The Women's View

Kimberly was at home with her two sleeping children when her estranged husband, high on methamphetamines and angry about their impending divorce, showed up at her door last September.

“He came in and said he wanted to talk about child-support payments. We were fighting about everything. The divorce was not final,” Kimberly said. “He raped me.”

Kimberly didn't call the police because she wanted to protect her children from further trauma. Their lives had been upended during the previous two and a half years, ever since she was pregnant with her younger son and discovered that her husband was an addict. Since then, he'd quit his job, and she'd worked two; he put $50,000 on their credit cards at casinos and strip clubs; he threatened to kill her when she moved out with the boys; and he stole $700 from her boss, costing her a part-time bookkeeping job. After taking medical leave because she feared a nervous breakdown, Kimberly was fired from her primary job in the business department of a Phoenix TV station.

Kimberly, then 33, didn't tell anyone about the rape, not even her closest friends. “I had no strength,” she explained. Two weeks later, she realized she was pregnant. She didn't tell anyone about that, either.

She wanted an abortion, but she couldn't afford one. “I didn't know what to do,” she said. “There was no way I could have had that baby. My ex would have killed me. That was never an option.” Adoption wasn't, either. Kimberly couldn't bring herself to let her pregnancy show in Phoenix, and she couldn't leave town for several months the way women used to when they got pregnant out of wedlock. “I couldn't take my kids, and I couldn't leave them with my ex. I couldn't bring another child into this world. It came out of this … ,” she said, swallowing the word “rape” as she uttered it.

So, Kimberly thought, she'd wait until she could scrape together enough money for an abortion. She had no idea how difficult that would be. “I didn't realize that the price was going up and up and up each week [as] I was going further along.”

Desperate and without medical care, Kimberly went to the state for help. She qualified for Medicaid, but was told it wouldn't cover her abortion. She found a Web site that showed her how to apply to nonprofit groups for money to pay for an abortion. The Minneapolis-based Hersey Abortion Assistance Fund offered her $100, not nearly enough. Determined not to let the fetus reach the point of viability (generally interpreted to be 24 weeks gestation in Arizona), after which the state prohibits most abortions, Kimberly applied to dozens of funds around the country and sold her TV. By the end of January, she'd pulled together $900, the amount one clinic had told her was enough to cover her second-trimester abortion. She made an appointment for the two-day procedure.

When she went in the first day, the sonogram showed that she was nearly 20 weeks into her pregnancy. The abortion would cost $1,000. She didn't have it. The doctor said Kimberly would have to get the money by the next morning or postpone the procedure another week, which would drive up the price again. She sat in a park and cried.

By the next morning, Kimberly had managed to get another $100 from an abortion fund, but the delay made her miss the training session for her brand-new state job. She lost the job.

As I listened to Kimberly pour out her story just three weeks after her abortion, I was struck not only by the tragedy of her situation, the rawness of her emotions, but by what it meant to the larger abortion debate. Here was a mother who was struggling to take care of a 5-year-old and a 2-year-old in the face of incredible psychological and financial hardships, a woman striving to make a moral decision for her family. She did not want an abortion. She didn't even want the sex that led to her pregnancy. But having had the latter forced on her, she felt the former was the best response.

Decades ago, supporters of abortion rights used women like Kimberly to illustrate a need and a danger. The male doctors and clergy members who were at the forefront of the modern abortion-rights movement argued that the procedure was necessary to protect women from death or injury brought on by botched, illegal abortions. Feminists asserted that women must have control over their own lives.

The movement won a tremendous victory on January 22, 1973, when the Supreme Court handed down Roe v. Wade and legalized abortion. Since then, abortion opponents have worked methodically, state by state, to chip away at what they saw as nearly unfettered access to abortion. Now, that access is very fettered indeed. State legislatures have passed more than 400 laws limiting access to abortion in the past decade alone. According to the Alan Guttmacher Institute, a pro-choice think tank whose statistics are cited by both sides, abortion is available in only 13 percent of U.S. counties.

