Published by CQ Press, an Imprint of SAGE Publications, Inc. www.cqresearcher.com Abortion Debates Will the Supreme Court impose new restrictions?

nti-abortion activists have been lobbying heavily in recent years in the nation’s state legislatures, which since 2010 have passed more than 200 laws impos - A ing new regulations on abortion. Supporters of the procedure are challenging many of the new state laws in court, contending they are unreasonable and prevent women — especially poor women — from accessing safe, legal abortions. Proponents of the laws say one of their primary goals is to test the limits of the Supreme Court’s 1973 Roe v. Wade decision legalizing abortion. meanwhile, the federal government is implementing its sweeping Advocates of legislation to restrict abortions rally on health-care reform law, which requires health insurance plans to July 8, 2013, at the Texas capitol in Austin. Since lawmakers passed the controversial law last year, many of the state’s abortion providers have shut cover contraception, leading two companies whose owners oppose down. In recent years, state legislatures have passed some 200 laws imposing new regulations on abortions. A majority of U.S. voters continue to birth control on religious grounds to sue the government — a case support abortion rights. the Supreme Court will hear this month. Anti-abortion activists say they’ll bring their arguments to a receptive electorate in 2014, while their opponents say polls show a majority of voters continue to I THIS REPORT N support abortion rights. THE ISSUES ...... 267 S BACKGROUND ...... 274 I CHRONOLOGY ...... 275 D CURRENT SITUATION ...... 280 E CQ Researcher • March 21, 2014 • www.cqresearcher.com AT ISSUE ...... 281 Volume 24, Number 12 • Pages 265-288 OUTLOOK ...... 282 RECIPIENT Of SOCIETY Of PROfESSIONAL JOURNALISTS AwARD fOR BIBLIOGRAPHY ...... 286 EXCELLENCE N AmERICAN BAR ASSOCIATION SILvER GAvEL AwARD THE NEXT STEP ...... 287 ABORTION DEBATES

March 21, 2014 THE ISSUES SIDEBARS AND GRAPHICS Volume 24, Number 12

MANAGING EDITOR: Thomas J. Billitteri • will the strategy of restrict - States Limit Abortion [email protected] 267 ing abortions at the state 268 Period level lead to Roe v. Wade forty-two states limit when ASSISTANT MANAGING EDITOR: Kathy Koch , being overturned? women can get abortions. [email protected] • Does emergency contracep - SENIOR CONTRIBUTING EDITOR: tion cause abortion? 269 States Tighten Laws for Thomas J. Colin • Should employers with re - Providers [email protected] ligious objections be able to Abortion-rights advocates and CONTRIBUTING WRITERS: Brian Beary, exclude coverage for abor - opponents see different aims. marcia Clemmitt, Sarah Glazer, Kenneth Jost, tions and birth control ex - Reed Karaim, Peter Katel , Robert Kiener, penses in company health 273 Regional Divide on Barbara mantel, Tom Price, Jennifer weeks insurance plans? Abortion Grows SENIOR PROJECT EDITOR: Olu B. Davis Abortion support grew in New England, declined in EDITORIAL ASSISTANT: Ethan mcLeod BACKGROUND South Central states. FACT CHECKERS: Eva P. Dasher, michelle Harris, Nancie majkowski Banning Abortion Chronology INTERN: Kaya Yurieff 274 By 1880 every state had 275 Key events since 1973. banned abortion, except to protect the mother’s life. Compromise Remains Elu - 276 sive in Abortion Debate Decriminalizing Abortion Politicians “benefit from keep - 276 In 1970, prompted by the ing the divisiveness alive.” American medical Association, An Imprint of SAGE Publications, Inc. states began to loosen their Abortion Debate Takes to VICE PRESIDENT AND EDITORIAL DIRECTOR, abortion restrictions. 279 the Road HIGHER EDUCATION GROUP: “Choose Life” license plates michele Sordi Challenging Roe available in 29 states. 278 EXECUTIVE DIRECTOR, ONLINE LIBRARY AND A House bill calls for banning REFERENCE PUBLISHING: abortions after the 20th week Abortion Rate at 38-Year Todd Baldwin of pregnancy. 280 Low Abortions peaked in 1981 at Copyright © 2014 CQ Press, an Imprint of SAGE Pub - 29 per 1,000 women. lications, Inc. SAGE reserves all copyright and other CURRENT SITUATION rights herein, unless pre vi ous ly spec i fied in writing. At Issue: No part of this publication may be reproduced Abortion and the ACA 281 Do abortion limits dispropor - electronically or otherwise, without prior written 280 The Affordable Care Act’s tionately harm low-income permission. Un au tho rized re pro duc tion or trans mis- treatment of abortion services women? sion of SAGE copy right ed material is a violation of is stirring controversy. federal law car ry ing civil fines of up to $100,000. Upcoming Elections FOR FURTHER RESEARCH CQ Press is a registered trademark of Congressional 280 Republicans are seeking the Quarterly Inc. right tone on the abortion For More Information CQ Researcher (ISSN 1056-2036) is printed on acid- issue to win votes. 285 Organizations to contact. free paper. Pub lished weekly, except: (march wk. 4) (may wk. 4) (July wk. 1) (Aug. wks. 3, 4) (Nov. wk. Bibliography 4) and (Dec. wks. 3, 4). Published by SAGE Publica - OUTLOOK 286 Selected sources used. tions, Inc., 2455 Teller Rd., Thousand Oaks, CA 91320. Annual full-service subscriptions start at $1,054. for Pushback? The Next Step pricing, call 1-800-818-7243. To purchase a CQ Re - 282 State lawmakers are introduc - 287 Additional articles . searcher report in print or electronic format (PDf), ing provisions supporting visit www.cqpress.com or call 866-427-7737. Single abortion rights. Citing CQ Researcher reports start at $15. Bulk purchase discounts and 287 Sample bibliography formats. electronic-rights licensing are also available. Periodicals postage paid at Thousand Oaks, California, and at additional mailing offices . POST mAST ER: Send ad dress chang es to CQ Re search er , 2300 N St., N.w., Suite 800, wash ing ton, DC 20037. Cover: Getty Images/Erich Schlegel

266 CQ Researcher Abortion Debates BY WILLIAM WANLUND

regulations for abortion clinics, THE ISSUES anti-abortion candidates for the legislatures and shorter periods he falls Church during a pregnancy when legal Healthcare Center is abortions can be performed. T facing a financial cri - The ultimate goal, the groups sis, according to director Rose - say, is to test the limits of the mary Codding. Supreme Court’s landmark de - A state law enacted in 2011, cision and possibly even get she says, requires the small the ruling overturned. Abortion- Northern virginia abortion rights groups are suing dozens clinic to abide by the same of states over the laws, con - building and safety standards tending they impose unreason - that apply to new hospital able demands on abortion construction. She says regu - s providers, making it more diffi - d r lations stemming from the law a cult for women to get safe, legal h c i

will require $1.5 million in R and affordable abortion care.

. J

renovations to the facility, such l further fueling the debate, u as enlarging a janitor’s utility a the federal government this year P / closet, expanding laundry fa - s is implementing its sweeping e g cilities and upgrading heat - a health-care reform law, which m I ing, ventilation and air con - requires that health insurance y t t ditioning equipment. e plans cover contraception. Com - G Codding is suing the state / panies with religious objections P F

over the regulations, arguing A to birth control are suing the they are unreasonable and Members of NARAL Pro-Choice America protest at a government over the require - “include things that have ab - hotel in Washington hosting a fundraiser for Republican ment, a case that will be ar - solutely no impact on health, presidential hopeful Mitt Romney on March 22, 2012. gued before the Supreme Court The protesters were objecting to Romney’s proposal to patient safety or the well- stop federal support for the abortion rights/family later this month and which some being of our small staff.” On planning group Planned Parenthood of America. The say could have far-reaching im - Oct. 9 a judge rejected the federal government’s sweeping, new health-care reform plications on the availability of state’s effort to have Cod - law — dubbed Obamacare — requires that health birth control. ding’s case thrown out; a cir - insurance plans cover contraception. Later this month the Polls show most Americans U.S. Supreme Court will hear a challenge to the law by cuit court in Arlington, va., companies with religious objections to birth control. still want abortion to be legal, is scheduled to hear the case but regional diff erences in at - April 29. titudes are growing. A Pew Re - Abortion-rights activists say the vir - But lawmakers who support such search Center survey conducted last July ginia law is among 205 similar mea - laws say they are designed to protect found that 54 percent of A mericans say sures enacted in 29 states since 2011 patients. “This is not about banning abortion should be legal in all or most designed to restrict the number of abor - abortion in virginia,” Republican state circumstances, while 40 per cent said it tions performed in the United States. Sen. Jill Holtzman vogel said when t he should be illegal all or most of the The new laws — which, among other law was passed. “It is simply caring for time. Opposition to legal abortion was things, require abortion providers to women who are about to have an in - highest — 52 percent — in the South have admitting privileges and/or trans - vasive surgical procedure and creating Central states and lowest — 20 percent fer agreements with local hospitals or an environment for them . . . to have — in New England, according to the impose structural requirements on [the procedure] in a place that’s safe. ” 2 survey. The disparity between the two clinics — are partly responsible for After decades of trying to get the regions has risen 19 percentage points the more than 70 abortion facilities in Supreme Court to weaken its 1973 Roe since 1996. 3 30 states that have closed or stopped v. Wade decision legalizing abortion, op - The number of abortions performed offering abortions since 2010, say op - ponents of abortion rights have turned each year has been declining s ince ponents of the laws. 1 their focus on the states, supporting new 2000 and fell 13 percent between 2008

www.cqresearcher.com March 21, 2014 267 ABORTION DEBATES

As for the new rules like the ones States Limit When Women Can Get Abortions Codding is challenging, a sensational Since the Supreme Court in 1992 allowed states to restrict abortions case in Pennsylvania last year height - after fetal viability, 42 states have enacted laws limiting when a ened the debate over the need for new regulations. Philadelphia abortion pregnant woman can get an abortion. A law pending in Mississippi doctor Kermit Gosnell was sentenced would be the most restrictive, banning abortions at 18 weeks of to life in prison without parole in may pregnancy. Thirteen other states banned abortions as early as 20 2013 after being convicted in the grue - weeks, but since medical professionals generally say fetal viability, some deaths of a patient and three or survival, cannot occur before 23 weeks, several of those laws babies born alive during late-term abor - already have been challenged in court and the cases are expected to tions at a filthy clinic. 7 be appealed to the Supreme Court. “for many years, abortion providers have been treated as a special class,” State Abortion Bans, by Length of Pregnancy Tobias says. “They have hidden behind the idea that . . . abortion should some - Wash. Mont. N.D.*** N.H. how be treated differently from other Minn. Vt. Maine surgical procedures. As a result, we end S.D. Wis. Ore. Idaho* Wyo. Mich. N.Y. Mass. up with situations . . . where abortion - Iowa Neb. R.I. ists are allowed to operate in substan - Pa. Ill. Ind. Ohio Conn. dard conditions that put women at risk.” Nev. Utah Colo. Kan. Mo. W.Va.** N.J. Ky. The new state regulations are “com - Calif. Va. Del. mon-sense requirements” that man - Tenn. Okla. Ark.*** N.C. Md. Ariz.* N.M. D.C. date such things as improved sanitary Miss. S.C. ** Ala. Ga.* conditions, working emergency equip - Texas La. ment and larger hallways and rooms Fla. Alaska so emergency personnel can quickly Range access patients in distress, says michael (in weeks) New, a political scientist and adjunct 18 Hawaii 20 scholar with the Charlotte Lozier In - 22 stitute, a washington policy research 24-26 * Blocked by court order or litigation and not in effect. organization that opposes abortion. 28 But abortion-rights activists — who ** Awaiting final approval. call the new measures TRAP laws, for *** North Dakota and Arkansas passed 6-week and 12-week restrictions, respectively, targeted regulation of abortion providers which were blocked by federal judges. — say they are designed to make it Source: “State Policies on Later Abortions,” Guttmacher Institute, March 1, 2014, too expensive or logistically impossi - http://tinyurl.com/k83kfmk; see also Niraj Chokshi, “West Virginia’s legislature ble for abortion clinics to stay open. passes a 20-week abortion ban,” The Washington Post, March 10, 2014, “The TRAP laws we are challenging http://tinyurl.com/lpzacw6; Jeff Amy, “Mississippi Senate passes amended 20-week make it harder for good providers to abortion ban,” The Associated Press, March 11, 2014, http://tinyurl.com/kmbpmg8; Erik Eckholm, “Judge Blocks North Dakota Abortion Restrictions,” The New York continue providing abortion services, Times , July 22, 2013, http://tinyurl.com/msavshk. which means that women have less ac - cess to legal abortion,” says Julie Rikel - and 2011 (the latest year for which nancy rates between 1990 and 2008 to man, litigation director at the Center statistics were available), according to improved contraception and economic for Reproductive Rights, a New York- a march report from the Guttmacher instability. 5 But Carol Tobias, presi - based legal advocacy organization that Institute, a policy research organiza - dent of the anti-abortion organiza - supports women’s access to abortion. tion that supports abortion rights. 4 tion National Right to Life (NRL), says “TRAP laws are designed to seem be - Those numbers do not yet reflect the abortion rate is falling because nign, but they’re not.” the impact of the new state laws, say “pro-life legislative efforts at the state Jennifer Dalven, director of the Re - experts. A 2012 Centers for Disease and federal level” have “raised aware - productive freedom Project at the Control and Prevention (CDC) report ness about the humanity of the un - American Civil Liberties Union (ACLU), attributed a 9 percent drop in preg - born child.” 6 says, “more and more, we are seeing

