Paul calls himself "strongly pro-life"[198] and "an unshakable foe of abortion."[199] However, he believes regulation of medical decisions about maternal or fetal health is "best handled at the state level."[200][201][202] He believes that, for the most part, states should retain jurisdiction, in accordance with the U.S. Constitution.
Paul refers to his background as an obstetrician as being influential on his view, recalling inadvertently witnessing a late-term abortion performed by one of his instructors during his residency, “It was pretty dramatic for me to see a two-and-a-half-pound baby taken out crying and breathing and put in a bucket.”[203] During a May 15, 2007, appearance on the Fox News talk show Hannity and Colmes, Paul argued that his pro-life position was consistent with his libertarian values, asking, "If you can't protect life then how can you protect liberty?" Furthermore, Paul argued in this appearance that since he believes libertarians support non-aggression, libertarians should oppose abortion because abortion is "an act of aggression" against a fetus, which is alive, human, and he believes possesses legal rights.[204]
Paul has said that the ninth and tenth amendments to the U.S. Constitution do not grant the federal government any authority to legalize or ban abortion, stating that "the federal government has no authority whatsoever to involve itself in the abortion issue."[205]
Paul introduced the Sanctity of Life Act of 2005, a bill that would have defined human life to begin at conception, and removed challenges to prohibitions on abortion from federal court jurisdiction.[206] In 2005, Paul introduced the We the People Act, which would have removed "any claim based upon the right of privacy, including any such claim related to any issue of ... reproduction" from the jurisdiction of federal courts. If made law, either of these acts would allow states to prohibit abortion.[141] In 2005, Paul voted against restricting interstate transport of minors to get abortions.[207]
In order to "offset the effects of Roe v. Wade," Paul voted in favor of the federal Partial-Birth Abortion Ban Act of 2003. He has described partial birth abortion as a "barbaric procedure." He also introduced H.R. 4379 that would prohibit the Supreme Court from ruling on issues relating to abortion, birth control, the definition of marriage and homosexuality and would cause the court's precedents in these areas to no longer be binding.[208] He once said, “The best solution, of course, is not now available to us. That would be a Supreme Court that recognizes that for all criminal laws, the several states retain jurisdiction.”[209]
