Revue de recherche en civilisation américaine
8 | 2018 Mapping the Landscapes of Abortion, Birth Control, and Power in the United States: Body Politics since the 1960s
Christen Bryson, Anne Légier and Amélie Ribieras (dir.)
Electronic version URL: http://journals.openedition.org/rrca/964 ISSN: 2101-048X
Publisher David Diallo
Electronic reference Christen Bryson, Anne Légier and Amélie Ribieras (dir.), Revue de recherche en civilisation américaine, 8 | 2018, « Mapping the Landscapes of Abortion, Birth Control, and Power in the United States: Body Politics since the 1960s » [Online], Online since 17 December 2018, connection on 28 March 2020. URL : http://journals.openedition.org/rrca/964
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TABLE OF CONTENTS
Abortion Providers and the New Regulatory Regime: The Impact of Extreme Reproductive Governance on Abortion Care in the United States Carole Joffe
An Abortion Minister: the Reverend Spencer Parsons’s Struggle for Abortion Rights before Roe v. Wade Anne Légier
Sterilization in the United States: The Dark Side of Contraception Sandrine Piorkowski Bocquillon
Abortion and Phyllis Schlafly’s Pro-life Contribution to the Culture Wars from the 1970s to the 1990s Amélie Ribieras
Reproductive Rights Sit on a “Dangerous Precipice”: The Stakes of the Abortion Debate Playing Out in Idaho and Oregon Christen Bryson
Providing Comprehensive Care: Marissa Galloway Interview Anne Légier
Varia
Récit d'une crise à venir : religion et tensions raciales dans American Crime, saison 1 Dominique Cadinot
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Abortion Providers and the New Regulatory Regime: The Impact of Extreme Reproductive Governance on Abortion Care in the United States
Carole Joffe
AUTHOR'S NOTE
Research for this paper was partially funded by the Society for Family Planning.
1 In a useful contribution to social science work on reproduction, the anthropologists Lynn Morgan and Elizabeth Roberts (2013) have elaborated the concept of reproductive governance: they have described this as “the mechanisms through which different historical configurations of actors—such as state, religious and international financial institutions, NGOs, and social movements—use legislative controls, economic inducements, moral injunctions, direct coercion, and ethical incitements to produce, monitor and control reproductive behaviors and population practices.” In this article, I suggest that the regulation of abortion in the United States, particularly since the consequential midterm elections of 2010, can be viewed as an extreme version of such reproductive governance: this governance manifests primarily through the “legislative controls” identified by Morgan and Robert. These controls, in turn, are reinforced by powerful religious forces and social movements which commit large resources to electing politicians firmly opposed to abortion. Relatedly, another concept that guides this paper is that of “abortion exceptionalism,” described by the legal scholar Caitlin Borgmann (2014) as “a term that has been used to describe the tendency of legislatures and courts to subject abortion to unique, and uniquely burdensome, rules.” I contend that the elements of reproductive governance in play in the abortion issue, which have
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contributed to the resulting “abortion exceptionalism” prevalent in many states’ regulation of the procedure, are both reflective of, and contribute to the significant cultural stigmatization of abortion in the U.S. (Norris et.al. 2011). This stigma, which affects abortion patients and abortion providers alike, makes resistance against a harsh regulatory regime even more difficult.
2 The particular focus of this paper is a discussion of how abortion providers located in highly regulated “red” states are affected by this challenging regulatory climate. Though not the focus of this paper, others have documented the hardships on patients imposed by recent restrictions which have made accessing abortion care more difficult (Grossman et. al. 2014; Jerman et. al. 2017).
Background: The regulation of abortion since Roe v Wade.
3 To offer briefly some historical background on the regulation of abortion, Congressional efforts in this realm started immediately after the Roe v Wade decision in 1973 which legalized the procedure. In the same year, Congress passed the Church amendment (named after its chief sponsor, Frank Church) which stipulates that hospitals or individuals’ receipt of federal funds in various health programs will not require them to participate in abortion and sterilization procedures, if they object based on moral or religious convictions. The measure also forbids hospitals in these programs to make willingness or unwillingness to perform these procedures a condition of employment (C. Marshall 2013). The Coats amendment (named for its chief sponsor Daniel Coats) passed in 1996, and similarly states that no federal funding will be withheld from any hospital that refuses to engage in abortion training; this amendment, a prime example of the above-mentioned “abortion exceptionalism” that typifies legislative oversight of this procedure, was unprecedented in that it nullified a ruling of the American Council of Graduate Medical Education and CREOG (the Committee on Residency Education in Obstetrics and Gynecology) which had recently put in place a requirement that residencies in this field include routine abortion training, with an allowance for an opt-out for residents with moral or religious objections to abortion (Foster et.al. 2003). I could locate no other cases of Congressional interference in the setting of standards by medical educational bodies.
4 The Supreme Court, in a series of decisions starting shortly after Roe, gradually permitted more and more limitations on abortion provision at both the state and federal level. Among the first of these was the Harris v McCrae decision in 1976, upholding the Hyde amendment (named after the late Congressman, Henry Hyde) which forbade the use of Medicaid funding for abortion, except in very limited circumstances, a policy which stands to this day. Subsequent Court rulings upheld such regulations as parental notification and consent requirements, and waiting periods before a woman can receive an abortion (which currently extends to 72 hours in some states). The 2007 Gonzales v Carhart case marked the first time that the Court expressly banned a particular medical technique, in this case a fairly rare procedure used in later abortions that doctors felt to be safer in certain situations. Gonzales v Carhart is also notable for the fact that it marked the first time in abortion jurisprudence that the Court did not require an exception for women’s health (Luker and Murray 2015).
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5 Most regulation of abortion however, takes place at the state level. These restrictions, designed specifically for abortion facilities, have earned a special name in legal circles: TRAP laws, or Targeted Regulations of Abortion Providers (Center for Reproductive Rights 2015). All told, there have been over 1,200 restrictions passed by state legislatures since Roe. The number of these increased dramatically after the 2010 midterm elections (widely seen as a backlash to Barack Obama’s election two years earlier), which brought a significant increase in Republican governorships and control of state legislatures—and strong pressure for favorable legislation from anti-abortion groups which had worked assiduously for Republicans’ elections. Republicans made similar gains in the 2014 election, again seen as a backlash to Obama’s re-election. Nearly a quarter of all state-level restrictions (over 300) have been passed since 2011. The election of Donald Trump to the presidency in 2016 was accompanied by even more victories for Republicans in state legislatures, and as of this writing in fall 2017, Republicans control 33 governorships and control 69 state legislative bodies, and additional abortion restrictions continue to be introduced at a rapid pace (Phillips 2016). 6 In addition to Republican electoral gains at the state levels, there have been two additional recent events of note which have also increased pressures for additional restrictions on abortion providers. The first is the explosive case of Kermit Gosnell, a “rogue abortion provider” (Joffe, 2010) in Philadelphia, who was arrested in 2010 for the negligent care (including some deaths) of patients and for the murder of several newborns who were born alive after failed abortions (Hurdle and Gabriel 2013.) Gosnell’s case was further inflammatory because of the unsanitary conditions of his clinic and of his illegal use of untrained staff. Though many complaints had been lodged against him, including by other Pennsylvania abortion providers, inexplicably the state Department of Health had for years not responded to these complaints. Both in Pennsylvania and elsewhere, the Gosnell affair was invoked as justification for stringent new regulations. In Pennsylvania, for example, almost immediately after the Gosnell case came to light, the legislature passed a law requiring that all abortion clinics become licensed as Ambulatory Surgical Facilities (an onerous and expensive requirement, to be explained further, below). 7 The release in July 2015 of undercover videos made by an anti-abortion group, the Center for Medical Progress, which purported to show clinic personnel “selling” fetal tissues to researchers for profit was the second event that spurred additional intense scrutiny on abortion clinics. These videos, which were highly edited and misleading, and which have resulted in ongoing litigation against the perpetrators, including felony charges (Hamilton 2017), nonetheless resulted in numerous investigations of abortion clinics by both state and federal agencies. Though the primary targets of the video-makers were Planned Parenthood clinics which performed abortions, some independent clinics were also caught in this sting operation. In response to these videos, Republicans in Congress established a “Select Committee on Infant Lives” which began an investigation of the practices of abortion providers, whether implicated in the videos or not, who provided later (post 20-week) abortions. This Committee was roundly denounced as a “witch hunt” by many in the press and Democrats in Congress (Washington Post Editorial Board 2016).
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TRAP Laws
8 The restrictions that have been introduced since the 2010 election, generally speaking, represent a switch in emphasis from the historic pattern of regulating the behaviors of individual women seeking abortions e.g. “the demand” side, to those providing abortion—the “supply side” (Joyce 2011). That is, while earlier abortion restrictions focused on such matters as waiting periods, and parental notification and consent provisions, more recently the emphasis has shifted to restrictions bearing on the physical and staffing characteristics of abortion providing facilities. Many of these restrictions have been put forward as model legislation by a leading anti-abortion legal group, Americans United for Life (2016). In terms of clinics’ ability to comply with the new regulatory regime, the most consequential of these so-called “TRAP” laws have been the above-mentioned Ambulatory Surgical Facilities (also known as Ambulatory Surgery Center (ASC)) requirements, and physician admitting privilege ones. The former stipulate that abortion facilities must conform to the physical specifications of small hospitals, with respect to such issues as air flows, hallway widths, janitor locker space, and so on, as well as to hospital-level sterility practices —and the physical requirements that can cost well over one million dollars, as was noted by the Majority in the recent Supreme Court case Whole Woman’s Health v Hellerstedt (Whole Woman’s Health), a landmark case which I shall shortly discuss further. The latter, which requires doctors providing abortions to have admitting privileges at local hospitals, has been extremely difficult for many clinics to implement, both because of the local political climate leading hospitals to refuse such applications, as has been widely reported in states such as Texas, Mississippi and Alabama, as well as the fact that routine abortion care is so safe that abortion providers are typically unable to meet the requisite number of hospital admissions per year that many institutions require. As the director of the only clinic in North Dakota, threatened with an admitting privileges restriction, said to a journalist, “I would never employ a doctor who had to admit ten patients a year. That would mean they were a terrible doctor.” She went on to point out that her clinic had only one hospital admission in the past ten years (Marty 2013).
9 Numerous medical groups, including the American College of Obstetricians and Gynecologists (2014) have asserted that both the ASC and the admitting privileges requirements do not have an impact on patient safety, but have as their sole purpose the closing of clinics. Indeed, the safety record of legal abortion in the U.S. since the Roe v Wade decision in 1973 is very impressive, with medical researchers demonstrating that the death rate from legal abortion is 0.6 per 100,000 procedures, meaning that a woman is about fourteen times more likely to die in childbirth than from abortion (Raymond and Grimes 2012). Moreover, observers have pointed out that in a number of states requiring ASC standards for abortion clinics, other outpatient facilities offering comparable levels of procedural complexity—for example, those offering vasectomies, sigmoidoscopies and minor neck and throat surgeries—do not have such a requirement. Similarly, the Majority in the Texas case, Whole Woman’s Health, noted (Whole Woman’s Health 2016, p. 30) that colonoscopies, which are not subject to ASC requirements, have a mortality rate ten times higher than abortion, while outpatient liposuction, also not subject to such regulation, has twenty-eight times the mortality rate of abortion. 10 Beyond passing new abortion restrictions, anti-abortion politicians in various places have additionally brought pressure on state bureaucracies to more frequently inspect
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abortion clinics to ascertain that these facilities were complying with both existing and new laws. This heightened scrutiny of abortion clinics has had significant consequences, obviously, for the clinics themselves, but also for state health departments, which are the main (though not sole) agencies charged with monitoring these facilities, Therefore, in this article I also note the dilemma this situation can impose for health department employees, when the political imperatives of their superiors clash with the inspectors’ integrity as public health professionals. In short, this is a story of what happens when health care regulation becomes inextricably bound up with the most divisive issue in American politics. As of 2016, some 162 abortion clinics stopped operating, in large part because of an inability to meet the various “TRAP” regulations imposed by state legislators (Deprez 2016).
Recent Supreme Court developments
11 The landmark Supreme Court case, Whole Woman’s Health, handed down in June 2016, marked an important development in the fate of abortion provision in the United States. The case, brought by a Texas abortion provider, challenged the two restrictions mentioned above, ASC requirements and admitting privileges. In a 5-3 decision, the Majority ruled in favor of the plaintiff, stating, “Both the admitting privileges and the surgical-center requirements place a substantial obstacle in the path of women seeking a pre-viability abortion, constitute an undue burden on abortion access, and thus violate the Constitution” (Whole Woman’s Health 2016, p. 3). Had the plaintiff not prevailed, the number of abortion clinics in Texas would have gone from 40 to about 10. (However, a number of Texas clinics which had closed have not been able to re-open, for logistical reasons, in the aftermath of this decision and as of fall 2017, there are some 21 clinics in operation.
12 Encouraging as this case has been for abortion providers and the larger prochoice movement, the decision hardly ends the struggle over restrictions and “abortion exceptionalism,” or indeed the future of legal abortion more generally in the United States. Given the 2016 election of Donald Trump to the presidency, which occurred several months after Whole Women’s Health was announced, and his vow to nominate only “prolife” Supreme Court Justices, the fate of Roe v. Wade itself is unclear. (The appointment of Neil Gorsuch to the Supreme Court, early in the Trump presidency, brings another vote to the Court who is widely expected to favor the overturn of Roe). Some states, in the wake of Whole Woman’s Health, have dropped attempts to impose ASC or hospital admitting privileges, but others have not, and these cases will have to be litigated. As the legal scholar David Cohen has pointed out, while this case may seal the fate of certain restrictions claiming to improve women’s health, other restrictions remain and new ones will continue to be introduced. Cohen particularly points to the likelihood of more restrictions pertaining to “the dignity of the fetus,” such as a law that the Texas legislature passed, immediately after the decision, which required that all aborted fetuses be given burials or cremation (Cohen 2016). At the time of this writing, this law remains in litigation. Beyond the emotional difficulties such a law might bring to some abortion patients, representatives of the funeral industry in Texas estimated that such a measure could add nearly $1,000 to the cost of an abortion (Goodwyn 2016).
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13 The harsh regulatory climate in the years immediately preceding the Whole Woman’s Health decision and continuing into the present have taken a considerable toll on the work force in abortion provision. As noted, over 160 clinics have had to close, many because of an inability to comply with restrictions. Of those facilities that managed to stay open in highly regulated, often politically hostile states, this feat has come at the cost of a huge expense of money and time and a struggle to sustain providers’ commitment to long established principles of quality “woman-centered” abortion care. To be clear, none of the abortion providers interviewed for this study believed that their facilities should be free from state oversight. In simplest terms, this workforce wished to have their facilities regulated in a manner comparable to that governing other out- patient health care services, and not, as one clinic director put it, “to have regulatory tools used as a weapon against us.”
Methods
14 Data from this study are drawn from in-depth interviews with individuals and small groups of abortion workers who work in independent (as opposed to Planned Parenthood) clinics in states that have a high degree of regulation. The decision was made to exclude Planned Parenthood clinics because clinics belonging to the Federation are more apt to have their policies set by a national office staff, while the independent clinics are freer to adjust their own practices to evolving political situations. All of the clinics contacted for this study are members of the National Abortion Federation (NAF), the leading professional organization of the abortion providing field. NAF membership implies that the clinics in this study were vetted by a visiting team of clinicians and were found to be in compliance with the standards of care set by that organization.
15 These interviews, which altogether involved some 50 individuals from nine states, were conducted both in person and by phone. The interviewees worked primarily in clinics in the South and Midwest, though staff members from several clinics in one Northeastern state were also included. I also conducted focus groups for three successive years (2014-2016) at an annual meeting of abortion providers from independent clinics. “Abortion provider” as it is used in this article does not refer to clinicians who actually perform the abortion procedure, but rather to those who are directors or managers of clinics and those who work in various senior staff positions. As the staff positions in independent abortion clinics are not uniform, often varying by size—in some cases, e.g. the director of a clinic may also be head of counseling or a manager may also work directly in patient care—my criterion for choosing informants was to select those who had some degree of supervisory authority over other staff. As the abortion providing community is very small (almost 90% of U.S. counties are without an abortion providing facility), especially in the highly regulated “red” states, it was not difficult to identify clinics whose staff who were most appropriate for this study. 16 In order to protect confidentiality, particularly in light of the security concerns of those in this field, I use no names of individuals or of clinics, except when these are identified in the press. Instead of the names of states in which clinics are located, I identify clinics by the region of the country, except when I quote from published material. I conducted data analysis in an inductive manner, first reading though the
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interview and focus group transcripts line by line to develop a list of themes, and then developing detailed coding schemes (Lofland et. al. 2005). This research was approved by the Institutional Review Board at the University of California San Francisco.
The Impact of Restrictions
1: Money and Time
17 Most fundamentally, complying with restrictions can impose enormous financial costs on clinics (clinics already have substantial extra costs—particularly in the area of security—that most other health care facilities do not (Deprez 2016)). This financial burden of ASC requirements was made explicitly in the Majority decision in Whole Woman’s Health which cited costs of over one million dollars as not uncommon to upgrade an existing clinic to an ASC (2016, p. 7). Obviously, not all clinics under such a mandate are able to meet this expense. The difficulty in paying for the transition to an ASC has been compounded because the increase in such restrictions has coincided with a sharp decline in the number of abortion patients for the same period (Guttmacher Institute, 2017), thus producing lowered revenues. In short, many abortion-providing facilities, before the imposition of ASC guidelines, already existed in a financially precarious situation.
18 But transforming a freestanding clinic into an ASC is costly beyond the funds involved, and involves a substantial expenditure of staff time. When a state legislature votes such a restriction, typically clinics are initially given a quite short time period to comply. Clinic staff persons therefore are suddenly compelled to spend a vast amount of time in political lobbying, both for extra time to comply, and to attempt to negotiate less stringent requirements. This lobbying of course takes them away from the everyday world of staffing a clinic. One director of a Midwest clinic told me she literally spent three months at the state capitol (several hours away from her clinic) as head of a state coalition attempting to stop, or at least modify the very harsh proposed restrictions under discussion by the legislature; she thus was forced to leave the running of the clinic to her subordinates. But at least lobbying is something usually at least one staff member knows how to do. The ASC regulation also abruptly thrusts clinic staff into a world of arcane details about widening existing corridors and developing measures of hallway airflow and so on—issues about which they have little prior knowledge. 19 A clinic owner in a Midwestern state showed me photos of a set of sinks—too high for her and most of her employees to reach—that cost $25,000. These sinks were demanded by the licensing agency in her states. As she said to me, “But it was not only the cost of the sinks…each sink took three days to install, when we could not see patients. The walls had to be reinforced to hold them up and then re-wallpapered. This whole thing was just one example of what a huge waste of money (the newly imposed licensing requirements were)… Our old sinks worked just fine.” 20 One clinic visited for this study was subjected to an ASC requirement after the state legislature voted to impose such a regulation in response to the Gosnell scandal. The clinic spent thousands of dollars in obtaining outside legal and architectural consultation, and senior staff spent numerous hours in meetings with other abortion providers in the state, attempting to come up with a coordinated response to the new rule. One of the major tasks facing this particular clinic was to install a new HVAC
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(Heat, Ventilation and Air Conditioning) system. The requirements for this unit were so specific that the new system had to be built by a company halfway across the country and installed by crane, disrupting several blocks of traffic in the surrounding urban area. The clinic was forced to replace all the ceilings and floors in the procedure rooms to conform to the requirements of a hospital operating room. After showing me this the new HVAC system, which truly resembled a Rube Goldberg contraption, the clinic director turned to me and said ruefully : “and if you think about it, knowing what we know about abortion safety, our infection rates are not going to go down because of a change into the air flow, or the changes we made to the ceilings.” 21 This particular clinic, in short, spent hundreds of thousands of dollars for structural changes to their physical plant, changes that none of the staff felt in any way contributed to patient safety. And these expenditures for physical upgrades inevitably jeopardized other clinic functions. “We spent every cent we had [meeting ASC requirements] in order to survive,” the clinic director told me sadly, and went on to recount how the clinic had to eliminate their practice of administering free STD (sexually transmitted disease) tests to patients. However, a rare positive note in this clinic’s ASC saga occurred when staff encountered a woman who ran her own construction company. As one staff member related, the woman in question said : “20 years ago I had an abortion at your clinic…when I left, I said, ‘somehow this will come back around’, and here we are…I would like to do as much as possible to help you.” 22 This company owner went on to devote a fair amount of free labor and construction material, a gesture that greatly lifted staff morale.
The Impact of Restrictions
2: Health departments and Disruptive Inspections
23 Inspections of abortion clinics have become inextricably embroiled in abortion politics. As one clinic director put it, “health department inspections are the anti-abortion’s movement latest tool of harassment.” The states of Virginia and Ohio serve as illustrative examples of the politicization of health departments with respect to abortion. The Virginia case moreover reveals the crucial role played by elections in changing the regulatory climate facing clinics. In Virginia, a Republican governor and a Republican-dominated state legislature passed legislation in 2011 mandating all of Virginia’s clinics conform to ASC standards, a move that threatened to close nearly all of the state’s clinics. The ensuing battle between the state’s then Attorney General—a religious right stalwart and a fervent opponent of abortion—and the state Board of Health over how to interpret and implement these regulations ultimately led to the resignation of the state’s Health Commissioner. In her resignation statement, she cited “an environment in which my ability to fulfill my duties is compromised and in good faith I can no longer serve in my role.” (Vozzella 2012).
24 The issue of abortion regulation played a key role in Virginia’s 2013 gubernatorial election, which saw a Democrat win over the above-mentioned Attorney General, who had threatened legal sanctions against those members of the State Board of Health who questioned such measures (Washington Post 2012). The newly elected Democratic
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governor put the ASC regulation on hold; moreover, at the governor’s direction, the state health department completed an exhaustive two year study of all 18 of the state’s remaining clinics--and as the Washington Post put it, “No evidence was found of violations that resulted in harm to patients at any of the state’s clinics, which perform an estimated 25,000 first-trimester abortions annually”; the Post went on to label the argument that the ASC requirement was needed for “safety” was “transparent nonsense” (Washington Post 2015). In September 2015, the Virginia Board of Health, dominated by appointees of the recently elected governor, voted to rescind the ASC and admitting privilege requirements for existing clinics, though future clinics will have to comply with some portions of the ASC code. 25 The state of Ohio has had for some time an especially hostile political culture with respect to abortion, perhaps best symbolized by the state legislature several years ago summoning a fetus to “testify” (via ultrasound technology) before that body (A. Marshall 2011). In particular, there has long been overt tension between the leadership of the state’s Health Department and the abortion providing community. This tension increased after the election in 2010 of a strongly anti-abortion governor with presidential ambitions; his appointments to high positions in the health department and the state medical board were of individuals without medical backgrounds but with long histories in the anti-abortion movement (Thompson-DeVeaux 2015). The pro- choice group NARAL sued in 2015 to obtain records of phone calls between anti- abortion groups and the state Department of Health, records which confirmed the collusion between these two groups (Ludlow 2015). Nine of the state’s seventeen abortion clinics have closed since 2010 due to various restrictions put in place by a conservative state legislature and signed by the governor, and several others are at risk of closing as of this writing. 26 Similar to the above examples, numerous clinics in this study reported intensified inspections from state and local health department, as well as other agencies, after 2010. These inspections were a major source of stress for clinic staff. To be sure, some portion of clinic inspections was regularly scheduled, as part of a state’s mandate to inspect all licensed health care facilities. However, some inspections, typically unannounced, were for the purpose of seeing if clinics were in compliance with recently passed ASC regulations. In other instances, the increase in inspections was a response to larger political events in abortion politics; for example, after the summer 2015 release of the misleading sting videos about alleged sales of fetal tissue in Planned Parenthood clinics, one clinic director (not affiliated with Planned Parenthood) responded to a knock on her door one morning to find agents sent by the state’s Attorney General who were there to investigate if the clinic “was selling baby parts.” Notably, some portion of the unannounced inspections recounted by clinic staff was triggered by often anonymous complaints, typically from anti-abortion groups such as Operation Rescue. One clinic director told me of an inspection that was prompted by a complaint left on Facebook by abortion opponents. 27 Some changes in the number and tone of inspections, providers reported, were in response to political events at the local level, for example, to meet the political ambitions of a governor or state legislator. A staff person at a Midwestern clinic, which had been regularly inspected for years, mainly without incident, reported a particularly agonizing occasion after the governor of the state publicly announced he was considering a run for president:
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“This year it was different. They were here for two days…they kept asking me to leave the room and they’d get on the phone with somebody in [state capitol]…then, they’d come back and ask to see such and such…I mean, it went on and on… someone else was pulling the strings.” 28 A clinic director in the South told of an inspection that involved nurses from the state health department, dressed in hazardous material suits, sifting through the clinic’s garbage dumpster due to unfounded accusations from Operation Rescue members that aborted fetuses were being discarded there. This dumpster search—which drew puzzled stares from patients watching through the clinic windows—occurred in a period in which the clinic was involved in a high profile challenge to some of the state’s restrictions law.
29 At the other extreme, some within the clinic world were told of health department inspectors who took pains to be helpful and made clear their dissatisfaction with the often blatantly politicized nature of their assignments. For example, a clinic manager in one Midwestern state recounted how one state inspector “went above and beyond” by giving her advice on upgrading the classification of her lab techs, making them eligible to become lab directors after a certain period. This tip, the staff person went on to say, came because the inspector realized the current lab director was aging and likely would be retiring in the near future. But, given the politics that inevitably surround abortion in “red” states, even those health department personnel who express their sympathy for clinics typically do so surreptitiously. “I’m your friend, not your foe,” one health department employee told clinic employees in a Mid-Atlantic state, “but you can’t repeat that publically.” 30 Even if hostility is not blatant, repeated inspections can create disruptions in clinic proceedings and are demoralizing to staff and upsetting to patients. One of the most frustrating aspects of the inspection process is that in many instances, these visits are unannounced and in some cases quite frequent (one clinic reported receiving such surprise visits eleven times in an eight month period, including two separate visits on one memorable day). As one staff person said : “So, it’s always with a sense of dread when I get that call from Security [that a state inspector has arrived] but I bring him or her upstairs and I ‘dance’, and we are found to be ok.” 31 Even when the inspection goes well, however—“well” in this case meaning that the clinic is found to be in compliance with recently passed regulations—the inspectors’ visits can be highly disruptive to clinic operations (and expensive—one director quoted a figure of $800 for each unannounced inspection). As one manager said : “They come in, they commandeer a whole room for a day, a room that we really can’t spare, they demand all kinds of files, there is a tremendous drain on staff time, and patients—who are already nervous about their procedures—are rattled by these people with briefcases, who come off like FBI agents.” 32 Staff in one Midwestern clinic, which had recently seen an intensification of inspections, told of “men with guns” abruptly entering the clinic and “freaking out” both staff and patients. These were DEA—Drug Enforcement Administration—agents (who routinely are armed) who came, the staff assumed, because of an unfounded anti- abortion complaint about improper dispensation of drugs. In answer to a question as to whether, given the enormous political pressures involved on inspectors, there was still “integrity” in the inspection process, one clinic staff person told of her educational efforts with inspectors:
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“The people who come here aren’t ideologues necessarily—the people who send them here are. But if I get them [health department employees] in a room, I talk about social justice, about why we are here, I talk about [our founder] and why it matters that we survive….I give them a big dose of philosophy while I am showing them our narcotics logs…I really try to get across to them that…we’re not who the antis portray, that we’re not all money grubbing leeches just trying to make money off women.” 33 Frustrated as they were with the repeated, unannounced inspections, some clinic staff spoke sympathetically about the bind of many health department inspectors in the new regulatory climate after 2011. As one clinic consultant in a state that abruptly imposed ASC requirements observed, “They do care about public health, they do have a sense of professionalism….of course they have political stuff they have to answer to, but they are not a bunch of wackos.” She continued, “This whole thing [new state regulations that mandated unannounced inspections] got thrown at them too…their heads were spinning! The guidelines they had to follow had never been used in the state before… they were answering these questions in real time for themselves before they could answer them with us. They were thrown under the bus, too.