268 CQ Researcher politicians pass laws that either di - rectly ban abortion or are back-door States Tighten Laws for Providers bans that purport to protect women’s At least 29 states in the past four years have enacted laws to regulate health but in fact are laws designed abortion clinics that supporters say are designed to protect patients to shut down women’s health centers and opponents say aim to make it more difficult for women to get safe, and outlaw abortion.” legal and affordable abortions. Among other things, the laws require In Texas, at least a third of the state’s abortion providers, mostly in rural areas, that abortion clinic doctors have admitting privileges and transfer have stopped providing abortion ser - agreements with local hospitals or require clinics to meet the same vices since the state passed one of structural standards as ambulatory surgical centers. the country’s toughest abortion clinic laws last year. Among other things, it States with Recent Laws on Abortion Clinics requires doctors performing abortions to be accredited at a hospital within Wash. Mont. N.D. N.H. Minn. Vt. 30 miles of the abortion clinic. By march Maine S.D. Wis. Ore. Idaho of this year, only 24 abortion facilities Wyo. Mich. N.Y. Mass. Iowa were still operating in Texas, a state Neb. R.I. Pa. with a population of more than 26 mil - Ill. Ind. Ohio Conn. Nev. Utah 8 Colo. Kan. Mo. W.Va. N.J. lion people. Ky. Va. The American medical Association Calif. Del. Okla. Tenn. N.C. and the American College of Obstetri - Ariz. Ark. Md. N.M. S.C. D.C. Miss. cians and Gynecologists, which oppose Ala. Ga. the Texas law, wrote in a legal brief Texas La. Fla. that: “There is simply no medical basis Alaska to impose a local admitting-privileges requirement on abortion providers.” The law “does not serve the health of women Hawaii in Texas, but instead jeopardizes women’s health by restricting access to Source: “Targeted Regulation of Abortion Providers,” Guttmacher Institute, March 1, abortion providers and denying 2014, http://tinyurl.com/mnhuenr women well-researched, safe, evidence- based and proven protocols for the 2014 election season, as state legisla - As supporters and opponents of provision of medical abortion.” 9 ture and congressional races get un - abortion rights carry their messages Abortion-rights supporters have chal - derway. Erika west, political director into the 2014 election campaigns, here lenged the Texas law in court, and of NARAL Pro-Choice America, a wash - are some key questions being asked: the fifth U.S. Circuit Court of Appeals ington, D.C.-based advocacy organi - heard the case on Jan. 6. Both sides zation that supports abortion rights, Will the strategy of restricting expect the case to eventually reach told a press conference that, with na - abortions at the state level lead the Supreme Court. 10 tional politics largely at a standstill due to Roe v. Wade being overturned? A Bloomberg News investigation to a highly polarized government, the In the 2010 mid-term elections, vot - found that abortion clinics have been organization would focus on races for ers swept Republicans by the hun - closing in record numbers across the state offices and support candidates dreds into state legislatures. Republi - country since the new state laws went who advocate abortion rights. 12 cans won 675 new seats and wrested into effect but that only about a third But NRL’s Tobias thinks abortion- control of 11 legislatures from Democ - of closings have been due to the new rights proponents will face “an up - rats , according to the National Con - laws. The rest closed due to demo - hill battle” in trying to affect state- ference of State Legislatures (NCSL). graphic changes, declining demand, level elections, given the recent After the elections, 25 state legislatures industry consolidation, doctor retire - successes of anti-abortion groups in were in GOP hands, and 11 gover - ments and crackdowns on unfit getting states to adopt new abortion norships had flipped from Democratic providers, the news service said. 11 laws. “People in the states are elect - to Republican control. 14 The warring sides in the abortion ing pro-life legislators because they It was a moment that James C. Bopp debate are gearing up for an active support pro-life laws.” 13 Jr., a conservative Indiana lawyer and

www.cqresearcher.com March 21, 2014 269 ABORTION DEBATES

general counsel for National Right to sense from a political perspective,” be - as governor was to “make abortion, at Life, had been waiting for since 2007, cause there had been “an unprece - any stage, a thing of the past.” 19 when he and law firm colleague dented level of abortion advocacy at Richard E. Coleson wrote an 11-page the federal level and a hostility to de - Does emergency contraception strategy memo for anti-abortion ac - fending life.” cause abortion? tivists. The ultimate target was getting Anti-abortion groups found that the Emergency contraception — pills Roe v. Wade overturned. state legislatures were an appropriate taken after intercourse to prevent preg - “Astute pro-life leaders . . . have venue for carrying out the debate. nancy — have been available in the been working hard to get pro-life of - “States truly are the laboratories of United States since 1999, when the ficials elected,” wrote Bopp and Cole - democracy,” she says. “we are seeing food and Drug Administration (fDA) son, so that “over the long term, there real policy innovation at the state level.” approved the sale of levonorgestrel, a might emerge a majority on the John Green, director of the Ray C. high dose of progestogen hormones, Supreme Court willing to overrule Roe. Bliss Institute of Applied Politics at the the basis for many birth control pills. [That] has been a powerful motivator University of Akron, says using state marketed as Plan B One-Step and its for pro-life political activism.” 15 legislation to reduce the availability of generic versions, my way and Next Encouraged by the prospect of a abortion “can be effective in reducing Choice One Dose, the medication is more sympathetic Supreme Court and the number of abortions, but it won’t available without prescription on phar - emboldened by the wave of social make such procedures illegal.” Ulti - macy shelves. conservatives elected to state office, mately, he says, “it depends on how Often called the “morning-after pill,” abortion opponents began focusing on the courts rule.” the drug, if taken within five days — state legislatures, pushing for the new In fact, some of the new laws have ideally, within 72 hours — after un - abortion clinic laws. Since 2011, states been designed to confront Roe v. Wade protected sex, works primarily by de - enacted 205 laws that the Guttmach - head-on, say anti-abortion activists, laying ovulation, or the release of an er Institute says restrict access to abor - specifically by challenging the court egg from the uterus. tion, compared to 189 over the pre - on how many weeks into a woman’s The availability of the drug was vious decade. In 2013 alone, 70 pregnancy she can legally obtain an potentially an important development abortion-restricting measures were en - abortion. In 1992, the Supreme Court for women who did not want to have acted in 22 states, according to the in - allowed states to restrict abortions after a child but who did not want an stitute. 16 (See map, p. 269. ) fetal viability, which medical profes - abortion either. About 5.8 million Donna Crane, policy director for sionals generally occurs between 23 American women used the morning NARAL Pro-Choice America, says the and 28 weeks. A new Arkansas law after pill from 2006 to 2010, accord - tough laws were a hidden agenda among bans abortions after 12 weeks of preg - ing to a CDC report. 20 the social conservatives elected in 2010. nancy, however, and a North Dakota Abortion-rights supporters say sci - “In the 2010 elections, a crop of real - law bans the procedure after a fetal entific studies have proved that the pill ly conservative, anti-choice [candidates] heartbeat is detected, usually at about only prevents a pregnancy from oc - ran for office, and they ran cleverly [by] the six-week point. And nine states curring and does not end an existing talking about jobs and the economy have banned abortions after 20 weeks. pregnancy. because in 2010 that was really on top (See map, p. 268. ) many medical experts, including of everyone’s mind,” she says. “But after Courts have blocked both the Arkansas the American College of Obstetricians they got into office, they immediately and North Dakota laws, and in January and Gynecologists (ACOG), say preg - . . . began attacking the issue of re - the Supreme Court refused to review a nancy does not occur until an egg is productive freedom.” lower court decision barring an Arizona fertilized in the uterus and then im - The “dominant theme” in the last 20-week ban from taking effect, thus planted in the lining of the woman’s three years for abortion-rights sup - striking down the law . 17 uterus, which does not happen until porters, she says, has been “dealing Still, some legislators believe the several days after intercourse. 21 “Re - with these guys who are just hell-bent time is right for a direct challenge to view of evidence suggests that emer - on taking away a woman’s right to Roe. “when is enough enough?” asked gency contraception cannot prevent choose.” Republican state Sen. Jason Rapert, implantation of a fertilized egg,” so it But Charmaine Yoest, president and who sponsored the Arkansas law. “It’s does not cause an abortion, accord - CEO of Americans United for Life, time to take a stand.” 18 ing to an ACOG committee report. which opposes abortion, says the switch Republican Texas Governor Rick But many abortion opponents be - to “a state-based approach has made Perry has said that one of his goals lieve that life begins at fertilization, not

270 CQ Researcher at implantation, so they say the defi - doubt. It found that emergency con - The fDA has announced no plans nition of pregnancy does not address traceptives do not cause abortions under to change the label’s wording, al - the question of when life begins. And the implantation definition of preg - though Acting Assistant Commission - the morning-after pill, they say, can nancy accepted by ACOG and the fDA. er for media Affairs Erica Jefferson says cause an abortion if an egg was re - However, according to the study, “To that if a woman is already pregnant leased into the uterus before the pills make an informed choice, women must when she takes the pill, “that is — were taken. know that [although the drugs] pre - when the fertilized egg has attached “It is scientifically undisputed that vent pregnancy primarily by delaying to the uterine wall — the drug will a new human organism begins at fer - or inhibiting ovulation and inhibiting not cause the pregnancy to end.” tilization,” the Catholic medical Asso - fertilization . . . it is not scientifically The agency is “aware of emerging ciation and other organizations of health possible to definitively rule out that data” suggesting that Plan B “does not care professionals opposing abortion have stated. “[If] a drug or device can work after fertilization, by blocking the implantation of a developing human embryo, [it] might not end a ‘preg - nancy’ . . . but it does end the life of a unique human being.” Interpretation of a government- approved description of the pill’s ef - fects also plays a role in the dispute. fDA’s product information label for n a v i l Plan B One-Step says the medication l u S “will not work if you are already preg - n i t nant and will not affect an existing s u J pregnancy.” However, the label also / s e

says the product may work “by pre - g a m

venting attachment [of a fertilized egg] I

y t to the uterus” — and that possibility t e rankles abortion opponents. G The American Association of Pro- Nonprescription emergency contraception (EC) medication has been available in the United States since 1999, marketed as Plan B One-Step and its generic Life Obstetricians and Gynecologists has versions, My Way and Next Choice One Dose. The availability of EC’s was seen said, “Terminating a human embryo is as an important development for women who did not want a child but did not abortion, whether before or after its want to have an abortion. But abortion opponents say the so-called morning-after implantation into the uterus.” 22 pill can go beyond contraception in some cases and cause an abortion. many scientists say the fDA’s la - According to a federal report, 5.8 million women used the pill from 2006 to 2010. beling doesn’t reflect the latest scien - tific knowledge about Plan B. ACOG [the drugs] may inhibit implantation of inhibit or prevent implantation of the and other health care professional or - a fertilized egg in the [uterus].” How - fertilized egg” and can change a drug’s ganizations have written that the ever, the study also found “no avail - labeling, but it must be “at the request label’s statement about preventing at - able evidence” of that happening. 24 of a company to reflect new infor - tachment of a fertilized egg “has not Biochemist Diana Blithe, program mation from clinical trials or other sci - been updated since the product was director for the Contraceptive Devel - entific sources,” Jefferson says. originally approved in 1999 and . . . opment Research Centers Program at does not reflect the most current re - the National Institute of Child Health Should employers with religious search [showing] that Plan B . . . func - and Human Development, said the objections be able to exclude tions by inhibiting or postponing ovu - possibility of Plan B One-Step’s effect coverage for abortions and birth lation. . . . It does not prevent fertilization on implantation no longer belongs on control expenses in company or implantation” so it does not cause the label. “As a scientist, I would def - health insurance plans? an abortion.” 23 initely take [the implementation refer - Under the new, comprehensive A Princeton University study pub - ence] off of emergency contraception,” health care reform law — the Afford - lished in february left some room for she said. 25 able Care Act (ACA) — for-profit

