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NOTICE: This opinion is subject to formal revision before publication in the
preliminary print of the United States Reports.  Readers are requested to
notify the Reporter of Decisions, Supreme Court of the United States, Wash-
ington, D.C. 20543, of any typographical or other formal errors, in order that
corrections may be made before the preliminary print goes to press.
SUPREME COURT OF THE UNITED STATES
                 --------
          Nos. 91-744 and 91-902
                 --------
    PLANNED PARENTHOOD OF SOUTHEASTERN
     PENNSYLVANIA, et al., PETITIONERS
91-744              v.
       ROBERT P. CASEY, et al., etc.

      ROBERT P. CASEY, et al., etc.,
                PETITIONERS
91-902              v.
    PLANNED PARENTHOOD OF SOUTHEASTERN
            PENNSYLVANIA et al.
on writs of certiorari to the united states court of
       appeals for the third circuit
              [June 29, 1992]

  Justice O'Connor, Justice Kennedy, and Justice
Souter announced the judgment of the Court and delivered
the opinion of the Court with respect to Parts I, II, III, V-A,
V-C, and VI, an opinion with respect to Part V-E, in which
Justice Stevens joins, and an opinion with respect to
Parts IV, V-B, and V-D.
                     I
  Liberty finds no refuge in a jurisprudence of doubt.  Yet
19 years after our holding that the Constitution protects a
woman's right to terminate her pregnancy in its early
stages, Roe v. Wade, 410 U. S. 113 (1973), that definition of
liberty is still questioned.  Joining the respondents as
amicus curiae, the United States, as it has done in five
other cases in the last decade, again asks us to overrule
Roe.  See Brief for Respondents 104-117; Brief for United
States as Amicus Curiae 8.
  At issue in these cases are five provisions of the Pennsyl-
vania Abortion Control Act of 1982 as amended in 1988 and
1989.  18 Pa. Cons. Stat. 3203-3220 (1990).  Relevant
portions of the Act are set forth in the appendix.  Infra, at
60.  The Act requires that a woman seeking an abortion
give her informed consent prior to the abortion procedure,
and specifies that she be provided with certain information
at least 24 hours before the abortion is performed.  3205.
For a minor to obtain an abortion, the Act requires the
informed consent of one of her parents, but provides for a
judicial bypass option if the minor does not wish to or
cannot obtain a parent's consent.  3206.  Another provi-
sion of the Act requires that, unless certain exceptions
apply, a married woman seeking an abortion must sign a
statement indicating that she has notified her husband of
her intended abortion.  3209.  The Act exempts compliance
with these three requirements in the event of a -medical
emergency,- which is defined in 3203 of the Act.  See
3203, 3205(a), 3206(a), 3209(c).  In addition to the above
provisions regulating the performance of abortions, the Act
imposes certain reporting requirements on facilities that
provide abortion services.  3207(b), 3214(a), 3214(f).
  Before any of these provisions took effect, the petitioners,
who are five abortion clinics and one physician representing
himself as well as a class of physicians who provide
abortion services, brought this suit seeking declaratory and
injunctive relief.  Each provision was challenged as uncon-
stitutional on its face.  The District Court entered a prelimi-
nary injunction against the enforcement of the regulations,
and, after a 3-day bench trial, held all the provisions at
issue here unconstitutional, entering a permanent injunc-
tion against Pennsylvania's enforcement of them.  744 F.
Supp. 1323 (ED Pa. 1990).  The Court of Appeals for the
Third Circuit affirmed in part and reversed in part,
upholding all of the regulations except for the husband
notification requirement.  947 F. 2d 682 (1991). We granted
certiorari.  502 U. S. ____ (1992).
  The Court of Appeals found it necessary to follow an
elaborate course of reasoning even to identify the first
premise to use to determine whether the statute enacted by
Pennsylvania meets constitutional standards.  See 947 F.
2d, at 687-698.  And at oral argument in this Court, the
attorney for the parties challenging the statute took the
position that none of the enactments can be upheld without
overruling Roe v. Wade.  Tr. of Oral Arg. 5-6.  We disagree
with that analysis; but we acknowledge that our decisions
after Roe cast doubt upon the meaning and reach of its
holding.  Further, the Chief Justice admits that he would
overrule the central holding of Roe and adopt the rational
relationship test as the sole criterion of constitutionality.
See post, at ___.  State and federal courts as well as
legislatures throughout the Union must have guidance as
they seek to address this subject in conformance with the
Constitution.  Given these premises, we find it imperative
to review once more the principles that define the rights of
the woman and the legitimate authority of the State
respecting the termination of pregnancies by abortion
procedures.
  After considering the fundamental constitutional ques-
tions resolved by Roe, principles of institutional integrity,
and the rule of stare decisis, we are led to conclude this: the
essential holding of Roe v. Wade should be retained and
once again reaffirmed.
  It must be stated at the outset and with clarity that Roe's
essential holding, the holding we reaffirm, has three parts.
First is a recognition of the right of the woman to choose to
have an abortion before viability and to obtain it without
undue interference from the State.  Before viability, the
State's interests are not strong enough to support a
prohibition of abortion or the imposition of a substantial
obstacle to the woman's effective right to elect the proce-
dure.  Second is a confirmation of the State's power to
restrict abortions after fetal viability, if the law contains
exceptions for pregnancies which endanger a woman's life
or health.  And third is the principle that the State has
legitimate interests from the outset of the pregnancy in
protecting the health of the woman and the life of the fetus
that may become a child.  These principles do not contradict
one another; and we adhere to each.
                    II
  Constitutional protection of the woman's decision to
terminate her pregnancy derives from the Due Process
Clause of the Fourteenth Amendment.  It declares that no
State shall -deprive any person of life, liberty, or property,
without due process of law.-  The controlling word in the
case before us is -liberty.-  Although a literal reading of the
Clause might suggest that it governs only the procedures by
which a State may deprive persons of liberty, for at least
105 years, at least since Mugler v. Kansas, 123 U. S. 623,
660-661 (1887), the Clause has been understood to contain
a substantive component as well, one -barring certain
government actions regardless of the fairness of the proce-
dures used to implement them.-  Daniels v. Williams, 474
U. S. 327, 331 (1986).  As Justice Brandeis (joined by
Justice Holmes) observed, -[d]espite arguments to the
contrary which had seemed to me persuasive, it is settled
that the due process clause of the Fourteenth Amendment
applies to matters of substantive law as well as to matters
of procedure.  Thus all fundamental rights comprised within
the term liberty are protected by the Federal Constitution
from invasion by the States.-  Whitney v. California, 274
U. S. 357, 373 (1927) (Brandeis, J., concurring).  -[T]he
guaranties of due process, though having their roots in
Magna Carta's `per legem terrae' and considered as proce-
dural safeguards `against executive usurpation and tyr-
anny,' have in this country `become bulwarks also against
arbitrary legislation.'-  Poe v. Ullman, 367 U. S. 497, 541
(1961) (Harlan, J., dissenting from dismissal on jurisdiction-
al grounds) (quoting Hurtado v. California, 110 U. S. 516,
532 (1884)).
  The most familiar of the substantive liberties protected by
the Fourteenth Amendment are those recognized by the Bill
of Rights.  We have held that the Due Process Clause of the
Fourteenth Amendment incorporates most of the Bill of
Rights against the States.  See, e.g., Duncan v. Louisiana,
391 U. S. 145, 147-148 (1968).  It is tempting, as a means
of curbing the discretion of federal judges, to suppose that
liberty encompasses no more than those rights already
guaranteed to the individual against federal interference by
the express provisions of the first eight amendments to the
Constitution.  See Adamson v. California, 332 U. S. 46,
68-92 (1947) (Black, J., dissenting).  But of course this
Court has never accepted that view.
  It is also tempting, for the same reason, to suppose that
the Due Process Clause protects only those practices,
defined at the most specific level, that were protected
against government interference by other rules of law when
the Fourteenth Amendment was ratified.  See Michael H.
v. Gerald D., 491 U. S. 110, 127-128, n. 6 (1989) (opinion of
Scalia, J.).  But such a view would be inconsistent with our
law.  It is a promise of the Constitution that there is a
realm of personal liberty which the government may not
enter.  We have vindicated this principle before.  Marriage
is mentioned nowhere in the Bill of Rights and interracial
marriage was illegal in most States in the 19th century, but
the Court was no doubt correct in finding it to be an aspect
of liberty protected against state interference by the
substantive component of the Due Process Clause in Loving
v. Virginia, 388 U. S. 1, 12 (1967) (relying, in an opinion for
eight Justices, on the Due Process Clause).  Similar
examples may be found in Turner v. Safley, 482 U. S. 78,
94-99 (1987); in Carey v. Population Services International,
431 U. S. 678, 684-686 (1977); in Griswold v. Connecticut,
381 U. S. 479, 481-482 (1965), as well as in the separate
opinions of a majority of the Members of the Court in that
case, id., at 486-488 (Goldberg J., joined by Warren, C. J.,
and Brennan, J., concurring) (expressly relying on due
process), id., at 500-502 (Harlan, J., concurring in judg-
ment) (same), id., at 502-507 (White, J., concurring in
judgment) (same); in Pierce v. Society of Sisters, 268 U. S.
510, 534-535 (1925); and in Meyer v. Nebraska, 262 U. S.
390, 399-403 (1923).
  Neither the Bill of Rights nor the specific practices of
States at the time of the adoption of the Fourteenth
Amendment marks the outer limits of the substantive
sphere of liberty which the Fourteenth Amendment pro-
tects.  See U. S. Const., Amend. 9.  As the second Justice
Harlan recognized:
-[T]he full scope of the liberty guaranteed by the Due
Process Clause cannot be found in or limited by the
precise terms of the specific guarantees elsewhere
provided in the Constitution.  This `liberty' is not a
series of isolated points pricked out in terms of the
taking of property; the freedom of speech, press, and
religion; the right to keep and bear arms; the freedom
from unreasonable searches and seizures; and so on.  It
is a rational continuum which, broadly speaking,
includes a freedom from all substantial arbitrary
impositions and purposeless restraints, . . . and which
also recognizes, what a reasonable and sensitive
judgment must, that certain interests require particu-
larly careful scrutiny of the state needs asserted to
justify their abridgment.-  Poe v. Ullman, supra, at 543
(Harlan, J., dissenting from dismissal on jurisdictional
grounds).
Justice Harlan wrote these words in addressing an issue
the full Court did not reach in Poe v. Ullman, but the Court
adopted his position four Terms later in Griswold v. Con-
necticut, supra.  In Griswold, we held that the Constitution
does not permit a State to forbid a married couple to use
contraceptives.  That same freedom was later guaranteed,
under the Equal Protection Clause, for unmarried couples.
See Eisenstadt v. Baird, 405 U. S. 438 (1972).  Constitu-
tional protection was extended to the sale and distribution
of contraceptives in Carey v. Population Services Interna-
tional, supra.  It is settled now, as it was when the Court
heard arguments in Roe v. Wade, that the Constitution
places limits on a State's right to interfere with a person's
most basic decisions about family and parenthood, see
Carey v. Population Services International, supra; Moore v.
East Cleveland, 431 U. S. 494 (1977); Eisenstadt v. Baird,
supra; Loving v. Virginia, supra; Griswold v. Connecticut,
supra; Skinner v. Oklahoma ex rel. Williamson, 316 U. S.
535 (1942); Pierce v. Society of Sisters, supra; Meyer v.
Nebraska, supra, as well as bodily integrity.  See, e.g.,
Washington v. Harper, 494 U. S. 210, 221-222 (1990);
Winston v. Lee, 470 U. S. 753 (1985); Rochin v. California,
342 U. S. 165 (1952).
  The inescapable fact is that adjudication of substantive
due process claims may call upon the Court in interpreting
the Constitution to exercise that same capacity which by
tradition courts always have exercised: reasoned judgment.
Its boundaries are not susceptible of expression as a simple
rule.  That does not mean we are free to invalidate state
policy choices with which we disagree; yet neither does it
permit us to shrink from the duties of our office.  As Justice
Harlan observed:
     -Due process has not been reduced to any formula;
its content cannot be determined by reference to any
code.  The best that can be said is that through the
course of this Court's decisions it has represented the
balance which our Nation, built upon postulates of
respect for the liberty of the individual, has struck
between that liberty and the demands of organized
society.  If the supplying of content to this Constitu-
tional concept has of necessity been a rational process,
it certainly has not been one where judges have felt
free to roam where unguided speculation might take
them.  The balance of which I speak is the balance
struck by this country, having regard to what history
teaches are the traditions from which it developed as
well as the traditions from which it broke.  That
tradition is a living thing.  A decision of this Court
which radically departs from it could not long survive,
while a decision which builds on what has survived is
likely to be sound.  No formula could serve as a substi-
tute, in this area, for judgment and restraint.-  Poe v.
Ullman, 367 U. S., at 542 (Harlan, J., dissenting from
dismissal on jurisdictional grounds).
See also Rochin v. California, supra, at 171-172 (Frank-
furter, J., writing for the Court) (-To believe that this
judicial exercise of judgment could be avoided by freezing
`due process of law' at some fixed stage of time or thought
is to suggest that the most important aspect of constitution-
al adjudication is a function for inanimate machines and
not for judges-).
  Men and women of good conscience can disagree, and we
suppose some always shall disagree, about the profound
moral and spiritual implications of terminating a preg-
nancy, even in its earliest stage.  Some of us as individuals
find abortion offensive to our most basic principles of
morality, but that cannot control our decision.  Our obliga-
tion is to define the liberty of all, not to mandate our own
moral code.  The underlying constitutional issue is whether
the State can resolve these philosophic questions in such a
definitive way that a woman lacks all choice in the matter,
except perhaps in those rare circumstances in which the
pregnancy is itself a danger to her own life or health, or is
the result of rape or incest.
  It is conventional constitutional doctrine that where
reasonable people disagree the government can adopt one
position or the other.  See, e.g., Ferguson v. Skrupa, 372
U. S. 726 (1963); Williamson v. Lee Optical of Oklahoma,
Inc., 348 U. S. 483 (1955).  That theorem, however, assumes
a state of affairs in which the choice does not intrude upon
a protected liberty.  Thus, while some people might disagree
about whether or not the flag should be saluted, or disagree
about the proposition that it may not be defiled, we have
ruled that a State may not compel or enforce one view or
the other.  See West Virginia State Bd. of Education v.
Barnette, 319 U. S. 624 (1943); Texas v. Johnson, 491 U. S.
397 (1989).
  Our law affords constitutional protection to personal
decisions relating to marriage, procreation, contraception,
family relationships, child rearing, and education.  Carey v.
Population Services International, 431 U. S., at 685.  Our
cases recognize -the right of the individual, married or
single, to be free from unwarranted governmental intrusion
into matters so fundamentally affecting a person as the
decision whether to bear or beget a child.-  Eisenstadt v.
Baird, supra, at 453 (emphasis in original).  Our precedents
-have respected the private realm of family life which the
state cannot enter.-  Prince v. Massachusetts, 321 U. S. 158,
166 (1944).  These matters, involving the most intimate and
personal choices a person may make in a lifetime, choices
central to personal dignity and autonomy, are central to the
liberty protected by the Fourteenth Amendment.  At the
heart of liberty is the right to define one's own concept of
existence, of meaning, of the universe, and of the mystery
of human life.  Beliefs about these matters could not define
the attributes of personhood were they formed under
compulsion of the State.
  These considerations begin our analysis of the woman's
interest in terminating her pregnancy but cannot end it, for
this reason: though the abortion decision may originate
within the zone of conscience and belief, it is more than a
philosophic exercise.  Abortion is a unique act.  It is an act
fraught with consequences for others: for the woman who
must live with the implications of her decision; for the
persons who perform and assist in the procedure; for the
spouse, family, and society which must confront the knowl-
edge that these procedures exist, procedures some deem
nothing short of an act of violence against innocent human
life; and, depending on one's beliefs, for the life or potential
life that is aborted.  Though abortion is conduct, it does not
follow that the State is entitled to proscribe it in all
instances.  That is because the liberty of the woman is at
stake in a sense unique to the human condition and so
unique to the law.  The mother who carries a child to full
term is subject to anxieties, to physical constraints, to pain
that only she must bear.  That these sacrifices have from
the beginning of the human race been endured by woman
with a pride that ennobles her in the eyes of others and
gives to the infant a bond of love cannot alone be grounds
for the State to insist she make the sacrifice.  Her suffering
is too intimate and personal for the State to insist, without
more, upon its own vision of the woman's role, however
dominant that vision has been in the course of our history
and our culture.  The destiny of the woman must be shaped
to a large extent on her own conception of her spiritual
imperatives and her place in society.
  It should be recognized, moreover, that in some critical
respects the abortion decision is of the same character as
the decision to use contraception, to which Griswold v.
Connecticut, Eisenstadt v. Baird, and Carey v. Population
Services International, afford constitutional protection.  We
have no doubt as to the correctness of those decisions.  They
support the reasoning in Roe relating to the woman's liberty
because they involve personal decisions concerning not only
