Starting out as a Harvard undergrad in 1967, Dr. Lolly Delli-Bovi remembers a very different Massachusetts than the one she sees today.
“Abortion was illegal,” said Delli-Bovi, who now runs an abortion clinic in Brookline. “[If you] needed an abortion, you basically had to go before a panel of psychiatrists and convince them that you were suicidal to be allowed to get a legal abortion.”
In the pre-Roe v. Wade United States, that made Massachusetts part of the norm. Abortion was broadly legal in only a handful of states.
But 50 years ago, on Jan. 22, 1973, everything changed. The Supreme Court justices decided, 7–2, that the Constitution guaranteed the right to terminate a pregnancy — which meant abortion could not be entirely banned at the state level, changing most states’ laws overnight.
Last June, a Supreme Court decision upended abortion policy again: Dobbs v. Jackson Women’s Health Organization overturned Roe’s 49-year precedent, returning the question of legal abortion to the states. Today’s Massachusetts is pouring millions of dollars into organizations that provide and aid abortions, and has passed several laws in recent years to loosen restrictions at the state level. And here, abortion-rights advocates and politicians call the commonwealth a “destination state” with a newfound focus on equity for women seeking abortions.
Abortion-rights advocates today remember Massachusetts as a leader in the 1960s and ’70s — but back then, the commonwealth was on the forefront of restricting access to abortion rather than expanding it.
For the 50th anniversary of Roe v. Wade, GBH News traced the history of abortion access and restrictions in Massachusetts, and what the future is poised to bring.
A ‘blueprint’ for abortion restrictions
The early 1970s were a time of seismic change for abortion with fights in the courts and state legislatures deciding the contours of what legal abortion would — and would not — look like.
Massachusetts was the first state to restrict how minors could get abortions, passing a law in 1974 that required teens under 18 to get both parents’ permission.
Despite facing hurdles in the Supreme Court, it was eventually enforced in 1981 — and the law created a blueprint that states follow to this day. Now 36 states have parental consent restrictions on the books, even after Massachusetts has loosened its own.
“Massachusetts was one of the places that inspired the strategy of eliminating access, even if you can’t eliminate Roe,” said Mary Ziegler, a legal historian at UC Davis who has written several books on abortion politics in the United States.
Getting parents’ consent was one piece of the strategy; criminal prosecution was another.
In a case that made national headlines, Dr. Kenneth Edelin, the chief obstetrical resident at Boston City Hospital, was convicted of manslaughter after he performed an abortion on a 17-year-old in October 1973.
“A lot came together for [the prosecutors] in my case: They got a Black physician, they got a woman more than 20 weeks pregnant, and they got a fetus in a mortuary,” Edelin told the Boston Globe in February 1975 soon after his conviction, which was eventually overturned.
Dr. Kenneth C. Edelin, 35, chief resident in obstetrics and gynecology at Boston City Hospital, continues work at the hospital, May 30, 1974, as hearings are held on charges of manslaughter in connection with the death of a fetus in an abortion.
Mary Ziegler, an expert on the law and politics of reproduction at UC Davis School of Law, on how the rest of the country saw Dr. Kenneth Edelin’s trial
While these policies and trials played out in the press, access on the ground in Massachusetts was expanding. Attorneys collaborated with court staff in the early 1980s to create straightforward ways around the parental consent law by going in front of judges. Much like the law itself, it’s a process that was essentially exported to other states.
After medical school, Delli-Bovi went to Boston Hospital for Women, now Brigham and Women's, the first program in the country to provide abortion training to residents. She remembered, when she first went into private practice in the early 1980s, the older doctors she knew supported providing legal abortions. Roughly 800,000 abortions were performed in the United States each year before Roe, mostly illegally.
“[They] were all tremendous proponents of legal and safe abortion because they had dealt so much during their residencies with unsafe and illegal abortions,” Delli-Bovi recalled. “It seemed like the normal thing to do if you were an obstetrician gynecologist — to provide all of the care that you might need to provide for women’s health.”
