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@PT:Contents Tables, Figures, and Map 000 Preface 000 Introduction 1 A Brief History of American Abortion Policy 3 The Early Years 3 The Movement to Re-Legalize Abortion 5 The Opposition Emerges 7 The Current Debate 10 Abortion as Social Regulatory Policy 11 Political Labels 14 Research Methodology 14 Maternal and Fetal Citizenship 15 Book Overview 17 Discussion Questions 18 Suggested Reading 19 Notes 19 1. Abortion: Just the Facts 25 Is the United States Unique on the World Stage? 29 Incidence of Abortion in the United States 29 The United States Compared to the World 31 Why Women Have Abortions 31 Abortion and Safety 33 Who Has Abortions in the United States 34 When Women Have Abortions 39 The Court of Public Opinion 41 Conclusion 50 Discussion Questions 51 Suggested Reading 51 Notes 52 2. Abortion on Demand? The Supreme Court and Abortion Rights 57 Physicians as Authorities 58 The Supreme Court¿s First Appearance in Abortion Policy: Challenges to the Comstock Law 59 Margaret Sanger: Advocate for Women¿s Reproductive Rights 60 Physicians and the Contraception and Abortion Movements 62 The U.S. Supreme Court Acknowledges a Right to Privacy 63 Griswold v. Connecticut 63 Roe v. Wade 64 The Intermediate Years: Protecting Choice, Denying Rights 67 Neutral No More: Webster v. Reproductive Health Services 73 Casey: Supplanting Doctor Authority with State Authority 75 Stenberg v. Carhart: A Footnote or a Shift? 78 Conclusion 81 Discussion Questions 81 Suggested Reading 82 Notes 82 3. Abortion Restrictions in the States 87 Practical Barriers to Abortion Access 89 Location of Providers 89 Competition and Profit Margins 90 The Graying of a Generation 93 Anti-Abortion Extremism and Violence 94 Pro-Choice Advocates Respond 98 A Lack of Education 99 Pharmacists as Roadblocks to Abortion 101 Statutory Barriers to Abortion Access 102 Illegal and Unenforceable Barriers 102 Legal Barriers 105 Barriers to Funding 109 State Protections for Abortion 112 Patterns of Restriction and Protection 115 State Protections for the Fetus 117 Conclusion 119 Discussion Questions 120 Suggested Reading 120 Notes 121 4. Abortion and the Federal Government 125 Constitutional Amendment or Statutory Ban? 127 Banning Federal Funding of Abortion 128 The Pro-Life Movement Begins to Organize 132 The Pro-Life Movement Sets the Terms of the Debate 136 A New Strategy for a New Century: Persuade, Protect, and Prohibit 138 Persuade 138 Statutory Protection of the Fetus 141 Prohibit 146 Nomination Politics and the Making of a New Supreme Court 148 Conclusion 150 Discussion Questions 150 Suggested Reading 151 Notes 151 5. Pro-Choice, Pro-Life, or Pro-Birth? The Partisan Maneuverings of Abortion Politics 157 Party Lines Converge 158 General Party Lines 160 The Parties Organize to Win Elections 161 The 1960s: The Parties of Lincoln and Douglas 161 The 1970s: New Coalitions for New Positions 162 The 1980s: The Parties Change Sides 163 The 1990s: Republican Loyalty and Democratic Disunity 165 2000 and Beyond: Party Platforms Dictate Policy 166 Party in Government 167 Crossing Party Lines on Funding 169 Partisan Loyalty in Prohibition and Fetal Protection 171 Democratic Disunity, Republican Unity 172 The 2004 Election: Abortion as a Wedge Issue? 174 Conclusion 178 Discussion Questions 179 Suggested Reading 180 Notes 180 6. Conclusion: The Pendulum Swings 185 Introduction 185 The Physicians Return 186 Women¿s Self-Help Movement 188 The Religious Left 190 Conclusion 193 Discussion Questions 193 Suggested Reading 194 Notes 194 Appendix A: Landmark Contraception and Abortion Cases 198 Appendix B: National Political Party Platforms Statements on Abortion 216 Appendix C: Web Resources 224 Tables, Figures, and Map Tables 1.1 Age of Women Obtaining Abortions, 1994 and 2000 35 1.2 Characteristics of Women Obtaining Abortions, 1994 and 2000 37 1.3 Percentage of Respondents Who Believe Abortion Should Be Available 43 3.1 Number of Abortion Providers by Region, 1992, 1996, 2000 90 3.2 Number of Abortion Providers by State, 1992 and 2000 91 3.3 Abortion Restrictions by State 103 3.4 State Funding of Abortion under Medicaid 111 3.5 Abortion Rights Laws by State 113 3.6 State Abortion Restriction Scores 116 4.1 Medicaid Abortion Funding Exceptions by Year, 1977Present 130 5.1 Recent Examples of Party-Line Abortion Voting in the House of Representatives 172 Figures 1.1 Rate of Abortions, 19732000 30 1.2 Abortion Ratio by Number of Previous Live Births, 2001 38 1.3 Legal Abortions by Number of Previous Legal Abortions 39 1.4 Legal Abortions by Weeks Gestation, 2001 40 1.5 Support for Abortion: For Any Reason 46 1.6 Support for Abortion: All Reasons 47 3.1 Incidents of Clinic Violence per Year, 19892004 96 3.2 Incidence of Clinic Blockades per Year, 19892004 97 3.3 Incidence of Clinic Disruption per Year, 19892004 98 5.1 Party Control of State Legislatures, 19642004 168 5.2 Party Control of Governorships, 19642004 169 Map 3.1 State Abortion Restriction Patterns 118 @CT:Preface @EPI: ¿Of course, in our culture, children are sacred, but women are sacred too....¿ @EPIS:--Chief Fire Thunder, Pine Ridge Reservation, South Dakota @TEXTNO:Early in 2006, South Dakota became the first state in the nation to pass a ban on abortion in all circumstances except when necessary to save a woman¿s life. Shortly thereafter, opponents of the new law threatened to challenge its legality under the landmark ruling, Roe v. Wade, and began an initiative process to take the issue to the voters in November. @TEXT:Of course, to observers of abortion politics, this ¿clash of absolutes,¿as Laurence Tribe, Carl M. Loeb University Professor at Harvard Law School, describes it, is familiar. There are new features to this most recent chapter in abortion politics, however; one is the recently remade Supreme Court, whose new composition emboldened pro-life legislators in South Dakota to create a challenge to Roe v. Wade¿s central holding that the right to privacy extends to abortion. One of the most provocative and intriguing responses to the South Dakota law came from a voice rarely heard in the abortion battle; Chief Fire Thunder of South Dakota¿s Pine Ridge Reservation spoke strongly in opposition to the new regulation. Her voice carried loud and strong for two reasons: first, in contemporary abortion politics women of color are rarely heard. Primarily the issue of large interest groups and political parties dominated by middle-class white Americans, abortion politics is long overdue for some fresh perspectives on the national landscape. Secondly, the chief¿s statements echoed across America because her central theme is the sacredness of women. Fire Thunder¿s focus on the spiritual value of healthy women in her community struck a chord in what is otherwise a dissonant conversation: abortion policy today often is argued between those advocating for women¿s rights and those who champion the moral property of the fetus. In privileging the moral property of women in her comments, Fire Thunder voiced a view seldom heard in today¿s polarized debates. This book is the product of a rare and valuable synthesis of my teaching and research interests. In teaching courses about women and politics for more than a decade, I have taught abortion policy to many students at all levels of their education. In doing so, I have learned a simple and unsettling truth: few Americans know the current status of abortion policy today. In my classes, students are as likely to ask whether abortion is illegal as they are wont to argue that it is available on demand. These perspectives, once unpacked in the rarefied environment of an open classroom, generally reflect deeply held ideological values, not policy knowledge. I hope that in these pages I have offered an accurate reflection of the current status of abortion. By arguing that abortion is neither illegal nor available on demand, I hope that I will provide instructors like me with a tool for investigating a critical public policy battle with clarity, accuracy, and room for many intriguing conversations. In my moments of greatest conceit, I hope the text will allow for a spark of enlightenment, in some classroom somewhere. Still, the book is not without argument. As the title suggests, I maintain that abortion is becoming so highly regulated that while it remains both legal and safe, it is becoming more difficult to access, especially for the women for whom Fire Thunder speaks; the poor, the young, and the geographically remote are experiencing this public policy very differently than middle-class, urban white women. The abortion case is framed here as a classic case of social regulatory policy. In social regulatory policy formation, debates are polarized, court centered, and intuitively appealing to the casual observer. Often the associated debate takes on entrenched, ideological positions that lack substance and reflection. In these ways, abortion debates today are classic examples of social regulatory policy. I maintain however, that contemporary abortion politics go beyond the features ¿typical¿ to social regulatory policy--the current debate is so entrenched, so polarizing, that it looks similar to another deeply dividing issue of many years ago: slavery. All social regulatory issues are the stuff of ¿gut¿ politics: they go to the core of our personal mores. But more than any other policy in this arena, abortion (and slavery) touches upon our deepest held beliefs about the very value of life. The book has obvious utility in courses on social regulatory policy, women and politics, and women and the law--courses I teach regularly. But as a policy case study, this book is useful to the introductory student of American politics and to students of public policy in general. I have written the book with this wider audience in mind; the special features are designed to facillitate discussion, critical thinking, and learning among a broad spectrum of college students. The text procedes simply. The Introduction offers a brief background to abortion law and politics, and introduces the basic concepts of the book. Chapter 1 focuses on the nuts