Impact of restrictions
3: Newer staff and threats to the “institutional memory” of women- centered abortion care
34 Given the fairly high turnover of junior staff in many abortion facilities, dealing with newer hires’ confusion and upset is one of the major challenges clinic managers face as a result of the intensified level of scrutiny I have described. For example, one clinic director whose facility was subjected to an unusual amount of inspections because of complaints from the group Operation Rescue, said: “I noticed the staff internalizing the criticism from the Right…I noticed [the newer] staff feeling like ‘maybe, we are bad if somebody says enough times that what you are doing is bad….so it’s really challenging for me as a manager when you start to see the stigma taking hold.” 35 Quite poignantly, several senior clinic staff compared the current state of siege they felt from the current regulatory climate to the large scale blockades the abortion provider community experienced in the 1980s, and worried about the impact of the more recent events, particularly on newer staff. These staff ruminated about the differing levels of public support clinics received in each era. As one of these veterans put it: “The blockades were really public, and they were physical. And so you dealt with them on a physical level…but people on the outside saw it, and they sympathized with us. The police came, they were on our side…but now, with the onslaught of attacks through the regulatory system and the legislative system, it’s invisible to the majority of Americans—people have no idea what’s happening. It’s not thugs invading our clinic, it’s state sanctioned harassment, and it’s easier [for newer staff] to internalize.” 36 Most worrisome to senior staff is the possibility that junior staff will accept the demands of the new regulations unquestioningly, and in the process, lose the veterans’ vision of what good abortion care ideally should be. To explain further how ASC regulations actually effect on-the- ground abortion care, and in particular, the
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requirement of conforming to the sterility standards of hospital operating suites, this means in practice that all personnel encountering the patient during the procedure and after—not just those medically attending the patient—must be gowned and masked; that no pictures can be hung on the walls of procedure rooms or recovery rooms (because of dust); that the long-time practice of clinics having journals in their recovery rooms where patients can write reflections or notes of support to future patients must be abandoned (again because of dust); and the equally longstanding custom of offering patients tea and snacks in the recovery room after their abortion was also forbidden.
37 As one veteran manager put it: “As you make hires, and as they come in—every new nurse, every new medical assistant—they think that these ASC regulations are the actual standard of what abortion care should be… They entirely practice to the regulation, without an understanding that we do that bullshit part because we have to. The institutional memory of our field is being lost.” In this instance, the speaker was specifically referring to the fact that the clinic could no longer offer herbal tea or heating pads to patients in the recovery room because of the hospital-level sterility regulations now in force. 38 The irony of having freestanding clinics turned into essentially small hospitals was not lost on a woman, now a clinic consultant, who has worked in the abortion field ever since the Roe decision in 1973. As she commented in a focus group discussion: “In the first ten years post-Roe, our whole mission as independent providers was about pulling this caring service out of a hospital situation. We fought really hard not to be in a hospital or an ambulatory surgi-center—which wasn’t even invented yet!—but being able to offer personalized care in a woman-to-woman manner that the safety of the procedure certainly made possible…we would care for women in a way that make it as personal and as good an experience as you could possibly have…And out of this came the idea of special touches…[we wanted] the women to feel like somebody went out of their way to help you feel comfortable today.” 39 The speaker went on to recount how she and a colleague had approached various herbal tea makers to find a blend that would be most helpful in soothing a woman’s uterus after the procedure.
40 Her statement was followed by others who were nodding their agreement. As one counselor put it, “It’s really hard to maintain intimacy when you have a mask on, or when you have a weird hat on your head [of the type worn by surgeons] and you’re holding someone’s hand and you have this gown on. …the overarching message to me is that they [new regulations] are interfering with the intimacy you have with the patient.” 41 In a similar vein, another long time clinic director, with tears in her eyes, said that after making the mandated ASC changes, “You walk into our surgery center, and it’s so cold, and intimidating…there’s no art. The lights are too bright, the recovery rooms smell like bleach. Everyone’s wearing gowns. We have actually implemented doulas, but they’re still gowned up in the same things. The warmth is gone.” 42 In light of their perception of the threats that ASC regulations in particular posed to their career-long commitment to “quality” abortion care, members of the abortion providing community, including those participating in this study, were particularly heartened by a passage in Justice Stephen Breyer’s Majority decision in the Whole
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Woman’s Health case, where he was responding to the state of Texas’ argument that the few existing ASCs in the state could meet the needs of Texas women: “[I]n the face of no threats to women’s health, Texas seeks to force women to travel long distances to get abortions in crammed-to-capacity super facilities. Patients seeking these services are less likely to get the kind of individualized attention, serious conversation, and emotional support that doctors at less taxed facilities may have offered. Healthcare facilities and medical professionals are not fungible commodities. Surgical centers attempting to accommodate sudden, vastly increased demand…may find that quality of care declines” (Whole Woman’s Health 2016, p. 35-36).
43 While the non-physician providers under discussion here would question Breyer’s exclusive focus on the role of doctors in the abortion experience, they were deeply gratified by his acknowledgement that the actual character of abortion care matters—a first in abortion jurisprudence.
Conclusion: Reproductive Governance and Abortion Exceptionalism
44 How, in conclusion, should we comprehend the situation described in this paper: that a new, intensified regulatory regime governing abortion care since the 2010 elections has emerged, and has brought such evident difficulties to this field? If, as the anthropologists Faye Ginsburg and Rayna Rapp (1995, p. 1) suggest, reproduction can be used “as an entry point to the study of social life,” then one might reasonably find that the reproductive politics of the contemporary United States reveal a society deeply conflicted about sexuality and women’s autonomy. More concretely, even though polls consistently show a majority of Americans wishing abortion to remain legal (PollingReport.com 2017), this majority is seemingly approving of, or more likely, oblivious of, the massive restrictions on abortion provision that have been enacted in recent years. The public’s passive acceptance of these restrictions is arguably yet another indication of the continuing stigmatization of abortion some forty-five years after legalization.
45 To return to the ideas presented at the beginning of this paper, I argue that the two concepts of “reproductive governance” and “abortion exceptionalism” help us understand what has transpired with the clinics. Abortion exceptionalism, again, conveys the idea that abortion as a health care service has been treated differently— and more harshly—by the regulatory arms of various states than have comparable out- patient health services, a point that was resoundingly affirmed by the Supreme Court in the Whole Woman’s Health decision. The aspect of the reproductive governance paradigm most clearly pertinent in this instance is that of legislative controls: the precarious situation of abortion provision in the United States, in simplest terms, is due to state legislators who, complicit in abortion exceptionalism, have implemented over 300 restrictions since the 2010 election. But these legislative actions exist in a mutually reinforcing universe with the other mechanisms named in the reproductive governance formulation: 46 1. The economic inducements cited by Morgan and Roberts can, in the abortion case, more properly be understood as economic disincentives. For example, the Hyde Amendment forbids any federal dollars being used for abortion services, except in very
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limited circumstances, and a growing number of state laws curtail the ability of private insurance plans to cover abortion, if these plans wish to be listed on a state’s exchange under the Affordable Care Act. Though some 15 states do allow state Medicaid funds to be used for abortions, the authorized reimbursements in many instances are so low that clinics actually lose money on these transactions. The lack of public funding for abortion has put providers in a difficult position. The average price of a first trimester abortion is about $550.00, representing a negligible increase in the 40 odd years since Roe, when the price of a 1973 abortion was about $150.00. But given that abortion patients are disproportionately poor—some 75% are near or below the poverty line (Guttmacher Institute 2016)— providers feel constrained from raising prices. 47 2. The negative moral injunctions pertaining to abortion are arguably omnipresent in American society, ranging from the religious figures who denounce abortion and threaten excommunication of politicians who support it; to political figures, such as the current president of the United States, who has stated that women who have abortions should be “punished” (Flegenheimer and Haberman 2016), (a statement later retracted), to the distortions of abortion in popular culture (Sisson and Kimport 2016) and to the ideological messages contained in some laws, such as the one in Kansas essentially forbidding abortion providers from setting foot on public school grounds—a distinction, surely not lost on legislators, that puts these providers in the same category as sex offenders (Joffe 2013). 48 3. Direct coercion in the abortion case is most dramatically revealed by the eleven individuals who have been murdered by anti-abortion zealots and the thousands of others in the abortion providing community who have been terrorized at their homes and workplaces (Cohen and Connon 2015). 49 Though the Whole Woman’s Health Supreme Court decision in 2016 brought some welcome relief to this field, at the time of this writing in the fall of 2017, with the Supreme Court only one Justice away from a majority in favor of overturning Roe, abortion care is as embattled as ever. To be sure, the abortion providers interviewed for this study, by definition, were among the more fortunate in their respective states in that they managed to keep their clinics open, even in the face of expensive and cumbersome restrictions, while other facilities in their states were forced to close. Nevertheless, as I have argued, complying with these restrictions takes a considerable toll on clinic managers and staff, involving much added labor to already demanding work. What, finally, keeps the abortion providers discussed here committed to doing this work, in the face of these challenges? 50 Not surprisingly, providers responded to this question by citing a profound belief in the importance of reproductive justice and a very direct sense of commitment to their patients. As a director of a Midwest clinic, which has a long history of being picketed by aggressive protesters, put it: “It’s because of the patients…Because when you go into a room and you can hold the patient’s hand and she says, ‘thank you for being here,’ it makes it worth it. You temporarily forget about the five people who just threatened to beat you up….[I stay] because I love this work.” In a similar vein, a veteran clinic director discussed how the very process of campaigning, with local political officials, to protect her facility against draconian regulations improved her morale and that of her staff: “So we’ve been talking a lot about independent abortion provision with people who don’t know anything about abortion—except they have a lot of power to influence things about abortion…and this [campaigning] has reminded us of the really good
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things we have been able to do, and I think it’s offset some of the trauma we’ve gone through.” 51 But this ability to stay involved in abortion care is fueled also by a determination to not let the “antis” win. A senior staff person from a city in which national anti-abortion groups had made significant (and unsuccessful) attempts to shut the one remaining clinic down, acknowledged that that “what keeps her going,” beyond a commitment to her patients, is the satisfaction at having stood up to her foes. “They [antiabortion forces] did not stop abortion in — because we are there and it pisses —[nationally known leader of antiabortion group] off, and that feels good to me…at the end of the day that asshole’s sitting right down the street and he knows we’re still here. That gets fire in my belly.” 52 For some of those interviewed, even my raising the issue of how they managed to remain in this field, given the challenges, was met with puzzlement. As respondent said to this writer, “Carole, there’s joy in this work.”
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Thompson-DeVeaux, A. (2015). “How anti-abortion lawmakers are hijacking state health departments” in The Week. http://theweek.com/articles/444720/how-antiabortion-lawmakers- are-hijacking-state-health-departments. Retrieved June 17, 2017.
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Whole Woman’s Health v Hellerstedt. (2016). 136 S. Ct. 2292.
ABSTRACTS
This article discusses the impact of the recent wave of abortion restrictions on abortion provision in the United States, a phenomenon that has led to the closing of numerous clinics. The article
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offers some context of the political forces that led to this expansion of restrictions, and describes two of the most consequential ones: Ambulatory Surgi-Center (ASC) requirements, which dictate that clinics conform to the physical specifications of small hospitals; and hospital-admitting privileges ones, which mandate that doctors providing abortions obtain privileges at local hospitals. I draw on research I have conducted with abortion providers in nine “red” or conservative states that have imposed new restrictions or intensified the monitoring of existing ones. I show how responding to this new regulatory environment, which includes a greatly intensified schedule of surprise inspections, has consequences for the daily operations of the clinic, for the morale of both staff and patients, and for senior staff’s ability to sustain and transmit to junior staff their original vision of woman-centered care. I conclude by suggesting that the current regulatory regime governing abortion care in many states represents an extreme example of “reproductive governance,” a recent concept in the social science literature on reproduction.
Cet article explore comment la récente vague de restrictions législatives en matière d’avortement a conduit à la fermeture de nombreuses cliniques. L’article examine comment contexte politique a favorisé l’essor de ce type de mesures. Il se penche également sur l’exemple de deux de ces mesures dont l’impact a été conséquent : la première requiert que les cliniques pratiquant des avortements se conforment aux normes demandées pour un centre de chirurgie ambulatoire (ambulatory surgical center), la seconde exige que les médecins pratiquant des avortements soient autorisés à admettre leurs patients dans un hôpital proche (admitting privileges).Il s’appuie sur des recherches menées auprès de cliniques qui pratiquent des avortements dans neuf états « rouges », autrement dit conservateurs, ayant imposé de nouvelles restrictions ou ayant intensifié l’application des mesures déjà existantes. Il démontre que s’adapter à ce climat de régulation, qui a eu pour effet d’intensifier le rythme des inspections surprises, a des conséquences certaines sur le quotidien d’une clinique, sur le moral du personnel et des patients, sur la capacité des médecins expérimentés à fournir une qualité de soin axée sur les patientes tout en transmettant ce modèle à leurs jeunes collègues. Il suggère en conclusion que le système actuel de régulation qui régit la prise en charge des avortements dans de nombreux États est un exemple, poussé à l’extrême, de « contrôle reproductif », concept émergent en recherche en science sociale sur la reproduction.
INDEX
Mots-clés: avortement, hopitaux, restrictions, contrôle reproductif Keywords: abortion clinics, restrictions, reproductive governance
AUTHOR
CAROLE JOFFE
Professor, Department of Obstetrics, Gynecology & Reproductive Sciences Advancing New Standards in Reproductive Health (ANSIRH) Professor Emerita, Dept. of Sociology, University of California, Davis
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An Abortion Minister: the Reverend Spencer Parsons’s Struggle for Abortion Rights before Roe v. Wade
Anne Légier
Introduction
1 In a Dec. 14, 1969 article entitled “Guidance for Women in Trouble,” Chicago Sun Times readers learned about the existence of a group of Protestant and Jewish clergymen helping women secure safe, albeit illegal, abortions in the Chicago area. The article, written by Linda Rockey, featured a large picture of the Reverend E. Spencer Parsons, who was then Dean of the Rockefeller Memorial Chapel, in his office at the University of Chicago. The article, which launched the group’s public existence, quoted Parsons extensively. In the following years, Spencer Parsons went on to become the most visible advocate of the abortion rights movement in the Midwest, as the Chairman of the Chicago area and Illinois Clergy Consultation Service on Problem Pregnancies (CCSP).
2 His individual trajectory as a seemingly unlikely abortion rights advocate embodies both a movement and its time: the story of his spiritual, political, and very practical involvement in favor of the legalization of abortion is symbolic of the way in which the clergy shaped the social landscape of the 1960s and 1970s. 3 As a man of God whose faith was rooted in the Baptist tradition known for stressing free will, Parsons was enticed by the ideas of civil disobedience developed by Rev. Martin Luther King Jr. Just like the civil rights icon, his profession gave him an aura of respectability, more freedom to express subversive ideas and enabled him to be heard in ways others could not be. 4 In this article, I will try to explain how a well-respected middle-aged minister came to embrace an issue mostly seen as a young women’s struggle. I will also try to highlight how, through practical activism involving civil disobedience and public advocacy for
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abortion reform as well as theological reflection, Spencer Parsons reshaped the abortion landscape before Roe v. Wade.
Becoming an Abortion Minister
5 From a contemporary perspective, the idea of a minister devoted to defending abortion rights might seem incongruous. However, in many ways, Spencer Parsons’s involvement in the abortion rights struggle makes perfect sense: his theological background, his position as a university minister, and his connection to the political movements of the 1960s shaped his approach to the issue.
6 As a Baptist, Parsons belonged to a religious tradition emphasizing freedom of conscience. The Southern Baptist leader, Albert Mohler, explains that Baptists consider “each individual soul is independently competent to adjudicate all matters of religious importance” (Mohler n.d.). This idea of “soul competency” is so central to the Baptist faith, argues theologian E. Y. Mullins, that it distinguishes it from other Christian faiths (Mullins 1908, pp. 68–73). This theological framework allowed for very diverse views on social issues such as abortion.1 In 1968, Parsons and his friend Howard Moody, who had founded the first chapter of the Clergy Consultation Service on Abortion (CCS) in New York the previous year, successfully submitted a proposal to the American Baptist Convention stating early abortion should be “at the request of the individuals concerned, and be regarded as an elective medical procedure governed by the laws regulating medical practice and licensure” (“Early Resolution on Abortion, American Baptist Convention, Boston, MA” 1968; Gorney 1998, p. 72; Kaplan 1997, p. 62; United Press International 1968c, 1968b, 1968a).2 7 Parsons did not only benefit from a religious tradition encouraging individuals to make their own moral choices: as a university minister, he was awarded even more freedom than his colleagues with more traditional congregations. Before joining the University of Chicago, Parsons had been a university chaplain for most of his adult life.3 In an interview he gave in 1993 to Paula Kamen, he mentioned the fact that the position afforded him a great deal of freedom: “Well, I think a university community is more open to something like that than other communities. And I didn’t, I really wasn’t answerable to a local congregation. Being Dean of the chapel at the university, I was pretty freewheeling in terms of what I chose to do” (Parsons 1993).4 Nanette Davis, a sociologist who studied the Clergy Consultation Service in Michigan, argues that “highly autonomous positions” like Parsons’s were common among early members of the CCS because they “offered relatively little public surveillance and maximum personal freedom” (N. J. Davis 1985, p. 130). 8 The University of Chicago of the late 1960s did offer Parsons “maximum personal freedom” for his abortion ministry. The university, notably founded with contributions from the American Baptist Education Society and John D. Rockefeller, had a long tradition of encouraging freedom of expression. In a 1902 speech delivered on the university’s tenth anniversary, President William Rainey Harper stated that “complete freedom of speech on all subjects” had from the start “been regarded as fundamental in the University of Chicago and was a principle that could never be called in question” (Stone et al. 2015). When, in 1971, Parsons faced legal challenges as a result of his involvement in favor of abortion rights, the university’s administration quietly offered support. Parsons had been subpoenaed to testify in front of a Grand Jury in the hope
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that he would name abortion providers (O’Connor 1971); the chief counsel for the university called him “unofficially for a chat” and offered strategic advice (Good 1971; Dirks and Relf 2017, p. 95).5 9 As Dean of the Rockefeller Memorial Chapel, Parsons also benefitted from a long tradition of open Christianity and social activism. According to historian Frederik Borsch, who authored a book devoted to religion at Princeton and other universities, the very architecture of the Rockefeller Chapel reflects a spiritually inclusive approach meant to appeal to a religiously diverse student body: the stained glass windows feature geometrical forms instead of Christian iconography and the great front doors include representations of Plato and Zoroaster6 with additional iconography offering tribute to philosophers, artists, and scientists (Borsch 2012, p.179). The chapel’s tradition of social activism was constructed by its deans, all of whom were involved in the issues of their time. During the Depression, the first dean, Charles Gilkey, organized a fund for the university’s employees who had been laid off and provided assistance for Chicago’s poorest residents. The second dean, John Thompson, was a white southerner famous for his involvement in favor of civil rights (Borsch 2012, pp.181–82) who invited Rev. Martin Luther King Jr. to preach at the Rockefeller Chapel twice, in 1956 and 1959 (Allen and Drapa 2012).7 10 Reflecting many years later on the university’s quiet support for his abortion ministry, Parsons suggested that the administration might have had a practical motivation: “The university supported me all through that period and there were people working in the Dean of Students’ Office who had dealt with students who had unwanted pregnancies” (Parsons 1993). Unintended pregnancies were indeed a possibility for young people experiencing life away from home for the first time. University chaplains, to whom students sometimes turned for advice, were well aware of the personal turmoil associated with not being able to control one’s fertility. As early as the 1950s, when he was a university chaplain in Boston, Parsons had embraced the issue of reproductive rights, campaigning against Massachusetts’s ban on contraceptives (Kaplan 1997, p. 61; Parsons 1993). 11 Because it was likely to have some practical knowledge of the difficulty of securing a safe abortion, Parsons theoretical congregation—the student body of the university— was also more likely to be supportive of abortion rights. A 1970 opinion poll conducted among college students across the country indicated that 64.5% of them supported abortion “regardless of circumstances” while 30.3% agreed that it should be legal “only in certain cases” (Huffman 1970; Beggs and Copeland 1970; Finlay 1981). 12 Parsons, like many university chaplains was immersed in the student culture which, at the time, questioned authority in general. Like many of his colleagues, he was involved in the movements embraced by the students of the 1960s: the civil rights struggle and the anti-war protests. In 1963, while he was a minister at Hyde Park Union Church, he published Rev. Martin Luther King Jr.’s Letter from Birmingham City Jail in the church’s newsletter only a few weeks after it was written (Johnson 2012). In 1967, he invited King to preach again at the Rockefeller Chapel. In the invitation letter he wrote to the civil rights leader, he added a “personal note” congratulating him for the leadership he had given to the Clergy Committee Concerned about Vietnam and informing him of a “Memorial Day Peace Service” conducted at the Chapel attracting close to 800 people (Parsons 1967). Parsons’s involvement in the draft resistance movement was also underlined in a 1968 Chicago Sun Times article mentioning a sermon in which Parsons
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encouraged young men “to so examine the moral implications of the Vietnam War that they will be moved to declare their conscientious objection and refuse to be drafted” and an October 1969 photograph shows that a draft protest organized at the Rockefeller Chapel drew a very large crowd (Brant 1969). 13 Parsons recalled in a 2003 interview that people who were interested in the anti-war movement and the civil rights movement were undoubtedly “also interested in the rights of women in terms of the abortion problem” (Dirks and Relf 2017, p. 57). In doing so, he echoed the idea, expressed by Howard Moody and Arlene Carmen in their 1973 book, that the strategy of the CCS was to draw on the network of clergymen involved against the war and in favor of civil rights to find members: “It was apparent from the start that the clergy who would be the most likely to become involved in a project of this kind would be the same ones who had been the most active in the school integration battle in New York, in the civil rights battle both here and in the South, as well as other areas of civil liberties. It was to those clergy whose liberal attitudes and commitments had been clearly established that we turned for help in developing the original nucleus of the Clergy Consultation Service on Abortion” (Carmen and Moody 1973, p.21). 14 In the years before he launched the local chapter of the CCS, Spencer Parsons widened the scope of his progressive activism to include abortion rights. At first, his focus was on the legal aspect of abortion. However, he soon turned to a more comprehensive approach as he developed a real “abortion ministry.”
Spencer Parsons’s Abortion Ministry
15 Parsons began his abortion ministry as a founding member of the Illinois Citizens for the Medical Control of Abortion (ICMCA) (The Chicago Tribune 1967). The group, led by a female doctor, Lonny Myers, and an Episcopalian minister, Don Shaw, campaigned for the repeal of Illinois’s abortion ban, arguing that abortion should be a private matter between a patient and her doctor (ICMCA 1971; ICMCA leaflet, n.d.). In January 1969, Parsons, Shaw, and another member of the ICMCA, the Rabbi Robert Marx, wrote a letter to “Religious and Civil Leaders in Illinois” including Democratic politician Adlai Stevenson, philanthropist Abram Pritzker, and John Sengstacke, publisher of the Chicago Defender8 as well as a number of ministers and rabbis who would ultimately join the effort to constitute the Chicago CCS. The letter urged them to offer their support to the repeal of Illinois’s abortion law in order to “bring […] abortion under competent medical control where it belongs” (Marx, Parsons, and Shaw 1969).
16 Like many who campaigned for legal change, Parsons was eventually confronted with the practical aspect of abortion. In the interview he gave to Paula Kamen in 1993, he recalled that his first direct experience with abortion occurred in 1968. A Baptist chaplain from Indiana University contacted him, hoping he could help secure an abortion for a graduate student. The Indiana minister believed that, since Parsons lived in “the old big bad Windy City,” he would know where to go. At the time, Parsons did not. However, he tried to find a solution and, through people he knew from the Dean of Students Office at the university, came in contact with an underground abortion network organized by a feminist group called Jane (Parsons 1993). A letter kept by Spencer Parsons in his personal files dating from February 1968 and emanating from Bloomington seems to have been written by the young woman he remembered as being
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his first abortion counselee. The author of the letter (whose name was cut out to protect her privacy), thanked Parsons and assured him the group had provided a “professional” service (Bloomington woman 1968): “Dear Dr. Parsons, I want to thank you very much. Without your help, I don’t know what we would have done. Frankly, until we met you and your kindness, we had begun to feel like social outcasts. We did contact the first choice. This is a team operating in a manner most analogous to the proverbial crap game. I feel they were utter professionals and I could not have hoped for better treatment anywhere. All I can say is thank you. We are very grateful. Sincerely yours.” 17 Parsons subsequently developed a relationship with the group “operating in a manner most analogous to the proverbial crap game”9 and referred a number of women to the feminist underground service Jane before he founded the Chicago CCS in 1969 (Parsons 1993; Kaplan 1997, 62; Rockey 1969; Bloomington woman 1968). Parsons also counseled women whom he sent to the New York CCS, which had been founded in 1967 by his friend Howard Moody.