www.cqresearcher.com March 21, 2014 271 ABORTION DEBATES

companies must include coverage will be heard together by the U.S. which would subject them to fines of for physician-prescribed and fDA- Supreme Court on march 25, are based $1.3 million a day, or dropping em - approved contraceptive services for on similar arguments, lower courts ar - ployee insurance altogether, which would women enrolled in company insur - rived at different conclusions in their cost them $26 million in fines . 27 ance plans. The coverage must be free rulings on the cases. Hobby Lobby lawyer Kyle Duncan — that is, an employee does not have One case was filed by the owners said, “No one should be forced to give to provide a co-payment or a deductible of the arts-and-crafts chain Hobby up their constitutionally protected civil — so the employer ends up paying Lobby, who say they apply biblical rights just to go into business. . . . [T]he for insuring the services. principles to their company’s man - government’s efforts to strip this fami - The law “is designed to ensure that agement. The owners say they don’t ly business of its religious rights repre - health care decisions are made be - object to providing coverage for cer - sent a gross violation of the Religious tween a woman and her doctor,” tain forms of contraception, such as freedom Restoration Act [RfRA, a 1993 white House press secretary Jay Car - diaphragms, condoms or sterilization federal law intended to remove obsta - cles to an individual’s religious practice] and the first Amendment.” 28 The 10th U.S. Circuit Court of Ap - peals in Denver agreed with Hobby Lobby, concluding that a corporation has a constitutional right of religious ex - pression and thus is not required to cover abortion services or contracep - tion. 29 Appealing the decision to the Supreme Court, the Justice Department argued that RfRA is not “a sword . . . to deny employees of for-profit com - mercial enterprises the benefits and pro - tections of generally applicable laws.” 30

i The American Civil Liberties Union, k s e

i which supports the government posi - r d

n tion, wrote in a “friend of the court” A

d brief, “Although the business owners E

/ are certainly entitled to their religious o t o

h beliefs, the companies are not per - P

P mitted to invoke those beliefs to dis - A The new Affordable Care Act requires employers to provide free contraception criminate against their female em - services for employees in company insurance plans. Owners of the Hobby Lobby ployees. Just as the companies’ owners chain and another firm object to contraception and have sued the government to would not be able to use religion to overturn the mandate, contending it interferes with their constitutional right to hire only men, or refuse to pay their practice their religion. The U.S. Supreme Court will hear arguments female employees equally, they should in the case on March 25. not be allowed to use religion to vi - ney said Nov. 26, 2013. “The president surgery, which prevent an egg from olate a contraception rule that is de - believes that no one, including the being fertilized. However, they do ob - signed to promote gender equality.” 31 government or for-profit corporations, ject to emergency contraception drugs The other case involves Conestoga should be able to dictate those deci - such as Plan B One-Step which, they wood Specialties Corp., a cabinet maker sions to women.” 26 say, can prevent fertilized embryos from in East Earl, Pa., owned by a men - But two businesses, whose owners implanting in the uterus and therefore nonite family opposed to contracep - object to contraception on religious — under their definition — constitutes tion and abortion. The company em - grounds, have sued the federal gov - an abortion. ploys 950 workers; the owners say their ernment over the birth control man - Hobby Lobby’s owners said they faith requires them to apply their re - date, claiming it interferes with their are faced with either refusing to offer ligious principles to their business constitutional right to practice their re - their 13,000 employees the compre - practices. 32 In ruling that the com - ligion. Although the two cases, which hensive coverage required by ACA, pany was not exempt from the ACA

272 CQ Researcher mandate, the Third U.S. Circuit Court of Appeals wrote, “we simply cannot Regional Divide on Abortion Grows understand how a for-profit, secular The regional disparity in attitudes about abortion nearly doubled corporation — apart from its owners between 1995 and 2013. The difference between those in New — can exercise religion.” 33 England who broadly support legal abortion compared to those in But Randall wenger, one of Conestoga’s attorneys, said in announcing the com - the South Central region rose from 18 percentage points to 35 pany’s decision to appeal the case to during that period.* As support for abortion in all or most cases the Supreme Court, “How can the gov - grew in New England, it declined in the South Central states. ernment tell families operating businesses that they can no longer apply their con - Percentage Who Favor Legal Abortion in All or Most Cases, by Region victions in the workplace? Living con - sistently with one’s beliefs is a basic tenet 75% 70% 1995-1996 of a free society. ” 34 Some churches and other religious - 2012-2013 ly affiliated organizations also oppose 52% the contraception mandate. In response 40% to their complaints, the white House in 2012 exempted “churches, other hous - es of worship and similar organiza - tions” from paying for their employees’ contraception coverage on the basis of the employer’s religious objections; in those cases, the insurance companies New England South Central would cover the costs. 35 Despite the exemption, some em - ployers maintain that the ACA’s contra - * New England includes Connecticut, Massachusetts, Maine, New Hampshire, ception requirement requires them to vi - Rhode Island and Vermont. South Central region includes Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee and Texas. olate their religious convictions that forbid the practice of birth control. The Little Source: “Widening Regional Divide over Abortion Laws,” Pew Research Center, Sisters of the Poor, an order of Catholic July 29, 2013, http://tinyurl.com/pwg3fcl nuns which operates nursing and assist - ed living facilities for the elderly, sued case is pending before the 10th U.S. ceptive coverage, Little Sisters need the government over a requirement to Circuit Court of Appeals in Denver. 37 only certify that they are nonprofit or - sign a form requiring their insurance In a case raising similar issues, ganizations that hold themselves out company to provide the contraception the Chicago-based Seventh Circuit as religious and that, because of reli - coverage. Signing the form, the sisters on feb. 21 denied the University of gious objections, they are opposed to said, would violate their religious con - Notre Dame’s request for a temporary providing coverage for some or all victions by making contraception avail - injunction exempting it from ACA’s con - contraceptive services . . . [there is] no able to their female employees. 36 traception requirement, which the uni - substantial burden on their exercise of On Jan. 21, 2014, the Supreme Court versity said forced it to go against its religion.” 39 ruled that the Little Sisters should not religious beliefs. The court wrote, “while But George mason University profes - be required to sign the form before a religious institution has a broad im - sor Helen Alvaré, a strong abortion op - their case is resolved in the courts. In - munity from being required to engage ponent who teaches family law and re - stead, a written notice to the Depart - in acts that violate the tenets of its ligion and the law, has written, “Legally, ment of Health and Human Services faith, it has no right to prevent other the [contraception] mandate has put would suffice, stating that as a reli - institutions, whether the government the Catholic Church in the exemption- gious order they have “religious ob - or a health insurance company, from seeking business — the business of seek - jections to providing coverage for con - engaging in acts that merely offend ing not to comply with laws billed as traceptive services.” The court made the institution.” 38 advancing human rights for women. This clear its ruling was not “an expression The Justice Department has argued is a position more than disagreeable to of [its] view” of the case’s merits. The that, “To opt out of providing contra - anyone pushed to take it.” 40

www.cqresearcher.com March 21, 2014 273 ABORTION DEBATES

tion was the official cause of death Hoping to quell the debilitating for nearly 2,700 women, or 18 per - nausea, she took a tranquilizer that BACKGROUND cent of childbirth-related deaths record - had been prescribed for her husband ed that year. 41 The actual number of while he was on a business trip to abortion-related deaths is unknown. England. The drug, thalidomide, was Banning Abortion “many deaths from illegal abortion not available in the United States. A would go unlabeled as such because few weeks later, she saw a newspa - uring the 18th and early 19th of careless or casual autopsies, lack of per account of babies being born in D centuries, abortions were illegal experience and ability of autopsy sur - England with grotesque deformities only after “quickening,” or when a geons, and simply the shame and fear after their mothers had taken an un - woman could feel movement of the associated with abortion’s illegality,” named tranquilizer during pregnancy. fetus, generally considered to occur according to a study by NARAL Pro- Eventually she learned that the drug around the fourth month of pregnan - Choice America. 42 was thalidomide. Her doctor told her cy. Drugs and other medications that Childbearing in general was danger - the odds were significantly against her induce abortions were widely avail - ous, as well. In her book When Abor - delivering “a normal baby.” able; practitioners were also beginning tion Was a Crime , historian Leslie Rea - At the time, abortion was illegal in to offer surgical abortions. gan wrote, “The mortality associated with Arizona except to save a woman’s life. In 1857, the American medical Asso - abortion must be assessed within the Even though Chessen’s life was not in ciation (AmA) began campaigning to make context of overall maternal mortality. In danger, the doctor recommended ter - abortion at any stage of pregnancy ille - the 1920s, observers believed that at minating the pregnancy, calling it a “therapeutic” abortion. She agreed; he made the arrangements. Her situation soon became national, then international, news. fearing pros - “I was hardly thinking 50 years ahead to what impact ecution, the hospital canceled the pro - my decision would have on the world of the future. . . . cedure. So Chessen sought an abortion overseas and received permission to It was simply the perfect storm for this long-delayed have the procedure done in Sweden. The obstetrician who performed it told debate to be brought to the forefront.” her the baby was too badly deformed to have survived. 45 — Sherri Chessen, Lee Epstein, a professor of law and political science at the University of who had a controversial abortion in 1962 after taking the drug Southern California, wrote that Chessen’s “situation evoked sympathetic reactions thalidomide and learning her child would be born severely deformed. . . . and, in essence, led to the creation of an American abortion reform move - ment.” 46 Chessen told CQ Researcher she “was gal, partly on moral grounds, partly out least 20,000 women died each year due not a spearhead, but a catalyst.” She of concern for patients’ health and part - to [childbirth-related] causes .” 43 says she was just “a mother . . . with ly to limit competition from homeopaths By the 1960s perhaps as many as four small children to care for, and and midwives, according to historian James 1.2 million illegal abortions were being was facing the possibility of know - C. mohr. By 1880, every state had banned performed each year. 44 ingly giving birth to what was de - abortion except when needed to protect In 1962, a high-profile case brought scribed to me as ‘a head and a torso.’ the life of the mother. the issue out from the shadows. Sherri I was hardly thinking 50 years ahead But illegal abortion remained an Chessen — known as miss Sherri, host to what impact [my] decision [would] option, although it carried serious of the Phoenix, Ariz., edition of the have on the world of the future. . . . risks, such as poisoning from untest - popular “Romper Room” children’s Tv It was simply the perfect storm for ed and unregulated medications and show — was pregnant with her fifth this long-delayed debate to be brought surgical procedures carried out under child and suffering from severe morn - to the forefront.” unsanitary conditions. In 1930, abor - ing sickness. Continued on p. 276

