive freedom is no longer a national right and is dependent on state governments.

This context helps guide the central question on if the First Amendment offers meaningful protections for reproductive rights, or if it has been used to restrict access. While the First Amendment provides many protections, the Dobbs decision emphasizes limitations when it comes to being able to access reproductive care. In this way, Dobbs demonstrates how the amendment’s interpretation  may be used to reinforce barriers to reproductive care  instead of protect it. 

This concern is reflected in the SCOTUSblog on NIFLA v. Becerra, which emphasizes that “if behavior harmful to public health that could otherwise be regulated to protect public health evades regulation because it involves speech, we are all in a lot of trouble” (Smith). This highlights how if courts allow people to avoid regulations by claiming certain actions are protected speech, it may end up preventing the government from being able to help more; this shows a potential danger of a broad First Amendment interpretation to where it can block public health protections.

Both Dobbs and NIFLA together underscore the tension that lies between balancing speech, state power, and individual liberties in the context of reproductive care.

Figure 5: Map of abortion policies in the US by state (Image from Guttmacher Institute).

The court ruled in favor of Roe with a 7-2 majority, with justices Burger, Douglas, Brennan, Stewart, Marshall, Blackmun, and Powell making up the majority. It most notably established the precedent of abortion rights being included in the Due Process clause of the Fourteenth Amendment, citing how, “Inherent in the Due Process Clause…is a fundamental ‘right to privacy’ that protects a pregnant woman’s choice whether to have an abortion” (Oyez 2). The Due Process Clause prevents government intervention on personal rights, such as free speech or other aspects of a citizen’s life, without a fair legal reason and procedure. Following Roe v. Wade, abortion was understood to be included in this, since the right to decisions concerning one’s body was ruled in the case to have protection from interference such as the Texas bans. This laid the foundation for the constitutionality of abortion for decades to come, as it was now considered a protected right rather than left to the discretion of the states, and setting a further precedent for related areas of marriage and sexuality in regards to government involvement. As explained by the Center for Reproductive Rights in, “Roe and Intersectional Liberty Doctrine,” a large part of Roe’s significance stemmed from how,  “Roe moved beyond the earlier contraception cases by providing a firmer, clearer grounding for the source of the right to make reproductive choices, and tying it to related liberty rights” (Center for Reproductive Rights 10). By giving abortion a firmer stance, Roe was capable of being utilized as a firm precedent in a variety of later cases surrounding topics of sexuality, marriage, and LGBTQIA+ rights. 

The Roe v. Wade case offers a major example of the Supreme Court backing the claim that the First Amendment does in fact offer meaningful protection of abortion rights as  bodily autonomy and individual reproductive health fall under a category of rights protected from government intervention based on the logic of its ruling. Roe v. Wade is recognized as a landmark case used to justify not only women’s right to access to an abortion, but decisions on autonomy as a whole, resulting in its overturning causing concerns over potential threats to other rights as well.

Figure 1: Support during the Roe v. Wade case (Image from Landmark Cases).

Unlike in earlier cases such as Roe v. Wade, the court did not rule in favor of the plaintiff and their challenging of the law, and instead ruled that it was constitutional due to not being overly vague. Justices Roberts, Scalia, Kennedy, Thomas, and Alito made up the majority, with Kennedy delivering their opinion. Specifically, the court determined that, “the Act applies only to a specific method of abortion…[and] held that the ban was not unconstitutionally vague, overboard, or an undue burden on the decision to obtain an abortion” (Oyez 4). This offers a contradiction of judicial opinion compared to prior cases such as Roe and Cases, exemplifying how despite the precedent established by them, the court has still ruled in favor of restriction on abortion even with the context of it being a protected right. 

The case of Gonzales v. Carhart brings to question concerns over the limitation of abortion even in regards to medical situations. As explained by the Center for Reproductive Rights in, “The Constitutional Right to Reproductive Autonomy: Realizing the Promise of the 14th Amendment,” explains how, “Even in the best of circumstances, pregnancy carries the potential for significant health risks” (Center for Reproductive Rights 7) and that “for people who can become pregnant, control over fertility and decisions about their body and health care are critical” (Center for Reproductive Rights 7). It is for reasons such as these that abortion began to be considered a protected right to begin with, as decisions surrounding a person’s health affect the quality and liberty of their life.