18 Moody eventually convinced Parsons that the demand for abortion in the Midwest was too great for New York to take on. The Dean of the Rockefeller Chapel embraced the project knowing that it had been successful in the Big Apple (Rockey 1969). He reached out to ministers and rabbis with previous political involvement, many of whom were connected to University of Chicago and its neighborhood of Hyde Park.10 At the beginning of March 1969, Parsons, Ronald Hammerle—a divinity student at the University of Chicago—and Edgar Peara—a minister who was a graduate of a Hyde Park theological school and worked in the wealthy suburb of Wilmette—started contacting prospective members. They invited 50 Chicago area clergymen to a “formal organizational meeting” in Hyde Park, hoping to “lay the groundwork for the organization, cover all questions and recommendations, and set up a working structure” (Parsons, Peara, and Hammerle 1969). At the meeting, two “distinguished doctors” answered questions on the medical aspect of abortion. In the report he sent after the meeting, Parsons summarized the medical information which would be relevant for counselors: the difficulty in determining the length of a pregnancy, what do before the procedure and warning signs of a complication. According to Parsons’s report, most rabbis and ministers who came to the founding meeting agreed that sending women to London, where the procedure could be safely performed in a medical facility, should be the preferred option. Parsons also mentioned the fear of being overwhelmed by calls once the service went public. He cited the example of the Cleveland CCS being “desperate” at receiving 50 calls per day after being featured in a CBS news report (Parsons 1969a). 19 In the months following its creation, the ministers and rabbis who constituted the group operated quietly and counseled more than 500 women (Rockey 1969). They opted to call themselves the Clergy Consultation Service on Problem Pregnancies (CCSP), instead of on Abortion like New York, a choice they felt better suited to the more conservative Midwest (Hammerle 2013). In December, the group—now composed of 30 clergymen— decided to go public. Parsons was tasked with contacting Linda Rockey from the Chicago Tribune, whom the group felt would write a positive article (Parsons and Leifer 1969). 20 By that time, the service had a phone number available through Directory Assistance (667-6015) (Rockey 1969) and an answering machine apparently located at Rockefeller Chapel (Parsons 1969b). The message provided the name of the ministers available for counseling as well as practical advice. An August 1972 tape message archived at the
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University of Illinois explained: “Before you see a counselor, you must have a urine pregnancy test and a note from a physician stating the length of the pregnancy.” It gave specific information about the cost of early and later abortions, mentioned the Midwestern cities covered by the Chicago area CCS and stated that counseling was free but that contributions were welcome (Chicago Area CCSP 1972). After scheduling an appointment over the phone, the women then personally met a clergyman, theoretically to discuss all options (getting married, keeping the baby, giving it up for adoption etc.) but in practice mostly to secure an abortion. Parsons explained that CCSP counselors did “not tell the women what to do” but “provide[d] information and guidance as to the alternatives available for abortion or adoption,” acknowledging that most of the women had opted to have an abortion before contacting the service (Rockey 1969). The counselor outlined the procedure and gave women the name and phone number of a physician who had been vetted by the group (Rockey 1969; Carmen and Moody 1973; T. Davis 2004, p. 128). That included physicians both at home and abroad.11 The women were also given extensive explanations on what to expect, from how to deal with cab drivers in a foreign country (CCS, n.d. p. 64; Carmen and Moody 1973) to the specifics of abortion techniques used by the provider. 21 The advice given was informed by the constant feedback the Chicago clergymen encouraged and received from the women who had previously gone through the service. The CCSP elaborated a form to help women report on their experience. The questionnaire, which could be filled anonymously, was very comprehensive. It included questions on travel, on whether receptionists and nurses were “sympathetic and considerate,” on pain management, on specific testing performed by the facility and on the occurrence of complications (CCSP, n.d.). Some women also wrote letters to thank the clergymen and report on their experience. The letters that have been kept are wonderful windows into the journeys of women seeking help from clergymen. In a letter Parsons received circa 1969, a mother of nine from Monmouth, IL gave a detailed account of her experience. She started her letter, which she called a “report” by describing the long and complicated search for help. She explained that her husband, a chiropractic physician, unsuccessfully asked numerous colleagues where he could find information on abortion. She then wrote to a newspaper requesting a copy of articles mentioning abortion in the hope that they would provide practical information. After receiving the clippings, she called the local Planned Parenthood in Peoria, IL. She was told to call the Medical Society. The Medical Society referred her back to her ob-gyn. However, she “felt certain that he would find [her] fit […] and mentally able to carry and deliver this [pregnancy] and that [she] would be forced12 to accept his decision” (“Letter from Monmouth” 1969). By that time, she was almost three months pregnant. Luckily, she received more comprehensive information from the Chicago Planned Parenthood and was able to reach Parsons over the phone and plan a trip to London. The physician, Dr. Sopher, was able to perform a second trimester abortion (“Letter from Monmouth” 1969). 22 Following the model established by the New York CCS, Parsons played the role of a patients’ advocate. He collected information on physicians, developed a correspondence with some of them and visited their facilities whenever possible. Safety was always the priority but Parsons also tried to drive prices down. While in 1969, an abortion secured through the Chicago CCSP cost between $400 and $500 (Rockey 1969), only a year later the group had negotiated a fee of $250 with their Kansas contact, Dr. Lynn Weller (“Letter to Lynn Weller” 1970). Parsons believed that cost was a very
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important part of the abortion issue because they determined who could have access to a safe, albeit illegal, abortion (Rockey 1969; Carmen and Moody 1973). In 1969, he told Linda Rockey that he had one regret about the service: “We are still working with middle income people who can afford to leave the state or the country. It is very difficult for the poor to get safe medical abortions.” He explained that he was hoping that, as the consultation services expanded and build up a network of licensed physicians, they would drive down the price for abortion (Rockey 1969). 23 Although the CCSP operated openly for 4 years, it faced very few legal challenges. In January 1970, only three weeks after the group announced its public existence through the Chicago Tribune article, one of Parsons’s colleagues from the University of Chicago and founding member of the CCSP, Rabbi Max Ticktin, was accused of “conspiracy to commit abortion.” The accusations stemmed from police investigation involving a Detroit physician named Jesse Ketchum. Ticktin’s office at the university was raided and his files confiscated, causing widespread outrage (The Chicago Sun Times 1970; Sprain Wilson 1970). Parsons told the press that the group was “solidly behind Ticktin” and believed it had “acted lawfully” in referring women out of state for an abortion (Chicago Today 1970). He expressed his “unqualified faith in Max Ticktin as a religious counselor” and said he was “greatly angered” at the violent tactics used by the Chicago police while searching the rabbi’s office (The Chicago Maroon 1970). The CCSP did not stop operating (Hyde Park Kenwood Voices 1970) and the charges were soon dropped by the Michigan District Attorney (Glazer 1970). 24 This first encounter with law enforcement probably prepared Parsons for the legal problems he would face a year later. Parsons, who had testified in front of the House Judiciary Committee in favor of a bill that would have legalized abortion in Illinois, had mentioned the fact that he personally knew 12 men and one woman who performed abortions daily as well as an Illinois physician who had performed 20,000 abortions in his lifetime. Republican House Majority Henry Hyde, a Republican who was staunchly opposed to abortion,13 called for a Grand Jury to force Parsons to reveal the names of the abortion providers he had mentioned (Good 1971). By the time he was subpoenaed, Parsons had had the opportunity to develop a religious defense of his refusal to cooperate with authorities. He told the Chicago Daily News “he would refuse to testify on the grounds that, as a clergyman, he [had] the right to keep such information confidential” and that he was prepared to go to jail if cited for contempt (O’Connor 1971). When in front of the Grand Jury, he did refuse to answer questions, saying “I am sorry I can’t give you that information because it would violate the confidential character of my pastoral ministry” (Parsons 1993). Neither of the legal challenges faced by the CCSP had a significant impact on their activities: in the four years they operated, they never interrupted their abortion referrals, helping dozens of women a week secure safe medical procedures. However, Spencer Parsons’s contribution to the abortion rights movement was not only practical. Through his sermons, speeches, interviews and writings, the minister developed a moral and religious defense of abortion which redefined how it was perceived.
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Reframing the Landscape of Religious Perceptions on Abortion: Spencer Parsons the Abortion Theologian
25 In the years it was active, the CCS probably helped between 350,000 and 450,000 women secure safe abortions (Wolff 1998, p.110), a number no other group could ever have attained. The respectability associated with the ministry made clergymen like Parsons almost immune from legal prosecution. However, the idea of morality was not only a shield protecting the rabbis and ministers of the CCS, it was also a powerful tool they used to reframe the perception of abortion. Parsons made a huge contribution to the abortion debate through the moral defense of abortion he promoted.
26 The first argument he used was inspired by the ideas of the civil rights movement and the anti-war movement: he explained that Illinois’s abortion law, like many others across the country, was unfair. In the article launching the public existence of the Chicago Area CCS, Parsons told Linda Rockey why the clergy decided to embrace abortion referral, emphasizing the need for direct action in the face of unjust laws:14 “We decided that it was time to help people and not wait for legislative reform. While we are convinced that the law in Illinois must be repealed, between now and that time, an awful lot of women go through a whole lot of trauma over problem pregnancies, and many have dreadful experiences with back-alley abortionists. […] We regard our ministry as one of counseling women with problems. […] We want people to get trained, qualified medical assistance. What concerns us most are the 4,000 cases a year in Chicago of infection from induced abortion” (Rockey 1969). 27 Parsons was well aware that most infections affected the women who had the least resources. Abortion laws thus did not impact women equally. In a January 1971 sermon delivered at the Rockefeller Chapel, he talked about how the “excessive costs and difficulties” of illegal abortion “fell unequally on the poor and the rich.” He then went on to describe all the “moral” reasons for terminating a pregnancy: “I have talked with the frantic parents of a twelve year old girl impregnated by her father’s brother, I have seen a young war wife, lonely and foolish by her own admission, get herself involved with another man while her husband was overseas. She continued to love her husband and she believed the only possible way to save the marriage for her, her husband, and their two-year-old child was to terminate her pregnancy. A woman fifty-two, married at 49 for the first time without any intention of being a parent, found her whole relationship with her husband threatened by an unexpected and unwanted pregnancy. If you have ever listened to the frantic voice of a woman desperately seeking help for herself or a loved one, you will have sensed something of the intensity of the human agony tied up with the problem of an unwanted and rejected pregnancy” (Parsons 1971b). 28 In the same sermon, he also underlined the fact that, if the law was widely being violated by “the most competent and respected members of the medical profession,” it meant the law was unfair and inadequate (Parsons 1971b).
29 For Parsons, abortion laws were not only unjust but also violated religious freedom. As a Baptist minister, Parsons belonged to a tradition that considered freedom of religion to be of the utmost importance. Baptist historian Robert G. Torbet argued that “Baptists have made a unique contribution to Protestantism, for which the world is their debtor, in their consistent witness to the principle of religious liberty” (Torbet 1973; Miller 1976; Patterson 1976). Parsons applied this theological tenet to abortion, making a very convincing First Amendment argument in favor of choice. In a 1971
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article written for the publication of the University of Chicago’s Divinity School, Parsons suggested the State should not interfere in theological debates: “[S]ince we are a people representing many diverse religious traditions, is it not the best public policy, out of respect for our different convictions on the matter, for the State to withdraw from regulating this area of human intimacy? The State Legislature is in no position to adjudicate between the theological claims which divide us” (Parsons 1971a). 30 Parsons did not limit his religious freedom argument to scholarly publications. Fearing that the Catholic Church’s efforts to reinstate New York’s abortion ban—which had been repealed in 1970—might succeed, Parsons made the following statement to the press: “We believe that mandatory child-birth by state law is a violation of religious and moral sensitivities of millions of liberal Catholics, Protestants, Jews and other Americans. […] The Roman Catholic Church officially regards abortion at any moment after conception as murder. This is a theological and not a biological or legal statement of fact. It is a judgment not shared by most people in the nation. Yet the Church presumes to force by virtue of massive financial power and extensive network of local congregations, schools and hospitals its moral judgments upon the community by law” (Parsons 1973). 31 Parsons’s fears that the Catholic Church might succeed in imposing its belief on a religiously diverse population did not become reality: only four days after this statement was released to the press, the Supreme Court ruled in Roe v. Wade that abortion was a constitutionally protected right. However, in the years since Roe, most anti-abortion groups have used religious language and many have trusted state legislatures to “adjudicate between theological claims” that divide Americans15.
Conclusion
32 Parsons was one of the many faces that shaped the abortion landscape before Roe v. Wade. Although he might seem an unlikely abortion-rights activists to the modern reader, Parsons viewed the issue as an integral part of his religious calling. Through direct civil disobedience and moral advocacy, he changed the landscape of reproductive rights in the late 1960s and early 1970s, bringing abortion from the margins of the underground to the mainstream of moral respectability.
33 After Roe, Parsons went on to found the Religious Coalition for Abortion Rights, an organization that is still in existence today and promotes ideas mapped by the Clergy Consultation Service. He continued to voice a progressive religious message on issues of reproductive rights, campaigning against the emerging anti-abortion movement as early as the 1970s and promoting new abortion techniques such as Mifepristone (RU 489) in the 1980s. Spencer Parsons died in Boston in October 2013.
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Wolff, Joshua. 1998. “Ministers of a Higher Law: The Story of the Clergy Consultation Service on Abortion.” Amherst. http://classic.judson.org/MinistersofaHigherLaw.
NOTES
1. On how the fragmentation of the modern American Protestant Church enabled social activism, see N. J. Davis 1985, p. 129. 2. Kaplan, who mostly uses pseudonyms to refer to the individuals she mentions in her book, calls Parsons “Harris Wilson.” 3. He worked at Harvard, Radcliffe, Wellesley and the Massachusetts Institute of Technology (MIT), then moving to Hyde Park, the neighborhood of the University of Chicago in 1959. He became the minister of the Hyde Park Union Church and in 1965 Dean of the Rockefeller Memorial Chapel at the University (Philbrick 1965). 4. When she interviewed Parsons, Paula Kamen was researching another abortion referral group from Chicago called Jane for a play she was writing. The Play, entitled Jane: Abortion and the Underground was performed at the Green Highway Theater in Chicago in the Fall of 1999. Spencer Parsons was featured in the play as a friend and ally of Jane’s feminist members (The Green Highway Theater 1999). 5. The university’s lawyer told him he did not believe the argument of privileged information would be considered legally admissible. Parsons nonetheless used it successfully. 6. Zoroaster, also known as Zarathustra, founded Zoroastrianism, is one of the world’s oldest monotheist religions in Ancient Iran (Bonnasse 2016). 7. The 1956 sermon is believed to be King’s first major address in Chicago. He stressed the need for resistance against political injustice: “There are some things we never intend to become adjusted to: lynch mobs, oppression, economic exploitation and political domination. I call upon you to resist with your heart and strength the forces of evil” (King in Davenport 2012). 8. The Chicago Defender, a weekly newspaper based in Chicago, was founded in 1905 to cater to an African-American readership. It quickly became “the most important publication in the colored press” (Staples 2018). 9. Craps is a game of dice. The author of the letter is here referring to “floating craps” an illegal operation of the game which was popular at the beginning of the 20th century. To evade law enforcement, the operators used portable tables and equipment that could be moved quickly. Jane, the Chicago abortion network used a “floating” strategy, using people’s homes for a day, to avoid drawing attention to themselves. For more on the group, see (Kaplan 1997). 10. 15 of the 25 founding members of the Chicago CCSP were connected to the university or Hyde Park (Chicago Area CCSP “members list” 1970). 11. At the time, abortion was legal in places like Japan and England. While it was illegal in Mexico and Puerto Rico, some physicians there still provided safe abortions. 12. The word forced was underlined by the author of the letter. 13. This is the Henry Hyde who later sponsored the 1976 Hyde Amendment preventing federal funding from being used to pay for abortions. 14. The New York CCS’s position statement, released in 1967, defended the idea of unjust laws: “Therefore believing as clergymen that there are higher laws and moral obligations transcending legal codes, we believe that it is our pastoral responsibility and religious duty to give aid and assistance to all women with problem pregnancies” (Carmen and Moody 1973, 30–31). 15. On the roles of pro-life Christian lobbies in shaping state legislation after Planned Parenthood of Southeastern Pennsylvania v. Casey (1992), see for instance how Americans United for Life explain their strategy in Aaronson-Rath 2005.
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ABSTRACTS
Since pro-life activism has been mostly organized by conservative religious movements, the general public has come to believe spiritual positions on abortion are necessarily hostile to it. By focusing on the individual trajectory of a Baptist minister’s involvement in the struggle for abortion rights, this article will attempt to highlight the key role played by progressive clergymen like the Reverend Spencer Parsons in shifting the abortion landscape before Roe v. Wade. Drawing essentially on archival documents, this paper will explore how Parsons’s religious, professional and political background led him to embrace the ideas of abortion rights. It will then focus on Parsons’s “abortion ministry” and how he organized the Clergy Consultation Service on Problem Pregnancies (CCSP ou CCS), a network that helped thousands of Midwestern women navigate the world of illegal abortion. Finally, it will examine how Parsons’s theological contributions helped frame the issue of abortion rights in terms of ethical obligations and religious freedom.
Les mouvements « pro vie » américains émanant aujourd’hui essentiellement de groupes religieux conservateurs, le grand public a tendance à considérer que tout point de vue religieux sur l’avortement lui est nécessairement hostile. En s’intéressant au parcours individuel d’un pasteur baptiste impliqué dans la lutte pour le droit à l’avortement, cet article se propose de souligner le rôle capital joué par des hommes d’Église, parmi lesquels le révérend Spencer Parsons, dans le combat pour la légalisation de l’avortement. L’article, basé essentiellement sur un travail d’archives, s’intéressera d’abord au contexte spirituel, professionnel et politique qui permit à Parsons de s’impliquer dans le combat pour le droit à l’avortement. Il examinera ensuite son engagement concret en faveur de l’avortement : comment il organisa le Clergy Consultation Service on Problem Pregnancies (CCSP ou CCS), un réseau qui permit à des milliers de femmes dans le Midwest d’accéder à un avortement sûr. Enfin, il se penchera sur la contribution théologique de Parsons qui permit de resituer la question en termes de devoir moral et de liberté religieuse.
INDEX
Mots-clés: avortement, clergé, pasteur, théologien, baptistes, désobéissance civique, loi injuste Keywords: abortion, clergy, referral, counseling, ministry, theologian, Baptists, civil disobedience, unjust law
AUTHOR
ANNE LÉGIER
Université Sorbonne Nouvelle, EA 4399 Centre for Research on the English-speaking World (CREW). Faculté de droit et de Science Politique, Aix-Marseille Université (AMU)
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Sterilization in the United States: The Dark Side of Contraception
Sandrine Piorkowski Bocquillon
1 In contemporary America, sterilization, that is, salpingectomy, also called tubal litigation, or vasectomy for men, is considered as a radical, but safe method of contraception. Actually, it is quite an old practice, since the first sterilization law was adopted in 1907 in Indiana. The history of sterilization practices in the United States is quite telling, for it reveals the ideological currents at work in society throughout the twentieth century. One might think that from the beginning of the twentieth century, when it was a punitive and eugenic practice first experimented on men, to the 1960s and 1970s, when it was a contraceptive device, sterilization had evolved from an evil practice to a means of freeing women from unwanted pregnancies. But reality has proven to be different, and sterilization reveals the existing tensions between race, gender, and class, raising the question of who is in power when it comes to controlling reproduction. In fact, a comparative analysis of compulsory sterilization under states’ eugenic laws until the 1950s and federally funded sterilization in the 1970s unveils the ideological legacy of the eugenic movement, but it also reveals the power exercised by physicians in the field of reproduction and the ambiguity of the feminist movement on this question.
2 Ideologically, sterilization first had a punitive and a eugenic aspect since it targeted “confirmed criminals,” “idiots,” and “imbeciles,” as they were then called. It concerned institutionalized “retarded” persons, and the first 1907 law stressed the fact that “heredity plays an important part in the transmission of crime, idiocy and imbecility” (Sharp 1907). With eugenic proponents becoming more influential, the idea that the “unfit” represented a burden on society became more and more popular. Since it was believed that “poverty,” “crime” and “insanity” could not be cured and were the results of mental deficiency, institutionalized patients and prisoners came to be seen as a threat, called “the menace of the feeble-mined” (Goddard 1920). Thus, eugenicists supported the idea of sterilizing those who were deemed “unfit” to reproduce, arguing that it would reduce the tax payer’s burden. Eugenicists drafted a model sterilization law, which served as a basis for many states. This practice was even justified by the
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Supreme Court in 1927, in the Buck v. Bell case, stating that, “The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes […]. Three generations of imbeciles are enough.” Thus, forced sterilization was justified in the name of public health, just as compulsory vaccination had been before. It is estimated that between 1907 and 1963, more than 60,000 persons were sterilized in the United States under these laws. However, it is only in “the 1960s [that] the practice of sterilizing retarded persons in state institution virtually ceased” (Reilly 1987). These data might seem surprising, since one might think that the horrors perpetrated by the Nazi regime during World War II put an end to such practices, but “[a]lthough sterilization reached its zenith during the 1930s, several states vigorously pursued this activity through the 1940s and the 1950s” (Reilly 1987). Moreover, in 1941, when the Supreme Court was called upon once again to discuss forced sterilization, in Skinner v. Oklahoma, it did not invalidate the decision rendered in Buck v. Bell. Instead, it questioned the equity of Oklahoma sterilization law, “Sterilization of those who have thrice committed grand larceny, with immunity for those who are embezzlers, is a clear, pointed, unmistakable discrimination.” However, when delivering the opinion of the Court, Justice Douglas warned against the evils which might result from compulsory sterilization, thus making a marked allusion to Nazi Germany, “Marriage and procreation are fundamental to the very existence and survival of the race. The power to sterilize, if exercised, may have subtle, far reaching and devastating effects. In evil or reckless hands, it can cause races or types which are inimical to the dominant group to wither and disappear.” 3 The 1960s, which represent a revolution in American contraceptive practice, can be seen as the decade during which sterilization evolved from a coercive method of forced contraception used in state institutions to a federally funded contraceptive device. Prior to 1969, physicians had assumed that sterilization used as a contraceptive device was illegal, but a 1969 federal court case, Jessin v. County of Shasta, eased doctors’ fears when it stated that “sterilization [was] an acceptable method of family planning” (Lawrence 2000). And “on May 18, 1971, the Office of Economic Opportunity began funding sterilizations” (Dorr 2011). At the same time, Medicaid was permitted to reimburse up to 90% of the operation (Minna Stern 2005). As a result, “[b]y 1975, 7.9 million Americans had undergone sterilization, and sterilization had become the most popular method of contraception used by married couples” (Kluchin 2011). However, concerns and protests over the resurgence of coerced sterilization arose all around the country, thus revealing the dark side of this contraceptive device. 4 In fact, when taking a closer look at sterilization during the 1970s, it can be noticed that some ethnic groups are overrepresented when it comes to sterilization data. Native American, Black or Mexican women were, thus, more likely to undergo sterilization than white women. Concerning Native American women, it appears that the Indian Health Service (an agency within the Department of Health, Education and Welfare) provided for a very significant number of sterilizations on Indian reservations, to such an extent that Senator James Abourzek of South Dakota asked the Government Accounting office (GAO) to launch an investigation in 1976, after numerous complaints were made that sterilization was being used as a birth control procedure on Indian women of child-bearing age without their informed consent. As the GAO officials explained in their report, they found out that when carrying out the operation, there was no informed consent obtained from the patients, that the patients were not informed of their right to withdraw consent, and that sterilizations had been carried
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out on women under 21 years old. Even though the GAO report insisted on the lack of informed consent from the patients, it did not stress the fact that the number of sterilizations was particularly alarming (Comptroller of the U.S. 1976). But other sources emphasized this issue and accused the GAO report of underestimating the phenomenon: “Cheyenne tribal judge Marie Sanchez questioned fifty Cheyenne women and discovered that IHS doctors had sterilized twenty-six of them. She announced her belief that the number of women the GAO reported sterilized was too low and that the percentage was much higher than 25 percent” (Lawrence 2000). Though the percentage of Native American women who were sterilized in the 1970s may still be questioned, it is clear, from the GAO report, that those women did not always make a free choice. 5 Nevertheless, these abuses were not confined to Indian reservations and could be observed nationwide. In 1973, Dr. Bernard Rosenfeld coauthored a report on sterilization abuse across the nation. Its abstract is quite telling: “Evidence is presented indicating that in many instances of surgical sterilization, the operation is carried out without the informed consent of the patient. Cases in which surgeons ‘are selling’ disadvantaged patients on sterilization without informing them of reversible methods are presented. There is an epidemic of sterilization in almost every major American teaching hospital today. Hysterectomies are being performed unnecessarily because the operation is more of a challenge for the surgeon and provides good experience for the junior resident.” (Rosenfeld 1973). The point made by Dr. Rosenfeld concerning hysterectomy, that is, the complete or partial removal of the uterus, is noteworthy here, since it is not indicated for sterilizing a patient. Normally, hysterectomy is done when there is an indication of cancer, or a disease related to this part of the body. In part, Rosenfeld was prompted to write this report after witnessing these bad practices when he was a resident at Los Angeles County Hospital. This hospital came under public attention for its treatment of Mexican women, when, in 1975, in Madrigal v. Quilligan, a suit was filed against the hospital by twelve women of Mexican origin, who had been sterilized without their consent. They were all “poor, usually on welfare, and of a racial minority.” Their stories, told by their attorney, are shocking: one of them “was presented with sterilization consent forms while in labor, and after being assured that the operation could be easily reversed […] was sterilized.” Another one was given general anesthesia after the delivery of her child. “While under this unconscious state, she was surgically sterilized by a staff doctor without her consent. She was not informed about the sterilization until six weeks later.” Still another one, who was “given general anesthesia in preparation for a delivery by caesarean section [...] was approached by a staff doctor who told her she should have her “tubes tied,” because her children were a burden on the government” (Hernandez 1976). The twelve stories in this case all reveal the prejudices of the medical staff against Mexican-American women, perceived as hyper-breeders living on welfare benefits who needed to be sterilized to prevent overpopulation and to protect the tax payer. As we can see, a kind of neo-eugenics was at work, equating minority women with welfare benefits, and their having children with a burden imposed on the state. 6 This view was also upheld in the case of black women. In the Relf v. Weinberger case (1974), two black girls of twelve and fourteen years old were sterilized in an Alabama hospital, after their mother, who was illiterate, had signed a consent form with a cross. She thought she was signing a form allowing her daughters to get access to an experimental, long-term birth control drug (Dorr 2011). When District Court Judge Gesell gave the verdict of the court, he recognized that sterilization abuses were a
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reality: “Although Congress has been insistent that all family planning programs function on a purely voluntary basis, there is uncontroverted evidence in the record that minors and other incompetents have been sterilized with federal funds and that an indefinite number of poor people have been improperly coerced into accepting a sterilization operation under the threat that various federally supported welfare benefits would be withdrawn unless they submitted to irreversible sterilization. Patients receiving Medicaid assistance at childbirth are evidently the most frequent targets of this pressure” (Relf v. Weinberger 1974). According to physician Helen Rodriguez-Trias, “In 1970, it was found that 43% of the women sterilized in federally- financed family planning programs were black, although they represented only one- third of the patient population” (Rodriguez-Trias, 1976). 7 But the Department of Health, Education, and Welfare (DHEW) also funded sterilizations in Puerto Rico. In a 1973 study, demographer José Vasquez Calzada found that 35% of Puerto Rican women were sterilized, compared to 16.5% in 1953-54 (Vasquez Calzada 1973). American sociologist and demographer Harriett B. Presser demonstrated that sterilization in Puerto Rico played a major role in the population control of the island (Presser 1969). The Puerto Rican Decolonization Committee published articles on this issue, assimilating it to a kind of neocolonialism. 8 As we can see through these examples, forced sterilization—which had been practiced following eugenic laws in various state institutions such as prisons or asylums from the beginning of the twentieth century to the 1950s—became a federally funded practice financed by the American government, which came to target minority women in the 1960s and 1970s. Such practices raise the question of who is in power when it comes to women’s access to contraception. 9 The first sterilization laws voted on between 1907 and 1913 reveal the implication of physicians in the promotion of this eugenic practice, “Advocacy within the medical profession for eugenic sterilization grew steadily; between 1909 and 1910, twenty-three papers on eugenic sterilization were listed in the Index Medicus. Every medical article published between 1899 and 1912 on eugenic sterilization favored this practice. These papers often had a most activist tone” (Reilly 1991). 10 Moreover, sterilization laws enabled the medical profession to increase its power within public institutions since most sterilization laws provided for the creation of a committee in charge of analyzing potential cases of sterilization. In their vast majority, these committees were composed of physicians. 11 The role of physicians in coerced sterilizations in the 1970s, cannot be denied either. After the Relf case broke, sterilization guidelines were edited by the government: they provided for the creation of local review committees, which were to decide on the sterilization of people under 21 or considered incapable under state law. Though these guidelines were much needed, they did not cover the whole population, and officials doubted that it would be sufficient. Dr. Carl Shultz, director of H.E.W.'s office of population affairs, declared in the August 12th, 1973 edition of the New York Times that “until we adequately police them, the guidelines aren't going to be fully effective.” And since coerced sterilizations continued well into the 1970s, we may conclude that many physicians did not take into account these procedures, perhaps considering themselves as the ones who were to be in power when it came to the reproductive rights of women. And even as incomplete as they were, the guidelines were challenged in court by six chairmen of gynecology and obstetrics (Kluchin 2011). Since physicians were
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predominantly white males, their prejudices and class bias often influenced their practices. It may be argued that the popular figures of “the welfare queen” and “the pregnant pilgrim” in the 1960s influenced physicians in deciding that minority women were to stop having babies who would supposedly become welfare recipients. 12 Finally, it is only in 1978 that comprehensive guidelines were issued, requiring the patient’s signature of a form in her own language, requiring the physicians to certify in writing that the patient had been informed of the nature of the operation and that she would still be eligible to welfare benefits if she did not accept sterilization, extending the waiting period from 72 hours to 30 days, prohibiting payment of sterilization for persons under 21, prohibiting hysterectomy as a form of birth control and prohibiting the sterilization of mentally incompetent persons (Evanoff 1978). It also stated that consent could not be obtained during labor, or before or after an abortion (Petchesky 1979). If these guidelines triggered heated debates between anti-sterilization abuses groups and physicians before being adopted, they also did so within the feminist movement. 13 The Committee to End Sterilization Abuse (CESA) was established in the winter of 1974 in New York City, and included many prominent reproductive rights activists, among whom Helen Rodriguez-Trias. A member of the feminist movement, she recalled a 1974 conference in Boston, attended by thousands of women, during which the issue of sterilization abuse came up: “we got a lot of flack from White women who had private doctors and wanted to be sterilized […] they had been denied their request for sterilization because of their status (unmarried), or the number of their children (usually the doctor thought they had too few). They therefore opposed a waiting period or any other regulation that they interpreted as limiting access […]. While young white middle class women were denied their request for sterilization, low income women of certain ethnicity were misled or coerced into them.” (Wilcox 2002). 14 We can find another example of this opposition in the creation of the Committee for Abortion Rights and Against Sterilization Abuse (CARASA) in 1977. Involved in feminist reproductive rights, it rejected the single issue of abortion defended by the National Organization for Women (NOW), the National Abortion Rights Action League (NARAL) and Planned Parenthood. CARASA wanted to include in the debate over reproductive freedom “a wide range of other issues ranging from women’s health to sexuality to class and race.” It also defined reproductive freedom as “the freedom to have, as well as not have children” (Kluchin 2011). Thus, CARASA strongly defended the establishment of the guidelines the Health, Education, and Welfare adopted in 1978. But NOW and NARAL refused to support them, arguing that the extension of the waiting period and the establishment of a minimum age of 21 would deny women their right to reproductive choice. NOW’s executive board even adopted a formal statement against the proposed regulations in the summer of 1978. 15 This ambiguity of the feminist movement in the 1970s reminds us of the ambiguity of Margaret Sanger towards the eugenic movement in the 1920s. If Sanger fought for women’s rights to contraception, she sometimes endorsed the eugenicists’ views on the subject, “[W]e permit our feeble-minded to set the path in child-bearing. Nothing can so rapidly or so inevitably drag down a civilization as an increasing population of mental defectives. They form a terrific burden on American society. We are only beginning to realize the immediate necessity of sterilization” (Sanger 1925).