274 CQ Researcher Chronology

the Supreme Court reaffirms Roe ’s 25 percent drop from the 1990 all- 1973-1989 holding that states may not ban time high. Supreme Court establishes con - abortions but upholds mandatory stitutional right to abortion, ig - 24-hour waiting periods and 2012 niting ongoing political battles. parental-consent laws. Supreme Court in June upholds Court later upholds some re - the ACA but says states can de - strictions, strikes down others. 1996 cide the level of abortion coverage Congress passes law banning late- each woman must receive. . . . 1973 term abortions (also called “partial Owners of Hobby Lobby craft Supreme Court’s landmark Roe v. birth” abortions); President Clinton stores and Conestoga wood Spe - Wade decision establishes constitu - vetoes the bill. cialties Corp. sue the government tional right to abortion. . . . In Doe on religious grounds over the v. Bolton , the court strikes down a • ACA’s contraception mandate. . . . Georgia law requiring a woman to white House exempts churches get approval from three physicians and religious organizations from before having an abortion. 2000-2007 U.S. paying for employees’ contracep - abortion rate declines steadily. tion coverage. 1976 Congress passes Hyde Amendment 2003 2013 banning the use of medicaid and President George w. Bush signs States enact 70 laws regulating other federal funds for abortions. partial birth abortion legislation. abortion, compared to 189 over the entire previous decade. . . . 1979 2007 Tenth U.S. Circuit Court of Ap - Supreme Court rules unconstitutional Supreme Court upholds the consti - peals rules that Hobby Lobby does a missouri law requiring abortions tutionality of the partial birth abor - not have to provide contraception be performed in hospitals after the tion ban. coverage for employees, but Third first trimester. Circuit rules that Conestoga wood • Specialties does. Both decisions 1983 are appealed to the Supreme Supreme Court declares unconstitu - Court, which agrees to hear them tional an Ohio law requiring a 24- 2010-Present together. . . . House of Represen - hour waiting period before an Social conservatives push for tatives in June passes the Pain - abortion, parental consent for abor - more state regulations on Capable Unborn Child Protection tions on girls under 15 and that abortion; abortion coverage Act, which would ban abortions abortions after the first trimester be becomes issue in debate over after the 20th week of pregnancy; performed in a hospital. comprehensive health care law. a companion bill in the Senate is given little chance of passage. 1989 2010 Supreme Court strikes down a Congress passes Affordable Care 2014 washington state law declaring Act (ACA) in march, requiring Supreme Court in January gives that “life begins at conception.” Americans to have health insur - religious organizations temporary ance. . . . In November voters relief from complying with the ACA • elect hundreds of social conserva - contraception mandate while the tives to state legislatures and gov - issue is being resolved in the courts ernors’ mansions. and refuses to review a lower court 1990s Court broadens decision striking down an Arizona states’ right to regulate abortions; 2011 ban on abortions at 20 weeks of abortion opponents try to get the federal government says insurance pregnancy. . . . Supreme Court court to chip away at Roe. companies must cover women’s will hear arguments in Hobby contraceptives under the ACA. . . . Lobby and Conestoga cases on 1992 Number of abortions reaches low - march 25. In Planned Parenthood v. Casey , est level since Roe v. Wade — a

www.cqresearcher.com March 21, 2014 275 ABORTION DEBATES

Compromise Remains Elusive in Abortion Debate Politicians “benefit from keeping the divisiveness alive.”

n march 1993, David Gunn, a physician in Pensacola, fla., shops and public forums to 20 cities. By then, however, the who performed abortions, was shot to death by michael f. abortion conflict was out of the headlines, Jacksteit says, and I Griffin as he shouted “Don’t kill any more babies,” the first “the foundation world became bored with the issue. In 1998, of five killings or attempted killings of U.S. abortion providers when [abortion doctor Barnett Slepian] was killed in Buffalo, over the next two years. He was convicted of murder and sen - it wasn’t page one news.” tenced to life in prison. with foundation grants disappearing, the two women sought “The 1990s was a tumultuous decade,” says mary Jacksteit, funding from advocacy organizations on both sides of the abor - a specialist in conflict resolution. “The abortion issue was very tion issue. “we had good conversations, but no traction be - divisive and disruptive at the local level.” cause at that level of advocacy, you raise money by demoniz - Jacksteit and Sister Adrienne Kaufmann, a Benedictine ing the other side,” not by “quiet, reasonable discussion,” nun, thought there might be a way to reduce the conflict Jacksteit says. The network closed up shop in 1999. through dialogue between activists on both sides of the de - Today, Jacksteit says she sees no prospect of movement to - bate. In the months following Gunn’s murder they founded ward common ground “as long as politics in washington and the Network for Life and Choice under the sponsorship of in the states are so polarized. 1 Until that overall dynamic Search for Common Ground, a conflict prevention organi - changes, I don’t see anything happening very soon.” zation in Boston. Even an effort in 2009 to get legislation passed that aimed for them, common ground didn’t mean legislating agree - “to reduce the need for abortion while preserving the right ment and defining what was and was not permissible; their to have one” could not get support from both sides. Rachel goal was to make the debate more civil. “we wanted to know, Laser, then-director of the culture program at Third way, a ‘How can we wage this battle [over abortion rights] without liberal washington think tank, worked on legislation with being violent, by finding areas where we agree?’ ” Jacksteit says. U.S. Reps. Tim Ryan of Ohio, who called himself a “pro-life “we were very focused on changing the relationships between Democrat,” and Rosa DeLauro, D-Conn., who supported abor - advocates and opponents.” tion rights. They crafted a bill to provide funds for increased “we found people, both pro-life and pro-choice, who want - access to contraception, expanded public information about ed to have a serious discussion without destroying relation - adoption, increased health care coverage for pregnant women ships or being ugly or violent,” Jacksteit says. with funds and broadened access to comprehensive sex education. The mostly from grants from philanthropic foundations, Jacksteit legislation had the backing of abortion rights groups such and Kaufmann by 1999 had brought their program of work - as NARAL Pro-Choice America and Planned Parenthood, as

Continued from p. 274 women (NOw) adopted a Bill of Rights consent of the “informed patient.” The A Gallup poll conducted in Sep - that included “the right of women to evolution of the AmA’s position pre - tember of 1962 showed that 52 per - control their own reproductive lives” sents “a portrait of a profession — like cent of Americans thought Chessen by decriminalizing abortion. the society it served — on the cusp “had done the right thing,” while 32 Religious organizations also were tak - of change,” wrote legal affairs jour - percent called it “the wrong thing.” ing sides. Conservative denominations nalist Linda Greenhouse and law pro - Sixteen percent were unsure or had such as Roman Catholics and the Luther - fessor Reva B. Siegel. 49 no opinion. 47 an Church’s missouri Synod took strong States soon began to loosen their stands against legalizing abortion out abortion restrictions. Beginning in 1970, of respect for human life. more liber - Alaska, Hawaii, New York and wash - Decriminalizing Abortion al denominations, including methodists ington repealed their antiabortion and the United Church of Christ, sup - statutes and allowed abortions on re - ith the Chessen case, America’s ported abortion rights. 48 quest before fetal viability, generally, w decades-old conversation about In 1970 the AmA, which had led during the first trimester. Of the four, abortion, which had focused mostly the 19th-century effort to criminalize however, only New York did not im - on moral perspectives, expanded to abortion, reconsidered its position and pose a 30-day residency requirement incorporate other medical, legal and declared that decisions about abortion on the patient, making it a destination political concerns. In 1967 the newly should be left to the “sound clinical for out-of-state women who could af - established National Organization for judgment” of the physician and the ford the trip. 50

276 CQ Researcher well as some evangelical Christian A 2011 Gallup poll found “plenty of leaders who opposed abortion. common ground” between the two sides. But major anti-abortion groups did for instance, 86 percent of adults favor - not endorse it because, they believed, ing abortion rights and 87 percent op - s

“Planned Parenthood and NARAL n posing them agreed in requiring informed o i t

wouldn’t back a so-called ‘common c consent for women seeking abortions, and e r

ground’ bill unless it included abortion r 79 percent and 94 percent, respectively, o C

services,” said Charmaine Yoest, presi - agreed with making abortion illegal in the f o dent and CEO of Americans United for third trimester. t n

Life, which calls itself “the nation’s pre - e Ted Jelen, a political science professor m

2 t

mier pro-life legal team.” The bill died r at the University of Nevada, Las vegas, a

in committee. p says polls show that “most people think e D Laser says it failed because it tried abortion should be legal but restricted.” a d i

“to depoliticize an issue that a lot of r However, Jelen says, the fact that “both o l

politicians thrive on.” Politicians “are not F sides are able to frame their positions in interested in calming the debate,” she Michael F. Griffin, above, shot and terms of rights — the fetal right to life says, because “they benefit from keep - killed David Gunn, a physician who versus the maternal right to choos e— ing the divisiveness alive,” since extremists performed abortions in Pensacola, “makes it difficult for the two sides to on both sides are most likely to vote Fla., in 1993. Gunn was the first of come together. ‘Rights’ is a very power - and to make campaign contributions. five abortion providers killed or ful symbol in American politics.” attempted to be killed over the next Like Jacksteit, Laser is pessimistic about two years. Griffin was convicted and — William Wanlund the near-term chances for reaching com - sentenced to life in prison. mon ground, which she defines as shared values both sides can agree on “while 1 for background, see Tom Price, “Polarization in staying true to their core values.” Laser calls the current politi - America,” CQ Researcher , feb. 28, 2014, pp. 193-216. 2 Press release, “AUL: So-Called ‘Common Ground’ Ryan-DeLauro Bill would cal climate “challenging,” and says, “we have not seen the end Actually force All 50 States to Pay for Abortion,” Americans United for Life, of finding shared values on abortion, but right now it doesn’t Aug. 7, 2009, http://tinyurl.com/kt7yr26. seem as though some major effort is going to emerge.”

A study by an economic research for the Department of Health and tively broadened the rights of states to organization found a “robust associa - Human Services to pay for an abor - regulate abortion. 53 tion” between distance to New York tion except in the case of rape, incest Also in 1992, Democrat Bill Clinton and abortion rates in the pre- Roe v. or when the woman’s life is endan - was elected president. He said abor - Wade years, with abortion rates falling gered. The amendment primarily af - tion decisions “should be left to a “11.9 percent for every hundred miles fects medicaid, the health care pro - woman, her conscience, her doctor a woman lived from New York.” 51 gram for low-income individuals, which and her God” and that “abortion should In 1973, the landmark Supreme Court is funded jointly by states and the fed - not only be safe and legal, it should Roe decision establishing a woman’s eral government. be rare.” 54 with a supporter of abor - constitutional right to abortion was In 1992 a more conservative court, tion rights in the white House, and a based on a woman’s right to privacy led by Chief Justice william Rehnquist, Supreme Court apparently unwilling under the 14th Amendment, which lim - in Planned Parenthood of Southeastern to reverse Roe , abortion opponents its the activities of government offi - Pa. v. Casey , reaffirmed Roe ’s “essential “moved away from the all-or-nothing cials as they affect citizens. 52 principle” of the right to abortion with - attitude” of trying to overturn Roe out - In 1976, in response to the con - out undue state interference but also right, a tactic they had concluded cerns of abortion opponents, Congress found that states could impose certain “would simply generate more court passed legislation that became known reasonable requirements, including a decisions re-endorsing Roe ,” says as the Hyde Amendment, which pro - 24 -hour waiting period and parental David Garrow, a history and law pro - hibits the use of funds appropriated consent for minors. The decision effec - fessor at the University of Pittsburgh.

