For outsiders, those contesting the abortion wars in the United States seem uniquely preoccupied with constitutional rights. At first blush, that preoccupation might make sense: in the United States, activists did not win abortion rights by popular vote. Because the US Supreme Court created abortion rights, the justices all but ensured that future battles would unfold at least partly in the courts. Whereas abortion is neither a major political nor legal issue in most countries, the issue dominates presidential elections and Supreme Court nominations in the United States. Embracing what seem to be diametrically opposed rights, the right to choose and the right to life, clashing movements define themselves in relation to the Constitution. While many jurisdictions primarily deal with abortion as a matter of public health, the United States treats abortion as a question of religion, politics and constitutional law.

This narrative is not incorrect so much as it is incomplete. Those at the heart of the American culture wars do fight for constitutional principles, and the possibility of compromise on underlying constitutional issues seems remote. But ever since the Supreme Court first recognized abortion rights in Roe v. Wade in 1973, the focus of the debate has shifted ever more to questions of public health. This shift might at first seem counterintuitive. For at the beginning, when physicians first mobilized to reform abortion laws, reform proponents asserted that access to the procedure would improve women's physical, psychological and reproductive health. As incremental reforms failed to change the overall rate of illegal abortions, however, activists demanded the full repeal of criminal laws and often went to court to pursue their agenda. In Roe v. Wade, those efforts paid off. Roe foregrounded concerns about health, seeking to strike a balance between the prerogatives of physicians, the needs of patients, and the state's concerns about safety and fetal life. The seven-to-two decision further emphasized that the right to abortion was not unlimited: in the second trimester, some restrictions might pass muster, and states could ban abortion altogether after fetal viability. Yet despite Roe's focus on health-based arguments, at least for a time, the Court made constitutional arguments more salient. Movements on opposing sides of the issue clashed about whether the Court was right about the right to choose abortion (or the right to life).

But the push to overturn Roe brought questions about women's health back to the centre of debate.