In the case of Poelker, Mayor of St. Louis, et al. v. Doe in 1976, a pregnant woman challenged the constitutionality of a policy implemented by city-owned hospitals in St. Louis that prohibited performing abortions except when necessary to save the life of the mother. The plaintiff argued that this policy violated her constitutional rights under both equal protection and due process clauses as it denied indigent women access to medical services available to wealthier women who could afford private care or travel expenses for out-of-town procedures. The Supreme Court ruled against Doe, upholding the city's right to choose not to provide elective abortions at its public hospitals even if they provided other types of pregnancy-related care. The court found no violation of either equal protection or due process rights since there was no evidence suggesting an intent on part of city officials' decision-making based on race or income level discrimination nor any infringement upon fundamental personal rights or liberties.

In the dissenting opinion for Poelker v. Doe, Justice Brennan disagreed with the majority's decision to uphold a St. Louis policy that prohibited public hospitals from performing abortions except when necessary to save a woman's life. He argued that this policy violated women’s constitutional right to choose an abortion as established in Roe v. Wade and was therefore unconstitutional under the Fourteenth Amendment’s Equal Protection Clause because it discriminated against poor women who could not afford private healthcare services where they might access safe and legal abortions elsewhere. Furthermore, he contended that by allowing public funds to be used for childbirth but not for medically necessary abortions, the city of St.Louis had taken sides in a debate over whether childbirth or abortion is preferable which infringed upon personal decisions protected by privacy rights recognized in previous Supreme Court rulings.