Abortion in Maryland: History, Legislation, and Access

Abortion in Maryland is legal at all stages of pregnancy.

Historical Practices of Abortion in Maryland

Abortion has been documented since the colonial period in Maryland. Abortion practices included the use of herbal remedies such as opium, savin (see Juniperus Sabina) and other herbs that caused the body to "purge". These practices are mainly recorded in the context of legal proceedings, such as a 1663 case in which a Maryland doctor was accused of administering an abortifacient to a servant he impregnated, though the case was not prosecuted.

Other herbal remedies included snakeroot, (also known as Polygala senega), to induce abortion. A medical student at the University of Pennsylvania by the name of Thomas Massie wrote in his 1803 doctoral dissertation that snakeroot was used as an abortifacient, citing a physician in Harford County, Maryland who reported its use among the rural population there.

Midwives also performed abortions throughout the nineteenth and early twentieth centuries. Progressive-era public health reformers in Baltimore sought to restrict midwifery, and conducted a survey in 1909 in which they claimed that 32% of the city's midwives were "suspected of criminal practice," that is, of providing abortion services. This Progressive coalition was made up of white, middle-class physicians, nurses, and female reformers, such as doctors Mary Sherwood and Lilian Welsh, who characterized midwifery and abortion as vices of the immigrant and African American lower classes. Historian Leslie Reagan points out that physicians were also performing abortions at this time, but sought to direct enforcement towards midwives and lower-class patients.

Legislative History of Abortion in Maryland

The first laws regulating abortion in the state were passed in 1867, banning abortion except by a physician to "secure the safety of the mother." Maryland was listed among states with no criminal abortion law by Dr. Horatio Storer, a leader of the campaign by physicians to enact abortion bans. The first law regulating abortion in Maryland was passed in 1867 and completely banned the procedure, but there was no enabling clause in the bill, leaving it unenforceable. A second law was passed in 1868, banning abortion except by a physician, after consulting "one or more respectable physicians," to "secure the safety of the mother." The vague language of this law exposed physicians and hospitals to legal risk. From the 1930s onward, physicians began seeking greater authority to determine the need for therapeutic abortion without risking legal consequences. This reform movement influenced the American Law Institute (ALI) Model Penal Code of 1962.

In 1968, Maryland enacted a law allowing abortion in hospital settings in cases of rape, severe fetal deformity, or when life and health were endangered. In 1973, the Supreme Court's decision in Roe v. Wade made abortion legal without restrictions until the third trimester of pregnancy, overruling Maryland law. After Roe, clinics opened in the state to provide abortions outside of hospitals, and Planned Parenthood began providing outpatient abortion services. In 1991 the Maryland General Assembly passed a law that codified Roe v. Wade, which was upheld in a public referendum. Dobbs v. Jackson Women's Health Organization overturned the federally-protected right to abortion in 2022; abortion remains legal in Maryland.

Current Abortion Rights and Access in Maryland

In March 2023, the Maryland House of Delegates and the Maryland Senate voted to enshrine a broad right to abortion access into the state constitution. The constitutional amendment received approval by the voters in November 2024. A voter referendum adding abortion rights to the state constitution passed in 2024.

In April 2022, the Maryland General Assembly passed the Abortion Care Access Act. The bill allows a broader range of qualified healthcare workers—nurse practitioners, nurse midwives, and physician assistants—to perform abortions and allocates $3.5 million to a new program within the Maryland Department of Health to train healthcare workers. Additionally, the bill requires the majority of health insurance plans, including private health insurance plans, to cover abortions cost free. The legislation was enacted in 2022 with a gubernatorial veto override.

The following table summarizes key legislative milestones regarding abortion in Maryland:

The 2024 Maryland Question 1 results map by county illustrates the public support for abortion rights across the state.