Legal but…Framing the Ethics of Abortion Rights
The 25th anniversary of legal abortion in the United States produced a media barrage of articles, TV movies, talk shows and opinion polls showing that a majority of Americans believe abortion should be legal but restricted. Fifty percent respond "yes" to the question of whether abortion is murder, yet large numbers of the same people believe that abortion is sometimes the best choice. Younger women, according to focus group research, may be mixed on the question of the morality of abortion. They are, however, clear about believing it will be there for those who truly need and deserve it. What these polls tell us is that most people in the U.S. really do not believe that abortion should be available when needed, for any woman, for any reason. Unfortunately, in 1998 this is as radical a position as it was when abortion was legalized in 1973.
At the same time, millions of women continue to have abortions at close to the rate they have had them for many years. Abortion remains routine, the most common surgical procedure in the country, as common as divorce. This means that many of those who say abortion is murder have had abortions and will have them.
The recent polls also show that a majority of people in the U.S. believe that the anti-abortion movement is extremist. At the same time, they give high marks to anti-abortion activists for being "principled." It seems that the anti-abortion movement is perceived as resorting to violent measures, such as the recent clinic bombing in Alabama, because of an ethical position. Conversely, while pro-choice activists are viewed as more reasonable and moderate, we are often not viewed as holding an ethical position.
How should we understand this complicated picture of abortion today? And, how, after so many years of battle, do we assess what pro-choice activists have accomplished? What inroads has the anti-abortion movement made when abortion has not declined much, but when high levels of violence against clinics and their personnel are tolerated? How we answer these questions will direct the fight for reproductive freedom in the future.
Abortion rights activists face long term ideological and legal challenges. We have to find the language, strategies and allies to guarantee every woman a fundamental right to make her own reproductive choice. Simultaneously, we have to find ways to interrupt the widespread complacency about abortion rights. We need to impart a sense of urgency about our agenda. Women who are denied access to reproductive health care due to restrictions on abortion, as well as poverty and welfare reform, have unmet needs which cannot wait. While the anti-abortion movement has been unable to stop the majority of abortions from taking place, they have thrown enormous impediments in the path of many women. These include deadly violence, decreases in the number of doctors trained or willing to perform abortions, denial of public funding, efforts to ban the "D & X" procedure (so called "partial birth" abortion), parental consent and notification laws, family caps and other punitive welfare policies. Clearly we must continue to fight for immediate expanded access even as we pursue longer term goals and strategies.
Resurrecting the history of abortion for ourselves and for public discussion is a way to examine underlying ethical questions while at the same time highlighting women's immediate needs.
"The Deaths Stopped Overnight"
There is overwhelming documentation from the criminal era, beginning in the mid 1800s, of death and serious health consequences from illegal abortion. Before the Roe decision legalized abortion, 1,000 to 5,000 women died annually. In the 1920s and 30s abortion accounted for 14% of all maternal deaths with higher rates in urban areas. Race and class were significant factors - the death rate for women of color was four times that for white women.
The safety of abortion was a political matter. The same methods which reduced mortality in childbirth and generally in surgery, the introduction of antiseptics in the late 1800s and sulfa drugs and penicillin in the 1930s, were the means to make abortion safe. While these methods were used for the relatively small number of therapeutic abortions (legal procedures which became increasingly restricted), abortion mostly remained dangerous because it was criminalized.
Roe transformed abortion from a life threatening and terrifying experience to a safe one for those women who had access to it. With the passage of Roe the mortality rates dropped dramatically. A coroner who worked at a hospital in Pennsylvania said it simply, "The deaths stopped overnight in 1973, and I never saw another abortion death in all the eighteen years after that until I retired. That ought to tell people something about keeping abortion legal." (The Worst of Times, Patricia G. Miller, Harper 1993, p. 13) Today a first trimester abortion in the US done in appropriate settings is one of the safest surgical procedures, as safe as a tonsillectomy.
Twenty-one million women have had thirty-five million abortions since Roe v Wade. The pre-Roe figures are more difficult to come by, but what we do know tells us that abortion was quite common then as well. In the first half of the 1800s, before criminalization, an estimated 25% of all pregnancies were aborted. In the 1920s and 30s there were an estimated 1.2 to 2 million abortions a year - 20% of all pregnancies in the 1920s. Kinsey's study found that white upper and middle class women aborted 24.3% of their pregnancies; 64% of unmarried white women had abortions and 40% of unmarried black women (When Abortion Was A Crime, Leslie J. Reagon, University of California Press, 1997).
Our own history, and contemporary data from countries where abortion continues to be illegal or severely restricted, underscore the pervasiveness of abortion regardless of its legal status, and it reminds us that the legal status of abortion does not affect whether women have them. It does determine the toll on the lives and health of women.
Re-framing the Issues
The reality of abortion has been framed by its opponents and the picture is a distorted one. The anti-abortion movement pretends that widespread abortion was caused by legalization and denies the consequences of criminalization. Perhaps most problematic is the characterization that women themselves fall into two categories: those who want to have babies and the others who want abortions. The truth is that the same women are having babies and abortions, just at different times in their lives.