The painful and complex Odyssey of the right to choose in America
Once again, I'm struck by how astute it was of Amanda Marcotte to recommend Leslie Reagan's When Abortion Was a Crime to her readers at Pandagon. Judging by this article by Caitlin Flanagan in The Atlantic Monthly, she could also benefit from reading it, though it does seem she is making progress toward the light indeed. But she has a ways to go.
One thing I picked up from Leslie Reagan's book was the complex nuances of the evolution of abortion practice and its opposition.
For those who have not had the chance to read it yet, I can summarize by saying that essentially there were about 4 phases between the movement to initially criminalize abortion in the mid-19th century and Roe v Wade:
1) Professional MDs (or rather, the precursors of the faction of medical practitioners that we recognize today as "real doctors," in part because of their political success in this period) led, indeed founded and mostly constituted, the movement to make abortion a crime, primarily as a way of attacking their rivals, the folk-medical practioners who included midwives, and establishing themselves as a closed, self-governing guild of arbiters of medicine. I think it is clear that the particular movement to ban abortions (except for "therapeutic" ones done by MDs like themselves) also had a specific element of desire to bring women under tighter control. But in the first period, once the legislative battles were won to criminalize abortion, such objectives were only partially accomplished, for women continued as they had always done to go to midwives, or increasingly, as their family income permitted and ethnic ties guided them, to MDs acting as family practitioners, to get "therapeutic" abortions. Because the doctors never disputed that certain abortions were necessary; the question was, who decided. Under the old rules, pre-criminalization, the law ignored the whole matter and women decided among themselves. This was not the same as recognizing women's individual right to choose; if the law did pay attention it frowned deeply on deliberate abortion, and it would often not be the pregnant woman but rather other women, such as her mother, who arbitrated. Women did not talk about it, to men or generally among themselves, because sexuality in general was under a veil of silence and shame. Under the new rules, this would only have been worse, since abortion itself was now a crime explicitly, and this emphasized Victorian denial of female sexuality in general. Now, if a woman chose the traditional folk medicine track she and her midwife were under the shadow of explicit law, and if she chose a family practioner MD she was subject to his judgement and scrutiny. On the other hand, MDs were generally private practioners who served families, and women (the same matriarchs who traditionally governed decisions about pregnancy and abortion) generally held the purse strings in these matters. The lady of the house was their client in other words, and smart doctors did not want to alienate them. (In this period the few women MDs tended to be more outspoken in their conservatism and opposition to practices like abortion, because they were already under very skeptical scrutiny and probably had internalized Victorian values in self-defense and as essential steppingstones to success.) So in practice, abortion went on much as before, except increasingly in the hands of MDs, particularly among white Protestant middle-and-upper class families. Most of Reagan's data from this period came from situations where something went wrong and a woman died or was seriously ill, or from the investigations of crusading journalists who regarded abortion as part of the general sexual "dangerousness" of big cities and the rising industrial society. The tendency of critics was to blame midwives, but doctors ran some risk of being held accountable. But there was no movement to arrest and imprison women who had or sought abortions; for them, the basic punishment was to expose them to public shame.
2) In the next period, roughly corresponding to the Progressive Era shading into the 1920s, things went on much as before except that now the drive to criminalize midwives and folk medicine in general went into higher gear. Police were more aggressive in trying to root out midwives and social progressives generally sought to bring them under medical supervision as a step toward eliminating them outright. Meanwhile more women went to MDs and sought "therapeutic" abortions, which MDs were still inclined to give for purely social reasons. However medicine was getting more specialized; just as the MDs had sought to marginalize midwives, so now the new specialists in gynecology and obstestrics sought to discredit GPs in matters relating to pregnancy, and patients were increasingly diverted to hospitals, where there was no longer the client/professional relationship that covered the joint discretion of families and private doctor in reaching decisions on abortion.
3) In the Great Depression especially, a sort of equilibrium existed whereby the medical profession argued quietly among themselves about what was and was not "therapeutic" abortion but in the general desperation of the times, a place was quietly made for abortion clinics which were illegal but had fairly high standards. Flanagan's mother and her peers would have come of age in a time when official doctrine stressed more and more that abortion was wrong, but in fact networks of women and their doctors still could quietly find a woman who needed one a fairly safe place for a reasonable price. But as medicine grew more specialized and centralized, the practices came under more and more scrutiny, while the doctors and nurses involved in abortion became more and more specialized in that practice, which exposed them to more effective prosecution. All along in these latter two periods especially, there was a rising threat that exposure as an abortionist would result in expulsion from the medical community; this went hand in hand with the threat of legal action but also worked largely by shame and ostracism, just as women were generally "punished" and terrorized.