the meaning of procreation but also human responsibility
and respect for it.  As with abortion, reasonable people will
have differences of opinion about these matters.  One view
is based on such reverence for the wonder of creation that
any pregnancy ought to be welcomed and carried to full
term no matter how difficult it will be to provide for the
child and ensure its well-being.  Another is that the
inability to provide for the nurture and care of the infant is
a cruelty to the child and an anguish to the parent.  These
are intimate views with infinite variations, and their deep,
personal character underlay our decisions in Griswold,
Eisenstadt, and Carey.  The same concerns are present
when the woman confronts the reality that, perhaps despite
her attempts to avoid it, she has become pregnant.
  It was this dimension of personal liberty that Roe sought
to protect, and its holding invoked the reasoning and the
tradition of the precedents we have discussed, granting
protection to substantive liberties of the person.  Roe was,
of course, an extension of those cases and, as the decision
itself indicated, the separate States could act in some
degree to further their own legitimate interests in protect-
ing pre-natal life.  The extent to which the legislatures of
the States might act to outweigh the interests of the woman
in choosing to terminate her pregnancy was a subject of
debate both in Roe itself and in decisions following it.
  While we appreciate the weight of the arguments made
on behalf of the State in the case before us, arguments
which in their ultimate formulation conclude that Roe
should be overruled, the reservations any of us may have in
reaffirming the central holding of Roe are outweighed by
the explication of individual liberty we have given combined
with the force of stare decisis.  We turn now to that doc-
trine.
                    III
                     A
  The obligation to follow precedent begins with necessity,
and a contrary necessity marks its outer limit.  With
Cardozo, we recognize that no judicial system could do
society's work if it eyed each issue afresh in every case that
raised it.  See B. Cardozo, The Nature of the Judicial
Process 149 (1921).  Indeed, the very concept of the rule of
law underlying our own Constitution requires such continu-
ity over time that a respect for precedent is, by definition,
indispensable.  See Powell, Stare Decisis and Judicial
Restraint, 1991 Journal of Supreme Court History 13, 16.
At the other extreme, a different necessity would make
itself felt if a prior judicial ruling should come to be seen so
clearly as error that its enforcement was for that very
reason doomed.
  Even when the decision to overrule a prior case is not, as
in the rare, latter instance, virtually foreordained, it is
common wisdom that the rule of stare decisis is not an
-inexorable command,- and certainly it is not such in every
constitutional case, see Burnet v. Coronado Oil Gas Co., 285
U. S.  393, 405-411 (1932) (Brandeis, J., dissenting).  See
also Payne v. Tennessee, 501 U. S. ____, ____ (1991) (slip
op., at ___) (Souter, J., joined by Kennedy, J., concurring);
Arizona v. Rumsey, 467 U. S. 203, 212 (1984).  Rather,
when this Court reexamines a prior holding, its judgment
is customarily informed by a series of prudential and
pragmatic considerations designed to test the consistency of
overruling a prior decision with the ideal of the rule of law,
and to gauge the respective costs of reaffirming and overrul-
ing a prior case.  Thus, for example, we may ask whether
the rule has proved to be intolerable simply in defying
practical workability, Swift & Co. v. Wickham, 382 U. S.
111, 116 (1965); whether the rule is subject to a kind of
reliance that would lend a special hardship to the conse-
quences of overruling and add inequity to the cost of
repudiation, e. g., United States v. Title Ins. & Trust Co.,
265 U. S.  472, 486 (1924); whether related principles of law
have so far developed as to have left the old rule no more
than a remnant of abandoned doctrine, see Patterson v.
McLean Credit Union, 491 U. S. 164, 173-174 (1989); or
whether facts have so changed or come to be seen so
differently, as to have robbed the old rule of significant
application or justification, e.g., Burnet, supra, at 412
(Brandeis, J., dissenting).
  So in this case we may inquire whether Roe's central rule
has been found unworkable; whether the rule's limitation
on state power could be removed without serious inequity
to those who have relied upon it or significant damage to
the stability of the society governed by the rule in question;
whether the law's growth in the intervening years has left
Roe's central rule a doctrinal anachronism discounted by
society; and whether Roe's premises of fact have so far
changed in the ensuing two decades as to render its central
holding somehow irrelevant or unjustifiable in dealing with
the issue it addressed.
                     1
  Although Roe has engendered opposition, it has in no
sense proven -unworkable,- see Garcia v. San Antonio
Metropolitan Transit Authority, 469 U. S.  528, 546 (1985),
representing as it does a simple limitation beyond which a
state law is unenforceable.  While Roe has, of course,
required judicial assessment of state laws affecting the
exercise of the choice guaranteed against government
infringement, and although the need for such review will
remain as a consequence of today's decision, the required
determinations fall within judicial competence.
                     2
  The inquiry into reliance counts the cost of a rule's
repudiation as it would fall on those who have relied
reasonably on the rule's continued application.  Since the
classic case for weighing reliance heavily in favor of
following the earlier rule occurs in the commercial context,
see Payne v. Tennessee, supra, at ____ (slip op., at ___),
where advance planning of great precision is most obviously
a necessity, it is no cause for surprise that some would find
no reliance worthy of consideration in support of Roe.
  While neither respondents nor their amici in so many
words deny that the abortion right invites some reliance
prior to its actual exercise, one can readily imagine an
argument stressing the dissimilarity of this case to one
involving property or contract.  Abortion is customarily
chosen as an unplanned response to the consequence of
unplanned activity or to the failure of conventional birth
control, and except on the assumption that no intercourse
would have occurred but for Roe's holding, such behavior
may appear to justify no reliance claim.  Even if reliance
could be claimed on that unrealistic assumption, the
argument might run, any reliance interest would be de
minimis.  This argument would be premised on the hypoth-
esis that reproductive planning could take virtually immedi-
ate account of any sudden restoration of state authority to
ban abortions.
  To eliminate the issue of reliance that easily, however,
one would need to limit cognizable reliance to specific
instances of sexual activity.  But to do this would be simply
to refuse to face the fact that for two decades of economic
and social developments, people have organized intimate
relationships and made choices that define their views of
themselves and their places in society, in reliance on the
availability of abortion in the event that contraception
should fail.  The ability of women to participate equally in
the economic and social life of the Nation has been facili-
tated by their ability to control their reproductive lives.
See, e.g., R. Petchesky, Abortion and Woman's Choice 109,
133, n. 7 (rev. ed. 1990).  The Constitution serves human
values, and while the effect of reliance on Roe cannot be
exactly measured, neither can the certain cost of overruling
Roe for people who have ordered their thinking and living
around that case be dismissed.
                     3
  No evolution of legal principle has left Roe's doctrinal
footings weaker than they were in 1973.  No development
of constitutional law since the case was decided has
implicitly or explicitly left Roe behind as a mere survivor of
obsolete constitutional thinking.
  It will be recognized, of course, that Roe stands at an
intersection of two lines of decisions, but in whichever
doctrinal category one reads the case, the result for present
purposes will be the same.  The Roe Court itself placed its
holding in the succession of cases most prominently
exemplified by Griswold v. Connecticut, 381 U. S. 479
(1965), see Roe, 410 U. S., at 152-153.  When it is so seen,
Roe is clearly in no jeopardy, since subsequent constitu-
tional developments have neither disturbed, nor do they
threaten to diminish, the scope of recognized protection
accorded to the liberty relating to intimate relationships,
the family, and decisions about whether or not to beget or
bear a child.  See, e.g., Carey v. Population Services Interna-
tional, 431 U. S. 678 (1977); Moore v. East Cleveland, 431
U. S. 678 (1977).
  Roe, however, may be seen not only as an exemplar of
Griswold liberty but as a rule (whether or not mistaken) of
personal autonomy and bodily integrity, with doctrinal
affinity to cases recognizing limits on governmental power
to mandate medical treatment or to bar its rejection.  If so,
our cases since Roe accord with Roe's view that a State's
interest in the protection of life falls short of justifying
any plenary override of individual liberty claims.  Cruzan
v. Director, Missouri Dept. of Health, 497 U. S. 261,
278 (1990); Cf., e.g., Riggins v. Nevada, 504 U.S. ____, ____
(1992) (slip. op., at 7); Washington v. Harper, 494 U. S.
210 (1990); see also, e.g., Rochin v. California, 342 U. S. 165
(1952); Jacobson v. Massachusetts, 197 U. S. 11, 24-30
(1905).
  Finally, one could classify Roe as sui generis.  If the case
is so viewed, then there clearly has been no erosion of its
central determination.  The original holding resting on the
concurrence of seven Members of the Court in 1973 was
expressly affirmed by a majority of six in 1983, see Akron
v. Akron Center for Reproductive Health, Inc., 462 U. S. 416
(1983) (Akron I), and by a majority of five in 1986, see
Thornburgh v. American College of Obstetricians and
Gynecologists, 476 U. S. 747 (1986), expressing adherence
to the constitutional ruling despite legislative efforts in
some States to test its limits.  More recently, in Webster v.
Reproductive Health Services, 492 U. S. 490 (1989), al-
though two of the present authors questioned the trimester
framework in a way consistent with our judgment today,
see id., at 518 (Rehnquist C. J., joined by White, and
Kennedy, JJ.); id., at 529 (O'Connor, J., concurring in part
and concurring in judgment), a majority of the Court either
decided to reaffirm or declined to address the constitutional
validity of the central holding of Roe.  See Webster, 492
U. S., at 521 (Rehnquist, C. J., joined by White and
Kennedy, JJ.); id., at 525-526 (O'Connor, J., concurring in
part and concurring in judgment); id., at 537, 553 (Black-
mun, J., joined by Brennan and Marshall, JJ., concurring in
part and dissenting in part); id., at 561-563 (Stevens, J.,
concurring in part and dissenting in part).
  Nor will courts building upon Roe be likely to hand down
erroneous decisions as a consequence.  Even on the assump-
tion that the central holding of Roe was in error, that error
would go only to the strength of the state interest in fetal
protection, not to the recognition afforded by the Constitu-
tion to the woman's liberty.  The latter aspect of the
decision fits comfortably within the framework of the
Court's prior decisions including Skinner v. Oklahoma ex
rel. Williamson, 316 U. S. 535 (1942), Griswold, supra,
Loving v. Virginia, 388 U. S. 1 (1967), and Eisenstadt v.
Baird, 405 U. S. 438 (1972), the holdings of which are -not
a series of isolated points,- but mark a -rational continu-
um.-  Poe v. Ullman, 367 U. S., at 543 (1961) (Harlan, J.,
dissenting).  As we described in Carey v. Population
Services International, supra, the liberty which encom-
passes those decisions
     -includes `the interest in independence in making
     certain kinds of important decisions.'  While the
     outer limits of this aspect of [protected liberty] have
     not been marked by the Court, it is clear that among
     the decisions that an individual may make without
     unjustified government interference are personal
     decisions `relating to marriage, procreation, contra-
     ception, family relationships, and child rearing and
     education.'-  Id., at 684-685 (citations omitted).
  The soundness of this prong of the Roe analysis is
apparent from a consideration of the alternative.  If indeed
the woman's interest in deciding whether to bear and beget
a child had not been recognized as in Roe, the State might
as readily restrict a woman's right to choose to carry a
pregnancy to term as to terminate it, to further asserted
state interests in population control, or eugenics, for
example.  Yet Roe has been sensibly relied upon to counter
any such suggestions.  E.g., Arnold v. Board of Education
of Escambia County, Ala., 880 F. 2d 305, 311 (CA11 1989)
(relying upon Roe and concluding that government officials
violate the Constitution by coercing a minor to have an
abortion); Avery v. County of Burke, 660 F. 2d 111, 115
(CA4 1981) (county agency inducing teenage girl to undergo
unwanted sterilization on the basis of misrepresentation
that she had sickle cell trait); see also In re Quinlan, 70
N.J. 10, 355 A. 2d 647, cert. denied sub nom. Garger v. New
Jersey, 429 U. S. 922 (1976) (relying on Roe in finding a
right to terminate medical treatment).  In any event,
because Roe's scope is confined by the fact of its concern
with postconception potential life, a concern otherwise likely
to be implicated only by some forms of contraception
protected independently under Griswold and later cases,
any error in Roe is unlikely to have serious ramifications in
future cases.
                     4
  We have seen how time has overtaken some of Roe's
factual assumptions: advances in maternal health care
allow for abortions safe to the mother later in pregnancy
than was true in 1973, see Akron I, supra, at 429, n. 11,
and advances in neonatal care have advanced viability to a
point somewhat earlier.  Compare Roe, 410 U. S., at 160,
with Webster, supra, at 515-516 (opinion of Rehnquist,
C.J.); see Akron I, supra, at 457, and n. 5 (O'Connor, J.,
dissenting).  But these facts go only to the scheme of time
limits on the realization of competing interests, and the
divergences from the factual premises of 1973 have no
bearing on the validity of Roe's central holding, that
viability marks the earliest point at which the State's
interest in fetal life is constitutionally adequate to justify a
legislative ban on nontherapeutic abortions.  The soundness
or unsoundness of that constitutional judgment in no sense
turns on whether viability occurs at approximately 28
weeks, as was usual at the time of Roe, at 23 to 24 weeks,
as it sometimes does today, or at some moment even
slightly earlier in pregnancy, as it may if fetal respiratory
capacity can somehow be enhanced in the future.  Whenev-
er it may occur, the attainment of viability may continue to
serve as the critical fact, just as it has done since Roe was
decided; which is to say that no change in Roe's factual
underpinning has left its central holding obsolete, and none
supports an argument for overruling it.
                     5
  The sum of the precedential inquiry to this point shows
Roe's underpinnings unweakened in any way affecting its
central holding.  While it has engendered disapproval, it
has not been unworkable.  An entire generation has come
of age free to assume Roe's concept of liberty in defining the
capacity of women to act in society, and to make reproduc-
tive decisions; no erosion of principle going to liberty or
personal autonomy has left Roe's central holding a doctrinal
remnant; Roe portends no developments at odds with other
precedent for the analysis of personal liberty; and no
changes of fact have rendered viability more or less appro-
priate as the point at which the balance of interests tips.
Within the bounds of normal stare decisis analysis, then,
and subject to the considerations on which it customarily
turns, the stronger argument is for affirming Roe's central
holding, with whatever degree of personal reluctance any of
us may have, not for overruling it.
                     B
  In a less significant case, stare decisis analysis could, and
would, stop at the point we have reached.  But the sus-
tained and widespread debate Roe has provoked calls for
some comparison between that case and others of compara-
ble dimension that have responded to national controversies
and taken on the impress of the controversies addressed.
Only two such decisional lines from the past century
present themselves for examination, and in each instance
the result reached by the Court accorded with the principles
we apply today.
  The first example is that line of cases identified with
Lochner v. New York, 198 U. S. 45 (1905), which imposed
substantive limitations on legislation limiting economic
autonomy in favor of health and welfare regulation,
adopting, in Justice Holmes' view, the theory of laissez-
faire.  Id., at 75 (Holmes, J., dissenting).  The Lochner
decisions were exemplified by Adkins v. Children's Hospital
of D.C., 261 U. S. 525 (1923), in which this Court held it to
be an infringement of constitutionally protected liberty of
contract to require the employers of adult women to satisfy
minimum wage standards.  Fourteen years later, West
Coast Hotel Co. v. Parrish, 300 U. S. 379 (1937), signalled
the demise of Lochner by overruling Adkins.  In the
meantime, the Depression had come and, with it, the lesson
that seemed unmistakable to most people by 1937, that the
interpretation of contractual freedom protected in Adkins
rested on fundamentally false factual assumptions about
the capacity of a relatively unregulated market to satisfy
minimal levels of human welfare.  See West Coast Hotel Co.,
supra, at 399.  As Justice Jackson wrote of the constitu-
tional crisis of 1937 shortly before he came on the bench,
-The older world of laissez faire was recognized everywhere
outside the Court to be dead.-  R. Jackson, The Struggle for
Judicial Supremacy 85 (1941).  The facts upon which the
earlier case had premised a constitutional resolution of
social controversy had proved to be untrue, and history's
demonstration of their untruth not only justified but
required the new choice of constitutional principle that West
Coast Hotel announced.  Of course, it was true that the
Court lost something by its misperception, or its lack of
prescience, and the Court-packing crisis only magnified the
loss; but the clear demonstration that the facts of economic
life were different from those previously assumed war-
ranted the repudiation of the old law.
  The second comparison that 20th century history invites
is with the cases employing the separate-but-equal rule for
applying the Fourteenth Amendment's equal protection
guarantee.  They began with Plessy v. Ferguson, 163 U. S.
537 (1896), holding that legislatively mandated racial
segregation in public transportation works no denial of
equal protection, rejecting the argument that racial separa-
tion enforced by the legal machinery of American society
treats the black race as inferior.  The Plessy Court consid-
