The debate about whether a woman should have the right to abort a fetus is one of the most controversial questions of the 21st century. The terms pro-life and pro-choice attempt to reduce this complex issue to simplistic, black-and-white positions of being either against protecting the life of a fetus or against a woman’s right to choose what to do with her own body. In reality, this debate is much more complicated than these simple terms suggest. The complex ethical issues surrounding abortion include moral and medical considerations, changing cultural attitudes over time, and an evolving body of law that includes key U.S. Supreme Court cases and state and federal legislation. Internationally, abortion as an accepted practice has been guided by religious and cultural attitudes since ancient times. While abortion has been a common medical practice throughout the history of Western civilization, beliefs about the morality or legality of abortion have remained unsettled. The ancient Greek Stoic philosophers believed that a fetus was akin to a plant until it was born and breathed air; therefore, abortion was not considered to be immoral. Aristotle argued that a fetus was not infused with a human soul until after the early stages of pregnancy, when the mother could feel the fetus move in her womb, a stage known as “quickening.”
Prior to 1588, the Catholic Church followed Aristotle’s approach, believing that a fetus did not receive a soul until quickening; thus, abortion was not considered to be murder until this developmental stage was reached. In 1588, Pope Sixtus V outlawed abortion at any developmental stage; this papal bull was soon rescinded, however, in 1591 by Pope Gregory IV, who returned the church to its earlier position that abortion was not considered to be murder until quickening of the fetus. Pope Gregory IV’s doctrine remained in place until 1869, when Pope Pius IX reinstated Pope Sixtus V’s prohibition against abortion as murder at any stage of pregnancy. This limited history illustrates how the question of when a fetus becomes a person lies at the core of the abortion debate, and informs many current attitudes about abortion.
In America, abortion was legal until 1821, when Connecticut passed the first law prohibiting abortion after quickening. By 1910, the vast majority of states enacted legislation criminalizing abortion except when essential to save a woman’s life. As a result, unless they could afford to pay for a safe legal abortion from a private doctor, women either sought illegal abortions or attempted to self-induce abortion. Thousands of women were treated in hospital emergency rooms for life threatening complications resulting from such abortion attempts; many of these women died or suffered permanent damage or disability.
The key issues involved in the abortion debate concern the rights of the fetus and the reproductive autonomy of women. Does a pregnant woman have the right to choose to terminate her pregnancy? Can the fetus be considered to be a person and, if so, at what point in its development? If a fetus can be considered to be a person at some point, what effect does that have upon a woman’s right to control her own body? What ethical standards should be applied to answer these questions? And what role should the government play in resolving these questions? In regulating abortion, many governments around the world attempt to strike a balance between the competing rights of a pregnant woman and her fetus.
In addition to considering what should be legal, there is also the question of what is moral. For that reason, many opponents of abortion have resorted to acts of civil disobedience and civil resistance to counter what they believe are evil acts. Opponents of abortion argue that, because the fetus is a person, it is wrong to end its life; aborting a fetus is tantamount to murdering an innocent person. In contrast, proponents of a woman’s right to choose to have an abortion argue that a woman has the right to determine what she can do with her own body. Any restrictions on a woman’s right to choose to have an abortion is paternalistic and reduces women to second-class citizens. Further, restricting access to abortion endangers women. In the decades before abortion was legalized in the 1973 U.S. Supreme Court decision in Roe v. Wade, over a million women underwent illegal abortions each year, resulting in up to 5,000 deaths. In the 1960s, illegal abortion was the most common cause of maternal death in California.
Prior to 1973, opinions about the legality of abortion were in flux in the United States. By the early 1960s, abortion was prohibited in the majority of states, unless the fetus was endangering the woman’s life. By the end of that decade, additional exceptions allowing for abortion of a pregnancy resulting from rape or incest, or in the case of a fetus with a severe defect, were enacted in a number of states. In 1972, a burgeoning abortion rights movement persuaded four states to permit all abortions judged necessary by a woman and her doctor.
In Roe v. Wade, the Supreme Court considered the constitutionality of a Texas law prohibiting abortion except in cases where the mother’s life was endangered. In addition to finding that this law violated a woman’s right to privacy in restricting her ability to choose whether or not to carry her pregnancy to term, the court determined that the state had a compelling interest in protecting the potential life of the fetus only after “viability,” that is, when the fetus could survive outside the womb. The effect of this decision was to render state laws prohibiting abortions during the first trimester of pregnancy unconstitutional. In reaching this decision, the court attempted to balance the rights of women to control their own bodies with the rights of a viable fetus. During the first trimester, the court determined that a decision to abort a fetus should be made by a woman and her doctor. After the first trimester, the state can regulate the abortion procedure in order to protect the woman’s health. Once the fetus becomes viable, the state can regulate and even prohibit abortion, unless abortion is essential to protecting the woman’s health or life.
The court’s decision in Roe v. Wade resulted in decades of passionate debate in the United States about abortion that continues to the present day. In response to Roe v. Wade, in 1976, Congress passed the Hyde Amendment to the Department of Health and Human Services appropriations bill, prohibiting the use of Medicaid funds for abortions for low-income women. A revision of the Hyde Amendment in 1977 made an exception for rape, incest, or “severe and long-lasting” damage to a woman’s health.