4) But various political forces were on the rise that explicitly sought to eliminate, or at least more effectively criminalize abortion, notably various agencies of the Catholic Church and their political supporters--a strong and rising constituency in the mid-20th century. In the medical community, it was hard to speak for abortion, even "therapeutic," and increasingly respectable to speak very harshly against it. In any case the doctors worried about liability and losing their collective reputations on which their professional independence of external regulation rested, so the profession began tightening and clarifying standards of what did and did not qualify as properly medical justifications for abortions, and gave at least verbal support to the crusaders. In the late 1930s (about when Flanagan's mother had her shocking experience) and notably in the early '40s, police began raiding medical abortion clinics that had been operating discreetly for decades in major cities. At first they sought the identites of the female patients, whom they then apprehended, threatened with prosecution, and thus compelled to testitfy against the clinic workers themselves--thus also "punishing" them by again exposing them as sexual offenders to public shame and compelling them to speak about sexual details women normally were ashamed to talk about; they were not actually jailed. Soon the DAs began to focus on the mainstream doctors, nurses, and hospitals that referred women to these clinics, as ways of shutting them down.
Thus Flanagan's mother was living in a transitional time. Even in earlier days, of course, there were far too many women who did not in fact find the discreet networks that steered pregnant woment toward relatively safe abortions, and thus went to quacks or tried to do it themselves; this is a basic ugly fact of criminalization. (In fact, even where abortion is perfectly legal, we still have some women who are ashamed, or afraid, to risk exposure, or feel self-destructive shame, or just plain can't afford reputable care; perhaps we shall always have such tragedies, though one can hope otherwise in a society that finally gets away from shaming women for having sex.) But the bitter experience of Flanagan's mother's friend was not the universal reality for most women who sought abortions before WWII--though she may have chosen the way she did it because it was indeed headed that way.
Because the 4th period of criminal abortion, the period between WWII and Roe, is I think the most bitter and tragic of all. Indeed scientific medical practice had always held out the promise of technically safer and more effective abortions (though in the mid-19th century I think on the whole a good midwife might have been a safer bet) and by WWII the cumulative progress of antisepsis and medicines including the new antibiotics would indeed have made it far safer--if not for the much more effective enforcement of the law that went along with it. The crackdown on abortion was part of the general reactionaryism of the post-war and McCarthyite era; indeed Reagan stresses how effectively the era's conformism straightjacketed medical professionals of all kinds into following a reactionary script for fear of being singled out and expelled. This was the period in which women were forced to seek anonymous and dubious practitioners for extortionate prices in the dead of night, and suffered most severely from running these medical as well as social risks. The medical profession, soon underscored by law, required proposals for therapeutic abortions to undergo reviews by committees before being authorized; no longer could a GP or even Ob/gyn specialist make that decision on his professional say-so, as the original laws had provided. These committees in turn were having their decisions scrutinized by anti-abortion watchdogs of various kinds; the number of women who got abortions at hospitals was also being critically and skeptically watched, so that even liberally inclined hospitals (especially those that had a reputation for being laxer in these matters) had to tighten their standards to match the most reactionary, lest they stand out for legal attention.
It was these conditions that led women to organize to reclaim their right to choose, by clandestine action, by court challenge, and eventually to speaking out at last on why they had to regard this choice as essential and their basic right as women and human beings. It was this testimony that underlay both movments of legal reform (which were often disappointing, as they left the basic notion of abortion as a questionable option at best in place and retained mechanisms of scrutiny and judgement that intimidated women and denied even the bravest abortions except for strictly interpreted reasons) and the eventually successful path of court challenge on basic human rights grounds.
I hope that women like Flanagan learn, if they don't already know, this basic historical trajectory that shows how essential the right of choice as a basic, unchallengeable, unashamed human right is, and that they acknowledge how every other alternative has in fact been tried and exhausted.
To my perhaps overly spiritual way of thinking, I think that both medical facts and the trying ordeal American women have gone through in our history demonstrate that early-term feti simply cannot be human beings, as I do believe in an underlying justice in the Universe and I don't see how such a benign cosmic order could put these women into conflict with real human beings. Maybe I'm too soft-headed; I've spoken to women whom I respect who say they believe in choice and yet that "it's still a baby." I just can't process that, and medical fact seems to relieve me of the need to. In any case, the absolute value that a pregnant woman alone should decide if she is to become a mother or not is established in my mind. This is a big improvement I think on the status quo before the MDs decided to attempt to criminalize abortion, since the matter was kept in discreet limbo back then and the default position of law and society was that women were subordinate to others--perhaps to other women, but not seen as free and autonomous in the sense that men were. And vice versa, I think free women, who never bear children unless they have freely decided to do so, are more likely to birth and raise healthy, loved, valued children, and pass on the values and virtues that underly effective, real, human freedom. We are thus better off than we were, and perhaps the sufferings of past generations can be redeemed--if we hang on to what we have gained.