www.cqresearcher.com March 21, 2014 277 ABORTION DEBATES

Instead, he says, they adopted a strat - reproductive rights and is an assault on egy of “chipping away at the margins.” a woman’s right to choose.” 60 without directly challenging Roe ’s In January 2013, Obama signed leg - t n

precepts, states began passing legisla - e islation permitting military service - m t

tion making access to abortion more r women to use their government in - a p

difficult — for example by forbidding e surance to pay for an abortion in case D the use of public funds for abortion; of rape or incest. Previously, military e c i restricting private insurance coverage l insurance had covered only abortions o P

for abortions; mandating waiting peri - a performed to save the woman’s life; i h p

ods between gynecological counseling l servicewomen who wanted to termi - e and performance of an abortion; and d nate a non-life-threatening rape- or in - a l i requiring parental consent before a h cest-caused pregnancy had to pay for P /

minor could get an abortion. o the procedure themselves. t o

It’s the kind of incremental, long-term h Defense Department figures show P

approach that anti-abortion strategist P 467 reports of rape of service mem - A Bopp of National Right to Life favors. Philadelphia abortion doctor Kermit bers during the fiscal year beginning “The Supreme Court’s current makeup Gosnell was sentenced to life in Oct. 1, 2011. However, the department assures that a declared federal constitu - prison without parole after being also estimates that fewer than 15 per - tional right to abortion remains secure convicted in the deaths of a patient cent of military sexual-assault victims for the present,” he and Coleson wrote and three babies born alive during report the attack to a military author - abortions at a filthy clinic. The in their 2007 memo. “Eschewing incre - sensational 2013 case heightened ity, due to stigma “and other barriers 61 mental efforts to limit abortion where the controversy over tough, new state that deter reporting.” legally and politically possible makes regulations on abortion clinics. The Senate legislation was sponsored the error of not saving some because Abortion opponents say they are by Sen. Jeanne Shaheen, D-N.H., who not all can be saved. It also makes the needed to protect women’s health. also has co-sponsored a pending bill to Abortion-rights advocates contend strategic error of believing that the pro- the laws are unreasonable and make the same benefits available to 62 life issue can be kept alive without such designed to put abortion clinics Peace Corps volunteers. According to incremental efforts.” 55 out of business. agency statistics, 212 rapes or attempt - ed rapes were reported by volunteers “At 20 weeks, the fetal brain has the during the decade 2001-2010. 63 Challenging Roe full complement of brain cells present The bill “is a matter of basic fairness,” in adulthood, ready and waiting to re - said Cecile Richards, president of the bill passed by the House of Rep - ceive pain signals from the body, and pro-choice Planned Parenthood federa - A resentatives last June 18 — the their electrical activity can be recorded tion of America. “It will ensure that a Pain-Capable Unborn Child Protection by standard electroencephalography.” 57 woman serving in the Peace Corps will Act — would ban abortions after the Dr. Nicholas fisk, a senior maternal- have the same access to abortion if she 20th week of pregnancy and directly fetal medicine specialist at Royal Bris - is the victim of rape or incest, or when challenge Roe ’s gestation strictures. bane and women’s Hospital in Aus - her life is endangered, as women in the Sen. Lindsey Graham, R-S.C., who tralia, once considered early fetal pain armed services and many other women introduced a companion bill in the a possibility. 58 But the former presi - covered by federal health programs.” 64 Senate on Nov. 7, said, “we are choos - dent of the International fetal medicine However, Americans United for Life ing today to speak up for all babies and Surgery Society later revised his president Yoest said in a statement that, at 20 weeks, and trying to create legal opinion, saying recent neurological re - rather than resorting to abortion, more protections under the theory that if search convinced him pain “is not pos - attention should be paid to protecting you can feel pain, the government sible at all” before 24 weeks . 59 the volunteers. “Rather than addressing should protect you from being de - The fetal pain bill, with broad sup - the egregious security concerns that we stroyed by an abortion.” 56 port among Republicans, is considered should all have for these young women The measure’s supporters cited re - unlikely to clear the Democratic-controlled who are being sent in dangerous situ - search concluding that fetuses can feel Senate and faces a likely presidential ations, the Obama administration and pain at that stage, but that theory is veto. In a statement, the Obama admin - their allies are using the horrific events controversial. Dr. Paul Ranalli, a Uni - istration has said the measure “would un - in [their] lives to expand federal in - versity of Toronto neurologist, has said, acceptably restrict women’s health and volvement in abortion.” 65

278 CQ Researcher Abortion Debate Takes to the Road “Choose Life” license plates available in 29 states. andy Harris, a florida county commissioner, was stuck prising,” says Elizabeth Nash, state issues manager at the Guttmach - in traffic in 1996 when he found himself thinking about er Institute, a research organization that supports abortion rights. R an environmental message on the license plate of the “Pro-choice and pro-life license plate efforts come from differ - vehicle ahead of him. If a plate can carry a “Protect the Pan - ent motivations,” Nash says. Choose Life plates help fund adop - thers” message, he wondered, why not one that says “Choose tion agencies and similar organizations, while pro-choice plates are Life” to promote adoption as an alternative to abortion? “more of a messaging piece” promoting family planning, she says. Getting the florida legislature to approve the idea, however, virginia offers both Choose Life plates and plates with the wasn’t easy. At first, lawmakers wouldn’t even move a bill out of slogan, “Trust women/Respect Choice.” funds from sales of the committee, and in 1998 Democratic Gov. Lawton Chiles rejected latter are used for gynecological exams and sexually transmit - the plates as politically divisive. But the following year Republi - ted disease testing and follow-up care — but not for abortion- can Gov. Jeb Bush signed legislation allowing sales of the plates, related services — at Planned Parenthood centers in virginia . 6 although a court challenge delayed their distribution until 2000. s t o

“Adoption is as worthy a cause as [Bush] can think of,” his h s

1 n

spokesman said at the time. e e r Since florida became the first to adopt Choose Life plates, c S / s

28 other states have done so. As of December 2013, some s e r P 910,000 Choose Life plates had been bought or renewed na - Q

tionally, raising nearly $20 million for organizations that pro - C Virginia offers both “Choose Life” license plates, which mote adoption instead of abortion, according to Choose Life help fund adoption agencies, and “Trust Women-Respect America, a group formed in 2011 to promote the sale of plates Choice” plates, which fund gynecological exams to fund adoptions as an alternative to abortion. 2 and related services. But efforts to win state approval of the plates have been difficult at times. Last July, Rhode Island’s Democratic gover - Tarina Keene, executive director of NARAL Pro-Choice vir - nor, Lincoln Chafee, vetoed Choose Life legislation that would ginia, says, “we really don’t feel like a license plate is the place have sent $20 of the $40 cost of each plate to a Christian to be promoting a political agenda.” However, she says, her CareNet crisis pregnancy center that opposes abortion rights. organization saw the Choose Life plate as a challenge that need - The function of a license plate is “to register and identify ed to be answered, so NARAL and other organizations that sup - a motor vehicle,” Chafee wrote in his veto message to law - port abortion access lobbied for the pro-choice plate. It was makers. “It is my belief that state participation in the trans - approved by the state legislature in 2010. mission of funds to this organization would violate the sepa - ration of church and state, one of the fundamental principles — William Wanlund upon which our state was founded.” 3 Likewise, in December 2012, a federal judge ruled that North 1 David Nitkin, “Gov. Bush Signs Controversial License Law,” Orlando Sen - Carolina’s offering of a Choose Life license plate “in the ab - tinel , June 9, 1999, http://tinyurl.com/m4lbz97. 2 sence of a pro-choice alternative” amounts to “viewpoint dis - “Newsletter,” Choose Life America, Inc., Dec. 12, 2013, http://tinyurl.com/n8rr5yy. 3 4 “Rhode Island Governor vetoes ‘Choose Life’ License Plates,” Governing.com , crimination” and violates the first Amendment. July 17, 2013, http://tinyurl.com/pduo8z6. North Carolina appealed the decision to the fourth U.S. Cir - 4 Opinion, U.S. District Court for the Eastern District of North Carolina, cuit Court of Appeals, which rejected the appeal in february. western Division, ACLU of North Carolina v. State of North Carolina , Dec. 7, The state attorney general’s office was reviewing the decision, 2012, http://tinyurl.com/qyelt7q. 5 5 Dan mcCue, “Anti-Abortion License Plates in N.C. Tossed,” Courthouse a spokeswoman said. News Service, feb. 14, 2014, http://tinyurl.com/n99ty6f. while more than half of the states offer Choose Life plates, only 6 “Support Trust women/Respect Choice License Plates,” fact sheet, Planned four have offered plates with a pro-choice message. That’s “not sur - Parenthood, http://tinyurl.com/pdxdwre.

The Peace Corps legislation was ap - meanwhile, in 1999, the food and prescription to women over 18, and proved last July 25 by the Senate Ap - Drug Administration approved emer - by prescription to those 17 and propriations Committee for inclusion gency contraceptives for prescription- younger. In June 2013, under pres - in the overall State Department and only sale in the United States. sure from federal courts and finding foreign relations appropriations bill, In 2006 the agency partially re - no medical evidence that the drug which has not been scheduled for a moved the pill’s prescription require - was harmful, the agency dropped the vote by the full Senate. ment, making it available without a age restriction altogether . 66

www.cqresearcher.com March 21, 2014 279 ABORTION DEBATES

ACA circumvents Hyde because “in - Abortion Rate at 38-Year Low surance plans in the new state ex - The abortion rate in 2011 — about 16 per 1,000 women between changes are permitted to cover abor - the ages of 15 and 44 — was the lowest since 1973, the year the tion unless states prohibit it.” Thus, the group said, “many Americans will Supreme Court legalized abortion. The rate peaked in 1981 at 29 be railroaded into paying directly for abortions per 1,000 women, and has generally fallen since then. abortions with their insurance premi - Between 2008 and 2011, the abortion rate fell by 13 percent. ums — sometimes without their knowl - edge and consent.” 71 Number of Abortions (ages 15-44), 1973-2011 According to an analysis by the No. of Abortions Per 1,000 Women Charlotte Lozier Institute, the research 30 organization opposed to abortion rights, the ACA will result in an annual net 25 increase of up to 111,500 insured abor - tions that are either fully publicly fund - ed through medicaid or heavily sub - 20 sidized through the state health insurance exchanges, depending on 15 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 how many women forego insurance and pay out-of-pocket.” 72 Sources: Rachel Jones and Kathryn Kooistra, “Abortion Incidence and Service Availability in the United States, 2008,” Perspectives on Sexual and Reproductive Health, Guttmacher Institute, March 2011, http//tinyurl.com/mnxrghj; 2008-2011 data is from Rachel Jones and Jenna Jerman, “Abortion Incidence and Service Upcoming Elections Availability in the United States, 2011,” Perspectives on Sexual and Reproductive Health, Guttmacher Institute, March 2014, http//tinyurl.com/plk68q2. s Republican politicians prepare A for next fall’s midterm elections, ance premiums for policies that include the party hopes its candidates will strike abortion coverage, it is subsidizing abor - the right tone in their public com - CURRENT tions with taxpayer money in violation ments about abortion. of the Hyde Amendment. The 1976 law In their 2012 Senate campaigns SITUATION prohibits the use of funds appropriated Rep. Todd Akin in missouri and for the Department of Health and Human Richard mourdock in Indiana made Services to pay for an abortion except controversial assertions about rape Abortion and the ACA in the case of rape, incest or when the and abortion that contributed to their woman’s life is endangered. The amend - defeat by their Democratic oppo - s expansion of public and private ment primarily affects medicaid. nents. 73 In virginia’s 2013 guberna - A insurance under the Affordable In march 2010 Obama issued an torial election, Democrats portrayed Care Act (ACA) got underway Jan. 1, executive order intended to ensure Republican candidate Ken Cuccinel - controversy has intensified over how that the ACA was consistent with the li as hostile to women for his op - the new law treats abortion services . 67 amendment. If abortion is covered in position to abortion and stands on One aspect of the controversy re - an exchange insurance plan, the order other issues. Cuccinelli lost the volves around the health insurance ex - said, the policyholder must pay a sep - women’s vote by 9 percentage points, changes — the government-supervised arate premium out of her own pock - which contributed to his defeat by “marketplace” of insurance plans from et for that service. 69 moreover, under Democrat Terry mcAuliffe in an elec - which potential ACA enrollees can the ACA, states may exclude abortion tion decided by a vote difference of choose federally subsidized health in - coverage from plans offered in their health 2.5 percent. 74 surance. The plans are offered by pri - insurance exchanges. As of feb. 1, near - Republican virginia state Sen. vate companies, but the marketplaces ly two dozen states had prohibited Stephen martin said on feb. 24, 2014, are run by either the states or the fed - their state exchanges from covering “once a child does exist in your eral government. 68 most abortions. 70 womb, I’m not going to assume a Abortion opponents contend that, be - However, Americans United for Life right to kill it just because the child’s cause the ACA subsidizes some insur - announced in a statement that the Continued on p. 282

280 CQ Researcher At Issue:

Do yes abortion limits disproportionately harm low-income women?

