June 29, 1992
Plurality Decision
Joint Opinion: O’Connor, Kennedy, and Souter
Dissenting in Part: Stevens, Blackmun, Rehnquist, White, Scalia, and Thomas

In Planned Parenthood v. Casey, the court rejected a request to overturn Roe, stating that "the essential holding of Roe v. Wade should be retained and once again reaffirmed." In so holding, the court placed great emphasis on the importance of precedent, noting, "[a]n entire generation has come of age . . . free to assume Roe’s concept of liberty," and that "[t]he ability of women to participate equally in the economic and social life . . . has been facilitated by their ability to control their reproductive lives."

The Court, however, did not leave Roe unchanged. Finding that the trimester framework adopted in Roe undervalued the State’s interest in potential life by limiting its expression prior to viability, the plurality replaced Roe’s strict scrutiny standard of review with the less protective "undue burden" standard. The joint opinion stated that "[a]n undue burden exists, and therefore a provision of law is invalid, if its purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability." Applying this test, the Court struck down Pennsylvania's spousal notification provision, but upheld a requirement that doctors furnish state-mandated information 24 hours prior to an abortion.

The Casey undue burden standard also made it more difficult to prevail on a facial challenge to an abortion statute by shifting the burden of proof from the State to the individuals challenging the statute. Moreover, the undue burden standard articulated in Casey, established a new test for determining the constitutionality of abortion regulations: a facial challenge to an abortion regulation will succeed if the plaintiff shows that the regulation will operate as a "substantial obstacle" in a "large fraction of cases."

Applying the undue burden standard, the court upheld previously unconstitutional regulations on abortion such as mandatory waiting periods. Although permitting restrictions that necessarily delayed women from obtaining abortions, the plurality affirmed the principle that such restrictions must provide an exception that would allow a woman to obtain an immediate abortion if delay would pose a significant threat to the woman’s health.

Four of the dissenting justices, Chief Justice Rehnquist and Justices Scalia, White, and Thomas voted to overturn Roe and send the abortion issue back to the states. Rehnquist boldly stated, "[w]e believe that Roe was wrongly decided . . .and that it can and should be overruled." Justice Scalia’s concurring and dissenting opinion, in which Chief Justice Rehnquist and Justices White and Thomas joined, criticized the plurality for creating an ambiguous constitutional test which, in practice, would be unworkable and subject to manipulation. Justice Blackmun would have retained the strictest judicial scrutiny for restrictions placed on women’s reproductive rights.