CFC in the News 2003
New York Times

30 Years after Abortion Ruling, New Trends but the Old Debate

 

J’Vante Anderson is 16, the age her mother was when she had her first child. Growing up in one of Atlanta’s poorest neighborhoods, she has seen the cycle: teenage girl has baby, drops out of school, goes on welfare and raises a child who in turn becomes a teenage mother.

“I want to break that cycle,” she said, her turtleneck perfectly coordinated with her pink velvet jeans. “I have a life, and I do plan on living it.” She does not believe in abortion, so she is choosing abstinence. Newly 22 and newly married, Allison C. has just had her second abortion in a year, at a clinic near Tacoma, Wash. She does not think of herself as “one of those people” who use abortion as birth control. “But if it is, who cares?” she said.

Thirty years after Roe v. Wade, the rate of abortions has come almost full circle, declining to its lowest level since 1974.

The decline is largely because of a steady decrease among teenagers like J’Vante, who are avoiding pregnancy through birth control or abstinence. Increasingly, the common denominator for women having abortions is poverty. And, like Allison, they are using birth control unevenly at best.

Abortion is taken so much for granted in America today that most women surveyed by a group of clinics in Washington State did not know that it had ever been illegal. The rate of repeat abortions has risen slowly, so that nearly half the women who terminated pregnancies in 2000 had done so at least once before.

Yet abortion today is neither “abortion on demand,” as opponents call it, nor as inaccessible as some supporters of abortion rights insist. Both sides in the debate often say that if the Supreme Court overturned Roe, the 1973 ruling that established a woman’s right to end her pregnancy, abortion would be shaped by a patchwork of state laws. But in fact, that has already happened.

Now, as before Roe, a woman’s access to abortion depends on an ever-shifting equation of geography, money, politics and personal sympathies. Women in Texas raise money from concerts and yard sales to help poor women in Kansas and North Carolina pay for abortions. Mothers from Mississippi, where two parents must consent before a girl under 18 can get an abortion, take their daughters to Alabama, where only one parent must agree. Doctors, too, work around hurdles, ad-libbing a defense of abortion rights into the scripts that many states require them to read to any woman seeking to end a pregnancy.

Meanwhile, public opinion is as fractured as ever. A recent New York Times/CBS News poll found that about 40 percent of Americans say abortion should be legal, 20 percent say it should not, and another 40 percent say it should be legal with stricter limits. Those numbers have barely budged in polls since 1989.

With Republicans controlling Congress and the White House, advocates on both sides of the debate are expecting an intense round of new anti-abortion legislation at the state and federal levels. In particular, abortion opponents want to press for a ban on what they call partial-birth abortion and for a law making it a crime to cross state lines to avoid parental notification requirements.

Both sides also see the anniversary of Roe v. Wade on Wednesday as a symbolic moment to press their arguments, and neither is interested in softening its position.

“If you look at public opinion, most people want abortion to be legal, and they would like some restrictions,” said Frances Kissling, president of Catholics for a Free Choice. “The court and public opinion are in sync with each other, and those of us who are advocates on either side of the question don’t like the compromise. For our side, it’s that it will be regulated; for them, the compromise is that it’s legal.”

A Ruling, a Rise, Then a Drop

The Supreme Court announced its decision in Roe v. Wade on Jan. 22, 1973, ruling 7-2 that a Texas statute banning abortion except when a woman’s life was in danger violated a constitutional right to privacy.

In the decades before, a woman who wanted an abortion had to leave the country or choose an underground, often dangerous one.

Some women, particularly the rich, found doctors who relied on sympathetic psychiatrists to declare to a hospital committee that the woman would kill herself if forced to give birth. By 1970, stories of poor women dying from self-induced abortions had persuaded several states, including New York and Washington, to legalize abortion.

In the years immediately after Roe, the abortion rate rose sharply, according to the Alan Guttmacher Institute, which is considered by anti-abortion and abortion rights groups to be the most accurate source. It peaked at 29.3 per 1,000 women between 15 and 44 in 1981, began a big drop in 1992, and now stands at 21.3.

Both sides take credit for the drop. “At one time, we were aborting one of every three pregnancies in this country,” said David O’Steen, executive director of the National Right to Life Committee, the largest of the anti-abortion groups. “Whatever side you’re on politically, if you step back and consider this, that the richest people that have ever lived on the face of this earth have somehow engaged in killing one of every three of their own offspring, you have to think something is bad, bad wrong there. Now we’re at one out of every four. That’s not a good thing, but this is much better.”

Gloria Feldt, the president of Planned Parenthood, pushes abortion’s opponents to do more: “If they really wanted to reduce the number of abortions, they would work with us to make sure everyone has real access to family planning and real sex education. It is about more than abortion. It really comes down to whether women will have an equal place at life’s table, whether we value children enough that we want them to be planned and wanted and cared for.”

The Teenage Perspective

No group has seen a bigger drop in abortions in recent years than teenagers. The rate among women ages 15 to 19 dropped 20 percent from 1987 to 1994, and another 27 percent from 1994 to 2000, according to the Guttmacher Institute.

It is not that more young women are keeping their babies, but that fewer are getting pregnant. The pregnancy rate in this country is still far higher than in most — data for the city of Hartford, for example, show that for the last several years more teenagers have given birth than have graduated from high school. But teenage pregnancies have fallen since peaking in 1990.

