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At the invitation of Samuel Goldenberg, a dozen persons -- including physicians, Catholic and Protestant clergymen, an attorney, a social worker, and a housewife -- met in early 1967 to discuss the problem of illegal abortions in Washington State. Goldenberg, a Seattle-area clinical psychologist, was troubled by the situation of two patients facing unwanted pregnancies who were denied legal abortions. Washington law allowed "therapeutic" abortions only after a committee of physicians determined that one was necessary to save the life of the mother. Goldenberg's group, which expanded beyond its initial dozen members and adopted the name Citizens' Abortion Discussion Group, explored the possibilities for reforming Washington's abortion law. It continued its study of the issue for two years and drafted a proposed amendment to the state's abortion statute. The group's bill was introduced by Democratic representative William Chatalas and Republican senator Joel Pritchard during the 1969 legislative session. Despite the endorsement of the Washington State Medical Association and the recommendation of the Attorney General's Citizens' Committee on Crime that abortion laws be liberalized, the legislation died in both houses.

Following its legislative defeat, the group incorporated as Washington Citizens for Abortion Reform (WCAR) with Goldenberg as its president and explored a possible court challenge to the abortion statute. During a special legislative session in 1970, Pritchard introduced another WCAR-supported bill. An amended version, which permitted abortions performed by a licensed physician within the first four months of pregnancy with the consent of the woman's husband, if married and living together, or legal guardian, if under the age of 18, was approved and sent to the voters as Referendum 20. WCAR established branches across the state and campaigned vigorously for its passage. The measure was approved by voters in November 1970, making Washington the first state in which abortion was legalized by popular vote.