ered -the underlying fallacy of the plaintiff's argument to
consist in the assumption that the enforced separation of
the two races stamps the colored race with a badge of
inferiority.  If this be so, it is not by reason of anything
found in the act, but solely because the colored race chooses
to put that construction upon it.-  Id., at at 551.  Whether,
as a matter of historical fact, the Justices in the Plessy
majority believed this or not, see id., at 557, 562 (Harlan,
J., dissenting), this understanding of the implication of
segregation was the stated justification for the Court's
opinion.  But this understanding of the facts and the rule
it was stated to justify were repudiated in Brown v. Board
of Education, 347 U. S. 483 (1954).  As one commentator
observed, the question before the Court in Brown was
-whether discrimination inheres in that segregation which
is imposed by law in the twentieth century in certain
specific states in the American Union.  And that question
has meaning and can find an answer only on the ground of
history and of common knowledge about the facts of life in
the times and places aforesaid.-  Black, The Lawfulness of
the Segregation Decisions, 69 Yale L. J. 421, 427 (1960).
  The Court in Brown addressed these facts of life by
observing that whatever may have been the understanding
in Plessy's time of the power of segregation to stigmatize
those who were segregated with a -badge of inferiority,- it
was clear by 1954 that legally sanctioned segregation had
just such an effect, to the point that racially separate public
educational facilities were deemed inherently unequal.  374
U. S., at 494-495.  Society's understanding of the facts upon
which a constitutional ruling was sought in 1954 was thus
fundamentally different from the basis claimed for the
decision in 1896.  While we think Plessy was wrong the day
it was decided, see Plessy, supra, at 552-564 (Harlan, J.,
dissenting), we must also recognize that the Plessy Court's
explanation for its decision was so clearly at odds with the
facts apparent to the Court in 1954 that the decision to
reexamine Plessy was on this ground alone not only
justified but required.
  West Coast Hotel and Brown each rested on facts, or an
understanding of facts, changed from those which furnished
the claimed justifications for the earlier constitutional
resolutions.  Each case was comprehensible as the Court's
response to facts that the country could understand, or had
come to understand already, but which the Court of an
earlier day, as its own declarations disclosed, had not been
able to perceive.  As the decisions were thus comprehensible
they were also defensible, not merely as the victories of one
doctrinal school over another by dint of numbers (victories
though they were), but as applications of constitutional
principle to facts as they had not been seen by the Court
before.  In constitutional adjudication as elsewhere in life,
changed circumstances may impose new obligations, and
the thoughtful part of the Nation could accept each decision
to overrule a prior case as a response to the Court's
constitutional duty.
  Because the case before us presents no such occasion it
could be seen as no such response.  Because neither the
factual underpinnings of Roe's central holding nor our
understanding of it has changed (and because no other
indication of weakened precedent has been shown) the
Court could not pretend to be reexamining the prior law
with any justification beyond a present doctrinal disposition
to come out differently from the Court of 1973.  To overrule
prior law for no other reason than that would run counter
to the view repeated in our cases, that a decision to
overrule should rest on some special reason over and above
the belief that a prior case was wrongly decided.  See, e.g.,
Mitchell v. W.T. Grant, 416 U. S. 600, 636 (1974) (Stewart,
J., dissenting) (-A basic change in the law upon a ground no
firmer than a change in our membership invites the popular
misconception that this institution is little different from
the two political branches of the Government.  No miscon-
ception could do more lasting injury to this Court and to the
system of law which it is our abiding mission to serve-);
Mapp v. Ohio, 367 U. S. 643, 677 (1961) (Harlan, J.,
dissenting).
                     C
  The examination of the conditions justifying the repudia-
tion of Adkins by West Coast Hotel and Plessy by Brown is
enough to suggest the terrible price that would have been
paid if the Court had not overruled as it did.  In the present
case, however, as our analysis to this point makes clear, the
terrible price would be paid for overruling.  Our analysis
would not be complete, however, without explaining why
overruling Roe's central holding would not only reach an
unjustifiable result under principles of stare decisis, but
would seriously weaken the Court's capacity to exercise the
judicial power and to function as the Supreme Court of a
Nation dedicated to the rule of law.  To understand why
this would be so it is necessary to understand the source of
this Court's authority, the conditions necessary for its
preservation, and its relationship to the country's under-
standing of itself as a constitutional Republic.
  The root of American governmental power is revealed
most clearly in the instance of the power conferred by the
Constitution upon the Judiciary of the United States and
specifically upon this Court.  As Americans of each succeed-
ing generation are rightly told, the Court cannot buy
support for its decisions by spending money and, except to
a minor degree, it cannot independently coerce obedience to
its decrees.  The Court's power lies, rather, in its legiti-
macy, a product of substance and perception that shows
itself in the people's acceptance of the Judiciary as fit to
determine what the Nation's law means and to declare
what it demands.
  The underlying substance of this legitimacy is of course
the warrant for the Court's decisions in the Constitution
and the lesser sources of legal principle on which the Court
draws.  That substance is expressed in the Court's opinions,
and our contemporary understanding is such that a decision
without principled justification would be no judicial act at
all.  But even when justification is furnished by apposite
legal principle, something more is required.  Because not
every conscientious claim of principled justification will be
accepted as such, the justification claimed must be beyond
dispute.  The Court must take care to speak and act in
ways that allow people to accept its decisions on the terms
the Court claims for them, as grounded truly in principle,
not as compromises with social and political pressures
having, as such, no bearing on the principled choices that
the Court is obliged to make.  Thus, the Court's legitimacy
depends on making legally principled decisions under
circumstances in which their principled character is
sufficiently plausible to be accepted by the Nation.
  The need for principled action to be perceived as such is
implicated to some degree whenever this, or any other
appellate court, overrules a prior case.  This is not to say,
of course, that this Court cannot give a perfectly satisfac-
tory explanation in most cases.  People understand that
some of the Constitution's language is hard to fathom and
that the Court's Justices are sometimes able to perceive
significant facts or to understand principles of law that
eluded their predecessors and that justify departures from
existing decisions.  However upsetting it may be to those
most directly affected when one judicially derived rule
replaces another, the country can accept some correction of
error without necessarily questioning the legitimacy of the
Court.
  In two circumstances, however, the Court would almost
certainly fail to receive the benefit of the doubt in overrul-
ing prior cases.  There is, first, a point beyond which
frequent overruling would overtax the country's belief in the
Court's good faith.  Despite the variety of reasons that may
inform and justify a decision to overrule, we cannot forget
that such a decision is usually perceived (and perceived
correctly) as, at the least, a statement that a prior decision
was wrong.  There is a limit to the amount of error that can
plausibly be imputed to prior courts.  If that limit should be
exceeded, disturbance of prior rulings would be taken as
evidence that justifiable reexamination of principle had
given way to drives for particular results in the short term.
The legitimacy of the Court would fade with the frequency
of its vacillation.
  That first circumstance can be described as hypothetical;
the second is to the point here and now.  Where, in the
performance of its judicial duties, the Court decides a case
in such a way as to resolve the sort of intensely divisive
controversy reflected in Roe and those rare, comparable
cases, its decision has a dimension that the resolution of the
normal case does not carry.  It is the dimension present
whenever the Court's interpretation of the Constitution
calls the contending sides of a national controversy to end
their national division by accepting a common mandate
rooted in the Constitution.
  The Court is not asked to do this very often, having thus
addressed the Nation only twice in our lifetime, in the
decisions of Brown and Roe.  But when the Court does act
in this way, its decision requires an equally rare
precedential force to counter the inevitable efforts to
overturn it and to thwart its implementation.  Some of
those efforts may be mere unprincipled emotional reactions;
others may proceed from principles worthy of profound
respect.  But whatever the premises of opposition may be,
only the most convincing justification under accepted
standards of precedent could suffice to demonstrate that a
later decision overruling the first was anything but a
surrender to political pressure, and an unjustified repudia-
tion of the principle on which the Court staked its authority
in the first instance.  So to overrule under fire in the
absence of the most compelling reason to reexamine a
watershed decision would subvert the Court's legitimacy
beyond any serious question.  Cf. Brown v. Board of
Education, 349 U. S. 294, 300 (1955) (Brown II) (-[I]t should
go without saying that the vitality of th[e] constitutional
principles [announced in Brown v. Board of Education, 347
U. S. 483 (1954),] cannot be allowed to yield simply because
of disagreement with them-).
  The country's loss of confidence in the judiciary would be
underscored by an equally certain and equally reasonable
condemnation for another failing in overruling unneces-
sarily and under pressure.  Some cost will be paid by
anyone who approves or implements a constitutional
decision where it is unpopular, or who refuses to work to
undermine the decision or to force its reversal.  The price
may be criticism or ostracism, or it may be violence.  An
extra price will be paid by those who themselves disapprove
of the decision's results when viewed outside of constitu-
tional terms, but who nevertheless struggle to accept it,
because they respect the rule of law.  To all those who will
be so tested by following, the Court implicitly undertakes to
remain steadfast, lest in the end a price be paid for nothing.
The promise of constancy, once given, binds its maker for as
long as the power to stand by the decision survives and the
understanding of the issue has not changed so fundamen-
tally as to render the commitment obsolete.  From the
obligation of this promise this Court cannot and should not
assume any exemption when duty requires it to decide a
case in conformance with the Constitution.  A willing
breach of it would be nothing less than a breach of faith,
and no Court that broke its faith with the people could
sensibly expect credit for principle in the decision by which
it did that.
  It is true that diminished legitimacy may be restored, but
only slowly.  Unlike the political branches, a Court thus
weakened could not seek to regain its position with a new
mandate from the voters, and even if the Court could
somehow go to the polls, the loss of its principled character
could not be retrieved by the casting of so many votes.  Like
the character of an individual, the legitimacy of the Court
must be earned over time.  So, indeed, must be the charac-
ter of a Nation of people who aspire to live according to the
rule of law.  Their belief in themselves as such a people is
not readily separable from their understanding of the Court
invested with the authority to decide their constitutional
cases and speak before all others for their constitutional
ideals.  If the Court's legitimacy should be undermined,
then, so would the country be in its very ability to see itself
through its constitutional ideals.  The Court's concern with
legitimacy is not for the sake of the Court but for the sake
of the Nation to which it is responsible.
  The Court's duty in the present case is clear.  In 1973, it
confronted the already-divisive issue of governmental power
to limit personal choice to undergo abortion, for which it
provided a new resolution based on the due process guaran-
teed by the Fourteenth Amendment.  Whether or not a new
social consensus is developing on that issue, its divisiveness
is no less today than in 1973, and pressure to overrule the
decision, like pressure to retain it, has grown only more
intense.  A decision to overrule Roe's essential holding
under the existing circumstances would address error, if
error there was, at the cost of both profound and unneces-
sary damage to the Court's legitimacy, and to the Nation's
commitment to the rule of law.  It is therefore imperative
to adhere to the essence of Roe's original decision, and we
do so today.
                    IV
  From what we have said so far it follows that it is a
constitutional liberty of the woman to have some freedom
to terminate her pregnancy.  We conclude that the basic
decision in Roe was based on a constitutional analysis
which we cannot now repudiate.  The woman's liberty is not
so unlimited, however, that from the outset the State
cannot show its concern for the life of the unborn, and at a
later point in fetal development the State's interest in life
has sufficient force so that the right of the woman to
terminate the pregnancy can be restricted.
  That brings us, of course, to the point where much
criticism has been directed at Roe, a criticism that always
inheres when the Court draws a specific rule from what in
the Constitution is but a general standard.  We conclude,
however, that the urgent claims of the woman to retain the
ultimate control over her destiny and her body, claims
implicit in the meaning of liberty, require us to perform
that function.  Liberty must not be extinguished for want of
a line that is clear.  And it falls to us to give some real
substance to the woman's liberty to determine whether to
carry her pregnancy to full term.
  We conclude the line should be drawn at viability, so that
before that time the woman has a right to choose to
terminate her pregnancy.  We adhere to this principle for
two reasons.  First, as we have said, is the doctrine of stare
decisis.  Any judicial act of line-drawing may seem some-
what arbitrary, but Roe was a reasoned statement, elabo-
rated with great care.  We have twice reaffirmed it in the
face of great opposition.  See Thornburgh v. American
College of Obstetricians & Gynecologists, 476 U. S., at 759;
Akron I, 462 U. S., at 419-420.  Although we must overrule
those parts of Thornburgh and Akron I which, in our view,
are inconsistent with Roe's statement that the State has a
legitimate interest in promoting the life or potential life of
the unborn, see infra, at ___, the central premise of those
cases represents an unbroken commitment by this Court to
the essential holding of Roe.  It is that premise which we
reaffirm today.
  The second reason is that the concept of viability, as we
noted in Roe, is the time at which there is a realistic
possibility of maintaining and nourishing a life outside the
womb, so that the independent existence of the second life
can in reason and all fairness be the object of state protec-
tion that now overrides the rights of the woman.  See Roe
v. Wade, 410 U. S., at 163.  Consistent with other constitu-
tional norms, legislatures may draw lines which appear
arbitrary without the necessity of offering a justification.
But courts may not.  We must justify the lines we draw.
And there is no line other than viability which is more
workable.  To be sure, as we have said, there may be some
medical developments that affect the precise point of
viability, see supra, at ___, but this is an imprecision within
tolerable limits given that the medical community and all
those who must apply its discoveries will continue to
explore the matter.  The viability line also has, as a
practical matter, an element of fairness.  In some broad
sense it might be said that a woman who fails to act before
viability has consented to the State's intervention on behalf
of the developing child.
  The woman's right to terminate her pregnancy before
viability is the most central principle of Roe v. Wade.  It is
a rule of law and a component of liberty we cannot re-
nounce.
  On the other side of the equation is the interest of the
State in the protection of potential life.  The Roe Court
recognized the State's -important and legitimate interest in
protecting the potentiality of human life.-  Roe, supra, at
162.  The weight to be given this state interest, not the
strength of the woman's interest, was the difficult question
faced in Roe.  We do not need to say whether each of us,
had we been Members of the Court when the valuation of
the State interest came before it as an original matter,
would have concluded, as the Roe Court did, that its weight
is insufficient to justify a ban on abortions prior to viability
even when it is subject to certain exceptions.  The matter is
not before us in the first instance, and coming as it does
after nearly 20 years of litigation in Roe's wake we are
satisfied that the immediate question is not the soundness
of Roe's resolution of the issue, but the precedential force
that must be accorded to its holding.  And we have con-
cluded that the essential holding of Roe should be
reaffirmed.
  Yet it must be remembered that Roe v. Wade speaks with
clarity in establishing not only the woman's liberty but also
the State's -important and legitimate interest in potential
life.-  Roe, supra, at 163.  That portion of the decision in
Roe has been given too little acknowledgement and imple-
mentation by the Court in its subsequent cases.  Those
cases decided that any regulation touching upon the
abortion decision must survive strict scrutiny, to be sus-
tained only if drawn in narrow terms to further a compel-
ling state interest.  See, e.g., Akron I, supra, at 427.  Not
all of the cases decided under that formulation can be
reconciled with the holding in Roe itself that the State has
legitimate interests in the health of the woman and in
protecting the potential life within her.  In resolving this
tension, we choose to rely upon Roe, as against the later
cases.
  Roe established a trimester framework to govern abortion
regulations.  Under this elaborate but rigid construct,
almost no regulation at all is permitted during the first
trimester of pregnancy; regulations designed to protect the
woman's health, but not to further the State's interest in