and bolts of who gets abortions, how many women get them, and why. Chapter 2 outlines the consitutional environment of abortion. In chapter 3, the states¿ many abortion policies and practices are outlined, while national policies are described in chapter 4. Chapter 5 develops a party-based argument to explain why abortion policy is trending toward restriction; in chapter 6 I point to signs of change. Each chapter concludes with discussion questions meant to stimulate conversation as well as a list of further readings. @H1: Acknowledgments @TEXTNO:I am delighted to write this note of thanks to the many people who helped me, in one way or another, to write this book. At CQ Press, I worked with an amazing group of professionals. As the acquisitions editor, I am indebted to Charisse Kiino for believing in my project from the beginning. For scrupulous editing, my thanks to Colleen Ganey and Lorna Notsch. And to Terri Susan Fine, University of Central Florida; Wendy Martinek, Binghamton University, SUNY; Christiane Olivo, University of Northern Colorado; Robert Spitzer, SUNY Cortland; Nikki Van Hightower, Texas A&M University who encouraged CQ Press to print the book and who provided valuable feedback, I am grateful. @TEXT:For the many students over the years who prodded me with challenging questions and let me test theories in the Abortion Politics seminar, I am eternally grateful; the book bears their mark in numerous places. My deep thanks go especially to Tina Gentzkow, Travis Kennedy, Sunny Petit, and Laura Terrill Patten for having the patience, over and over again, to look up an arcane piece of administrative rule-making or obscure newspaper article; the book is so much better because they worked on it. And although I could not have done this without their faithful assistance, any errors in the text are mine alone. Some long-time students may be frustrated to find the book more balanced than my own personal position. They, of course, have known my passionate position all along. Some will be disappointed to find a book that reflects many views--not just theirs, or mine. I trust, however, that they will see the virtue of a text that encourages the kind of spirited debates and thoughtful analyses we enjoyed in our courses. I reveled in these discussions and the puzzling areas of disagreement and common ground, and through writing and teaching this material I have grown and I hope they have, too. In courses that invite debate, critical thinking expands, understanding mounts, and public dialogue hopefully grows more civil and compassionate. That is my purpose in this text. One final note of thanks goes to the physicians I interviewed in the course of writing this text. Their generosity toward me benefited the book in many ways; most notably, I was able to incorporate the physician¿s perspective, which is rarely integrated into abortion politics today. More than anything, spending time in their homes, offices, and clinics afforded me a richer view of the humanity and care they offer their patients, whose situations I came to learn are often sad, if not tragic. With little pay, and risk to their own lives, these doctors continue to provide compassionate care for women at a time of great need. The book reflects the support and challenges of my colleagues and good friends at Portland State University. Without Richard Clucas¿s guidance, mentoring, and faith in my abilities, I would not have had the chance to write this book. Gretchen Kafoury deserves thanks for all she does to encourage and challenge me. For reading and responding to endless e-mails that began with ¿you¿re not going to believe what I found!¿ my deepest thanks to Regina Lawrence. I am grateful to Patricia Schechter who provided support in the most unlikely places: campaign trail, delivery room, birthday party. For allowing me to bend her ear on the preschool playground through my entire sabbatical, many thanks to Jennifer Ruth. I could not ask for better colleagues. In some ways this is a book that has been ruminating for twenty years. Many thanks to Wendy Mink and Bob Meister for the exceptional undergraduate education they provided me at University of California, Santa Cruz. Substantively, they sparked in me an interest in women, justice, and the law. But their impact on my life is much greater than that: as a first-generation college student, I would never have had the courage to go to graduate school without their early belief in my abilities. They are a testimony to the radical potential of public education, and I thank them for changing the course of my life. I cannot believe my good fortune in academic mentors. At Cornell University, I found phenomenal mentors in Elizabeth Sanders, Mary Katzenstein, and Ted Lowi, who prepared me well for the rigors of academic life. Elizabeth consistently challenged me to dig deeper, think harder, and write better. Mary provided the warmth and understanding that every graduate student--especially one who is also a mother--deserves to have. To Ted especially I am indebted; his joie de vie and commitment to the discipline taught me that the academic life should be lived with passion; his words of encouragement and challenge ring still in my ears, although I work three thousand miles away. I can only hope one day to give a student what he gave to me. I also am indebted to a core of friendships that support and sustain me personally. For the ¿other mothers¿ who work the carpools, make much-needed casseroles, and celebrate my victories with me, my whole family is indebted. It does take a village to raise children; I am so fortunate to have found mine. My children are the true inspiration for this book, as they are for all that I do. They challenge and affirm me every day, always tugging me back to earth for what really matters: a warm dinner, a walk in the crinkly leaves, or a bubble bath. Simone, Madison, Cloe, and Bella are the great works of my life, and I am much improved by their existence. The world--my world--is better because they are in it. Still, they remind me each day that the hardest and most fulfilling job in the world is being a mother; I am glad I chose that role freely and with great abandon. The job of mothering is made infinitely easier and more rewarding when it is shared. I dedicate this book to my loyal and loving companion, Eric Butler. @CT:Introduction @EPI: ¿The fear in their faces would haunt Dr. Larch forever, the epitome of everything he could never understand about the great ambiguity in the feelings people had for children. There was the human body, which was so clearly designed to want babies--and then there was the human mind, which was so confused about the matter. Sometimes the mind didn¿t want the babies, but sometimes the mind was so perverse that it made other people have babies they knew they didn¿t want. For whom was this insisting done? Dr. Larch wondered. For whom did some minds insist that babies, even clearly unwanted ones, must be brought, screaming, into the world?¿ @EPIS:--The Cider House Rules by John Irving @EPI: ¿We respect the individual conscience of every American on the painful issue of abortion, but believe as a matter of law that this decision should be left to a woman, her conscience, her doctor and her God. But abortion should not only be--abortion should not only be safe and legal, it should be rare.¿ @EPIS:--Presidential nominee Bill Clinton at the 1996 Democratic National Convention @TEXTNO:When he accepted the Democratic nomination for the presidency on August 29, 1996, Bill Clinton attempted to find compromise within an increasingly polarized debate over abortion in the United States by stating that abortion should be ¿safe,¿ ¿legal,¿ and ¿rare.¿ His statement reflected the wishes of many Americans, that the procedure should remain both legally and medically accessible, but hardly used. It also became a catchphrase for late twentieth-century abortion politics, reflecting a desire to create harmony between the competing pro-life and pro-choice positions. The outcome Clinton likely sought was a general agreement that abortion is an unfortunate event, and that working together to prevent unwanted pregnancies, the pro-life and pro-choice communities would find common purpose.1 @TEXT:What Clinton perhaps did not anticipate was that the two movements, rather than finding common ground in making abortion rare, would instead pursue fundamentally different strategies in achieving this goal. For when the pro-choice side of the equation hears ¿rare,¿ they are moved to prevent the circumstances that cause a woman to seek abortion: inadequate reproductive health education, poverty, imperfect contraceptive technologies, and gender inequality within relationships. For pro-life organizations, however, the goal has always been to stop abortions, irrespective of the circumstances that prompt women to seek them. Clinton¿s objective is being fulfilled, although perhaps not in the way he intended. Abortion rates are declining, although there is little consensus on why this is so. The argument of this book is that efforts to chip away at the practical aspects of abortion access have been successful; in fact, they have been far more successful than most Americans realize. Abortion is slowly becoming rare because, among other reasons, it is increasingly difficult for some groups of women to access. For while abortion does remain legal, the number and types of circumstances in which a woman can gain access to the procedure have diminished greatly in recent years because of new restrictions at both the state and national levels. Through a myriad of statutory and normative changes in policy and provisions over the past thirty years, a legal and safe abortion is becoming increasingly harder to procure, particularly if the woman who seeks it is young or poor. This book documents the complete set of barriers to abortion that a woman faces in the United States in the early twenty-first century. Implicit in the movement toward more restrictive policies is a shift in concern away from women¿s health and rights and toward fetal protection. Much of the debate fueling this is based not on the