A woman two months pregnant goes to see her Ob-Gyn for prenatal care. As required by law, her doctor informs her that her condition places her at greater risk for a wide range of medical problems: hypertension and diabetes if she is overweight; complications of surgery if, like one in four women, she has a Caesarean section; permanent weight gain with its attendant problems, including heart disease; urinary tract infections and prolapsed uterus if she has had multiple pregnancies; postpartum depression or psychosis, leading in rare cases to suicide or infanticide; not to mention excruciating childbirth pain, stretch marks and death. There are ominous social possibilities, too, the doctor continues, reading from his state-supplied script: increased vulnerability to domestic violence; being or becoming a single mother, with all the struggles and poverty that entails; job and housing discrimination; the curtailment of education and professional training; and lowered income for life.
No state legislature would compel doctors to confront patients with the statistical risks of childbearing, serious though they are; a doctor who did so on his own would strike many as intrusive, offensive and out of his mind. Should a woman seek abortion, however, anti-choicers are pushing state laws requiring that she be informed of a risk most experts do not believe exists: a link between abortion and breast cancer. Like the supposedly widespread psychological trauma of abortion, which even anti-choice Surgeon General Dr. C. Everett Koop was unable to find evidence of, the abortion-breast cancer connection is being aggressively promoted by the anti-choice movement. (Even Mother Jones, always quick to take feminists down a peg, leapt on this bandwagon, with an April/May 1995 piece entitled "Abortion's Risk.")
"It's yet another example of efforts to encumber this legal choice and make it more difficult and painful for women," says Dr. Wendy Chavkin, professor of public health and clinical obstetrics and gynecology at New York's Columbia Presbyterian Hospital, and editor in chief of the Journal of the American Medical Women's Association. It's also an attempt by anti-choicers to reframe their opposition to abortion as concern for women's health, something not usually high on their list. These are, after all, the same people who fight health exceptions to "partial birth" abortion bans and who have successfully prevented poor women from receiving medically necessary abortions with Medicaid funds.
Nonetheless, such is the power of the anti-choice movement that laws have been passed in Montana and Mississippi, and bills are pending in fifteen other states, mandating a breast cancer warning (and in some cases, a waiting period for it to sink in). Along with laws come lawsuits: In Fargo, North Dakota, the Red River Women's Clinic is being sued for failing to give such a warning; a 19-year-old Pennsylvania woman is suing a New Jersey clinic for her abortion two years ago, which left her, she claims, with an overwhelming fear of contracting breast cancer. In ferociously anti-choice Louisiana, a new law permits women to sue for damages--including damages to the fetus!--up to ten years after their abortion. Given today's high rates of breast cancer, a deluge of litigation is in the making.
Does abortion cause breast cancer? Some studies have appeared to suggest a connection: Dr. Janet Daling, for example, an epidemiologist who says she is pro-choice, compared the abortion histories of 1,800 women with and without breast cancer and found that, among those who had been pregnant at least once, the risk of breast cancer was 50 percent higher for those who had abortions--but her cancer-free sample was obtained through telephone interviews with women chosen at random from the phone book. Not everyone has a phone, of course, which raises questions about the comparability of the samples, and besides, how many women would volunteer information about their abortion history to a voice on the phone? Like other studies showing a link, this one was marred by "recall bias": Cancer patients are more likely to volunteer negative information about themselves than healthy people. They are looking for an explanation for a disease--and one many feel must somehow be their fault. Demographic studies, which are free from recall bias, produce different results: Lindefors Harris, analyzing the national medical database of Swedish women in 1989, found that women did deny their abortions, that breast cancer patients were less likely to do so--and that women who had had abortions were less likely to get breast cancer. The largest study to date, of 1.5 million Danish women, found no correlation.
"The supposed link between breast cancer and abortion is motivated by politics, not medicine," says Dr. David Grimes, clinical professor of obstetrics and gynecology at the University of North Carolina. "The weight of the evidence at this time indicates no association. To force this on women is just cruel." Indeed, the National Cancer Institute, the American Cancer Society and the World Health Organization, none of which have an ax to grind, reject the notion. The standard medical textbook, Diseases of the Breast, concurs. The main figure advocating the link is Dr. Joel Brind, professor of biology and endocrinology at Baruch College, who has done no original research on this issue but is a tireless anti-choice propagandist--plug "abortion breast cancer" into a search engine and the top half dozen sites are his.
