Yesterday was the 33rd anniversary of Roe v. Wade, the Supreme Court case that legalized abortion nationwide and finally gave women back the basic right to control their own bodies and shape their own destinies. Check out all the good Blogging for Choice that went on yesterday, and I apologize for the day-lateness of this post. And I’ll warn you: It’s a doozy.
Today, it’s important to evaluate the current status of choice, to see how far we’ve come, where we’ve regressed, and where we should go. A year and a half ago, we saw more than a million people come together in the name of choice and march for women’s lives in Washington, D.C. We saw the Supreme Court vacancies re-open a national dialogue on the the role of the judiciary with regard to the right to choose. We’ve seen attacks on Emergency Contraception mobilize a new generation of pro-choice activists, as the so-called “pro-life” movement tries to block a drug that could prevent millions of abortions, and as women were denied access to their prescriptions at pharmacies. It’s been a mixed bag.
The biggest problem that the pro-choice side often points to is lack of access. And it’s a major problem, as detailed here in the Seattle PI. Eighty-seven percent of U.S. counties and 98 percent of rural counties lack an abortion provider. Almost a quarter of women have to travel 50 miles or more to obtain an abortion. This, despite the fact that abortion is one of the most common (and one of the safest) surgical procedures in the United States, with more than 1 million women terminating pregnancies every year.
The shortage of abortion providers is startling. More than 50 percent of U.S. providers are over the age of 50. The number of Ob/Gyns performing abortions has been steadily declining over the past 20 years. Currently, a mere 2 percent of Ob/Gyns perform more than 50 percent of U.S. abortions.
Perhaps more disturbing is the lack of abortion training for medical students and residents. Two-thirds of all U.S. medical students spend less than 30 minutes of class time on all aspects of abortion. Ironically, infertility and Viagra receive more required class time, on average, than contraception or abortion. Clinical training also suffers exclusion. Fewer than 27 percent of U.S. Ob/Gyn residency programs require first-trimester abortion training. Further, 74 percent of all family practice chief residents receive no training in first-trimester abortion.
To quote the last line of Amelia Welsh Jones’ op/ed, “What good is the legal right to abortion if there is no one to provide it?”
She’s right. And access needs to be a major tenet of the pro-choice movement, along with fighting state restrictions and expecting Supreme Court justices to uphold the law of the land. But the pro-choice movement cannot be simply reactionary. I don’t believe that, at heart, we are, but abortion is so thoroughly and consistently under attack that our resources are disproportionally allocated to defending it, sometimes at the expense of our other core values.
Enter William Saletan, who launches a nice attack on the pro-choice movement, couched in quasi-support of our political aims. It’s worth a read, even if Saletan apparently has no idea of what organizations like Planned Parenthood and NARAL actually do.
Every year, on the anniversary of Roe v. Wade, pro-lifers add up the fetuses killed since Roe and pray for the outlawing of abortion. And every year, pro-choicers fret that we’re one Supreme Court justice away from losing “the right to choose.” One side is so afraid of freedom it won’t trust women to do the right thing. The other side is so afraid of morality it won’t name the procedure we’re talking about.
…abortion? I don’t know where Saletan is doing his research, but the word we apparently won’t say is front-and-center on Planned Parenthood’s website today.
The lesson of those decades is that you can’t eliminate the moral question by ignoring it. To eliminate it, you have to agree on it: Abortion is bad, and the ideal number of abortions is zero. But by conceding that, you don’t end the debate, you narrow it. Once you agree that the goal is fewer abortions, the only thing left to debate is how to get there. As a politician might put it: “My opponent and I are both pro-life. We want to avoid as many abortions as we can. The difference is, I trust women to work with me toward that objective, and he doesn’t.”
Isn’t that better than anything you heard from John Kerry?
Sure, I agree. Most pro-choicers do too. That’s why Planned Parenthood and other pro-choice organizations focus on things like comprehensive sex education and contraception access.
The pro-choice path to those results is simple. Help every woman when she doesn’t want an abortion: before she’s pregnant. That means abstinence for those who can practice it, and contraception for everybody else. Nearly half of the unintended pregnancies in this country result in abortions, and at least half of our unintended pregnancies are attributable to women who didn’t use contraception. The pregnancy rate among these women astronomically exceeds the pregnancy rate among women who use contraception. The No. 1 threat to the unborn isn’t the unchurched. It’s the unprotected.
How novel. Really, Planned Parenthood, NARAL and NOW have never, ever thought of this. This in no way resembles exactly what we’ve been fighting for for decades.