language of philosophy, science, or rights, which is the language that pro-choice groups favor, but is instead based on the language of religion and morality, which is the language that most pro-life activists prefer.2 With this shift in perspective comes two related, if relatively unnoticed, trends. First, the movement toward greater restrictions marginalizes the traditional role of medical professionals in controlling access and practice. Whereas earlier periods in abortion politics in the United States elevated the physicians¿ gatekeeping role (for better or worse), today that role is being taken up by politicians. And while many would argue that physician-controlled access has its limitations, replacing medical judgment with political judgment would seem to insert a new host of problems into the politics and practice of abortion. Whether the nation might break free of this physician-politician dichotomy in the future is a subject I address in chapter 6. Second, many of the new restrictions remove the assumption of the doctor¿s reasonableness and professionalism, supplanting physicians¿ judgment for that of politicians. When American abortion policy deferred to doctors in making the abortion decision with their patients, society basically embraced the reasonableness of those actors. Allowing women to make this decision with their doctors suggests that women know best the circumstances of their lives; with proper medical assistance, they can determine the best course of action when they face unwanted pregnancy. This formula also assumes the physician¿s reasonableness: to give pertinent information, to select the best procedure for the immediate patient, and to provide a level of care appropriate to the situation. However, current restrictions undermine both the authority, and therefore, the legal options, of women and their doctors.3 @H1:A Brief History of American Abortion Policy @H2:The Early Years @TEXTNO:The earliest American abortion policy followed English Common Law, which established a ¿born alive¿ rule, meaning that the law only applied to cases in which infants were born alive, and then were subject to homicide. Abortion practices in the earliest decades of America¿s founding were therefore largely overlooked by local statutes. In the early to mid-nineteenth century, states began to adopt an understanding of the fetus that reflected religious doctrine, protecting fetal life only after ¿ensoulment.¿ In general, most Americans believed that the fetus was imbued with a soul at the time of ¿quickening,¿ or when the pregnant woman first felt the fetus move, which is generally at about eighteen weeks gestation. This view largely reflected the provision of Pope Gregory XIV, who in 1591 had declared that only ensouled fetuses were protected from abortion. Before quickening, therefore, Western society did not view the fetus as fully human, and abortion was largely unregulated until the mid-nineteenth century as a consequence. @TEXT:At the end of the seventeenth century, Pope Innocent XI issued two rulings that allowed abortion, claiming at one point that ¿no abortion is homocide.¿4 The courts generally upheld this understanding; for instance, in 1812 the Massachusetts Supreme Court upheld abortion before quickening in Commonwealth v. Bangs, and in 1821 Connecticut enacted the first criminal abortion law, which made abortions post-quickening illegal. By 1841, eight of twenty-six states and one territory had banned abortions, but only after quickening.5 Although it is not known definitively how many abortions occurred in early America, the practice is generally believed to have been widespread, in part because medical practices in the early nineteenth century favored liberal access to it. Pregnant women were cared for by other women; midwives and mature female family members assisted women in managing their reproductive lives, making the practice of fertility control quite private and a regular aspect of general health. Not until the mid-nineteenth century, when magazines began advertising abortifacients and midwifery practices, did legislators get involved in the provision of abortion. Even then, the objective of most abortion regulations was to make abortion safe for women and to guard the discretion of doctors to make exceptions when they felt the procedure to be medically necessary to protect the health of the mother. Mid-century abortion regulations were handled exclusively at the local level, where America¿s founders had argued that intimate matters of morality and health properly belonged. It was not until the late nineteenth century that abortion restrictions grew in both their severity and number. By the late nineteenth century, several key sociological and professional developments lent themselves toward a more restrictive abortion atmosphere. First, the establishment of ¿regular¿ medical schools produced a new medical industry of doctors, most of whom tried to establish themselves as the moral and professional superiors of the common midwife. In opposing abortion, the new doctors gained moral credibility at a time when abortion practices were being questioned publicly for the first time.6 The new American Medical Association (AMA) announced its anti-abortion policy at its founding in 1847, and immediately pursued a lobbying effort to ban abortion through state law. As the states began restricting abortion access, often due to the influence of the AMA, Pope Pius IX also issued a powerful declaration in 1869, proclaiming that all abortions would lead to excommunication. This statement from the Roman Catholic Church coincided with a wave of ¿vice¿ movements in the United States that were designed to improve the health and morality of the people, often through coercive and patronizing methods. The practice of abortion came to be challenged by physicians as well as by those concerned about the declining fertility rate of white middle-class women relative to those of recent immigrants. Just as middle-class women were gaining access to educational and social institutions, and were therefore more eager to control the number and spacing of their children, new waves of immigrants from eastern and southern Europe were entering the country in record numbers. In the final decades of the nineteenth century, social engineers asserted that the new immigrants, many of whom were Catholic, would overrun the ¿native¿ white social groups and outnumber them with their larger families.7 At the same time, abortion became a more public topic, as the women¿s magazines that proliferated at this time advertised the availability of abortion as a means of controlling fertility.8 This public exposure facilitated and enhanced public scrutiny of the practice. As a result of these various developments, state legislatures began to regulate abortion by the 1880s with a new fervor. In addition, Congress had passed the first federal restriction on abortion in 1873; the Comstock Act criminalized the transmission of ¿obscenity,¿ including materials containing abortion-related advertisements, through the postal system. The tenor of anti-abortion lobbying escalated further by the turn of the twentieth century. As political scientist Jean Reith Schroedel argues, the lobbying effort at that time included an attempt to make it illegal for midwives--the physicians¿ primary competitors--to perform abortions. Abortion practices continued despite these efforts. In the early twentieth century, abortions were provided by midwives as well as by private physicians whose practices would have been jeopardized without the service. Then, state lawmakers began to pass ¿midwife bans,¿ which made it illegal for anyone but physicians to perform the procedure. Although outside the cover of the law, many providers who had performed abortions for decades continued to do so. Many flourished in the early decades of the twentieth century. Ruth Barnett of Portland, Oregon, for instance, ran a thriving business for more than forty years in the heart of downtown, where local law enforcement shielded her from scrutiny, viewing her work as a public health necessity.9 Contrary to the images of the ¿back-alley¿ abortionist, providers like Barnett offered women a safe--albeit illegal--end to their pregnancies. Abortion provision became more dangerous in the 1940s, when the legal community began targeting not just abortion providers, but also the women who sought their services. For the first time in the history of the United States, women themselves were put on trial for the procurement of abortion services. This heightened legal scrutiny pushed the industry further underground, and resulted in the provision of fewer safe procedures. Most of the images Americans have today of back alley abortions are from the 1940s and 1950s, when many American women lost their reproductive organs or their lives in an effort to control their fertility.10 As historian Rickie Solinger puts it, it was the law that made abortions unsafe by forcing the procedure underground, where it could not be regulated.11 @H2:The Movement to Re-Legalize Abortion @TEXTNO:The movement in the 1960s to expand the availability of safe, legal abortions was initiated, surprisingly, in the medical community. Two specific events turned the medical community, which had long been opposed to legal abortion, into an advocate for increased access. @TEXT:One event was the case of Sherry Finkbine. The mother of four children and the producer of a popular children¿s program in Arizona, Finkbine found herself pregnant with a fifth child in 1962. She soon discovered that the drug her husband had imported from a trip abroad to alleviate her morning sickness had in fact severely impaired the fetus. Finkbine learned, as many women did at this time, that abortion was available to her only through the local hospital¿s therapeutic abortion review board, a committee of her hospital¿s obstetrician-gynecologists, who would decide her case. She made her request for an abortion, arguing that she could not provide proper care for such a compromised child with four other small children at home. Initially, the board granted her request. But when