The Dobbs Decision and Its Impact on North Carolina: A Pro-Life Perspective Three Years Later

Restoring the Right to Life in the Tar Heel State  

The Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade and returned authority over abortion laws to the states. For pro-life advocates, this historic ruling opened the door for laws that reflect the belief in the dignity of unborn life. In North Carolina, this sparked a wave of legal and cultural engagement aimed at both protection and support.

What Dobbs Changed: Dobbs upheld Mississippi’s 15-week abortion ban and found that the Constitution does not confer a right to abortion. Justice Samuel Alito’s majority opinion emphasized that abortion regulation is a matter best left to “the people and their elected representatives.” This reversed nearly five decades of precedence and marked a new era for state-led policymaking.

North Carolina Before Dobbs: Prior to the ruling, North Carolina allowed abortion up to 20 weeks of pregnancy, with exceptions for medical emergencies. Regulations like a 72-hour waiting period, parental consent for minors, and required counseling were in place, but federal precedent limited the state’s ability to go further.

According to the CDC, approximately 98% of abortions occurred before 20 weeks.

After Dobbs: A Shifting Legal Landscape: Without a trigger law in place, North Carolina’s abortion laws remained unchanged immediately after Dobbs. That changed in May 2023, when the General Assembly passed Senate Bill 20—the Care for Women, Children, and Families Act—protecting most preborn babies after 12 weeks. The law allows exceptions up to 20 weeks for rape or incest, up to 24 weeks for “life-limiting” fetal anomalies, and at any stage for medical emergencies. Unfortunately, this still allows 90% of all abortions to occur.

Governor Roy Cooper vetoed the bill, but the Republican-led legislature overrode the veto with votes of 30–20 in the Senate and 72–48 in the House. This successful override highlighted the legislature’s strengthened authority to enact pro-life policy in the post-Dobbs climate and reshaped the state's legal framework.

Pro-Life Priorities in the Wake of Dobbs: With new legal footing, pro-life lawmakers and advocates advanced policy initiatives such as:

• Expanding informed consent laws to ensure women receive clear information about fetal development and abortion alternatives

• Increasing funding for pregnancy centers and maternity homes to offer housing, prenatal care, parenting classes, and job assistance

• Reforming adoption and foster care systems to promote loving alternatives to abortion

• Considering stricter limits on late-term abortions with narrowly defined exceptions

The Moral Framework: The movement is rooted in the belief that each human life—beginning at conception—possesses inherent value. Supporters emphasize that the unborn are genetically distinct human beings and argue that laws should affirm this scientific and moral reality.

Beyond legal change, pro-life advocates aim to provide real compassion. They highlight the emotional and psychological toll abortion can leave and strive to walk with women through crisis pregnancies with empathy and tangible resources.

Public Sentiment and Expanding Outreach: A recent poll by North Carolina Right to Life found widespread support for initiatives that may both protect 95% of preborn babies and expand services for women. This underscores the state’s desire to protect life while caring for women in difficult situations. New North Carolina Poll Points the Way to Successful Pro-Life Strategies

Pro-life outreach has intensified since Dobbs. Over 78 pregnancy help centers, with 93 locations across the state, continue to provide free services—including ultrasounds, counseling, infant supplies, and recovery support—funded largely through private donations and volunteer work. These efforts reflect a community-based approach to building a “culture of life.”

Looking Ahead: The Dobbs decision has transformed the moral and legal landscape in North Carolina. With greater legislative authority comes the responsibility to protect the vulnerable and uplift mothers. As debates continue in the General Assembly, the pro-life movement seeks to extend its vision beyond policy—to a society that embraces every life with dignity and compassion.

How this story unfolds will depend on the choices made by North Carolinians, who now face a pivotal opportunity: to be a voice for the voiceless and to ensure that no woman or child is left behind.

Bill Pincus, MD

President, NCRTL