Solutions are already on the table. Give more money to Title X, the federal program that finances family-planning. Expand health insurance and access to morning-after pills. Educate teenagers about sex, birth control and abstinence. Many of these ideas are in the Prevention First Act, which Democrats ritually file and Republicans ritually ignore. Some pro-choice activists would go further, by pushing for more contraceptive diligence in the abortion counseling process, especially on the part of those women who come back for a second abortion. What’s missing is a clear anti-abortion message to unite these proposals.
He’s right that these solutions are already on the table. Who does he think put them there?
A year ago, Senator Hillary Clinton marked Roe’s anniversary by reminding family planning advocates that abortion “represents a sad, even tragic choice to many, many women.” Some people in the audience are reported to have gasped or shaken their heads during her speech. Perhaps they thought she had said too much.
The truth is, she didn’t say enough. What we need is an explicit pro-choice war on the abortion rate, coupled with a political message that anyone who stands in the way, yammering about chastity or a “culture of life,” is not just anti-choice, but pro-abortion. If the pro-choice movement won’t lead the way, politicians just might.
The pro-choice movement has been saying this for decades — minus the judgmentalism of “abortion is always bad.” Now, in my ideal world abortion wouldn’t exist. Every pregnancy would be a wanted pregnancy. Every woman and family would have access to the resources that make child-rearing possible: Insurance, a reasonable income, good medical care, childcare, education, etc. There would be no fetal abnormalities. Every pregnancy would be healthy.
But that isn’t reality. The reality is that, even if every single person uses contraception to prevent unintended pregnancies, there will still be a need for abortion. There will be extreme fetal abnormalities. There will still be life-threatening pregnancies. There will still be pregnancies resulting from rape and incest. There will still be contraceptive failures. There will still be mid-pregnancy personal tragedies that turn a wanted pregnancy into an impossible one. This is life. Abortion, like sex and pregnancy and childbirth and miscarriage, will always be a part of it.
The question is, how can we best give all people the widest range of options possible? That’s what the pro-choice movement is truly about. And Saletan is right when he says that the vast majority of women — I would even go as far as to say all women — would prefer not to have an abortion if they could avoid it. We’d rather not get pregnant unintentionally in the first place. We’d rather not have health- and life-threatening pregnancies. We’d rather not have severely deformed fetuses, or fetuses who die in utero. We’d rather not be two months pregnant and then lose our job, or have our spouse die, or experience all the other situational things that sometimes turn a wanted pregnancy into an unwanted one. But in recognizing that these things happen, we must defend the right to abortion. Further, we must assert the right to abortion as a basic human rights issue — that anyone who says that it isn’t inherently up to the woman to decide which eggs she grows to term isn’t challenging the right to abortion, they’re challenging the very notion of women’s self-sovereignty and individual autonomy. Our internal organs are not political chesspieces. They are ours, and anyone who suggests otherwise does not believe that women are complete individuals who are, by their simple existence as human beings, worthy of shaping their own lives and making decisions about what does and does not happen to their physical selves.
The future of the pro-choice movement encompasses this. If abortion wasn’t an issue — if we all simply agreed that, person issues with abortion aside, women should have the right to choose it without state interference — our movement could be a whole lot more effective, because we would be able to allocate more resources to promoting access to all choices. As it stands, women are not able to choose freely. As detailed above, the right to abortion is already very limited. The ability to prevent pregnancy in the first place is limited, as comprehensive sexual health education is absent from too many schools and contraception is not affordable or accessible for too many women. Too many women are relegated to low-paying pink-collar employment, where they don’t have medical insurance and are limited in their economic ability to provide for a child (or for multiple children). Too many women rely on a welfare system that requires them to work 40+ hours a week and then doesn’t provide childcare and penalizes them with each additional child. Too many women are at the will of a political party that doesn’t think Medicare should cover contraception or abortion because it values “life,” but then demonizes welfare recipients and holds up the too-many-baby-having Black “welfare queen” as a racist symbol of why welfare should end. Too many young women have their sexualities defined for them by a popular culture that views girls’ and women’s bodies as commodities, where you’re simultaneously rewarded and punished for just about any sexual choice you make — act out “sexiness” as defined by MTV and Girls Gone Wile, and you get attention for being attractive, but you’re also a slut; wear your True Love Waits ring and you’re a good girl but your virginity is being passed along like a piece of property; search for a relatable example of genuine eroticism and sexuality and you’ll be looking for a while. Culturally, young women cannot win — and this impossible situation is compounded by adults who, on one hand, are the people peddling the notion that 16-year-olds are the height of male-defined sexiness, and on the other hand are refusing to give young people basic information about how their bodies work, what sex means, and how they can assert themselves and make their own decisions.