Abortion is just about the only medical procedure in which doctors and patients are hemmed about by lawmakers. No other operation has legally mandated waiting periods, although many are dangerous, life-altering and irreversible; with no other operation are doctors legally required to give specific information--certainly not information that the vast preponderance of medical opinion believes to be false or at best unproven. Good medical practice calls for discussion of the pros and cons of particular courses of treatment, not burdening the patient's choice with unsubstantiated fears. Will we ever see a law requiring doctors to tell pregnant patients that abortion is statistically safer than carrying to term--which it is? Sure, the day state lawmakers put a waiting period on Viagra prescriptions, to let male patients really consider whether an erection is worth a heart attack.
Young women, who've never lacked abortion rights, are tough to mobilize.
How many times did we hear during the endless campaign that Bush wouldn't go after abortion if elected? Republicans, Naderites and countless know-it-alls and pundits in between agreed: Pro-choice voters were too powerful, the country was too divided, the Republicans weren't that stupid and Bush didn't really care about abortion anyway. Plus whoever won would have to (all together now) "govern from the center." Where are all those smarties now, I wonder? Bush didn't even wait for his swearing-in ceremony to start repaying the immense debt he owes to the Christian right, which gave him one in four of his votes, with the nominations of anti-choice die-hards John Ashcroft for Attorney General and Tommy Thompson to head Health and Human Services.
On his first full day in office, Bush reinstated the "gag rule" preventing international family-planning clinics and NGOs from receiving US funds if they so much as mention the word "abortion." (This action was widely misrepresented in the press as being a ban on funding for performing abortions; in fact, it bans clinics that get US aid from performing abortions with their own money and prohibits speech--whether lobbying for legal changes in countries where abortion is a crime or informing women with life- or health-threatening pregnancies about their legal options.) A few days later, Thompson announced he would look into the safety of RU-486, approved by the FDA this past fall--a drug that has been used by half a million European women over twelve years and has been more closely studied here than almost any drug on the market. In the wake of Laura Bush's remark to NBC News and the Today show that she favored retention of Roe v. Wade, both the President and the Vice President said the Administration has not ruled out a legal challenge to it, placing them to the right of Ashcroft himself, who told the Judiciary Committee he regarded Roe as settled law (at least until the makeup of the Supreme Court changes, he did not add).
Don't count on the media to alert the public. The press is into champagne and confetti: Who would have thought "Dick" Cheney would be such an amiable talk show guest! Time to move on, compromise, get busy with that big tax cut. "Who in hell is this 'all' we keep hearing about?" a friend writes, "as in 'all agree' that the Bush transition has been a smashing success?" An acquaintance at the Washington Post, whose executive editor, Leonard Downie Jr., claims to be so objective he doesn't even vote, says word has come down from "on high" that stories must bear "no trace of liberal bias"--interestingly, no comparable warnings were given against pro-Bush bias. So, on abortion, look for endless disquisitions on the grassiness of the anti-choice roots, the elitism of pro-choicers and the general tedium of the abortion issue. Robin Toner could barely stifle a yawn as she took both sides to task in the New York Times ("The Abortion Debate, Stuck in Time," January 21): Why couldn't more anti-choicers see the worth of stem cell research, like anti-choice Senator Gordon Smith, who has several relatives afflicted with Parkinson's (but presumably no relatives unwillingly pregnant); and why can't more pro-choicers acknowledge that sonograms "complicate" the status of the fetus? In an article that interviewed not a single woman, only the fetus matters: not sexuality, public health, women's bodies, needs or rights.
Now is the time to be passionate, clever, original and urgent. I hate to say it, but pro-choicers really could learn some things from the antis, and I don't mean the arts of arson, murder and lying to the Judiciary Committee. Lots of right-wing Christians tithe--how many pro-choicers write significant checks to pro-choice and feminist organizations? Why not sit down today and send President Bush a note saying that in honor of the women in his family you are making a donation to the National Network of Abortion Funds to pay for a poor woman's abortion (NNAF: Hampshire College, Amherst MA 01002-5001)? March 10 is the Day of Appreciation for Abortion Providers--send your local clinic money for an abortion "scholarship," flowers, a thank-you note, a bottle of wine, a Nation subscription for the waiting room! (Refuse & Resist has lots of ideas and projects for that day--call them at 212-713-5657.)
