Reproductive freedoms and reproductive health care have presented legislative issues since the 19th century, when the legal system determined reproductive healthcare to be a legal matter. The “first statutory abortion regulation” came into being in 1821 in Connecticut in an effort to bar abortions after the first movement of the fetus, and control the distribution of contraceptives.  Legislative limitations on reproductive freedoms continued throughout the century. In 1873, the Comstock Act was passed by the United States Congress, making it a “federal crime to sell or distribute contraception through the mail or across state lines.”  In 1965, the United States Supreme Court determined that marital privacy rights are protected by the Constitution, which revoked Connecticut’s contraception ban for married people. This decision also introduced the question of privacy and an individual's right to privacy, which was paramount to future decisions regarding reproductive healthcare and freedoms.

Large advancements regarding reproductive healthcare blossomed in the 1970s when four states (Alaska, Hawaii, New York, and Washington) legalized abortions for all women within their states. Only three years later, abortion became legal nationwide in the landmark case Roe v. Wade, in which the Supreme Court ruled “that a woman’s right to an abortion is protected under the U.S. Constitution’s 14th Amendment.”  This ruling was monumental for reproductive rights, as it found that “a woman has full rights to an abortion in the first trimester…” Roe v. Wade continued to be altered and argued until the 2022 ruling in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade.  The Supreme Court’s ruling left abortion laws up to the states and concluded that the United States Constitution does not protect the right to abortive procedures. 

Reproductive freedom, and consequently the lack of said freedom, is intrinsically connected to a number of other systemic issues, such as women’s rights, the right to privacy, the underrepresentation of marginalized communities, and medically underserved areas. Prior to Roe v. Wade, abortions were still being performed, but the criminalization of the procedures forced them underground. This resulted in many abortions being performed in unsafe environments and often by unqualified individuals. This also resulted in incredibly high death rates among women getting abortions. Botched abortions were determined to be the cause of death for “2,700 women in 1930 — almost one out of every five (18%) of recorded maternal deaths that year.”  These underground abortions were often very expensive, meaning that only individuals with certain means had the option to search out reproductive health care procedures. Abortion became far safer and more accessible with the legalization of abortion in New York, Hawaii, Alaska, and Washington, but the issue of accessibility was very much still present. The legalization of abortion in these states led to the end of many underground abortions, as people had the opportunity to have a safe and legal abortion. Barrier to access still existed, however, as many individuals, often those from marginalized communities, did not have the means to travel to other states for abortion care.