One thing I picked up from Leslie Reagan's book was the complex nuances of the evolution of abortion practice and its opposition.
For those who have not had the chance to read it yet, I can summarize by saying that essentially there were about 4 phases between the movement to initially criminalize abortion in the mid-19th century and Roe v Wade:
1) Professional MDs (or rather, the precursors of the faction of medical practitioners that we recognize today as "real doctors," in part because of their political success in this period) led, indeed founded and mostly constituted, the movement to make abortion a crime, primarily as a way of attacking their rivals, the folk-medical practioners who included midwives, and establishing themselves as a closed, self-governing guild of arbiters of medicine. I think it is clear that the particular movement to ban abortions (except for "therapeutic" ones done by MDs like themselves) also had a specific element of desire to bring women under tighter control. But in the first period, once the legislative battles were won to criminalize abortion, such objectives were only partially accomplished, for women continued as they had always done to go to midwives, or increasingly, as their family income permitted and ethnic ties guided them, to MDs acting as family practitioners, to get "therapeutic" abortions. Because the doctors never disputed that certain abortions were necessary; the question was, who decided. Under the old rules, pre-criminalization, the law ignored the whole matter and women decided among themselves. This was not the same as recognizing women's individual right to choose; if the law did pay attention it frowned deeply on deliberate abortion, and it would often not be the pregnant woman but rather other women, such as her mother, who arbitrated. Women did not talk about it, to men or generally among themselves, because sexuality in general was under a veil of silence and shame. Under the new rules, this would only have been worse, since abortion itself was now a crime explicitly, and this emphasized Victorian denial of female sexuality in general. Now, if a woman chose the traditional folk medicine track she and her midwife were under the shadow of explicit law, and if she chose a family practioner MD she was subject to his judgement and scrutiny. On the other hand, MDs were generally private practioners who served families, and women (the same matriarchs who traditionally governed decisions about pregnancy and abortion) generally held the purse strings in these matters. The lady of the house was their client in other words, and smart doctors did not want to alienate them. (In this period the few women MDs tended to be more outspoken in their conservatism and opposition to practices like abortion, because they were already under very skeptical scrutiny and probably had internalized Victorian values in self-defense and as essential steppingstones to success.) So in practice, abortion went on much as before, except increasingly in the hands of MDs, particularly among white Protestant middle-and-upper class families. Most of Reagan's data from this period came from situations where something went wrong and a woman died or was seriously ill, or from the investigations of crusading journalists who regarded abortion as part of the general sexual "dangerousness" of big cities and the rising industrial society. The tendency of critics was to blame midwives, but doctors ran some risk of being held accountable. But there was no movement to arrest and imprison women who had or sought abortions; for them, the basic punishment was to expose them to public shame.
2) In the next period, roughly corresponding to the Progressive Era shading into the 1920s, things went on much as before except that now the drive to criminalize midwives and folk medicine in general went into higher gear. Police were more aggressive in trying to root out midwives and social progressives generally sought to bring them under medical supervision as a step toward eliminating them outright. Meanwhile more women went to MDs and sought "therapeutic" abortions, which MDs were still inclined to give for purely social reasons. However medicine was getting more specialized; just as the MDs had sought to marginalize midwives, so now the new specialists in gynecology and obstestrics sought to discredit GPs in matters relating to pregnancy, and patients were increasingly diverted to hospitals, where there was no longer the client/professional relationship that covered the joint discretion of families and private doctor in reaching decisions on abortion.
3) In the Great Depression especially, a sort of equilibrium existed whereby the medical profession argued quietly among themselves about what was and was not "therapeutic" abortion but in the general desperation of the times, a place was quietly made for abortion clinics which were illegal but had fairly high standards. Flanagan's mother and her peers would have come of age in a time when official doctrine stressed more and more that abortion was wrong, but in fact networks of women and their doctors still could quietly find a woman who needed one a fairly safe place for a reasonable price. But as medicine grew more specialized and centralized, the practices came under more and more scrutiny, while the doctors and nurses involved in abortion became more and more specialized in that practice, which exposed them to more effective prosecution. All along in these latter two periods especially, there was a rising threat that exposure as an abortionist would result in expulsion from the medical community; this went hand in hand with the threat of legal action but also worked largely by shame and ostracism, just as women were generally "punished" and terrorized.