The antis look big and powerful because they have a built-in base in the Catholic and fundamentalist churches. But (aha!) pro-choicers have a built-in constituency too: the millions and millions of women who have had abortions. For all sorts of reasons (privacy concerns, overwork, the ideology of medicine) few clinics ask their patients to give back to the cause. Now some providers and activists are talking about changing that. "My fantasy," Susan Yanow of the Abortion Access Project wrote me, "is that every woman in this country gets a piece of paper after her procedure that says something like, 'We need your help. You just had a safe, legal abortion, something that the current Administration is actively trying to outlaw. Think of your sisters/ mothers/daughters who might need this service one day. Please help yourself to postcards and tell your elected representatives you support legal abortion, join (local group name here), come back as a volunteer' and so on." If every woman who had an abortion sent her clinic even just a dollar a year, it would mean millions of dollars for staff, security, cut-rate or gratis procedures. Think how different the debate would be if all those women, and the partners, parents, relatives and friends who helped them, spoke up boldly--especially the ones whose husbands are so vocally and famously and self-righteously anti-choice. If women did that, we would be the grassroots.
* * *
Correction: It was Joe Conason, not Chip Berlet, who reported that John Ashcroft had met with the St. Louis head of the racist Council of Conservative Citizens. Berlet's equally fascinating story, cut for space reasons, was that Ashcroft made a cameo appearance in a 1997 Phyllis Schlafly video that claims that environmentalism, feminism, multiculturalism, gay rights and even chemical weapons treaties are part of a conspiracy to bring about One World Government. See clips at www.publiceye.org.
Throughout the last campaign, while liberal Democrats warned that Bush was much more reactionary than he pretended to be, Naderites argued that Democrats were much less progressive than their rhetoric. From the evidence of the first days of the Bush Administration, it turns out both were right.
For all the dulcet compassion written into his inaugural address, Bush turned right even before entering the White House. His nomination of John Ashcroft as Attorney General showed contempt, not compassion, for the broad center of American politics. His environmental troika--Norton, Abraham and Whitman--are an affront even to Republican environmentalists. While professing her love for nature Norton preposterously invoked the California power crisis as a reason to start drilling in the Arctic wildlife preserve. The troika also threatened a review of the environmental regulations Clinton issued in his last weeks in power.
On his first day in office Bush targeted women's right to choose by reinstating the odious gag rule defunding any international organization that counsels women abroad on family planning and abortion. He also opened fire on women's rights at home, announcing that "it is my conviction that taxpayer funds should not be used to pay for abortions or advocate or actively promote abortions either here or abroad." He hailed those gathered at the annual national protest against Roe v. Wade, saying that "we share a great goal" in overturning the constitutional protection of a woman's right to seek an abortion. And Health and Human Services Secretary Tommy Thompson announced that he would review RU-486, which anti-choicers want banned, fearful that it will make abortion more accessible. So much for compassion.
Bush launched his push for an education plan that will demand lots of testing in exchange for a little new funding for beleaguered urban and rural schools. The $5 billion annual price tag for his education bill is mocked by the $68 billion annual tax cut he wants to give to the wealthiest 1 percent of Americans--to say nothing of the tens of billions about to be thrown at the Pentagon. But Bush knows what he calls "my base." The lily-white, mink-draped crowd at his inauguration broke into loud applause only twice: when Bush promised to reduce taxes and when Chief Justice Rehnquist was introduced. So much for bipartisanship.
Yet, despite the stolen election, the wolf politics after a sheep's campaign and a furious and frightened constituency, many Democrats in the Senate seem content with getting rolled. Conservatives in the party didn't pause before trampling their leaders to embrace the tainted President. While Senate Democratic leader Tom Daschle was urging his troops to hold off on any announcements about Ashcroft, the opportunistic Robert Torricelli and dubious Democrat Zell Miller of Georgia were hailing the Missouri tribune of the Confederacy as Attorney General. Despite a furious reaction by Democrats across the country, opponents like Ted Kennedy are struggling to summon even forty votes against a zealot whose career has been marked by his willingness to abuse his office for political gain. While Daschle was trying to get some agreement on a smaller tax-cut package from Democrats, Miller leapt in to co-sponsor the equivalent of the Bush plan with Texas Senator Phil Gramm.