Nationally, President George W. Bush in 2003 signed the first federal law -- since blocked by three courts in rulings the administration is appealing -- that would criminalize one or more abortion procedures. And in his second term, this most anti-abortion of presidents is almost certain to appoint some justices to the Supreme Court, potentially enough to reverse or further weaken Roe. (Pro-choice leaders estimate that if Roe were overturned, 30 states would immediately outlaw abortion except in extreme circumstances.) Meanwhile, the Republican Congress is bent on passing additional legislation to restrict access to abortion or, like the Partial-Birth Abortion Ban Act of 2003, to reduce public support for it simply by making people queasy.

Abortion opponents have engaged in a brilliant public-relations campaign designed to manipulate the emotions of a nation that overwhelmingly supports abortion rights, but with some limits. They've used issues like “partial-birth abortion,” a term they made up, to play to a general uneasiness, a discomfort felt not only by abortion opponents but by some pro-choicers as well. They've made us nervous about the “unborn,” and in doing so obscured the concern we used to feel for women in dire situations.

While the right has appealed to our sentiments, the left has relied on dry legal arguments, abandoning the 1960s-style speak-outs that so successfully demonstrated why women like Kimberly need choices. But today those sorts of arguments are critical: We've just moved into an era when every woman of childbearing age has always had the right to choose abortion. Young women don't remember the hangers and back alleys; they didn't live with the fear. And now, when a right they've taken for granted is in jeopardy, virtually the only people speaking out about their choice to terminate a pregnancy are those who say they regret having made it.

Perhaps if more people heard Kimberly's story they would understand how difficult choosing abortion can be. They would see that most women who have abortions are responsible, often poor, adults, not the reckless teens that the right often claims use abortion as birth control. In fact, 61 percent of women who have abortions are mothers, 57 percent are poor, and 78 percent report a religious affiliation, according to the Guttmacher Institute. Some can afford the $400-and-up price tag, but many can't. Often they don't know where to turn for help. Many have to travel out of town to find a clinic, to spend a night or more in hotels or cars, to miss work, to parcel out their kids. Many agonize between their own lives and children and that of a potential baby that they never intended to create.

“I felt guilty,” Kimberly said, more so as the fetus grew and she felt familiar tummy flutters. “I felt I was going to be killing a baby. And there was a baby. ... I had two kids. I knew what I was feeling. ... It was a matter of choosing my children or this person. My children's lives would have been turned upside down. We might not be safe; we would have been worse off financially. They were already there. I had to take care of them … . I just had to choose.”

* * *

When this nation was founded, abortion was legal before “quickening,” the first movement of the fetus, usually detected around four months gestation. It wasn't until the mid- to late 19th century -- because of doctors' concerns for their own profession and for the safety of women, not for the well-being of fetuses -- that abortion was outlawed one state at a time. “Women did terminate pregnancies in unsafe conditions, done often by nonprofessionally trained practitioners,” said Kate Michelman, former president of NARAL Pro-Choice America. “The medical profession, under the aegis of wanting to protect women's health, started to campaign to make abortion illegal.”

Outlawing abortion didn't end it. An estimated 700,000 to 800,000 women underwent illegal abortions each year in the 1950s and '60s. After untold numbers of women died or were maimed through the process, doctors and clergymen, mostly, who had seen the awful effects of bungled abortions in the mid-1900s, sought to reverse those laws. “It wasn't framed in terms of women's rights. It was the horrors that women were faced with,” said Laura Kaplan, who wrote a book about the underground abortion movement she worked for in the early '70s in Chicago.

Clergymen and others set up referral services for women seeking abortions, Kaplan wrote in The Story of Jane: The Legendary Underground Feminist Abortion Service. In 1966, Lawrence Lader, an author and co-founder of the National Association for Repeal of Abortion Laws (now NARAL Pro-Choice America) announced he would begin making referrals in New York. The following year, the Reverend Howard Moody, a Baptist minister, ran the Clergy Consultation Service on Abortion out of a New York church. The Reverend Harris Wilson, a Baptist and dean of the Rockefeller Chapel at the University of Chicago, set up another referral service. Those two ministers then drafted a resolution, passed at the American Baptist Convention in 1968, “calling on ministers to counsel and assist women with family planning and abortion,” Kaplan wrote. “As a minister,” Wilson wrote in a letter to a nun, “I must consider the human trauma of a live, breathing woman and her interests over against the interests, whatever they might be, of a fertilized ovum.”