4) But various political forces were on the rise that explicitly sought to eliminate, or at least more effectively criminalize abortion, notably various agencies of the Catholic Church and their political supporters--a strong and rising constituency in the mid-20th century. In the medical community, it was hard to speak for abortion, even "therapeutic," and increasingly respectable to speak very harshly against it. In any case the doctors worried about liability and losing their collective reputations on which their professional independence of external regulation rested, so the profession began tightening and clarifying standards of what did and did not qualify as properly medical justifications for abortions, and gave at least verbal support to the crusaders. In the late 1930s (about when Flanagan's mother had her shocking experience) and notably in the early '40s, police began raiding medical abortion clinics that had been operating discreetly for decades in major cities. At first they sought the identites of the female patients, whom they then apprehended, threatened with prosecution, and thus compelled to testitfy against the clinic workers themselves--thus also "punishing" them by again exposing them as sexual offenders to public shame and compelling them to speak about sexual details women normally were ashamed to talk about; they were not actually jailed. Soon the DAs began to focus on the mainstream doctors, nurses, and hospitals that referred women to these clinics, as ways of shutting them down.
Thus Flanagan's mother was living in a transitional time. Even in earlier days, of course, there were far too many women who did not in fact find the discreet networks that steered pregnant woment toward relatively safe abortions, and thus went to quacks or tried to do it themselves; this is a basic ugly fact of criminalization. (In fact, even where abortion is perfectly legal, we still have some women who are ashamed, or afraid, to risk exposure, or feel self-destructive shame, or just plain can't afford reputable care; perhaps we shall always have such tragedies, though one can hope otherwise in a society that finally gets away from shaming women for having sex.) But the bitter experience of Flanagan's mother's friend was not the universal reality for most women who sought abortions before WWII--though she may have chosen the way she did it because it was indeed headed that way.
Because the 4th period of criminal abortion, the period between WWII and Roe, is I think the most bitter and tragic of all. Indeed scientific medical practice had always held out the promise of technically safer and more effective abortions (though in the mid-19th century I think on the whole a good midwife might have been a safer bet) and by WWII the cumulative progress of antisepsis and medicines including the new antibiotics would indeed have made it far safer--if not for the much more effective enforcement of the law that went along with it. The crackdown on abortion was part of the general reactionaryism of the post-war and McCarthyite era; indeed Reagan stresses how effectively the era's conformism straightjacketed medical professionals of all kinds into following a reactionary script for fear of being singled out and expelled. This was the period in which women were forced to seek anonymous and dubious practitioners for extortionate prices in the dead of night, and suffered most severely from running these medical as well as social risks. The medical profession, soon underscored by law, required proposals for therapeutic abortions to undergo reviews by committees before being authorized; no longer could a GP or even Ob/gyn specialist make that decision on his professional say-so, as the original laws had provided. These committees in turn were having their decisions scrutinized by anti-abortion watchdogs of various kinds; the number of women who got abortions at hospitals was also being critically and skeptically watched, so that even liberally inclined hospitals (especially those that had a reputation for being laxer in these matters) had to tighten their standards to match the most reactionary, lest they stand out for legal attention.
It was these conditions that led women to organize to reclaim their right to choose, by clandestine action, by court challenge, and eventually to speaking out at last on why they had to regard this choice as essential and their basic right as women and human beings. It was this testimony that underlay both movments of legal reform (which were often disappointing, as they left the basic notion of abortion as a questionable option at best in place and retained mechanisms of scrutiny and judgement that intimidated women and denied even the bravest abortions except for strictly interpreted reasons) and the eventually successful path of court challenge on basic human rights grounds.
I hope that women like Flanagan learn, if they don't already know, this basic historical trajectory that shows how essential the right of choice as a basic, unchallengeable, unashamed human right is, and that they acknowledge how every other alternative has in fact been tried and exhausted.
To my perhaps overly spiritual way of thinking, I think that both medical facts and the trying ordeal American women have gone through in our history demonstrate that early-term feti simply cannot be human beings, as I do believe in an underlying justice in the Universe and I don't see how such a benign cosmic order could put these women into conflict with real human beings. Maybe I'm too soft-headed; I've spoken to women whom I respect who say they believe in choice and yet that "it's still a baby." I just can't process that, and medical fact seems to relieve me of the need to. In any case, the absolute value that a pregnant woman alone should decide if she is to become a mother or not is established in my mind. This is a big improvement I think on the status quo before the MDs decided to attempt to criminalize abortion, since the matter was kept in discreet limbo back then and the default position of law and society was that women were subordinate to others--perhaps to other women, but not seen as free and autonomous in the sense that men were. And vice versa, I think free women, who never bear children unless they have freely decided to do so, are more likely to birth and raise healthy, loved, valued children, and pass on the values and virtues that underly effective, real, human freedom. We are thus better off than we were, and perhaps the sufferings of past generations can be redeemed--if we hang on to what we have gained.
posted by Mark H. Foxwell | 4:36 AM
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