Opponents debate whether this is the result of more abstinence or better birth control. Those who work with teenagers say the answer is both, as does most research.

In surveys of high schoolers by the Centers for Disease Control and Prevention, the percentage saying they had ever had sex declined to 46 percent in 2001 from 54 percent in 1991.

But teenage girls — and boys — are also becoming savvier about contraception. In Atlanta, a group of girls gathered after school at a community center casually talk about how everyone has “the shot.”

“Nobody takes pills anymore,” said Latonja Swint 17.

The shot is Depo-Provera, a three-month contraceptive that doctors say has been effective among teenage girls, who tend to be fickle about taking birth control pills. Yet the teenage pregnancy rate began to fall before Depo was introduced, and more closely matched a rise in condom use — and fear of AIDS.

A Matter of Money

Most of the women who got the 1.31 million abortions in this country in 2000 were in their 20’s and never married. Most of them had given birth at least once, described themselves as Protestant or Catholic, and lived in cities. They were disproportionately black or Hispanic.

And more and more, the women getting legal abortions are the very poor — a mirror image of the picture before Roe.

After years of heading down, abortion rates for poor women rose sharply between 1994 and 2000, according to Guttmacher numbers. The rate for women below the federal poverty level — $8,350 for a single woman and $14,150 for a family of three in 2000 — rose 25 percent. The rate for women earning up to twice that went up 23 percent. Meanwhile, the rate among the most well-off of those surveyed fell 39 percent.

An abortion comes relatively cheap — $372 on average, the Guttmacher Institute found, about half what it did, adjusted for inflation, in 1973. But across the country, a network of nearly 100 private funds set up to help poor women pay for abortions says it is hearing from more women who cannot pay even that.

About 608,000 of the women who had abortions in 2000 had not used contraception, according to estimates from the Guttmacher survey. Another 610,000 used contraception but not correctly. Just 95,000 had been using birth control properly.

In 2001, officials in Washington State began offering a year of free birth control to any woman or man earning up to twice the poverty level. Officials say it is too early to say whether the program has reduced the abortion rate, but with 76,000 people enrolled so far — almost the number of births a year in the state — they are confident it will.

RU-486, which induces abortion, was supposed to be the miracle drug. It accounted for 37,000 abortions nationwide in the first six months of 2001, although it was approved only in September 2000. But some clinic workers say they have spotted a worrisome trend: women having repeat abortions with the drug.

The Battle Over Access

The Army of God, a militant anti-abortion group, will mark the anniversary of Roe v. Wade by celebrating a killing: that of Dr. Barnett Slepian, an abortion provider in Buffalo, in 1998. The group’s Web site encourages supporters to attend a march outside Dr. Slepian’s former clinic to support the man accused of killing him, James Kopp.

Yet Operation Rescue, once feared as the Army of God’s angry twin, besieging abortion clinics in the 1980’s and early 1990’s, is now bankrupt and defunct. And over all, clinic violence is down from the rash of clinic shootings in the 1990’s.

Now, the most frequent reports of harassment are about picketers, and their numbers have thinned, often to just one or two people standing shouting distance away and offering pamphlets. Clinic workers talk about dealing with them the way they might a batty aunt at Thanksgiving: smile, acknowledge, ignore.

Abortion rights advocates and opponents both say the access battle is increasingly in state legislatures.

Nationwide, restrictions on abortion started as early as 1976, when Congress passed the Hyde Amendment, which prohibited Medicaid from paying for the procedure except in rare cases. It seems to have worked: the abortion rate is far higher in the 17 states that pay for abortions for women on Medicaid.

The biggest shift came after the Supreme Court ruled in 1992 that states could impose restrictions but not a “substantial obstacle.” States rushed in. Thirty-two now require girls under 18 to get a parent’s consent, or to tell their parents, before an abortion; two require consent of both birth parents, though all allow girls to seek a waiver from a judge.

Eighteen states require a waiting period, generally 24 hours, between mandatory counseling and an abortion. Seven more require that women get the counseling, in which a doctor reads a script detailing the risks of abortion and the alternative of adoption, and also require that women be given a pamphlet showing pictures of a fetus at two-week intervals.

Four states allow private insurers to pay for abortions only if the woman pays an additional premium. Almost all say that only a physician can perform the procedure.

Many restrictions are more political than practical: the so-called partial-birth abortion ban that has been pushed in Congress, for example, would have meant 2,200 fewer abortions in 2000 — or 0.17 percent. The Louisiana Legislature, meanwhile, has passed a ban on all abortions except to save a woman’s life. It would take effect the moment the Supreme Court overturned Roe.

So, as in the pre-Roe days, women and doctors work around the restrictions. Many restrictions send women across state lines for abortions, or money: one abortion fund in Seattle sends 20 percent of its money to women in Idaho, which restricts private insurance for abortions. It helps fly women to Seattle from Alaska, where clinics are rare. The Planned Parenthood clinic in Appleton, Wis., flies in a doctor from Oregon.

Abortion opponents say the restrictions have worked in reducing the number of abortions. Those on the other side say that as in the days before Roe, women who want abortions will get them somehow.

This article courtesy of the New York Times.