Issues and Views

Barriers to Reproductive Services

Definition

A barrier to a woman’s reproductive rights is any obstacle that prevents her from obtaining the services she wants and needs upon her demand. Since legalization of abortion in the US in 1973, different sectors of the Right have employed dual strategies to limit a woman’s access to reproductive health services—the Right has aimed at criminalizing abortion in the long run, while working to decrease access to abortion and other reproductive services immediately. Today, lack of funding, restrictive legislation, and campaigns of terror and violence by the antiabortion movement have severely eroded reproductive rights. The Right’s deliberate efforts to curtail women’s reproductive rights have resulted in major barriers to access for women seeking reproductive health services, especially for low-income women and women of color. These barriers fall into six major categories:

  • Access to Contraception
  • Violence and Intimidation
  • Economic Barriers
  • Legislative Barriers
  • Abortion Provider Shortages
  • Hospital Mergers

Since Roe v. Wade, abortion access has been under attack from many different sectors of the Right. Violence and intimidation as well as hospital mergers and other factors have resulted in a shortage of abortion providers. This shortage results in fewer hospitals providing abortion services, thus severely limiting access to many women.

These barriers to access affect everyone, but often women from rural areas and low-income women are the hardest hit by these restrictions. It is crucial to continue to challenge these barriers to access, and to recognize that the ultimate goal of the anti-abortion Right is to outlaw all abortion.

Through harassment and violence directed at doctors and other health care providers, antichoice forces have discouraged both the teaching and provision of abortions. According to a 1998 study published by the Alan Guttmacher Institute, abortion services are declining precipitously across the country. Anti-choice efforts have radically diminished the number of hospitals and individual providers offering abortion services, leaving 86 percent of US counties without an abortion provider. Twenty-five percent of women seeking abortions travel at least 50 miles from home to obtain them, and some women travel hundreds of miles. Few OB/GYN residency programs require training in abortion procedures. Almost no family practice physicians have access to abortion training as part of their OB/GYN rotations. According to the Abortion Access Project, laws in 44 states prohibit mid-level providers (nurse-midwives, physician assistants and nurse practitioners) from performing abortions. As a result, a dangerous shortage of training and abortion services threatens access to abortion for many women, especially lowincome, immigrant, rural, and young women.

Access to Contraception

Like many health-care services for women, not all contraceptive drugs, devices and medical services are available to all women. Following the 1994 election, which gave social conservatives a majority in the US House of Representatives for the first time in 40 years, conservatives and leaders of the anti-abortion movement began to campaign openly against government-subsidized family planning programs.

What the Right Says About Contraception

Many sectors of the religious Right have a fundamentalist worldview in which sex is for procreation. Therefore they seek to limit women and men’s access to contraception.

For instance, the Catholic Church maintains strict policies prohibiting artificial contraception, abortion, and other chemical, surgical and barrier methods of reproductive technologies that go against church doctrine. For the Church, access to condoms, even for STD and HIV prevention, encourages higher rates of sex outside marriage, especially among youth. It believes that this practice must be condemned and that limiting access to contraception prevents sex outside of marriage. For such groups, it is acceptable to limit insurance coverage or the use of public funds for contraception as well, because in their eyes, many women use contraceptives in order to engage in promiscuous sexual activity.

Response

All men and women have a right to control their own reproductive health, which includes access to voluntary contraception.

Common sense still leads most people to the conclusion that more effective contraception means fewer abortions—and research results point to that conclusion as well. Individual women who use an effective method of contraception are much less likely to face an unintended pregnancy and the decision of whether to have an abortion than women who do not. Similarly, the advent of high-quality contraceptive services, both in the United States and elsewhere, has been shown over time to be associated with lower levels of abortion.

As more and more couples feel strongly about limiting the number of children they have, and about having those children when they want them, the demand for contraception will be great; in its absence or in the event of its failure, so will the demand for abortion. The choice for societies is whether to facilitate access to contraception or to leave women and their families with abortion, legal or not, as the only means of achieving their childbearing goals.

Contraception, even under the best of circumstances, cannot end the need for abortion entirely. Contraceptive methods will never be perfect, and women and men will never be perfect users of them. What common sense and research show, however, is that the most effective means of reducing abortion is preventing unintended pregnancies in the first place. No serious effort to achieve this end, and thus reduce abortion, can succeed without contraception.

Violence and Intimidation

Abortion providers and individuals seeking abortion services are often harassed and intimidated at the clinic site. These acts include death threats, stalking, attacks with chemicals, arson, bomb threats, invasions, and blockades. While some abortion opponents behave in a non-violent manner, and publicly denounce violence against providers (while still asserting that abortion is killing), members of the hard-Right anti-abortion movement sometimes have different views. For this sector of the Right, abortion represents the mass murders of millions of innocent babies; in this world-view, violence against clinics and providers is the most fitting way to stop the killing.

What the Right says About Violence and Intimidation

According to many anti-choice leaders, abortion is in itself a violent act, equivalent to murder. Their reasoning suggests that since abortion is still legal in this country, it is up to people of conscience to intervene to do whatever they can to prevent abortions from taking place. Clinics and abortion providers are the targets for these interventions. While some clinic protest groups may stop short of admitting they condone physical violence, they use a variety of tactics to prevent women from obtaining abortions from verbal harassment to mass demonstrations blocking clinic entrances. Many of these actions have erupted into more violent outbursts.