The movement experienced a public-relations bonanza in 1962. Sherri Finkbine, a mother of four in Phoenix and host of the Romper Room children's show, sought an abortion after reading that the tranquilizer she had been taking, thalidomide, was proven to cause severe birth defects. (The drug was ultimately banned worldwide after tens of thousands of babies were born with deformities, including short, flipper-like arms and malformed legs.) A local hospital scheduled the procedure, then canceled it after The Arizona Republic wrote about Finkbine's quest, without naming her. Following a legal battle that made their identities public, Finkbine and her husband, Bob, flew to Sweden, where they were attacked as killers by Vatican Radio. She underwent the procedure nonetheless, and her doctors told her the fetus had been horribly deformed.

A Gallup Poll taken that year showed that the majority of Americans supported Finkbine, and her case was a turning point in the abortion wars. Before Finkbine, wrote abortion opponent Guy M. Condon in 1991 in Christianity Today, “abortion had been almost universally seen as an act that killed a child and was thus criminal. Afterward, the law prohibiting abortion was perceived as an injustice that denied help to desperate women.” Three years later, an outbreak of German measles, also known to cause serious birth defects, prompted a surge in women seeking abortions and another burst of support for legalization.

It took two more years before state laws began to catch up with public opinion. Between 1967 and 1972, 13 states adopted reforms, mostly permitting abortion if the life or health (physical or mental) of a pregnant woman was endangered, if she were the victim of rape or incest, or if the fetus had major physical or mental defects.

Feminists took the argument one step further. “Women's liberation reformulated the issue from ‘What extenuating circumstances might justify abortion?' to ‘What circumstances could possibly justify forcing a woman to bear a child against her will?'” said Ellen Willis, who joined New York Radical Women, the state's first women's liberation group, in 1968.

They used the stories of women's suffering to make their case. In 1969, Willis and others who soon would form the radical feminist group Redstockings disrupted a New York legislative hearing on a proposal to reform the state's abortion ban because the panel of “expert” witnesses consisted of 13 men and a nun. “We argued that women were the experts who ought to be heard,” Willis, now a New York University journalism professor, wrote me in an e-mail. “Redstockings followed up with our own public ‘hearing' in which women testified about their illegal abortions -- to my knowledge the first women to do so in public.” That gathering, at a church in Greenwich Village, spurred other women to talk openly about their abortions as well.

* * *

After New York legalized abortion in 1970, and again after the Supreme Court handed down Roe three years later, the anti-abortion movement, initially led by the Catholic hierarchy, stepped up its crusade. It took its battle to clinics -- and to pregnant women themselves. Kim Gandy, president of the National Organization for Women (NOW), recalls how protesters in New Orleans, where she was living, offered juice and donuts to women seeking abortions. A nice gesture? Not exactly, Gandy said. “Our opponents knew you couldn't have an abortion if you had eaten anything because of the anesthesia.” Gandy remembers her mother calling from Bossier City, Louisiana, to tell her that people were photographing women entering an abortion clinic. “From free orange juice and donuts to looking up license plates and calling up families, talking to women's husbands and kids,” Gandy said. “It was bad stuff.”

It would get worse. In the mid-'80s, segments of the anti-abortion movement became violent. Clinics were blockaded and firebombed, doctors who performed abortions assassinated.

Although courts ruled in favor of the clinics, it was too late. Doctors were scared, and many decided to stop offering abortions.

The anti-abortion forces also fought in Washington, with mixed results. In 1976, the Senate defeated the Human Life Amendment, which would have outlawed abortion. That same year, however, Congress passed the Hyde Amendment prohibiting the use of federal Medicaid money to pay for most abortions. In 1984, President Ronald Reagan enacted the so-called Mexico City policy, which blocked federal money from going to foreign organizations that perform or promote abortion overseas. In 1987, Reagan said that any program that provided abortion counseling or referrals wouldn't be eligible for money through Title X, the government's family-planning program for low-income people.