In addition to congressional action, states continue to test the boundaries of Roe v. Wade, resulting in the Supreme Court’s refinement of its 1973 ruling. In Ohio v. Akron Center for Reproductive Health (1990), the Supreme Court found that a state law requiring a physician to notify a parent or a “parent substitute” of an unemancipated minor at least 24 hours before performing an abortion or, alternatively, requiring the minor to obtain a “judicial bypass order” from a court allowing the minor to obtain an abortion without such parental notice, was constitutional. Since this decision, 44 states have passed laws requiring minors to obtain either parental notification or consent before having an abortion.
In 1992, in Planned Parenthood v. Casey, the Supreme Court affirmed the essential holding of Roe v. Wade, that a woman has a privacy right to choose to have an abortion. However, the strict trimester approach followed in Roe v. Wade was abandoned in light of modern medical developments that allow a fetus to survive outside the womb earlier than the third trimester. The court acknowledged that the state had an interest in protecting the life of a fetus and enlarged states’ authority to regulate abortion, moving away from its earlier reliance on a fetus viability standard and instead restricting state regulations that place an “undue burden” on a woman’s choice to have an abortion. Under this standard, the court determined that a 24-hour waiting period, informed consent counseling, parental consent requirements for minors, and provider reporting procedures were all constitutional. However, a requirement that a woman notify her spouse before having an abortion was found to be an undue burden, providing husbands too much authority over their wives.
Since the court’s 1973 decision in Roe v. Wade, 91 percent of abortions in the United States occur during the first trimester, 9 percent during the second trimester, and less than 1 percent during the third trimester. The rare third trimester abortion procedure is known as a “intact dilation and extraction,” in which the fetus is killed by extraction of the contents of its skull, which is then collapsed prior to the removal of the fetus from the woman’s body. During the 1990s, a number of states banned these third trimester abortions, which were given the politically charged label “partial birth abortions” by opponents. The Supreme Court consistently found state bans on partial birth abortions to be unconstitutional.
Abortion opponents rallied around the example of partial birth abortions to garner public support for a universal ban on abortion. The most extreme opponents have engaged in harassment of abortion clinic clients and even violence to protect the lives of unborn fetuses. On March 10, 1993, Dr. David Gunn, an OB/GYN practitioner offering abortion services in Alabama, was murdered by an antiabortion activist. Dr. Gunn’s assassination prompted passage of the federal Freedom of Access to Clinic Entrances (FACE) Act, signed into law by President Bill Clinton in 1994. The FACE Act prohibits the use of “force, threat of force or physical obstruction” of clients of reproductive health clinics and provides both criminal and civil penalties for violations. Nevertheless, verbal harassment of clinic clients by antiabortion activists continues.
Between 1998 and 2009, three other doctors performing abortion services were murdered: Barnett Slepian, John Britten, and George Tiller. Slepian was shot in his home by James Kopp, who was affiliated with the Lambs of Christ, a militant Roman Catholic antiabortion organization. Kopp was found guilty of second-degree murder and is serving a sentence of 25 years to life. Britten was shot by Paul Hill, an antiabortion activist with alleged ties to the militant group Army of God. Hill was convicted of murder and sentenced to death; he was executed by lethal injection by the state of Florida on September 3, 2003. Tiller was specifically targeted by a branch of the antiabortion group Operation Rescue, which moved to Kansas specifically to monitor and organize protests against Dr. Tiller’s provision of late-term abortions. Tiller’s clinic was firebombed in 1986, and he was shot in both arms in 1993, before finally being assassinated as he was serving as an usher in his church in Wichita, Kansas, on May 31, 2009.
In November 2003, President George W. Bush signed into law the Partial Birth Abortion Ban Act, the first federal law rendering an abortion procedure a crime. In 2007, a divided Supreme Court upheld the federal Partial Birth Abortion Act in Gonzales v. Carhart. The majority opinion affirmed that the state had an interest in protecting fetal life and adopted congressional findings that partial birth abortion was never needed to protect a woman’s life. As a result, no health exception was necessary for this act to be constitutional. A passionate dissenting opinion by Associate Justice Ruth Bader Ginsburg argued for the need to protect women’s reproductive autonomy. The majority and dissenting opinions in Gonzales v. Carhart demonstrate that the essential conflict at the core of the abortion debate—the right of a woman to control her own body and her own destiny versus the right of a fetus to survive until birth remains as controversial as ever.
Following the Supreme Court’s decision in Gonzales v. Carhart, states began rolling back their abortion protections. A majority of states now impose some kind of preabortion parental consent or notification requirements, mandatory waiting periods, mandatory counseling, and a mandatory ultrasound. In addition, states have passed a variety of fetal homicide laws. On March 17, 2013, Senator Rand Paul introduced the Life Begins at Conception Act, declaring that life begins at conception and endowing a fertilized egg with all the rights of personhood. To date, similar fetal personhood initiatives in several states have been defeated.
Looking beyond the United States, women’s access to abortion services is limited by a combination of laws, cultural norms, religious doctrines, and a shortage of adequate medical services. Women in developing countries are especially in need of adequate contraceptive services. It is estimated that over 40 million abortions take place around the world; more than half of these abortions take place in unsanitary conditions, resulting in many deaths. Despite the complex ethical issues surrounding abortion, women will continue to seek them; pro-choice advocates argue for the need to provide adequate medical care for all women, regardless of their decisions concerning abortion.
Bibliography:
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- Ralston, Michelle and Elizabeth Podrebarac. Abortion Laws Around the World. The PEW Forum on Religion & Public Life. PEW Research Center: Washington, DC: September 30, 2008.
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