The political fight that has broken out in the US about funding for contraception must seem to Europeans both shocking and at the same time quintessentially American. It is both, but at the same time it is part of a global trend in several respects: as an expression of wrath at the radical transformation of the gender system, and as a form of moral panic 1 in which extremist views escalate themselves in a dangerous rising spiral of fanatical beliefs. It contains also elements of racism and of corporate exploitation and incitement of hysterical intolerance – to the extent that many old-fashioned conservatives wish it would go away.
American controversies about reproduction control go back at least 175 years, when the many states of the USA began to criminalize abortion. At the time, abortion was the main method of reproduction control in use and it had traditionally been treated as a regrettable necessity. In most of the world and in almost all religions, abortion before “quickening” – the moment when a pregnant woman could feel a fetus stir – was a respectable, traditional practice.
The first anti-abortion campaign, at its peak in the 1870s, was led by Protestant ministers in both US and Europe; Catholic priests were then the followers, not the leaders, of this reform. At this time people made little if any distinction between abortion and contraception, and opponents condemned any attempts to control reproduction except through sexual abstinence. Their arguments did not focus on protecting fetuses, as they do today, but on the dangers of allowing women to evade their allegedly God-and-Nature-ordained role as mothers. The anti-abortion movement was in large part a backlash, a fearful response to changing possibilities and aspirations among women. 2 Industry had brought many poor women into factory employment, which in turn increased their independence. More privileged women were clamoring for education and were venturing into public political debate, particularly in the anti-slavery movement. In 1848 the first women’s-rights advocates issued the famed Seneca Falls Declaration of Sentiments, which, cleverly, copied the US Declaration of Independence – thus the very form and voice of the document was threatening. Moreover it was sharply critical of men. In it the signers accused men of withholding, usurping, and monopolizing rights that should belong to women: “because women do feel themselves aggrieved, oppressed, and fraudulently deprived of their most sacred rights, we insist that they have immediate admission to all the rights and privileges which belong to them as citizens of the United States.”
At the same time “regular” or allopathic physicians had their own reasons for joining the anti-abortion campaign. Abortions had been traditionally performed by midwives or practitioners of traditional healing and obstetrics, and physicians used the campaign to render them disreputable and to establish their own control over obstetrics. 3
The peak victory of this movement came in 1873 when, for the first time, federal legislation outlawed all reproduction control practices throughout the USA, labeling them obscene. Abortion did not disappear, of course, but went underground. Moreover a class double standard became more visible: prosperous women who could command the services of private physicians could persuade them to perform legal abortions in the guise of treatments for medical problems, with privacy and impunity.
By the end of the 19th century the birth-control situation changed, at both supply and demand ends of the market. Contraceptive cervical pessaries and vaginal diaphragms were being distributed in some European clinics, and wealthy Americans traveled there to get them. Others smuggled them into the USA. Meanwhile urbanization, the need to educate children, and the increasing employment of women intensified the need for smaller families. Shortly before World War I, a large social movement for birth control developed, with organized groups in cities and towns throughout the country demanding the legalization of birth control. Gradually a new distinction allowed the creation of a compromise: distinguishing contraception from abortion, the movement pushed for legalization of the former while accepted the continued prohibition on the latter. State after state decriminalized contraception. This did not happen easily, and the Catholic Church refused the compromise and continued to ban contraception; the last state to legalize contraception – Massachusetts, a state with significant Catholic political power – did not end the prohibition until 1965.
Despite the laggard states, by at least 1930 most Americans considered legal contraception a permanent fixture of modern society. Moreover, by the 1960s, a new coalition was pushing for abortion rights as well. Civil libertarians and physicians in particular argued that prohibiting abortion was a violation of individual freedom and of independent medical discretion. They were responding to increased pressure from women, especially those for whom contraception had failed. In response, during the 1940s and 1950s hospitals were establishing abortion review boards to grant medical exemptions from the prohibition and thereby to take the pressure off individual doctors. 4 In 1962 an epidemic of rubella (which can cause deformities in fetuses) increased popular demand for abortion. In the same year the case of Sherri Finkbine, a TV actress, became an international cause célèbre: having taken the drug thalidomide, she learned that she was likely carrying a deformed fetus; denied an abortion in Arizona she flew to Sweden to get it done.
These influences led to a wave of state legislation repealing or liberalizing their anti-abortion laws. Eighteen states had done so by the time the US Supreme Court found that bans on abortion were unconstitutional in 1973, in Roe v. Wade. At this time the issue seemed settled. In the legalization of abortion it was unnecessary even to mention the now established consensus on contraception as not only standard practice, but one that responsible sexual partners were expected to use.