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16 If the eugenic sterilizations of the beginning of the twentieth century revealed the states’ desire to control reproduction, those of the 1970s reveal the federal state’s lack of protection of women’s rights. In both cases, the prevalence of eugenic thinking within the medical profession is a striking element. Theodore Roosevelt, alarmed by “race suicide,” had warned that undesirable immigrants were reproducing faster than more valuable old stock Americans. Thus compulsory sterilization was imposed upon “the unfit,” while access to contraceptive devices were refused to women. In the 1970s, sterilization was imposed on minority women out of fear of overpopulation and raising welfare expenditures, while sterilization was denied to middle class women in private practices. And though the feminist movement organized itself to protect women’s reproductive rights, some ambiguities concerning sterilization could still be felt in both cases.
BIBLIOGRAPHY
Calzada, José. “La Esterilizacion Femina en Puerto Rico” in Revista de Ciencias Sociales, 1973, n° 3, pp. 283-308.
Comptroller General of the U.S. 1976. Investigation of Allegations Concerning Indian Health Service (Washington, D.C.: U.S. Government Printing Office).
Dorr, Gregory. “Protection or Control? Women’s Health, Sterilization Abuse, and Relf v. Weinberg” in Lombardo, Paul (ed.). 2011. A Century of eugenics in America (Bloomington: Indiana University Press).
Buck V. Bell, 274, U.S. 200 (1927).
Evanoff, Ruthann. “Women: Sterilization Guidelines” in Health Policy Advisory Center Bulletin, 1978, n°80, pp.19-20.
Goddard, Henry. 1920. Feeble-Mindedness: Its Causes and Consequences (New York: The Macmillan Company).
“Guidelines No Bar to Sterilization” in The New York Times, August 12, 1973, p. 39.
Hernandez, Antonia. “Chicanas and the Issue of Involuntary Sterilization: Reforms Needed to Protect Informed Consent” in Chicana/o Latina/o Law Review, 1976, n°3, pp. 3-37.
“H.E.W. Chief Issues Guidelines to Protect Rights of Minors and Others in Sterilization Cases” in The New York Times, July 23, 1973, p.32.
Kluchin, Rebecca. 2009. Fit to Be Tied, Sterilization and Reproductive Rights in America, 1950-1980 (New Brunswick: Rutgers University Press).
Lawrence, Jane. “The Indian Health Service and the Sterilization of Native American Women” in American Indian Quarterly, 2000, no3, pp. 400-419.
Minna Stern, Alexandra. “Sterilized in the Name of Public Health” in American Journal of Public Health, 2005, n° 7, pp. 1128-1138.
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The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 1978. Ethical Guidelines for the Delivery of Health Services by DHEW (Washington, D.C.: Government Printing Office).
Petchesky, Rosalind. “Reproduction, Ethics, and Public Policy: The Federal Sterilization Regulations” in Hastings Center Report, 1979, n° 5, pp. 29-41.
Presser, Harriet. “Puerto Rico: The Role of Sterilization in Controlling Fertility” in Studies in Family Planning, 1969, n° 45, pp. 8-12.
Reilly, Philip. “Involuntary Sterilization in the United States: A Surgical Solution” in The Quarterly Review of Biology, 1987, n°2, pp. 153-170.
Reilly, Philip. 1991. The Surgical Solution: A History of Involuntary Sterilization in the United States (Baltimore: The John Hopkins University Press).
Relf v. Weinberger, 372 F. Supp. 1196 (1974)
Rodriguez-Trias, Helen. “Guidelines on Sterilization Under Attack” in Women Health: Issues in Women's Health Care, 1976, n° 1, pp. 30-31.
Rosenfeld, Bernard, Sydney Wolfe, and Robert McGarrah. 1973. A Health Research Group Study on Surgical Sterilization: Present Abuses and Proposed Regulations (Washington, D.C.: Health Research Group).
Sanger, Margaret. “The Need of Birth Control in America” in Meyer, Adolf (ed.) 1925. Birth Control, Facts and Responsibilities: A Symposium Dealing with This Important Subject from a Number of Angles (Baltimore: The Williams and Wilkins Company), pp. 11-49.
Sharp, Harry. “Rendering Sterile of Confirmed Criminals and Mental Defectives” in National Prison Association of the United States (ed.). 1907. Proceedings of the Annual Congress of the National prison Association (Chicago: Knight and Leonard), pp. 177-185.
Skinner v. Oklahoma, 316 U.S. 535 (1941)
Wilcox, Joyce. “The Faces of Women’s Health: Helen Rodriguez-Trias” in American Journal of Public Health, 2002, n°4, pp. 566-569.
ABSTRACTS
The history of sterilization in the United States provides an interesting insight into the ideological currents underlying the perception of women’s bodies. Through a comparative analysis of this practice from 1907 to 1963 and in the 1970s, this article aims at highlighting the similitudes between these two periods. It analyzes how sterilization, which was first a coercive eugenic method of contraception before World War II, developed into a federally funded contraceptive device in the 1970s. Relying on statistical analyses, it aims at debunking the eugenic heritage which influenced the discourse over the sterilization of minority women after 1969. Besides, a study of the role played by physicians when performing involuntary sterilizations in both periods reveals their influence and, for some, their prejudices and racial bias. Finally, this article examines the ideological position of the feminist movement over that issue, thus exposing the growing tensions around the questions of race and class in the 1970s, which can be compared to Margaret Sanger’s ambiguity toward the eugenic movement in the 1920s.
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L’histoire de la stérilisation aux États - Unis est révélatrice des courants idéologiques relatifs à la perception du corps des femmes. A travers une étude comparative de cette pratique sur la période 1907-1963 et durant les années 1970, cet article vise à mettre au jour les similitudes entre ces deux périodes. Il analyse la façon dont la stérilisation, qui était initialement un mode de contraception coercitif à visées eugénistes, se transforma en un moyen de contraception financé par l’État après 1969. En se basant sur des analyses statistiques, il entend mettre au jour l’héritage eugéniste qui influença le discours concernant la stérilisation des femmes issues de minorités ethniques dans les années 1970. L’étude du rôle joué par les médecins durant ces deux périodes révèle leur influence, et parfois aussi leurs préjugés raciaux et sociologiques. Enfin, cet article examine le positionnement idéologique du mouvement féministe, mettant ainsi au jour ses tensions internes autour des notions de race et de classe, ce qui renvoie à l’ambiguïté de Margaret Sanger vis-à-vis du mouvement eugéniste dans les années 1920.
INDEX
Mots-clés: stérilisation, contraception, droit des femmes, santé publique, eugénisme, race, classes sociales Keywords: sterilization, contraception, women’s rights, public health, eugenics, race, social classes
AUTHOR
SANDRINE PIORKOWSKI BOCQUILLON
Membre associé du Centre de Recherche sur l’Amérique du Nord (CRAN), Université Sorbonne Nouvelle – Paris 3
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Abortion and Phyllis Schlafly’s Pro- life Contribution to the Culture Wars from the 1970s to the 1990s
Amélie Ribieras
1 For conservative activist Phyllis Schlafly, “abortion is the right-or-wrong issue of our time” (Schlafly 2016, p. 54). It is true that the topic is nowadays indubitably polarizing, as shown by the way pundits scrutinize presidential candidates’ position on the issue during elections. This can be explained in part by the recent efforts of conservatives to lock abortion in a moral framework and exploit it for political purposes, hindering the progress of reproductive justice claims. Although the Supreme Court liberalized abortion in its 1973 landmark decision Roe v. Wade, tensions on body politics escalated after the 1970s, invading the national public discourse. Earlier in the century, abortion began to be debated when 16 states decriminalized the procedure starting with Colorado in 1967. However, after Roe, it went from being “a technical, medical matter controlled by professionals” to a “public and moral issue of nationwide concern” (Luker 2009 [1984], p. 127). The scope of the debate, thus, changed scale and the topic occupied political discourse.
2 Abortion can in fact be envisioned within a paradigm of alternative phases of politicization (Fassin 1997). A first phase occurred from the middle of the 19th century; while women were taking control of their fertility, physicians sought to be the sole purveyors of abortion as a way to regulate their profession and maintain some social power. After a century of silence and a certain degree of social acceptance, abortion reemerged in the public realm. A second phase started in the 1950s, at the instigation of jurists who wanted to legally acknowledge the procedure. Abortion was again questioned at that time. Second-wave feminism then framed it as a gender claim and abortion became a prerequisite to women’s liberation. This article postulates the existence of a third phase, starting in the 1970s, during which abortion was the keystone of the polarization of American politics, creating new dynamics of political and cultural power. Phyllis Schlafly, as a social movement entrepreneur and a leading
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public figure, adopted a resolutely pro-life position and mobilized conservatives on the issue. She, thus, contributed to the conservative shift in reproductive politics.1 3 Phyllis Schlafly (1924-2016) was a lawyer, the mother of six children, and a devout Catholic. As such, she became involved in politics over issues such as gender roles, family rights, and abortion.2 She was particularly engaged in the struggle against the Equal Rights Amendment (ERA) in the 1970s. If ratified, this amendment, which was proposed by feminists, would have inserted equality of the sexes into the Constitution.3 It was a principle with which Schlafly disagreed on the basis that men’s and women’s roles were to be seen as complementary. Schlafly subscribed to a functionalist view of the family (popularized in the 1950s), whereby men would be the providers, working outside the home to ensure its economic survival, and women the homemakers, taking care of children and housekeeping (Coontz 1992; Cott 2000; Bryson 2016). Abortion did not fit into this traditional view of the family, whose ultimate goal was to nurture children. 4 This article discusses Schlafly’s commitment to abortion rights and attempts to show how she participated in politicizing abortion, drawing on archival research conducted at Eagle Forum, Phyllis Schlafly’s conservative organization based in St Louis, Missouri.4 I will draw upon Ziad Munson’s subdivision of pro-life activism to characterize Schlafly’s anti-abortion efforts.5 She prioritized two strategies when fighting against abortion: spreading conservative rhetorical frames to conceptualize abortion and lobbying the Republican Party in order for conservatives to win back some political and cultural power. The first section of the analysis focuses on situating Schlafly’s in the general conservative reaction to abortion. Schlafly’s endeavor consisted in tying several feminist demands together (abortion and the ERA) in order to better reject them. The second section considers the rhetorical strategies adopted by Schlafly’s Eagle Forum to appropriate the language of abortion, which is related to Munson’s “public outreach” category (2008). By packaging knowledge for the public, the group engaged in “a process of cultural transformation” (Ginsburg 1989, p. 173). Finally, as the cultural counteroffensive led by conservatives also took place in the political sphere, the last section examines Eagle Forum’s lobbying tactics inside the Grand Old Party (GOP), which corresponds to what Munson characterizes as “politics stream” (2008). Even though her relationship to the party remained uncertain, she managed to infiltrate its structure and collaborate with Republican politicians in order to turn it into the pro- life party, as she explains in her 2016 book How the Republican Party Became Pro-Life.
Conservatives, Abortion, and the Culture Wars
5 The salience of abortion rights in the political realm can be understood through the framework of the “culture wars.” This phenomenon was described by James D. Hunter as “political and social hostility rooted in different systems of moral understanding” and “being ultimately about the struggle for domination” (Hunter 1991, pp. 42-52).6 Hunter identifies “polarizing impulses,” taking shape in the 1980s and early 1990s, after a period of cultural protest, waning societal cohesiveness, and large-scale societal transformations. Cultural warfare was rooted in the rise of social movements during the 1960s, such as the civil rights movement, the feminist movement, and the anti- Vietnam war movement. The pervasive initiative of challenging the social and political status quo triggered a “backlash” in the 1970s and beyond.7
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6 This atmosphere of social contest and disorder aroused anxiety among conservative Americans (Crawford 1980; Klatch 1987; Himmelstein 1990; McGirr 2001; Critchlow 2005; Gould 2012). They found refuge in the American Right, which had started a process of reconstruction in the mid-1950s and was reaching the status of a legitimate political contender, after years of having a minority status (Himmelstein 1990; Mason 2011). The social traditionalist branch of the Right was flourishing, and it solidified around issues linked to defending the family, which was “the most conspicuous field of conflict in the culture war” (Hunter 1991, p. 176).8 Within this framework, abortion then came to symbolize the rejection of traditional sexual patterns leading to creating a family. It was understood by conservatives as a contraceptive method aiming to regulate the American population. For example, in December 1974, Phyllis Schlafly’s newsletter The Phyllis Schlafly Report displayed a front page on the matter. It read: “ERA Means Abortion and Population Shrinkage” (Schlesinger Library archives, Phyllis Schlafly Report collection). 9 7 Protests linked to sexuality had been pushed forward by the feminist movement, which gained momentum in the late 1960s. Women’s rights activists were focused on winning back women’s power over their own bodies by publicizing issues involving sexuality and reproduction. “The personal is political” was their motto (Evans 2003).10 Scientific and legal changes had also encouraged this climate of sexual liberalization. The pill was approved for contraceptive use by the Food and Drug Administration in 1960. The Supreme Court ruled that the Bill of Rights afforded rights to privacy to the marital couple in Griswold v. Connecticut (1965), thus barring states infringing on a couple’s decision in regards to contraceptive use. This was latter extended to single persons in 1972 in the Eisenstadt v. Baird case. However, conservatives, and especially conservative women, viewed female sexual liberation with suspicion, believing it to be contrary to their biological roles. They did not identify reproductive justice as an imperative for the advancement of women, and they resented abortion as it appeared to make motherhood optional. “Abortion […] represents an active denial by women of two essential conditions of female gender identity: pregnancy and the obligations of nurturance that should follow” (Ginsburg 1989, p. 216). Female conservatives took on the fight against feminists to resist the questioning of traditional motherhood and femininity. It triggered a formidable counter-movement, whose participants injected a moral component to the debate. The abortion issue thereafter created a cultural fracture between feminists and conservative women. For Schlafly, “abortion [was] the litmus test of whether or not you are feminist” (Schlafly 2016, p. 7). 8 Phyllis Schlafly’s main strategy throughout the years was to link abortion to the ERA. The STOP ERA movement surfaced in the early 1970s, in opposition to the process of ratification of the amendment. In 1975, she launched Eagle Forum as an offshoot of STOP ERA, which, as its name clearly indicates, was created to combat the ERA. In fact, she “tied ERA with a variety of distressing situations” (Conover & Gray 1983, p. 80). Schlafly took hold of ERA and abortion at the same time and used language to conflate these feminist claims, because she knew that associating the idea of a greater availability of abortion to the ERA had the potential to scare Americans. Early in the 1970s, Schlafly started to write in her newsletter about what she perceived as the deceptiveness of the ERA. In 1974, for instance, she warned that “if the Equal Rights Amendment is ratified, ERA will repeal all and every kind of anti-abortion laws that we now have” (Schlafly 1974). She also distributed leaflets displaying visual connections
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between the two issues, such as a knot with two distinguishable strings (Schlesinger Library archives, Phyllis Schlafly Report collection, book 2: 1978-79). This was all the more a priority in 1976 as Congress passed the Hyde Amendment, which prohibited the use of federal funding for abortion, except in cases of rape, incest, and to save the life of a woman. Under the ERA, restricting abortion rights in any way would have been considered sex discrimination because it would impact only one sex. In her book The Power of the Christian Woman, Schlafly explains what she thought was the source of the demand for abortion, “women must be made equal to men in their ability not to become pregnant and not be expected to care for babies they may bring into the world” (Schlafly 1981, p. 18, the italics are hers). Equality of the sexes was thus problematic and it had to be fought against, in whatever shape possible and by whatever means necessary.
Rhetorical Tactics: The Language of Abortion
9 Phyllis Schlafly was part and parcel of the culture wars raging around social issues, insofar as the rhetoric she used in her Eagle Forum helped conservatives influenced the terms of the debate. As the abortion struggle was a conflict over “the means of cultural production,” she helped conservatives took a rhetorical stance on the issue (Hunter 1991, p. 64). Schlafly belonged to the contingent of political entrepreneurs who developed ideas with a mobilizing potential and monitored the polarization of politics at the level of language. This enterprise is described by Munson as “public outreach” activism, that is to say, “educating the wider public about what they see as the horrors of abortion” in order to promote a “culture of life” (2008, p. 116).
10 On the word front, Schlafly used discursive manipulations like framing to produce a cultural discourse able to compete with the feminists’.11 She deconstructed the commonly-accepted cultural framework in which abortion was embedded by reframing the feminist demand for abortion, the feminist message, and the perception of the feminists themselves. First, abortion was a collective financial burden. “Abortion on demand” was a recurrent expression used in their language and it shows Schlafly’s intention to exaggerate the scope of the phenomenon. She went as far as talking about an “abortion industry” (Schlafly 1995, Eagle Forum archives, DVD 461). The shared cost of the procedure was an injustice imposed on all Americans and conservatives resented the use of taxpayers’ money for a private decision that went counter to their beliefs. 11 Abortion was also tied to fantasized alternative lifestyles encouraged by permissiveness, which conservatives associated with the alleged effects of the sexual revolution endorsed by feminists. Their support for abortion reflected “their accepting a promiscuous lifestyle, […] [and their] engaging in premarital sex,” adding that “a woman always pays double for illicit sex” (Schlafly 1983, Eagle Forum archives, DVD 22). For Schlafly, the act of getting rid of a baby was then perceived as the result of a large-scale phenomenon of rampant promiscuity, which was morally reprehensible. Conservatives worried about the growing tolerance of recreational sex that occurred outside the marital sphere, in opposition to procreational sex within the structure of marriage. Their goal was to protect this unit as the only legitimate place where sex would be performed and within which babies could be conceived. By promoting abortion, feminists were promoting reckless sexuality and optional parenting, consequently overthrowing the normative sexual order. In opposition to feminism,
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which Schlafly described as anti-family, she shaped a “pro-family” movement based on the ideal unit of the heterosexual couple and their children. Schlafly then discredited feminists as defenders of a unrighteous cause. 12 Hoping to achieve a reversal of perceptions, Schlafly framed feminists as careless murderers. They were vilified for what was perceived as their carelessness. Abortion was a selfish act, performed only for reasons such as “comfort, convenience, and embarrassment” (Schlafly 1983, Eagle Forum archives, DVD 22). It epitomized the individualistic drift of the sexual revolution, and while conservative women displayed their enthusiasm about fulfilling their (almost) patriotic mission to bring new life on earth, Schlafly insisted that feminists’ number one right was “the right to kill a baby” (Schlafly 1991, Eagle Forum archives, DVD 307). This contrast underlined the subversive behavior of women’s rights activists, whose rhetoric of choice clashed with the moralizing vision of conception. Schlafly’s portrayal of feminists as “a bunch of marital misfits who are seeking their identity as Ms., mistaken about morals, misinformed about history, motivated by the axiom ‘misery loves company,’ and who want to remake our laws, revise the marriage contract, restructure society, remold our children to conform to lib values instead of God’s values, and replace the image of woman as virtue and mother with the image of prostitute, swinger and lesbian” (Schlafly 1981, p. 175) is blatantly indicative of a cultural clash centered on contested views of gender and sexuality. On the issues of sexuality and reproduction, and by extension, abortion, conservative women and feminists appeared to be polarized and irreconcilable. 13 Not only were feminists denigrated but they were also held responsible for putting women and babies in danger. Through a technique called boundary framing, which aimed to delineate the limit between good and bad, Schlafly participated in framing feminists as the real source of women’s misery (Benford & Snow 2000). As argued by an Eagle Forum activist during a workshop organized in 1989 for Eagle Council (Eagle Forum’s annual conference), people opposing abortion should frame the issue to their own advantage; in other words, paint a compassionate picture of themselves and demonize their adversaries (Janine Hansen 1989, Eagle Forum archives, DVD 780). Formerly seen as advocates of women’s rights, feminists then came to be represented by their opponents as threats to female interests. At the aforementioned workshop, another speaker went so far as to qualify abortion as “an act of violence against women” (Olivia Dart, Ibid.). Since feminists were being depicted as the threat, women needed new defenders. Conservatives demonstrated a sense of acuteness when they coined a powerful counter-adjective to the one adopted by feminists (pro-choice).12 They reshaped the adversarial categories of the debate when they popularized the label “pro-life,” rather than the negative term “anti-choice” or even “anti-abortion.” As linguistics professor Andrea Tyler argues, “by positioning themselves as ‘pro-life’, this group essentially won the war of words” (Tyler in Shepard 2010). Such a rhetorical strategy allowed them to channel the emotions related to abortion in a new direction: defending innocent fetuses’ lives, instead of defending women’s rights. Pitting the life of the mother against the life of the child, the spread of the word “pro-life” created a cultural climate in which the protection of the unborn took on a great deal of importance. The spread of this pro-fetus narrative initiated the birth of “embryo politics: an effort, on many fronts, to define the meaning of life in ways that are at odds with conventional understandings” (Di Mauro & Joffe 2007). Hence why Phyllis Schlafly could be seen wearing an “It’s a Child not a Choice” button at an anti-abortion
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demonstration on the steps of the Supreme Court (1991, Eagle Forum archives, photographs collection). 14 Reframing the aggressor/defender/victim trio also entailed insisting on the fate of the baby. Their position as selfless defenders of the vulnerable taken up by conservatives can be situated in the master frame of civil rights, which they co-opted from previous social movements.13 Conservatives like Schlafly envisioned the rights of the baby in a framework large enough to encompass ideals such as justice and equality. As she stated in her 2016 book, “the question of abortion […] is ultimately concerned with equality of rights under the law” (Schlafly 2016, p. 62). Therefore, she believed that the 14th amendment, which guarantees equal protection of the law to every American citizen, must apply to the unborn. This conception of individual rights was an attempt to introduce new legal grounds by defining an unborn fetus as a legally independent person, an endeavor in which conservatives have yet to be successful.14 15 The discourse displayed at Eagle Forum helped conservatives to obtain a voice in the abortion debate and develop new perspectives. Moreover, these rhetorical strategies were directed at a specific audience. They targeted potential supporters for validation or recruitment purposes. Sociologists Robert D. Benford and David A. Snow talk about motivational framing when social movement entrepreneurs issue a “call to arms” to future participants (2000). Leaders manipulate issues so that they resonate with citizens’ daily experiences: this is what is referred to as salience. Consequently, manufacturing words can help mobilize new participants as much as it can help rally new political allies.
Prolife Lobbying Within the Republican Party
16 From 1980 onwards, abortion conspicuously became a partisan issue and polarized the political landscape. Phyllis Schlafly took it upon herself to characterize abortion in a partisan framework. This can be associated with what Munson calls the “politics stream” of pro-life activities. One might wonder how could the Republican Party go from being the first party to endorse the ERA in 1940 to the pro-life party at the turn of the twenty-first century, but the answer is quite simply Phyllis Schlafly. Armed with a solid anti-abortion rhetoric and fortified by the deceleration of the ratification of the Equal Rights Amendment starting in 1977, she took advantage of her outsider position to infuse the Republican Party with anti-abortion rhetoric.15 This effort culminated in the withdrawal of both the ERA and abortion from the Republican plank in 1980. In return, the GOP utilized Phyllis Schlafly and her organization to court new constituents.
17 Throughout her activist years, Schlafly kept a prudent position towards the Republican Party. Early on, she was involved in the National Federation of Republican Women (NFRW).16 In 1967, the internal crisis between moderates and conservatives within the party, after Barry Goldwater’s failure in the 1964 presidential election, impacted the NFRW. The party was trying to rid itself of its more extremist elements and Schlafly was known for being conservative. When she sought to run for the national presidency of the federation, she was purged from leadership positions in the party (Critchlow 2005). This is the reason why she started her own organization, STOP ERA, with her loyal followers.
