It is hard to say precisely what set the abortion reform movement in motion. State abortion laws had remained essentially unchanged since the nineteenth century, but by 1960 pressure for liberalization was building. As the population of the world increased and natural resources were used up, many people thought that it was imperative to limit population growth. Restrictions on birth control and an absolute ban on all abortions seemed to embody unreasonable governmental policies.

Indeed, many illegal abortions were taking place in spite of the prohibitions in state criminal laws. Physicians were dismayed at the toll in injury and death paid by women who went to illegal, unqualified abortionists. Women did not need to die during abortions; with existing medical technology abortion should be safer than childbirth. The medical profession, which had lobbied for strict laws against abortion in the 1870s and 1880s, was now willing to accept the idea that medically necessary abortions should be performed legally, in hospitals. Lawyers were also concerned, disturbed that so many people were willing to flout and disobey the law.

The women's movement emerged in the early 1960s, and abortion rights became one of the issues around which feminists could rally. Feminists contended that it was a woman's right to exercise control over her own body, and that government had no business interfering in private decisions by women and their families. Abortion seemed a necessary, if regrettable, solution to pregnancies where the fetus was likely to be abnormal, where pregnant teenagers were not ready for maternal responsibilities, or where a pregnancy was due to rape, incest, or some other devastating experience.

Public opinion seemed to be changing in ways that would support revisions of state abortion laws. A few bold reformers introduced bills in state legislatures to allow therapeutic abortions (abortions that were deemed necessary for medical reasons). These early reform laws were largely modeled on the American Law Institute's Model State Abortion Statute, which would allow abortions to be performed in hospitals under strictly regulated conditions. A number of European countries had laws of this sort, while the United States still retained one of the most restrictive systems in the world.

While some states were considering new legislation to change their abortion statutes, another type of reform effort began to take place. Women's organizations began to file lawsuits challenging the constitutionality of the older, strict abortion laws. Lawyers arguing these cases in court claimed that the older statutes denied women liberty and equality. The early 1970s saw a wave of reform activity, both in state legislatures and in state and federal courts.

As reform efforts escalated, those opposed to abortion began to organize and speak out. The Roman Catholic Church had a long history of opposition to abortion, and Catholic bishops encouraged the organization of Right-to-Life Leagues across the country. By 1970 Rightto-Life Committees were meeting in thirty-seven states, ready to lobby in state legislatures against bills legalizing abortion.