HEATHER D. BOONSTRA HELEN ALVARÉ SENIOR PUBLIC POLICY ASSOCIATE , PROFESSOR OF FAMILY LAW AND GUTTMACHER INSTITUTE LAW AND RELIGION , G EORGE MASON UNIVERSITY SCHOOL OF LAW WRITTEN FOR CQ RESEARCHER , MARCH 2014 WRITTEN FOR CQ RESEARCHER , MARCH 2014

estrictions on abortion fall hardest on low-income eople seeking easier abortion access for poor women women, who already are disadvantaged in a variety of dwell on the apparently popular ends they pursue: r ways, including lacking access to the information and p avoiding creating children who are unwelcome and services necessary to prevent unplanned pregnancy in the first avoiding child poverty and the associated taxpayer ex - place. Indeed, low-income women bear a disproportionate penditures. They also champion “empowering” poor women to burden from unintended pregnancies. In 2008, the rate of un - make decisions without the interference of the state, or of men intended pregnancy among poor women was more than five who may not have their best interests in mind. These ends times that of women with an income of at least 200 percent seem to exude concern for the poor and for women’s equality. of the federal poverty level (137 vs. 26 per 1,000 women, The problems with this position, however, are profound: They ages 15-44). As a result, low-income women are disproportion - concern both the “means” proposed and the collateral effects. ately likely to be faced with the decision about whether to first, abortion advocates refuse to squarely face the means seek an abortion. they endorse to reach their ends. Abortion destroys human Some abortion restrictions — such as the Hyde Amendment, life. This is not mere “opinion,” but a fact acknowledged by which sharply limits abortion coverage for women who rely on everyone from the Guttmacher Institute to the Planned Parent - medicaid for yinsurance — sepecifically tasrget low-income women. hood federation to abortion provo iders far and wide. Solicitude The impact of these restrictions is significant. Unable to use on behalf of the poor is one thing; working to ensure access their coverage, poor women living at or near the poverty line to aborting poor children is another. If anything, legal abortion often have to postpone an abortion because of the time it is more disturbing today than 40 years ago, before ultrasound takes to scrape together the funds to pay for the procedure. machines began depicting the human victim. moreover, one in four women enrolled in medicaid who Second, an “abortion-access-for-the-poor” campaign is waist- would have had an abortion if coverage were available is high in collateral damage. No matter how strenuously the Na - forced to carry a pregnancy to term. tional Institutes of Health avoids the question, or abortion ad - Other anti-abortion measures — such as pre-viability abor - vocates flatly deny it, abortion scars many women. European tion bans, unwarranted doctor and clinic regulations and limits studies give us some idea of the how and who, but in the on the provision of medication abortion — have forced clinics United States we know about it more from the thousands of in many states to close and otherwise cut off access to abor - women flooding post-abortion distress programs. tion in rural communities. In states or regions with these restric - There is also the matter of how abortion changes the tions, getting to an abortion provider is not easy, especially for “marketplace” for sex and marriage by its ultimate divorcing of those with few resources. Raising money not only for the pro - sex from children. well-off Americans have managed to avoid cedure but also for transportation, a hotel and child care — the nonmarital parenting and abortion rates that legal abortion more than six in 10 women obtaining an abortion already are facilitates, but the poor have not. mothers — are challenges that, although surmountable, may finally, the pursuit of abortion access for the poor — who cause a serious delay that only increases risk. are already a disproportionately aborted population — smells Simply put, restrictions on abortion make it more costly of class disdain. The vocal “concern” for more abortion among — financially and in terms of women’s health and safety. It the poor doesn’t reflect what poor women seek for them - is cruel and ultimately self-defeating for governments to inter - selves: marriage and marital childbearing, stable work and fere with women’s decision-making. Rather than coercing transcendent meaning in their lives. poor women to carry an unwanted pregnancy to term, we when it comes to abortion among the poor, both the poor should focus on supporting all of a woman’s pregnancy deci - and the public should trust the people and institutions who sions: empowering poor and low-income women to prevent renounce the violence of abortion, while also running a mas - unintended pregnancy through access to high-quality contra - sive network of social service programs for women, children ceptives; supporting women so they can raise their children and families. Don’t trust the interest groups that have spent with dignity; and ensuring they can access safe and timely most of their enormous economic and social capital working to secure easier access to the abortion of poor children. abortiono n care.

www.cqresearcher.com March 21, 2014 281 ABORTION DEBATES

Continued from p. 280 over excessive government spending. favor of . . . what they see as moder - host (some refer to them as mothers) for many lawmakers, abortion “ties into ate restrictions on abortion. At the same doesn’t want it,” prompting Democ - the issue they want to be talking about time, the public is generally favorable ratic colleague Barbara favola to say this election, which is Obamacare,” said to abortion being legal and available to martin’s comment showed a “total lack Tom mcClusky, using the nickname Re - them and their families.” of respect for women. ” 75 publicans have given the ACA. mc - In 2008, wilcox co-authored a study “Republicans have struggled in the Clusky is vice president for government that found that abortion was one of past on a whole range of reproductive affairs for the march for Life, which op - the rare issues over which a voter issues. They haven’t talked about those poses abortion. 76 might change political allegiances de - issues with a whole lot of understand - Ted Jelen, a political science pro - pending on a party’s presentation of ing of the situation that women some - fessor at the University of Nevada, Las its views of the subject. “Partisanship times find themselves in,” says Kate vegas, who researches the politics of moves when parties send clear signals Gage, a partner in Burning Glass Con - abortion, doesn’t think abortion will be on issues about which many in the pub - lic care deeply,” the authors wrote . 77 But wilcox thinks voters’ attitudes have solidified since that report was pub - lished. “Really, we don’t know any - “Republicans have struggled in the past on a thing about abortion today we didn’t know before,” he says. “People who whole range of reproductive issues. They haven’t were going to switch parties on this have already switched. I don’t think talked about those issues with a whole lot of there’s going to be a lot more party- understanding of the situation that women switching on this issue.” In a 2012 Gallup poll, 17 percent sometimes find themselves in.” of registered voters surveyed said a candidate’s position on abortion — Kate Gage, would be “decisive” in how they voted. forty-five percent considered abortion Political Consultant, Alexandria, Va. “one of many important issues,” while 34 percent didn’t see it as a major issue. Overall, 48 percent considered themselves “pro-life” and 45 percent sulting of Alexandria, va., which ad - “terribly important” in the 2014 gener - described themselves as “pro-choice,” vises Republican candidates on women al elections but could have a major im - giving the electorate “a slight pro-life voters. “we saw what happened in 2012 pact on who gets on the fall ballot. tilt,” according to Gallup. 78 with candidates like mourdock and Akin. The abortion issue “might have an im - It’s like they’ve never even spoken to pact on some Republican primary races” women who’ve been in these situations. this spring, he says, when activists on when talking about these issues, you the issue “are more likely to turn out.” OUTLOOK have to understand that women who Clyde wilcox, a professor of gov - are facing an unwanted pregnancy are ernment at Georgetown University in women in real crisis.” washington, says if abortion becomes Gage says she tells candidates, “It’s an election issue it will favor Repub - Pushback? important to communicate with more licans, because abortion is the only than a woman’s reproductive system. “culture war” issue that “Republicans n a blustery Saturday morning Let’s talk to women’s brains and their seem to be making inroads with.” O in December, Chuck weichbrecht pocketbooks and about issues that they Public opinion is trending “massive - stood on the sidewalk outside the confront on a day-to-day basis.” ly in a liberal direction” on issues such falls Church Healthcare Center, dis - By alleging that the ACA and its as same-sex marriage and legalization playing a placard with the image of abortion provisions are examples of fis - of marijuana, he says, “but on abortion, a bloody, dismembered fetus to peo - cal irresponsibility, Republicans think the trend is, if anything, slightly more ple entering the building and to mo - they can tap into conservative anger conservative. The public is generally in torists passing by.

282 CQ Researcher weichbrecht’s graphic poster is a con - in how abortion may be dealt with at 4 Rachel K. Jones and Jemma Jerman, “Abor - troversial medium for his message: That the state level. There’s momentum, an tion Incidence and Service Availability in the the public should be conscious of the effort to stop this wave of restrictions.” United States, 2011,” Perspectives on Sexual facts of abortion. “If people find these “I think we are at a potential turn - and Reproductive Health , The Guttmacher In - pictures horrifying, isn’t the act [of abor - ing point,” said Suzanne Goldberg, di - stitute, march 2014, http://tinyurl.com/plk68q2 . tion] itself even more horrifying?” he asks. rector of the Center for Gender and Also see Karen Pazol, et al. , “Abortion Sur - veillance — United States, 2010,” Morbidity weichbrecht, who says he is a de - Sexuality Law at Columbia University. and Mortality Weekly Report , Centers for Dis - vout Christian, believes the images “Either access to abortion will be dra - ease Control and Prevention, Nov. 29, 2013, “make people more conscious of the matically restricted in [2014] or per - http://tinyurl.com/nlrcs7m . 79 consequences” of abortion. “These are haps the pushback will begin.” 5 Stephanie J. ventura, et al. , “Estimated Preg - the last images they see before they Dan mcConchie, vice president of nancy Rates and Rates of Pregnancy Out - go inside to kill their babies.” government affairs at Americans Unit - comes for the United States, 1990-2008,” Na - Center director Codding, who calls ed for Life, isn’t concerned about the tional Vital Statistics Report , vol. 60, No. 7, herself “a woman of faith,” sometimes surge in abortion rights legislation. “we June 20, 2012, http://tinyurl.com/7xous32 . confronts the demonstrators. “I tell them had a strategy that lined up with where 6 Tatiana Bergum, “Report: Abortions Drop that I’m praying for them so they can the American people are,” he said. 32 Percent from All-Time High as Roe Turns understand the true meaning of being “what’s being offered by the other 41,” LifeNews.com, Jan. 21, 2014, http://tiny url.com/krgrjzt . a Christian and open their hearts to side is not something that the Amer - 7 80 Jon Hurdle, “Doctor Starts His Life Term in understanding and supporting our ican people appear to embrace.” Grisly Abortion Clinic Case,” The New York Times , women,” she says. Abortion opponent Tobias, mean - may 15, 2013, http://tinyurl.com/o4vwm56 . The drama playing out at this sub - while, said she is “very encouraged” 8 manny fernandez, “Abortion Law Pushes urban clinic illustrates the passion that by developments on the state level. Texas Clinics to Close Doors,” The New York is likely to continue to accompany the “we’ve been gaining ground in recent Times , march 6, 2014, http://tinyurl.com/pbx abortion debate in the United States. years with laws that are a stronger chal - 8zdh . And much of that dialogue is taking lenge to Roe ,” she said, referring to the 9 Christy Hoppe, “Appeals court taking up place in communities, state legislatures new laws that limit the period during Texas law that’s shuttered abortion clinics,” and the courts, rather than in Congress. which a woman can get an abortion. Dallas News , Jan. 5, 2014, http://tinyurl.com/ According to Elizabeth Nash, state is - “I think it is more difficult to get an l2xw74q . 10 Becca Aaronson, “5th Circuit Court of Ap - sues manager at the Guttmacher Insti - abortion in the country today .” 81 peals weighs Abortion Rules,” The Texas Tri - tute, in the first two months of this year, Jelen, at the University of Nevada, bune , Jan. 7, 2014, http://tinyurl.com/kd8s2f6 . legislators in 14 states introduced 51 pro - Las vegas, doesn’t think the Supreme 11 Esmé E. Deprez, “Abortion Clinics Close visions in support of abortion rights, the Court will overturn Roe v. Wade , at least at Record Pace After States Tighten Rules,” heaviest volume of abortion-rights legis - not during Chief Justice John Roberts’ Bloomberg News, Sept. 3, 2013, http://tinyurl. lation since the early 1990s. The mea - term. “Roberts is very concerned about com/mxcp7yl . sures would either repeal new abortion the court’s legitimacy and the value of 12 Blake Neff, “NARAL shifts strategy to fight restrictions or ease access to abortion. precedent,” Jelen says. “I think you can ‘backward momentum’ on abortion,” The Hill , “we’re probably seeing the begin - expect to see Roe chipped away at Jan. 14, 2014, http://tinyurl.com/lssopka . 13 ning of an effort to push back against over a period of time, but not being Ibid. 14 all of these abortion restrictions,” Nash necessarily overturned outright.” Karen Hansen, “A GOP wave washed over state legislatures on Election Day,” Red Tide , says. And “most of these bills are being National Council of State Legislatures blog, introduced in states where abortion December 2010, http://tinyurl.com/mopvyab . rights have not been treated favorably Notes Also see Corey Dade, “GOP’s ‘Sweet’ wins in over the past few years, such as Ari - Governors’ Races may Pay Off,” NPR, Nov. 8, 1 zona, virginia, Ohio and Nebraska. Esmé E. Deprez, “The vanishing Abortion 2011, http://tinyurl.com/lwja4pd . what this says to me is that the spon - Clinic,” BloombergBusinessweek , Nov. 27, 2013, 15 James Bopp, Jr. and Richard E. Coleson, sors of these bills really want to stand http://tinyurl.com/pbef3xo . “memorandum, To whom It may Concern, Re: 2 up and say enough is enough.” Rosalind S. Helderman, “virginia assembly Pro-Life Strategy Issues,” Bopp, Coleson and for instance, she notes, the virginia says abortion clinics should be regulated as Bostrom, Aug. 7, 2007, http://tinyurl.com/krpgept . hospitals,” The Washington Post , feb. 25, 2011, 16 Senate voted this year to repeal a re - Elizabeth Nash, et al. , “ Laws Affecting Re - http://tinyurl.com/o567hzf . productive Health and Rights: 2013 State Policy strictive abortion law. Although the mea - 3 “widening Regional Divide over Abortion Laws,” Review,” The Guttmacher Institute, http://tinyurl. sure was defeated in the House of Del - Pew Research Center for the People and the com/mlkngn . egates, Nash says, “It marks a change Press, July 29, 2013, http://tinyurl.com/pwg3fcl . 17 Ibid.