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18 However, Schlafly never completely separated from the GOP, and she tried to retain influence behind the scenes. She nurtured ties with Republican politicians with whom she knew she could collaborate. She counted on authority figures such as Henry Hyde to promote her cause. A representative in the Illinois legislature from 1967 to 1974, and then Representative for Illinois in the US Congress, he is remembered for sponsoring the so-called Hyde Amendment in 1976. Hyde and Schlafly moved in the same political circles, Illinois being their common political playground.17 Since Schlafly served as an elected delegate to the 1956, 1964, 1968, 1984, 1988, 1992, 1996, 2004, 2012 and 2016 Republican National Conventions (RNC), and as an alternate delegate in 1960, 1980, 2000 and 2008, their paths also crossed at the national level (Ibid.). 19 Schlafly and Hyde benefitted from one another. Schlafly campaigned vehemently in favor of the Hyde Amendment, and she used it as a strong argument against the ERA in return. For example, according to a leaflet from the Eagle Forum archives, Schlafly used her organization to draw a connection between the 1983 House’s vote on the Hyde Amendment and the subsequent one on the ERA (Eagle Forum Archives, ERA series, box 5, file 16). She compared Republicans’ voting records in order to identify the real pro- life congressmen.18 That same year, she included in her newsletter Hyde’s testimony to the Senate Judiciary Committee on the ERA-abortion connection, in which he denounced the pro-choice view of seeing abortion restrictions as sex discrimination (Schlafly 1983, Schlesinger Library archives, Phyllis Schlafly Report collection: book 4: 1982-1984). Since Hyde was her political ally inside the party, Schlafly gave him a platform in her newsletter. Their political commitment to one another proved to be mutual, and their alliance was quite fruitful. For example, when both were delegates for the state of Illinois at the 1984 RNC, they joined efforts to strengthen the language on abortion on the Republican plank and pushed for a Human Life Amendment (Schlafly 2016). They were able to convince the RNC to adopt the following paragraph: “The unborn child has a fundamental, individual right to life, which cannot be infringed. We therefore reaffirm our support for a human life amendment to the Constitution, and we endorse legislation to make clear that the fourteenth Amendment’s protections apply to unborn children […]” (Critchlow 2008, p. 286). The Hyde-Schlafly duo thereafter pressured the Republican leadership into adopting and maintaining a resolutely pro-life agenda throughout the 1980s. 20 However, perhaps because of the 1989 Supreme Court’s decision Webster v. Reproductive Health Services, pro-choice Republicans became more vocal in 1990.19 Right-to-life advocates started to be challenged from within the party, particularly by Ann Stone’s efforts. Her work as a fundraiser for the Republican Party and her pro-abortion campaign reinvigorated the group Republicans for Choice, which put pro-life activists on the defensive. Phyllis Schlafly mobilized two of her friends to work on this problem: Colleen Parro, a faithful member of Eagle Forum and Kathleen Sullivan, the Eagle Forum leader for Illinois. With Schlafly’s approval and help, they worked to identify pro-life leaders in the different states to encourage them to run as delegates to the convention and help maintain the pro-life momentum. Together, they created the Republican National Coalition for Life (RNCL) in 1990. According to Schlafly’s website, it was founded “after two groups, Republicans for Choice and National Republican Coalition for Choice, publicly announced their intention to provoke a floor fight at the 1992 Republican National Convention in Houston in order to remove the pro-life plank from the platform” (“Republican National Coalition for Life”). In 1992, dissensions
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within the party openly erupted. A joint interview of two protagonists clearly embodies the polarizing impact of the abortion issue within the GOP: during the convention, Phyllis Schlafly was interviewed by CBS alongside Mary Dent Crisp, a Republican women’s rights advocate who had been disavowed by her own party in 1980 during the struggle over abortion (1992, Eagle Forum archives, DVD 183). As Schlafly tried to adopt the role of watchdog for the right-to-life plank, Crisp advocated for another familial vision whereby women could have the right to choose, highlighting the enduring dissensions within the party on the issue of abortion. 21 Yet, Schlafly’s influence won her the support to maintain the pro-life plank from the majority of members.20 She made a real show of force by distributing red cowboy hats, sponsored by the RNCL, to the pro-life delegates at the convention (immortalized by photographs found in the Eagle Forum archives). The tension over abortion in 1992 was symptomatic of the intensity of the culture wars at work in American politics at that moment, as was shown also by the so-called “Culture War Speech” delivered by Pat Buchanan, in which he denounced President Clinton’s “unrestricted abortion on demand.”21 Schlafly’s endeavors at the 1992 RNC seemed to confirm that the 1992 elections were much more about abortion than the economy (Abramowitz 1995). 22 Besides, the GOP made use of personalities like Schlafly to co-opt single-issue voters for whom abortion was a key concern in politics (Petchesky 1981). Schlafly herself drew the same conclusion: “the pro-life constituency has been a major, even decisive, factor in the unprecedented growth of the Republican Party in the 1980s and 1990s” (“The Republican Party is the Pro-life Party,” Eagle Forum headquarters). According to her, the Republican Party gained strength and coherence as a political entity when partisan politics started to become polarized on abortion. The GOP had been a party on the defensive throughout the 1960s and the 1970s, and social issues, especially abortion, helped to shift the balance of power. It seems worth speculating on the link between the party’s transformation into an effective political entity and Schlafly’s own endeavors. It appears that she fought hard to insert the pro-life rhetoric into the GOP, and I would like to suggest that she can probably be linked to the so-called “Catholic Strategy” developed by the Republican Party, starting with President Nixon (Himmelstein 1990; Wilcox 2011; Williams 2011; Chélini-Pont 2013). For Williams, “abortion policy played a pivotal role in transforming the GOP from a predominantly mainline Protestant party into a party of conservative Catholics and Evangelicals” (Williams 2011). Schlafly, herself a Catholic, was surely instrumental in attracting Catholic voters to the Republican Party, notably through the pro-life language she disseminated, as well as her active partisan lobbying.22 She stood as an influential activist and showed that Catholics had a place in the GOP. Moreover, Schlafly’s friend Kathleen Sullivan mentioned that churches were a key mobilizing pool where they recruited homemakers for the STOP ERA movement (2016). Thanks to the overlapping of different networks of loyalty, Schlafly had not only access to Catholics, but also to the wider Christian Right.23 Clyde Wilcox defines it as “a social movement that attempt[ed] to mobilize evangelical Protestants and other orthodox Christians into conservative political action” (Wilcox 2011, p. 8).24 Most of these people had been shaken by the landmark Supreme Court decisions of the 1960s, notably Engel v. Vitale (1962) which forbade prayer in public schools. This potential constituency, wary of societal changes having to do with faith, sexuality, and gender roles was a formidable resource for Schlafly, from the 1970s onwards, because it provided access to valuable religious networks from diverse denominations. It allowed her to co-opt religious
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supporters whom she channeled towards her own organization and the Republican Party, and thus standing out as a real manifestation of the party’s conservative turn.
Conclusion
23 The issue of abortion provided Phyllis Schlafly with a powerful point of entry in the late twentieth century’s cultural debates. As she was successful at romanticizing and publicizing her accomplishments, she proclaimed herself and her forces responsible for the cultural shift of the party. At the end of her life, in 2016, she wrote a book to explain her intervention. How the Republican Party Became Pro-Life tells the story of “a person who holds no public office, usually not a party position, doesn’t run a big lobbying firm, doesn’t represent a big corporation or a special interest group, and she instills awe, fear, respect, and she has influence” (Bob Novack in Schlafly 2016, p. iii). 25 Thus, even as an outsider, she was seemingly able to weigh in on the positions taken by the party.
24 Concerning Schlafly’s pro-life efforts, they were circumscribed to the two aforementioned areas: language and partisan politics. Schlafly’s involvement with the abortion issue is the story of how effective she was in appealing to citizens who would be ready to mobilize and cast their votes from a cultural perspective. Among other factors, Schlafly led the “sexual conservatives” to prominence in American politics (Di Mauro & Joffe 2007). As much as they had an impact on reproductive politics over the last fifty years, so too did Phyllis Schlafly.
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NOTES
1. I follow the lead of Kristin Luker and Daniel K. Williams in their use of the words “pro-life” and “prochoice” to qualify the sides of the abortion debate, nevertheless aware of their political and partisan connotations (Luker, 2009 [1984]; Williams, 2011). I also use the terms “anti-abortion,” “right-to-life,” and “pro-abortion.” 2. Phyllis Schlafly had a rich and diverse career. She was also greatly interested in issues such as anticommunism, this paper, however, focuses on her activism in regards to women’s issues. 3. The ERA was first introduced in Congress in 1923 thanks to suffragist Alice Paul. Yet, it only gained substantial support in 1972 when it passed. Because conservative women mobilized against it, in particular thanks to Schlafly’s organization STOP ERA (created in 1972), it was abandoned in 1982. Only 35 states voted in favor of the amendment, when the required number was 38. In March 2017 and May 2018, the Nevada and Illinois legislatures voted for it, bringing the number of states to 37. 4. I conducted doctoral research on Phyllis Schlafly and her Eagle Forum during two field trips in 2016 and 2017. I was able to study documents from various archives. I consulted the collections of the Eagle Forum archives in Saint Louis, Missouri, those of the Schlesinger Library, Boston, Massachusetts, and those of the Library of Congress and the Daughters of the American Revolution in Washington DC. I also conducted oral history interviews with Eagle Forum members and Schlafly’s closest friends and relatives. 5. In his book The Making of Pro-life Activists : How Social Movement Mobilization Works (Chicago, University of Chicago Press, 2008), Munson envisioned four categories to study pro-life activism : the politics stream (standard political and legal activity such as political campaigns, lobbying, and litigation), the direct action stream (protest and demonstrations), the individual outreach stream (support and guidance for patients), and the public outreach stream (reaching out to people and advertising about the wrongs of abortion and its alternative). 6. Hunter explains that religious orthodox forces and religious progressive forces were ready to compete for the definition of public culture based on shared values, national ideals and collective identity. Culture wars stemmed from their competing moral visions of the world (Hunter 1991, p. 76). 7. On the expression “backlash,” see Susan Faludi’s journalistic essay Backlash: The Undeclared War Against American Women (New York, Crown, 1991). 8. In 1990, Himmelstein described conservatism as a movement encompassing three branches: economic libertarianism, social traditionalism, and militant anticommunism (p. 14). The social traditionalism branch is particularly relevant to this topic, as the distinctiveness of the movement was the rising involvement of female activists, on which I focus. Rebecca Klatch, who was one of the first scholars to study conservative women, also identifies similar sensibilities: social conservatism and laissez-faire conservatism (Women of the New Right, Philadelphia, Temple University Press, 1987). The adjective “conservative” used in this article will then mostly refer to social conservatism, a branch concerned with the preservation, or restoration, of so-called traditional social and moral values. 9. The Phyllis Schlafly Report was first published in 1967 and started with 30,000 subscribers (Critchlow 2005). 10. The expression originated in a 1970 essay by feminist Carol Hanisch, published in Notes from the Second Year: Women’s Liberation, edited by Shulamith Firestone and Anne Koedt (Hanisch 2006). 11. Framing consists of “an active, processual phenomenon that implies agency and contention at the level of reality construction” (Benford & Snow 2000). 12. Pro-abortion activists had a hard time countering the pro-life branding of the anti-abortion side. New York Times’ reporter Linda Greenhouse and Yale historian Reva B. Siegel revealed a memo by Jimmye Kimmey attesting to the difficulty for the pro-abortion camp to find a name for
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the movement. Kimmey was the executive director of The Association for the Study of Abortion Inc., founded by Alan F. Guttmacher, president of Planned Parenthood Federation of America, and Robert E. Hall, professor at Columbia University’s College of Physicians and Surgeons. The association aimed to “support the early reform movement in New York and [serving] as a clearinghouse of information for activist groups around the country” (Greenhouse & Siegel 2012 [2010], p. 31). They considered alternatives like “Freedom of Conscience” or “Right to Choose.” Incidentally, the right to choose was legally described for the first time in People v. Belous, a 1969 decision by California’s Supreme Court (McGirr 2001, pp. 231-235). 13. A master frame is “quite broad in terms of scope, functioning as a kind of algorithm that colors and constrains the orientations and activities of other movements” (Benford & Snow 2000). 14. Conservatives have made several attempts to officialize the rights of unborn fetuses and to establish conception as the start of life, notably through the push for a Human Life Amendment, which the Republican Party officially supported in its platform as of 1984 (Schlafly 2016). The 2016 GOP platform reiterated this pledge (“Republican Party Platform”, 2016). 15. Between 1974 and 1977, the ratification process stalled as only five states voted in favor of it while five rescinded their vote (Nebraska, Tennessee, Idaho, South Dakota and Kentucky). 16. Schlafly was elected president of the Illinois Federation of Republican Women three times between 1960 and 1964 and was the first vice-president of the NFRW from 1964 to 1967. (“The Life and Legacy of Phyllis Schlafly” 2018). 17. Schlafly lived in Illinois from 1949 to 1993. (Ibid.) 18. The vote on the Hyde Amendment happened on Sept. 22, 1983 while the vote on the ERA took place on Nov. 5, 1983. The representatives who voted in favor of the Hyde Amendment and the ERA were identified as the traitors. 19. The Webster decision gave more leverage to states in terms of restricting abortion rights. 20. As Catherine Rymph shows, she also won the battle over feminism in the GOP (2006). 21. Patrick J. Buchanan ran for the presidential ticket in the Republican primaries in 1992, before throwing his support behind George H. W. Bush. 22. David C. Leege, emeritus professor of political science and expert on the links between Catholicism and politics, explains that Catholics were part of the New Deal coalition in the 1930s and thus tended to vote for the Democratic Party. However, several Republican presidents were successful in attracting the “Catholic vote”—a term about which Leege expresses skepticism—: Richard Nixon in 1972, Ronald Reagan in 1980, and George H. W. Bush in 1988. Leege contests the idea that religion be seen as the main factor for Catholics’ voting patterns from 1968 to 1992. For him “racially charged issues were far away the dominant reason why white Catholics left the Democratic Party,” though he also mentions how “moral-restorationist issues” affected the “Catholic vote” (Leege 2004). 23. At one of the two 2017 Eagle Councils, several Sunday services were offered to Eagle Forum members: one Protestant service, one Mormon service, one Church of Christ service, and one Catholic service, testifying to the religious diversity of Schlafly’s followers (Eagle Council program, 2017). 24. Wilcox explains that some scholars reject the term Christian Right, preferring to use Religious Rights because it also encompasses groups such as Orthodox Jews. The Christian Right mainly contains white evangelical Christians, especially the Fundamentalist and Pentecostal denominations. They participate in organizations like Focus on the Family, the Family Research Council, Concerned Women for America, among others (Wilcox 2011). 25. The foreword was written by CNN journalist Bob Novak.
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ABSTRACTS
Phyllis Schlafly, an activist and an icon of the American Right, appropriated social issues in order to mobilize conservatives from the 1970s onward. The struggle against abortion was key to her traditional view of the family, which was organized around traditional gender roles. Thanks to a pro-life rhetoric and intense lobbying within the Republican Party, she fought against the feminist movement and helped to polarize the political landscape on this crucial issue linked to sexuality and reproduction.
Phyllis Schlafly, militante et figure très connue de la droite américaine, s’empara des débats socioculturels pour mobiliser les conservateurs à partir des années 1970. La lutte contre l’avortement fut l’un des piliers de sa vision traditionnelle de la famille, qui s’organisait autour des rôles genrés traditionnels. Par l’utilisation d’une rhétorique dite pro-life et l’un lobbying poussé dans le Parti républicain, elle participa, en s’opposant au mouvement féministe, à la polarisation du paysage politique sur cette question primordiale liée à la sexualité et à la reproduction.
INDEX
Mots-clés: Phyllis Schlafly, anti-avortement, femmes conservatrices, guerres culturelles Keywords: Phyllis Schlafly, pro-life, conservative women, culture wars
AUTHOR
AMÉLIE RIBIERAS
Doctorante à l’Université Sorbonne Nouvelle-Paris 3, EA CREW 4399 (Center for Research on the English-speaking World)
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Reproductive Rights Sit on a “Dangerous Precipice”: The Stakes of the Abortion Debate Playing Out in Idaho and Oregon
Christen Bryson
Introduction
1 In February of 2018, the Population Institute, an international non-profit organization that promotes “universal acces to family planning information, education and services,” released its 2017 annual report card on reproductive health and rights in the United States (Population Institute n.d.). This was the sixth report of its kind. In the Population Institute’s 2016 Report Card, they noted that women’s access to reproductive information and services had been declining in the U.S. since 2014, causing the overall grade of the nation to fall from a C to a D+ (Population Institute 2016, p. 1). In the most recent report, this decline has continued, bringing the nation down yet further to a D- (Population Institute 2018c, p. 1). In 2016, the reasons for this change were said to be due to the U.S. House of Representatives attempts, seven in total, to defund Planned Parenthood; the U.S. House Appropriations Committee vote to end all funding for Title X,1 which would limit women’s access to contraception and other reproductive services, like cancer screening; and the physical attacks made on reproductive service providers throughout the nation (Population Institute 2016, p. 1). Though the attempts by House legislators were countered in the Senate, the Population Institute believed the United States stood on a “dangerous precipice” (Ibid.). The fear that access to reproductive services would decline has been meted out as conservatives have taken hold of reproductive governance and moral regimes in the United States (Morgan and Roberts 2012, pp. 242-43).2 Since January of 2017, conservative politicians have wielded control of the legislative and executive branches of the Federal government. In the nearly two years that they have been in power they have been able to undo the regulation that kept states from denying Title X funding to abortion
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providers that was put in place by the Obama administration (Population Institute 2018c, p. 2). They have also been able to roll back the birth control provision of the Obama administration’s healthcare reform in the Patient Protection and Affordable Care Act (ACA) (2010), also known as Obamacare, which stipulates that employers and insurers must provide birth control to their employees without charging co-pays, making birth control accessible to anyone with insurance (Ibid.). Employers may now opt out on religious or ethical grounds (Ibid.). While the overall grade of the nation has fallen, in 2016, Robert Walker, the Population Institute’s President, pointed out that the poor performances of some states were “one of the reasons that the Institute gave the U.S. a lower grade […]” (Population Institute 2016, p. 1). The politics and culture of each state have defined its moral regimes, which help for the meanings of reproductive rights to be codified in their laws. This is made manifest in a state’s reproductive governance, or the ways in which they “produce, monitor and control reproductive behaviours and practices” (Morgan and Roberts 2012, p. 243). This article will take the states of Idaho and Oregon as examples of how the debate on reproductive justice is influenced by and influences these states’ perspectives on sex education and access to abortion in hopes of exploring the ways in which reproductive governance represents political, ideological and geographical schisms within the American body politic. These two states are notable in that they are neigbors and yet, they take opposing positions in most cases on each of these issues. The purpose, then, in looking at the differences between Idaho and Oregon is to map the ideological, political, and geographical battleground that has come to represent the current reproductive justice debate in the United States and to look towards an uncertain future. If Roe v. Wade were overturned by a future Supreme Court decision,3 there is little doubt that access to reproductive services in Idaho would be severely limited, while in Oregon, there would be little state- wide change. Idaho and Oregon exist on the opposite spectrum in the 2018 report. Idaho received an F, while Oregon received an A+.
Sex Education
2 One might not naturally make a link between sexual education and reproductive justice. Sexual education is, after all, a means to simply expose children and adolescents to sexuality and its accompanying biology. However, it is also meant to help prevent unwanted pregnancies, so it is undoubtedly connected to reproductive justice on a practical level. As such, within the American context, sex education is an incredibly charged issue. In fact, in her book Talk about Sex (2002), Janice M. Irvine explains that “In part, sex education battles reflect different moral visions of the sort that have divided Americans […]” (p.2). Irvine goes on to explain that sex education is but a microcosm of the fight to control the larger American body politic and its morals. This is quite evident in the way that both Idaho and Oregon have constructed their state’s sexual education requirements and curricula.
Idaho
3 Part of the Population Institute’s report card focuses on what they call “prevention.” It is under this umbrella that sex education falls. According to Idaho’s 2017 report, Idaho is not effectively helping the state prevent pregnancy because it does not require sex education (2018, p.2). The moral regimes of the state’s populous are very much
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reflected in its legal positions on sex education. All of the laws on Idaho’s statute books relating to sex education date back to 1970. In her master’s dissertation in nursing, Annabeth Elliot explains the significance of this date in the history of sex education. Thanks in part to the social hygiene movement in the early twentieth century, sex education became part of the curriculum in public school as an attempt to provide moral and physical knowledge on sexuality (Elliott 2010, p. 13). At the end of the 1960s, conservative groups like the John Birch Society and the Christian Crusade took issue with the growing trend of public schools offering sex education, claiming that these courses encouraged sexual exploration (Donovan 1998; Elliott 2010, p. 13). They argued that sex education belonged in the home (Elliott 2010). Elliott recognizes the success of their efforts in noting that 17 state legislatures had adjusted their statutes in accordance with this argument by 1969. It is precisely this perspective that one sees in Idaho’s statute on sex education. Law 33-1608 reads, “the primary responsibility for family life and sex education, including moral responsibility, rests upon the home” (Idaho State Legislature 2016 [1970]). In addition to charging the family with the task of educating children about family life and sexuality, the law stipulates that “the church and the schools” are only meant to “complement and supplement those standards which are established in the family” (Ibid.). The wording of the law indicates that the Idaho State Legislature sees sex education not in terms of reproductive health and rights, but instead as an extension of an individual family’s values and morals. Nevertheless, the law allows for local school districts to decide whether or not they will provide sex education. In the event that a local school board decides to incorporate sex education into its curriculum, the legislature notes that it should continue to play a complementary role to the home. As part of this directive, sex education curricula should extol the role of the family home in relation to the larger social system, instruct young people about the role of American society in the home, and the responsibilities that accompany family life. Additionally, sex education in public schools is seen as providing young people with “scientific, physiological” understandings of sex and “its relation to the miracle of life, including knowledge of the power of the sex drive and the necessity of controlling that drive by self-discipline” (Ibid.). It is worth noting here that the Idaho State Legislature has codified religious language into this law in referring to the “miracle of life.” In order to clear up any misreading of this definition of sex education, statue 33-1609 defines sex education as “the study of anatomy and the physiology of human reproduction” (Idaho State Legislature 2016 [1970]). The third and final parameter placed on sex education is how it should develop young people’s “ideals,” “standards and attitudes” that will influence their lives as teenagers and when they are establishing families of their own (Idaho State Legislature, 33-1608, 2016 [1970]). As sex education is seen as an extension of both the standards taught in the home and the church, the Idaho State Legislature explains that parents and school district community groups should play a role in planning, developing, and evaluating sex education curricula (Idaho State Legislature, 33-1610, 2016 [1970]). In the school districts that deem it appropriate to have sex educational instruction, whether or not their child participates remains at the discretion of parents and legal guardians. Any parent or legal guardian can have their child excused from such courses (Ibid.) It is evident that Idaho was unmoved by the national trend in the 1980s to implement comprehensive sex education in response to the HIV and AIDS epidemic as there has been no modification to the statutes since 1970 (Elliott 2010, p. 13).
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4 The Idaho State Board of Education, however, did revise its health content standards in 2010 to be more in line with the Center for Disease Control’s Health Education Curricula Analysis Tool and the national health education standards (Ibid., pp. 14-15). These standards were adopted by the State Legislature and went into effect in the fall of 2010 (Idaho State Board of Education 2010). Sex education falls under two of the eight core concepts in the standards: Prevention and Control of Disease and Growth, Development and Family Life (Elliott 2010, p.14). These health standards are divided by grade level: K-2nd grade, 3rd-5th grade, 6th-8th grade, and 9th-12th grade.4 Sex education is introduced at the youngest ages, in a relatively unspecific way. The following age group, grades 3 through 5, are specifically told about the contraction, transmission, prevention, and treatment of HIV and “changes that occur during puberty” (Idaho State Board of Education 2010, pp. 5-6). It is at this time that they are introduced to “Family Life,” too, which includes STIs, development, and “healthy relationships” (Ibid., p. 6). For grades 6-8, sexually transmitted diseases, HIV and AIDS are all considered “important components” of discussion on the Prevention and Control of Disease (Ibid., p. 9). Growth, Development and Family Life includes sexuality in its discussion on healthy relationships (Ibid., p. 10). Additionally, “consequences of sexual activity, encouragement of abstinence from sexual activity, pregnancy prevention, and methods of prevention” are all to be discussed (Ibid.). The only difference between sex education between grades 6-8 and 9-12 is that “Knowledge of […] personal, legal and economic responsibilities of parenthood and other consequences of sexual activity” are added to the core concepts (Ibid., p. 15). It is worth noting that from the earliest age, educators are encouraged to present “factual, medically accurate and objective information” as part of the Prevention and Control of Disease and the Growth, Development and Family Life. 5 In spite of the revision to the Idaho State Health Education Content Standards in 2010, local school districts and communities formulate sex education curricula. Annabeth Elliott notes that in Boise, the second largest school district in the state comprising nearly 10,000 students, the Independent School District of Boise prohibited teachers from instructing students about methods of preventing pregnancy, which appeared still to be the case according to the health curricula provided by the district’s website in 2016 (Elliott 2010, p. 71; Independent School District of Boise 2016). The largest school district, West Ada School District, comprising some of Boise’s suburbs, appears to comply with the Idaho State Health Education Content Standards (West Ada School District 2010). Though it is worth mentioning that after both the Prevention and Control of Disease and the Growth, Development and Family Life segments of their curriculum, there is a note stipulating: “Student-initiated questions related to prevention, transmission, risk, process and treatment will be answered in class in an age-appropriate and medically accurate manner. All other questions will be referred home. No discussion of intricacies of intercourse, sexual stimulation or erotic behavior. Questions about homosexuality will be answered in a non–biased, non-advocating, scientifically factual manner. Methods of birth control will be discussed as they pertain to risk and effectiveness. No demonstrations will be permitted” (Ibid., pp. 22; 27). 6 Though on paper, Idaho appears to be moving towards comprehensive sex education, the state’s laws allow for school districts to opt out of the program and do not mandate a state-wide program.
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Oregon
7 Oregon has approached sex education in a very different way. The Population Institute lauds the state for mandating comprehensive sex education, which includes instruction on abstinence, the prevention of disease and infection, as well as contraception (Population Institute 2018b, p. 2). One of the reasons that Oregon received a “+” was due to the fact that within their sexual education curricula, school boards provide information on sexual orientation and make sexual education inclusive of all sexual orientations (Ibid.). Oregon’s sexual education program might be described as following in the vein of the International Conference on Population and Development’s (ICPD) vision of sex education, which includes, “sexual health as part of the defintion of reproductive health,” and can be described as “‘the enhancement of life and personal relations, and not merely counseling and care related to reproduction and sexually transmitted diseases’” (Nystrom, Duke, and Victor 2013, p. 90). Oregon’s comprehensive approach to sex education has been an endeavor since the early 2000s, the larger goal has been to make sex education sex positive.