potential life, are permitted during the second trimester;
and during the third trimester, when the fetus is viable,
prohibitions are permitted provided the life or health of the
mother is not at stake.  Roe v. Wade, supra, at 163-166.
Most of our cases since Roe have involved the application of
rules derived from the trimester framework.  See, e.g.,
Thornburgh v. American College of Obstetricians and
Gynecologists, supra; Akron I, supra.
  The trimester framework no doubt was erected to ensure
that the woman's right to choose not become so subordinate
to the State's interest in promoting fetal life that her choice
exists in theory but not in fact.  We do not agree, however,
that the trimester approach is necessary to accomplish this
objective.  A framework of this rigidity was unnecessary
and in its later interpretation sometimes contradicted the
State's permissible exercise of its powers.
  Though the woman has a right to choose to terminate or
continue her pregnancy before viability, it does not at all
follow that the State is prohibited from taking steps to
ensure that this choice is thoughtful and informed.  Even in
the earliest stages of pregnancy, the State may enact rules
and regulations designed to encourage her to know that
there are philosophic and social arguments of great weight
that can be brought to bear in favor of continuing the
pregnancy to full term and that there are procedures and
institutions to allow adoption of unwanted children as well
as a certain degree of state assistance if the mother chooses
to raise the child herself.  -`[T]he Constitution does not
forbid a State or city, pursuant to democratic processes,
from expressing a preference for normal childbirth.'-
Webster v. Reproductive Health Services, 492 U. S., at 511
(opinion of the Court) (quoting Poelker v. Doe, 432 U. S.
519, 521 (1977)).  It follows that States are free to enact
laws to provide a reasonable framework for a woman to
make a decision that has such profound and lasting
meaning.  This, too, we find consistent with Roe's central
premises, and indeed the inevitable consequence of our
holding that the State has an interest in protecting the life
of the unborn.
  We reject the trimester framework, which we do not
consider to be part of the essential holding of Roe.  See
Webster v. Reproductive Health Services, supra, at 518
(opinion of Rehnquist, C. J.); id., at 529 (O'Connor, J.,
concurring in part and concurring in judgment) (describing
the trimester framework as -problematic-).  Measures
aimed at ensuring that a woman's choice contemplates the
consequences for the fetus do not necessarily interfere with
the right recognized in Roe, although those measures have
been found to be inconsistent with the rigid trimester
framework announced in that case.  A logical reading of the
central holding in Roe itself, and a necessary reconciliation
of the liberty of the woman and the interest of the State in
promoting prenatal life, require, in our view, that we
abandon the trimester framework as a rigid prohibition on
all previability regulation aimed at the protection of fetal
life.  The trimester framework suffers from these basic
flaws: in its formulation it misconceives the nature of the
pregnant woman's interest; and in practice it undervalues
the State's interest in potential life, as recognized in Roe.
  As our jurisprudence relating to all liberties save perhaps
abortion has recognized, not every law which makes a right
more difficult to exercise is, ipso facto, an infringement of
that right.  An example clarifies the point.  We have held
that not every ballot access limitation amounts to an
infringement of the right to vote.  Rather, the States are
granted substantial flexibility in establishing the frame-
work within which voters choose the candidates for whom
they wish to vote.  Anderson v. Celebrezze, 460 U. S. 780,
788 (1983); Norman v. Reed, 502 U. S. ___ (1992).
  The abortion right is similar.  Numerous forms of state
regulation might have the incidental effect of increasing the
cost or decreasing the availability of medical care, whether
for abortion or any other medical procedure.  The fact that
a law which serves a valid purpose, one not designed to
strike at the right itself, has the incidental effect of making
it more difficult or more expensive to procure an abortion
cannot be enough to invalidate it.  Only where state
regulation imposes an undue burden on a woman's ability
to make this decision does the power of the State reach into
the heart of the liberty protected by the Due Process
Clause.  See Hodgson v. Minnesota, 497 U. S. 417, 458-459
(1990) (O'Connor, J., concurring in part and concurring in
judgment in part); Ohio v. Akron Center for Reproductive
Health, 497 U. S. 502, --- (1990) (Akron II) (opinion of
Kennedy, J.) Webster v. Reproductive Health Services,
supra, at 530 (O'Connor, J., concurring in part and
concurring in judgment); Thornburgh v. American College
of Obstetricians and Gynecologists, 476 U. S., at 828
(O'Connor, J., dissenting); Simopoulos v. Virginia, 462
U. S. 506, 520 (1983) (O'Connor, J., concurring in part and
concurring in judgment); Planned Parenthood Assn. of
Kansas City v. Ashcroft, 462 U. S. 476, 505 (1983) (O'Con-
nor, J., concurring in judgment in part and dissenting in
part); Akron I, 462 U. S., at 464 (O'Connor, J., joined by
White and Rehnquist, JJ., dissenting); Bellotti v. Baird,
428 U. S. 132, 147 (1976) (Bellotti I).
  For the most part, the Court's early abortion cases
adhered to this view.  In Maher v. Roe, 432 U. S. 464,
473-474 (1977), the Court explained:  -Roe did not declare
an unqualified `constitutional right to an abortion,' as the
District Court seemed to think.  Rather, the right protects
the woman from unduly burdensome interference with her
freedom to decide whether to terminate her pregnancy.-
See also Doe v. Bolton, 410 U. S. 179, 198 (1973) (-[T]he
interposition of the hospital abortion committee is unduly
restrictive of the patient's rights-); Bellotti I, supra, at 147
(State may not -impose undue burdens upon a minor
capable of giving an informed consent-); Harris v. McRae,
448 U. S. 297, 314 (1980) (citing Maher, supra).  Cf. Carey
v. Population Services International, 431 U. S., at 688
(-[T]he same test must be applied to state regulations that
burden an individual's right to decide to prevent conception
or terminate pregnancy by substantially limiting access to
the means of effectuating that decision as is applied to state
statutes that prohibit the decision entirely-).
  These considerations of the nature of the abortion right
illustrate that it is an overstatement to describe it as a
right to decide whether to have an abortion -without
interference from the State,- Planned Parenthood of Central
Mo. v. Danforth, 428 U. S. 52, 61 (1976).  All abortion
regulations interfere to some degree with a woman's ability
to decide whether to terminate her pregnancy.  It is, as a
consequence, not surprising that despite the protestations
contained in the original Roe opinion to the effect that the
Court was not recognizing an absolute right, 410 U. S., at
154-155, the Court's experience applying the trimester
framework has led to the striking down of some abortion
regulations which in no real sense deprived women of the
ultimate decision.  Those decisions went too far because the
right recognized by Roe is a right -to be free from unwar-
ranted governmental intrusion into matters so fundamen-
tally affecting a person as the decision whether to bear or
beget a child.-  Eisenstadt v. Baird, 405 U. S., at 453.  Not
all governmental intrusion is of necessity unwarranted; and
that brings us to the other basic flaw in the trimester
framework: even in Roe's terms, in practice it undervalues
the State's interest in the potential life within the woman.
  Roe v. Wade was express in its recognition of the State's
-important and legitimate interest[s] in preserving and
protecting the health of the pregnant woman [and] in
protecting the potentiality of human life.-  410 U. S., at 162.
The trimester framework, however, does not fulfill Roe's
own promise that the State has an interest in protecting
fetal life or potential life.  Roe began the contradiction by
using the trimester framework to forbid any regulation of
abortion designed to advance that interest before viability.
Id., at 163.  Before viability, Roe and subsequent cases treat
all governmental attempts to influence a woman's decision
on behalf of the potential life within her as unwarranted.
This treatment is, in our judgment, incompatible with the
recognition that there is a substantial state interest in
potential life throughout pregnancy.  Cf. Webster, 492 U. S.,
at 519 (opinion of Rehnquist, C. J.); Akron I, supra, at 461
(O'Connor, J., dissenting).
  The very notion that the State has a substantial interest
in potential life leads to the conclusion that not all regula-
tions must be deemed unwarranted.  Not all burdens on the
right to decide whether to terminate a pregnancy will be
undue.  In our view, the undue burden standard is the
appropriate means of reconciling the State's interest with
the woman's constitutionally protected liberty.
  The concept of an undue burden has been utilized by the
Court as well as individual members of the Court, including
two of us, in ways that could be considered inconsistent.
See, e.g., Hodgson v. Minnesota, 497 U. S., at --- (O'Con-
nor, J., concurring in part and concurring in judgment);
Akron II, 497 U. S., at --- (opinion of Kennedy, J.); Thorn-
burgh v. American College of Obstetricians and Gynecol-
ogists, 476 U. S., at 828-829 (O'Connor, J., dissenting);
Akron I, supra, at 461-466 (O'Connor, J., dissenting);
Harris v. McRae, supra, at 314; Maher v. Roe, supra, at
473; Beal v. Doe, 432 U. S. 438, 446 (1977); Bellotti I, supra,
at 147.  Because we set forth a standard of general applica-
tion to which we intend to adhere, it is important to clarify
what is meant by an undue burden.
  A finding of an undue burden is a shorthand for the
conclusion that a state regulation has the purpose or effect
of placing a substantial obstacle in the path of a woman
seeking an abortion of a nonviable fetus.  A statute with
this purpose is invalid because the means chosen by the
State to further the interest in potential life must be
calculated to inform the woman's free choice, not hinder it.
And a statute which, while furthering the interest in
potential life or some other valid state interest, has the
effect of placing a substantial obstacle in the path of a
woman's choice cannot be considered a permissible means
of serving its legitimate ends.  To the extent that the
opinions of the Court or of individual Justices use the
undue burden standard in a manner that is inconsistent
with this analysis, we set out what in our view should be
the controlling standard.  Cf. McCleskey v. Zant, 499 U. S.
---, --- (1991) (slip op., at 20) (attempting to -define the
doctrine of abuse of the writ with more precision- after
acknowledging tension among earlier cases).  In our
considered judgment, an undue burden is an unconsti-
tutional burden.  See Akron II, supra, at --- (opinion of
Kennedy, J.).  Understood another way, we answer the
question, left open in previous opinions discussing the
undue burden formulation, whether a law designed to
further the State's interest in fetal life which imposes an
undue burden on the woman's decision before fetal viability
could be constitutional.  See, e.g., Akron I, supra, at
462-463 (O'Connor, J., dissenting).  The answer is no.
  Some guiding principles should emerge.  What is at stake
is the woman's right to make the ultimate decision, not a
right to be insulated from all others in doing so.  Regula-
tions which do no more than create a structural mechanism
by which the State, or the parent or guardian of a minor,
may express profound respect for the life of the unborn are
permitted, if they are not a substantial obstacle to the
woman's exercise of the right to choose.  See infra, at ___-
___ (addressing Pennsylvania's parental consent require-
ment).  Unless it has that effect on her right of choice, a
state measure designed to persuade her to choose childbirth
over abortion will be upheld if reasonably related to that
goal.  Regulations designed to foster the health of a woman
seeking an abortion are valid if they do not constitute an
undue burden.
  Even when jurists reason from shared premises, some
disagreement is inevitable.  Compare Hodgson, 497 U. S.,
at ------- (opinion of Kennedy, J.) with id., at -------
(O'Connor, J., concurring in part and concurring in
judgment in part).  That is to be expected in the application
of any legal standard which must accommodate life's com-
plexity.  We do not expect it to be otherwise with respect to
the undue burden standard.  We give this summary:
  (a) To protect the central right recognized by Roe v. Wade
while at the same time accommodating the State's profound
interest in potential life, we will employ the undue burden
analysis as explained in this opinion.  An undue burden
exists, and therefore a provision of law is invalid, if its
purpose or effect is to place a substantial obstacle in the
path of a woman seeking an abortion before the fetus
attains viability.
  (b) We reject the rigid trimester framework of Roe v.
Wade.  To promote the State's profound interest in potential
life, throughout pregnancy the State may take measures to
ensure that the woman's choice is informed, and measures
designed to advance this interest will not be invalidated as
long as their purpose is to persuade the woman to choose
childbirth over abortion.  These measures must not be an
undue burden on the right.
  (c) As with any medical procedure, the State may enact
regulations to further the health or safety of a woman
seeking an abortion.  Unnecessary health regulations that
have the purpose or effect of presenting a substantial
obstacle to a woman seeking an abortion impose an undue
burden on the right.
  (d) Our adoption of the undue burden analysis does not
disturb the central holding of Roe v. Wade, and we reaffirm
that holding.  Regardless of whether exceptions are made
for particular circumstances, a State may not prohibit any
woman from making the ultimate decision to terminate her
pregnancy before viability.
  (e) We also reaffirm Roe's holding that -subsequent to
viability, the State in promoting its interest in the potenti-
ality of human life may, if it chooses, regulate, and even
proscribe, abortion except where it is necessary, in appro-
priate medical judgment, for the preservation of the life or
health of the mother.-  Roe v. Wade, 410 U. S., at 164-165.
  These principles control our assessment of the Pennsylva-
nia statute, and we now turn to the issue of the validity of
its challenged provisions.
                     V
  The Court of Appeals applied what it believed to be the
undue burden standard and upheld each of the provisions
except for the husband notification requirement.  We agree
generally with this conclusion, but refine the undue burden
analysis in accordance with the principles articulated above.
We now consider the separate statutory sections at issue.
                     A
  Because it is central to the operation of various other
requirements, we begin with the statute's definition of
medical emergency.  Under the statute, a medical emer-
gency is
-[t]hat condition which, on the basis of the physician's
good faith clinical judgment, so complicates the medical
condition of a pregnant woman as to necessitate the
immediate abortion of her pregnancy to avert her death
or for which a delay will create serious risk of substan-
tial and irreversible impairment of a major bodily
function.-  18 Pa. Cons. Stat. (1990).  3203.
  Petitioners argue that the definition is too narrow,
contending that it forecloses the possibility of an immediate
abortion despite some significant health risks.  If the
contention were correct, we would be required to invalidate
the restrictive operation of the provision, for the essential
holding of Roe forbids a State from interfering with a
woman's choice to undergo an abortion procedure if continu-
ing her pregnancy would constitute a threat to her health.
410 U. S., at 164.  See also Harris v. McRae, 448 U. S.,
at 316.
  The District Court found that there were three serious