Enter the women’s movement
What has happened in the ensuing forty years is a fascinating historical example of how political cultures change the meanings of common practices. The women’s liberation movement took up the cause of reproductive rights. This new identification produced a virulent backlash, expressing intense anxieties about gender transformation, then exploited by a renascent conservatism.
Feminists were not the major actors in legalizing abortion but they became its standard bearers. Previously abortion and contraception were treated in public discourse primarily as marital economic and social strategies for smaller families, which had become the national ideal. The New Left, of which the women’s liberation movement was a part, began to popularize the notion that birth control was also a matter of sexual rights, rights not confined to marriage. In actuality, there was not that much more non-marital sexual activity during the 1960s and 1970s, but it became more open; the young were no longer hiding their sexual affairs. For feminists in particular sexual rights meant claiming equality with men.
The Catholic Church had begun an anti-abortion campaign – the second in US history – in the 1960s, as soon as states began legalizing abortion. But even the Church hierarchy found it politically impossible to argue openly that women should not defy their “destiny” as mothers of innumerable children, or that spouses should limit their sexual activity to times when they wished to conceive. The society was simply too modern for that kind of discourse to be acceptable. In a brilliant form of spin, the issue got reframed as one of protecting embryos and fetuses. The greatest achievement of the anti-abortion campaign was the invention of the “Right-to-Life” slogan. I do not mean to suggest that people who oppose abortion because they consider it a form of murder are insincere. But by avoiding explicit disapproval of women’s employment, higher education, political activity, etc., the movement could harness anxieties about gender change to a discourse that featured helpless “unborn children.” The movement quickly gained support from a new revivalism among evangelical Protestants.
Then the anti-abortion campaign was consciously and quite cynically exploited by a “New Right” conservative strategy. The strategy was to break the Democratic Party electoral majority through de-emphasizing traditional Republican issues – conservative economic policy and anti-Communism – and focusing on “social” issues including race but primarily gender and sexual matters, including sex education, out-of-wedlock pregnancy, and birth control. Prior to 1976 these strategists rarely mentioned abortion. 5 Afterward they threw enormous resources into the anti-abortion movement. Their successes were great: hedging in abortion by a variety of burdensome restrictions and, most effectively, prohibiting the use of public funds for abortion and drastically reducing the number of abortion providers. The last phenomenon was the direct result of a true moral panic that the anti-abortion campaign built quite consciously. The American coalition of Life Activists circulated “Wanted” posters – mimicking official police placards identifying suspected criminals – with the photographs and, often, home addresses of physicians who performed abortions, identifying them as “war criminals” and, recalling the Nuremberg laws, guilty of “crimes against humanity.” 6 These resulted in a terrifying wave of violence against abortion personnel. From 1977 through 2001, assailants in this campaign murdered three doctors, two clinic employees, one clinic escort and one security guard; attempted 71 other murders; executed 41 bombings, 165 arson attacks, 82 attempted bombings and 372 clinic invasions; caused $8.5 million in damage. 7 This was enough to drive even staunch supporters of reproductive rights out of the practice and those who remained were heroes indeed. (However, “Operation Save America” has begun posting “Wanted” placards again in North Carolina. 8)
Public revulsion brought this violence to an end, happily. Pressure against abortion continued unabated, however, and in the new century came to focus particularly on Planned Parenthood.
Obama and Economic Depression
The current attack on contraception and Planned Parenthood cannot be understood without registering that it is a part of a general conservative attack detonated by rage at the election of Barack Obama. Just as no one predicted the backlash against Roe v. Wade, no one predicted the virulence of the hatred for Obama. Much of it is racial, compounded by his rational, considered, intellectual style – an aspect of long-standing American anti-intellectualism. With a moral panic escalating since his election in 2008, even traditionally Right-wing Republicans are shocked and nervous about the excesses of the “tea party” movement and its extremism.
Journalists have covered the tea-party movement extensively – indeed, excessively, for media coverage has both exaggerated its size and helped to expand it. Probably beginning as a grassroots explosion of fury toward related enemies – secularism, multi-culturalism, liberalism, regulation, “big government” – it was quickly seized, funded and controlled from the top, much as the original anti-abortion movement had been. Contrary to some popular views that imagine it a movement of “have-nots,” its average member is a wealthy, well educated white man over 45. 9 It has been the beneficiary of multi-million-dollar donations, notably from the extremely conservative billionaire brothers David and Charles Koch through various PACs (political action groups). This right-wing populism is an American tradition: using populism “little guy” rhetoric to advance economic policy that redistributes wealth upward to the very rich. The $ millions went into election campaigns and moved the Congress further to the Right.