The Army of God Manual, an anonymously published hard-Right instructional booklet for extremist anti-abortion activity, encourages activists to use a variety of methods, everything from gluing the locks of a clinic shut to sacrificial bombings, to end abortions. Practitioners justify these methods as acceptable, because abortion must be stopped by any means available. According to the manual,

The reason that things like bombs and arson techniques are relegated to the Appendix of this manual is not because they are wrong or ineffective. On the contrary, those methods are powerful, appropriate.... The difficulty is cost, i.e., charges, jail time, etc....So other tactics can be very effective when used over and over, and carry minimal risk. If some soul can't rest until a hundred abortuaries go up in smoke, fine. But at least they should use time delays and take them out all at once. Then lay very low for a very long time. Love is patient. Never even give in to the temptation to go back to see the results, or share the secret with anyone.

Even if such acts are illegal under the law, advocates holding this perspective claim a higher calling to God’s Law that they are obligated to obey. Individuals imprisoned for arson or murder are described as victims of an unjust system that persecutes people who act on their consciences.

Other anti-choice groups attempt to distance themselves from such tactics, claiming an antiviolence stance. They feel their “pro-life” position calls for consistency, and that means stopping short of activity that threatens life.

Response

Violence in any form is inappropriate—verbal, emotional, and physical harassment is wrong, no matter what the reason. Women have a right to decide when and whether to have children. And women have the right to determine their own sexual and reproductive lives. It is illegal and dangerous to resort to intimidation, harassment and violence as a way to express one’s views, especially claiming that the tactics used protect women and children.

Many organizations provide clinic defense and support for women seeking reproductive health services and providers. While many anti-choice groups condemn violence, they also use protest language that is so powerful it can encourage more extremist opponents of abortion to act illegally. Increased rhetoric from the Right is linked to increased violence from the hard-Right against clinics and providers.

Economic Barriers

Many women who need abortion and other reproductive services cannot afford them. Every year since 1977, Congress has passed the Hyde Amendment, which prohibits federal Medicaid funds to pay for abortions except in cases of life endangerment of the pregnant woman. Currently only 14 states allow the use of state Medicaid to fund abortions in all or most circumstances. In addition to the cost of reproductive services, women also must pay for related costs such as transportation and childcare, as well as the cost of lost time at work. Economic barriers also involve lack of support and resources, such as the removal of abortion services from health programs and health insurance for government workers and the military or the elimination of contraceptive coverage from many insurance plans.

What the Right Says About Economic Barriers

Some anti-choice leaders oppose spending taxpayers’ dollars on reproductive services, from family planning and contraceptives to abortion. They claim they do not want to participate in supporting a woman’s decision to choose an abortion, and they assert that it is their democratic right to express their opinion and exercise their influence over public policy. For some this includes opposing the use of US funds in population and family planning programs abroad as well as in the US.

Response

All people have the right to the highest attainable standard of physical and mental health, and for women, this includes reproductive and sexual health. In fact, access to affordable and appropriate contraceptive and reproductive services is a cornerstone of women’s health. Yet many women continue to be left without the ability to choose from the full range of contraceptive drugs, devices, and medical services because of a deliberate campaign by anti-abortion forces. As a result, the health and well-being of women and families continues to suffer due to preventable unintended pregnancies, poor birth outcomes, decreased educational or work opportunities, and inconsistent or inappropriate medical care.

Cutting public funding for reproductive services punishes not just low-income women but also those who rely on government-provided health insurance and medical services as well, creating an unfair system of access. This piecemeal method of denying access to services through a variety of restrictive policies is wrong, especially given the fact that the majority of people in the US continue to support women’s access to reproductive services.

Legislative Barriers

Since Roe v. Wade, many legislative policies have been created that inhibit or forbid a woman’s access to reproductive health services upon her demand and/or her access to information regarding her reproductive health or services available to her. Restrictive legislation has been passed on the state level, ranging from parental notification laws to mandatory waiting periods.

These laws restrict the reproductive rights of low-income women and women living in rural areas who must travel a long distance to an abortion clinic. In addition, these laws further the difficulties of at-risk young women who may be pregnant as the result of coercive sex, or who are facing abusive family situations.

Politicians, not doctors, write these laws, so the language used is often imprecise. This creates a situation where doctors and judges can have different interpretations of what procedures are legal. Some anti-abortion organizations run campaigns against doctors who perform abortions by initiating malpractice suits.

What the Right Says About Legislative Barriers

Anti-choice leaders have said that as long as abortion remains legal, they have a moral imperative to educate and inform the public about its dangers and to protect them from making the wrong decisions. They say we must build structures of accountability into the decision-making process. For instance, parents are responsible for their children’s welfare, and if a daughter becomes pregnant, her parents must be involved in her pregnancy and the future of her baby. Another example they use is the need for a structure to ensure that women reflect carefully on their situations if they are considering abortion, especially in the light of the significant risks involved. Finally, they assert that we must protect women from unscrupulous abortionists who may harm them physically and leave them emotionally scarred.