However, decisions such as the one made in Gonzales v. Carhart creates a contradiction on this standpoint due to the restriction it places, highlighting the continued tension that persists in scenarios where states are still able to constitutionally ban kinds of abortions. It makes evident that the protection of an abortion right is not absolute, and raises concern over the potential for continued government interference in a medical scenario. 

Figure 3: Gonzales v. Carhart proceedings (Image from Pew Research Center).

NIFLA argumented that the acts requirement to (1) required licensed clinics to inform their patients on free and inexpensive “publicly funded family planning services,” these included both contraception and abortions and  (2) clinics that were unlicensed inform their patients that they were unlicensed, violated  their first amendment rights.  Their motion was denied by the U.S. District Court for the Southern District of California on the basis that they didn't showcase a likelihood of success of the values required based on Winter v. Natural Resources Defense Council on their free exercise or free speech claims. 

It was then stated by the ninth court that the District court's ruling was valid and that they had not abused their power by denying NIFAs injunction. This was because in this case this the court ruled that even though this act did require clinics to inform their patients of family planning services, and if they were unlicensed, which may be content they may not always want to disclose, it was still legal because the law does not discriminate based on viewpoint. Since the information that was being provided to the patients was neither in favor or against abortions, it simply provided people with information, it was legal. They stated that this was just what was required of professional speech and since this speech simply informed the patients on the options available to them, it wa allowed. The courts also affirmed that patients had the right to know whether or not they were receiving licensed or unlicensed care. 

The Supreme Court ruled 5-4 to strike down the law and a majority claimed that this violated the first amendment right to free speech. They argued that this act was “content based” and that it forced people to relay messages that the government wanted. The argument that the rules for “professional speech” had different rules was conquered by the Supreme court when they stated that there was no specific category called professional speech. There are only two situations where governments can regulate professional’s speech, these being commercial speech and government regulations. Many simply though it was a violation because it forced people to say things that they didn't believe in. 

In this case it is suggested that the first amendment has been used to restrict access to abortion care and does not require clinics to make patients aware of their options when regarding family planning services. Many patients may not be aware of the options that are available to them which is why it may be important for clinics to make their patients aware of them otherwise they will not be able to utilize them.  In addition to this clinics are not required to inform their patients if they are licensed or unlicensed which is important because it can put the patients at risk if not otherwise stated.

Figure 4: Protests against the Becerra ruling (Image from the Free Speech Center).

Rather than using Roe’s trimester framework, Casey allowed states to regulate abortion as long as those regulations did not place a “substantial obstacle” in the way of someone seeking an abortion. This shift marked a compromise between individual liberty and state interest, and according to Justia, it weakened the original protections under Roe by opening the door to more state-level restrictions, which eventually made possible the full reversal of Roe and Casey in Dobbs.

The Court struck down the spousal notification requirement in the Pennsylvania law, stating it imposed an undue burden on people in abusive or unequal relationships. However, other provisions like informed consent, a 24-hour waiting period, and parental consent with judicial bypass were upheld. As noted by the Center for Reproductive Rights, while Casey affirmed the right to abortion, it also reinforced systemic barriers, disproportionately affecting people of color, immigrants, low-income communities, and people with disabilities, groups historically targeted by restrictive reproductive policies.

Casey is relevant to our guiding question because it illustrates how both the First and Fourteenth Amendments shape reproductive rights. While the First Amendment wasn’t the central issue, Casey’s treatment of informed consent laws echoes compelled speech debates, forcing physicians to deliver state-scripted messages about abortion. The Court found that this did not violate free speech if the information was truthful and not misleading. However, critics, including those from the Center for Reproductive Rights, argue that compelled speech in medical settings still raises concerns when it disproportionately burdens marginalized individuals or is driven by political motives rather than medical necessity.