www.cqresearcher.com March 21, 2014 283 ABORTION DEBATES

18 Erik Eckholm, “Arkansas Adopts a Ban on et al. , June 17, 2013, http://tinyurl.com/kvjt2up . 42 “The Safety of Legal Abortion and the Haz - Abortions After 12 weeks,” The New York Times , 30 Lawrence Hurley, “Obama asks high court ards of Illegal Abortion,” NARAL Pro-Choice march 7, 2013, http://tinyurl.com/cyzbxk9 . to review contraception mandate ruling,” Reuters, America, Jan. 1, 2014, http://tinyurl.com/2352qjc . 19 manny fernandez, “Abortion Law Pushes Sept. 19, 2013, http://tinyurl.com/khbvqf4 . 43 Leslie J. Reagan, When abortion was a crime: Texas Clinics to Close Doors,” The New York 31 American Civil Liberties Union, et al. , Am - Women, Medicine and Law in the United Times , march 6, 2014, http://tinyurl.com/mc6ws9f . icus Curiae brief, Sebelius v. Hobby Lobby, Inc. States, 1867-1973 (1997), p. 77. 20 Amicus Curiae Brief of the Catholic med - and Conestoga Wood Specialties Corp., et al., 44 “medical and Social Health Benefits Since ical Association, Kathleen Sebelius, et al. v. v. Sebelius , http://tinyurl.com/poop7q9 . Abortion was made Legal in the U.S.,” Planned Hobby Lobby Stores, Inc., et al. , American Bar 32 michelle Bauman, “mennonite-owned wood Parenthood federation, November 2009, Association Preview of United States Supreme manufacturer sues over contraception man - http://tinyurl.com/yavm4w7 . Court Cases, http://tinyurl.com/q9hl36a . date,” Catholic News Agency, Dec. 11, 2012, 45 Unless otherwise noted, the account of 21 Rachel Benson Gould, “The Implications http://tinyurl.com/kfl8oqa /. Sherri Chessen’s abortion experience is drawn of Defining when a woman Is Pregnant,” 33 Opinion, Conestoga Wood Specialties Corp., from Linda Greenhouse, “A Never-Ending Story,” The Guttmacher Report on Public Policy , may et al. v. Secretary of Health and Human Ser - The New York Times , Sept. 5, 2012, http://tiny 2005, volume 8, Number 2, http://tinyurl.com/ vices, et al. , United States Court of Appeals url.com/lvladq2 . pxxm8w5 . for the Third Circuit, July 26, 2013, http://tiny 46 Lee Epstein, “The Impact of the ACLU Re - 22 News release, “fDA Decision on Plan B is url.com/lbgffdp . productive freedom Project,” paper presented Bad medicine for women,” American Associa - 34 Press release, “Conestoga wood Products at the midwest Political Science Association tion of Pro-Life Obstetricians and Gynecologists , Lawyers Appeal to Supreme Court,” wood - meeting, April 15-18, 1981, http://tinyurl.com/ undated, http://tinyurl.com/nv7hgbj . working Network, Sept. 19, 2013, http://tiny p4ele3b . 23 “Sebelius v. Hobby Lobby and Conestoga url.com/mup2ruk . 47 Brian E. fisher, Abortion: The Ultimate Ex - wood Specialties Corp. v. Sebelius — Consol - 35 Office of the white House Press Secretary, ploitation of Women (2013), p. 60. idated,” Docket No’s. 13-354 and 13-356 Amer - “fact Sheet: women’s Preventive Services and 48 Ernest Ohlhoff, “Abortion: where Do the ican Bar Association Preview, http://tinyurl.com/ Religious Institutions,” feb. 10, 2012, http:// Churches Stand?” Pregnant Pause.com , Sept. 12, mazujqv . tinyurl.com/6r8p3gn . 2000, http://tinyurl.com/pvzs82 . 24 James Trussell, et al. , “Emergency Contra - 36 Lyle Denniston, “Analysis: The Little Sisters 49 Linda Greenhouse and Riva Siegel, Before ception: A Last Chance to Prevent Unin - case and EBSA form 700,” Scotusblog.com , Roe v. Wade: Voices that Shaped the Abortion tended Pregnancy,” Princeton University, feb - Jan. 4, 2014, http://tinyurl.com/pzp34va . Debate Before The Supreme Court’s Ruling ruary 2014, http://tinyurl.com/mgawwsg . 37 Lyle Denniston, “Partial win for Little Sisters,” (2010), p. 25. 25 Pam Belluck, “Abortion Qualms on morning- Scotusblog.com , Jan. 24, 2014, http://tinyurl. 50 Rachel Benson Gould, “Lessons from Be - After Pill may Be Unfounded,” The New York com/lrct2op . fore Roe: will Past Be Prologue?” The Guttmach - Times , June 5, 2012, http://tinyurl.com/l93eugn . 38 Elizabeth Laforgia, “federal appeals court er Report on Public Policy , march 2003, vol - 26 “Statement by the white House Press Sec - rules against Notre Dame in contraception case,” ume 6, Number 1, http://tinyurl.com/pnbz933. retary Regarding Sebelius v. Hobby Lobby Stores, Jurist , feb. 23, 2014, http://tinyurl.com/mos96cn . 51 Theodore Joyce, Ruoding Tan and Yuxiu Inc.,” white House, Nov. 26, 2013, http://tinyurl. 39 Steve Kenny and Robert Pear, “Justice Blocks Zhang, “Back to the future? Abortion Before & com/n6jxcez . Contraception mandate on Insurance in Suit After Roe,” National Bureau of Economic Re - 27 Appellants’ brief, Hobby Lobby Stores v. Se - by Nuns,” The New York Times , Dec. 31, 2013, search, Working Paper No. 18338 , August 2012, belius, et al. , Nov. 20, 2012, http://tinyurl.com/ http://tinyurl.com/nywxqse . http://tinyurl.com/qds86et . nd592au . 40 Helen Alvaré, “No Compelling Interest: The 52 Text of decision, Roe v. Wade , U.S. Supreme 28 News release, “Hobby Lobby Supreme Court ‘Birth Control’ mandate and Religious free - Court, Jan. 22, 1973, Cornell University Law Brief Counters Government ‘Divide and Con - dom,” Villanova Law Review , vol. 58, No. 3, School Legal Information Institute, http://tiny quer’ Attempt to violate Business Owners’ Re - 2013, pp. 379-436, http://tinyurl.com/msd9gw4 . url.com/meufhlt . ligious Rights,” The Becket fund for Religious 41 Rachel Gould Benson, “Lessons from Before 53 Text of decision, Planned Parenthood of Liberty, feb. 10, 2014, http://tinyurl.com/mz33plx . Roe: will Past be Prologue?” The Guttmacher Southeastern Pennsylvania v. Casey , U.S. 29 Opinion, Tenth U.S. Circuit Court of Appeals, Institute, Report on Public Policy , march 2003, Supreme Court, June 29, 1992, Cornell Uni - Hobby Lobby Stores et al., vs. Kathleen Sebelius, volume 6, Number 1, http://tinyurl.com/o63ht . versity Law School Legal Information Institute, http://tinyurl.com/nwdqm7y . 54 william J. Clinton, speech accepting the About the Author Democratic nomination for president, Aug. 30, 1996, http://tinyurl.com/pu5ve6d . Bill Wanlund is a freelance writer in the Washington, D.C., 55 Bopp memo, op. cit. area. He is a former Foreign Service officer, with service in 56 Seth mcLaughlin, “Graham introduces ‘his - Europe, Asia, Africa and South America. He holds a journal - toric’ 20-week abortion ban; says no prima - ism degree from The George Washington University and has ry politics at play,” The Washington Times , written for CQ Researcher on drone warfare and downtown Nov. 7, 2013, http://tinyurl.com/pqe5v2l . development. 57 “Babies feel Pain,” wisconsin Right to Life, http://tinyurl.com/ojjpa5m .

284 CQ Researcher 58 Anne murphy Paul, “The first Ache,” The New York Times , feb. 10, 2008, http://tinyurl. com/qfs24qn . FOR MORE INFORMATION 59 Pam Belluck, “Complex Science at Issue American Civil Liberties Union Reproductive Freedom Project , 125 Broad St., in Politics of fetal Pain,” The New York Times , New York, NY 10004 ; 212-549-2500 ; https://www.aclu.org/reproductive-freedom . Active Sept. 17, 2013, http://tinyurl.com/m9tdqj2 . in litigation, advocacy and public education to protect women’s access to abortion. 60 Statement of Administration Policy, “H.R. 1797: Pain-Capable Unborn Child Protection Americans United for Life , 655 15th St., N.w., washington, DC 20005 ; 202-289- 1478 ; http://aul.org /. Advocacy organization that litigates and provides information Act,” Executive Office of the President, Office in opposition to abortion. of management and Budget, June 17, 2013, http://tinyurl.com/ofj87jx . Centers for Disease Control Abortion Surveillance System , 1600 Clifton Rd., 61 “Department of Defense Annual Report on Atlanta, GA 30333 ; 800-232-4636 ; www.cdc.gov/reproductivehealth/data_stats/Abortion. Sexual Assault in the military, fiscal Year 2012,” htm . federal agency that tracks the number and characteristics of women seeking vol. I, http://tinyurl.com/pzwgguj . legal abortions. 62 Lisa Rein, “women’s health groups want Charlotte Lozier Institute , 1707 L St., N.w., washington, DC 20036 ; 202-223-8073 ; Peace Corps volunteers to have insurance www.lozierinstitute.org /. Provides information and offers leadership training in op - coverage for abortions,” The Washington Post , position to abortion. April 25, 2013, http://tinyurl.com/czqyt9g . 63 Guttmacher Institute , 125 maiden Lane, New York, NY 10038 ; 212-248-1111 ; “final Report: Review of the Peace Corps’ https://www.guttmacher.org /. Provides information, research and analysis on abortion Implementation of Guidelines Related to volun - issues; supports access to abortion. teer victims of Rape and Sexual Assault,” Of - fice of the Inspector General, Peace Corps, NARAL Pro-Choice America , 1156 15th St., N.w., washington, DC 20005 ; 202-973- September 2012, http://tinyurl.com/nz9lcw9 . 3000 ; www.naral.org /. Provides information and lobbies in favor of access to abortion. 64 Press release, “Planned Parenthood Applauds National Right to Life , 512 10th St., N.w., washington, DC 20004 ; 202-626-8800 ; the Introduction of the Peace Corps Equity www.nrlc.org /. Provides information and lobbies in opposition to abortion. Act,” Planned Parenthood, April 25, 2013, http:// Planned Parenthood Federation of America , 434 west 33rd St., New York, NY tinyurl.com/qfa4cdc . 65 10001 ; 212-541-7800 ; www.plannedparenthood.org /. Provides reproductive health Rein, op. cit. care services and information; supports access to abortion. 66 The story of LNG’s evolution from a strict - ly controlled prescription medication to a non- prescription over-the-counter product is laced 70 most states allow exceptions in cases of fox News, Nov. 6, 2013, http://tinyurl.com/ with charges of political interference in fDA’s rape or incest, or where the health or safe - mrh7a6b . regulatory process touching the presidential ty of the fetus or mother are at risk; two 75 Petula Dvorak, “Pregnant women as hosts? administrations of George w. Bush and Barack states, however — Louisiana and Tennessee Sure, state Sen. Stephen martin, why not?” Obama. A website operated by Princeton Uni - — prohibit any abortion coverage under poli - The Washington Post , feb. 27, 2014, http:// versity’s Office of Population Research and the cies sold in those states. “Restricting Insurance tinyurl.com/kvnm7ps . Association of Reproductive Health Professionals Coverage of Abortion,” The Guttmacher Insti - 76 Jeremy w. Peters, “Parties Seize on Abor - offers a timeline: http://tinyurl.com/3o2g9y7 . tute, march 1, 2014, http://tinyurl.com/qfozmlu . tion Issues in midterm Race,” The New York See also marc Kaufman, “fDA Official Quits 71 Press release, “AUL Says the Anti-Life Poli - Times , Jan. 20, 2014, http://tinyurl.com/o2x98rm . over Delay on Plan B,” http://tinyurl.com/ cies Intertwined Throughout Obamacare Re - 77 mitchell Killian and Clyde wilcox, “Do a3nmx ; Gardiner Harris, “Plan to widen Avail - quire its Repeal,” Americans United for Life, Abortion Attitudes Lead to Party Switching?” ability of morning-After Pill Is Rejected,” The Sept. 17, 2013, http://tinyurl.com/k4goac2 . Political Research Quarterly 61.4 (2008): 561- New York Times , Dec. 7, 2011, http://tinyurl. 72 Charles A. Donovan, “multi-State Health Plans: 572, JSTOR, Nov. 16, 2010, http://tinyurl.com/ com/chaqgqk ; and maggie fox, “Judge re - A Potential Avenue to Tens of Thousands of qf7nfpd . fuses to delay ruling on Plan B,” NBC News, Publicly Subsidized Abortions,” Charlotte Lozier 78 Lydia Saad, “Abortion Is Threshold Issue for may 12, 2013, http://tinyurl.com/p9uqp45 . Institute, September 2013 , http://tinyurl.com/ One in Six U.S. voters,” Gallup, Oct. 4, 2012, 67 Text of the Affordable Care Act can be pfhv9bg . http://tinyurl.com/q2qx74r . found at http://tinyurl.com/pqukxj4 . 73 Transcript, remarks of missouri Senate can - 79 Erik Eckholm, “Access to Abortion falling 68 fact sheet, “what is the Health Insurance didate Todd Akin on Abortion, Aug. 19, 2012, as States Pass Restrictions,” The New York Times , marketplace?” Healthcare.gov, http://tinyurl. http://tinyurl.com/cfk9u8b. Also see press re - Jan. 3, 2014, http://tinyurl.com/lyrewgd . com/moyadrv . lease, “NARAL Pro-Choice America Calls on 80 Esmé E. Deprez, “Abortion-Rights Backers 69 “Executive Order 13535 — Patient Protec - Gov. Romney to withdraw His Endorsement on Offense After 3-Year Drubbing,” Bloomberg, tion and Affordable Care Act’s Consistency of Senate Candidate Richard mourdock,” feb. 24, 2014, http://tinyurl.com/poah87y . with Longstanding Restrictions on the Use of NARAL Pro-Choice America, Oct. 24, 2012, 81 Erik Eckholm, “Access to Abortion falling federal funds for Abortion,” Office of the http://tinyurl.com/pvl9hsp . as States Pass Restrictions,” The New York white House Press Secretary, march 24, 2010, 74 Dana Blanton, “Exit polls: mcAuliffe wins Times , Jan. 3, 2014, http://tinyurl.com/qbrdu6r . http://tinyurl.com/y9tb6jg . in virginia with strong support among women,”