Response

Parental notification, mandatory waiting periods and abortion provider malpractice suits are not designed to protect women; they are all indirect, but effective, methods of preventing women from getting abortions.

The goal of parental notification laws is not to improve communication between parents and children. A majority of pregnant teens do tell at least one parent. But evidence suggests that requiring parental permission or its legal alternative, an appearance before a judge, effectively denies many adolescent girls access to abortions. In some cases, these laws can create dangerous situations for women who may have legitimate fears about telling parents due to past experiences at home that may include violence, substance use, sexual, or emotional abuse. Minors make up almost half of the most common age group of women seeking abortions, which is women under 25, and these laws target them.

Mandatory waiting periods prohibit a woman from obtaining an abortion for a certain arbitrary time period and may prevent her from getting an abortion at all. Often she is required to receive material about pregnancy, adoption options and abortion risks. Women traveling long distances to clinics may wait days away from home at added expense. The longer a woman delays her decision, especially into the second trimester, the more likely it is that she will not have an abortion, due to reduced numbers of facilities that offer the service and its added expense. This inflicts a disproportionate burden on younger, poorer, more rural and less educated women who make up a larger percentage of late-term abortion recipients.

Malpractice suits against abortion providers are usually frivolous; that is, they are not designed in good faith to protect women. Rather, they are filed with the purpose of harassing an abortion clinic and of creating disruptions, financial stress, and bad publicity. Along with clinic violence, they have resulted in increased insurance costs for abortion providers and their facilities, sometimes putting a clinic out of business altogether. Mark Crutcher, a proponent of such suits, considers any clinic closure a victory, not for women’s health but for the cause of ending abortions.

A number of activist pro-choice organizations work on limiting these restrictions. Some work through the courts, while others oppose restrictive legislation. Since some of the promoters of restrictive legislation are faith-based, it can be helpful to work with local and national faithbased organizations that support reproductive rights and diversity on the issues surrounding reproductive freedom.

Provider Shortages

There is a severe shortage of abortion providers in the United States. According to the Alan Guttmacher Institute, “The number of abortion providers declined by 8% from 1988 to 1992. 84% of all US counties lacked an abortion provider in 1992. (By their 1998 report, the figure rose to 96%). These counties were home to 30% of all 15 to 44-year-old women.”

Medical schools have also been affected by the increasing influence of abortion opponents and many have removed reproductive health, specifically abortion, from their curricula. Some institutions are staffed by faculty who actively discourage students from practicing abortions. As older abortion providers retire, new physicians cannot replace them because they lack the skills.

Individual physicians are not the only providers affected; hospitals also have become more reluctant to provide abortion services for fear of picketing, vandalism, and other violence, which plague clinics. According to the National Abortion Federation only about 36% of hospitals offer abortion services. As a result, many medical students in residency are unable to receive training at hospitals on how to perform abortions.

What the Right Says About Provider Shortages

Some anti-choice spokespeople, like Mark Crutcher of Life Dynamics, argue that reducing the number of abortion providers will protect women from unscrupulous “abortionists” who are reviled by the rest of the medical profession. Opponents claim that abortionists are often unskilled doctors who cannot get more attractive job offers. They are reduced to charging high fees and taking advantage of women at their most vulnerable moments. Medical students should avoid considering becoming an abortionist, a specialty with low status and high risk.

Doctors trained to perform abortions may work in settings where they are not allowed to do them, such as a Catholic hospital. Anti-choice advocates argue that even if a doctor does not personally oppose abortion, he or she has a professional obligation to comply with an employer’s policies. Such an individual has freedom to choose where to work, and if they disagree with the hospital’s rules, they can go elsewhere.

Response

Medical students do not steer away from becoming abortion providers because they are worried about their image in the profession. Fewer doctors are becoming abortion providers because there is little opportunity to become trained in the procedures. Furthermore, they are being intimidated by clinic violence and the potential for being sued for malpractice by antichoice activists.

Becoming an abortion provider means taking a very visible stand on one of the most emotional and volatile topics in the United States. Abortion providers continue to be the targets of kidnapping, stalking, picketing, assault and murder.

In response to limited access to information and training in medical school, students have formed organizations such as Medical Students For Choice. This organization and its chapters are actively challenging the lack of training in reproductive services.

Hospital mergers are being monitored and opposed by a number of organizations. Faith-based organizations, such as Catholics For a Free Choice are involved in organizing against Catholic hospital mergers and exploring the implications for reproductive freedom.

Hospital Mergers

Mergers, joint ventures, and affiliations have become common between hospitals that are faltering financially and hospitals that are wealthier and usually religiously-controlled. Often, the religious hospital is Catholic, as the Catholic health-care system is the largest single private sector health care provider in the US; it continues to grow in size and strength. This poses a major threat to the availability of reproductive health services. In the process of such mergers, the policy of the religious hospital usually prevails under an amendment to Roe v. Wade, called the “conscience clause,” which gives an individual or an institution the right to refuse to provide any service on the grounds of religious beliefs or moral convictions.