Ultimately, Casey demonstrated how legal protections for reproductive autonomy rest on a combination of liberty, privacy, and speech rights. As highlighted in the article Roe and Intersectional Liberty Doctrine, the decision broadened the interpretation of the Fourteenth Amendment to include not just the right to avoid pregnancy, but also bodily integrity, family planning, and medical decision-making, all core aspects of personhood and autonomy. Its partial overruling in Dobbs reopens debate over how and whether constitutional rights meaningfully protect access to abortion and whether liberty can truly exist without reproductive control.

Figure 2: Pro-choice activist holds a sign reading “No Government Intervention in Women’s Wombs” during a demonstration supporting Roe v. Wade. (Image from TIME & LIFE Pictures, via Thirteen.org)

Center for Reproductive Rights. “Roe and Intersectional Liberty Doctrine.” Center for Reproductive Rights, 2018,  https://reproductiverights.org/wp-content/uploads/2020/12/Liberty-Roe-Timeline-spread-for-web.pdf

Hudson Jr., David. “National Institute of Family and Life Advocates v. Becerra (2018),” Free Speech Center, 2018, https://firstamendment.mtsu.edu/article/national-institute-of-family-and-life-advocates-v-becerra/. 

Justia. “Abortion and Reproductive Rights Under the Constitution.” Justia, 2022, https://www.justia.com/constitutional-law/abortion-and-reproductive-rights-under-the-constitution/.

Justia. “Planned Parenthood of Southeastern Pa v. Casey, 505 U.S. 833 (1992).” Justia, 2025, 

https://supreme.justia.com/cases/federal/us/505/833/.

Landmark Cases. “Roe v. Wade (1973) Abortion is Legalized Nationwide.” Street Law, Inc. https://landmarkcases.org/cases/roe-v-wade/. 

Nash, Elizabeth. “State Policy Trends 2022: In a Devastating Year, US Supreme Court’s Decision to Overturn Roe Leads to Bans, Confusion and Chaos.” Guttmacher Institute, 2022, https://www.guttmacher.org/2022/12/state-policy-trends-2022-devastating-year-us-supreme-courts-decision-overturn-roe-leads. 

NIFLA. “NIFLA | National Institute of Family and Life Advocates.” NIFLA, 2021, nifla.org/.

Oyez. “Gonzales v. Carhart.” Oyez,  https://www.oyez.org/cases/2006/05-380.

Oyez. “National Institute of Family and Life Advocates v. Becerra.” Oyez, 2017,  www.oyez.org/cases/2017/16-1140.

Oyez. “Roe v. Wade.” Oyez, https://www.oyez.org/cases/1971/70-18.

Pew Research Center. “After Gonzales v. Carhart: The Future of Abortion Jurisprudence.” Pew Research Center, 2007, 

https://www.pewresearch.org/religion/2007/06/14/after-gonzales-v-carhart-the-future-of-abortion-jurisprudence/. 

Sherbow, Robert. Pro-choice activist holding “No Government Intervention in Women’s Wombs” sign during demonstration in favor of Roe v. Wade.  https://www.thirteen.org/wnet/supremecourt/rights/landmark_casey.html 

Smith, Priscilla. “Symposium: NIFLA v. Becerra - Compelling the truth in health-care delivery.” SCOTUSblog, 2017,

The First Amendment, from the beginning, is meant to protect freedom of expression, but at times, has restricted access to reproductive care on the basis of laws preventing it are not necessarily always unconstitutional. Cases like National Institute of Family Advocates v. Becerra present instances where the first amendment has been used to limit access to reproductive rights. In this case it was ruled unconstitutional to require clinics to inform their patients of family planning services and their licensed status since it was considered a violation of their first amendment rights. This however creates limitations for those who are in need of family planning services since many individuals may not know they even exist. 

While the First Amendment is able to support and protect reproductive care for individuals, there have been many challenges that limit abortion access, and in recent years there seems to have been a growing trend of the court ruling in favor of restriction rather than continuing to uphold abortion as a protected first amendment right. This is a cause for concern not only in regards to abortion, but also for further liberties that Roe v. Wade and earlier abortion cases had laid the foundation for protection for, such as LGBTQIA+, sexuality, and marriage rights.