Change on the horizon
Even as people in Massachusetts were in favor of broader access, the Legislature’s anti-abortion stance persisted for several years.
Lawmakers wanted to amend the state Constitution in 1986, seeking the power to limit abortions as far as was allowed under federal law — which, if Roe were ever overturned, could mean banning it altogether. They put the question to voters on the 1986 ballot.
“I couldn't believe that,” Melissa Kogut said. “It was the first time I, sort of, heard or understood that the right to abortion was threatened.”
Kogut, then in her twenties, ended up spending “all [her] free time” volunteeering for an organization named Mass Choice, now known as Reproductive Equity Now. She got a full-time job with the nonprofit and, eventually, led it for more than a decade, from the mid-’90s up to 2007.
As for the ballot question, Massachusetts voters in 1986 rejected it — 58% to 42%. And the results of that vote turned out to be crucial in the fight to elect more pro-abortion lawmakers on Beacon Hill.
“Not only was it an incredible victory, but we had documentation in every city and town in Massachusetts of where the public stood on abortion,” Kogut said.
"Massachusetts was one of the places that inspired the strategy of eliminating access, even if you can't eliminate Roe."Mary Ziegler, abortion scholar at UC Davis School of Law
Some experts tie the dramatic change in Massachusetts to another major shift: changes in the hearts and minds of Catholics, and the fading power of the Catholic Church after the sex abuse scandal was exposed in the early 2000s.
“It’s a story about political realignment in Massachusetts, but it’s also a story about Catholic America changing,” Ziegler said.
What followed was a slew of small but significant policy changes. Landmark bills closed loopholes in the late 1990s and early 2000s, like ensuring that state employees’ health insurance covered abortion and easing access to contraception.
Experts say the ability to get an abortion, regardless of laws, was easier in Massachusetts than many other places in New England. While states like Vermont, New Hampshire and Maine allowed for second-trimester abortions, outside Massachusetts, few providers offered them.
“[Our access] has usually been very strong over the years, particularly in comparison to surrounding states,” said Liz Janiak, the director of social science research at Planned Parenthood League of Massachusetts. “One of the reasons that we’ve had better access is partly legislation, but also a stronger health care workforce and a stronger network of abortion providers in the state.”
While the tides turned in favor of abortion in Massachusetts, the national tide was pulling the other way, driven by a litany of Supreme Court cases like 1992’s Planned Parenthood v. Casey that set the bounds of what kinds of state-level restrictions were constitutional.
Violence was also a looming threat for providers, particularly in the early ’90s, Half of the nation’s abortion clinics reported being targeted with harassment or violence in 1993. Amid what Ziegler called a “wave” in killings of abortion providers, largely in the South, Massachusetts had its own attack: John Salvi killed two people at two Brookline abortion clinics in 1994.
“I think it's really easy to think that abortion violence happens elsewhere, but indeed it has happened here in our own backyard,” said Rebecca Hart Holder, who’s led Reproductive Equity Now for the last six years. “That's a scar and a legacy that, I think, those of us who work in this movement feel a real responsibility towards when we think about: How do we make sure abortion is safe?”
Under former Govs. Deval Patrick and Charlie Baker, Massachusetts took out-of-date laws off the books and created new, stronger protections for abortion. Patrick signed laws to limit protests at abortion clinics, and Baker signed the “NASTY Women Act” in 2018, which scrubbed long-unenforced bans on abortion and unmarried people accessing contraception.
And at the end of 2020, the State House pushed through the Roe Act, a landmark law that eliminated the decades-old parental consent requirement for 16- and 17-year-olds. After Massachusetts put the first parental consent requirement on the books in 1974, it became the first state to ever roll back such a law.
“What we’ve seen since the passage of the NASTY Women Act while Donald Trump was president is that it has increasingly become clear to elected officials that fighting for reproductive freedom is actually a winning political issue,” Hart Holder said. “Especially in Massachusetts, abortion care is really a winner for politicians.”
Former Gov. Charlie Baker handed a pen to Rebecca Hart-Holder, the executive director of Reproductive Equity Now after signing the so-called NASTY Women Act on July 27, 2018.