According to the Abortion Access Project, there has been an acceleration in the rate of hospital mergers in the last fifteen years. When these mergers include Catholic or other religious institutions, women’s access to comprehensive reproductive health services is often dramatically curtailed or eliminated. The largest number of secular/religious hospital mergers has involved Catholic hospitals.

Catholic hospitals are governed by the Ethical and Religious Directives for Catholic Health Care. Under the Directives, Catholic hospitals will not provide contraception, sterilization, most infertility treatments, condom distribution for AIDS prevention, or abortion services. Living wills are also not honored. When a Catholic hospital merges with another hospital, the non-sectarian hospital must abide by the conditions laid out in the Directives, in effect becoming a Catholic facility itself. In such circumstances, the non-sectarian partner in the new affiliation—whether or not it previously provided abortions or abortion referrals—generally can no longer provide these services.

Nationally, Catholic health-care systems control over 600 hospitals.

What the Right Says About Hospital Mergers

The Catholic Health Association of America, which advocates for Catholic health-care systems, explains that changes in market forces have forced Catholic hospitals to merge for fiscal reasons. It says that despite large-scale adjustments in the organizational structure of healthcare delivery, including shifts in Medicare and Medicaid funding, Catholic hospitals must continue to follow the dictates of the Catholic Church and have the right to do so as part of their freedom of religious expression. The Association further argues that it is vital to the future of Catholic hospitals that they continue to be able to exercise a conscience clause in service delivery. Also, mergers with other-than-Catholic health-care organizations have the potential to provide services to the poor that would otherwise lessen or disappear.

Response

Hospitals are a critical part of providing abortion access and related services to all women. However, many hospitals are failing to offer this vital health-care service. As a result, it is difficult for rural and low-income women to get the abortion services that they need, and the responsibility for caring for these women falls disproportionately on a few urban hospitals that are committed to abortion care. Too many hospitals do not even provide the most minimal service to women seeking abortions, namely, respectful and accurate referrals. Furthermore, the failure of hospitals to offer abortion services means that many family practices and OB/GYN residents working in these locations do not have the opportunity to learn how to perform abortions.

Hospitals have an obligation to meet the health care needs of the women in their communities. Hospitals must make a commitment to providing comprehensive reproductive health care to the women they serve. Medical residency programs must require OB/GYN residents to learn to perform abortions. Likewise, residents in other specialties such as family practice or adolescent medicine must be given the opportunity to train if they want to integrate abortion services and other reproductive services, such as appropriate information about contraception, into their practices. The dangerous trend of decreasing hospital-based abortion services and the decrease in abortion training must be reversed if women are going to have the option to exercise their legal right to abortion.

Abortion as Violence

Definition

The anti-choice movement may be made up of diverse sectors, but it has a clear, common goal: to ban all abortions, of any kind, at any stage of a woman’s pregnancy. Individual anti-choice strategies may appear to be less absolute, but such apparent compromises are only part of a larger comprehensive strategy of eradicating legal protection for abortion in this country and prohibiting the use of US funds for abortions and family planning organizations abroad. Combining religious belief and savvy political acumen, the anti-choice movement has remained true to this goal. Opposition to abortion has been the Right’s largest fundraiser and the greatest movement-builder in this country since Prohibition. And a candidate’s stance on abortion remains a litmus test for many voters across the political spectrum.

How the Right frames the debate, uses the issue, and crafts its strategies warrants close scrutiny by pro-choice activists who seek some understanding of the patterns and trends that highlight the anti-choice agenda.

Anti-abortion activists have consistently framed abortion as violence against the “unborn child.” The filmmakers of “The Silent Scream” wanted to shock the public with evidence that a standard abortion like the kind done every day in this country is a disturbingly violent procedure. Claiming that abortion causes a painful death to the fetus, they described abortion as a repugnant, immoral act.

A central feature of the religious right’s “frame” for abortion is that human life begins at conception. To many of those who hold this belief, embryos and fetuses are defined as people even though they have not been born. Others in the anti-choice movement may see a fetus as a living organism, but may not be certain of its status. Yet the leadership of the Christian Right consistently uses the arbitrary benchmark of conception as a useful tool to persuade individuals that abortion is not only violent; it is murder.

Many followers of the Christian Right embrace the equation Abortion = Murder as a deeply held personal belief. The anti-choice movement has relentlessly promoted the idea that abortion is taking the life of a child. For those who believe abortion should be stopped, lobbying in the political arena through campaigning, voting and writing elected officials are appropriate responses. For those who see abortion as inherently immoral, despite its current protection under Roe, their conscience may require something more radical, such as direct action, either non-violent or violent. The language of some more militant anti-choice leaders encourages their followers to consider abortion as murder and then to decide what are the right steps to take. Randall Terry of Operation Rescue has said, “If you think abortion is murder, then act like it.” This theme of abortion as violence appears consistently throughout the Right’s discussion of abortion.