Dick Cheney's former opponent, Joe Lieberman, didn't even thank African-Americans and the unions for their remarkable support this past fall before kicking them in the teeth in January. He joined nine other New Democrats in an unctuous letter to "President-Elect Bush" indicating their willingness to work with him on an education bill and urging him to make a top priority of the fight for "Fast Track trading authority" for "expansion of trade in the Americas." Lieberman et al. begged to meet with Bush as early as possible. So much for Democratic unity.
But the Democratic collaborators are likely misjudging the temper of the country. What the inaugural also revealed was the depth of voter anger nationwide. Demonstrators often outnumbered celebrators along the parade route. And from San Francisco to Kansas City to Tallahassee, citizens turned out to express their dismay at the installation of the illegitimate President. Bush seems committed to refighting old battles against choice, affirmative action and environmental and consumer protection, as well as to waging a new offensive in the continuing class warfare of the privileged against the poor. But citizens are showing that they are ready to resist. Some Democrats--Maxine Waters, Dennis Kucinich, Jan Schakowsky, Barney Frank, George Miller and others in the House, as well as Kennedy and Richard Durbin in the Senate--are already engaged. The day before Bush was sworn in, the Progressive Caucus led a daylong conference on political reform that featured a bold agenda and a promise to push for change at the state and national levels. In the coming fray, Democrats who decide to cozy up to the new Administration are likely to find themselves caught in the crossfire.
While partisans debate whether a victorious George W. Bush would nominate Supreme Court Justices who would overturn Roe v.
It took twelve years for the FDA to approve mifepristone--also known as
RU-486--and most of that time had less to do with medicine than with the
politics of abortion. Still, the late-September decision was a
tremendous victory for American women. In approving RU-486, the FDA
showed that science and good sense can still carry the day, even in an
The long delay may even backfire against the drug's opponents. In 1988,
when mifepristone was legalized in France, it was a medical novelty as
well as a political flashpoint. Today, it's been accepted in thirteen
countries, including most of Western Europe; it's been taken by more
than a half-million women and studied, it sometimes seems, by almost as
many researchers. By the end of the approval process, the important
medical professional organizations--the AMA, the American Medical
Women's Association, the American College of Obstetricians and
Gynecologists--had given mifepristone their blessing; impressive
percentages of Ob-Gyns and family practitioners said they would consider
prescribing it; thousands of US women had taken it in clinical trials
and given it high marks, with 97 percent in one study saying they would
recommend it to a friend. Against this background of information and
experience, the antichoicers' attempt to raise fears about the drug's
safety sounds desperate and insincere.
In a normal country, RU-486 would simply be another abortion method, its
use a matter of personal preference (in France it's the choice of 20
percent of women who have abortions, while in Britain only 6 percent opt
for it). But in the United States, where abortion clinics are besieged
by fanatics and providers wear bulletproof vests, mifepristone's main
significance lies in its potential to widen access to abortion,
especially in those 86 percent of US counties that possess no abortion
clinic, by making it private--doctors unable or unwilling to perform
surgical abortions could prescribe it, and women could take it at home.
It is unlikely, however, that Mifeprex, as the drug will be known when
it comes on the market, will prove to be the magic bullet that ends the
war on abortion by depriving antichoice activists of identifiable
targets. The nation has been retreating from Roe v. Wade for a
quarter-century, and a good portion of the patchwork of state and local
regulations intended to discourage surgical abortion will apply to
Mifeprex as well: parental notification and consent laws (thirty-two
states), waiting periods (nineteen states), biased counseling and
cumbersome reporting and zoning requirements. States in which
antichoicers control the legislatures will surely rush to encumber
Mifeprex with hassles, and small-town and rural physicians in particular
may find it hard to prescribe Mifeprex without alerting antichoice
activists. Doctors are a cautious bunch, and the anticipated flood of
new providers may turn out to be a trickle, at least at first. Abortion
rights activists should also brace themselves for a backlash from their
hard-core foes: Just after the FDA's decision was announced, a Catholic
priest crashed his car into an Illinois abortion clinic and hacked at
the building with an ax.
