First, from The New York Times, The New Abortion Providers:
[After Roe vs. Wade,] the clinics also truly came to stand alone. In 1973, hospitals made up 80 percent of the country’s abortion facilities. By 1981, however, clinics outnumbered hospitals, and 15 years later, 90 percent of the abortions in the U.S. were performed at clinics. The American Medical Association did not maintain standards of care for the procedure. Hospitals didn’t shelter them in their wings. Being a pro-choice doctor came to mean referring your patients to a clinic rather than doing abortions in your own office.
This was never the feminist plan. “The clinics’ founders didn’t intend them to become virtually the only settings for abortion services in many communities,” says Carole Joffe, a sociologist and author of a history of the era, “Doctors of Conscience,” and a new book, “Dispatches From the Abortion Wars.” When the clinics became the only place in town to have an abortion, they became an easy mark for extremists. As Joffe told me, “The violence was possible because the relationship of medicine to abortion was already tenuous.” The medical profession reinforced the outsider status of the clinics by not speaking out strongly after the first attacks. As abortion moved to the margins of medical practice, it also disappeared from residency programs that produced new doctors. In 1995, the number of OB-GYN residencies offering abortion training fell to a low of 12 percent.
“Under pressure and stigma, more doctors shun abortion,” wrote David Grimes, a leading researcher and abortion provider of 38 years, in a widely cited 1992 medical journal article called “Clinicians Who Provide Abortions: The Thinning Ranks.” In a 1992 survey of OB-GYNs, 59 percent of those age 65 and older said that they performed abortions, compared with 28 percent of those age 50 and younger. The National Abortion Federation started warning about “the graying of the abortion provider.” In the decade after Roe, the number of sites providing abortion across the country almost doubled from about 1,500 to more than 2,900, according to the Guttmacher Institute. But by 2000 the number shrank back to about 1,800 — a decline of 37 percent from 1982.
There’s another side of the story, however — a deliberate and concerted counteroffensive that has gone largely unremarked. Over the last decade, abortion-rights advocates have quietly worked to reverse the marginalization encouraged by activists like Randall Terry. Abortion-rights proponents are fighting back on precisely the same turf that Terry demarcated: the place of abortion within mainstream medicine. This abortion-rights campaign, led by physicians themselves, is trying to recast doctors, changing them from a weak link of abortion to a strong one. Its leaders have built residency programs and fellowships at university hospitals, with the hope that, eventually, more and more doctors will use their training to bring abortion into their practices. The bold idea at the heart of this effort is to integrate abortion so that it’s a seamless part of health care for women — embraced rather than shunned.
Second, from Newsweek.com, The Anti-Lesbian Drug:
Genetic engineers, move over: the latest scheme for creating children to a parent’s specifications requires no DNA tinkering, but merely giving mom a steroid while she’s pregnant, and presto — no chance that her daughters will be lesbians or (worse?) ‘uppity.’
Or so one might guess from the storm brewing over the prenatal use of that steroid, called dexamethasone. In February, bioethicist Alice Dreger of Northwestern University and two colleagues blew the whistle on the controversial practice of giving pregnant women dexamethasone to keep the female fetuses they are carrying from developing ambiguous genitalia. (That can happen to girls who have congenital adrenal hyperplasia (CAH), a genetic disorder in which unusually high prenatal exposure to masculinizing hormones called androgens can cause girls to develop a deep voice, facial hair, and masculine-looking genitalia.) The response Dreger got from physicians and scientists who were outraged over this unapproved use of dexamethasone caused her to dig deeper into the scientific papers of the researcher who has promoted it.
Dreger is one of the women who brought the clitoral surgeries performed by Dr. Dix Poppas to light.
I have wanted to write about this for a while, now, ever since I read through the thread called (Very) Basic Economics and Abortion over at Alas, A Blog. Since then, though, a number of things have happened: the Supreme Court has agreed to hear a case concerning so-called “partial-birth abortions,” South Dakota has passed the most restrictive law in the country against abortion, Utah has a proposed law that would eliminate incest exceptions in its parental notification law, and I have been in another conversation, What If Your Mother Was Pro-Choice, on Alas, the initial post of which concerned a common strategy used by people who are anti-choice to try to silence those of us who are pro-choice: what would have happened if your mother had chosen to have an abortion instead of giving birth to you?