conditions which would not be covered by the statute:
preeclampsia, inevitable abortion, and premature ruptured
membrane.  744 F. Supp., at 1378.  Yet, as the Court of
Appeals observed, 947 F. 2d, at 700-701, it is undisputed
that under some circumstances each of these conditions
could lead to an illness with substantial and irreversible
consequences.  While the definition could be interpreted in
an unconstitutional manner, the Court of Appeals construed
the phrase -serious risk- to include those circumstances.
Id., at 701.  It stated: -we read the medical emergency
exception as intended by the Pennsylvania legislature to
assure that compliance with its abortion regulations would
not in any way pose a significant threat to the life or health
of a woman.-  Ibid.  As we said in Brockett v. Spokane
Arcades, Inc., 472 U. S. 491, 499-500 (1985): -Normally, . . .
we defer to the construction of a state statute given it by
the lower federal courts.-  Indeed, we have said that we will
defer to lower court interpretations of state law unless they
amount to -plain- error.  Palmer v. Hoffman, 318 U. S. 109,
118 (1943).  This -`reflect[s] our belief that district courts
and courts of appeals are better schooled in and more able
to interpret the laws of their respective States.'-  Frisby v.
Schultz, 487 U. S. 474, 482 (1988) (citation omitted).  We
adhere to that course today, and conclude that, as construed
by the Court of Appeals, the medical emergency definition
imposes no undue burden on a woman's abortion right.
                     B
  We next consider the informed consent requirement.  18
Pa. Cons. Stat. Ann. 3205.  Except in a medical emer-
gency, the statute requires that at least 24 hours before
performing an abortion a physician inform the woman of
the nature of the procedure, the health risks of the abortion
and of childbirth, and the -probable gestational age of the
unborn child.-  The physician or a qualified nonphysician
must inform the woman of the availability of printed
materials published by the State describing the fetus and
providing information about medical assistance for child-
birth, information about child support from the father, and
a list of agencies which provide adoption and other services
as alternatives to abortion.  An abortion may not be
performed unless the woman certifies in writing that she
has been informed of the availability of these printed
materials and has been provided them if she chooses to
view them.
  Our prior decisions establish that as with any medical
procedure, the State may require a woman to give her
written informed consent to an abortion.  See Planned
Parenthood of Central Mo. v. Danforth, 428 U. S., at 67.  In
this respect, the statute is unexceptional.  Petitioners
challenge the statute's definition of informed consent
because it includes the provision of specific information by
the doctor and the mandatory 24-hour waiting period.  The
conclusions reached by a majority of the Justices in the
separate opinions filed today and the undue burden
standard adopted in this opinion require us to overrule in
part some of the Court's past decisions, decisions driven by
the trimester framework's prohibition of all previability
regulations designed to further the State's interest in fetal
life.
  In Akron I, 462 U. S. 416 (1983), we invalidated an
ordinance which required that a woman seeking an abortion
be provided by her physician with specific information -de-
signed to influence the woman's informed choice between
abortion or childbirth.-  Id., at 444.  As we later described
the Akron I holding in Thornburgh v. American College of
Obstetricians and Gynecologists, 476 U. S., at 762, there
were two purported flaws in the Akron ordinance: the
information was designed to dissuade the woman from
having an abortion and the ordinance imposed -a rigid
requirement that a specific body of information be given
in all cases, irrespective of the particular needs of the
patient . . . .-  Ibid.
  To the extent Akron I and Thornburgh find a constitu-
tional violation when the government requires, as it does
here, the giving of truthful, nonmisleading information
about the nature of the procedure, the attendant health
risks and those of childbirth, and the -probable gestational
age- of the fetus, those cases go too far, are inconsistent
with Roe's acknowledgment of an important interest in
potential life, and are overruled.  This is clear even on the
very terms of Akron I and Thornburgh.  Those decisions,
along with Danforth, recognize a substantial government
interest justifying a requirement that a woman be apprised
of the health risks of abortion and childbirth.  E.g.,
Danforth, supra, at 66-67.  It cannot be questioned that
psychological well-being is a facet of health.  Nor can it be
doubted that most women considering an abortion would
deem the impact on the fetus relevant, if not dispositive, to
the decision.  In attempting to ensure that a woman
apprehend the full consequences of her decision, the State
furthers the legitimate purpose of reducing the risk that a
woman may elect an abortion, only to discover later, with
devastating psychological consequences, that her decision
was not fully informed.  If the information the State
requires to be made available to the woman is truthful and
not misleading, the requirement may be permissible.
  We also see no reason why the State may not require
doctors to inform a woman seeking an abortion of the
availability of materials relating to the consequences to the
fetus, even when those consequences have no direct relation
to her health.  An example illustrates the point.  We would
think it constitutional for the State to require that in order
for there to be informed consent to a kidney transplant
operation the recipient must be supplied with information
about risks to the donor as well as risks to himself or
herself.  A requirement that the physician make available
information similar to that mandated by the statute here
was described in Thornburgh as -an outright attempt to
wedge the Commonwealth's message discouraging abortion
into the privacy of the informed-consent dialogue between
the woman and her physician.-  476 U. S., at 762.  We
conclude, however, that informed choice need not be defined
in such narrow terms that all considerations of the effect on
the fetus are made irrelevant.  As we have made clear, we
depart from the holdings of Akron I and Thornburgh to the
extent that we permit a State to further its legitimate goal
of protecting the life of the unborn by enacting legislation
aimed at ensuring a decision that is mature and informed,
even when in so doing the State expresses a preference for
childbirth over abortion.  In short, requiring that the
woman be informed of the availability of information
relating to fetal development and the assistance available
should she decide to carry the pregnancy to full term is a
reasonable measure to insure an informed choice, one which
might cause the woman to choose childbirth over abortion.
This requirement cannot be considered a substantial
obstacle to obtaining an abortion, and, it follows, there is no
undue burden.
  Our prior cases also suggest that the -straitjacket,-
Thornburgh, supra, at 762 (quoting Danforth, supra, at 67,
n. 8), of particular information which must be given in each
case interferes with a constitutional right of privacy
between a pregnant woman and her physician.  As a
preliminary matter, it is worth noting that the statute now
before us does not require a physician to comply with the
informed consent provisions -if he or she can demonstrate
by a preponderance of the evidence, that he or she reason-
ably believed that furnishing the information would have
resulted in a severely adverse effect on the physical or
mental health of the patient.-  18 Pa. Cons. Stat. 3205
(1990).  In this respect, the statute does not prevent the
physician from exercising his or her medical judgment.
  Whatever constitutional status the doctor-patient relation
may have as a general matter, in the present context it is
derivative of the woman's position.  The doctor-patient
relation does not underlie or override the two more general
rights under which the abortion right is justified: the right
to make family decisions and the right to physical autono-
my.  On its own, the doctor-patient relation here is entitled
to the same solicitude it receives in other contexts.  Thus,
a requirement that a doctor give a woman certain informa-
tion as part of obtaining her consent to an abortion is, for
constitutional purposes, no different from a requirement
that a doctor give certain specific information about any
medical procedure.
  All that is left of petitioners' argument is an asserted
First Amendment right of a physician not to provide
information about the risks of abortion, and childbirth, in
a manner mandated by the State.  To be sure, the physi-
cian's First Amendment rights not to speak are implicated,
see Wooley v. Maynard, 430 U. S. 705 (1977), but only as
part of the practice of medicine, subject to reasonable
licensing and regulation by the State.  Cf. Whalen v. Roe,
429 U. S. 589, 603 (1977).  We see no constitutional
infirmity in the requirement that the physician provide the
information mandated by the State here.
  The Pennsylvania statute also requires us to reconsider
the holding in Akron I that the State may not require that
a physician, as opposed to a qualified assistant, provide
information relevant to a woman's informed consent.  462
U. S., at 448.  Since there is no evidence on this record that
requiring a doctor to give the information as provided by
the statute would amount in practical terms to a substan-
tial obstacle to a woman seeking an abortion, we conclude
that it is not an undue burden.  Our cases reflect the fact
that the Constitution gives the States broad latitude to
decide that particular functions may be performed only by
licensed professionals, even if an objective assessment
might suggest that those same tasks could be performed by
others.  See Williamson v. Lee Optical of Oklahoma, Inc.,
348 U. S. 483 (1955).  Thus, we uphold the provision as a
reasonable means to insure that the woman's consent is
informed.
  Our analysis of Pennsylvania's 24-hour waiting period
between the provision of the information deemed necessary
to informed consent and the performance of an abortion
under the undue burden standard requires us to reconsider
the premise behind the decision in Akron I invalidating a
parallel requirement.  In Akron I we said: -Nor are we
convinced that the State's legitimate concern that the
woman's decision be informed is reasonably served by
requiring a 24-hour delay as a matter of course.-  462
U. S., at 450.  We consider that conclusion to be wrong.
The idea that important decisions will be more informed
and deliberate if they follow some period of reflection does
not strike us as unreasonable, particularly where the
statute directs that important information become part of
the background of the decision.  The statute, as construed
by the Court of Appeals, permits avoidance of the waiting
period in the event of a medical emergency and the record
evidence shows that in the vast majority of cases, a 24-hour
delay does not create any appreciable health risk.  In
theory, at least, the waiting period is a reasonable measure
to implement the State's interest in protecting the life of
the unborn, a measure that does not amount to an undue
burden.
  Whether the mandatory 24-hour waiting period is
nonetheless invalid because in practice it is a substantial
obstacle to a woman's choice to terminate her pregnancy is
a closer question.  The findings of fact by the District Court
indicate that because of the distances many women must
travel to reach an abortion provider, the practical effect will
often be a delay of much more than a day because the
waiting period requires that a woman seeking an abortion
make at least two visits to the doctor.  The District Court
also found that in many instances this will increase the
exposure of women seeking abortions to -the harassment
and hostility of anti-abortion protestors demonstrating
outside a clinic.-  744 F. Supp., at 1351.  As a result, the
District Court found that for those women who have the
fewest financial resources, those who must travel long
distances, and those who have difficulty explaining their
whereabouts to husbands, employers, or others, the 24-hour
waiting period will be -particularly burdensome.-  Id.,
at 1352.
  These findings are troubling in some respects, but they do
not demonstrate that the waiting period constitutes an
undue burden.  We do not doubt that, as the District Court
held, the waiting period has the effect of -increasing the
cost and risk of delay of abortions,- id., at 1378, but the
District Court did not conclude that the increased costs and
potential delays amount to substantial obstacles.  Rather,
applying the trimester framework's strict prohibition of all
regulation designed to promote the State's interest in
potential life before viability, see id., at 1374, the District
Court concluded that the waiting period does not further
the state -interest in maternal health- and -infringes the
physician's discretion to exercise sound medical judgment.-
Id., at 1378.  Yet, as we have stated, under the undue
burden standard a State is permitted to enact persuasive
measures which favor childbirth over abortion, even if those
measures do not further a health interest.  And while the
waiting period does limit a physician's discretion, that is
not, standing alone, a reason to invalidate it.  In light of the
construction given the statute's definition of medical
emergency by the Court of Appeals, and the District Court's
findings, we cannot say that the waiting period imposes a
real health risk.
  We also disagree with the District Court's conclusion that
the -particularly burdensome- effects of the waiting period
on some women require its invalidation.  A particular
burden is not of necessity a substantial obstacle.  Whether
a burden falls on a particular group is a distinct inquiry
from whether it is a substantial obstacle even as to the
women in that group.  And the District Court did not
conclude that the waiting period is such an obstacle even
for the women who are most burdened by it.  Hence, on the
record before us, and in the context of this facial challenge,
we are not convinced that the 24-hour waiting period
constitutes an undue burden.
  We are left with the argument that the various aspects of
the informed consent requirement are unconstitutional
because they place barriers in the way of abortion on
demand.  Even the broadest reading of Roe, however, has
not suggested that there is a constitutional right to abortion
on demand.  See, e.g., Doe v. Bolton, 410 U. S., at 189.
Rather, the right protected by Roe is a right to decide to
terminate a pregnancy free of undue interference by the
State.  Because the informed consent requirement facili-
tates the wise exercise of that right it cannot be classified
as an interference with the right Roe protects.  The in-
formed consent requirement is not an undue burden on that
right.               C
  Section 3209 of Pennsylvania's abortion law provides,
except in cases of medical emergency, that no physician
shall perform an abortion on a married woman without
receiving a signed statement from the woman that she has
notified her spouse that she is about to undergo an abor-
tion.  The woman has the option of providing an alternative
signed statement certifying that her husband is not the
man who impregnated her; that her husband could not be
located; that the pregnancy is the result of spousal sexual
assault which she has reported; or that the woman believes
that notifying her husband will cause him or someone else
to inflict bodily injury upon her.  A physician who performs
an abortion on a married woman without receiving the
appropriate signed statement will have his or her license
revoked, and is liable to the husband for damages.
  The District Court heard the testimony of numerous
expert witnesses, and made detailed findings of fact
regarding the effect of this statute.  These included:
     -273.  The vast majority of women consult their
husbands prior to deciding to terminate their preg-
nancy. . . .
          .      .     .      .      .

