Before I formed you in the womb I knew you
Jeremiah 1:5, Hebrew Scriptures
Perhaps it's fate, or perhaps just a useful coincidence, but as we approach this particular season of healthcare discussion, we are passing an eye-catching symbolic milestone.
Approximately 50 million abortions have been induced legally in the United States since the infamous Roe v. Wade decision.
Abortion doesn't rank very highly on my list of public policy priorities. I can say that; I'm a highly educated white male with reasonable access to contraception and a decent enough job where I could, in a pinch, take a girlfriend to another city, county, state, or country, if it came to that. I can walk to my city's Planned Parenthood location. In short, my family would be able to 'choose' between raising our baby, giving it up for adoption, or having an abortion.
Representative Stupak didn't focus attention on abortion due to some groundswell of demand from Democratic constituents. But when abortion is thrust into the spotlight, my contention is that it's critically important that we deal with it, both substantively and politically. I think that's why there are apparently so many discussions about this the past couple days. I hope this can provide a good overview and perhaps summary or closure for this particular wave of interest.
An outline of the core issues
I think beginning of life issues are very interesting. They involve much nuance and uncertainty, much passion and ideals. And most people approach these issues in good faith, while a few people take advantage of that good faith for their own ends. Frequently when we discuss these issues, we blur them in ways that muddle rather than clarify the situation. Below, I outline six broad areas that are best thought of as independent decisions. A perspective has to be formed in each area, apart from the others.
The first issue to address with abortion is personhood. One of the really important developments of the Civil War is that we solved, once and for all, some core questions about the supremacy of the Union, the federal government, and the necessity of a national, universal definition of personhood. Some things simply cannot vary from state to state, county to county, city to city. You have to be a person, a full person, and nothing but a person, everywhere or nowhere, at a specific, defined moment in time.
I ramble on about that because this is an area where many people get tripped up. If the 'unborn' are people, or to use another turn of phrase, 'the moral equivalent of a human being', then any society that defines murder (illegal killing) must define abortion as murder; it must be criminalized. There are no circumstances under which we would allow rights violations against blacks or toddlers. The exact same reasoning applies to the collection of cells growing during pregnancy. If that's a person, intentionally causing it harm should be assault and, ultimately, murder, and accidentally or wrecklessly causing harm should also be illegal, as well as other activities like IVF clinics (kidnapping or child endangerment or perhaps illegal detainment). In fact, IVF clinics are a great case study for exploring this. They essentially commit genocide if the life forms they affect are people. Obviously, embryonic stem cell research is another area that is completely off limits if embryos are people.
The second issue deals with the pragmatic difficulties of translating biology into policy. One inconvenient fact about abortion is that miscarriages (ie, spontaneous abortions) are extremely common. If God and evolution were absolutely dead set against them, one might expect the fetus to not be quite so disposable. There is something about time in the womb that is important, too; the mother affects the pregnancy in ways unparalleled in other kinds of human relationships. Another difficulty arises with defining specific moments of maturity. When, exactly, does conception occur, anyway? We have this problem across many policy areas. There are lots of 16 year olds who are 'competent' enough to vote and drink. And there are 60 year olds whose competence is more dubious. Across many policy areas, we use arbitrary age cutoffs to assign rights; birth (or, perhaps, the third trimester), far from being an oddball definition, actually fits in well with this process of allocation. A final intriguing thought is why, if abortion is so wrong, do so many mothers contemplate it? Are women inferior decision-makers, perhaps not fully competent adults, who need guidance from male lawmakers? You can't uphold motherhood and women's rights as ideals if you then say the best way to put decision-making in their hands is to remove the decisions from their hands.
The third area concerns whether any rights apply and whether personhood begins sometime after conception but before birth. After all, we have many laws for non-persons; just look at Michael Vick. He served more jail time than many of the biggest crooks in our country, from Wall Street to DC. For example, this is where talks about limiting when abortions happen come into play. This is also where discussions about exceptions for 'the health of the mother' or cases of 'rape or incest' try to appeal. But they really don't belong here because they're attempts to circumvent the issue of personhood.
The fourth issue addresses what it means for abortion to be legal. Does that mean government agents won't throw you in jail for getting an abortion? Or does it mean that women should have access to abortion services based upon discourse with their healthcare professional, regardless of ability to pay? This is where much of the disagreement, in practice, unfolds. Abortion reflects rather well the class warfare in our country. In practice, abortion is extremely difficult to obtain for women in poverty, while affluent women have relatively easy access. Across vast swaths of our country, abortion services (and reproductive health more generally) aren't available; technical legality isn't the barrier.