"Partial-Birth Abortion"

The Right claims that “partial-birth abortion” causes the death of an unborn or “partiallyborn” child. Opponents have used their own graphic illustrations of an abortion procedure, Dilation and Extraction, and accompanied them with sensational language, claiming the procedure is the ultimate gruesome evidence that “partial-birth abortions” must be outlawed. They claim that the procedure is “outright infanticide.” In addition they represent pregnant women who seek such abortions as selfish and irresponsible—weak women who are exploited by ruthless abortion providers often referred to contemptuously as “abortionists” or “murderers.”

Efforts to ban “partial-birth abortions” have resulted in restrictive laws passed in 31 states. Many of these statutes use language that in its lack of clarity would outlaw more abortions than just the Dilation and Extraction procedure. In June 2000, The Supreme Court ruled in a 5-4 decision, Stenberg v. Carhart, that such a Nebraska law is unconstitutional. Because most of the states used language similar to Nebraska’s law, these laws are now unconstitutional as well. While this case ends a chapter in one of the most visible anti-choice campaigns of the 1990’s, the issue will undoubtedly continue to resurface, because the claim that “partial-birth abortion” is violent has been so successful.

What the Right Says About “Partial-birth Abortion”

Anti-choice activists call “partial-birth abortion” the most heinous example of a practice that kills millions of unborn children in the United States every year. Because this particular practice occurs late in a pregnancy, they say, the baby is developed enough to live outside the womb. To them this makes the mother and abortionist guilty of infanticide, since the baby is actually “partially born” and then killed. The only appropriate response to a partial-birth abortion is to acknowledge it is a crime and to outlaw it.

Response

So-called “partial-birth abortion” is a fabricated term designed to mislead the public. On the surface the language appears to prohibit only abortions performed late in a pregnancy. But ambiguity in the meaning of a key phrase often used in state bills, “partially vaginally delivering a living fetus,” gives the bill the potential of outlawing most abortions, since most abortions are performed vaginally.

Since the early 1990’s, the anti-choice movement has consistently used the issue of “partialbirth abortion” as a central part of its debate about abortion in general. In reality, leaders of the anti-abortion movement want not only a ban on abortions late in a pregnancy but also a complete ban on all abortions.

The so-called “partial-birth abortion” campaign needs to be challenged for its intent and its misleading formulations. By focusing on the fetus, it places a higher value on the fetus than it does on the physical and mental health of a pregnant woman. Its shock effect desensitizes the public and our legislatures and courts to the tactics of the Right, and it is one more link in a chain of attempts to wipe out the protections guaranteed by Roe. With this campaign, the antichoice movement has moved the discussion away from arguing that life begins at conception (the focus of attempts to pass the Human Life Amendment in the 1980’s). Instead this is now assumed, and the focus shifts to the violence of “partial-birth abortions” and a campaign for their illegality. This formulation makes the idea that abortion is murder more acceptable to a larger audience and, if unchecked, will lead to further restrictions on a woman’s right to reproductive freedom.

The "Abortion Holocaust"

Many anti-abortion advocates believe that abortion is murder. To them the phenomenon of abortion in the US since 1973 is actually a kind of mass murder so huge that it constitutes a holocaust. When anti-choice spokespeople use this term, they conjure up an image of the Nazi Holocaust. We are expected to associate the German government’s sanction of the murder of millions of Jews and others with the US government’s protection of abortion providers and their female patients who, in the eyes of anti-choice activists, have murdered millions of unborn children.

What the Right Says About Abortion as Holocaust

The Right argues that millions of murders have occurred because of Roe v. Wade since 1973. This holocaust must be stopped. The Nazi Holocaust required a huge effort on the part of many thousands of people to overthrow it. So, too, will it take a similar fight to eradicate the evil of abortion.

Response

The term “holocaust” is designed to create an emotional reaction. It brings up images of horror in Nazi Germany and the holocaust that occurred in Europe over 50 years ago.

Using the word “holocaust” also serves at least two functions. This framing of abortion implies that opposing abortion is morally right. And associating abortion with a holocaust allows followers to feel they are doing the right thing as Christians.

“Abortion as holocaust” also conjures up Nazi eugenics experiments, conducted by Nazi scientists in a quest for a “purer” race. Anti-choice activists will sometimes claim that abortion is used by women as a kind of personal eugenics—that a woman will use it to determine whether her child will live based on its gender or potential birth defects. Since eugenics is an unpopular concept except to far-Right groups such as the White Aryan Resistance, this language may attract more mainstream support for anti-choice activities.

A significant minority of anti-choice activists believes that the massive violence they see resulting from abortion deserves an equally strong response, perhaps a similarly aggressive one. While they argue that it is because abortion is murder that they are justified to act, responding with acts of violence may have developed for some out of a frustration with what they saw as the slow pace of anti-choice progress.

It could be that it is not just their repugnance for abortion that motivates perpetrators of violence, but a desperation incited by past defeats. Any abortion clinic that remains open is a symbol that they have not yet reached their goal: the eradication of all abortions. This kind of absolutist thinking helps to simplify the way some on the far Right see abortion, but it makes it difficult for the same eyes to recognize how much they have gained in rolling back the rights protected in the Roe decision.