Because of all these things, we are not yet able to choose freely. The pro-choice movement has touched on all of these issues, but because of unyielding anti-choice forces, the focus has been on abortion — to the detriment of everyone.
What would a movement look like if it truly valued life, including fetal life and the lives of born people? Would it actively block women from accessing things that prevented unintended pregnancies, and therefore abortions, in the first place? Would it tell women world-wide, many of whom have no rights to say no to sex and many of whom are at much greater risk of abuse and disease transmission when married, “just wait until marriage”? Would it look the other way when doctors are shot to death and clinics are bombed — or even create a network to hide the fugitive terrorists? Would it argue against universal healthcare, and financial aid to women with dependant children? Would it cut funding to education, school lunch programs, pre-k programs and Head Start? Would it look like the modern Republican party, or the “pro-life” movement?
I don’t think so. I’ve said it a million times, but when it comes down to it, the pro-life movement doesn’t care about life after the moment of birth; they don’t care about preventing abortion; their only focus is control, and penalizing women who make choices that they don’t agree with. They offer women world-wide a single solution: Be abstinent, marry a man, have as many babies as God gives you. They peddle the notion that this one-size-fits-all answer can be appropriately applied to every single woman, everywhere in the world.
It can’t. It doesn’t apply to me; it doesn’t apply to most women I know. It has never worked in the history of the world, even when social norms about extramarital sex were much stricter, even when there were criminal penalties against abortion, even where sex before marriage was punishable by death. It is a universal failure. Trying to control your fertility is nothing new. And the fact that it’s still being presented as a perfect solution to all of our woes — “do it my way and I promise you’ll be happy forever” — would be laughable, if the political party in power didn’t seem to follow it so closely. I’ve read a million times about how the pro-choice movement needs a make-over, how we need to prove that we want to prevent abortions in the first place, not just access them. And I agree. But what about pro-lifers? Where are you in this one? Do you want to prevent abortions or not? Because your solution — illegalization and criminalization without any sort of prevention — just isn’t going to work.
So what now? As William Baude points out in the New York Times, taking abortion to the states won’t actually solve anything.
The common refrain in the anti-Roe pro-choice camp is that women in anti-abortion states will simply travel elsewhere to end their pregnancies. But it’s unlikely that states with strict regulations on abortion would stand idle, and they will have many legal tools at their disposal.
States could make it illegal to cross state lines in order to abort a fetus – a tactic Ireland tried in the early 1990’s, until a court decision and subsequent constitutional amendment recognized a right to travel. While the Supreme Court has recognized a constitutional right to travel across state lines, it has also recognized exceptions.
If states can decree that life begins at conception, they might also be able to use child custody laws to curtail the movements of pregnant women. For example, many states are legally allowed to hold children in protective custody if there is reason to believe the parents will misbehave. Once Roe has been overturned, a state may be able to place unborn children into protective custody, forbidding their mothers to take them across state lines.
Furthermore, in recent decades, the Supreme Court has ruled that a state can regulate its citizens’ activities while they are elsewhere and prosecute them for violations of state law upon their return. This so-called long-arm jurisdiction has been invoked to allow states to regulate Internet sites based beyond their borders, or to prosecute murders that followed interstate kidnappings. Anti-abortion states could forbid their residents to obtain or perform abortions, even while out of state. Would such measures be legal? The current law is unclear.
Abortion-rights states would undoubtedly respond in kind. For example, Rhode Island, where 63 percent of residents favor abortion rights, has rebuffed efforts at regulation in the past. Just as Utah could make it a crime for a resident to go to Rhode Island for an abortion, Rhode Island could forbid Utah’s law-enforcement officials from interfering with her decision to get one. Similarly, if an anti-abortion state places a fetus in protective custody, an abortion-rights state might do the same for the woman. And so on.
Sounds pleasant, doesn’t it? Taking Roe from the courts to the states also explicity says that women are not equally protected actors under the Constitution (yes, I realize that Roe was not an equal protection case; this post is getting long, but in the next couple days I’ll follow up on this point and explain myself a little better). The individual right to our bodies shouldn’t be up for a popular vote any more than our right to enslave others should be. It’s just that simple.
And of course, it wouldn’t be appropriate to examine reproductive rights without looking at the individuals they affect. Check out this must-read piece in the New York Times about one man and his father’s abortion war.
