Sunday, January 20, 2013

Safe, Legal, And Rare, Indeed

It was twenty years ago, twenty years after Roe v. Wade (whose anniversary is Tuesday) and in the midst of the first Clinton Administration that Cynthia Tucker would applaud the President's "safe, legal, and rare" prescription for abortion.  Described by Wikipedia as "a liberal American columnist and blogger for the Atlanta Journal-Constitution, syndicated by Universal Press Syndicate," Tucker praised the approach as "a rare example of developing a wise and humane strategy on an issue so often discussed only in extremes." "The only way to lower the abortion rate," she wrote, "is to make contraceptives much more widely available."

Or so we thought back then, when it seemed that the only way to make abortion rarer would be to empower women, to offer them access to contraceptive care and thereby some control over their reproductive choices.

What a quaint thought.  A year ago, Rachel Benson Gold and Elizabeth Nash of the pro-reproductive rights Guttmacher Institute compared the status of the right to an abortion among the years 2000, 2005, and 2011 along the measures of ten general categories of major abortion restrictions:

• mandated parental involvement prior to a minor’s abortion;
• required pre-abortion counseling that is medically inaccurate or misleading;
• extended waiting period paired with a requirement that counseling be conducted in-person,
  thus necessitating two trips to the facility;
• mandated performance of a non–medically indicated ultrasound prior to an abortion;
• prohibition of Medicaid funding except in cases of life endangerment, rape or incest;
• restriction of abortion coverage in private health insurance plans;
• medically inappropriate restrictions on the provision of medication abortion;
• onerous requirements on abortion facilities that are not related to patient safety;
• unconstitutional ban on abortions prior to fetal viability or limitations on the              circumstances under which an abortion can be performed after viability;
• preemptive ban on abortion outright in the event Roe v. Wade is overturned

The Institute observed

the number of both supportive and middle-ground states shrank considerably, while the number of hostile states ballooned. In 2000,19 states were middle-ground and only 13 were hostile. By 2011, when states enacted a record breaking number of new abortion restrictions (see box), that picture had shifted dramatically: 26 states were hostile to abortion rights, and the number of middle-ground states had cut in half, to nine.

Restrictions enacted in 2011 (trend displayed in graph from Guttmacher Institute,below) included banning abortion at or beyond 20 weeks' gestation; adopting waiting periods, some onerous; instituting an ultrasound requirement; prohibiting all insurance policies in the state from covering abortion unless the woman's life is endangered; financially prohibitive clinic regulations; and prohibiting the use of telemedicine, a common practice in rural counties lacking medical facilities.    While in 2012 fewer laws to restrict a woman's reproductive freedom were enacted, none at all was enacted, the Guttmacher Institute reports, "to facilitate or improve access to abortion, family planning or comprehensive sex education."

Abortion is still, for the most part, legal because Roe v. Wade has not yet been overturned. And it long has been safer for the woman than has childbirth, and has been getting safer. But while liberals have focused on making abortion rarer by expanding access to contraceptive services, conservatives have resisted at almost every juncture.  They have aggressively sought to make abortion rarer, even though- no, because- it emasculates women by thwarting them from determining the size of their own family.   That is part of the legacy of Bill Clinton's "safe, legal, and rare."

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