     ``279.  The `bodily injury' exception could not be
invoked by a married woman whose husband, if
notified, would, in her reasonable belief, threaten to (a)
publicize her intent to have an abortion to family,
friends or acquaintances; (b) retaliate against her in
future child custody or divorce proceedings; (c) inflict
psychological intimidation or emotional harm upon her,
her children or other persons; (d) inflict bodily harm on
other persons such as children, family members or
other loved ones; or (e) use his control over finances
to deprive of necessary monies for herself or her
children. . . .
          .      .     .      .      .

     ``281.  Studies reveal that family violence occurs in
two million families in the United States.  This figure,
however, is a conservative one that substantially
understates (because battering is usually not reported
until it reaches life-threatening proportions) the actual
number of families affected by domestic violence.  In
fact, researchers estimate that one of every two women
will be battered at some time in their life. . . .

     ``282.  A wife may not elect to notify her husband of
her intention to have an abortion for a variety of
reasons, including the husband's illness, concern
about her own health, the imminent failure of the
marriage, or the husband's absolute opposition to the
abortion. . . .

     ``283.  The required filing of the spousal consent form
would require plaintiff-clinics to change their counsel-
ing procedures and force women to reveal their most
intimate decision-making on pain of criminal sanctions.
The confidentiality of these revelations could not be
guaranteed, since the woman's records are not immune
from subpoena. . . .

     ``284.  Women of all class levels, educational back-
grounds, and racial, ethnic and religious groups are
battered. . . .

     ``285.  Wife-battering or abuse can take on many
physical and psychological forms.  The nature and
scope of the battering can cover a broad range of
actions and be gruesome and torturous. . . .

     ``286.  Married women, victims of battering, have
been killed in Pennsylvania and throughout the United
States. . . .

     ``287.  Battering can often involve a substantial
amount of sexual abuse, including marital rape and
sexual mutilation. . . .

     ``288.  In a domestic abuse situation, it is common for
the battering husband to also abuse the children in an
attempt to coerce the wife. . . .

     ``289.  Mere notification of pregnancy is frequently a
flashpoint for battering and violence within the family.
The number of battering incidents is high during the
pregnancy and often the worst abuse can be associated
with pregnancy. . . .  The battering husband may deny
parentage and use the pregnancy as an excuse for
abuse. . . .

     ``290.  Secrecy typically shrouds abusive families.
Family members are instructed not to tell anyone,
especially police or doctors, about the abuse and
violence.  Battering husbands often threaten their
wives or her children with further abuse if she tells an
outsider of the violence and tells her that nobody will
believe her.  A battered woman, therefore, is highly
unlikely to disclose the violence against her for fear of
retaliation by the abuser. . . .

     ``291.  Even when confronted directly by medical
personnel or other helping professionals, battered
women often will not admit to the battering because
they have not admitted to themselves that they are
battered. . . .

          .      .     .      .      .
     ``294.  A woman in a shelter or a safe house unknown
to her husband is not `reasonably likely' to have bodily
harm inflicted upon her by her batterer, however her
attempt to notify her husband pursuant to section 3209
could accidentally disclose her whereabouts to her
husband.  Her fear of future ramifications would be
realistic under the circumstances.

     ``295.  Marital rape is rarely discussed with others or
reported to law enforcement authorities, and of those
reported only few are prosecuted. . . .

     ``296.  It is common for battered women to have
sexual intercourse with their husbands to avoid being
battered.  While this type of coercive sexual activity
would be spousal sexual assault as defined by the Act,
many women may not consider it to be so and others
would fear disbelief. . . .

     ``297.  The marital rape exception to section 3209
cannot be claimed by women who are victims of
coercive sexual behavior other than penetration.  The
90-day reporting requirement of the spousal sexual
assault statute, 18 Pa. Con. Stat. Ann. 3218(c),
further narrows the class of sexually abused wives who
can claim the exception, since many of these women
may be psychologically unable to discuss or report the
rape for several years after the incident. . . .

     ``298.  Because of the nature of the battering relation-
ship, battered women are unlikely to avail themselves
of the exceptions to section 3209 of the Act, regardless
of whether the section applies to them.''  744 F. Supp.,
at 1360-1362.

