By Cynthia L. Cooper
Wednesday, January 23, 2013
The role of doctors in upholding Roe v. Wade over the past 40 years includes millions of procedures, key court battles and withstanding threats of violent attack. After all that, in the face of mounting abortion restrictions, one doctor says "we have to fight this state by state."
Credit: American Life League on Flickr, under Creative Commons (CC BY-NC-ND 2.0).
NEW YORK (WOMENSENEWS)-- Dr. Curtis Boyd remembers the day when Roe v. Wade, the Supreme Court decision that turns 40 this week, was decided.
After graduating from medical school in 1965, he risked skirting the law by providing abortions to women referred to him by a clergy consultation network in the Southwest.
"I was ecstatic and had tears in my eyes at the same time. I thought: 'It's over, it's finally over,'" said Boyd. "Of course, it was just beginning."
This month, people across the country have been finding all sorts of ways to commemorate the 40th anniversary of Roe, the 1973 Supreme Court decision finding that abortion falls within the constitutional right to privacy.
Trust Women/Silver Ribbon Campaign in San Francisco is hosting an online interactive map where people from different parts of the country can register support for reproductive rights. Other groups are showing films and organizing rallies.
Physicians for Reproductive Choice and Health, based in New York, organized a speaking panel for Boyd and others to commemorate the role of doctors in upholding Roe v. Wade, as medical providers, litigants, and, in too many cases, those at the frontlines at risk to their lives and safety.
In an interview seated beside his wife Glenna Boyd, who counsels patients, Curtis Boyd, now 75, lamented the shrunken state of Roe, which he called alive only in principle, saying, "We have to fight this out state by state. We've got to catch up."
Another speaker at the doctors' panel, Dr. Linda Prine, described her personal involvement with the procedure. As a teenager in Madison, Wisc., in the years before Roe, Prine navigated a labyrinth of laws to get an abortion. After getting two psychiatrists to agree that she needed an abortion, she endured a humiliating hospital stay.
"They muttered loudly: 'Those sluts,'" said Prine.
Now a doctor in New York, Prine provides abortions and teaches patient-centered care.
Doctors have provided more than 50 million legal abortions since Jan. 22, 1973, when the U.S. Supreme Court announced the Roe decision, according to the Guttmacher Institute, a policy organization in New York. Approximately 1,800 doctors in the U.S. provide abortion services.
Doctors have also fought for abortion rights in the courts. The last two cases heard by the U.S. Supreme Court -- Stenberg v. Carhart and Gonzales v. Carhart--bear the name of Dr. LeRoy Carhart. He objected to restrictions in Nebraska and by Congress that banned doctors from performing an ill-defined medical procedure, so-called partial birth abortion. The Supreme Court ruled in his favor in 2000, and then reversed itself seven years later and permitted the anti-abortion law.
To save the sole clinic in Mississippi, Dr.Willie Parker is a plaintiff in a lawsuit fighting against a state law that requires abortion-clinic doctors to have privileges at a nearby hospital. The problem? "The local hospitals won't admit any," said Parker, who also practices in Chicago. The Mississippi clinic is teetering on the verge of closure.
The decision in Roe and its companion case, Doe v. Bolton, from Texas and Georgia, respectively, made an indelible impression on medicine, society and women's lives.
But the Roe case itself is becoming an increasingly vague memory. Only 44 percent of those under 30 years old could correctly identify what it is about compared to an average of almost 67 percent over 30, a January survey by the Pew Center for the People and the Press reported.
The opinion by Justice Harry Blackmun in Roe said a constitutional right to privacy encompasses a woman's decision whether or not to terminate a pregnancy. Seven of the nine justices agreed. "The decision vindicates the right of the physician to administer medical treatment according to his professional judgment up to the point where the important state interests provide compelling justifications for intervention," Blackmun wrote in a concluding paragraph.
States could no longer make abortion a crime across the board. First trimester abortions should be unimpeded, the court said, but states could apply restrictions later in pregnancy, especially after fetal viability (an inexact measurement of approximately 23 to 24 weeks gestation). In all situations, safeguards were needed to protect the life and health of the woman.
Since 1973, 29 more abortion cases have found their way to the U.S. Supreme Court, ripping holes in Roe's protections.
In 1992 Planned Parenthood v. Casey, a plurality decision, permitted states to regulate abortion at any time, so long as it did not pose an "undue burden" on women. That opened a gaping pathway for anti-abortion activism. Since 1995, 755 anti-abortion measures have passed in states around the country, according to NARAL Pro-Choice America.
Now, 26 states have waiting periods, delaying women from getting an abortion; 33 states and the District of Columbia have laws blocking public health programs from offering abortion care; and other laws require parental notification for teens, compliance with regulatory minutiae in clinics and the submission of women to an ultrasound test or discouraging lectures.
All these newer restriction come on top of the federal Hyde Amendment, first passed in 1976, which restricts federal funding for abortion under Medicaid, the public health insurance program.
"A very limited right to pre-viability abortions appears to be safe with the current Supreme Court," said Priscilla Smith, senior fellow at the Yale Law School Information Society Project, who convened a legal panel at the New York City Bar Association for Roe's 40th. "But despite this legal protection, tougher restrictions on abortion are making it harder and harder for many women to access."
Despite the challenges, 22 percent of impregnated women in the United States have abortions; by age 45, 1-in-3 American women has had an abortion. Eighty-eight percent of abortions occur in the first 12 weeks, according to the Guttmacher Institute, and since the legalization of the drug mifepristone in 2000, one quarter of the abortions prior to nine weeks use a pill regimen.
Medical practitioners face harassment and violence. Four doctors and three clinic workers have been assassinated since 1993, according to the National Abortion Federation. One of these victims, Dr. George Tiller of Kansas, was shot point-blank in 2009 while attending church. Another eight medical personnel have been seriously injured by guns or bombs.
The spillover effects of anti-abortion fervor even harm women who want to carry their pregnancies to term. The zeal to protect a fetus has led to 413 arrests or forced interventions of pregnant women since 1973 for allegedly endangering fetal life, according to a study released in January by the New York-based National Advocates for Pregnant Women.
"The struggle to protect abortion as a human right has mutated and expanded in terms of the sites of struggle," said Loretta J. Ross, former national coordinator of SisterSong Women of Color Reproductive Justice Collective in Atlanta. "It is even more urgent that we understand the personal, as well as the economic, socio-political and educational, reasons women make critical decisions about their bodies."
That task will be left to the next generation. The Pew study found that less than 30 percent of those under 30 thought Roe should be overturned. But Sarah Erdreich, author of an upcoming book, "Generation Roe: Inside the Future of the Pro-Choice Movement," was struck in her interviews by the failure of peers to recognize the difficulties in access, an assumption, she said, "that since abortion is legal, anyone can get one."
Cynthia L. Cooper, a journalist living in New York, frequently covers reproductive justice and human rights.
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