8 When one looks closely at Oregon’s “Human Sexuality Education Law,” it reads very differently from that of Idaho’s. From the outset, Oregon differentiates itself from Idaho in that it requires all school districts to provide sex education in elementary and secondary schools (Oregon Administrative Rules and Oregon Revised Statutes n.d.). Additionally, those who write the curriculum—whether they be parents, teachers, staff, medical officials, or community members—are expected to take into account “[…] the latest scientific information and effective education strategies […]” (Oregon State Legislature 2013). While sex education is mandated and there are science-based requirements for the curricula, what is perhaps the most fascinating aspect of Oregon’s approach to sex education is the state’s attempt to wade into the moral conundrums that often pervade its waters without positioning itself ethically. The Oregon Department of Education describes its pedagogial principles thus, “Building on the most current research and the National Health Education standards, they do not promote sexuality or impose a set of values, but, rather, empower the students to recognize, communicate, and advocate for their own health and boundaries” (Oregon Department of Education n.d.). While maintaining moral and secular distance from the issue of sexual education and health, the Oregon Department of Educaiton and Legislature take the position that their responsibility is to provide students with the tools necessary to make their own decisions, to legitimize rather than castigate sexuality. Although it appears to be a more neutral position, it is important to keep in mind the ways in which sex education has been used to advance political and moral agendas. In looking at the construction of Oregon’s comprehensive sex education laws through time, it becomes apparent that they too play a role in the ideological battle for reproductive justice. 9 According to Robert J. Nystrom, Jessica E.A. Duke, and Brad Victor, between 1994 and 2002, Oregon’s sexual education program could have been qualified as risk-based. That is, it focused on abstinence, prevention of sexually transmitted infections, and was voluntary. If schools taught sexual education, they had to follow the parameters outlined in the law, but they were not required to teach sex ed (2013, p.90). 10 Because of mixed opinions about abstinence education and comprehensive education, and different stances amongst elected officials and the electorate, in 2005, the
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Governor’s Office set up an ad hoc committee that would lay out the next phase for teen pregnancy prevention in Oregon. The committee took this as the opportunity to review the scientific literature, work on creating a common strategy, and resolve moral quandries (Ibid.). This led to the creation of the Oregon Youth Sexual Health Partnership (OYSHP), which redirected the focus of sex education from teen pregnancy prevention to youth sexual health (Ibid., p. 91). 11 Between 2005 and 2009, the OYSHP used youth action research, community forums, issue briefs, and a community opinion survey to gather data that would help inform the OYSHP’s sexual health plan for Oregon’s youth. In 2009, the state legislature passed a bill, ridding the state of its if/then clause, thus mandating age-appropriate comprehensive sexual education that “enhances students’ understanding of sex as a natural and healthy part of human development” in Oregon schools, grades K-12 (Ibid., pp. 91-94). When the federal government announced its intentions to fund teen pregnancy prevention programs in 2010, shifting away from abstinence-only education, Oregon was ready with its youth sexual health plan. Five state agencies were awarded grants at that time. One year later, the Confederated Tribes of Grande Ronde—the political and social organization of 26 Tribes and bands from western Oregon, northern Califronia, and northern Nevada loacated to the southwest of Portland—also received a teen pregnancy prevention grant. Part of the plan’s success is attributable to the participation of young people at every level of its development and implementation, from research to advocacy and outreach. Additionally as a joint effort between agencies and organizations, it is believed that the development of the plan has allowed for many to see how “family, income, age, race/ethnicity, gender identity, immigration status, sexual orientation, and geography” intersect to shape one’s access to sexual education and health (Ibid.). Nystrom, Duke, and Victor claim not only is the Oregon Youth Sexual Health Plan an acme for state public policy, it is significant in its recasting of the issue of teen pregnancy within a larger framework that positively promotes young people’s sexual health and comprehensive sexual education (Ibid.). 12 Idaho and Oregon have, thus, taken very different approaches to sex education. Patricia Donavan explained back in 1998 that these differences reflect the “controversy raging in many communities over what public schools should teach […]” (188). Even though, one of the major aims of sex education is to prevent teen pregnancy and reduce the spread of STDs and STIs, comprehensive education proponents and abstinence-only or abstience-plus advocates have fundamentally different priorities in the promotion of reproductive health (Donovan 1998).5 Supporters of comprehensive sex education believe its purpose is “to give young people the opportunity to receive information, examine their values and learn relationship skills that will enable them to resist becoming sexually active before they are ready, to prevent unprotected intercourse and to help young people become responsible, sexually healthy adults” (Ibid., p.190). Abstinence-only and abstinence-plus sponsors focus on how sex education can be used to promote values and morality that potentially conflict with those of the family and the church—prioritizing safe sex techniques and contraception over abstinence, promoting homosexuality, “teach[ing] young people how to have sex and undermine parental authority,” for example (Ibid.). After having looked at Idaho’s and Oregon’s approaches to sex education, it is evident that each state has been swayed by one of these arguments more than the other.
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Abortion
13 Sex education is not the only major ideological and political difference between Idaho’s and Oregon’s positions on reproductive health and rights. So diametrical are these two states positions on abortion that the Population Institute’s report cards issued on the states of Idaho and Oregon might be looked at as indicators of what they meant when they claimed in 2016 that reproductive rights might be in peril of being drastically reduced or on the verge of expanding. These reports take four factors into consideration when evaluating a state: effectiveness, prevention, affordability, and access (Population Institute 2016, p.2).
Idaho
14 Idaho scored well in “Effectiveness,” in preventing teen and unwanted pregnancies receiving 28.2 points out of 30. This is due to the fact that Idaho appeared to be moving towards the goal of having only 29 pregnancies per 1,000 women aged 15-19 by 2020 as the state teen pregancy rate was 36 pregnancies per 1,000 (Population Institute 2018a, p. 2). The state had thus already reached 88.3% of the 2020 goal (Ibid.). This high score in “Effectiveness” is also attributable to Idaho’s rate of unintended pregnancies, 39%, which was lower than the Healthy People Objective 2020 set at 44%. The state received zeroes in nearly all of the sub-categories of “Prevention” and all those under “Affordability” because Idaho has no state-mandated sex education program; provides no legal protection for women’s rights to emergency contraceptives in the emergency room; has not expanded Medicaid6 under the Affordable Care Act; has not included family planning services as part of its Medicaid plan; and provides no insurance coverage for abortions (Ibid.). Idaho does, however, have laws in place that allow minors to acces contraception, which awarded the states five points under the “prevention” label for a grand total of five points out of twenty-five. In terms of “Access,” the state has not enacted any laws that are meant to impede providers from performing their jobs, known as TRAP laws, but it does require a 24-houring waiting period between abortion counseling and the procedure; parental consent for young women under the age of 18 seeking abortions; and clinicians to be licensed physicians (Ibid.). Additionally, Idahoan women’s access to abortion is limited according to their geographical location. 68% of Idaho women live in a county where there is no abortion provider. The Population Institute, thus, gave Idaho an F. The failing grade was due to the state’s inability to meet “prevention” and “affordability” standards (Ibid., p. 1). Idaho is one of eighteen states to receive a failing grade. One of Idaho’s neighbors, Utah, also failed. However, Idaho also shares a border with two of the eleven states that received an A, Washington and Oregon.7
Oregon
15 In conjunction with its comprehensive sex education model, Oregon promotes reproductive health and rights as basic human rights. Oregon scored lower than Idaho in its “Effectiveness” efforts. Like Idaho, Oregon’s teen pregnancy rate sits at 36 pregnanices per 1,000 women aged 15-19, however the rate of unintended pregnancies is higher, at 46% (Population Institute 2018b, p. 2). Oregon still has some work to do to reach the 44% target goal set for the Healthy People Objective 2020. Oregon received a near perfect score when it came to “Prevention,” “Affordability,” and “Access” as
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Oregon has mandated comprehensive sex education in schools; provides women in Emergency Rooms with emergency contraception; has expanded Medicaid under the Affordable Care Act; and offers a Medicaid “waiver” to individuals who normally do not qualify for Medicaid to cover family planning services (Ibid.). Oregon likewise outperforms Idaho in the accessibility of abortion services: the state has no laws that make it “unnecessarily difficult” for women to have abortions; there are no TRAP laws; and 70% of Oregon women live in counties with abortion providers (Ibid.). The Population Institute gave Oregon an A+ for their efforts to provide comprehensive sex education, access to contraceptives, to make family planning more affordable and accessible statewide.
Idaho Restrictions and Oregon Liberties
16 Where Idaho has implemented every type of law that Reed Boland and Laura Katzive have identified as threatening to reproductive rights8 (2008, pp. 116-117), Oregon according to The Washington Post was the only state that “has not layered restrictions on top of the Roe decision” (Kliff 2013). Oregon does have a conscientious objection clause, however.
The States’ Moral Regimes Under Fire?
17 In the 2018 midterm elections both states have seen some challenges to their moral regimes. While Idaho has long resisted giving into the temptations of Obamacare, Idahoans were asked to expand Medicaid and the proposition passed with a 60.6% majority (Idaho Election Results 2018). This could allow for family planning services to be accessible to families whose income does not exceed 133% of the Federal poverty level, representing up to 62,000 Idahoans who are now covered under the expansion, if Idaho would incorporate family planning services into its Medicaid program (Galewitz 2018). In defending her support of the expansion, State Representative Christy Perry has been quoted as saying that Medicaid expansion “fits right into our morals and values,” she explains those as including being “a conservative, Christian, right-to-life state” (Ibid.). While the implementation of ACA protections and benefits no longer seem to challenge the values of Idaho’s citizens, this does not necessarily indicate that Idaho will ultimately upend its moral framework around reproductive services. President Trump carried the state by 32 percentage points (Ibid.). The fact that he has indicated on multiple occasions that this decision might be turned back over to the states and that an Idaho state representative wraps the state’s identity around its position on abortion gives one pause on the future of reproductive rights for women in the state of Idaho.
18 Oregon, on the other hand, saw an attempt to erode its position on abortion access and services in the 2018 midterm elections. Ballot Measure 106 would ammend the state constitution to “prohibit spending ‘public funds’ for ‘abortion’ or health benefit plans that cover abortion” (Ballotpedia n.d.).9 Jeff Mapes with Oregon Public Broadcasting described this amendment as preventing “low-income women” from receiving aid for abortion services as well as keeping “public employees from receiving abortion coverage as part of their health insurance” (2018). Even though the measure was defeated by 64% of the state-wide vote, when one looks at a map of the state of Oregon and the way that votes were cast, it is evident that the state itself is quite divided on
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this issue. The entire eastern half of Oregon – as well as small pockets in the southwest – favored this amendment. Frequently between 60 and 75% of the voters in these areas wanted it to pass. The supporters of the measure argued that “they didn’t think taxpayers should have to pay for a procedure that they and many other people oppose on moral grounds” (Ibid.). In many ways, the fact that such a proposal wound up on the ballot, after three failed attempts, is indicative of a moral divide on this issue that is playing out largely between the state’s urban and rural areas. Thus, Oregon might be seen increasingly as one of those states that has a gaping political, moral, and cultural chasm between its cities and countryside. While there is little concern over whether or not the state would restrict reproductive services in the event of an overturned Roe, this schism within Oregon presents its own political and ethical challenges for residents and the state government.
Conclusion: Irreversible Trend towards Liberalization?
19 In 2008, Boland and Katzive concluded that their findings “[…] suggested […a] trend toward [the] liberalization of abortion laws” and that this “should be hard to reverse” (Boland and Katzive 2008, p. 117). Given the gulf that exists between Idaho and Oregon when it comes to reproductive health and rights, it remains to be seen if this is truly the case. Before his inauguration in November 2016, President-elect Donald Trump stated in an interview on 60 Minutes, “I’m pro-life. The judges will be pro-life. […] Having to do with abortion – if it were overturned it would go back to the states” (as cited in Avila 2016). Since his inauguration, he has appointed Neil Gorsuch and Brett Kavanaugh, both constitutional conservatives. With these appointments in mind, it appears that the Population Institute’s assertion that the U.S. stands at a “dangerous precipice” is more prescient than ever.
BIBLIOGRAPHY
Avila, Theresa. "Donald Trump Hints at the Future of Abortion in America" in New York Magazine, 13 November 2016. Accessed November 18, 2016. http://nymag.com/thecut/2016/11/donald- trump-talks-future-of-abortion-on-60-minutes.html.
Ballotpedia. n.d. Oregon Measure 106, Ban Public Fund for Abortions Initiative. Accessed December 2, 2018. https://ballotpedia.org/ Oregon_Measure_106,_Ban_Public_Funds_for_Abortions_Initiative_(2018).
Benson Gold, Rachel. "Title X: Three Decades of Accomplishment" in Title X - Guttmacher Institute, Feburary 2001. Accessed December 4, 2018. https://www.guttmacher.org/sites/default/files/ article_files/gr040105.pdf.
Boland, Reed and Laura Katzive. "Developments in Laws on Induced Abortion: 1998-2007" in International Family Planning Perspectives, 2008, Vol. 34, No. 3, pp. 110-120.
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Chappell, Bill. "Idaho's Abortion Ban Is Unconstitutional, Federal Court Says." NPR Two-Way Breaking News from NPR, 29 May 2015. Accessed November 18, 2016. http://www.npr.org/sections/ thetwo-way/2015/05/29/410560051/idahos-abortion-ban-is-unconstitutional-federal-court-says.
Donovan, Patricia. "School-Based Sexuality Education: The Issues and Challanges" in Perspectives on Sexual and Reproductive Health, July/August 1998, 4 ed., pp. 188-193.
Elliott, Annabeth. 2010. Master's disseration: Sex Education Decision Making at the Independent School District of Boise. Boise, ID: Boise State University.
Galewitz, Phil. "Republican Gun Store Owner And Legislator Campaigns for Medicaid Expansion in Idaho." NPR.org 23 October 2018. Accessed December 2, 2018. https://www.npr.org/sections/ health-shots/2018/10/23/659576261/republican-gun-store-owner-and-legislator-campaigns-for- medicaid-expansion-in-id.
Idaho State Board of Education. "Idaho Health Content Standards." Idaho Department of Education, 2010, pp. 1-18.
Idaho State Legislature. 2016 [1970]. Title 33 Education; 16 Courses of Instruction; 08 Family Life and Sex Education. Accessed November 17, 2016. https://legislature.idaho.gov/idstat/Title33/ T33CH16SECT33-1608.htm.
—. 2016 [1970]. Title 33 Education; 16 Courses of Instruction; 09 "Sex Education" Defined. Accessed November 17, 2016. https://legislature.idaho.gov/idstat/Title33/T33CH16SECT33-1609.htm.
—. 2016 [1970]. Title 33; 16 Courses of Instruction; 10 Involvement of Parents and Community Groups. Accessed November 17, 2016. https://legislature.idaho.gov/idstat/Title33/ T33CH16SECT33-1610.htm.
—. 2016 [1970]. "Idaho Statues: Title 33 Education; 16 Courses of Instruction; 11 Excusing Children from Instruction in Sex Education." Accessed November 17, 2016. https://legislature.idaho.gov/ idstat/Title33/T33CH16SECT33-1611.htm.
Independent School District of Boise. 2016. Secondary Health. November 16. Accessed November 17, 2016. http://www.boiseschools.org/cms/One.aspx?portalId=508306&pageId=1772604.
Irvine, Janice M. 2002. Talk about Sex: The Battles over Sex Education in the United States. (Berkely: University of California Press).
Kliff, Sarah. "All States except Oregon Now Limit Abortion Access" in The Washington Post 31 January 2013. Accessed November 17, 2016. https://www.washingtonpost.com/news/wonk/wp/ 2013/01/31/all-states-except-oregon-now-limit-abortion-access/.
Mapes, Jeff. "Oregon Voters Trounce Ballot Measure that Sought to Curb State Funding of Abortion." OPB.org. 6 November 2018. Accessed December 2, 2018. https://www.opb.org/news/ article/oregon-measure-106-abortion-funding-results/.
Morgan, Lynn M. and Elizabeth F.S. Roberts. "Reproductive Governance in Latin America" in Anthropology & Medicine, August 2012, Vol. 19, No. 2, pp. 241-254.
Nystrom, Robert J., Jessica E.A. Duke, and Brad Victor. "Shifting the Paradigm in Oregon from Teen Pregnancy Prevention to Youth Sexual Health." Public Health Reports (1974-), SUPPLEMENT 1: Understanding Sexual Health, 2013, No. 128, pp. 89-95.
Oregon Administrative Rules and Oregon Revised Statutes. n.d. Human Sexuality Education Law. Accessed December 2, 2018. https://www.oregon.gov/ode/rules-and-policies/StateRules/Pages/ HIV--AIDS-Law.aspx.
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Oregon Department of Education. n.d. Health and Sexuality Education Standards in Oregon. Accessed December 2, 2018. https://www.oregon.gov/ode/students-and-family/healthsafety/Documents/ Oregon%20CSE%20Summary%202018.pdf.
Oregon State Legislature. 2013. OAR Rule 581-022-1440. Accessed December 2, 2018. https:// www.oregon.gov/ode/rules-and-policies/StateRules/Pages/OAR-Rule-581-022-1440.aspx.
Planned Parenthood. n.d. Title X: The Nation’s Program for Affordable Birth Control and Reproductive Health Care. Accessed December 4, 2018. https://www.plannedparenthoodaction.org/issues/ health-care-equity/title-x.
Population Institute. 2018a. "Population Institute 2017 Report Card: Idaho." The Divided States of Reproductive Health and Rights: A 50-State Report Card. Accessed November 30, 2018. https:// www.populationinstitute.org/external/report-card/2018/id.pdf.
—. 2018b. "Population Institute 2017 Report Card: Oregon." The Divided States of Reproductive Health and Rights: A 50 State Report Card. Accessed December 2, 2018. https:// www.populationinstitute.org/external/report-card/2018/or.pdf.
—. n.d. Population Institute: About Us. Accessed November 30, 2018. https:// www.populationinstitute.org/about/.
—. 2018c. "The State of Reproductive Health and Rights: A 50 State Report Card 2018." The Divided States of Reproductive Health and Rights. February. Accessed December 2, 2018. https:// www.populationinstitute.org/external/report-card/2018/4_pager.pdf.
—. 2016. "The State of Reproductive Health and Rights: A 50-State Report Card." Washington, DC, 1-4.
The New York Times. "Idaho Election Results." 2 December 2018. Accessed December 2, 2018. https://www.nytimes.com/interactive/2018/11/06/us/elections/results-idaho-elections.html.
Walrath, Rowan. "An Anti-Abortion Initiaitve Just Got on the Ballot in the Nation's Most Pro- Choice State" in Mother Jones. 2 August 2018.. Accessed December 4, 2018. https:// www.motherjones.com/politics/2018/08/anti-abortion-initiative-oregon-alabama-west- virginia/.
West Ada School District. 2010. High School Health Curriculum. Accessed November 30, 2018. http:// www.westada.org/Page/15141.
NOTES
1. Enacted in 1970, Title X intends to provide family planning services—affordable birth control, information about health care, testing and screenings—to people with low incomes” (Benson Gold 2001; Planned Parenthood n.d.). 2. Morgan and Roberts define these frameworks as providing different means to control legal access to reproductive health services as well as the perceptions of how these services benefit and harm individuals and societies. 3. Since President Trump’s appointments of the conservative justices, Neil Gorsuch and Brett Kavanaugh, it is believed, by abortion rights and anti-abortion rights advocates, that Roe v. Wade could be overturned the next time the court hears an argument on it. 4. K-2nd grade represents children from the ages of five to eight; 3rd-5th nine to eleven; 6th to 8th twelve to fourteen; and 9th to 12th fifteen to eighteen.
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5. Abstinence-plus programs emphasize abstinence, but also give information on condom use and contraception to prevent the spread of disease and unwanted preganancy. 6. Medicaid was created as a result of the 1965 Social Security Act. It provide government-backed health insurance to low-income individuals. 7. Idaho’s other neighbors, Nevada, Wyoming and Montana, received a C, a D, and a B- respectively. 8. Idaho allows for conscientious objection in the form of the Freedom of Conscience Bill for Health Care Providers (2010), has attempted to extend human rights rhetoric to the embryo and fetus in the Pain-Capable Unborn Child Protection Act (2013), has passed statutes 18-608 and 18-609 placing restrictions on facilities and providers, has limited certain types of medical technologies as was done in 2015 when Idaho’s Governor C.L. “Butch” Otter signed a law that prohibits women from buying abortion-inducing medication on-line, and has created enough controversy around abortion that providers are few and far between, (Idaho has three abortion clinics [two in the Boise/Meridian area and one in Twin Falls, women in eastern and northern Idaho are thus required to commute for several hours to receive an abortion]) (Boland and Katzive 2008, pp. 116-17). 9. This measure closely resembled the wording and intentions of the Hyde Amendment, which passed at the Federal level in 1976. Its purpose was to restrict Federal funds from going to abortion, exempting situations in which a woman is raped, pregnancy is the result of incest or endangers the woman’s life (Walrath 2018).
ABSTRACTS
Since the Supreme Court decision in Roe v. Wade (1973), states have been the staging grounds for the debate on reproductive rights. The politics and culture of each state have defined its stance on reproductive rights, which is made manifest in its policies on sex education and abortion services. This article will take the states of Idaho and Oregon as examples of how the abortion debate is influenced by and influences these states’ perspectives on these issues. These two states are notable in that they take opposing positions in most cases on each of these issues despite the fact that they are neighbors. Researchers believed in the first decade of the 21st century that abortion laws were more likely to be increasingly liberalized around the globe. Yet, the differences between sex education and abortion services in the states of Idaho and Oregon demonstrate that the pendulum might swing the other way in the United States. In looking at the differences between Idaho and Oregon, one is able to map the ideological, political, and geographical battleground that has come to represent the current reproductive rights debate in the United States and its uncertain future.
Depuis la décision de la Cour suprême dans Roe v. Wade (1973), les États ont été au centre des débats sur les questions afférentes à la maitrise de la fertilité, en adoptant notamment des politiques différentes en matière d’éducation sexuelle et d’avortement. La politique et la culture de chaque État définissent sa position en matière des droits reproductifs, ce qui est évident dans ses politiques d'éducation sexuelle et d’accès à l'avortement. Cet article s’appuiera sur une comparaison entre deux états, l’Idaho et l’Oregon, et étudiera la manière dont ils se positionnent par rapport à ces questions. Bien qu’ils soient voisins, l’Idaho et l’Oregon se démarquent en adoptant dans la plupart des cas des positions opposées sur chacune de ces thèmes. Au début du
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XXIe siècle, les experts estimaient que le pays allait vers moins de restrictions en matière d’avortement. Cependant, les différences entre les politiques sur l'éducation sexuelle et l'avortement dans l’Idaho et l’Oregon démontrent que le pays pourrait prendre une tout autre direction. Examiner les différences entre ces deux États nous permettra d’appréhender combien le débat actuel sur la maitrise de la fertilité symbolise les conflits idéologiques, politiques et idéologiques de l’Amérique contemporaine.
