I love Roe v Wade. It took my breath away in 1973 and its promise continues to do so. It marked the United States as one of only two countries—South Africa is the other—with constitutions that enshrine the right to choose. Roe, under the penumbra of a right to privacy recognized that women were competent moral agents capable of making complex moral decisions. We did not need the legislature, the court, the church or our male partners to "help" us figure out right from wrong. What more sweeping affirmation of women's rights could a Catholic and a feminist hope for?
But Roe was a socially transformative decision made in a country that was not yet socially transformed. It was a visionary decision and we were not ready for it. And so it has failed.
We now have a seeming constitutional right to choose abortion and more restrictions on that right than countries with more "moderate" laws. We do not provide government funds for abortions for poor women although most countries where abortion is legal provide funding for all women. We regulate adolescent access, waiting periods, and what a doctor must tell a woman.
How did this happen? Not, as some claim, because the court shut down the democratic process by precluding debate in the state legislatures. The number of state bills introduced and state restrictions imposed is staggering. Articles, books, campus debates and TV programs on abortion probably exceed the total in all of the countries of the industrialized world. More alternative "crisis pregnancy centers" exist in the United States than in any other country. It happened because the core value behind Roe, the vision of women as moral agents, has never been realized. The Harris v McCrae decision in 1980 which allowed states and the federal government to prohibit the use of government funds for women on Medicaid demonstrated that we were not ready to recognize poor women as moral agents. The majority opinion in Gonzales v. Carhart provides the rhetorical case for the view that women are weak and need protection.
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While opinion is divided on whether Roe will be explicitly overturned or eviscerated through restrictions, it will only be available if we can convince the American public that it is a responsible choice as well as a right. At present, public opinion is not far removed from the Court's opinion. The public believes abortion is serious moral business. It can be justified but should not be celebrated. And above all, efforts should be made to avoid needing it.
Pro-choice forces share that view, although our historic and unrelenting emphasis on the promise of Roe and our fear of contributing to the stigmatizing of women who chose abortions often keeps us from leading with those beliefs. Our well founded suspicion of conservative moralism buries our deep morality in rights talk.
It is time to substitute straight talk for rights talk. Straight talk acknowledges that women themselves don't want to need abortions. They want to prevent pregnancies they can't bring to term. Legislatively that means an all out effort to increase funding for family planning and to end the idiocy of abstinence-only sexuality education. It means saying over and over again, that if you can't afford financially or emotionally to bring a child into the world, if you simply do not want children or a child, you have a responsibility to use contraception. Straight talk means accepting that however justifiable and whatever good comes from the decision to end a pregnancy, the act of abortion involves a departure from our common desire to live in a world where all positive forms of life can be nourished. On those grounds, it would be a better world if abortion were less frequently necessary. The Clinton formulation of "safe, legal and rare" is good ethics.
Straight talk includes an acknowledgment that abortion involves weighing competing values. Even if we believe they should be legal, abortions at the later stages of fetal development are morally more complex for most people. Only a few of us believe that fetuses have no value and only a few of us believe they have absolute value. Most believe they increase in value as the pregnancy continues. Adolescents have rights, but we want their parents involved—and they have a responsibility for the health and well being of their children. Health care professionals have a conscience, just as women do. Both need to be respected. Advances in fetal surgery, treatment of premature infants and the ability to bond with a wanted fetus through ultrasound are good things, not threats to the right to choose an abortion.
Most importantly, the moral high ground on abortion can best be found in the context of social justice and a commitment to all reproductive rights. It is found in insisting that the millions of women who rely on the government for health care have as much of a need to make the choice about abortion or childbirth freely as do women who are better off financially. In the United States, this means an all out consistent effort to secure federal and state Medicaid funds for low income women.
It also means working to reduce maternal mortality and morbidity world wide. The need for the abortion rights movement to take up the cause of Safe Motherhood is critical to the integrity of choices. Women world wide do not just die from unsafe abortions. In fact, a far larger number, at least 500,000, die from pregnancy related causes such as post partum hemorrhage and lack of skilled birth attendants. Solving the reproductive health problems of poor women in the United States who choose abortion and of poor women in the developing world who want healthy children requires a belief that women are not just moral adults, but that they matter.
I like to think that in the not too distant future, in a socially transformed United States, women will matter. Roe will be looked at as one of the most-forward-thinking, principled decisions for women in the 20th century. Right now our job is to be sure on whatever basis works that as many women as possible have access to safe affordable abortion services and to pregnancy related health care and safe delivery. That is what choice means. And our government aid, whether for Africa or Alabama, will reflect that value.