But in the long run, Mifeprex will make abortion more acceptable. In
poll after poll Americans have said that when it comes to terminating a
pregnancy, the earlier the better. Mifeprex, which has been approved for
the first forty-nine days after a woman's last menstrual period--when
the embryo's size varies from a pencil point to a grain of rice--may
well prove not to arouse the same kinds of anxieties and moral qualms as
surgical abortion. Then, too, Americans are used to taking pills. That,
of course, is what the antichoicers are afraid of.
The Supreme Court opens its new term with a case that raises the stakes dramatically in the politics of fetal rights. At issue in Ferguson v. City of Charleston is whether a public hospital violates the Constitution when it tests pregnant women for drug use and turns over positive results to the police without so much as obtaining a search warrant.
Medical professionals and the general public agree that it is not desirable for pregnant women to use drugs. But this case raises a different question: Do women forfeit basic constitutional rights to equal treatment, due process and protection against unreasonable searches and seizures when they become pregnant?
South Carolina has been a leader in the movement, building ever since Roe v. Wade legalized abortion, to establish rights for fetuses. No state has done more to target pregnant women who use drugs. Starting in 1989, the Medical University of South Carolina (MUSC) invited the police and local prosecutor to help implement a policy directed at prenatal-care patients. Women who came to MUSC, the only facility for indigent patients in Charleston, were threatened with arrest if they tested positive for drugs. Some were jailed for the duration of their pregnancies (surely not an optimal environment for pregnant women's health), and others were jailed after giving birth, still in their hospital gowns. All but one were black. The crimes they were charged with--drug possession, child neglect and distributing drugs to a minor--carried penalties of two to twenty years.
South Carolina Attorney General Charles Condon has said, "There is no constitutional right for a pregnant mother to use drugs." True enough. But the Constitution does guarantee rights of personal liberty and due process, which in turn require that all people, regardless of race or gender, be treated fairly and equally under the law. And the Charleston police department has never arrested a male hospital patient and charged him with possessing drugs on the basis of a positive urine test.
The real issue is how to respect pregnant women's constitutional rights while improving their (and their future children's) chances of a good outcome. The state maintains that the "stick" of criminal intervention is necessary to make its policy of "encouraging" pregnant women to get treatment effective. But at the time the policy took effect, there was not a single residential drug-abuse-treatment program for women in the entire state. MUSC itself would not admit pregnant women to its treatment center. And no outpatient program in Charleston provided childcare so that pregnant women with young children could keep their counseling appointments.
Finally, arresting women after they give birth does nothing to promote a healthy pregnancy or newborn. This practice also hinders the basic goals of keeping families together and promoting family stability through the provision of rehabilitative services instead of punishment.
Condon has made plain his desire to challenge the premise underlying abortion law: that a fetus is not a person in the constitutional sense and has no rights of its own. In 1998 he told the Washington Times that he would be "proud" and "very pleased" to defend his policies, "even in terms of reversing Roe v. Wade."
Faced with sanctions and the loss of federal dollars when the federal government investigated MUSC for ethics violations and discrimination against African-American women, the hospital suspended its policy in late 1994. But the program's architects got a boost when the State Supreme Court ruled in 1996 that a viable fetus is a person under the children's code, a ruling that the US Supreme Court allowed to stand. Condon then instructed district attorneys around the state to prosecute for "child abuse" women who take drugs during pregnancy.
Because most women in the United States get pregnant at least once in their lives, the practical and political implications of the Supreme Court's decision in Ferguson v. City of Charleston will be enormous. Fetal rights advocates recently scored a victory in Massachusetts when a judge entered an order of protection on behalf of a fetus and took a pregnant woman into state custody. The state alleges that the woman let her last baby die shortly after birth but has not charged her with any crime. If the Court upholds South Carolina's policy, it will encourage similar actions, effectively putting American women on notice that if they become pregnant, their lives are no longer their own.
Right now, there are three votes on the Court to get rid of Roe altogether and often four or five to impose costly, chilling and burdensome regulations on the exercise of that right by the patient and her doctor.
President Bush was not deterred by lack of expertise when it came to deciding a highly specialized scientific issue.
Which current candidate for President reversed the abortion stand he
espoused as a Congressional candidate in the seventies and adopted a
position more acceptable to the mainstream of his party