Abortion as a Medical Hazard

Definition

Many anti-choice groups have begun to claim that abortion should be outlawed, severely restricted or otherwise discredited because it is too dangerous. They assert that the abortion procedure itself has serious safety problems: that abortion providers do not maintain high standards in their clinics, and that abortion is linked to, or actually causes, illnesses ranging from depression to breast cancer. This shift in focus to an apparent concern for the well-being of women makes it seem that one can hold anti-choice beliefs and have the interests of women in mind. The fetus is no longer the only focus of the debate. Now, the Right wants us to think it is possible to be against abortion and to be in support of women at the same time.

Anti-choice advocates interpret scientific studies to support their assertion that abortion is dangerous to women and use them to support a call for the abolition of abortion. In reality, their use of this information is misleading. They are driven by an agenda that uses a political goal to exploit the complexity and technical nature of scientific research.

This campaign to discredit abortion as a medical procedure also seeks to demonize abortion providers by accusing them of being irresponsible, incompetent and/or greedy. Thus abortion becomes dangerous because it is practiced by dangerous men.

What the Right Says About the Medical Hazards of Abortion

Many anti-choice groups seek to represent abortion as a procedure that carries serious physical and psychological risks. They claim that abortion is more risky than most people believe, asserting that a single abortion may result in severe infection, intense pain, long-term gynecological problems, permanent infertility or even death. Multiple abortions, they say, create even more risks. Claiming that many abortion providers do not inform women fully of these risks, some anti-choice advocates encourage women to file malpractice claims against abortion providers. Some suggest that patient consent forms are invalid if signed without full disclosure of the risks involved, with risks defined by the anti-abortion movement.

Some groups have said that abortion can also be risky at a clinic, the location where most abortions take place. Anti-choice advocates have charged that abortion practitioners care less for their patients and are less committed to them than a woman’s primary care provider, because most abortions take place at privately run clinics. “The doctor performing the abortion is likely to be a stranger of whose skill and experience a woman knows very little,” warns the National Right to Life Committee.

Response

Legal abortion is one of safest types of surgery. A first trimester abortion is associated with fewer and less serious health risks than many other common medical procedures, including childbirth. Some pro-choice advocates have said that the most dangerous part of the abortion experience for many women is struggling past anti-abortion protesters at clinic doorways. The claims that abortion clinics practice under standards that are lower than the medical industry in general are false. Isolated incidents of individuals who have, in fact, experienced medical complications are touted as evidence of widespread incompetence on the part of practitioners. Many pro-choice organizations provide more objective information about the actual level of risk for infection and other potential medical complications.

Representing abortion as a risky medical procedure is designed to frighten women from seeking abortions. Since choosing to have an abortion is a legal option, this tactic is focused on deterring a woman from making such a choice. These scare tactics are based on inaccurate or unscientific interpretations of existing studies. Much of the public health and medical literature cannot be interpreted easily by people not trained in these fields, and much of the “evidence” presented by pro-life groups is unsubstantiated.

Statistics about complications from abortions are often misused, exaggerated or even invented by the Right. Often a risk is mentioned without indicating its actual level; while it is true that women have died as a result of complications associated with abortion, the rate of death is ten times less than the rate associated with childbirth. Another common practice is to dispute the accuracy of government statistics, especially those from the US Health Service and the Centers for Disease Control and Prevention. Yet another is to quote material from pro-choice publications out of context or in a way not intended by its authors. All these approaches are designed to discredit the source, and they do not, as the organizations claim, provide accurate information to women seeking the truth about abortion.

Some pro-life organizations initiate malpractice suits against abortion providers in an attempt to disrupt abortion clinics. While these actions are usually frivolous, they nevertheless succeed in affecting a clinic’s financial health and its reputation. Often the suits focus not on anything the clinic did, but what it allegedly failed to do. For instance, groups will claim that the provider did not adequately inform a woman of all the risks associated with abortion, even though many of these risks have been fabricated. Then they charge that the clinic failed to inform the patient of these risks as they define them.

What the Right Says About Abortion and Breast Cancer

Several pro-life groups claim that strong scientific evidence exists for a causal link between abortion and breast cancer. They also imply that because the rapid rise of breast cancer in this country coincided with the legalization of abortion in 1973, there is added evidence for a causal connection. Calling on the analysis of multiple journal articles and studies, various groups have published materials that assert that first trimester abortions, abortions for older Black women or for younger women in general all place women at higher risk for breast cancer.

Response

Breast cancer is a serious health concern for women, and many cancer researchers are studying its causes. The Right associates the high interest and emotional value of the breast cancer epidemic with abortion as another device to scare women.

Multiple studies have been published that examine the relationship between abortion and breast cancer; many of these studies contradict each other. In reality, the variety of methodolo-gies researchers have used contributes to a range of results. Pro-life groups claim the studies that show a link are more credible than those that do not. They also imply that a “link,” a technical term used by public health and medical researchers to describe a broadly defined relationship, means that the connection between abortion and breast cancer is causal, that is, that abortion can cause breast cancer. No study has conclusively shown this, and some have concluded there is no link. Several pro-choice groups have published materials that help women interpret the results of this research. (See the “Selected List of National Organizations Supporting Reproductive Rights” for some sources.)