INDEX
Mots-clés: avortement, IVG, contraception, éducation sexuelle, Idaho, Oregon, justice reproductive Keywords: abortion, contraception, sex education, Idaho, Oregon, reproductive justice
AUTHOR
CHRISTEN BRYSON
Université Sorbonne Nouvelle – Paris 3, Maîtresse de conférence en civilisation américaine/ Associate Professor of American Studies, EA 4399 Centre for Research on the English-speaking World (CREW))
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Providing Comprehensive Care: Marissa Galloway Interview
Anne Légier
AUTHOR'S NOTE
L’entretien a été réalisé en septembre 2018/ The interview was conducted in September 2018
Anne Légier (AL): You provide reproductive health care in a conservative state. Can you tell me a little about that: your experience, what it means for you, what it means for the women you provide care for? Marissa Galloway (MG): I think that the biggest thing that it means is that the options that women have and potentially the travel distance and barriers to seeking the services that they need are more so than in states or larger cities where there aren’t those challenges. Each state in the US is very different in which political challenges they have dealt with and impacts of these legislative initiatives on health care and how it’s provided, from the coverage issue, the health insurance coverage issue—I think that’s one of the biggest challenges in many of the conservative states—because the Affordable Care Act1 allowed for health exchanges to not include any abortion services in their plans and so, even if you have a private health insurance plan, there is no precedent that is being set by covering that and so many private plans don’t include that as well. AL: That’s also true for birth control, right? MG: For birth control, it is a little bit different because there was a mandate under the Affordable Care Act to cover contraceptive options as a part of preventive health care. AL: But, wasn’t there the Hobby Lobby (The US Supreme Court 2014) case…? MG: Yes, there are the options for these different companies who have a religious foundation—they have to be private companies and show proof of that in different ways legally—and they can opt out of coverage but they do have to still offer women
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a different plan that they can purchase that is external to their primary plan. The hard thing is that that’s one more barrier, you know? Most people don’t understand health insurance in this country, and you are already making it hard, and you are going to pay additional for something when you could also just walk in to a reproductive health clinic and get that without using your insurance for a low cost for many methods. So, women often don’t really understand what they may be missing out on their plans and what they have to ask additional coverage for. AL: Do you think there could also be a privacy issue: they don’t want to talk about this to their insurance company? MG: Absolutely, and it’s probably not so much the insurance company but the Human Resources at their individual company. They would then essentially out themselves as somebody who is using contraception because they are asking for an additional plan to cover these methods. Because, usually, the Human Resources person who is within that company helps to connect the employees to plans. So, they are already connecting them to their primary plan but they would have to ask for additional coverage for that service. AL: What about abortion coverage? Are there companies—I don’t know anything about insurance—so are there companies that do cover abortion? And would that mean that you would have to sort of disclose to your employer that you are having one? MG: No. So, for the private insurance plans that do cover it, the employer never sees what you are using it for. AL: So, it’s like if you have cancer? MG: Exactly. So, whether you have a bill for knee surgery or for an abortion, the company never knows. You just pay your premiums and they know you are a person who has that insurance plan. But many private insurance plans don’t have coverage for abortion care or they might have coverage in certain circumstances—and that’s something that we struggle with on a regular basis and becomes a barrier for women even when they’re terminating for a lethal fetal indication or for maternal health indications—often their insurance policy refuses coverage regardless of the indication and they’re left with having to pay out of pocket. AL: Even if it is life threatening? MG: Yes. So, the insurance policies will have coverage for maternity care and so they will pay for your labor and delivery if you go further in pregnancy but they won’t pay for termination and so women also struggle with where they can have their abortion care done too because, let’s say their fetus has a lethal abnormality such as trisomy 18 (a genetic abnormality), if they opt to terminate that pregnancy early on—and this is a baby that would never survive outside—the company won’t pay for it, and then they have to decide “well, do I have this in the hospital where it can cost upwards of $10,000 out of pocket to have a termination or have it in a freestanding abortion clinic where it can be more like a couple thousand dollars?” So it also marginalizes their care even, regardless of the reason that they are choosing is based upon their coverage. AL: In France it is very different because we don’t have the clinic system, at least for abortion care. From what I see, the fact that abortion care is part of a global hospital practice, it’s sort of lost in there which means it doesn't become a target… because hospitals provide abortion but it is not identifable in any way: people come in and out and nobody knows what they are coming in for2…. I know that the idea of abortion clinics comes
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from a feminist idea of a specifc kind of care, but I wondered if you had any thoughts on this idea of also marginalizing the practice by reinforcing clinic versus hospital care… MG: Well, it comes from the history of abortion in the US, of how this started. When abortion was illegal, in the states where they had more options to provide it, they often did it in these freestanding clinics and the only providers who knew how to do it were providers in these freestanding clinics. I shouldn’t say “the only”: there were many people in many settings who did, but the highest volume was often in these settings. And so then, once abortion became legal across the country, most ob-gyns had not had abortion training and now, how do you train a whole generation of providers and how do you suddenly get these services in the places that they weren’t? So, there were these barriers that just naturally evolved to provider training, to accessibility, and these freestanding clinics often took over the role of providing these services because they could also do it in a more timely, less costly setting. Because the hospital overhead costs are so high you’ve got to pay either out of pocket or through private insurance, so abortion clinics can do just that: they can keep the cost contained and provide that one service. But, unfortunately, it still limits how many trainees are seeing abortion care because it is not in the hospitals where they are training and so they have to actually choose and go out and access this additional training which may not be as easy, and there is still stigma associated with that when you are the person who is saying “I want to go out and do that.” AL: I understand you are a professor… You teach in a hospital, right? MG: I teach in many settings but primarily in hospitals and clinics. AL: So, your medical students…: do most of them just not have any training in termination or do they just do D&C3 training for miscarriages? MG: So, all medical students have these core rotations that they have to do and ob- gyn is one of them and their experience is usually split between inpatient labor and delivery and inpatient gynecology, and they do a little bit of clinic time as well so they can then opt—at least in our program—and each program is different—they can opt to have more of a family planning exposure and go to a freestanding clinic during their clinic time but that might be a couple dozen students for the whole year when you have got over a hundred. So most medical students are not actually going to the freestanding abortion clinics for any exposure and so they may, if they just happen to be on delivery when there is an induction termination that day, they may see that but that’s not the reality of most abortion care in this country; and when they are on gynecology they might see some D&Cs for miscarriage management so that they at least see the procedure but there is still this lack of understanding that it is the same procedure regardless of the indication. AL: Is that a concern for you? Are you worried about what the next generation of doctors— you are a pretty young doctor yourself—but the next generation of doctors is going to be able to do for women who need abortion care? MG: Absolutely, and this is something that’s been an ongoing conversation for a few decades in this country of how do we integrate this into our medical education training, how do we integrate it into our ob-gyn and family medicine residency training? And so each institution is doing things a little bit differently but it is one of the requirements through the Governing Board for accreditation of these residency programs that ob-gyn residency have to offer abortion training to their residents but that doesn’t mean it is done in a way that makes it easy in many settings: there are
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places where in order to get that—even though it is offered—the resident has to opt out of doing a gynecology rotation which then shifts that work on to their colleagues and then travel a couple hundred miles to stay in a place where there is a freestanding clinic and work there for a couple of weeks and leave their family behind and so there are barriers to getting that training even though places are supposed to offer it. AL: I also wanted to discuss one of your felds of interest, pregnancy intendedness: can you tell me how you think it’s an issue in the United States and do you think it has something to do with the sex education or the lack of sex education provided in American schools? I know that it is very different from state to state but from a French perspective, again, it is very surprising what some states consider to be sex education… MG: Yes there isn’t much, unfortunately…There isn’t much sex education. Sex education is definitely a barrier that starts early on for American citizens in general, each school does things differently, each school district, each state. There has been a big push because of national policy to really focus on this abstinence-only education but without giving adolescents any information on how their body works and how you could prevent a pregnancy or a sexually transmitted infection, how do you engage in a consent process with another partner, or not have a power differential in sexual encounters, there is so much that’s missing… And, as an ob-gyn, when I see young women who are often coming in for a first exam and we are talking about engaging in sex and use of contraception, they have no understanding of their anatomy when they go through these basic state-sponsored sexual education programs. They don’t understand where their cervix is or that it’s connected to their uterus. We really start these exams pulling out a pelvic model and just explaining to them their anatomy, which is something you would think would be part of their health education very early on and so you have to do that before you get even to the part about how sex functions and how pregnancy occurs, and how birth control can prevent a pregnancy if you don’t want it. So, it is hard as a provider. And that’s obviously variable, most doctors don’t have a half hour to spend giving you some baseline education that you should’ve already received. AL: There must be a lot of young women who never see a doctor before they actually get pregnant… MG: Right. We see a significant number of young women whose first encounter with a reproductive health provider is with their abortion care services. So, they are already having sex; many of them don’t understand timing of sex or when you can get pregnant—or their cycles—and then, unfortunately, are trying to walk themselves backwards a bit with this knowledge. That definitely affects pregnancy intention in this country: even though teen pregnancy numbers are declining, it’s not because of abstinence-only education. It’s been due to a push to get younger adolescents on to birth control before initiation of sex and that’s not been within the schools, it’s been a push from public health components and family planning groups to make these methods more acceptable to younger adolescents. AL: What types of contraceptives? I remember talking to an American ob-gyn who talked about IUD4s for teenagers? MG: Yes
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AL: Because in France they don’t do that5… MG: Yes, so the American Pediatric Association and the American College of Ob-Gyns both put up practice guidelines to support use of IUDs and also contraceptive implants as first line contraception for adolescents just because we know that the other methods are very user-dependent. Adolescents have chaotic lives and remembering to take a pill every day or putting in a ring once a month is hard for them when they are just trying to figure out how to navigate life. AL: So, these are very effective methods? MG: Yes, so we know that these long-acting methods you can use for many years: you put them in and forget about them and they can get these adolescents to a point when they can decide later on if they want to get pregnant or if they are not happy with that method too. So, there is definitely a push. But we see a lot of unintended pregnancies especially in unmarried couples and so the abstinence-only, wait-till- you-are-married thing does not seem to be working out so well in this country. AL: Do you see a link with some religious cultures? MG: Absolutely. AL: Do you see more teenagers who are actually from a religiously conservative background? MG: It’s really a mix. You could pick any religious group and say “well, it’s all this” or “it’s not this” but in the end all of the teenagers are teenagers and they all have hormones regardless of the religious teaching and some will get pushed into early marriages or some of them show up for an abortion and then they are right back preaching the anti-abortion strategies. AL: That must be tough, for the provider I mean. MG: Yes, awful. That’s definitely an issue. But the other big issue too, outside of the social implications of it, is that we have a country that does not really prioritize preventive health care. We have a huge chronic illness problem in this country: obesity, a lot of substance abuse issues… All these things increase the risk of adverse pregnancy outcomes and so when pregnancies aren’t planned and they happen at a time when a woman’s disease is not controlled or when she’s having issues with substance abuse or you put the social aspect of an abusive relationship into this, these are all things that affect both maternal and fetal outcomes. That’s where the issue of unintended pregnancy is even more detrimental not only to this generation but to the future one too. AL: Costly, also? MG: Yes. A lot of these pregnancies are funded on public insurance and so women who don’t have insurance until they get pregnant have this window of coverage during their pregnancy, and insurance will pay for their delivery and the second they deliver they are cut off again. There is no way to continue to optimize their health issues beyond that without insurance. AL: Can you tell me how you decided to become a reproductive care physician? Since it is not mainstream in a way—as you explained earlier—what made you want to do that? MG: So, I trained in a residency program in a place that wasn’t very restrictive but, regardless of that, I saw that most of the general ob-gyns who I worked with and saw a large number of providers did not receive training in abortion care in their residency programs, and so I just found it concerning that, as a generalist provider
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who is supposed to be able to take care of women throughout their reproductive lives, they would tell women “well, I’ll take care of you if you get pregnant, I’ll take care of you if you have a miscarriage, I’ll take care of you if you need a C-section, but if you decide to terminate the pregnancy, I’ll have to send you out to this freestanding clinic to see someone that you don’t know for a procedure that takes 5 minutes and is the exact same procedure that I could do for you if you were having a miscarriage.” And so it just seems so bizarre to me: if I want to be able to provide comprehensive care to my patients, this is just one of the many things that women need throughout their reproductive lives and I want to be able to safely provide it and not tell women and add to the stigma around the issue by saying “I can’t take care of you in this setting.” AL: It’s an argument that could be made for primary care physicians too. Do you know of primary care physicians that do provide abortion care as part of their general practice? MG: So, within primary care there are different tracks to get there and so many primary care physicians do internal medicine residency and in that residency training program they don’t really get exposure to obstetrics but there are family practice residency programs, and family practice doctors do obstetrical rotations as part of their training, and some of them can actually go on and do additional training and provide obstetrics as part of their practice. And so, for them, there are many who do provide abortion care too because they feel more comfortable with the obstetrical part of it but, unfortunately, the exposure to abortion in family practice training programs is even more limited than in ob-gyn training programs and so the number of providers from that background is pretty limited. AL: Do you think that the general fear of being identifed as a provider also hinders people from doing something they would want to do as part of a comprehensive practice but don’t feel comfortable enough to do? MG: Absolutely. Carole Joffe has written about that. So, there is definitely a provider stigma that’s associated with it and also other barriers too because if you don’t really get exposed during your training program… then you need to get a partner later on, it’s important, and there are many practice groups where, even if I came in and said “I want to provide this and they’ll say well, if you get a job with us we don’t want you providing this because we don’t want to be known as a group that provides that… then you’ve got privileges to do deliveries in a hospital and the hospital says well, you can’t do it here. There are some layers to it that become barriers to providing if you want to. AL: You have mentioned it already but would you say that being a provider is diffcult on a day-to-day basis? Would you also say it is rewarding? Is it both? MG: Well, it’s one part of my job, you know, I do a lot of things at my job, including providing general ob-gyn care and delivering babies in pregnancies that women want to go forward with and so, again, I think being able to provide comprehensive care and full-spectrum care is what’s important and rewarding to me. Patients who I care for, who have terminations, are so thankful that they can go forward with their lives and so fearful about it because there is so much stigma and misinformation out there, and so for me to provide them with a safe experience that’s just like any other health care is often shocking to them: they’ll come in and say “oh I’m so surprised that you weren’t mean to me.” Well, just because you are making a health care decision? Like, I would be mean to you if you were coming in and having… you know, knee surgery
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or whatever? There is that belief that it is somewhat different and should lead to lesser care [which] is hard. So, being able to provide good care and safe care is definitely rewarding and seeing them being able to leave with the birth control method of their choice and go on with their lives and plan for a pregnancy when it fits is very rewarding. AL: That’s interesting because there are a lot of providers who seem to—from the outside it seems like a lot of providers, because of the demand for it and the small number of providers—specialize and end up doing only that even if it is not necessarily what they would have wanted in the beginning… MG: I would say that most providers actually have a mix. There are some who that’s all that they do but the norm is more that you work in a hospital too or you work for a practice, and then you either provide it as part of your practice or some will go and work a day or a half day a month at a freestanding clinic and provide services there as well. So, I feel more and more it’s a mix. Historically, though, especially when it was illegal, and people were training to fill these freestanding-clinic models, that would be all the provider did. But that’s also why the abortion provider term is not really the same as it was 30 years ago. AL: So what’s the term you would use for yourself? MG: I’m an ob-gyn. I don’t call myself a C-sectionist or, you know, a hysterectomist…. It’s a procedure and it goes along with the comprehensive care I want to be able to provide to my patients. AL: That’s very interesting. I had never heard it phrased that way. I also wanted to ask you about the political climate. We mentioned the fact that you work in a conservative state but there is a global conservative climate, there are discussions around the Supreme Court, the composition of the Supreme Court… So, is that something you worry about? MG: Unfortunately, I have very little control over the Supreme Court, personally. And so while it is a concern, there are regular every day challenges just getting care for my individual patients that are more concerning to me. You know, I hope that people realize that when they don’t vote and when they might make a protest vote, they get many decades of challenges because of it, and so, I don’t foresee the road ahead being easy from a national perspective. But I just hope that, in my day-to-day work, I can continue to take care of the patients that I see and help them overcome the barriers that are put in place and have conversations with people who lead political agendas to make them understand that the most effective way of preventing an unintended pregnancy and an abortion is through comprehensive contraceptive coverage and education, and supporting women in their roles in this country. This conservative agenda is essentially just trying to keep women in their place and pregnant and not at work and leads to all these adverse outcomes that we see. So, I think most people— when you start really talking about how healthy pregnancies are planned pregnancies and how that occurs in women who have some say in their lives, that are happier in their lives, that have a relationship with somebody who supports them— you kind of get at the core of what everybody wants. And so taking away the labels that people put on it, and stop walking in and saying “I want to talk about abortion policy” or “Let’s talk about how we can support girls in this country.” It’s just the conversation we all want to have but then people get so politicized over these labels that it’s hard to get to common [ground].
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AL: I think I read recently that people identify with labels that they actually don’t really belong to. Meaning if you ask them specifc questions, they actually think that they are pro- life or pro-choice but are not really what they think they are… MG: Yes. AL: Because it’s more complex than just labels… MG: Yes. And that’s medicine. There’s a lot of [grey area] to it.
BIBLIOGRAPHY
Cohen, David S., and Krysten Connon. 2015. Living in the Crosshairs: The Untold Stories of Anti- Abortion Terrorism (New York, NY: Oxford University Press).
Joffe, Carole E. 1996. Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe V. Wade (Boston: Beacon Press).
———. 2014. “Commentary: Abortion Provider Stigma and Mainstream Medicine.” in Women & Health 54 (7).
Moreau, Caroline, Aline Bohet, Danielle Hassoun, Virginie Ringa, Nathalie Bajos, and FECOND group. 2014. “IUD Use in France: Women’s and Physician’s Perspectives” in Contraception 89 (1): 9– 16.
National Abortion Federation. 2018. “2017 Violence And Disruption Statistics” https:// prochoice.org/wp-content/uploads/2017-NAF-Violence-and-Disruption-Statistics.pdf.
The US Supreme Court. 2014. Burwell v. Hobby Lobby Stores. https://www.supremecourt.gov/opinions/13pdf/13-354_olp1.pdf.
NOTES
1. The Patient Protection and Affordable Care Act (PPACA), often shortened to the Affordable Care Act (ACA) and usually referred to as Obamacare is a 2010 federal law making health coverage easier to navigate and to afford. Patients can purchase heath insurance that comply with the PPACA from government-regulated health insurance marketplaces, also called “health exchanges.” The PPACA also expanded the Medicaid program to cover more people with low incomes. 2. In France, abortions can in fact also be performed in private clinics, but these facilities are not identified as being “abortion clinics” as they provide comprehensive health care. 3. D&C stands for Dilation and Curettage, a medical procedure where the cervix is dilated in order to remove uterine tissue with a small instrument called a curette. D&Cs are often used to remove retained tissue after a miscarriage. They are also commonly used to terminate a pregnancy. 4. IUD stands for Intra Uterine Device, a common contraceptive method. 5. While IUDs are the second most common contraceptive method in France, they are almost exclusively used by women who have already had children. As of 2010, only 1% of French women under 25 were using an IUD (Moreau et al. 2014).
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ABSTRACTS
Marissa Galloway is an ob-gyn who practices in a conservative state. At her request, we are not using her real name to protect her anonymity. Even though abortion is one of the safest and most common medical procedures in the United States, abortion providers hold a very unique position in the landscape of American healthcare. Anti-abortion violence has threatened and marginalized the procedure and those who make it possible (Cohen and Connon 2015; National Abortion Federation 2018). Since 1993, eleven people—including four doctors—have been killed by anti-abortion extremists. Other attacks on clinics and reproductive health care providers have included, sometimes on a daily basis, death threats, blockades, harassment of family and neighbors, but also bombing and arson of offices, battery, kidnapping and attempted murder. In this interview, Marissa Galloway explains, among other things, the barriers American women face in trying to access reproductive health care as well as her belief that abortion is an integral part of comprehensive obstetrical care.
Marissa Galloway est gynécologue-obstétricienne dans une région conservatrice des États-Unis. À sa demande et afin de protéger son identité, nous utilisons ici un pseudonyme. Elle fait en effet partie d’une petite minorité de médecins qui intègrent l’avortement à leur pratique médicale. Même si l’avortement est l’une des interventions médicales les plus sures et les plus courantes du pays, les médecins pratiquant des avortements sont relégués aux marges du système de santé américain et menacés par la violence des groupes anti-avortement (Cohen et Connon 2015; National Abortion Federation 2018). Depuis 1993, onze personnes, y compris trois médecins, ont ainsi été assassinées par des militants opposés à l’avortement. On dénombre également des enlèvements et des tentatives de meurtre ainsi que des attentats à la bombe et des incendies volontaires à l’encontre de cliniques. Le harcèlement et les menaces sont monnaie courante. Dans cet entretien, Marissa Galloway évoque, entre autres, les obstacles rencontrés par les Américaines en matière d’accès à la contraception et à l’avortement ainsi que la place de l’avortement dans sa pratique médicale. Galloway resitue l’IVG comme étant au cœur et non à la marge de la gynécologie américaine.
INDEX
Mots-clés: grossesse, avortement, IVG, contraception, éducation sexuelle, abstinence, santé, médecin, gynécologue-obstétricien, femmes Keywords: pregnancy, abortion, termination, birth control, sexual education, abstinence, healthcare, ob-gyn, physician, women
AUTHOR
ANNE LÉGIER
Université Sorbonne Nouvelle, EA 4399 Centre for Research on the English-speaking World (CREW. Faculté de droit et de Science Politique, Aix-Marseille Université (AMU)
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Varia
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Récit d'une crise à venir : religion et tensions raciales dans American Crime, saison 1
Dominique Cadinot
1 Un an avant l'élection de Donald Trump à la fonction suprême, la chaîne publique ABC diffusait le premier épisode de l'anthologie sérielle American Crime (ABC, 2015-2017) qui sous couvert de murder mystery expose les lignes de fracture de l'Amérique contemporaine. Prenant un échantillon de familles californiennes, le réalisateur et documentariste afro-américain, John Ridley, lauréat d'un Oscar pour l’adaptation de 12 Years a Slave, dresse le portrait sans concession d'une Amérique marquée par des clivages de classes ou des divisions ethniques et culturelles1. Les Nix, famille afro- américaine dont un des membres est converti à l'islam, les Guttièrez, Mexicains de souche et catholiques, et les Skokie ou les Carlin, blancs de confession protestante, incarnent dans cette série chorale les communautés qui seront amenées à confronter leurs héritages et leurs croyances après le meurtre de Matt, fils aîné de Barb et Russ Skokie, et l'agression de Gwen son épouse.
2 Dès la diffusion des premiers épisodes, le feuilleton s’attire à la fois les faveurs du public et celles de la critique. Dans les colonnes du New York Times, par exemple, on peut lire : «The stories are so artfully [...] drawn out, that it makes American Crime stand out. This is an ABC drama that is not just good, it’s startlingly good » (Stanley, 2015). De son côté, Hank Stuever du Washington Post déclare : « I can’t remember the last time a network drama had my rapt attention and respect on this many levels at once » (2015). Ou encore le magazine spécialisé Variety observe : « American Crime has quite eloquently made its case that a broadcaster can still lay claim to one of the best hours on television » (Lowry, 2016). American Crime s'impose donc d'emblée par la force de son propos et par les thématiques abordées. Mais surtout, John Ridley nous donne une vision prémonitoire du contexte dans lequel viendront s'inscrire la campagne électorale de 2016 et l’accession au pouvoir de Donald Trump. Critique du « système », extrémisme idéologique, mouvance suprématiste, émeutes raciales ou brutalité policière sont autant de manifestations symptomatiques que le cinéaste porte à l'écran
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quelques mois seulement avant leur mise en lumière dans les media américains et internationaux. Bien sûr, ces phénomènes s’étaient déjà manifestés, mais cette année là, à mesure que le scrutin approchait, leur visibilité devenait plus prononcée. L'univers d'American Crime nous offre ainsi la possibilité d'interroger le rapport du récit sériel à la réalité sociologique. Éléments incontournables de la culture populaire, les séries sont désormais conduites, pour le dire avec Jean-Pierre Esquenazi, à « présenter leurs mondes fictionnels comme des paraphrases de la réalité » (2014, p. 191). Souvent, les univers diégétiques viennent en effet « toucher » les faits conjoncturels du monde2. Parfois, de manière prophétique, ils anticipent leurs développements. Plus qu'un « effet de réel » barthien, l'univers d'American Crime offre donc aux spectateurs la représentation fictionnelle d'un avenir sombre et chaotique. 3 La série est très riche de thématiques et traite en profondeur des rapports de domination entre citoyens et institutions ou entre minorités et majorité culturelle. Toutefois, l'analyse de chacun des vecteurs responsable de la fragmentation sociale telle qu’elle est dépeinte dans la série n'étant pas possible dans le cadre cet article, nous nous limiterons, dans les lignes qui suivent, à examiner ce qu’American crime (saison 1) donne à voir des rapports entre religiosité et tensions sociales. Si les modalités d'inscription du religieux dans la diégèse sérielle forment un champ de recherche encore peu exploré, les spécialistes s'accordent à reconnaître que l'évocation du divin est souvent réservée aux feuilletons relevant du fantastique ou du surnaturel3. Game of Thrones (HBO, 2011-en production), par exemple, présente des religions inventées qui se manifestent par des rituels étranges et qui donnent lieu à la représentation télégénique de rivalités guerrières. Dans d'autres productions, la dimension religieuse est sous- jacente ou périphérique au propos des auteurs. La série Oz (HBO, 1997-2003), qui traite des défaillances de l'univers carcéral, aborde la question en faisant de l'engagement spirituel un facteur de résilience ou une condition de survie, mais la problématique n'est pas véritablement saillante. Bien sûr, les auteurs-scénaristes livrent parfois une réflexion plus aboutie. C'est par exemple le fondamentalisme religieux que dénonce Game of Thrones, ou l’instrumentalisation politique de la religion que dévoilent, par ailleurs, les saisons 5 et 6 de la série True Blood (HBO, 2008-2014) (Wells-Lassagne, Attali, 2014). Néanmoins, dans la majorité de ces productions, le fait religieux s'insère dans la trame narrative au même titre que d'autres faits culturels. Au contraire, l'originalité d'American Crime est d’ériger la question de la foi comme l’un des ressorts majeurs de la conflictualité sociale. A travers des arcs narratifs croisant le récit principal, la série montre en effet comment trois groupes confessionnels reçoivent l'onde de choc émise par l'assassinat d'un des leurs. Il s’agira donc ici d'étudier la manière dont la première saison d'American Crime qui compte onze épisodes met en évidence l'empreinte de la religion dans les conflits intercommunautaires. Comment chaque groupe confessionnel adapte-t-il son discours et sa pratique au contexte ? Quels messages les institutions religieuses diffusent-elles en situation de crise auprès de leurs congrégations ? En d'autres termes, comment la série rend-elle compte de l'influence du religieux sur les dynamiques de fragmentation qui traversent aujourd'hui la société américaine ? Il ne s'agira donc pas tant de nous pencher sur ce que Freud appelait la fonction consolatrice de la religion, mais plutôt sur la fonction hétéronomique des cultes institués qui traditionnellement énoncent des règles collectives afin d’organiser le comportement des fidèles en société.
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Héritages culturels et polarisation sociale
4 Interrogé en 1960 sur les rapports entre religion et racisme, Martin Luther King avait répondu avec consternation que le dimanche était sans doute le jour dans toute l’Amérique où la ségrégation raciale était la plus prononcée4. Or, en dépit des avancés obtenues en matière d’égalité et d’intégration des minorités depuis l’époque du combat pour les droits civiques, la fréquentation des lieux de culte est toujours majoritairement conditionnée par l’origine raciale des fidèles. Telle est en tout cas la situation que dépeint le cinéaste américain.
5 Les groupes de croyants mis en scène dans la série sont tous très homogènes, à commencer par celui des musulmans. Sans jamais désigner nommément la Nation of Islam (NOI), John Ridley façonne pour incarner cette communauté une galerie de personnages dont les tenues vestimentaires (un hidjab pour les femmes, costume- cravate pour les hommes) ressemblent fortement à celles portées par les membres de cette organisation. On aperçoit aussi dans quelques scènes son emblème officiel ; un drapeau rouge frappé d’une étoile et d’un croissant de lune blanc (voir figure 1).
Fig. 1 L’emblème de la Nation of Islam
6 Ainsi et conformément aux préceptes originaux de la NOI, le personnage d'Aliyah, sœur de Carter Nix suspect principal du meurtre, développe un discours manichéen qui repose sur l'opposition binaire entre Blancs et Noirs. A chaque apparition, Aliyah, nouvellement convertie à la religion islamique, souligne l'opposition entre « eux » et « nous », entre « them whities » et « us, brothers and sisters ». Entièrement dévouée à sa communauté d'adoption, elle reproche à son frère Carter d'enfreindre les principes de l'organisation : « You take their drugs and you sleep with their women » (E03). Dans l'esprit d'Aliyah, l’adoption de la foi islamique constitue une forme d’émancipation. En rejetant le système américain blanc responsable de l’assujettissement socio- économique des noirs, elle s'est débarrassée des chaînes de l’esclavage : « Debt is slavery, credit is slavery. I’m grateful for my freedom » (E04). Le personnage exprime aussi de manière furtive le racisme anti-blanc ou l’antisémitisme que Louis Farrakhan, chef charismatique de la NOI, a inscrit dans l’idéologie de cette branche minoritaire de l’islam américain. Dans l’épisode 4, lisant la carte de visite du substitut du procureur
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appelé Soderbergh, Aliyah ironise : « Soderbergh ? What kind of name is that ?! ». D'origine suédoise, ce nom de famille est, il est vrai, très peu répandu aux États-Unis. Mais la dernière syllabe du patronyme évoque aussi d'autres noms d'origine juive ashkénaze. Si l'intention précise du scénariste reste ambigüe, la réplique d'Aliyah apparait en substance et en tout cas révélatrice de préjugés xénophobes. Le cinéaste choisit ici de brosser le portrait d’un des groupes religieux les plus radicaux en matière de séparatisme racial, même si aujourd’hui la grande majorité des musulmans américains, qu’ils soient noirs, d’origine arabe ou asiatique, a rejoint le giron de l’islam sunnite. C'est aussi le plus hétérodoxe de tous les cultes islamiques implantés aux États- Unis. Contrairement à leurs coreligionnaires d'origine arabe, les Afro-Américains musulmans membres ou sympathisants de la NOI soutiennent la prévalence du marqueur racial sur le marqueur religieux et s'emploient à promouvoir la valeur de l'expérience islamique afro-américaine. C'est pourquoi Sherman Jackson, nouvelle figure intellectuelle afro-américaine, inaugure en 2005 le concept de Blackamerican (en un mot) pour distinguer les musulmans noirs de leurs coreligionnaires immigrés (2005). Il estime qu'aucun courant ne détient le monopole de la légitimité religieuse et que l’héritage afro-américain a autant de valeur que l’héritage proche ou moyen-oriental : « The false universals invoked by many immigrant and overseas Muslims […] exclude Blackamerican concerns and simply assume them to be subsumed under the models settled on in the Muslim world » (2009, p. 3).
7 Telle qu'elle est dépeinte dans la diégèse, la communauté musulmane afro-américaine défend donc une conception profondément essentialiste des clivages sociaux et pratique une forme d'ethnocentrisme hostile à toute population étrangère à la condition noire. Loin d’être caricaturale ou réductrice, la représentation effectuée de cette minorité montre un aspect peu connu de la réalité sociologique. 8 Plus importante par le nombre de ses fidèles, mais tout aussi ethniquement homogène, la congrégation catholique d’origine mexicaine, forme le second groupe religieux ébranlé par le meurtre de Matt Skokie. Ses représentants sont très pratiquants et respectueux des croyances propres à leur dénomination. Alonzo Guttièrez et ses enfants apparaissent dans plusieurs épisodes participant à la célébration d’une messe (voir figure 2).