the local media was alerted of this decision, the hospital reneged, relenting to the public scrutiny. Ultimately, Finkbine flew to Sweden for her procedure; upon her return, she was greeted by the American press corps at JFK Airport in New York. The Finkbine case highlights the vagaries of accessing safe abortions during the mid-twentieth century. Women whose grandmothers had accessed abortion services with relative ease through their family midwives found the hospital review board process demeaning and impersonal. It separated a woman¿s gynecological request from her overall health and family history--factors that the nineteenth-century midwife would have known intimately. Women objected to decisions being made on a seemingly ad hoc basis and in an intimidating setting. Furthermore, the review boards seemed to undermine the autonomy of women and their control over their bodies, sending a message that many women interpreted as stating that their judgment alone regarding their abortion decision was simply not enough to justify it. Some doctors objected to this system as well, even though it ostensibly gave physicians greater authority over abortion than did outright bans. Many individual doctors felt hospital review boards also undermined their authority; sometimes the review boards were comprised of physicians without obstetric-gynecological experience. Experts in the field wanted the flexibility to help their patients with their abortion decision in the privacy of the examination room and with a fuller understanding of each woman¿s particular situation. Still, physicians were unaccustomed to the lawmaking process, and were reluctant to enter into this heated issue. The rubella outbreaks during the late 1950s and early 1960s in San Francisco were the second major event that tipped the scales toward greater access to abortions. Some physicians were even propelled to bring their grievances into the legislative arena. As in the Finkbine case, the rubella epidemic highlighted the rigidity of prevailing local laws. Rubella was widely understood to cause terrible deformities in fetuses of women suffering from the disease, especially during the first three months of pregnancy, and still doctors in California found themselves unable to legally provide abortions to infected women. This launched the movement to reform California¿s abortion law, marked by the mobilization of the California Medical Association in the mid-1960s. With the help of the National Organization for Women (NOW), formed in 1966, California physicians were successful. Governor Ronald Reagan signed the California Therapeutic Abortion Act in 1967.12 Considered the most liberal abortion law of its time, the statute allowed physicians to perform abortions when continued pregnancy would threaten a woman¿s physical or mental health, creating greater authority for individual physicians to provide abortions when they believed the procedure was necessary.13 Many other states followed. Buoyed by support from the emergent women¿s movement, the abortion reform effort succeeded in many states in producing more lenient abortion laws. Still, for many advocates of legal abortion, reform was not sufficient. Thus NARAL (then the National Abortion Repeal Action League) was founded in 1969, with the goal of repealing all abortion laws in an effort to return abortion provision to its early nineteenth-century traditions. Abortion, advocates argued, could be provided safely and humanely without the state¿s intervention. In response, Alaska, Hawaii, and New York decriminalized abortion by 1970. For some, this process of state-based legislative reform was too painstakingly slow and uneven. By 1973, state-by-state lobbying efforts had produced a patchwork quilt of abortion regulations. To many in the women¿s movement, abortion access was so basic to women¿s liberation at home and at work that it was considered the right of all women--not just those who lived in progressive states. Without it, women could not control their educational and vocational aspirations. Uneven provision across the states created an inequality among women that many felt to be fundamentally unfair. Some groups therefore began to seek resolution through the courts. Just as the civil rights movement had been successful in abolishing inconsistent segregation laws through judicial channels, many feminists sought progress there, too. Ultimately, the U.S. Supreme Court settled some abortion debates and spawned many others when it issued its landmark ruling, Roe v. Wade, on January 22, 1973. Although a more detailed analysis is found in chapter 2, it is important to note here that Roe overturned nearly all state abortion regulations existing at the time, and expanded the fundamental right of privacy established earlier in Griswold v. Connecticut (1965) to include abortion. Feminists lauded the case for establishing equality across the states; of course, the case also provoked the ire of abortion opponents, who would gain momentum for their own movement as a result of the Court¿s decision. @H1:The Opposition Emerges @TEXTNO:Current efforts to roll back the abortion policy gains of the 1970s did not emerge in a vacuum: they are the result of a social movement. Roe v. Wade was heralded as the ultimate expression of women¿s progress by the groups who had fought for reproductive liberty. For those opposed to abortion, however, Roe signaled not only a shocking extension of federal judicial power, but also an affront to moral principles. The verdict set into motion a powerful backlash movement that identifies abortion as a grave example of the erosion of Christian values in this country. @TEXT:Although the United States has a long history of evangelism fueling its social movements (witness the abolition, prohibition, and civil rights movements, for example) the contemporary pro-life movement is unique in its rapid rise and its quick integration into national party politics.14 The pro-life movement today is part of a larger ¿Christian Right¿ movement. The Christian Right is often misrepresented in the popular media as a hegemonic political force. On the contrary, this movement is a melange of different conservative theological traditions: charismatics, evangelicals, fundamentalists, and Pentecostals, as well as some Roman Catholics. Occasionally, Orthodox Jews join the conservative Christians over particular legislation, broadening the scope of the movement beyond Christianity.15 The diversity within the movement is in fact one of its strengths: it cuts across denominations that traditionally have been at odds.16 The history of this affiliation, and its emergence in national politics, is important to understand in order to grasp the character of American politics today and the key role that abortion plays in it. During the 1960s, religious organizations were generally politically quiescent. Philosophically, most mainline Protestant churches adhered to the ¿dispensational¿ theory, which encourages religious adherents to focus on the afterlife rather than on the present. What is more, the Scopes monkey trial of 1925 made religious activism appear irrational in an era of increasing respect for science and technology.17 However, social and political events in the 1960s, including the women¿s movement, the Vietnam War, and later, Watergate, helped create a sense of betrayal and anger amongst the nation¿s conservative religious voters. Many Christian voters ultimately viewed these social shifts as so destructive of their worldview that they were unhappily compelled to action.18 The first denomination to enter the political realm was the Roman Catholic Church. In 1965, the same year that Protestant minister Jerry Falwell publicly denounced the participation of religious people in politics,19 the Second Vatican Council issued its ¿Church in the Modern World,¿ which officially empowered lay Catholics to apply their faith values toward issues of social justice. From this document grew a movement toward the ¿Social Gospel,¿ which formally linked theology with social action and politicized church teachings. One of the first issues the Catholic Church focused on was abortion. Three years later, when Pope Paul VI¿s 1968 encyclical, ¿Humane Vitae,¿ was issued, the Roman Catholic Church created the right-to-life movement by condemning abortion except when necessary to save a woman¿s life.20 Not long after, in 1972, he reversed church doctrine dating back to 1679, which had officially allowed abortion prior to quickening, by declaring that official church doctrine now recognized that fetuses have inalienable rights.21 Thus, abortion at any stage was impermissible.22 The Catholic Church¿s entrance into the abortion debate, which was at that time mainly confined to the medical community,23 lent financial resources, popular support, infrastructure, and manpower to the fledgling movement.24 The Catholic Church had protested abortion policy only at the local level until the Roe decision prompted the National Committee of Catholic Bishops to launch a national effort.25 Even then, the Catholic Church¿s activities were fairly modest until 1975, when it issued the ¿Pastoral Plan for Pro-Life Activities,¿ which called upon Catholics to act upon their life-affirming values. The plan provided an opening through which smaller church organizations could join the national abortion debate. By the late 1970s, the movement hit its stride, and many pro-life organizations were formed during that period and throughout the 1980s, including Focus on the Family (1977), Moral Majority (1979), Concerned Women for America (1979), Family Research Council (1988), and Operation Rescue (1988). Still, despite the profusion of organizations, the movement lacked the legitimacy and focus necessary to affect political change. As the following chapters describe, the early movement¿s efforts were so focused on an unequivocal federal abortion ban that anything short of this was viewed as a disappointment. Because of its slow early progress, the movement decided to institutionalize itself through a variety of new strategies aimed at mainstreaming its message. First, Christian Coalition, founded in 1991 by evangelist Pat Robertson as an outgrowth of his failed 1988 presidential campaign, traded alienating religious rhetoric and military metaphors for more choice- and civil rights-based language to appeal to a wider audience.26 Starting in 1991, the organization¿s director, Ralph Reed, began encouraging local affiliates to @EXT: find effective language that motivate[s] our supporters without turning off voters sitting on the fence.... Such rhetoric ... sets a standard of basic civility that allow[s] secular ears to hear our message of stronger families and traditional values.27 @TEXT:The Christian Coalition combined its rhetorical shift with lobbying and policy changes. Following the 1994 election, which ushered in a new cohort of anti-abortion lawmakers, the organization embraced a strategy of ¿bold incrementalism.