What the Right Says About Abortion, Depression and “Post-Abortion Syndrome”

Many in the Right claim that abortion can produce serious psychological harm in some women. They have labeled this collection of reactions “Post-Abortion Syndrome” or PAS. “Women who report negative after-effects from abortion know exactly what their problem is,” the psychologist Wanda Franz testified before Congress in 1989. “When they are reminded of the abortion, the women re-experienced it with terrible psychological pain....They feel worthless and victimized because they failed at the most natural of human activities—the role of being a mother.”

The anti-choice movement has created support organizations for post-abortion women in response to their claim that the psychological effects of abortion are profound. Even men, they say, can experience trauma as the result of their wives’ abortion experience, and they need support, too. According to these organizations, the after-effects of an abortion can include: guilt, depression, flashbacks, eating disorders, sexual promiscuity, increased bitterness towards men, and “overcompensation in a career.”

Response

While it is understandable that some women experience conflict over the decision to have an abortion, credible psychological research does not support the existence of PAS as a diagnostic condition. Much of the guilt some women experience after an abortion may indeed reflect society’s expectations of women of childbearing age, but those norms are being heavily reinforced by the Right’s traditional family values movement itself. A study published by the American Psychological Association in 1997 found no increased incidence in post-abortion distress. In fact, the best predictor of well-being for a post-abortion woman was her level of well-being before the abortion.

The anti-choice movement often calls on sympathetic researchers to present claims as science. Wanda Franz, for instance, the psychologist who testified before Congress in 1989, was invited to do so by House Members who created the Hearing on Medical and Psychological Impact of Abortion. She is now the President of the National Right to Life Committee and the head of the Association for Interdisciplinary Research in Values and Social Change, an organization that publishes anti-choice psychological papers.

The organizations that claim to support or “heal” victims of abortion often do so not through counseling but through anti-choice public awareness campaigns. These campaigns have used women who have sought assistance as spokespeople for anti-choice activities. The ultimate goal of the campaigns is to convince others not to choose an abortion by using post-abortion women who are motivated by guilt or remorse.

What the Right Says About the Dangers of RU-486

According to many in the Right, RU-486 is a dangerous abortifacient drug, despite its recent approval by the FDA for use in this country. They claim that complications uncovered in experimental use indicate that women have suffered unexpected after-effects including heavy bleeding, intense pain and anxiety from not understanding what is happening to them. The psychological effects of “the abortion pill” are said to be greater than from surgical abortion, and it does not work up to 10% of the time. Some groups claim that its method of use makes it a potential tool of population control, since women could be coerced or misled into taking the pills. Such “do-it-yourself abortions” will make abortion more common and less safe. Also, the pill may be manufactured in China, where quality control is a big problem, increasing safety concerns.

Response

Anti-abortion activists consistently distort the facts about RU-486. It has taken many years to overcome the barriers to the manufacture and distribution of RU-486 in this country, but this has not been because of concerns about its safety, which has been adequately demonstrated by US trials and its approval in 16 countries. RU-486 has not yet been widely available in this country because of political opposition.

The real opposition to RU-486 will continue to come from anti-choice forces that recognize that the use of this drug in the US will radically change the nature of how abortions are conducted. RU-486 can be administered and monitored in an outpatient setting like a doctor’s office; it does not require an abortion clinic’s equipment and staff. Many OB/GYN physicians who do not currently perform surgical abortions reported to the Kaiser Foundation in 1998 that they would be willing to administer RU-486. This would increase a woman’s privacy and make abortions much more accessible. Such a major change in how abortions are performed is a considerable threat to the anti-choice agenda.

As RU-486 becomes part of the abortion landscape in the US, anti-choice forces will increase the volume and tone of their arguments to stop widespread use. They will continue to engage in tactics such as spreading misleading statements about the safety of the drug, distorting the known facts about its side effects, demonizing its supporters and distributors and using language like “baby poison that stops a beating heart.” All these efforts are designed to scare women from using RU-486 and limit access to safe, legal abortions.

Reproductive Abuses and Population Control

Definition

Because abortion services are targeted so heavily by the Right, they may at first appear to be the only aspect of reproductive freedom that the Right opposes. But various sectors of the Right also seek to restrict a range of reproductive freedoms for many women, especially women of color, disabled women and low-income women. These issues include forced sterilization, coerced contraception, or caps on the maximum number of children under welfare “reform.” Different sectors of the Right approach these issues differently, ranging from overt race or class biased prejudice to more subtle stereotyping. An examination of the Right’s support for these issues also reveals the underpinnings of how the Right strategically uses reproductive rights issues to serve its own ends.

The more blatant and obvious denial of reproductive services other than abortion for women has focused on women from minority communities and on low-income women. The deliberate promotion of racial and class-based stereotypes has been a successful strategy for the Right to fuel public opinion about who deserves reproductive freedom and who should receive governmental support to exercise it. Sometimes efforts to affect public policy for certain reproductive rights services are blatantly prejudiced, as in the case of the Hyde Amendment for Medicaid funding for abortions, or the history of sterilization abuse and the use of Depo-Provera and Norplant among communities of color. (For more information on these campaigns, see the article, “Reproducing Patriarchy” in this kit.)

