Maryland's Abortion Laws: Understanding The Current Landscape

Abortion laws vary across the United States, with some states banning it under most circumstances and others permitting it at all stages of pregnancy. Maryland is one of the states that has highly ranked reproductive rights protections, and abortion is legal there at all stages of pregnancy. The state's abortion laws include express statutory protections for abortion, and there are few restrictions on abortion access.

Abortion is legal in Maryland at all stages of pregnancy

In 1973, the U.S. Supreme Court's Roe v. Wade decision legalized abortion without restrictions until the third trimester of pregnancy, superseding Maryland's existing laws. In response, clinics opened across the state to provide abortions, and Planned Parenthood began offering outpatient abortion services. Maryland further solidified abortion rights in 1991 when the Maryland General Assembly passed a law codifying Roe v. Wade, guaranteeing the right to abortion. This law was upheld by voters in a 1992 referendum, with 62% voting in favor.

Despite the Supreme Court's 2022 decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade and returned the power to regulate abortion to the states, abortion remains legal in Maryland. In 2022, the Maryland General Assembly passed the Abortion Care Access Act, which expanded the types of healthcare providers who can legally perform abortions and allocated funding for increased training. Additionally, Maryland has enacted interstate shield laws that protect providers, patients, and those who help others access abortion services from professional licensure consequences and out-of-state investigations and legal actions.

Maryland is set to vote on a referendum in November 2024 to amend the state constitution and enshrine abortion rights. This amendment would establish a fundamental right to reproductive freedom, including the ability to make and effectuate decisions about one's own pregnancy.

Parental notification laws

Maryland's Parental Notification for Abortion Law (Article 20-103 of the Maryland Annotated Code) requires that one parent or guardian be notified before a minor has an abortion. The parent or guardian does not need to consent to the minor's choice, but they must be aware of the minor's intention to have an abortion.

The law outlines specific circumstances in which notification is not required. These include situations where, in the judgement of the doctor performing the abortion:

• The minor is mature and capable of giving informed consent to the procedure.
• Notification would not be in the minor's best interest.
• Notice may lead to physical or emotional abuse of the minor.
• The minor does not live with their parent or guardian.
• Reasonable efforts to give notice have been unsuccessful.

The majority of adolescents (81%) involve a parent or other adult in the abortion decision. However, the remaining minors who do not often have difficult circumstances, do not live with their parents, or have legitimate concerns about abuse or being thrown out of their homes. Maryland law provides these exclusions to protect these minors.

In 1977, a parental notification law in Maryland was ruled unconstitutional.

Abortion Care Access Act

In 2022, the state of Maryland passed the Abortion Care Access Act, which expanded the types of healthcare providers who can legally perform abortions. The Act also included funding increases for training related to abortion and changes to insurance law that expanded coverage of abortion in Medicaid and private insurance plans.

The Abortion Care Access Act was passed in anticipation of the fall of Roe v. Wade, which federally protected the right to abortion. The Act expanded the pool of abortion providers to include any person licensed, certified, or otherwise authorized by the state to practice in Maryland, as long as abortion falls within the scope of their license or certification. This includes physicians, physician assistants, nurse practitioners, and licensed certified midwives.

The Act also addressed funding for training related to abortion. In February 2024, the Moore administration announced over $15 million in grant awards and a budget proposal to further improve reproductive health care and abortion access in Maryland. This included $10.6 million in grant funding awarded to the University of Maryland, Baltimore (UMB) to administer the state's Abortion Care Clinical Training Program, with a focus on training clinicians in rural and underserved areas.

Additionally, the Act brought about changes to insurance law, requiring the majority of health insurance plans, including private health insurance plans, to cover abortion costs. Maryland is one of the few states that cover abortion for patients receiving Medicaid.

Roe v. Wade

In January 1973, the Supreme Court issued a 7-2 decision in McCorvey's favour, holding that the Due Process Clause of the Fourteenth Amendment to the United States Constitution provides a fundamental "right to privacy", which protects a pregnant woman's right to an abortion. It also held that the right to abortion is not absolute and must be balanced against the government's interests in protecting women's health and prenatal life. The Court resolved these competing interests by announcing a pregnancy trimester timetable to govern all abortion regulations in the United States.

The Supreme Court's decision in Roe was among the most controversial in U.S. history. In addition to the dissent, Roe was criticized by some in the legal community, including some who thought that Roe reached the correct result but went about it the wrong way, and some called the decision a form of judicial activism. Others argued that Roe did not go far enough, as it was placed within the framework of civil rights rather than the broader human rights.

In June 2022, the Supreme Court overruled Roe and Casey in Dobbs v. Jackson Women's Health Organization on the grounds that the substantive right to abortion was not "deeply rooted in this Nation's history or tradition", nor considered a right when the Due Process Clause was ratified in 1868. The Court's decision in Dobbs did not have any immediate impact on Maryland abortion laws. However, in November 2024, Maryland voters will decide whether to pass a constitutional amendment establishing reproductive rights in the state constitution.

Medication abortion

The medication abortion process has several steps and usually includes two different medicines: mifepristone and misoprostol. Mifepristone is the first pill taken, which stops the pregnancy from growing by blocking the hormone progesterone, which is naturally produced by the mother’s body to enable her to sustain and nourish the pregnancy. When mifepristone blocks progesterone, the lining of the mother’s uterus breaks down, cutting off blood and nourishment to the baby, who then dies inside the mother’s womb. Twenty-four to forty-eight hours later, the woman ingests misoprostol, which causes contractions and bleeding to expel the baby from the womb.

The abortion pill causes cramping and bleeding that can last several hours or more. It is recommended that you take it easy for the day and plan ahead to make the process more comfortable. You can be at home, or wherever you feel comfortable. You may also want to have someone you trust nearby that you can call if you need anything.

You will have a lot of bleeding and cramping after you take misoprostol, so it is important to stock up on maxi pads, and to take pain medicine like ibuprofen about 30 minutes before you take the misoprostol to help with cramps. Do not take aspirin, as it can make you bleed more.

It is normal to have some bleeding and spotting for several weeks after your abortion. You can use pads, tampons, or a menstrual cup, but your nurse or doctor may recommend you use pads while the abortion is happening so you can track how much you're bleeding.

In the unlikely case that the abortion doesn't work and you're still pregnant, your doctor or nurse will discuss your options with you. You may need another dose of medicine or to have an in-clinic procedure to complete the abortion.

Frequently asked questions