All along, state lawmakers were passing bills to make it more difficult for women to obtain abortions. Several of the measures ended up before the Supreme Court. And while the Court stood by the basic tenets of Roe, it handed down two rulings in particular that effectively curbed access to abortion. In Webster v. Reproductive Health Services, the Court in 1989 upheld portions of a Missouri law that barred abortions in public facilities, such as hospitals, declared that life begins at conception, and required doctors to perform viability tests on fetuses after 20 weeks' gestation. Three years later, in Planned Parenthood of Southeastern Pennsylvania v. Casey, the Court allowed states to place restrictions on abortion prior to fetal viability as long as they didn't constitute an “undue burden” on women.

Since then, pro-choice groups have been on the defensive, trying desperately to hold back a tidal wave of anti-abortion activity in statehouses and in an increasingly conservative Congress. But the emotion that marked the abortion-rights movement's early days, the passion that spoke to people where they live, is by and large gone. It now is the province of the other side.

* * *

Georgette Forney speaks frequently, publicly, and emotionally about her abortion on October 4, 1976: “I was 16 years old and living in Detroit. I didn't want my parents or anybody else to know I was sexually active. I had a good-girl image. I thought I was big enough to take care of the problem myself. And I did. ... I remember driving to the clinic thinking, ‘This feels really wrong, but because it's legal, it must be OK.'” During the procedure, Forney recalled, she felt violated. The stirrups bothered her. So did the “vacuum cleaner.” But she moved on. “I decided to pretend it didn't happen,” she said. “I did that for 19 years.”

A decade ago, about five years after her daughter was born, Forney said she was flipping through her high-school yearbook when she felt a jolt. “I had this sensation that my baby was in my arms. ... I had never allowed myself to think about what I had aborted. There I was, all of a sudden really facing what I had lost, and I was unprepared for that.” She sobbed to a friend that she'd killed her baby.

Forney started talking openly about her experience. She founded an organization, the Silent No More Awareness Campaign, to help women like herself find ways to relieve their pain and gain forgiveness. (She's also executive director of the National Organization of Episcopalians for Life, which, along with Priests for Life, formed Silent No More.) As we talked and Forney repeated her story -- for the umpteenth? hundredth? thousandth? time -- she cried. In the past two years, she said, the Silent No More campaign had signed up more than 3,000 women to provide testimony at public gatherings and in TV commercials. “We don't want other people to make the same mistakes we did,” Forney said. “The mistake is not just the abortion; it's assuming the abortion will solve the problem. You think you're going to walk out of the clinic and be relieved and done. You're not prepared for when you go to bed that night and hear babies crying.”

Babies crying. Unborn children. The opposition has done a lot to humanize fetuses. The emotional appeal against abortion reached its pinnacle in the last 10 years, when anti-abortion forces served up a genius campaign against what they dubbed “partial-birth abortion,” a graphic term that doesn't exist in medical textbooks. Pro-choice leaders, ill-prepared to wrangle in human, as opposed to legal, terms, appeared to be twiddling their thumbs. Though not one abortion has been blocked by the ban, the gruesome images that accompanied the debate in Congress convinced even many abortion-rights supporters that this thing called “partial birth” was wrong.

Technology, too, has lent a hand to those who would end abortions. New 3D and 4D sonograms show in vivid detail what fetuses look like. How, some ask, can you abort a fetus after you've watched it suck its thumb?

Most recently, abortion battlers have proposed the Unborn Child Pain Awareness Act, which would require that providers inform women that fetuses can feel pain after 20 weeks gestation, and to offer them fetal anesthesia. (Tellingly, they don't offer money so that poor women could afford to spare their fetuses this trauma.) Pro-choice groups have been left standing on the side again.

Now, anti-abortion leaders are ratcheting up their emotional campaign further. Having raised sympathy for fetuses, they recently reached into the feminists' quiver to talk about what's best for women. Serrin Foster, president of Feminists for Life, contends that society has failed women by forcing them to choose between school or work and children. “We believe,” she told me, “that abortion is a reflection that we have not met the needs of women.”