¿28 Not wanting to rush Reed¿s agenda and risk a backlash, the group led the Christian Right movement in an effort to move slowly with legislative change. Part of that effort entailed focusing on issues less volatile than abortion or the other pillar of their platform, homosexuality.29 Reed began to support candidates on such issues as taxes and crime, which enhanced the ability of Christian Right activists to appeal to libertarian members of Congress (MCs) and voters: @EXT: Libertarians and social conservatives both want smaller government. By using fiscal policy as social policy--shifting control of education to the local level, ending tax subsidies for abortion, and transferring certain welfare functions to the civil society--social conservatives could reduce the size of government in such a way as to measurably advance traditional values.30 @TEXT:Reed especially targeted family tax relief as an issue that could bring secular and religious families together. Both the Christian Coalition¿s Contract with the American Family and their Web site are evidence of this strategy. The Contract with the American Family is an initiative that targets tax relief, crime, and education choice alongside abortion, pornography, and reform of the arts. On their Web page, the organization offers readers a voters¿ guide to the performance of MCs on issues of special importance to its members. Such issues include all abortion votes, but also votes on the balanced budget amendment, congressional term limits, and the line-item veto as well. This strategy allows the organization to moderate its image and win broader public appeal. As Reed put it, ¿Soon we discovered that it was far easier to win a school board seat than a Senate seat, and far more likely to change the vote of a state legislator than to change the mind of the president.¿31 The Christian Coalition now focuses its efforts on local school board elections, city councils, and state legislatures and emphasizes the role of lay leaders within the organization.32 Robertson¿s campaign had cultivated a ¿new generation of leaders and activists who were poised for later victory.¿33 In 1992, the Christian Coalition began to mobilize this group of activists, and through separate training seminars for candidates for state legislatures and school boards, the organization began to see its members winning elective office.34 Beginning in the mid-1990s, the success of this strategy could be seen in both state and federal legislation. @H1:The Current Debate @TEXTNO:The current battle over abortion policy is one fought largely between the pro-choice forces, who view reproductive rights as central and fundamental to women¿s freedom and equality, and the pro-life forces, who believe abortion in most if not all circumstances is morally reprehensible and an affront to the very definition of human life. Chapter 1 demonstrates that many Americans find themselves somewhere in between these two extreme positions. Still, the policies in place today are the work of abortion activists, most of whom take stronger and more rigid views than the majority of the nation. Whereas early anti-abortion forces wanted to make abortion illegal, given the strength of the Roe ruling and the lack of political will in the nation¿s capital, they simply could not do it. The movement then shifted its focus to making abortion inaccessible to as many groups of women as possible. By subtly redefining citizenship of the fetus, and more recently, the very definition of pregnancy, activists have been able to make tremendous inroads without the general public¿s awareness. @TEXT:These recent restrictions limit access by favoring fetal rights over women¿s rights and by excluding scientific information and expertise, repressing them, or both. In all the debates between those who advocate women¿s rights and those who embrace fetal rights, the language of science and medicine has largely gone missing. The images and language most often wielded by pro-life advocates are vivid and emotional, as subsequent chapters demonstrate. Recent developments in imaging techniques certainly have facilitated a reliance on powerful pictures that humanize the fetus in a way not possible two decades ago. Because fetuses now can be seen in intricate detail, opponents of abortion have striking images to use in support of abortion restrictions, despite what these restrictions might mean to women¿s health and freedom. The results are that abortion in the United States is less accessible than it was in 1973 and women¿s health and freedom are threatened, especially for the young and the poor. Pro-choice advocates counter these restrictions largely through the use of the language of rights and freedom from government intrusion. The final implication of this analysis is that the very definition of American citizenship is shifting to include the fetus (in some cases the zygote), but at the expense of women¿s status as complete social citizens. The pro-life policy agenda today has consequences for women¿s status as free and legal individuals and for the pro-choice premise that science and physicians should be controlling forces in all matters medical. @H1:Abortion as Social Regulatory Policy @TEXTNO:As the previous historical overview demonstrates, for most of the country¿s history, the federal government remained quiet on the question of abortion, as it was on most issues of morality. Scholars agree that early American political philosophy, and the Constitution itself, give little authority to the federal government in social regulatory policy. By definition, the philosophy of limited government keeps issues of intense personal morality close to the will of the people by delegating their regulation to local and state authorities. From marriage law to gun control, social regulatory policy, more commonly referred to as ¿morality policy,¿ was handled by localities until the mid-twentieth century. At that time, for a variety of reasons, the central government began taking a more active role in all policies, including social regulatory policy.35 For the purposes of this book, social regulatory policy is synonymous with morality policy.36 @TEXT:Local control serves a number of purposes. First, it allows state and local authorities to experiment with controversial policies without affecting the entire nation. Moreover, Americans are more likely to take an interest in issues of social control, and they have more opportunity for input at the local level than they do at the national level. The Founders also believed that with such a vast and diverse nation, it was possible that smaller groupings of Americans would be able to adjust policy to reflect the particular needs of their communities. Thus, social regulatory policy would vary--sometimes dramatically--by region or state. This outcome presents an obvious problem for those who believe certain social policies are a matter of right. The Constitution of the United States codifies a governing system of layered federalism. Article I, Section 8 delegates most national legislative authority to Congress, granting flexible powers to discern proper national policy. Still, that section is balanced by the various limits placed on federal authority by the Bill of Rights and by the Tenth Amendment, which invests police powers, or social regulatory control, in the lower levels of government. From the beginning, this structure created tension between the layers of government, confirming James Madison¿s suspicion that national government authorities would continually seek more power, but be checked by local authorities. Through the struggle for control of social regulatory policy, individual liberty would be protected, because no one level of government would have absolute or unlimited power. Until 1873 the federal government usually ceded authority over abortion policy to the states. That was the year Congress passed the Comstock Act, officially entitled the Act for the Suppression of Trade in, and Circulation of, Obscene Literature and Articles for Immoral Use. In some ways, even this act becomes the exception that proves the rule: opposition to this exercise of federal authority was quick and sharp, and the act was eventually allowed to expire under the stress of critical public scrutiny. Still, similar ¿mini-Comstock¿ laws were passed in Connecticut and Massachusetts, and remained in place for many years. Through much of the twentieth century, the federal branches of government recoiled from the abortion dilemma, which was roiling in the states. While the states struggled with how to respond to the tragedy of dangerous illegal abortions and the safe, but illegal, abortions provided by some caregivers, the federal government remained silent.37 As a consequence, the state policies at mid-twentieth century were a mish-mash of rules, regulations, and realities that reflected local prevailing sentiments. This outcome was theoretically respectful of the Founders¿ intentions for social policy; generally speaking, however, the loss of many women¿s lives and the deterioration of their health poignantly illustrated the dangers of localism. Abortion is unlike any other policy debate in the United States because it involves the presence of one emerging life within an existing one. Although activists on