Carhart filed suit against the Nebraska Attorney General, Don Stenberg, because a Nebraska law banned a form of abortion, dilation and extraction (D&X), which involves partially delivering a fetus from the uterus and is termed "partial-birth abortion." In Stenberg v. Carhart the United States Supreme Court struck down the Nebraska law with Sandra Day O'Connor providing the swing vote for the five-to-four decision because the law did not allow for the use of the procedure even when the mother's health would be put at greater risk by another abortion procedure.
Carhart later filed suit against U.S. Attorney General Alberto Gonzales seeking to strike down the 2003 Partial-Birth Abortion Ban Act, a federal law that is similar to the state law struck down in Stenberg, but while the Court did not officially reverse Stenberg, it upheld the federal ban as not imposing an undue burden on women, the test established in Planned Parenthood v. Casey. O'Connor's successor, Samuel Alito, sided with the four Justices who dissented in Stenberg, creating a five-to-four majority. In the Gonzales v. Carhart case, his attorney was Priscilla J. Smith.