On Oct. 23, 1998, a Friday evening, at about 6, Barnett Slepian, an obstetric gynecologist from Amherst, N.Y., called my parents’ home. He was phoning because, that weekend, as on every third weekend of the month, he was scheduled to cover deliveries for my father. A few hours later, after attending a memorial service commemorating the death of his father, as he stood in his kitchen waiting for a bowl of split-pea soup to heat in the microwave, Dr. Slepian was shot in the back by a sniper hiding in the wooded area behind his home. Within a few hours he was pronounced dead.
I found out about the murder the next morning, after having breakfast with an old friend from college. I was living in Brooklyn at the time. When I first heard the news, my heart stopped. I had never met Barnett Slepian, but I was well aware of who he was. I knew that he and my father shared something besides covering for each other on certain weekends: both were OB-GYN’s who devoted part of their practices to performing abortions, which is why, for more than a decade, they had both been subjected to abrasive treatment – protests in front of their offices and homes, harassment of their patients, death threats. I had witnessed some of this firsthand while growing up. I’d like to say that standing there in the street trying to make sense of the fact that now someone had made good on one of those threats, the first thing I felt was anguish and sympathy for Slepian’s family: his wife, Lynne, who had just lost her husband, and his four sons, who had watched their father bleed to death on the kitchen floor. But my initial reaction was more selfish. What I felt at first was fear – that the murder might upend my parents’ lives; that another shooting might follow in its wake.
And if that isn’t enough of a tease…
Yet there is one thing about the abortion conflict that has remained stubbornly persistent: its centrality and uniquely polarizing place in American life. “No other nation obsesses about abortion the way we do,” the columnist Michael Kinsley noted recently. Not Italy, home to the Vatican; not France, England or Germany. Only in America is a medical procedure that was legalized more than three decades ago at risk of once again being criminalized. Only here have doctors routinely taken to wearing bulletproof vests and hiring armed guards for protection.
He’s right. While abortion is certainly an issue in many places — especially in developing nations where women are second-class citizens and are routinely excluding from the political arena (I wonder why abortion rights so strongly correlate to women’s empowerment? Huh) — almost all other industrialized nations, where women enjoy basic rights as citizens and humans, have gotten over the whole abortion thing. It’s legal, it’s not really a problem, doctors aren’t killed, and women aren’t harassed. And their abortion rates are lower.
Yet as the scholar Jessica Stern notes, there are two sides to religion – “one that is spiritual and universalist, and the other particularist and sectarian.” The flip side of the desire to rid the world of evil in accordance with your spiritual beliefs is the impulse among some of those convinced of their righteousness to demonize, and in extreme cases to want to eliminate, anyone who does not subscribe to them, something that, as I saw up close in Buffalo, is not a mind-set unique to Islamic fundamentalists. When the police removed protesters from a clinic in Buffalo one time, a spokeswoman for the local branch of Operation Rescue likened them to Nazi storm troopers. When a group of local religious leaders sympathetic to abortion rights held a meeting on another occasion, a protester assailed them as “ministers of Satan.” Driving past my father’s office while still in high school, I saw the signs emblazoned with his name. “Murderer!” “Baby-Killer!” On several Jewish holidays, including Yom Kippur and Hanukkah, a group called Project House Call organized demonstrations in front of doctors’ homes, choosing as their targets two local physicians who happened to be Jewish: my father and Slepian. Later, during the Spring of Life, radio ads blared, announcing: “Some doctors deliver babies. Some doctors kill babies!” My father and several other physicians were singled out by name. On the corner of Maple and Exeter Roads, a quarter-mile or so from my parents’ home, a six-foot red banner reading “Press Kills Children” was unfurled. In case anyone missed the banner, leaflets were distributed throughout the neighborhood.
And then we wonder why there are so few abortion providers.
In one of the more powerful parts of her essay, we see how Dr. Slepian’s death should not have surprised us, given the dogmatism of the anti-choice movement:
Court fines and internal feuding had taken a toll on Operation Rescue. Congress passed and President Clinton signed the 1994 Freedom of Access to Clinic Entrances Act, which made blockading the entrance to a facility where abortions were performed a federal crime, effectively bringing the rescue movement to an end. It didn’t occur to me at the time that this new law might precipitate a more ominous phase of the conflict – leading some frustrated advocates to conclude that violence could achieve what civil disobedience had not. Soon, stories broke of doctors and clinic workers being shot in Florida, Massachusetts and Canada.
At least one physician in Buffalo saw what was coming. In August 1994, The Buffalo News published a letter by Barnett Slepian. “The members of the local nonviolent, pro-life community may continue to picket my home,” he wrote.