all sides of the debate seek resolution by making analogies to other policy debates, the difficulty of abortion may lie in its uniqueness, which in some ways leads to its intractability. The issue cannot be resolved by finding a parallel resolution; however, abortion politics can be better understood within a broader policy framework. Because it invokes intense moral debate and public scrutiny, abortion can comfortably be categorized as social regulatory policy. Social regulatory policy is distinct from other types of policy, both in its content and in how Americans engage it. Other types of policy, defined by Cornell University political scientist Theodore J. Lowi as patronage, regulatory, constituent, or redistributive, have existed since the nation¿s founding. Social regulatory policy, first identified and named in the latter part of the twentieth century, is distinct because it involves the regulation of intimate human behaviors and decisions. Whereas most other policies place boundaries on economic behaviors, social regulatory policy is personal. Abortion, prayer in schools, gay marriage, gun control, and some civil rights legislation are several contemporary examples.38 Legislation in these areas touches directly upon intimate individual choices, rather than business decisions or the decisions of demographic groups.39 Social regulatory policy--be it gun control, end-of-life decisions, or abortion--is especially distinct from other policy areas because of the politics it engenders. Thirty years ago, Lowi argued that different policy types inspire different types of political behavior and resolution.40 Each has a particular form and object of coercion. Political scientists Raymond Tatalovich and Byron W. Daynes argued that social regulatory policy is unique both in its object of regulation (the individual) and in its politics.41 These politics tend to be more acrimonious and more polarized than the political battles in other policy areas. Given the personal nature of social regulatory policy, this intensity is understandable. And as with any policy type, some of these issues are more contested than others.42 Abortion remains one of the most contested policy matters in modern history. The battles in social regulatory policy are therefore infused with language about morality, right and wrong, and religion. Moreover, such policy is often image-driven. Because of such emphases, these debates overlook the economic, scientific, and sociological aspects of the policy in question. The stakes are therefore high: an economic policy might be about winning or losing more money; a social policy debate is often about winning or losing souls. Finally, social regulatory politics is often protracted and difficult to resolve. Because these issues touch upon Americans¿ most deeply held core beliefs, and because they have a ¿gut level¿ appeal, politics in this arena can be theatrical and uncompromising.43 For example, abortion lends itself to visual imagery more easily than a debate over the regulation of fuel emissions. All parties in the abortion debate are prone to wielding passionate and sometimes shocking visual images to persuade others to their position. Thus, abortion policy remains unresolved in this nation more than thirty years after the landmark Supreme Court decision that attempted to provide resolution. The nation is long past the Court¿s decision to enter the abortion fray, and it might be reasonably argued that the stakes of abortion politics and the intensity of its activists have never been higher. Court intervention has in fact failed to yield either compromise or resolution. In part, this may be because abortion has features unlike other social policies. It challenges the definition of the person, the definition of the mother, and notions of morality and the role of science. It is, to activists on either side of the debate, a ¿clash of absolutes.¿44 Besides abortion, only the slavery debate challenged so pointedly society¿s definitions of personhood and citizenship, lending a particular poignancy and intransigence to both issues. James Davison Hunter, a professor of sociology and religious studies, helps form an understanding of these dynamics. In contemporary America, he argues, individuals have a tendency to line up on important social, or gut level, issues based upon their worldviews. And often, he argues, Americans see the world either through the lens of science or through the lens of morality. The two worldviews share little language for making sense of an issue like abortion. In this book, I argue that the pro-choice forces largely fall into the scientific camp, preferring to understand abortion as a medical matter with a rightful place within medical discourse and relying on scientific definitions of the fetus and pregnancy. For them, morality certainly is not absent, but it is secondary to the questions of maternal health and physical well-being that science asks. Pro-life groups, on the other hand, understand abortion through the lens of morality, and often argue that the science of abortion should be secondary to what they identify as the larger rubric of moralism. @H1:Political Labels @TEXTNO:To describe the major actors in abortion politics, it is important to use the language that the social and political groups involved use to describe themselves. Some of this language has already been used in the preceding material. Understanding that this language and these labels were created in part to define the issue and promote a particular cause, the reader should feel free to think critically about them because their accuracy, their political power, and their impact are critical to the terms of the debate. In chapter 5, the ¿pro-choice¿ and ¿pro-life¿ labels are examined as they are used, for better or worse, by political parties and officeholders. @TEXT:In addition, this discussion relies whenever possible on scientific definitions and terminology rather than religious or political ones, recognizing that all language in this debate is infused with political meaning. For instance, ¿embryo¿ is used when discussing the fertilized egg before four months gestation; ¿fetus¿ is used when discussing the fertilized egg at fourth months gestation until birth. ¿Pregnancy¿ refers to the time when the fertilized egg implants in the uterine wall until birth. To some, reliance on medical terminology may appear cold or distant; however, in the fevered debate over abortion, I believe scientific language provides the most accurate and neutral language available. @H1:Research Methodology @TEXTNO:The sources for this book are many and varied. Because it focuses on the accrual of abortion restrictions, I rely a good deal on legislative history and judicial decisions to document policy changes. For additional barriers to abortion procedures, I have relied on the input of the social movements themselves, which these days catalogue changes in abortion practices on their Web sites. I do not rely on a single ¿side¿ to document a trend or practice, but have looked broadly to verify claims. @TEXT:I also availed myself of the unusually large number of abortion providers living and practicing in my community of Portland, Oregon, a city with a strong tradition of abortion provision dating back to Ruth Barnett in the early twentieth century, as well as a more recent wave of anti-abortion activism. I spoke at length with seven providers, testing theories and asking questions about medical practices and trends. While their views cannot be characterized as representative of those of practitioners nationwide, particularly because they practice within a relatively permissive legal environment, their advice and information were invaluable to me, and their words in the following chapters give color and depth to a very human subject. Finally, newspapers, scholarly journals, and the many books on abortion-related political movements provided a consistently credible and informative set of sources. The influence of these materials is felt throughout this text. @H1:Maternal and Fetal Citizenship @TEXTNO:Through the cumulative effect of federal and state efforts to protect the fetus, the nation has eroded women¿s full inclusion in the very definition of citizenship, and has slowly developed a kind of fetal citizenship sure to undermine women¿s rights further. This conclusion is reached by traveling two parallel roads: first, that fetal citizenship rests on a compilation of affirmative fetal protections and abortion barriers, not on an unequivocal ban in the Constitution or from a federal statute. For while some pro-life activists once hoped for that sort of resolution, it remains distant and unfulfilled. More tenable, however, is the acquisition of fetal rights through a variety of protections and abortion regulations which, when viewed as a collection, provide a level of fetal protection not seen until now. @TEXT:Second, to realize fetal citizenship, and to appreciate the consequences to women¿s full citizenship, there needs to be an official definition of ¿citizen.¿ Justice Harry Blackmun concluded in his 1973 Roe v. Wade ruling that fetuses were not citizens because the Constitution refers only to born people as citizens. This observation, however, gives only a thin glimpse of the full meaning of the term. In its most basic form, citizenship bestows a set of rights and obligations onto individuals within a nation¿s borders. The basic, traditional features of political citizenship imply rights relative to the state: voting, serving on juries and in elected bodies, and inclusion in the military. Still, many scholars are quick to point out that there is a ¿wider setting of society¿s institutional and cultural traditions¿ that affects the definition of a citizen.45 British sociologist T.H. Marshall first called this extended form of belonging ¿social citizenship.¿46 Social citizenship ¿in its more general meaning [is] ¿citizenship¿ [that] refers to an individual¿s status as a full member of a particular political community.