www.cqresearcher.com March 21, 2014 285 Bibliography Selected Sources

Books Fowler , Anne , et al. , “Talking With the Enemy,” The Boston Globe , Jan. 28, 2001 , http://tinyurl.com/pzel752 . D’Antonio , William V. , Michele Dillon and Mary L. Gautier , Six activists — three from each side of the abortion de - American Catholics in Transition , Rowman and Littlefield , bate — describe the successes and frustrations of their five 2013 . years of secret meetings as they searched for ways to com - Three sociologists report on American Catholics’ beliefs, at - municate constructively and respectfully about abortion. titudes and behavior by tracking surveys conducted at six- year intervals, beginning in 1987. Leonhardt , David , “In Public Opinion on Abortion, Few Absolutes,” The New York Times , July 17, 2013 , http:// Forsythe , Clarke , Abuse of Discretion: The Inside Story tinyurl.com/ld8nydy . of Roe v. Wade , Encounter , 2013 . An economics journalist advises taking a critical look at The general counsel of Americans United for Life exam - public opinion surveys on the abortion issue. ines the deliberations that led to the landmark 1973 Supreme Court decision that legalized abortion, which he calls “a Levs , Josh , “Gosnell horror fuels fight for abortion laws,” unique combination of impulses, errors and miscalculations.” CNN , May 14, 2013 , http://tinyurl.com/o3spc7p . Revelations of murder and other illegal acts at a Philadelphia Greenhouse , Linda , and Reva Siegal , Before Roe v. Wade: women’s health care center led to a widespread push for Voices that Shaped the Abortion Debate Before the tighter state restrictions on abortion clinics. Supreme Court’s Ruling , Kaplan Publishing , 2010 . A journalist (Greenhouse) and a law professor examine Tarico , Valerie , “Abortion As a Blessing, Grace, or Gift — both sides of the abortion debate in the run-up to Roe v. A Renewed Conversation about Reproductive Rights,” Wade , using excerpts from primary sources, including arti - Ethical Technology , Dec. 12, 2013 , http://tinyurl.com/l3k6twd . cles, speeches, pamphlets, legal briefs and other documents. A psychologist argues that abortion is a moral and ethical act. Levine , Philip , Sex and Consequences: Abortion, Public Pol - icy, and the Economics of Fertility , Princeton University Thomson , Judith Jarvis , “A Defense of Abortion,” Phi - Press , 2004 . losophy and Public Affairs , Vol. 1, No. 1., Autumn 1971 , An economics professor looks at how increased access to pp. 47-66 , http://tinyurl.com/ppc43 . abortion affects individuals’ sexual behavior. Granting for argument’s sake that a fetus has a right to life, a philosopher offers a classic defense of the morality of abortion. Reagan , Leslie J. , When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867-1973 , Uni - Reports and Studies versity of California Press , 1997 (also available online : http://tinyurl.com/p5v2dd3 ). “Fact Sheet: Induced Abortion in the United States,” A law and history professor at the University of Illinois ex - Guttmacher Institute , February 2014 , http://tinyurl.com/ amines the history and enforcement of abortion laws in the 5wley . United States before the Supreme Court’s Roe v. Wade deci - A research organization that supports abortion rights sum - sion legalized the procedure. marizes information pertaining to abortion safety, laws and other topics. Articles Joyce , Theodore J. , Tan Ruoding and Yuxiu Zhang , “Back Alvaré , Helen M. , and Meg T. McDonnell , “Why pro-lifers to the Future? Abortion Before and After Roe,” Working keep fighting abortion,” The Washington Post , March 1, Paper 18338, National Bureau of Economic Research , 2013 , http://tinyurl.com/cmgs9wg . August 2012 , http://tinyurl.com/pa9vn2o . The president and the communications director of the Economists conclude that overturning Roe v. Wade would Chiaroscuro Institute, an educational organization that op - have resulted in 73,000-182,000 unintended births in 2007. poses abortion, explain why they believe the anti-abortion struggle is worth waging. Klick , Jonathan , and Thomas Stratmann , “Abortion Access and Risky Sex Among Teens: Parental Involvement Laws Beckwith , Francis J. , “Thomson’s ‘Defense of Abortion’ and Sexually Transmitted Diseases,” Journal of Law, Eco - at Forty,” The Catholic Thing , Aug. 6, 2011 , http://tiny nomics and Organization , Vol. 24, No. 1, 2008 , p. 2 . url.com/nkftbz8 . A law professor and a political economist find evidence A professor of philosophy and church-state studies rebuts a fa - that abortion laws requiring parental consent lead to less- mous 1971 defense of abortion’s morality (see Thompson, below). risky sexual behavior among teenagers.

286 CQ Researcher The Next Step: Additional Articles from Current Periodicals

Affordable Care Act rather than block implantation of eggs, an incorrect claim written on emergency contraceptive packaging labels and Collison , Kevin , “With its support of Hobby Lobby, JE Dunn made by some anti-abortion politicians. joins cultural debate,” The Kansas City Star , Feb. 15, 2014 , http://tinyurl.com/lfy7sw4 . Lane , Emily , “Morning after pill: Easier access brings Catholic business owners from Kansas City have filed sup - backlash,” The Clarion-Ledger (Miss.), April 10, 2013 , porting briefs on behalf of Hobby Lobby in the pending http://tinyurl.com/pvo7zf4 . Supreme Court case Sebelius v. Hobby Lobby Stores , arguing Pro Life mississippi asks pharmacists not to obey a federal that the Affordable Care Act violates religious liberty. order to sell emergency contraception over the counter to girls of all ages. Jones , Walter C. , “Georgia Senate votes to ban Obamacare abortions,” The Augusta (Ga.) Chronicle , March 4, 2014 , Rovner , Julie , “Morning-After Pills Don’t Cause Abortion, http://tinyurl.com/m559qm3 . Studies Say,” NPR , Feb. 21, 2013 , http://tinyurl.com/ The Georgia Senate voted to ban health plans under the aeuu4ap . Affordable Care Act that cover abortions. Studies show that the morning after pill is a contraceptive, rather than a form of abortion. Sherman , Bill , “4 Christian universities get injunction in ACA suit,” Tulsa World (Okla.), Dec. 25, 2013 , http:// State Laws tinyurl.com/ksu85bm . A federal district judge suspended enforcement of the Af - Botelho , Greg , and Suzanne Presto , “Alabama legislators fordable Care Act for four Christian Oklahoma universities that pass restrictive abortion bills,” CNN , March 5, 2014 , sued the government over a provision requiring employers’ http://tinyurl.com/olynn5r . health insurance plans to cover emergency contraceptives. The Alabama House of Representatives passed four bills imposing new regulations on abortions, including one that Catholic Church could press felony charges against doctors performing abor - tions on women who are only six weeks pregnant. Allen , John L. Jr. , and Lisa Wangness , “Pope softening tone, not stance, O’Malley says,” The Boston Globe , Feb. 9, 2014 , Fernandez , Manny , “Abortion Law Pushes Texas Clinics http://tinyurl.com/oveoxal . to Close Doors,” The New York Times , March 6, 2014 , A Boston cardinal says the pope has softened the tone of http://tinyurl.com/pbx8zdh . the Catholic Church but has not changed the church’s teach - The number of abortion facilities in Texas has dropped ings on contraception, abortion and other flashpoint issues. from 44 in 2011 to 24 in 2014, with numbers expected to fall to six once a new state law imposing new regulations Boorstein , Michelle, and Peyton M. Craighill , “Pope on abortion is fully implemented in September. Francis faces church divided over doctrine, global poll of Catholics finds,” The Washington Post , Feb. 9, 2014 , CITING CQ RESEARCHER http://tinyurl.com/np33994 . Sample formats for citing these reports in a bibliography Catholics disagree over the church’s teachings on issues such as abortion, with 57 percent of Catholics supporting include the ones listed below. Preferred styles and formats abortion in some cases. vary, so please check with your instructor or professor.

Gutting , Gary , “Should Pope Francis Rethink Abortion?” mLA STYLE The New York Times , Jan. 23, 2014 , http://tinyurl.com/ Jost, Kenneth. “Remembering 9/11.” CQ Researcher 2 Sept. m45l52y . 2011: 701-732. A philosophy professor says allowing for exceptions to the moral condemnation of abortion in certain situations would APA S TYLE not contradict the pope’s teachings. Jost, K. (2011, September 2). Remembering 9/11. CQ Re - Morning After Pill searcher, 9 , 701-732. CHICAGO STYLE Belluck , Pam , “Abortion Qualms on Morning-After Pill May Be Unfounded,” The New York Times , June 5, 2012 , Jost, Kenneth. “Remembering 9/11.” CQ Researcher , Sep - http://tinyurl.com/os68klh . tember 2, 2011, 701-732. Doctors say emergency contraceptive pills delay ovulation

www.cqresearcher.com March 21, 2014 287 In-depth Reports on Issues in the News

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