Fig. 2 La famille Guttièrez à l’église
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9 Leur maison est décorée de symboles religieux ; un crucifix près de la porte d’entrée, la statuette d’un ange dans la chambre de Jenny, sœur aînée de Tony accusé d’avoir loué la voiture familiale au meurtrier présumé. L’église que fréquente la famille Guttièrez, où l’office est conduit en espagnol, est représentative des congrégations d’immigrés qui lasses de leur exclusion de la communauté catholique américaine se replient sur une forme de religiosité fidèle aux coutumes observées en territoire d’origine. Il a en effet été établi que les Latinos de confession catholique font face au rejet de leurs coreligionnaires américains, principalement à cause de leur attachement à la doctrine sociale du christianisme mais aussi parce qu’ils sont associés aux classes les plus défavorisées5. Il en résulte, comme le souligne Laurence Monroe, un sentiment « d'invisibilité » (2006, p. 211). De fait, alors que les musulmans noirs membres de la NOI prônent le séparatisme racial, les Latinos sont, malgré eux, relégués en marge du catholicisme américain.
10 Le dernier et le plus représenté par le nombre de ses adeptes (près d’une douzaine), le groupe des protestants est lui aussi très uniforme. Apparaissant à l'écran en train de prier au sein d’une assemblée constituée exclusivement de blancs, Tom et Eve Carlin, parents de Gwen, sont les plus dévots (voir figure 3)
Fig. 3 Eve et Tom Carlin à l’offce
11 A plusieurs reprises, ils font valoir leurs croyances et leur fidélité aux valeurs chrétiennes. Dans l’épisode 3, par exemple, Eve rappelle à son mari que l’institution du mariage est sacrée : « Vows are sacred, Tom ». Tom de son côté enjoint régulièrement les Skokie à prier pour leurs enfants victimes de l’agression, car les prières, il en est convaincu, sont toujours entendues : « Never let it be said prayers aren’t answered » (E03). Alors que les télévisions locales s'emparent de l'affaire, les parents de Gwen affichent leur méfiance vis-à-vis des médias et refusent toute interview. Cette attitude est, comme nous le rappelle Benjamin E. Park, spécialiste d'histoire religieuse, fréquente chez de nombreux protestants évangéliques qui considèrent que la presse et les médias diffusent une idéologie séculariste et hostile aux dogmes fondamentaux de l’Église protestante (2017). Cela dit, aucun des personnages n'est explicitement décrit comme membre d'une église évangélique, même si les Carlin, lors d'un échange avec Russ Skokie, se défendent d'être des fanatiques (« a pair of zealots »), une réaction que l'on pourrait interpréter comme un aveu en creux ou une prise de conscience en
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devenir (E02). Quoiqu'il en soit, l’univers de la série se présente, on le voit, comme le miroir d’une société profondément divisée où les institutions religieuses sont le reflet des antagonismes sociaux.
12 Toutefois, le scénario et l'univers diégétique sont enrichis par la présence d’autres personnages qui sont portés par des convictions bien différentes. Barb Skokie, interprétée par Felicity Huffman, n’est pas aussi pratiquante que ses coreligionnaires et fait montre d’un racisme évident. Son discours est lui aussi porteur d’une vision essentialiste. De manière répétée, elle désigne les membres de la communauté noire en utilisant l'expression condescendante « Those people » (E02). Dans l'épisode 3, elle refuse d’écouter une inspectrice noire chargée de l’enquête et demande à être entendue par un officier blanc. Mais surtout, alors que Barb se débat pour faire entendre sa version des faits, elle prend contact avec Nancy, présidente d’une association de défense des victimes, qui, face au juge, réclame que l’affaire soit considérée comme un hate crime, c'est-à-dire motivée, d’après elle, par la haine anti-blanc de Carter Nix. La mère de Matt rencontre aussi la responsable d’une association suprématiste qui, bien que Barb s’y oppose au début, finira par organiser une manifestation en son soutien et en faveur du séparatisme racial. Autour des protestants les plus pieux, gravitent ainsi des personnages issus de la classe moyenne blanche représentant un courant ultra- conservateur, et opposés aux mutations identitaires de l’Amérique ; ceux-là même que les chaînes de télévision montreront en août 2017 participant à de violentes manifestations dans les rues de Charlottesville en Virginie. 13 Du côté des catholiques, le cinéaste brosse parallèlement au portrait des Guttièrez, celui d’une famille de Mexicains-Américains dont les convictions sont là aussi plus politiques que spirituelles. L’oncle et la tante des enfants Guttièrez, installés aux États-Unis de longue date, ont abandonné leur héritage spirituel au profit d’un engagement militant. Oscar, beau-frère d’Alonzo, se déclare socialiste et œuvre pour la défense de la Raza qui traditionnellement désigne la communauté des Mexicains immigrés. C’est la solidarité ethnique et l’expérience commune du déracinement et du racisme que privilégie son argumentation. 14 Par conséquent, tous les personnages principaux de la série qu’ils soient croyants ou non-croyants sont associés à un groupe confessionnel et plus largement à une communauté culturelle, chacune participant à sa manière à la fragmentation sociale. La série American Crime se propose donc de restituer les rapports de force intercommunautaires et de rendre visibles les dynamiques à la fois centrifuges et cloisonnantes qui mettent en remous l'Amérique contemporaine. 15 Seulement, dès le premier épisode apparaît une exception à cette dynamique de cloisonnement. Il s'agit du couple mixte que forment Carter Nix et sa petite amie Aubry Taylor, jeune femme blanche toxicomane et instable ; un couple atypique autours duquel l'intrigue va progressivement se nouer (voir figure 4).
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Fig. 4 Le couple mixte formé par Aubry et Carter
16 Contrairement à leurs semblables, les deux amoureux rejettent tout lien confessionnel ou culturel et s’opposent avec la même vigueur aux convictions religieuses de leurs familles respectives. Lors d’une visite de sa sœur, Carter lui reproche de faire passer sa foi avant la solidarité familiale. Il lui rappelle que son nom de naissance est Doreen et non pas Aliyah et que les liens de sang sont plus forts. Alors que sa sœur lui demande de reconnaître le pouvoir d’Allah, Carter s’insurge : ALIYAH. « Why is that wrong to believe in something that’s bigger than yourself ? ». CARTER. « Because I don’t believe in that crap » (E03). De son côté, Aubry, adoptée très jeune par une famille aisée et croyante, refuse d’écouter les arguments de ses parents qui la supplient de mettre un terme à sa liaison « contre nature » et se libérer ainsi de l’influence du jeune Carter Nix, responsable à leurs yeux de la déchéance physique et morale de leur fille. A mesure que la série progresse, parce que l’identification du ou des coupables devient de plus en plus incertaine, les rancœurs et les frustrations atteignent un point culminant. Le jeune couple devient alors le noyau de cristallisation de toutes les tensions et suscite la condamnation unanime des deux communautés noire et blanche puisque d'après Ruth, mère adoptive de Aubry : « It's a bad mix » (E09). En conséquence, dans le dernier épisode, le téléspectateur assiste à la mise à mort violente et sacrificielle des deux amoureux. L’énigme policière n'est pas pour autant résolue mais le statu quo ante est rétabli et les personnages se retranchent dans la familiarité rassurante de leurs préjugés. Le couple que forment Carter et Aubry, à la manière de Roméo et Juliette, parce qu’il s’affranchit des codes traditionnels et des préjugés hérités incarne donc la subversion. Plus encore que le crime lui-même, l’histoire d’amour fait figure de séisme qui vient ébranler les clivages de race que semblent perpétuer les institutions religieuses. La série American Crime rend ainsi visible l’émergence d’une génération d’Américains moins réticents que leurs aînés à l’élimination des clivages sociaux de race. Ces forces montantes de la société américaine que le journaliste et politologue Ronald Brownstein a appelé the coalition of ascendants rassemblent ceux qu'il est convenu d'appeler collectivement les millennials dont les rangs sont composés en partie de jeunes intellectuels progressistes mais aussi de personnes issues des minorités sociales, sexuelles ou ethniques (cité dans The Women’s Club of Richmond, 2016). En outre, les enquêtes du PEW Research Center confirment que les millennials sont aussi plus
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nombreux à se détourner des lieux de culte : seuls 41% considèrent que la religion tient une part importante dans leur vie (Alper, 2015). Clairement, la fiction diégétique est ici riche de correspondances avec les faits du monde réel.
17 En dépit des manifestations œcuméniques dénonçant publiquement le racisme comme une idéologie condamnable, certains dignitaires religieux américains reconnaissent la responsabilité des institutions confessionnelles dans la perpétuation du racisme : « L’Église doit admettre qu’elle a fait partie du problème raciste aux États-Unis » (cité dans Buisson, 2017), a par exemple indiqué le prêtre afro-américain Stephen Thorne, membre du National Black Catholic Congress, plus grande organisation de catholiques noirs dans le pays. Toutefois, la fiction policière n'a pas pour seul objectif de montrer la résurgence des vieux démons racistes et xénophobes. La crise que provoque le meurtre de Matt Skokie est aussi l'occasion d'évaluer le rôle tenu par les organisations confessionnelles et révèle le poids de l’hétéronomie religieuse dans le comportement des personnages.
Les communautés religieuses face à la crise
18 Le lecteur aura maintenant compris que l’affaire criminelle qui ouvre la narration n’est en fin de compte qu’un prétexte pour proposer une analyse de l’intersectionalité des divisions sociales. Les institutions religieuses, nous l’avons vu, ont selon le cinéaste une part de responsabilité. Mais qu’advient-il de leur influence lorsque les fidèles sont impliqués, de près ou de loin, dans une affaire de meurtre ?
19 Il a été déjà observé que le groupe de musulmans représenté à l’écran incarne la cohorte la plus radicale de l’islam américain. Estimant que son frère est victime d’un système juridique raciste, Aliyah ne tarde pas à mobiliser les fidèles de la mosquée. Dès l’épisode 2, un avocat issu de la NOI prend en charge le dossier et se révèle particulièrement adroit lors des convocations devant le juge. Dans l’épisode 3, Aliyah décide d’organiser une manifestation pour demander l’acquittement de Carter. A cette occasion, John Ridley nous montre une communauté parfaitement structurée et capable de rassembler en quelques heures via les réseaux sociaux un grand nombre de participants. Le téléspectateur attentif remarque dans le défilé des figurants qui brandissent une pancarte faisant référence au meurtre de Trayvon Martin (« Don't forget Trayvon »), jeune adolescent noir abattu en 2012 par un ex-policier en Floride. Dans cette séquence, le cinéaste évoque le drame qui avait à l’époque déclenché une vague de contestation dans la population afro-américaine et avivé plus encore les tensions raciales ; des événements qui, selon les déclarations de John Ridley, ont constitué l’amorce au processus d’écriture du scénario (cité dans Vlessing, 2017). Si les manifestants dans la scène sont visiblement membres de la NOI, on peut y voir aussi une représentation du mouvement militant afro-américain de Black Lives Matter né précisément suite au meurtre de Trayvon Martin, en particulier lorsque dans cette séquence l’un des manifestants se dirige vers un policier pour lui demander : “Are you gonna shoot me too because I'm black ?” (voir figure 5)
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Fig. 5 Manifestation de soutien à Carter Nix
20 Le portrait effectué de la communauté musulmane afro-américaine et l’attitude observée collectivement par ses membres rendent manifeste l'éclosion de mouvements alternatifs plus radicaux au sein de la communauté noire. Ce renouveau du militantisme afro-américain se caractérise, comme l’a démontré Audrey Célestine chercheuse à l’université de Lille 3, par la mobilisation d’acteurs et d’actrices préalablement exclus (2016). Aliyah, femme noire et musulmane, y a donc toute sa place. L’enlisement de l'enquête policière et l'inculpation de Carter Nix provoquent par conséquent la mobilisation politique de la congrégation musulmane afro-américaine ; un soulèvement qui dans l'esprit d'Aliyah témoigne de la persistance du nationalisme noir tel qu'il avait été conçu en 1930 par Wallace Fard Muhammad fondateur de la Nation of Islam.
21 Chez les catholiques, l’assemblée des fidèles suit avec désapprobation les démêlés de Tony Guttièrez avec la justice. Les reproches deviennent plus vifs lorsque son père met en cause les Hispaniques entrés illégalement sur le territoire. Offensés, les paroissiens exigent la mise à l’écart de la famille Guttièrez. C’est le prêtre de la paroisse lui-même qui vient exprimer la requête de ses ouailles auprès d’Alonzo. Il serait plus sage, selon lui, qu'Alonzo et les siens n'assistent plus à la messe dominicale. Par le biais de cet échange, le cinéaste nous donne à entendre deux types de discours face à l’expérience migratoire. Alonzo, père célibataire et propriétaire d’un petit atelier de mécanique, se présente comme l'archétype de l'immigré modèle. Courageux, dévot et assumant totalement son ambition d’intégrer la classe moyenne, il croit au rêve américain et fait porter aux clandestins la responsabilité de la mauvaise réputation donnée collectivement aux Mexicains-Américains : « Those make the rest of us look bad » (E03). Son désir d'intégration est tel que sa propre fille, adolescente et réfractaire aux règles paternelles, lui reproche de trahir la communauté et d'adopter trop facilement les coutumes majoritaires au point d'en oublier ses origines : « You wish you were white » (E02). Le prêtre, au contraire, plaide pour la défense des réfugiés et rappelle que les paroissiens se sont engagés pour leur offrir le sanctuaire. John Ridley fait ici allusion au Sanctuary Movement qui à partir des années 1980 a incité de nombreuses congrégations religieuses à dénoncer les législations locales ou fédérales en direction des clandestins originaires d’Amérique Latine. Depuis, des centaines de paroisses
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catholiques et hispaniques invoquent la tradition chrétienne du sanctuaire pour perpétuer cette forme de désobéissance civile6. Au final, la série montre à l'écran une congrégation religieuse soucieuse de préserver son unité autant que ses valeurs ; cette tentation isolationniste résultant, nous l'avons évoqué, du rejet de l’Église catholique américaine, mais procédant aussi des menaces de stigmatisation encourues à chaque fois que l'un des membres du groupe attire l'attention de l'opinion publique. 22 Parallèlement aux répercussions de l'affaire criminelle sur les communautés musulmane et catholique, les concepteurs de la série nous donnent à voir comment les protagonistes de culture protestante, pratiquants ou non-pratiquants, réévaluent les fondements religieux de leurs comportements ou, comme le résume dans une interview télévisée W. Earl Brown qui interprète Tom Carlin : « [how] their foundations are being torn one brick at a time » (2015). 23 Au cours de l'enquête, Tom et Eve Carlin découvrent avec stupeur que l'éducation morale et religieuse prodiguée à leur fille Gwen n'a pas porté ses fruits. Ils apprennent qu'avant l'agression, Gwen avait un mode de vie plutôt dissolu et que de surcroît elle n'a pas respecté l'engagement de fidélité pris devant Dieu lors de son mariage. Les investigations révèlent aussi que Matt Skokie présenté par sa mère comme un fils exemplaire, un bon soldat et un mari irréprochable est dans les faits un homme violent, profondément raciste, consommateur et trafiquant de drogues. En outre, on découvre que son engagement dans l'armée après les attentats du 11 septembre n'est pas en vérité le résultat d'un élan patriotique, mais plutôt d'une sommation de Barb, soucieuse de l'équilibre psychologique de son fils. On le voit, l'affaire provoque inéluctablement la tombée des masques. A mesure que la série progresse, c'est l'image idéalisée d’une société mainstream, blanche et protestante qui s'écroule. 24 Seulement, la pression conformiste de la culture religieuse dominante n'en est pas pour autant moins forte. Elle est notamment mise en évidence dans l'épisode 2, lors d'un échange entre Russ Skokie et Tom Carlin. Dans les couloirs de l'hôpital où Gwen poursuit sa convalescence, Russ interroge Tom sur le style de vie des deux victimes, mais il lui demande de ne pas donner la réponse que la morale exige : “Please don't just say what you think you are supposed to say. I'm really asking”. En réponse Tom finit par admettre : “They weren't perfect. Nobody is”. (E02). L'exégèse biblique traditionnelle est par ailleurs discréditée avec sarcasme par Barb Skokie. Dans l'épisode 4, un désaccord éclate entre les parents des deux victimes. Barb, contrairement à Eve, considère qu'il faut continuer de se battre pour obtenir la condamnation de Carter Nix. A la fin de la séquence, elle se tourne vers la mère de Gwen pour la mettre face à ses contradictions : « ‘An eye for an eye’. Isn't that right Eve ? ». Une autre scène révélatrice de la rupture entre le discours ecclésiastique et les attentes des personnages est celle où, dans l'épisode 3, Eve se rend au temple pour consulter le pasteur. Elle lui confie que sa fille Gwen est amnésique depuis son agression et qu'elle n'a aucun souvenir de ses errements passés : EVE. « She can't remember her husband, the drugs, the other men she was spleeping with ». PASTEUR. « Your daughter getting better is what's important. Not those other things » ; EVE. « But if we don't tell Gwen the truth, are we just living lies all over again ? ». PASTEUR. « You do have your daughter back. Start with that ». La caméra fait alors un plan serré sur le visage d'Eve qui reste muette, visiblement déçue de la réponse donnée à son appel (voir figure 6).
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Fig. 6 Eve Carlin déçue par les conseils du pasteur
25 John Ridley nous invite donc à une réflexion sur la responsabilité des autorités confessionnelles mais livre aussi une critique sévère du conformisme social qui impose aux individus des comportements stéréotypés particulièrement contraignants voire dommageables en situation de crise.
Conclusion
26 Le projet du cinéaste, que l'on pourrait en fin de compte qualifier de naturaliste tant il relève d'un travail de documentation, porte autant sur la fragmentation des identités culturelles et politiques que sur la persistance de discriminations systémiques. Exploitant de manière adroite le moteur narratif appelé « effet de Rashomon »7, le cinéaste parvient à multiplier les angles d'analyse pour rendre compte d'une réalité particulièrement complexe où les héritages culturels s'opposent et où l’histoire pèse de tout son poids. Mais surtout la création de John Ridley interroge la prééminence du religieux dans les rapports entre les différents groupes qui composent la mosaïque ethno-culturelle américaine. Subissant les effets d'un meurtre venant ébranler l'ordre social, les groupes confessionnels sont travaillés par des dynamiques croisées qui induisent, d'un côté le repli communautaire et, de l'autre, fragilisent la pérennité de la culture dominante. Si l'univers diégétique sériel est le reflet du monde réel, alors le mythe d'une société post-raciale apparue après la victoire de Barack Obama semble définitivement brisé.
27 Malgré les nombreuses récompenses que la série et certains de ses acteurs ont obtenues, (notamment Regina King qui interprète Aliyah) la chaîne ABC prend la décision en mai 2017 de mettre un terme à l'anthologie de John Ridley au bout de trois saisons8. On peut supposer que les sujets abordés dans les volets suivants -viol homosexuel puis esclavage moderne- ont contribué à détourner les spectateurs d'ABC9. Le ton toujours grave et dramatique y est peut être aussi pour quelque chose. En tout état de cause, la dernière séquence de l'ultime saison revêt une portée politique évidente. Alors que tous les personnages principaux de la saison 3, vivants ou défunts mais comme ressuscités, se tiennent debout dans une salle de tribunal, leurs regards
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braqués sur le prétoire et face caméra, le téléspectateur se demande s’il n’est pas là devant la représentation métaphorique d'une demande de justice collective adressée par les victimes et les coupables aux institutions du pouvoir (voir figure 7).
Fig. 7 Les personnages, victimes défuntes, de la saison 3 face au juge et au téléspectateur.
28 La série s’achève sur une dernière phrase éclairante prononcée par le juge : « We are here today with the purpose of seeing that justice is done. And done for all » (E08). Il en ressort que le titre de l'anthologie, American Crime, peut être lu autant comme la volonté de dresser une typologie du crime, que comme la dénonciation du caractère résolument criminogène de la hiérarchisation sociale qui divise l'Amérique d'aujourd'hui.
BIBLIOGRAPHIE
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Attali, Maureen. ‘Fondamentalisme religieux et féminité démoniaque : réflexions autour du personnage de Lilith dasn True Blood’ in TV/Series, 11 mai 2014. https:// journals.openedition.org/tvseries/439
Berho, Deborah. ‘Anglo and Spanish-speaking Church Relationships: A Brief History and an Oregon Case Study’ in Digital Commons @ George Fox University, 2010. http:// digitalcommons.georgefox.edu/lang_fac/6
Brown, Earl, W. ‘American Crime! The cast talks about the new show!’ in TV Guide Magazine, 3 mars 2015. https://www.youtube.com/watch?v=oKT6FUG-vvY
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Buisson, Alexis. ‘Après Charlottesville, l’Église américaine se mobilise contre le racisme’ in La Croix, septembre 2017. https://www.la-croix.com/Religion/Charlottesville-lEglise-americaine- mobilise-contre-racisme-2017-09-
Célestine, Audrey, et Nicolas Martin-Breteau. 2016. ‘Un mouvement, pas un moment : Black Lives Matter et la reconfiguration des luttes minoritaires à l’ère Obama’ in Politique américaine, vol. 28, no. 2, pp. 15-39.
Esquenazi, Jean-Pierre. 2014. Les Séries télévisées : l'avenir du cinéma ? (Paris : Armand Colin)
Glevarec, Hervé. ‘Trouble dans la fiction. Effets de réel dans les séries télévisées contemporaines et post-télévision’ in Questions de communication. 18 | 2010. décembre 2012. http:// questionsdecommunication.revues.org/405
Jackson, Sherman. 2005. Islam and the Blackamerican : Looking Toward The Third Resurrection (New York: OUP)
Jackson, Sherman. 2009. Islam and the Problem of Black Suffering (New York: OUP)
Lowry, Brian. ‘American Crime Finale Brings Sobering Close to Brilliant Second Season’ in Variety, 9 mars 2016. http://variety.com/2016/tv/columns/american-crime-season-two-finale-review- felicity-huffman-john-ridley-1201724816/
Luther, King Martin. ‘On NBC’s Meet the Press (1965)’. Archives NBC News. 13 janvier 2012. https:// www.youtube.com/watch?v=fAtsAwGreyE
Monroe, Laurence. 2006. ‘Les Hispaniques défient l'Eglise américaine’ in Études, tome 404,(2). https://www.cairn.info/revue-etudes-2006-2-page-211.htm.
Nededog, Jethro. ‘18 TV shows you’re watching that are probably going to be canceled’ in Business Insiders, 10 avril 2017. https://www.businessinsider.fr/us/tv-shows-getting-canceled-2017-4.
Park, Benjamin E. ‘The Democratic Lineage of Trump’s Ethnic Nationalism’ in Professor Park’s Blog, 13 avril 2017. http://www.professorpark.wordpress.com
Pirie, Sophie. ‘The Origins of a Political Trial: The Sanctuary Movement and Political Justice’ in Yale Journal of law & the Humanities, vol.2, Iss. 2, Article 7. 25 mars 2013. http:// digitalcommons.law.yale.edu/yjlh/vol2/iss2/7
Stanley, Alessandra. ‘Review: American Crime, a Series Where Justice Is Far From Black or White’ in The New York Times. 4 mars 2015. https://www.nytimes.com/2015/03/05/arts/television/ review-american-crime-a-series-where-justice-is-far-from-black-or-white.html
Stuever, Hank. ‘Review: ‘American Crime’ is the rare network drama that will get your rapt attention’ in The Washington Post, 4 mars 2015. https://www.washingtonpost.com/entertainment/ tv/american-crime-is-the-rare-network-drama-that-will-get-your-rapt-attention/2015/03/04/ bb84cbdc-c28c-11e4-9ec2-b418f57a4a99_story.html?noredirect=on&utm_term=.c4b46623153a
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Vlessing, Etan. ‘John Ridley Talks About Tackling Race With ‘American Crime’ Anthology’ in The Hollywood Reporter. 13 juin 2017. https://www.hollywoodreporter.com
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NOTES
1. 12 Years a Slave est une adaptation de la biographie éponyme de Solomon Northup (Mars Films, 2013). 2. L’expression est d’Hervé Glevarec, « Trouble dans la fiction. Effets de réel dans les séries télévisées contemporaines et post-télévision », Questions de communication [En ligne], 18 | 2010, mis en ligne le 01 décembre 2012, consulté le 30 mars 2018. URL : http://questionsdecommunication.revues.org/405 3. Voir le numéro 5 de la revue électronique TV/Series (http://journals.openedtion.org/ tvseries/433), 2014. 4. Voir l’interview sur “On NBC’s Meet the Press (1965)” |Archives| NBC News, https:// www.youtube.com 5. Voir par exemple Deborah Berho, « Anglo and Spanish-speaking Church Relationships: A Brief History and an Oregon Case Study”, Digital Commons @ George Fox University, http:// digitalcommons.georgefox.edu/lang_fac/6, mis en ligne 2010. Page consultée le 8 avril 2018. 6. Pour une étude approfondie, voir par exemple Sophie Pirie, “The Origins of a Political Trial: The Sanctuary Movement and Political Justice”, Yale Journal of law & the Humanities, vol.2, Iss. 2, Article 7, http://digitalcommons.law.yale.edu/yjlh/vol2/iss2/7, mis en ligne le 25/03/13. Page consultée le 5 avril 2018. 7. « L’effet Rashomon » désigne le procédé par lequel l'histoire est racontée suivant des points de vue différents. L'expression fait référence au film éponyme de Akira Kurosawa (Daiei MPC, 1950). 8. La saison 1 d’American Crime a reçu un total de 23 nominations, un Emmy Awards (Regina King) en 2015, un Satellite Award attribué à l’ensemble des acteurs, ainsi que le prix du meilleur réalisateur décerné à John Ridley au 47ème NAACP Image Award en 2016. 9. C’est en tout cas l’opinion exprimé par le journaliste et critique Jethro Nededog dans les colonnes du média économique Business Insiders, « 18 TV shows you’re watching that are probably going to be canceled », https://www.businessinsider.fr/us/tv-shows-getting-canceled-2017-4, mis en ligne le 10 avril 2017. Page consultée le 6 décembre 2018.
RÉSUMÉS
Si l’univers diégétique de nombreuses séries touche les faits du monde, d’autres constituent une préfiguration des développements à venir. La saison 1 de la série American Crime offre à la fois une critique sociologique de l’Amérique contemporaine et une évocation prémonitoire du contexte dans lequel viendront s’inscrire la campagne présidentielle de Donald Trump et son accession au pouvoir. Par le biais d’une analyse de la représentation des rapports entre religiosité et conflictualité sociale, cet article met en évidence le témoignage du cinéaste afro-américain John Ridley sur la responsabilité des institutions religieuses et sur le caractère criminogène de la hiérarchisation sociale telle qu’elle est aujourd’hui structurée aux États-Unis.
If in many television series the diegetic world intersects with the realm of reality, others may offer a glimpse of future developments. John Ridley’s American Crime (season 1) offers both a sociological study of contemporary America and a premonitory insight into the aftermath of
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Donald Trump’s election to the White House. By focusing on the relationships between faith and social conflict, this article seeks to examine the fictional representation of religious institutions and to highlight the political intentionality behind Ridley’s portrayal of social hierarchy as it presently exists in the US.
INDEX
Mots-clés : American Crime, racisme, hétéronomie religieuse, identité culturelle Keywords : American Crime, racism, religious heteronomy, cultural identity
AUTEUR
DOMINIQUE CADINOT
Laboratoire d’Etudes du Monde Anglophone (LERMA), Aix-Marseille Université
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