¿47 Feminist scholars have clearly demonstrated that women have historically been denied both proper political citizenship and the more loosely defined social citizenship. The social conditions for women before suffrage notwithstanding, the application of social citizenship can be seen today in abortion policy. As political science professor Ursula Vogel and others note, culture has a gendered notion of citizenship, and that gendered perspective often shapes the way citizenship is understood in society. Citizenship, as a relationship between the individual and government, is affected by government policies and preferences. A host of scholars have documented the ways in which public policy has created bifurcated citizenship: when policies treat people differently based upon their gender, the effect is different stacks of benefits, associations, and obligations for different people.48 Through different sets of public policies, ¿citizenship was rendered gender specific through a complex interplay of decisions by policymakers, institutional factors, political imperatives, and the unintended consequences of policy design which emerged in the course of implementation.¿49 Much of the literature in this area focuses on different treatment of women in the early twentieth century. However, some of this work clearly illuminates the ways in which early adoration of motherhood created a maternal citizenship: as a mother, a woman could receive greater support and rights under the law. Policies that regard a woman¿s role as mother as central to her societal contribution fundamentally linked full female citizenship with motherhood, laying a backdrop of citizenship against which abortion rests uncomfortably. Abortion relates to gendered citizenship in at least two ways. First, if female citizenship in this country is based on motherhood, women who end their pregnancies risk a social stigma that threatens their full experience as social citizens. Second, if policy barriers are erected specifically for women seeking to end their pregnancies, women are losing rights and facing an obligation to bear unwanted children. Without the ability to control their fertility in the way they choose, American women will find it difficult to embrace the other aspects of full citizenship: full-time employment, community service, civil service through jury duty and public office, and the list goes on. The connection between citizenship and abortion policy has therefore led feminist legal scholars to conclude that ¿[w]hen women are denied the sexual and reproductive autonomy of men, they are relegated to second-class citizenship.¿50 What, then, is the basis for fetal citizenship? As Justice Blackmun noted more than thirty years ago, all references to citizenship in the Constitution refer to a born person, implying that citizenship, and all the rights and obligations it entails, begins at birth. Pro-life activists posit, however, that the fetus is a developing, or potential, citizen, and as such is worthy of state protection on these grounds. Note that minors in this country have otherwise never enjoyed full citizenship, but rather have been considered ¿persons belonging to the community only through the representative agency of others.¿51 The law in the United States is founded on the notion of the individual, which poses a conceptual challenge in defining the citizenship of a pregnant woman and the citizenship of a fetus within the woman¿s body. Pregnancy challenges this notion, says political scientist Judith A. Baer, because during pregnancy two individuals ¿occupy the same space.¿52 How the interests of the mature female (and pregnant) citizen are weighed against those of the potential citizen reveals a great deal about American ideas about citizenship, as well as the role of religion and science in public policy. As I argue, the United States is gradually placing greater stock in the potential citizen than in the adult woman citizen through its abortion policies. @H1:Book Overview @TEXTNO:This book follows a simple path. In chapter 1, I offer the reader an overview of abortion facts: who has abortions, where, why, and when. I also discuss public opinion in order to provide a better understanding of how the nation regards the issue. Too many of these everyday facts have been obscured by political rhetoric to the point that many people are surprised to find that their preconceived notions about abortion rates do not match the facts. @TEXT:In chapter 2, I concentrate on the evolution of Supreme Court findings on abortion, which demonstrates a trend away from abortion rights, per se, given the judicial successes of the pro-life movement and development of legal protections for the fetus. Chapter 3 presents further evidence to support the argument that the pro-life movement has rolled back access to abortion by leveraging the full array of state-enacted abortion restrictions and practical barriers enacted over the last thirty years. In this regard, the pro-life strategy of using public opinion to affect and shape local legislation has been successful. I also demonstrate that the states have not ceded their role in social regulatory policy to any branch of the federal government, but rather are involved in an ongoing battle for regulatory control. In chapter 4, the full extent of recent federal abortion restrictions is considered, as well as the changes in the pro-life organizing strategy that made these restrictions possible. When chapters 3 and 4 are combined, the picture of fetal citizenship fully emerges. Chapter 5 explores the partisan dimension to these developments, explaining the uniting of the Republican Party and the pro-life movement. Democrats and pro-choice advocates, for their part, are increasingly defensive and unsure of their position. Recently, they seem unable even to defend all aspects of abortion access. Finally, in chapter 6 I consider the future of abortion politics, which will likely include further fetal protections, and ultimately, a political backlash from the medical, feminist, and religious communities. Each chapter is followed by resources meant to spark debate. Both the suggested additional readings and the discussion questions are intended to extend the puzzles and theories presented in the text. Additionally, there are three appendixes at the back of this book for further reference. Appendix A provides a description of pivotal judicial rulings regarding abortion. Appendix B shows the platforms of the national political parties in regard to abortion. Appendix C points the reader to a list of the nation¿s most significant abortion interest groups and their respective Web sites. I hope that readers of this book will take full advantage of the opportunity to ponder, argue, and challenge each other with meaningful debate through these resources. @H1:Discussion Questions @NL: 1. How did the concept of quickening affect early American views toward abortion? Why do you think this was the case? 2. How has the opinion of professionals in the medical field evolved toward abortion? How important should their voices be in the current debate? 3. Does the history of abortion in the United States pre-Roe resemble your preception of this historical era? How has this account changed your views on the issue? 4. What values do early abortion policies reflect about medical practices and religious beliefs? How have those values changed or remained the same in American culture? Are these changes for better or worse? 5. Are the hallmarks of early American abortion policy consistent with today¿s abortion policy? Should today¿s abortion policy be more or less consistent with historical abortion policy? Why or why not? 6. How did abortion policy become so restrictive in the mid-nineteenth century? Were these new restrictions appropriate for the times? Would they be appropriate today? Why or why not? 7. Has the strategy of the pro-life movement changed with time? If so, how? Are the changes making the movement more or less effective? What possible changes could be made in this movement in the future? 8. How is social regulatory policy unlike other forms of public policy? How well does abortion fit into the social regulatory policy category? Should abortion and slavery be in a separate policy category altogether? 9. What is the nature of American citizenship? How should it be defined? Should it be extended to the fetus, and if so, on what grounds? What would full fetal citizenship mean for women¿s citizenship? @H1:Suggested Reading @UL: Hunter, James Davison. Culture Wars: The Struggle to Define America. New York: BasicBooks, 1991. Irving, John. The Cider House Rules. New York: William Morrow and Company, 1985. Solinger, Rickie. Pregnancy and Power: A Short History of Reproductive Politics in America. New York: New York University Press, 2005. Tatalovich, Raymond, and Byron W. Daynes, eds. Moral Controversies in American Politics, 3rd ed. Armonk, N.Y.: M.E. Sharpe, 2004. Tribe, Laurence H. Abortion: The Clash of Absolutes. New York: W.W. Norton, 1990. @NH:Notes @NTEXT: 1. As Democratic senator from New York, Bill Clinton¿s wife Hilary Clinton would make a similar argument nearly a decade later, causing an upheaval within her own political party. More on this development is contained in chapter 5. 2. There are two very famous philosophical exegeses on abortion, written just before legalization. Although they are beyond the scope of this work, students might wish to study them. See Judith Jarvis Thomson, ¿A Defense of Abortion,¿ Philosophy and Public Affairs 1 no. 1 (Autumn 1971): 4766 and Michael Tooley, ¿Abortion and Infanticide,¿ Philosophy and Public Affairs 2, no. 1 (Autumn 1972): 3765. 3. My thanks to my friend and former student Tina Gentzkow, who pointed out the relevance of the ¿reasonableness doctrine¿ to abortion policy. 4. Connie Paige, The Right to Lifers: Who They Are, How They Operate, Where They Get Their Money (New York: Summit Books, 1983). 35. 5. Connecticut (1821), Ohio (1834), Indiana (1835), Missouri (1835), Arkansas (1837), Mississippi (1839), Iowa Territory (1839), Alabama (1840), and Maine (1840). 6. Kristin Luker, The Politics of Motherhood (Berkeley: University of California Press, 1984). 