Rebecca Hart Holder, executive director of Reproductive Equity Now, on the NASTY Women Act
What comes next
Last June, Roe was struck down with another Supreme Court decision: Dobbs v. Jackson Women’s Health Organization. The United States returned to a state-by-state system, and now, 12 states ban abortion altogether. Experts say that making abortions more difficult to obtain disproportionately affects poor people and women of color — who are also more likely to experience inequitable treatment through pregnancy with worse maternal health outcomes.
“Since Roe was passed ... it has been a slow downhill descent,” Delli-Bovi said. “But Dobbs obviously, I think, just pulled the rug out from under abortion protections.”
But by the time of the Dobbs decision, Massachusetts was at the forefront of providing abortion care.
State officials have made available abortion a political priority. With a wave of restrictions in other states, Massachusetts abortions for out-of-state residents ticked up, slightly, in 2021. Anecdotally, providers say that number rose again in 2022 with the Dobbs decision, though data won’t be publicly available until the fall.
Today, political opinion falls squarely in favor of abortion. A Suffolk University/Boston Globe poll last summer found that nearly four in five Massachusetts residents believe abortion should be legal in “all” or “most” cases, far outstripping national numbers.
Marisa Pizii, the co-chair of the Abortion Rights Fund of Western Massachusetts, says Massachusetts is now putting in the work to find any “missing links” in abortion care. It’s filling in where, she says, the Roe decision had always been limited: it guaranteed rights without guaranteeing access.
“Sometimes it’s like the Dobbs decision that really put [that] gasoline in our fire,” she said.
“I think we’re tremendously lucky here,” said Delli-Bovi, whose abortion clinic received a grant from the Baker administration to create better, more equitable access to abortion care. “We have a Legislature that allotted $2 million — and [nearly] $20 million over the next nine years. That’s incredible. I don’t know that you could find that anywhere else in the country.”
And within the state, improving access is still on advocates’ minds.
Massachusetts has four abortion funds — local organizations that help pay for the costs of someone’s abortion, which can extend beyond the procedure itself to travel, lodging or child care. The funds will use a state grant, together, to conduct what Kimika Ross calls a “community scan.”
Ross, a co-founder of Massachusetts’ newest abortion fund Tides for Reproductive Freedom, says that the project will be rooted in talking to people from across the commonwealth to get data about what barriers still get in the way abortion access, focusing on often-overlooked groups in rural areas, Native communities and immigrant communities.
“No one else has ever done this, right? For the state at this level,” Ross said. “The immigrant community in Massachusetts has increased over recent years and they're different immigrant communities, right? And so how do you welcome those folks into the state of Massachusetts and say, ‘Hey, this is a resource here for you.’”
Hundreds gathered and marched through Boston's Back Bay in support of reproductive rights Friday, May 6, 2022, days after leaked documents indicated that the Supreme Court was poised to overturn Roe v. Wade.
Kimika Ross, a co-founder of Tides for Reproductive Freedom, on what they hope Massachusetts’ reproductive future looks like
Another state grant will allow eight more sites on the Cape to offer medication abortion, which can be used up to around 10 weeks of pregnancy. It will help alleviate what some have called an “abortion desert” in the southeastern part of the state.
But west of Worcester, there is still just one clinic for in-person services. (“The state falls off after Worcester!” quipped Pizii, who lives in Amherst.)
In half a century, Massachusetts transformed from being compelled by the Supreme Court to provide abortion to its citizens to a national leader in abortion access — and one that’s opening its arms to women from other states who want abortions.
Another 50 years, though, may not bring relief to the ongoing fight across the country.
“The reason we're divided about abortion goes well beyond anything the Supreme Court has said or could say,” Ziegler said. “This issue, I think, for a lot of people feels quite literally existential, right? If you support reproductive rights and justice, you're talking about people's health and futures. If you’re opposed to abortion, you see abortion as the taking of a human life, that is and should be criminal. It’s very hard to imagine that divide being healed.”