Immediately after the 2008 financial collapse, the general public condemned the financial establishment, and identified them as predators who profited obscenely at the expense of the rest of us. The tea-party movement has fought to reverse that identification, charging that it is taxes (rather low and extremely regressive in the US as compared to those in European countries) that are responsible for poverty and unemployment; and that the “predators” are government employees (such as schoolteachers and social workers) and unionized workers who are responsible for these high taxes. In other words, just as Obama made mild efforts to stimulate the economy and reduce unemployment and the loss of homes to banks, he was confronted by a Congress determined to obstruct anything he proposed.
The assault on Planned Parenthood was integrated into the overall attack on big government, but this too was a cooptation of a much earlier initiative. It began decades ago as part of the anti-abortion movement, which also included opposition to sex education, the ERA, etc. It remained coded as anti-abortion until a decade ago – although those who watched it closely saw that it contained a strong anti-contraception stream from the beginning. At the federal level the current attack has focused on Title X of the Family Planning Services and Population Research act of 1970, passed under President Nixon. (The conservatives of that era, such as Nixon, Goldwater, etc., are now liberals when compared to today’s Republican Congress.) Title X funded birth-control clinics provide gynecological health services and birth control, but were always prohibited from using public funds for abortion. The most visible of these clinics are operated by Planned Parenthood, a descendant of the early 20th-century campaign to legalize contraception. Anti-abortion groups argue that providing any funds to such clinics frees up other, private, money for abortions. They have fought at both state and federal level, in three ways:
- to require elaborate separation of abortion from birth control services–such as requiring separate buildings;
- to defund the clinics altogether;
- and, most recently, to stop the new public medical insurance program and specifically to allow insurance companies not to pay for contraception and allow medical workers and pharmacists not to provide it.
It is important to note that today’s opponents of contraceptive services also oppose the entire medical-insurance program. Ironically, the new medical insurance program will reduce access to abortion because it includes millions more in publicly-funded health insurance which is not allowed to pay for abortions. (As I write, Americans are waiting for the extremely conservative Supreme Court to respond to tea-party and big-business claims that the whole medical-insurance program is unconstitutional.)
Some supporters of these initiatives rely on anti-big government, anti-tax rhetoric, arguing “why should we pay for other people’s birth control?”. Some rely on a claim that it would violate religious freedom to make contraception a required service. Some rely on explicitly misogynist rhetoric, assuming that married women should not need birth control and that unmarried women who want it are “sluts”. Some depend on the old claim that birth control creates sexual immorality. Planned Parenthood was “stung” by traps set up to prove that it supported immorality: its opponents sent people to the clinics asking for help under false pretenses – pretending to be pimps wanting abortions for child prostitutes, racists seeking to earmark donations for black women to abort. Some of Planned Parenthood’s approximately 27,000 workers, taken in by the deceptions, offered to help, thus embarrassing the organization (the unfortunate few who responded helpfully were fired).
The USA has a legacy of African American suspicion of birth control because some in the early-20th-century campaign for contraception garnered support from eugenists. For decades the Right has mounted a misleading use of that suspicion by claiming that abortion or birth control in general is a racist plot. There are billboards in black and Latina neighborhoods, showing images of babies or tots, with the accompanying text, “The most dangerous place for an African American baby is in the womb.” [“El lugar mas peligroso para un latino es el vientre de su madre.”] In fact, the vast majority of African-American women support and use contraception, as do all progressive and anti-racist African-American politicians and organizations.
Moreover, African-Americans and Latinas use abortion proportionally more than white Americans. The reasons are their disproportionate lack of access to contraception, worse health overall, victimization by sexual violence, and poverty and lack of resources to support children.
The current situation
As often happens when much of the action has hinged on complex legislative and legal maneuvers, often hidden inside irrelevant bills, it took some time for these extreme anti-contraception positions to become legible to a mass public. Now that they have, a mass defense of Planned Parenthood and contraception has arisen, labeling the Republican campaign a “war against women.”