“They may continue to scream that I am a murderer and a killer when I enter the clinics at which they ‘peacefully’ exercise their First Amendment Right of freedom of speech.
“They may do all of the above to me and other abortion providers in this community. But please don’t feign surprise, dismay and certainly not innocence when a more volatile and less restrained member of the group decides to react to their inflammatory rhetoric by shooting an abortion provider.”
And as we all know, anti-choice terrorists didn’t stop with Slepian.
The very next morning, around 10, as I was talking to my mother, the phone rang. She picked it up.
“Death threat?” she said. “Death threat?. . .Excuse me, you’ll have to speak with my son.”
Her hand shook as she passed me the phone. It was a detective from the Police Department. He was calling to inform us that a newspaper in Hamilton, Ontario, which days earlier received a package containing a photograph of Slepian with an X drawn through his face, had just received an anonymous threat that my father was “next on the list.”
The next morning, the story that another doctor had received a death threat was splashed across the front page of The Buffalo News. By week’s end, my parents were living under 24-hour protection by federal marshals. Their two-story house in the suburbs was converted into a bunker – cameras on every corner, the shades drawn, an armed guard out front.
And it’s had an effect.
Even so, the years of unrelenting pressure have created a stigma that has pushed abortion, if not into the back alley, then into an increasingly marginalized corner of the medical world. Back in the 70’s, two-thirds of all abortions in western New York were performed in hospitals. Today, hardly any are. Between 1992 and 2000, more than 250 hospitals and 300 private practitioners across the country stopped performing abortions. Many others never started. Not long ago, I spoke to a young OB-GYN, a friend of my family’s, who belongs to what is perhaps a silent majority of physicians in the field. He told me that he supported abortion rights and that he felt the decision about abortion should be left to a woman and her doctor. But he didn’t perform the procedure himself. He had a family to raise, a growing practice and he had watched with open eyes what happened in Buffalo.
Is overturning Roe the solution?
Not a few commentators lately, including some who support abortion rights, have suggested that it would not be the worst thing if the availability of abortion were left to state legislatures to decide, which is what will happen if Roe is overturned. Overnight, they note, middle-class women who take their reproductive freedom for granted no longer would. Republicans who tailor their rhetoric to the religious right would have to consider whether, in a country where 70 to 80 percent of people favor keeping abortion legal all or some of the time, they really want to endorse a blanket ban on the procedure. At the same time, Democrats would have to contemplate what, in light of medical advances and popular opinion, reasonable limits on abortion are. (Most European countries have implemented limitations that in America would be deemed unconstitutional because of Roe.) A debate currently framed in absolute terms – the right to choose versus the rights of the unborn – may begin to reflect what polls suggest most Americans, including a majority of Buffalonians, believe, which is that abortion should be legal but regulated.
It might even become possible for Americans to have a more practical conversation about how to create a society in which fewer unplanned crisis pregnancies happen in the first place. According to Stanley Henshaw, an analyst at the Alan Guttmacher Institute, the one exception to the trend of declining abortion rates in America is women below the poverty level, among whom the numbers have actually increased. Grappling with the reason for this, and how it might be addressed, would force both sides in the abortion debate to wrestle with things they might not like to. Among advocates of reproductive rights, it would mean acknowledging that in an ideal world, having an abortion is something that most women would prefer to avoid, and that the decision to raise a child is often the one that seems most impracticable to those who are disadvantaged. Among opponents of abortion, it would mean dropping the puritanical crusade against over-the-counter contraceptives and for abstinence-only sex education, as well as thinking seriously about whether they should support policies like those tucked into the recent Republican budget, which will leave states with billions of dollars less than what experts estimate they’ll need to maintain child care for low-income working families in the years to come.
In reality, though, overturning Roe v. Wade will not end the abortion conflict. It will probably transform it from one battle into 50 smaller ones raging across the states. Women who thought they had secured a right several generations ago would have to fight for it again. In the meantime, the least privileged (those who live in remote areas, those who can’t afford to travel) would face barriers to access far more restrictive than those in place in many states today. Many people believe that Roe is more likely to be chipped away at over the next several years than overturned. Whether they are right will rest in the hands of a Supreme Court seemingly more skeptical about abortion than any in recent history, one headed by a strongly observant Catholic, John G. Roberts Jr., who was born in Buffalo.
Read the whole thing. And, while I think the Times did a great job in selecting pieces for the Roe anniversary, it’s worth pointing out that all three were written by men.
Happy Anniversary, Roe. Sorry I’m a day late.