The Academy-Award winning film The Cider House Rules is the story of a young man's physical and emotional journey to self-actualization set against the backdrop of the enduring issues surrounding individual freedoms and rights. In this film, viewers encounter a critically-recognized debate concerning reproductive freedom, as the legality of abortion is specifically called into question. Echoes of the controversy over the Supreme Court’s 1973 decision in Roe v. Wade are inevitable.

The story centers on Homer Wells (Tobey Maguire), a young man who was born and raised at St. Cloud's Orphanage in an extremely rural area of Maine. Dr. Wilbur Larch (Michael Caine), the beloved director of the orphanage, displays an immediate fondness for this child and has nurtured a paternal bond with Homer throughout his life at St. Cloud’s. Believing that Homer should be of use at the orphanage, Dr. Larch instructs him in the field of gynecological medicine, even if Homer doesn't necessarily want to learn. Although his knowledge is substantial and his technique is nearly impeccable, Homer actively resists performing extreme doctoral duties, citing the reason that he is practicing without a license and has had no formal schooling. Among these duties that Homer refuses to perform are safe, albeit illegal, abortions, which Dr. Larch provides on the principle that he would rather offer an illegal abortion to a woman to preserve her health instead of the alternative coat-hanger "doctors" who frequented back alleys in the 1930s and 1940s. Larch's pro-choice perspective is akin to the rationale that underlies the landmark decision to legalize abortion in the case of Roe v. Wade (1973).

Despite all the favorable aspects of Homer's life at St. Cloud's, he yearns to see the world outside of the orphanage and to experience independence. After Wally Worthington (Paul Rudd) brings his pregnant girlfriend Candy Kendall (Charlize Theron) to St. Cloud’s for an abortion, Homer decides to hitch a ride with them back to Wally's family farm and to make a living picking apples with the farm staff, headed by Mr. Rose (Delroy Lindo). The Cider House in which they reside has a list of several rules posted on its wall, and since Homer is the only literate member of the group, he is beseeched by the others to read these rules to them. However, Mr. Rose believes these rules are unnecessary because they did not write them and declares that people need to make their own rules, which impresses the theme of charting one's own destiny upon the audience. This theme ties in well with the principles that justify Roe v. Wade and, in doing so, sparked a thoroughly controversial debate about the filmmaker's thematic intentions throughout the production of the film. Hence, John Irving, the writer of the novel and the screenplay, has been questioned about his inclusion of the controversial subject of abortion throughout a tale of self-actualization, particularly considering that this actualization includes the right to make or break the rules as one sees fit.

While Homer is enjoying his newfound freedom as an orchardman, Wally goes off to war, and Homer begins to develop a close relationship with Candy, eventually falling in love with her. Questions loom about how to handle the love between the two of them, if and when Homer should go back to St. Cloud's, and whether or not to use his medical knowledge when he is confronted with Rose Rose's (Erykah Badu) pregnancy by her father, Mr. Rose. After learning of Dr. Larch’s unexpected death, Homer recognizes that his true home is at St. Cloud's and returns there to fill Dr. Larch’s position, welcomed into the open arms of those who thought they had been left behind. At the conclusion of the film, Homer recognizes that, although he went out into the world and experienced freedom and love and heartbreak and excitement, he ultimately knew where he belonged all along. While the tale is heartwarming, pro-life advocates believe it consciously and shamelessly promotes abortion. On the other hand, pro-choice advocates acclaim the film and celebrate its focus on the freedom to make decisions on one's own behalf. This controversy is precisely what makes the film so relevant to the 1973 Roe v. Wade case.