7. James C. Mohr, Abortion in America: The Origins and Evolution of National Policy, 18001900 (Oxford: Oxford University Press, 1978). 8. Rosalind Pollack Petcheskey, Abortion and Woman¿s Choice: The State, Sexuality, and Reproductive Freedom, rev. ed. (Boston: Northeastern University Press, 1990). 9. Rickie Solinger, The Abortionist: A Woman against the Law (Berkeley: University of California Press, 1994). 10. In recent years, several authors have documented the humane practice of safe abortions during the period in American history in which abortion was illegal. See, for instance, Carole E. Joffee, Doctors of Conscience: The Struggle to Provide Abortion before and after Roe v. Wade (Boston: Beacon Press, 1995) and Laura Kaplan, The Story of Jane: The Legendary Underground Feminist Abortion Service (Chicago: University of Chicago Press, 1997). 11. Rickie Solinger, Beggars and Choosers (New York: Hill and Wang, 2001), 38. 12. More will be said about the interesting partisan dimensions of abortion politics in chapter 5. It is an intriguing historical point to note that Ronald Reagan wrote an anti-abortion book during his presidency. This would seem to directly contradict his earlier actions as governor. See Ronald Reagan, Abortion and the Conscience of a Nation (Nashville, Tenn.: T. Nelson, 1984). 13. A brief history of the California abortion law is provided on California¿s Planned Parenthood Web site: www.ppacca.org/site/pp.asp?c=kuJYJeO4F&b=139490. 14. Ralph Reed is quick to point out that religious-populist stirrings historically have been felt most powerfully within the Democratic Party. See his book, Active Faith: How Christians Are Changing the Face of American Politics (New York: The Free Press, 1996). Allen D. Hertzke makes an interesting argument about the unique role that religious activism plays in American politics. Responding to Mancur Olson¿s work about political passivity, Hertzke notes that religious motivation can sometimes override the rationality of not participating in political movements. See Representing God in Washington: The Role of Religious Lobbies in the American Polity (Knoxville: University of Tennessee Press, 1988). 15. For an excellent argument about the variety of theological and political views within the Christian Right, see Harvey Cox, ¿The Warring Visions of the Religious Right,¿ Atlantic Monthly, November 1995, 5969. Also see James Davidson Hunter¿s book Culture Wars: The Struggle to Define America (New York: BasicBooks, 1991) for an illustration of the myriad issues that divide religious conservatives from religious liberals today. This work focuses more narrowly on the Christian Right, which is the most politically active segment of the movement in America emphasizing the Christian Coalition specifically, the most active, although not the largest, Christian Right organization today. 16. The ability of the Christian Right to cut across denominational lines is recent. Movement leaders have made explicit their intentions to increase the movement¿s force by welcoming a range of denominations. Others argue that the movement¿s potential is nonetheless thwarted by denominational disagreements. See for instance Duane M. Oldfield, ¿The Christian Right in the Presidential Nominating Process,¿ in In Pursuit of the White House, ed. William G. Mayer (Chatham, N.J.: Chatham House Publishers, 1996), 254282. 17. For those unfamiliar with the Scopes trial, it was a challenge to a Tennessee statute that forbade any instructor in a public school to teach evolution. 18. Both Kristin Luker and Sara Diamond have characterized those on either side of the abortion movement as having entirely different views regarding sex, marriage, and women¿s roles. The fundamental nature of this disagreement is in part responsible for the protracted nature of this debate and the inability of either side to compromise. See Kristin Luker, Abortion and the Politics of Motherhood (Berkeley: University of California Press, 1984) and Sara Diamond, Roads to Dominion: Right-Wing Movements and Political Power in the United States (New York: The Guilford Press, 1995). 19. Falwell comments on his earlier disavowal of political life in his book Strength for the Journey: An Autobiography (New York: Simon & Schuster, 1987). 20. Paige, The Right to Lifers. 21. This position is not universally held by practicing Catholics. See data in later chapters, and also Mary Fainsod Katzenstein, ¿Discursive Politics and Feminist Activism in the Catholic Church,¿ in Feminist Organization: Harvest of the New Women¿s Movement, ed. Myra Marx Ferree and Patricia Yancey Martin (Philadelphia: Temple University Press, 1995) and Mary C. Segers, ¿The Loyal Opposition: Catholics for a Free Choice,¿ in The Catholic Church and the Politics of Abortion--A View from the States, ed. Timothy A. Byrnes and Mary C. Segers (Boulder: Westview Press, 1992). 22. Paige, Right to Lifers. 23. Luker, Abortion and the Politics of Motherhood. 24. The entrance of the Catholic Church into abortion politics provoked the ire of liberal mainline Protestants and Jews, who immediately organized in opposition. In 1967, the Association of Reformed Rabbis and the New York unit of the United Synagogue of America led the charge, criticizing the church openly. Not long after, American Baptists, Southern Baptists, Southern Presbyterians, United Presbyterians, and the United Church of Christ issued similar statements, calling for greater sensitivity for women. See Paige, Right to Lifers. 25. Byrnes, ¿The Politics of Abortion: The Catholic Bishops.¿ 26. This work focuses on the role of the Christian Coalition, whose membership numbered more than 1.5 million Americans at the end of the twentieth century. Two other organizations, Concerned Women for America and Focus on the Family, also figure prominently in the movement, although their emphasis has thus far been far less focused on the political parties. 27. Reed, Active Faith, 120. 28. Ibid, 188. This theme is echoed in William Kristol¿s arguments regarding abortion strategy. See Fred Barnes, ¿Try Again,¿ New Republic, June 13, 1994, 910. 29. Rob Eure, ¿Some Coalition Members Look beyond ¿Family Values¿,¿ The Ledger-Standard (Norfolk, Virginia), September 11, 1992. 30. Reed, Active Faith, 189. 31. Ibid., 132. 32. Mark J. Rozell and Clyde Wilcox, ¿Second Coming: The Strategies of the New Christian Right,¿ Political Science Quarterly 111 (Summer 1996): 274; Second Coming: The New Christian Right in Virginia Politics (Baltimore: Johns Hopkins University Press, 1996), for a book-length analysis of the movement¿s efforts in the state of Virginia; and, for a comparative state-by-state analysis of Christian Right efforts, God at the Grassroots: The Christian Right in the 1994 Elections (Lanham, Md.: Rowman and Littlefield Publishers, 1995). 33. Reed, Active Faith, 128. 34. In response, some progressive women¿s organizations have begun grassroots efforts of their own. See Cheryl Hyde, ¿Feminist Social Movement Organizations Survive the New Right,¿ Feminist Organizations: Harvest of the New Women¿s Movement, ed. Myra Marx Ferree and Patricia Yancey Martin (Philadelphia: Temple University Press, 1995). 35. William M. Lunch, The Nationalization of American Politics (Berkeley: University of California Press, 1987). 36. See, for instance, Kenneth J. Meier, The Politics of Sin and Christopher Z. Mooney and Mei-Hsien Lee, ¿Legislating Morality in the American States: The Case of Pre-RoeAbortion Regulation Reform,¿ American Journal of Political Science 39, no. 3: 599627. 37. Joffee Doctors of Conscience. 38. Robert J. Spitzer, The Politics of Gun Control, 3rd ed. (Washington, D.C.: CQ Press, 2004). 39. There is an ongoing debate between those like Lowi, who believe that social regulatory policy is a subset of traditional regulatory policy, and Tatalovich and Daynes, who argue that those categories are distinct. 40. Theodore J. Lowi, ¿American Business, Public Policy, Case Studies, and Political Theory,¿ World Politics 16, no. 4: 677715 and Theodore J. Lowi, ¿Four Systems of Policy, Politics, and Choice,¿ Public Administration Review 32, no. 4: 298310. 41. Raymond Tatalovich and Byron W. Daynes, eds., Moral Controversies in American Politics (Armonk, N.Y.: M.E. Sharpe, 2004). 42. Kenneth J. Meier, The Politics of Sin: Drugs, Alcohol and Public Policy (Armonk, N.Y.: M.E. Sharpe, 1994), 246247. 43. James Davison Hunter, Culture Wars and Before the Shooting Begins: Searching for Democracy in America¿s Culture Wars (New York: The Free Press, 1994). 44. Laurence H. Tribe, Abortion: The Clash of Absolutes (New York: W.W. Norton, 1990). 45. T.H. Marshall, quoted on page xi by Ursula Vogel and Michael Moran, introduction to The Frontiers of Citizenship, ed. Ursula Vogel and Michael Moran (New York: St. Martin¿s Press, 1991). 46. T.H. Marshall, ¿Citizenship and Social Class,¿ in Class, Citizenship, and Social Development, (Westport, Conn.: Greenwood Press, 1964), 65122. 47. Ursula Vogel, ¿Is Citizenship Gender-Specific?¿ in The Frontiers of Citizenship, 62. 48. See, in particular, Theda Skocpol, Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States (Cambridge: Harvard University Press, 1992); Gwendolyn Mink, The Wages of Motherhood: Inequality in the Welfare State, 19171942 (Ithaca, N.Y.: Cornell University Press, 1995); Suzanne Mettler, Dividing Citizenships: Gender and Federalism in New Deal Public Policy (Ithaca, N.Y.: Cornell University Press, 1998); and Linda Kerber, No Constitutional Right to Be Ladies: Women and the Obligations of Citizenship (New York: Hill and Wang, 1999). 49. Suzanne Mettler, Dividing Citizenships, xii. 50. Joan Hoff, Law, Gender, and Injustice: A Legal History of U.S. Women (New York: New York University Press, 1991), 315. 51. Michael Moran, ¿The Frontiers of Social Citizenship: The Case of Health Care Entitlements,¿ in The Frontiers of Citizenship, 62. 52. Judith A. Baer, ed., Women in American Law: The Struggle toward Equality from the New Deal to the Present (New York: Holmes and Meier, 2002), 171.
Library of Congress Subject Headings for this publication:
Abortion -- United States.
Abortion -- Law and legislation -- United States.
Abortion -- Political aspects -- United States.