  These findings are supported by studies of domestic
violence.  The American Medical Association (AMA) has
published a summary of the recent research in this field,
which indicates that in an average 12-month period in this
country, approximately two million women are the victims
of severe assaults by their male partners.  In a 1985 survey,
women reported that nearly one of every eight husbands
had assaulted their wives during the past year.  The AMA
views these figures as -marked underestimates,- because
the nature of these incidents discourages women from
reporting them, and because surveys typically exclude the
very poor, those who do not speak English well, and women
who are homeless or in institutions or hospitals when the
survey is conducted.  According to the AMA, -[r]esearchers
on family violence agree that the true incidence of partner
violence is probably double the above estimates; or four
million severely assaulted women per year.  Studies suggest
that from one-fifth to one-third of all women will be
physically assaulted by a partner or ex-partner during their
lifetime.-  AMA Council on Scientific Affairs, Violence
Against Women 7 (1991) (emphasis in original).  Thus on an
average day in the United States, nearly 11,000 women are
severely assaulted by their male partners.  Many of these
incidents involve sexual assault.  Id., at 3-4; Shields &
Hanneke, Battered Wives' Reactions to Marital Rape, in
The Dark Side of Families: Current Family Violence
Research 131, 144 (D. Finkelhor, R. Gelles, G. Hataling, &
M. Straus eds. 1983).  In families where wife-beating takes
place, moreover, child abuse is often present as well.
Violence Against Women, supra, at 12.
  Other studies fill in the rest of this troubling picture.
Physical violence is only the most visible form of abuse.
Psychological abuse, particularly forced social and economic
isolation of women, is also common.  L. Walker, The
Battered Woman Syndrome 27-28 (1984).  Many victims of
domestic violence remain with their abusers, perhaps
because they perceive no superior alternative.  Herbert,
Silver, & Ellard, Coping with an Abusive Relationship: I.
How and Why do Women Stay?, 53 J. Marriage & the
Family 311 (1991).  Many abused women who find tempo-
rary refuge in shelters return to their husbands, in large
part because they have no other source of income.  Aguirre,
Why Do They Return? Abused Wives in Shelters, 30 J. Nat.
Assn. of Social Workers 350, 352 (1985).  Returning to one's
abuser can be dangerous.  Recent Federal Bureau of
Investigation statistics disclose that 8.8% of all homicide
victims in the United States are killed by their spouse.
Mercy & Saltzman, Fatal Violence Among Spouses in the
United States, 1976-85, 79 Am. J. Public Health 595
(1989).  Thirty percent of female homicide victims are killed
by their male partners.  Domestic Violence: Terrorism in
the Home, Hearing before the Subcommittee on Children,
Family, Drugs and Alcoholism of the Senate Committee on
Labor and Human Resources, 101st Cong., 2d Sess., 3
(1990).
  The limited research that has been conducted with
respect to notifying one's husband about an abortion,
although involving samples too small to be representative,
also supports the District Court's findings of fact.  The vast
majority of women notify their male partners of their
decision to obtain an abortion.  In many cases in which
married women do not notify their husbands, the pregnancy
is the result of an extramarital affair.  Where the husband
is the father, the primary reason women do not notify their
husbands is that the husband and wife are experiencing
marital difficulties, often accompanied by incidents of
violence.  Ryan & Plutzer, When Married Women Have
Abortions: Spousal Notification and Marital Interaction, 51
J. Marriage & the Family 41, 44 (1989).
  This information and the District Court's findings
reinforce what common sense would suggest.  In well-
functioning marriages, spouses discuss important intimate
decisions such as whether to bear a child.  But there are
millions of women in this country who are the victims of
regular physical and psychological abuse at the hands of
their husbands.  Should these women become pregnant,
they may have very good reasons for not wishing to inform
their husbands of their decision to obtain an abortion.
Many may have justifiable fears of physical abuse, but may
be no less fearful of the consequences of reporting prior
abuse to the Commonwealth of Pennsylvania.  Many may
have a reasonable fear that notifying their husbands will
provoke further instances of child abuse; these women are
not exempt from 3209's notification requirement.  Many
may fear devastating forms of psychological abuse from
their husbands, including verbal harassment, threats of
future violence, the destruction of possessions, physical
confinement to the home, the withdrawal of financial
support, or the disclosure of the abortion to family and
friends.  These methods of psychological abuse may act as
even more of a deterrent to notification than the possibility
of physical violence, but women who are the victims of the
abuse are not exempt from 3209's notification require-
ment.  And many women who are pregnant as a result of
sexual assaults by their husbands will be unable to avail
themselves of the exception for spousal sexual assault,
3209(b)(3), because the exception requires that the woman
have notified law enforcement authorities within 90 days of
the assault, and her husband will be notified of her report
once an investigation begins.  3128(c).  If anything in this
field is certain, it is that victims of spousal sexual assault
are extremely reluctant to report the abuse to the govern-
ment; hence, a great many spousal rape victims will not be
exempt from the notification requirement imposed by
3209.
  The spousal notification requirement is thus likely to
prevent a significant number of women from obtaining an
abortion.  It does not merely make abortions a little more
difficult or expensive to obtain; for many women, it will
impose a substantial obstacle.  We must not blind ourselves
to the fact that the significant number of women who fear
for their safety and the safety of their children are likely to
be deterred from procuring an abortion as surely as if the
Commonwealth had outlawed abortion in all cases.
  Respondents attempt to avoid the conclusion that 3209
is invalid by pointing out that it imposes almost no burden
at all for the vast majority of women seeking abortions.
They begin by noting that only about 20 percent of the
women who obtain abortions are married.  They then note
that of these women about 95 percent notify their husbands
of their own volition.  Thus, respondents argue, the effects
of 3209 are felt by only one percent of the women who
obtain abortions.  Respondents argue that since some of
these women will be able to notify their husbands without
adverse consequences or will qualify for one of the excep-
tions, the statute affects fewer than one percent of women
seeking abortions.  For this reason, it is asserted, the
statute cannot be invalid on its face.  See Brief for Respon-
dents 83-86.  We disagree with respondents' basic method
of analysis.
  The analysis does not end with the one percent of women
upon whom the statute operates; it begins there.  Legisla-
tion is measured for consistency with the Constitution by
its impact on those whose conduct it affects.  For example,
we would not say that a law which requires a newspaper to
print a candidate's reply to an unfavorable editorial is valid
on its face because most newspapers would adopt the policy
even absent the law.  See Miami Herald Publishing Co. v.
Tornillo, 418 U. S. 241 (1974).  The proper focus of constitu-
tional inquiry is the group for whom the law is a restriction,
not the group for whom the law is irrelevant.
  Respondents' argument itself gives implicit recognition to
this principle, at one of its critical points.  Respondents
speak of the one percent of women seeking abortions who
are married and would choose not to notify their husbands
of their plans.  By selecting as the controlling class women
who wish to obtain abortions, rather than all women or all
pregnant women, respondents in effect concede that 3209
must be judged by reference to those for whom it is an
actual rather than irrelevant restriction.  Of course, as we
have said, 3209's real target is narrower even than the
class of women seeking abortions identified by the State: it
is married women seeking abortions who do not wish to
notify their husbands of their intentions and who do not
qualify for one of the statutory exceptions to the notice
requirement.  The unfortunate yet persisting conditions we
document above will mean that in a large fraction of the
cases in which 3209 is relevant, it will operate as a
substantial obstacle to a woman's choice to undergo an
abortion.  It is an undue burden, and therefore invalid.
  This conclusion is in no way inconsistent with our
decisions upholding parental notification or consent require-
ments.  See, e.g., Akron II, 497 U. S., at ---; Bellotti v.
Baird, 443 U. S. 622 (1979) (Bellotti II); Planned Parent-
hood of Central Mo. v. Danforth, 428 U. S., at 74.  Those
enactments, and our judgment that they are constitutional,
are based on the quite reasonable assumption that minors
will benefit from consultation with their parents and that
children will often not realize that their parents have their
best interests at heart.  We cannot adopt a parallel assump-
tion about adult women.
  We recognize that a husband has a -deep and proper
concern and interest . . . in his wife's pregnancy and in the
growth and development of the fetus she is carrying.-
Danforth, supra, at 69.  With regard to the children he has
fathered and raised, the Court has recognized his -cogniza-
ble and substantial- interest in their custody.  Stanley v.
Illinois, 405 U. S. 645, 651-652 (1972); see also Quilloin v.
Walcott, 434 U. S. 246 (1978); Caban v. Mohammed, 441
U. S. 380 (1979); Lehr v. Robertson, 463 U. S. 248 (1983).
If this case concerned a State's ability to require the mother
to notify the father before taking some action with respect
to a living child raised by both, therefore, it would be
reasonable to conclude as a general matter that the father's
interest in the welfare of the child and the mother's interest
are equal.
  Before birth, however, the issue takes on a very different
cast.  It is an inescapable biological fact that state regula-
tion with respect to the child a woman is carrying will have
a far greater impact on the mother's liberty than on the
father's.  The effect of state regulation on a woman's
protected liberty is doubly deserving of scrutiny in such a
case, as the State has touched not only upon the private
sphere of the family but upon the very bodily integrity of
the pregnant woman.  Cf. Cruzan v. Director, Missouri
Dept. of Health, 497 U. S., at 281.  The Court has held that
-when the wife and the husband disagree on this decision,
the view of only one of the two marriage partners can
prevail.  Inasmuch as it is the woman who physically bears
the child and who is the more directly and immediately
affected by the pregnancy, as between the two, the balance
weighs in her favor.-  Danforth, supra, at 71.  This conclu-
sion rests upon the basic nature of marriage and the nature
of our Constitution:  -[T]he marital couple is not an inde-
pendent entity with a mind and heart of its own, but an
association of two individuals each with a separate intel-
lectual and emotional makeup.  If the right of privacy
means anything, it is the right of the individual, married or
single, to be free from unwarranted governmental intrusion
into matters so fundamentally affecting a person as the
decision whether to bear or beget a child.-  Eisenstadt v.
Baird, 405 U. S., at 453 (emphasis in original).  The
Constitution protects individuals, men and women alike,
from unjustified state interference, even when that interfer-
ence is enacted into law for the benefit of their spouses.
  There was a time, not so long ago, when a different
understanding of the family and of the Constitution
prevailed.  In Bradwell v. Illinois, 16 Wall. 130 (1873),
three Members of this Court reaffirmed the common-law
principle that -a woman had no legal existence separate
from her husband, who was regarded as her head and
representative in the social state; and, notwithstanding
some recent modifications of this civil status, many of the
special rules of law flowing from and dependent upon this
cardinal principle still exist in full force in most States.-
Id., at 141 (Bradley J., joined by Swayne and Field, JJ.,
concurring in judgment).  Only one generation has passed
since this Court observed that -woman is still regarded as
the center of home and family life,- with attendant -special
responsibilities- that precluded full and independent legal
status under the Constitution.  Hoyt v. Florida, 368 U. S.
57, 62 (1961).  These views, of course, are no longer
consistent with our understanding of the family, the
individual, or the Constitution.
  In keeping with our rejection of the common-law under-
standing of a woman's role within the family, the Court
held in Danforth that the Constitution does not permit a
State to require a married woman to obtain her husband's
consent before undergoing an abortion.  428 U. S., at 69.
The principles that guided the Court in Danforth should be
our guides today.  For the great many women who are
victims of abuse inflicted by their husbands, or whose
children are the victims of such abuse, a spousal notice
requirement enables the husband to wield an effective veto
over his wife's decision.  Whether the prospect of notifica-
tion itself deters such women from seeking abortions, or
whether the husband, through physical force or psychologi-
cal pressure or economic coercion, prevents his wife from
obtaining an abortion until it is too late, the notice require-
ment will often be tantamount to the veto found unconstitu-
tional in Danforth.  The women most affected by this
law-those who most reasonably fear the consequences of
notifying their husbands that they are pregnant-are in the
gravest danger.
  The husband's interest in the life of the child his wife is
carrying does not permit the State to empower him with
this troubling degree of authority over his wife.  The
contrary view leads to consequences reminiscent of the
common law.  A husband has no enforceable right to
require a wife to advise him before she exercises her
personal choices.  If a husband's interest in the potential
life of the child outweighs a wife's liberty, the State could
require a married woman to notify her husband before she
uses a postfertilization contraceptive.  Perhaps next in line
would be a statute requiring pregnant married women to
notify their husbands before engaging in conduct causing
risks to the fetus.  After all, if the husband's interest in the
fetus' safety is a sufficient predicate for state regulation,
the State could reasonably conclude that pregnant wives
should notify their husbands before drinking alcohol or
smoking.  Perhaps married women should notify their
husbands before using contraceptives or before undergoing
any type of surgery that may have complications affecting
the husband's interest in his wife's reproductive organs.
And if a husband's interest justifies notice in any of these
cases, one might reasonably argue that it justifies exactly
what the Danforth Court held it did not justify-a require-
ment of the husband's consent as well.  A State may not
give to a man the kind of dominion over his wife that
parents exercise over their children.
  Section 3209 embodies a view of marriage consonant with
the common-law status of married women but repugnant to
our present understanding of marriage and of the nature of
the rights secured by the Constitution.  Women do not lose
their constitutionally protected liberty when they marry.
The Constitution protects all individuals, male or female,
married or unmarried, from the abuse of governmental
power, even where that power is employed for the supposed
benefit of a member of the individual's family.  These
considerations confirm our conclusion that 3209 is invalid.
                     D
  We next consider the parental consent provision.  Except
in a medical emergency, an unemancipated young woman
under 18 may not obtain an abortion unless she and one of
her parents (or guardian) provides informed consent as
defined above.  If neither a parent nor a guardian provides
consent, a court may authorize the performance of an
abortion upon a determination that the young woman is
mature and capable of giving informed consent and has in
fact given her informed consent, or that an abortion would
be in her best interests.
  We have been over most of this ground before.  Our cases
establish, and we reaffirm today, that a State may require
a minor seeking an abortion to obtain the consent of a
parent or guardian, provided that there is an adequate
judicial bypass procedure.  See, e.g., Akron II, 497 U. S., at
---; Hodgson, 497 U. S., at ---; Akron I, supra, at 440;
Bellotti II, supra, at 643-644 (plurality opinion).  Under
these precedents, in our view, the one-parent consent
requirement and judicial bypass procedure are constitu-
tional.
  The only argument made by petitioners respecting this
provision and to which our prior decisions do not speak is
the contention that the parental consent requirement is
invalid because it requires informed parental consent.  For
the most part, petitioners' argument is a reprise of their
argument with respect to the informed consent requirement
in general, and we reject it for the reasons given above.
Indeed, some of the provisions regarding informed consent
have particular force with respect to minors: the waiting
period, for example, may provide the parent or parents of a
pregnant young woman the opportunity to consult with her
in private, and to discuss the consequences of her decision
in the context of the values and moral or religious princi-
ples of their family.  See Hodgson, supra, at ---.
                     E
  Under the recordkeeping and reporting requirements of
the statute, every facility which performs abortions is
required to file a report stating its name and address as
well as the name and address of any related entity, such as
a controlling or subsidiary organization.  In the case of
state-funded institutions, the information becomes public.
  For each abortion performed, a report must be filed
identifying: the physician (and the second physician where
required); the facility; the referring physician or agency; the
woman's age; the number of prior pregnancies and prior
abortions she has had; gestational age; the type of abortion
procedure; the date of the abortion; whether there were any
pre-existing medical conditions which would complicate
pregnancy; medical complications with the abortion; where
applicable, the basis for the determination that the abortion
was medically necessary; the weight of the aborted fetus;
and whether the woman was married, and if so, whether
notice was provided or the basis for the failure to give
notice.  Every abortion facility must also file quarterly
reports showing the number of abortions performed broken
down by trimester.  See 18 Pa. Cons. Stat. 3207, 3214
(1990).  In all events, the identity of each woman who has
had an abortion remains confidential.
  In Danforth, 428 U. S., at 80, we held that recordkeeping
and reporting provisions -that are reasonably directed to
the preservation of maternal health and that properly
respect a patient's confidentiality and privacy are permis-
sible.-  We think that under this standard, all the provi-
sions at issue here except that relating to spousal notice are
constitutional.  Although they do not relate to the State's
interest in informing the woman's choice, they do relate to
health.  The collection of information with respect to actual
patients is a vital element of medical research, and so it
cannot be said that the requirements serve no purpose
other than to make abortions more difficult.  Nor do we find
that the requirements impose a substantial obstacle to a
woman's choice.  At most they might increase the cost of
some abortions by a slight amount.  While at some point in-
creased cost could become a substantial obstacle, there is no
such showing on the record before us.
  Subsection (12) of the reporting provision requires the
reporting of, among other things, a married woman's
-reason for failure to provide notice- to her husband.
3214(a)(12).  This provision in effect requires women, as
a condition of obtaining an abortion, to provide the Com-
monwealth with the precise information we have already
recognized that many women have pressing reasons not to
reveal.  Like the spousal notice requirement itself, this
provision places an undue burden on a woman's choice, and
must be invalidated for that reason.

                    VI
  Our Constitution is a covenant running from the first
generation of Americans to us and then to future genera-
tions.  It is a coherent succession.  Each generation must
learn anew that the Constitution's written terms embody
ideas and aspirations that must survive more ages than
one.  We accept our responsibility not to retreat from
interpreting the full meaning of the covenant in light of all
of our precedents.  We invoke it once again to define the
freedom guaranteed by the Constitution's own promise, the
promise of liberty.
              *      *      *
  The judgment in No. 91-902 is affirmed.  The judgment
in No. 91-744 is affirmed in part and reversed in part,
and the case is remanded for proceedings consistent with
this opinion, including consideration of the question of
severability.
                         It is so ordered.
            APPENDIX TO OPINION
Selected Provisions of the 1988 and 1989
Amendments to the Pennsylvania
Abortion Control Act of 1982

      18 PA. CONS. STAT. ANN. (1990).
  ``3203.  Definitions.
       .      .     .      .      .

  -`Medical emergency.'-  That condition which, on the
basis of the physician's good faith clinical judgment, so
complicates the medical condition of a pregnant woman as
to necessitate the immediate abortion of her pregnancy to
avert her death or for which a delay will create serious risk
of substantial and irreversible impairment of major bodily
function.''