This was one of the really funny parts about the South Dakota abortion debate. There are few abortion providers in the state. And some of the staff come in from Minnesota.
Fifth, there is a deceptively complex question of whether abortion is related to women's health, to healthcare. It's a surgical procedure that happens over a million times a year. It involves extended communication between patients and healthcare providers. Doctors need access to training in medical school curricula. Yet, there's an interesting counter narrative that healthcare is a separate issue from abortion. This is a truly intriguing concept. Can it really be possible that abortion isn't relevant in a healthcare discussion? Maybe all reproductive health services are an issue distinct from healthcare?
The final area is the politics of abortion. When you look at core Democratic groups: women, young people, minorities, poor people, and so forth, what's striking is that they are almost all disproportionately pro-choice. There are Democrats who believe abortion should be criminalized; the ones genuinely advocating that opinion should be respected for that opinion. I drive by the Planned Parenthood clinic everyday, and I find it pretty amazing that more days than not, there is a group of people peacefully protesting abortion. That's America; that's how we roll. But the flip side of respecting minority opinion is that most decisions are made by the majority. There are times to be strategic in erring in the side of caution and conciliation. But other times, the most strategic course of action is laying out a clear principle, confident that it's okay if not everyone agrees. At the end of the day, most pro-lifers and pro-choicers actually share many common goals.
We have to constantly recognize that abortion is primarily used as a wedge issue to divide people who otherwise have a lot of common ground to explore. Those who employ the abortion wedge issue as a weapon aren't reachable through any means of rational exchange of ideas or similar forms of persuasion; compromising with them makes us weaker. The GOP has long enjoyed straddling the fence on this one, firing up the religious right with much talk and nibbling actions against abortion while making sure not to alienate the corporatists with anything that would actually prevent a woman of means from seeking an abortion. This could be a political wedge issue for us, something that divides the puritans from the worst immoralizers of 'em all, those corporate dunces (not to mention CIA agents) blowing wads of cash on everything from drugs to prostitutes to gambling. No matter how else we feel about the money wing of the GOP, one thing they have going for them is that they're on our side in the 'culture wars'. That's part of why the culture wars are ancient history, left behind sometime back in the 1960s or 1970s, before most Gen Xers and Gen Yers were even born.
How the Stupak-Pitts Amendment fits in
The Stupak-Pitts Amendment is about one thing: derailing healthcare reform. This is very important to keep in mind. This is not about abortion. It's about the noninsurers, drug dealers, and hospital franchises in the country wanting to keep their enlarged portion of the pie. There's an easy way to tell this. The amendment doesn't address issue number one, personhood. Rather, it simply engages in class warfare, chipping away at funding for abortion. The amendment wasn't offered on a corporate-friendly piece of legislation, like the FISA Amendments Act, EESA (TARP), or the 'emergency' war appropriations. Rather, it was offered on healthcare reform.
I want to offer one bit of optimism, though, that perhaps is a bit distinct from the general tenor of this development. The fact that the Stupak-Pitts Amendment was introduced to make this particular bill worse reveals two very important successes for us.
- It demonstrates that the political powers that be understand that attacking abortion access is a political liability, and
- It demonstrates that the political powers that be understand that it's necessary to attach political liabilities to healthcare reform because genuine, transformative change of our healthcare system is widely demanded across the electorate.
To that limited extent, we can actually celebrate Stupak-Pitts. It is times like this that reveal desperation through desperate acts. Or as your local friendly OFA organizer might say, we're 'this close' to healthcare reform. The most powerful corporate interests in the country know this. They're scared we might actually get quality, affordable healthcare for all Americans.
What does Obama have to say about all this?
As we are incapable of talking about anything these days without asking WWOD, it's revealing to compare two sets of statements on the matter.
This is from then-Senator Obama's comments on the 35th anniversary of Roe v. Wade.
Chicago, IL | January 22, 2008
Chicago, IL -- Senator Barack Obama today released the following statement on the 35th anniversary of the Roe v. Wade decision.
"Thirty-five years after the Supreme Court decided Roe v. Wade, it's never been more important to protect a woman's right to choose. Last year, the Supreme Court decided by a vote of 5-4 to uphold the Federal Abortion Ban, and in doing so undermined an important principle of Roe v. Wade: that we must always protect women's health. With one more vacancy on the Supreme Court, we could be looking at a majority hostile to a women's fundamental right to choose for the first time since Roe v. Wade. The next president may be asked to nominate that Supreme Court justice. That is what is at stake in this election.
"Throughout my career, I've been a consistent and strong supporter of reproductive justice, and have consistently had a 100% pro-choice rating with Planned Parenthood and NARAL Pro-Choice America.
