WASHINGTON (CNN/WJZ) -- The Supreme Court overturned Roe v. Wade on Friday, holding that there is no longer a federal constitutional right to an abortion.
The opinion is the most consequential Supreme Court decision in decades and will transform the landscape of women's reproductive health in America.
Going forward, abortion rights will be determined by states, unless Congress acts. Already, nearly half of the states have or will pass laws that ban abortion while others have enacted strict measures regulating the procedure.
"Roe was egregiously wrong from the start," Justice Samuel Alito wrote in his majority opinion. "Its reasoning was exceptionally weak, and the decision has had damaging consequences. And far from bringing about a national settlement of the abortion issue, Roe and Casey have enflamed debate and deepened division."
During the most recent legislative session, the Maryland General Assembly failed to advance legislation enshrining the right to abortion in the state's constitution, a move supporters backed in anticipation of the Supreme Court's ruling. The House of Delegates passed the measure but it stalled in the Maryland State Senate.
"I know there are lots of other possible ideas out there. I think this is the issue that we will take on for this session," Senate President Bill Ferguson, a Baltimore Democrat, told his colleagues.
The legislature did, however, pass a law during the session that expands abortion access by allowing nurse practitioners, nurse midwives and physician assistants with training to perform the procedure.
Lawmakers went on to successfully override Gov. Larry Hogan's veto of the bill. The policy takes effect July 1.
In 1991, Maryland lawmakers passed legislation protecting the right to an abortion, saying the the state "may not interfere with the decision of a woman to terminate a pregnancy" before the fetus is viable, if the procedure is necessary to protect the life of the mother, or the fetus is suffering from a "genetic defect or serious deformity or abnormality," according to he bill text.
Then-Gov. William Donald Schaefer, a Democrat, quickly signed the bill into law, even though he said he personally opposes abortion, according to a report in The Washington Post.
"It's not a happy occasion," Schaefer said. "I had great difficulty with it [but] I think the bill is right."
The measure was petitioned to referendum and put to the voters during the 1992 presidential election. Marylanders approved Question 6, 62% to 38%.
In a joint dissenting opinion, Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan heavily criticized the majority, closing: "With sorrow -- for this Court, but more, for the many millions of American women who have today lost a fundamental constitutional protection -- we dissent."
The opinion represents the culmination of a decades-long effort on the part of critics of abortion seeking to return more power to the states. It was made possible by a solid six-member conservative majority -- including three of Donald Trump's nominees.
At least 21 states have laws or constitutional amendments already in place that would make them certain to attempt to ban abortion as quickly as possible, according to the Guttmacher Institute, which favors abortion rights. And an additional four states are likely to ban abortions as soon as possible without federal protections.
Chief Justice John Roberts did not join the majority, writing in a concurring opinion that he would not have overturned Roe but instead would have only uphold Mississippi's law banning abortions after 15 weeks.
Similar to leaked draft
The final opinion was strikingly similar to the draft written by Alito that was leaked earlier this year. It repeats his scornful language towards the original Roe v. Wade decision that enshrined abortion rights.
Like the draft opinion, Alito included a list of cases that also rested on a right to privacy, as Alito asserted that Roe was distinct from those cases.
"What sharply distinguishes the abortion right from the rights recognized in the cases on which Roe and Casey rely is something that both those decisions acknowledged: Abortion destroys what those decisions call 'potential life' and what the law at issue in this case regards as the life of an 'unborn human being,'" Alito wrote, in a line that was also present in the draft.
What's new is Alito's response to the dissent, jointly written by the three liberal justices. The dissent would not have been written at the time that the leaked draft was circulated around the court.
"The dissent is very candid that it cannot show that a constitutional right to abortion has any foundation, let alone a 'deeply rooted' one, 'in this Nation's history and tradition.'" Alito wrote. "The dissent does not identify any pre-Roe authority that supports such a right -- no state constitutional provision or statute, no federal or state judicial precedent, not even a scholarly treatise."
In that four-page section, Alito said that the dissent's failure "engage with this long tradition is devastating to its position."
Challenge brought by Mississippi
Championed by supporters of abortion and long reviled by critics, Roe v. Wade was decided in 1973 establishing a constitutional right to abortion before fetal viability which most experts say occurs now at around 23-24 weeks of pregnancy. The decision was reaffirmed in 1992, in Planned Parenthood v. Casey.
A majority of the court in that case replaced Roe's framework with a new standard to determine the validity of laws restricting abortions. The court said that a regulation cannot place an "undue burden" on the right to abortion which is defined as a "substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability."
Before the court was Mississippi's Gestational Age Act, passed in 2018 but blocked by two federal courts, which allows abortion after 15 weeks "only in medical emergencies or for severe fetal abnormality" and has no exception for rape or incest. A district court blocked the law, holding that it is in direct violation of Supreme Court precedent legalizing abortion nationwide prior to viability, which can occur at around 23-24 weeks of pregnancy.
A panel of judges on the 5th US Circuit Court of Appeals agreed with the district court holding that in an "unbroken line dating to Roe v. Wade, the Supreme Court's abortion cases have established (and affirmed and re-affirmed) a woman's right to choose an abortion before viability." The court said states may "regulate abortion procedures prior to viability" so long as they do not ban abortion. "The law at issue is a ban," the court held.
Mississippi appealed the decision to the Supreme Court, and after the justices agreed to hear the case, the state raised the stakes and argued that the justices should not only uphold the law but also invalidate Roe and Casey.
Mississippi Solicitor General Scott Stewart was blunt at oral arguments.
"Roe vs. Wade and Planned Parenthood versus Casey haunt our country," Stewart said. "They have no basis in the Constitution. They have no home in our history or traditions. They've damaged the democratic process. They poison the law. They've choked off compromise. For 50 years they've kept this court at the center of a political battle that it can never resolve and 50 years on, they stand alone. Nowhere else does this court recognize a right to end a human life."
Solicitor General Elizabeth Prelogar argued on behalf of the Biden administration in support of the clinics. She urged the justices to uphold precedent and avoid a ruling that would disproportionally harm women who have come to depend upon the decision.
"For a half century, this Court has correctly recognized that the Constitution protects a woman's fundamental right to decide whether to end a pregnancy before viability," she argued. "That guarantee, that the state cannot force a woman to carry a pregnancy to term and give birth, has engendered substantial individual and societal reliance. The real-world effects of overruling Roe and Casey would be severe and swift."
She added: "The court has never revoked a right that is so fundamental to so many Americans and so central to their ability to participate fully and equally in society.
Julie Rikelman, a lawyer for Jackson Women's Health Organization, the only licensed abortion clinic in Mississippi and Sacheen Carr-Ellis, the clinic's medical director, told the justices that Mississippi's ban on abortion "two months before viability" is "flatly unconstitutional under decades of precedent."
Additional reporting by WJZ.com's Brandon Weigel
for more features.