Ask someone to list the most fundamental Supreme Court cases impacting women’s health, and Griswold v. Connecticut, decided fifty years ago, on June 7, 1965,is unlikely to rise to the top; few Americans outside of health and legal spheres have ever heard of it. Yet the Supreme Court’s Griswold decision not only paved the way for Roe v. Wade, but in its own right profoundly impacted legal protections for women’s healthcare.

Griswold established the right to privacy in the marital bedroom, and from that flowed a recognition of the right of a woman to make reproductive decisions without interference from the state. Seven justices based their majority opinion in Griswold on the Bill of Right’s privacy protections, which, they found, include the ability to make reproductive decisions within the confines of marriage. Essentially, after Griswold, the state cannot make contraception for married persons illegal. The same Court eventually extended those rights to unmarried persons in Eisenstadt v. Baird in 1972, and, a year later, protected the ability of a woman to end a pregnancy in the considerably more recognized Roe v. Wade.

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Birth control was one of the significant achievements of the 20st century, furthering women’s physical health and economic stability and mobility as few health interventions have. Examining the list of positives for both mother and infant alike, it is not hard to understand why.

Contraception is the bedrock of women’s health and wellbeing. It is an accepted part of the standard of care that a medical provider delivers—backed by science and informed by patient need. For more than five decades, family planning has allowed women to plan their futures and protect their livelihoods. Family planning allows a woman to time her pregnancy to allow her body to support a healthy baby and thereby reduce the likelihood of low birth weight and neonatal death. Family planning is a necessary part of reducing the burden of unintended pregnancy, particularly for low-income women and women of color, for whom unintended pregnancy is disproportionately associated with poor health outcomes and maternal morbidity and mortality.

The benefits of contraception are more than just family planning. Contraception is recognized as an essential part of managing a number of chronic diseases when an unplanned pregnancy can endanger a woman’s life. Heart disease is the number one killer, and, if left untreated before pregnancy, can bring serious health consequences. Standard medical care also advises that women with diabetes wait to become pregnant until their conditions are under control. A pregnant woman with lupus—known as the “women’s disease”—is twenty times more likely to die than a pregnant woman without lupus. Contraception can mean the difference between life and death.

Griswold took a major leap for women’s health by removing state interference with one of the most important and private decisions an individual considers: whether and when to have a child. Since that time, policy makers and insurers have come on board to expand coverage and tackle the other barrier to access: cost. The Affordable Care Act now requires that most plans cover contraceptives without cost-sharing, and Medicaid provides millions of women of reproductive age with the same. It is impossible to imagine these advances ever taking shape were it not for Griswold decades ago.

Despite fifty years of evidence about the critical role that birth control plays in women’s health, we are again battling for access to contraception. Last year, the Supreme Court in Hobby Lobby erected a tremendous barrier for millions of women and students to accessing birth control coverage – a for profit employer may assert a religious objection and deny its employees health insurance coverage for contraception. In addition, insurers are violating the ACA’s critical protections with practices such as charging unlawful co-payments, or refusing to cover a person’s birth control method of choice.

On June 7, 1965, the Supreme Court protected a right to privacy, lifting up the right to make one of the most important decisions in private: reproduction. In the controversial sphere that is women’s health in America, it is easy to forget this victory. There is much work still to be done, but Griswold reminds us just how far we have come.  

Taylor is the executive director of the National Health Law Program (NHeLP). NHeLP is a nationally recognized legal non-profit dedicated to protecting and advancing the health rights of low-income and underserved individuals.