"When South Dakota passed a law banning all abortions in a direct effort to have Roe overruled, I was the only candidate for President to raise money to help the citizens of South Dakota repeal that law. When anti-choice protesters blocked the opening of an Illinois Planned Parenthood clinic in a community where affordable health care is in short supply, I was the only candidate for President who spoke out against it. And I will continue to defend this right by passing the Freedom of Choice Act as president.
"Moreover, I believe in and have supported common-sense solutions like increasing access to affordable birth control to help prevent unintended pregnancies. In the Illinois state Senate, when Congress failed to require insurance plans to cover FDA-approved contraceptives, I made sure those contraceptives were covered for women in Illinois. In the U.S. Senate, I've worked with Senator Claire McCaskill (D-MO) on a bill that would make birth control more affordable for low-income and college women, and introduced the Senate version of Representative Hilda Solis' bill to reduce unintended pregnancies in communities of color. As President, I will improve access to affordable health care and work to ensure that our teens are getting the information and services they need to stay safe and healthy.
And this is from a highly-discussed diary about the most recent statement to ABC News.
I laid out a very simple principle, which is this is a health care bill, not an abortion bill," Obama said. "And we're not looking to change what is the principle that has been in place for a very long time, which is federal dollars are not used to subsidize abortions.
Saying the bill cannot change the status quo, the President said "there are strong feelings on both sides" about an amendment passed on Saturday and added to the legislation, "and what that tells me is that there needs to be some more work before we get to the point where we're not changing the status quo."
In an exclusive television interview in the Map Rom of the White House, Obama told ABC News' Jake Tapper that he was confident that the final legislation will ensure that "neither side feels that it's being betrayed."
Notice the buzzwords from 2008: women's health; reproductive justice; fundamental right to choose; affordable health care; etc.
Notice the triangulating (or balancing, if that's too harsh a word for you) in 2009: healthcare bill, not abortion bill; not looking to change; subsidize abortions; strong feelings on both sides; neither side feeling betrayed; etc.
I'm not asking the President to come out swinging with an impassioned call to arms to overturn the Hyde Amendment (the restrictions on federal funding of abortion which the President's comments reference) in the middle of the healthcare debate. I'm just asking for the President not to use the linguistic frameworks set up by the GOP for the purpose of 'divide and conquer', not good faith exchange of ideas. I think it's sad that the President views his best political option as shifting rhetoric from promising to pass the Freedom of Choice Act because reproductive justice is on the line to not changing the status quo so that nobody feels betrayed. Perhaps I'm projecting or extrapolating unfairly, but that sounds like advice from the Chief of Staff, not the President's gut political instincts.
What would I do?
Of course, it's not fair to critique if I don't offer my own ideas. What I would counter is that, even if you're not a passionate advocate of reproductive health issues, it is the best political calculation to use clear, principled language. Demographically speaking, richer pro-life men don't vote for Democrats; less affluent pro-choice women do. I think the best response to Stupak-Pitts is to call its inherent bluff, that we're too cowardly to escalate this to the next level. An important observation here is that the right already hates Obama, particularly on abortion. There is nothing that can be said to make them think he is being reasonable on the issue.
Now is the time for us to start asking the question at the heart of all of the two-faced calculations at the GOP. Is abortion murder, or is it part of comprehensive reproductive healthcare? It's time to squeeze out the middle ground; most Americans don't really care, anyway. Few people go about life stressing about medical procedures that are funded by taxpayer dollars. It was hardly even news when Obama lifted the global gag rule. This is a great opportunity to make the choice as stark as possible. Or, yet another chance to show that when the going gets tough, we run for cover.
The message to what's left of the GOP's culture warriors can be simple: either propose a criminal statute defining induced abortion as murder, or get out of the way and allow abortion services (and all reproductive health services) to be fully integrated into national healthcare policy.
Some discussions worth catching if you haven't read them
I think MeteorBladesand LaFeministacapture my personal perspective pretty well. For some other perspectives, see Drdemocrat(linked above) and Troutfishing.
As Angry Mouse summarized
it's time for Democrats to choose a side
At a personal level, decisions about abortion are messy, uncomfortable affairs. However, at a policy level, the choices are pretty clear and pretty easy. Criminalize it, or treat it like a common medical procedure.
Update: Some other links worth tracking that I'm exploring.
Tetris on supporting Stupak-Pitts
mcjoan describing the amendment
ebirch1 with a personal story
mcjoan on my own Senator's wishy-washyness
greywolfe359 on talking about abortion
a historical view from RenderQT
Marie on Viagra