Let me review briefly what these publicly-funded clinics do. There are about 7,000 in the US, and they serve approximately 6.6 million women annually, primarily the very poor. One-quarter of all poor women who get birth control get it at one of these clinics and for many, they are the first entry point into any adult health care. At most clinics, initial visits are free and fees for further services depend on income – for the poor, typically $20. The majority of clinics provide women with postpartum and prenatal care, well-baby care, immunizations, and physical exams. More than 40 percent provide primary health care and many also provide genetic screening, mammograms, infertility counseling and mental health care. Approximately three percent of Planned Parenthood clinic resources go to abortions. Planned Parenthood claims that its services avoided 973,000 unplanned pregnancies in 2008 alone, which prevented many abortions – figures based on their studies of typical consequences of unprotected sex. 10
These clinics are usually the only source of reproductive health care for the most marginalized groups: drug abusers, prison inmates, the disabled and the homeless. Moreover they serve men as well as women, providing HIV testing and referrals, safe sex instruction, and prostate and testicular cancer screening. 11
Although the Supreme Court is not ruling on funding for Planned Parenthood’s birth-control clinics, its decision regarding the medical insurance law will exert great impact on the fight about contraception. Adding fuel to the already-hot fire, the Obama administration recently ruled that if religious institutions do not want to fund contraception in their insurance plans for employees, the insurance companies much independently offer those employees to provide it. Many Americans imagine that the court – that probably stole the presidential election from Al Gore in 2000 – would not risk its legitimacy by overturning such a widely supported program and condemning tens of millions to remain without the ability to pay for medical care. But the majority of the nine judges are deeply ideological conservatives and dependent on the right-wing sponsors who put them in power. If they do reject the Obama health care plan, they will embolden those who deny that health care, reproduction control and sexual freedom are human rights. Even in that eventuality, however, birth control and abortion will not go away. They are necessities for men and women alike; the vast majority understands that the way to reduce abortion is through contraception; and no one in the USA will accept the notion that people should engage in sex only when they want to have babies.
- Stanley Cohen, the creator of the term, defined it as a response to a threat to prevailing social or cultural values, started by those he labels “moral entrepreneurs”; Folk Devils and Moral Panics (1972). Stuart Hall theorized that moral panics were often ignited by these entrepreneurs to create the illusion of a crisis which could then evoke public support for heavier policing; Policing the Crisis: Mugging, the State, and Law and Order (1978). ↩
- Linda Gordon, The Moral Property of Women: A History of Birth Control Politics in America (Chicago; University of Illinois Press, 2002). ↩
- James Mohr, Abortion in America (New York: Oxford University Press, 1978), chapter 6. ↩
- Leslie Reagan, When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867–1973 (Berkeley: University of California Press, 1997). ↩
- Gary Clabaugh does not mention abortion in his Thunder on the Right: The Protestant Fundamentalists (Burnham 1974). Tim and Beverly LaHaye, who became leading spokespeople for anti-feminism, were tolerant of abortion in their The Act of Marriage(Zondervan 1976). Thanks to Allen Hunter’s research on this point. ↩
- Eugene Volokh, UCLA School of Law, “Menacing Speech, Today and During the Civil Rights Movement,” Wall Street Journal, April 3, 2001, on line at http://www2.law.ucla.edu/volokh/nurember.htm, accessed 3.30.12. A 9th Circuit Court of Appeals decision finally shut the site down in 2002 after a prolonged debate. The Nuremberg Files case, which is officially titled Planned Parenthood v. American Coalition of Life Activists, is available online at http://laws.findlaw.com/9th/9935320.html. ↩
- Data from National Abortion Foundation, available at http://www.prochoice.org/about abortion/violence/violence statistics.html, accessed 3.30.12. ↩
- http://videocafe.crooksandliars.com/david/abortion-docs-say-wanted-posters-are-bait-th, accessed 3.30.12. ↩
- NYTimes/CBS poll of April 2010 on line at http://documents.nytimes.com/new-york-timescbs-news-poll-national-survey-of-tea-party-supporters?ref=politics, accessed 3.30.12. ↩
- Susan Cohen, loc. Cit. ↩
- Jennifer Frost and Michele Bolzan, “The Provision of Public Sector Services by Family Planning Agencies,” Family Planning Perspectives, 29 #1, Jan./Feb. 1997, online at http://www.guttmacher.org/pubs/journals/2900697.html; Susan Cohen, “The Numbers Tell the Story,” in Guttmacher Policy Review, 14 #2, spring 2011, online athttp://www.guttmacher.org/pubs/gpr/14/2/gpr140220.html. ↩