  ``3205.  Informed Consent.
  ``(a) General Rule. - No abortion shall be performed or
induced except with the voluntary and informed consent of
the woman upon whom the abortion is to be performed or
induced.  Except in the case of a medical emergency,
consent to an abortion is voluntary and informed if and only
if:
``(1)At least 24 hours prior to the abortion, the physi-
      cian who is to perform the abortion or the referring
      physician has orally informed the woman of:
         ``(i)The nature of the proposed procedure or
            treatment and of those risks and alterna-
            tives to the procedure or treatment that a
            reasonable patient would consider mater-
            ial to the decision of whether or not to
            undergo the abortion.

          ``(ii)The probable gestational age of the
            unborn child at the time the abortion is to
            be performed.
         ``(iii)The medical risks associated with car-
            rying her child to term.
``(2)At least 24 hours prior to the abortion, the physi-
      cian who is to perform the abortion or the referring
      physician, or a qualified physician assistant,
      health care practitioner, technician or social
      worker to whom the responsibility has been dele-
      gated by either physician, has informed the preg-
      nant woman that:
         ``(i)The department publishes printed mater-
            ials which describe the unborn child and
            list agencies which offer alternatives to
            abortion and that she has a right to
            review the printed materials and that a
            copy will be provided to her free of charge
            if she chooses to review it.
          ``(ii)Medical assistance benefits may be avail-
            able for prenatal care, childbirth and
            neonatal care, and that more detailed
            information on the availability of such
            assistance is contained in the printed
            materials published by the department.
         ``(iii)The father of the unborn child is liable to
            assist in the support of her child, even in
            instances where he has offered to pay for
            the abortion.  In the case of rape, this
            information may be omitted.
``(3)A copy of the printed materials has been pro-
      vided to the woman if she chooses to view these
      materials.
``(4)The pregnant woman certifies in writing, prior to
      the abortion, that the information required to be
      provided under paragraphs (1), (2) and (3) has
      been provided.
  ``(b) Emergency. - Where a medical emergency compels
the performance of an abortion, the physician shall inform
the woman, prior to the abortion if possible, of the medical
indications supporting his judgment that an abortion is
necessary to avert her death or to avert substantial and
irreversible impairment of major bodily function.
  ``(c) Penalty. - Any physician who violates the provisions
of this section is guilty of `unprofessional conduct' and his
license for the practice of medicine and surgery shall be
subject to suspension or revocation in accordance with
procedures provided under the act of October 5, 1978 (P.L.
1109, No. 261), known as the Osteopathic Medical Practice
Act, the act of December 20, 1985 (P.L. 457, No. 112),
known as the Medical Practice Act of 1985, or their succes-
sor acts.  Any physician who performs or induces an
abortion without first obtaining the certification required by
subsection (a)(4) or with knowledge or reason to know that
the informed consent of the woman has not been obtained
shall for the first offense be guilty of a summary offense
and for each subsequent offense be guilty of a misdemeanor
of the third degree.  No physician shall be guilty of violating
this section for failure to furnish the information required
by subsection (a) if he or she can demonstrate, by a prepon-
derance of the evidence, that he or she reasonably believed
that furnishing the information would have resulted in a
severely adverse effect on the physical or mental health of
the patient.
  ``(d) Limitation on Civil Liability. - Any physician who
complies with the provisions of this section may not be held
civilly liable to his patient for failure to obtain informed
consent to the abortion within the meaning of that term as
defined by the act of October 15, 1975 (P.L. 390, No. 111),
known as the Health Care Services Malpractice Act.''
  ``3206.  Parental Consent.
  ``(a) General rule. - Except in the case of a medical
emergency or except as provided in this section, if a
pregnant woman is less than 18 years of age and not
emancipated, or if she has been adjudged an incompetent
under 20 Pa. C.S. 5511 (relating to petition and hearing;
examination by court-appointed physician), a physician
shall not perform an abortion upon her unless, in the case
of a woman who is less than 18 years of age, he first
obtains the informed consent both of the pregnant woman
and of one of her parents; or, in the case of a woman who
is incompetent, he first obtains the informed consent of her
guardian.  In deciding whether to grant such consent, a
pregnant woman's parent or guardian shall consider only
their child's or ward's best interests.  In the case of a
pregnancy that is the result of incest, where the father is a
party to the incestuous act, the pregnant woman need only
obtain the consent of her mother.
  ``(b) Unavailability of parent or guardian. - If both
parents have died or are otherwise unavailable to the
physician within a reasonable time and in a reasonable
manner, consent of the pregnant woman's guardian or
guardians shall be sufficient.  If the pregnant woman's
parents are divorced, consent of the parent having custody
shall be sufficient.  If neither any parent nor a legal
guardian is available to the physician within a reasonable
time and in a reasonable manner, consent of any adult
person standing in loco parentis shall be sufficient.
  ``(c) Petition to the court for consent. - If both of the
parents or guardians of the pregnant woman refuse to
consent to the performance of an abortion or if she elects
not to seek the consent of either of her parents or of her
guardian, the court of common pleas of the judicial district
in which the applicant resides or in which the abortion is
sought shall, upon petition or motion, after an appropriate
hearing, authorize a physician to perform the abortion if the
court determines that the pregnant woman is mature and
capable of giving informed consent to the proposed abortion,
and has, in fact, given such consent.
  ``(d) Court order. - If the court determines that the
pregnant woman is not mature and capable of giving
informed consent or if the pregnant woman does not claim
to be mature and capable of giving informed consent, the
court shall determine whether the performance of an
abortion upon her would be in her best interests.  If the
court determines that the performance of an abortion would
be in the best interests of the woman, it shall authorize a
physician to perform the abortion.
  ``(e) Representation in proceedings. - The pregnant
woman may participate in proceedings in the court on her
own behalf and the court may appoint a guardian ad litem
to assist her.  The court shall, however, advise her that she
has a right to court appointed counsel, and shall provide
her with such counsel unless she wishes to appear with
private counsel or has knowingly and intelligently waived
representation by counsel.''

 ``3207.  Abortion Facilities.
       .      .     .      .      .
 ``(b) Reports. - Within 30 days after the effective date of
this chapter, every facility at which abortions are performed
shall file, and update immediately upon any change, a
report with the department, containing the following
information:
``(1)Name and address of the facility.
``(2)Name and address of any parent, subsidiary or
       affiliated organizations, corporations or associa-
       tions.
``(3)Name and address of any parent, subsidiary or
       affiliated organizations, corporations or associa-
       tions having contemporaneous commonality of
       ownership, beneficial interest, directorship or
       officership with any other facility.
The information contained in those reports which are filed
pursuant to this subsection by facilities which receive State-
appropriated funds during the 12-calendar-month period
immediately preceding a request to inspect or copy such
reports shall be deemed public information.  Reports filed
by facilities which do not receive State-appropriated funds
shall only be available to law enforcement officials, the
State Board of Medicine and the State Board of Osteopathic
Medicine for use in the performance of their official duties.
Any facility failing to comply with the provisions of this
subsection shall be assessed by the department a fine of
$500 for each day it is in violation hereof.''

 ``3208.  Printed Information.
 ``(a) General Rule. - The department shall cause to be
published in English, Spanish and Vietnamese, within 60
days after this chapter becomes law, and shall update on an
annual basis, the following easily comprehensible printed
materials:
``(1)Geographically indexed materials designed to
       inform the woman of public and private agencies
       and services available to assist a woman through
       pregnancy, upon childbirth and while the child is
       dependent, including adoption agencies, which
       shall include a comprehensive list of the agencies
       available, a description of the services they offer
       and a description of the manner, including tele-
       phone numbers, in which they might be con-
       tacted, or, at the option of the department,
       printed materials including a toll-free 24-hour a
       day telephone number which may be called to
       obtain, orally, such a list and description of
       agencies in the locality of the caller and of the
       services they offer.  The materials shall provide
       information on the availability of medical assis-
       tance benefits for prenatal care, childbirth and
       neonatal care, and state that it is unlawful for
       any individual to coerce a woman to undergo
       abortion, that any physician who performs an
       abortion upon a woman without obtaining her in-
       formed consent or without according her a private
       medical consultation may be liable to her for
       damages in a civil action at law, that the father of
       a child is liable to assist in the support of that
       child, even in instances where the father has
       offered to pay for an abortion and that the law
       permits adoptive parents to pay costs of prenatal
       care, childbirth and neonatal care.
``(2)Materials designed to inform the woman of the
       probable anatomical and physiological character-
       istics of the unborn child at two-week gestational
       increments from fertilization to full term, in-
       cluding pictures representing the development of
       unborn children at two-week gestational incre-
       ments, and any relevant information on the
       possibility of the unborn child's survival; provided
       that any such pictures or drawings must contain
       the dimensions of the fetus and must be realistic
       and appropriate for the woman's stage of preg-
       nancy.  The materials shall be objective, non-
       judgmental and designed to convey only accurate
       scientific information about the unborn child at
       the various gestational ages.  The material shall
       also contain objective information describing the
       methods of abortion procedures commonly em-
       ployed, the medical risks commonly associated
       with each such procedure, and the medical risks
       commonly associated with carrying a child to
       term.
 ``(b) Format. - The materials shall be printed in a
typeface large enough to be clearly legible.
 ``(c) Free distribution. - The materials required under
this section shall be available at no cost from the depart-
ment upon request and in appropriate number to any
person, facility or hospital.''

 ``3209.  Spousal Notice.
 ``(a) Spousal notice required. - In order to further the
Commonwealth's interest in promoting the integrity of the
marital relationship and to protect a spouse's interests in
having children within marriage and in protecting the
prenatal life of that spouse's child, no physician shall
perform an abortion on a married woman, except as
provided in subsections (b) and (c), unless he or she has
received a signed statement, which need not be notarized,
from the woman upon whom the abortion is to be per-
formed, that she has notified her spouse that she is about
to undergo an abortion.  The statement shall bear a notice
that any false statement made therein is punishable by law.
 ``(b) Exceptions. - The statement certifying that the
notice required by subsection (a) has been given need not be
furnished where the woman provides the physician a signed
statement certifying at least one of the following:
``(1)Her spouse is not the father of the child.
``(2)Her spouse, after diligent effort, could not be
       located.
``(3)The pregnancy is a result of spousal sexual
       assault as described in section 3128 (relating to
       spousal sexual assault), which has been reported
       to a law enforcement agency having the requisite
       jurisdiction.
``(4)The woman has reason to believe that the fur-
       nishing of notice to her spouse is likely to result
       in the infliction of bodily injury upon her by her
       spouse or by another individual.
Such statement need not be notarized, but shall bear a
notice that any false statements made therein are punish-
able by law.
 ``(c) Medical emergency. - The requirements of subsec-
tion (a) shall not apply in case of a medical emergency.
 ``(d) Forms. - The department shall cause to be pub-
lished, forms which may be utilized for purposes of pro-
viding the signed statements required by subsections (a)
and (b).  The department shall distribute an adequate
supply of such forms to all abortion facilities in this
Commonwealth.
 ``(e) Penalty; civil action. - Any physician who violates
the provisions of this section is guilty of `unprofessional
conduct,' and his or her license for the practice of medicine
and surgery shall be subject to suspension or revocation in
accordance with procedures provided under the act of
October 5, 1978 (P.L. 1109, No. 261), known as the Osteo-
pathic Medical Practice Act, the act of December 20, 1985
(P.L. 457, No. 112), known as the Medical Practice Act of
1985, or their successor acts.  In addition, any physician
who knowingly violates the provisions of this section shall
be civilly liable to the spouse who is the father of the
aborted child for any damages caused thereby and for
punitive damages in the amount of $5,000, and the court
shall award a prevailing plaintiff a reasonable attorney fee
as part of costs.''

 ``3214.  Reporting.
 ``(a) General rule. - For the purpose of promotion of
maternal health and life by adding to the sum of medical
and public health knowledge through the compilation of
relevant data, and to promote the Commonwealth's interest
in protection of the unborn child, a report of each abortion
performed shall be made to the department on forms
prescribed by it.  The report forms shall not identify the
individual patient by name and shall include the following
information:
  ``(1)Identification of the physician who performed
        the abortion, the concurring physician as
        required by section 3211(c)(2) (relating to abor-
        tion on unborn child of 24 or more weeks gesta-
        tional age), the second physician as required by
        section 3211(c)(5) and the facility where the
        abortion was performed and of the referring
        physician, agency or service, if any.
  ``(2)The county and state in which the woman
        resides.
  ``(3)The woman's age.
  ``(4)The number of prior pregnancies and prior abor-
        tions of the woman.
  ``(5)The gestational age of the unborn child at the
        time of the abortion.
  ``(6)The type of procedure performed or prescribed
        and the date of the abortion.
  ``(7)Pre-existing medical conditions of the woman
        which would complicate pregnancy, if any, and
        if known, any medical complication which
        resulted from the abortion itself.
  ``(8)The basis for the medical judgment of the physi-
        cian who performed the abortion that the abor-
        tion was necessary to prevent either the death
        of the pregnant woman or the substantial and
        irreversible impairment of a major bodily func-
        tion of the woman, where an abortion has been
        performed pursuant to section 3211(b)(1).
  ``(9)The weight of the aborted child for any abortion
        performed pursuant to section 3211(b)(1).
``(10)Basis for any medical judgment that a medical
        emergency existed which excused the physician
        from compliance with any provision of this
        chapter.
``(11)The information required to be reported under
        section 3210(a) (relating to determination of
        gestational age).
``(12)Whether the abortion was performed upon a
        married woman and, if so, whether notice to her
        spouse was given.  If no notice to her spouse
        was given, the report shall also indicate the
        reason for failure to provide notice.
       .      .     .      .      .

 ``(f) Report by facility. - Every facility in which an
abortion is performed within this Commonwealth during
any quarter year shall file with the department a report
showing the total number of abortions performed within the
hospital or other facility during that quarter year.  This
report shall also show the total abortions performed in each
trimester of pregnancy.  Any report shall be available for
public inspection and copying only if the facility receives
State-appropriated funds within the 12-calendar-month
period immediately preceding the filing of the report.  These
reports shall be submitted on a form prescribed by the
department which will enable a facility to indicate whether
or not it is receiving State-appropriated funds.  If the
facility indicates on the form that it is not receiving
State-appropriated funds, the department shall regard its
report as confidential unless it receives other evidence
which causes it to conclude that the facility receives State-
appropriated funds.''