Whole Woman’s Health v. Hellerstedt

Following is the case brief for Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292 (2016)

Case Summary of Whole Woman’s Health v. Hellerstedt:

  • Texas passed a law in 2013 with the clear intention of restricting abortions in the State.
  • The Texas law placed two requirements on abortion clinics in the state – the “admitting-privileges” requirement and the “surgical-center” requirement.  Both requirements resulted in substantially reducing the number of abortion clinics in the State.
  • In response to a lawsuit by abortion providers, the Fifth Circuit went to great lengths in trying to find some legal justification to uphold the requirements as constitutional.
  • The U.S. Supreme Court, however, reversed all of the Fifth Circuit’s reasoning, holding that Texas’ requirements were an undue burden on abortion access for Texas’ citizens, and therefore they violated the Fourteenth Amendment of the Constitution.

Whole Woman’s Health v. Hellerstedt Case Brief

Statement of the Facts:

Texas’ House Bill 2, enacted in 2013, included two provisions that were obviously designed to limit access to abortions in Texas.  The first provision, the so-called “admitting-privileges requirement,” required that abortion physicians had admitting privileges at a hospital within 30 miles of where the physician was performing an abortion.  The second provision, the so-called “surgical-center requirement,” required that the minimum standards of an abortion clinic must match the minimum standards for ambulatory surgical centers.”

Procedural History:

  • Before the House Bill took effect, abortion providers filed an action in federal District Court, seeking an injunction that the “admitting-privileges requirement” was facially unconstitutional. The District Court granted the injunction.
  • Three days later, the Fifth Circuit vacated the injunction, allowing the House Bill to take effect. Five months later, it issued an opinion essentially holding that the admitting-privileges requirement would not impede access to abortions.
  • One week after the Fifth Circuit’s decision, abortion providers filed another lawsuit, seeking to enjoin enforcement of the admitting-privileges requirement on two particular abortion facilities, and to enjoin enforcement of the surgical-center requirement throughout Texas.
  • After hearing evidence, the District Court granted the injunctions, holding that both requirements would impose an undue burden on access to abortions in Texas.
  • The Fifth Circuit stayed the injunctions.
  • The U.S. Supreme Court vacated the Fifth Circuit’s stay.
  • The Fifth Circuit then reversed the District Court’s decision on the merits, finding both requirements constitutional, but not constitutional as applied to one of the specific abortion clinics in the suit.
  • The U.S. Supreme Court granted certiorari.

Issue and Holding:

Do State law provisions that substantially restrict the number of abortion clinics that can legally operate in the State constitute an undue burden on a woman’s right to obtain an abortion?  Yes.


The decision of the Fifth Circuit Court of Appeals is reversed.

Rule of Law or Legal Principle Applied:

State law provisions that place a substantial obstacle in front of a woman’s right to an abortion and offer no medical benefits sufficient to justify such obstacles violates the Constitution.


The Evidence Makes Clear that the 2 Requirements are Not Medically Necessary

The evidence obtained through the trial before the District Court reveals that imposition of the two requirements in Texas’ House Bill 2 reduced the number of abortion clinics from over 40 to 8.  Such a reduction in abortion-related services meant that each of the remaining abortion clinics would need to serve up to 10,000 patients per year.  It would be impossible for the remaining 8 providers to serve such a demand.  Further, the distance patients would need to travel to obtain abortion services increases exponentially due to the two requirements in House Bill 2.

The evidence also showed that the admitting-privileges requirement is medically unnecessary because abortion is such a safe procedure that virtually no patient had to be moved to a hospital based on complications from an abortion.  Also, the risks are not appreciably lowered for patients who undergo abortions at ambulatory surgical centers as compared to nonsurgical-center facilities, thereby undermining the need for the surgical-center requirement.  In sum, the two requirements created a very high barrier to abortion for poor, rural, or disadvantaged women.

The Fifth Circuit’s Legal Standard and Reasoning Were Fatally Flawed in Every Respect

The majority opinion took the Fifth Circuit’s opinion to task.  First, the Fifth Circuit’s attempt to say that res judicata barred the second lawsuit was incorrect.  Second, the Fifth Circuit used the incorrect legal standard in evaluating abortion-related constitutional matters.  Third, the Fifth Circuit ignored clear factual evidence to adduced at the District Court to reverse the District Court’s decision.

The Texas Law Put an “Undue Burden” on a Texas Citizen’s Right to an Abortion

Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) held that a law is unconstitutional if the purpose or effect of the law is to place a “substantial obstacle” in the path of a woman seeking an abortion before the time of viability.  In this case, the Texas law places a substantial obstacle in the way of a woman’s right to an abortion, and the medical benefits of the law are not sufficient to justify the burdens on access that it imposes.

Concurring and Dissenting Opinions:

Concurring Opinion (Ginsburg):

Complications from an abortion are rare, and rarely dangerous.  Therefore, Texas’ argument that the two requirements are there to protect women’s health are disingenuous.  Many medical procedures, like childbirth, are far more dangerous, yet Texas does not subject them to admitting-privileges or surgical-center requirements.

Dissenting Opinion (Thomas):

The Court is bending the rules to stop any limits on abortion.  There are procedural oddities to this case that were not considered fully by the majority.

Dissenting Opinion (Alito):

The case should have been dispensed with on res judicata grounds, and no delving into abortion-case jurisprudence was necessary here.


Whole Woman’s Health v. Hellerstedt is landmark case because it provides a good example of statutory provisions that do put up obstacles to access to a pre-viability abortion that violate the Constitution.  It has been described as the most important abortion rights case since Planned Parenthood of Southeastern Pa. v. Casey.  It is important to note that Texas barely tried to justify the House Bill’s two requirements on medical necessity grounds.  There is virtually no question that the two requirements in the law were specifically designed to make abortion impossible for many women in Texas.

Student Resources:

Full Text of Majority Opinion

Listen to the Oral Argument