At one point the thread became a conversation about whether the immaculate conception was an instance of divine rape or not (start reading here). This was relevant because it went to the question of what it means for women to have real choice in terms of pregnancy and childbirth — which also means in terms of when and whether and under what conditions to have sex — and, though I don’t remember that this point was brought out explicitly, to the question of what we model our understanding of women’s reproductive choice on. (I have italicized this because it will become important later on, towards the end of what I want to say.) What I want to do here is to try to tie all these various things together under the title I have given this post because I think it goes to the heart of understanding a rarely articulated aspect of what is at stake in the anti-choice position, whether it is articulated in explicitly religious terms or not, and because, under the general strategy of “know thine enemy,” I think this is an important understanding to reach. It’s going to take a while, and I’m going to have to make a number of leaps, to get where I want to go in this, so I hope you will bear with me.
» Read the rest of this entry «
This post is a continuation of my second response as part of this thread on reproductive rights at Alas, A Blog where I raised the differences between the Jewish and Christian approaches to the status of the fetus — because I think there is no way to avoid the fact that the entire abortion debate in this country is being carried out, explicitly and implicitly, in Christian, or at least Christianized terms — and also between the Jewish approach and the approach which made abortion legal in the United States, which is grounded in a woman’s right to privacy. I’m not so much interested here in arguing that either the Jewish or right-to-privacy approach is better than the other in supporting a woman’s right to choose than I am simply in laying out a different way of framing the issue of abortion and seeing what people make of it in the context of the struggle to maintain abortion rights that is going on in this country.
In presenting the Jewish position on abortion, I will be summarizing from Rachel Biale’s book, Women & Jewish Law (Schocken Books 1984), and David M. Feldman’s Marital Relations, Birth Control and Abortion in Jewish Law (Schocken Books 1968). Each of these two authors discusses at great length the justifications within Jewish law for therapeutic abortions, abortions that are preformed in order to save the mother’s life, at the core of which is the assumption that there is, as Biale writes, “a clear distinction…between the woman and her child: the woman is a living person…and anyone who…kills her [has committed a capital crime].… The fetus is not a person in this sense” because the fetus has not yet become an individual; it cannot live independently outside the womb and so is not understood to have the same status in legal or moral/ethical terms as the mother (220). After this discussion, the authors turn their attention to the Jewish position on non-therapeutic abortions, citing a passage in Tractate Arakhin in which the rabbis ask – and here I am going to paraphrase rather than quote, but immediately relevant pages in the two texts are: Biale, 223 – 225; Feldman, 289 – 294 – whether a woman who is sentenced to death and who is discovered to be pregnant after her sentence has been pronounced can be executed before she gives birth.
The point of the question is to consider not the ethics of the death penalty, but rather the status of the fetus. If the sentence is carried out before the woman gives birth, executing her means killing the fetus as well, and so the question arises, since there is no medical reason to consider the fetus a danger to the mother’s life, whether the fetus’ life should be given sufficient precedence so that it is not killed for its mother’s crimes. The answer the rabbis come to is that one does not wait for the woman to give birth to execute her because “a delay between sentencing and execution is a form of torture” called in Jewish law innui ha-din, and “innui ha-din, delay in carrying out the sentence, is prohibited in Jewish law because it adds unwarranted anguish to the punishment” (Biale, 225), and one can only imagine how much more anguish would be added in this case, forcing a woman to carry a pregnancy to term knowing all the while that the birth of her child will also signal the end of her life. According to Biale, “It is possible to deduce from [this passage in] Arakhin a general principle that a fetus may be aborted to avoid mental anguish (any condition analogous to innui ha-din) or disgrace to the mother” (ibid.).
Biale seems to hint that, depending on the interpretive strategies one uses and the precedents one chooses to cite, it might be possible to arrive at a position within Jewish law that would allow abortion-on-demand and that would give a woman control over her own body in the way we think about reproductive rights today, though that position, as I read Biale and Feldman, is not surprisingly not in the mainstream of Jewish thought. What really interests me about this reasoning, however, is that it posits the permissibility of abortion not from the point of view of a woman’s right-to-privacy, but rather from the point of view of protecting and preserving the quality of a woman’s life, even if that life is measured only in the relatively short time between the handing down of a death sentence and the execution it mandates. More to the point, this reasoning obligates the state to respect the quality of the woman’s life even when the state has an interest in bringing that life to an end. This position is only possible, however, because Jewish law starts from the position that the fetus is not and cannot be construed as a person in the same way that the mother can.
Unfortunately, I will have to pick this up again in another post. I am off to play with my son, whom I cannot put off any longer.