More often the call to curtail certain reproductive rights is more subtle. Some groups on the Right call for compassion towards minority communities and the poor, because they have been the victims of policies that limit their freedom. Many anti-choice groups claim they are opposed to sterilization abuse and coercive population control. In fact, strategists for the Right have capitalized on the ambivalence of some people of color towards the reproductive rights movement by claiming such compassion. Anti-choice forces will assert that they are sympathetic to how such groups have been wronged in the past. They frame a position that appears to support people who have been victimized by governmental interference in their reproductive lives. At the same time, though, these voices refuse to compromise on their own conservative ideals, setting the tone and direction for the public policy decisions that follow. In reality, they are only trying to develop support from people of color by appealing to their fears as a way to expand their anti-choice influence. In this way, they can simultaneously oppose the use of public funds for reproductive services such as abortion and appear to embrace racial diversity.

This argument extends beyond abortion to include positions on immigration and population policy as well. Some right-wing intellectuals such as Charles Murray continue to claim that racial minorities are naturally inferior, mirroring earlier arguments from the eugenics movement. Far-Right leaders like David Duke and his sympathizers use these arguments to justify the call for rigid anti-immigration policies and sanctions on welfare mothers who bear too many children. Other groups take a very different approach. In keeping with an absolute opposition to abortion and other family planning issues, some groups, especially Catholic organizations like Human Life International, are forced into a circular argument that there is no population problem at all. The need for population control is a myth, they say, cultivated by those who want to use the immoral interventions of birth control, sterilization, and abortion to alter the birth rate. They demand compassion for poor people around the world who have been victimized by these public policies. They vehemently oppose taxpayer support of Planned Parenthood nationally and internationally. And they engage in a persistent campaign to try to discredit family planning organizations and the US government by accusing them of being modern supporters of eugenics and selectively targeting minority groups for coercive contraception.

What the Right Says About Reproductive Services and Population Control

Virtually all anti-choice groups agree that abortion should be prohibited for all women, whether their position is based on religious principle or political perspective. But attitudes range widely among various groups on the Right about the related issues of other reproductive services and population control. The most extreme perspectives advocate direct intervention in the reproductive lives of certain “undesirable” women, despite their opposition to abortion. Some hard-Right groups and individuals claim that attempts to control the birth rate of lowincome women or women from communities of color (such as mass sterilization programs) have been justified because these women are having too many children and are contributing to the population problem. David Duke: “To solve America’s poverty problem, the soaring illegitimate birth rate must be curtailed.”

Other groups express shock at the history of reproductive abuses in the Third World and among low-income women in the US. They condemn US foreign aid policy that supports the use of Norplant and other contraception abroad, and many are opposed to birth control in this country. The Family Research Council, for example, has been highly critical of such practices.

In reality, America’s population imperialism has abused and harmed people worldwide, trampled on the religious and cultural values of other nations, and placed America at risk for retaliation by foreign countries. Muslim terrorism is already a threat to American foreign policy, and the official US zeal for population control only increases those threats. Furthermore, the US government is straining relations with the Catholic Latin American countries as well as many African countries because of its contemptuous actions against their moral beliefs and cultural traditions. (Family Policy, Volume 10, Number 4, July, 1997)

Response

Many anti-choice opponents are interested not only in prohibiting abortion but in controlling the reproductive lives of women in other ways as well. The focus of these additional restrictions is on low-income women, disabled women and women of color. The fact that these women are targeted exposes these efforts as ones laced with race and class bias and fear. These strategies include both overt and subtle support for such issues as the abuse of contraception and sterilization and the denial of expensive reproductive services to these groups that remain accessible to middle class white women, such as high tech fertilization procedures. No matter what the opposition looks like, it is all part of an effort to control a woman’s sexuality and restrict her reproductive freedom.

Many parts of the Right, from religious and social conservatives to those with more extreme opinions, hold very traditional views about the value of women in society. Such views of women justify restricting access to reproductive services and punishing women for being sexually active or for having children. This perspective must be challenged and overcome. All women have the right to control their reproductive choices, including when, if and how to bear children. Often people with conservative gender values also harbor deep-seated prejudices against communities of color, people with disabilities and poor people, based on the deliberate cultivation of beliefs about the inferiority of these groups. This helps account for their restrictive positions on immigration policy and population control.

When anti-choice groups connect their ideas about women’s reproductive rights to their opinions about immigration policy and population control, they are revealing their overall conservative agenda. Scapegoating immigrants and people of color and blaming these groups for social problems plays to an uninformed public’s fears. Besides being inaccurate, it exposes hypocrisy in the message some groups transmit about being compassionate towards the poor. They use race and class bias to build their conservative movement and splinter the pro-choice one.

Their range of opposition to women’s reproductive freedom is very broad and extends far beyond their attack on abortion. Perhaps the strongest reason for pro-choice activists to look at the big picture of the attack on the full range of reproductive rights is that the Right already has defined the conflict in these larger terms and has been organizing on several simultaneous fronts. All attempts to restrict a woman’s right to choose need to be seen as part of this larger vision and confronted as an attack on women’s freedom.