* * *

Abortion opponents haven't won yet -- Roe is still in place -- but they can take solace in numbers. Abortion rates have fallen, in part because of better birth control, but also because of state laws. “Roe at this point has been so eviscerated that in many respects, although I don't want to see it overturned -- heavens, no -- the fact is that this current Supreme Court has thus far found almost no burden undue,” said Gloria Feldt, who recently resigned as president of the Planned Parenthood Federation of America.

According to NARAL, states enacted 409 anti-abortion laws in the past decade, 29 last year. NARAL reports that 47 states plus the District of Columbia allow individuals or institutions to refuse to provide women with abortions or other reproductive health services and referrals; 44 states require young women to notify or obtain consent from a parent before having an abortion, though 10 of the laws have been ruled unconstitutional; 33 states plus the District of Columbia ban public financing of abortions; 30 states have mandatory waiting periods of up to three days or requirements that abortion providers give women seeking abortions negative literature or lectures; 26 states restrict the performance of abortions to hospitals or specialized facilities; and 17 states prohibit insurance from covering abortions or require women to pay higher premiums for abortion care.

NOW's Gandy said that even pro-choice lawmakers mistakenly fall victim to arguments that restrictions don't hurt women. “Unfortunately, the legislators on our side don't get it,” she told me. “They vote for these, what they call ‘little restrictions,' all the time. It seems little to them, but the cumulative effect, or the effect on individual groups of women, can be enormous.”

As a result of restrictive laws, violence, and the stigma that has become attached to abortion, fewer doctors and other health-care professionals are providing them. The number of abortion providers declined from a high of 2,908 in 1982 to 1,819 in 2000, a 37-percent drop, according to the Guttmacher Institute. Almost no nonmetropolitan area had an abortion provider in 2000, the institute reported, which might explain why the abortion rate among women in small towns and rural areas is half that of women in metropolitan areas.

State restrictions almost certainly have caused some women, perhaps thousands a year, to forgo abortions. Research suggests that Wisconsin's two-day waiting period might have contributed to a 21-percent decline in abortions there. Shawn Towey, spokeswoman for the National Network of Abortion Funds, a group comprising 102 organizations that provides money and support for low-income women seeking abortions, estimates that 60,000 women a year find the restrictions so onerous that they carry their babies to term. The Guttmacher Institute stated in a 2001 report that between 18 percent and 35 percent of Medicaid-eligible women who want to have abortions continue their pregnancies if public funding isn't available.

“The biggest chunk of women who are unable to get abortions right now are poor women on Medicaid,” said Towey. While 17 states do pay for the abortions of low-income women, 33 do not. “The big irony,” she said, “is that low-income women get later abortions because they have to delay to save the money.” The Guttmacher report said that 22 percent of Medicaid-eligible women who had second-trimester abortions would have ended their pregnancies earlier if the government paid.

And behind every one of these numbers lies the story of a woman.

* * *

The good news, if there is any, is that women's rights activists are waking up to their public-relations problem. “I think we have to face the reality that public support for abortion is eroding,” said Martha Burk, chair of the National Council of Women's Organizations. “I think we've clearly lost the terminology war. They keep coming up with very reasonable-sounding restrictions, and we are unable to counter that. … The movement is in a bind.”

Feldt said, “For way too many years, the pro-choice movement was reacting to things. They thought they had won, and when you win you only have to defend. When you are in a defensive posture, your adversaries will nibble off one finger at a time, and pretty soon your whole arm is gone.” That's precisely what happened when Congress passed the 2003 abortion ban, Feldt said.

“The ban ... was not our finest moment,” Michelman agreed. “We got caught up on numbers and procedures and we allowed the other side to define the terrain.”

Neither were pro-choice leaders helped by the 2004 Democratic nominee for president, John Kerry, who said that he personally opposed abortion but supported a woman's right to choose. “He seemed equivocal. He ceded the moral high ground to the other side,” Feldt told The Associated Press after resigning from Planned Parenthood in January.

The solution du jour is a clever tactic to trap the anti-abortion side in a seeming contradiction. Join us, pro-choice leaders are saying, in reducing the need for abortions. “The fact is that the best way to reduce the number of abortions is to reduce the number of unwanted pregnancies in the first place,” Hillary Rodham Clinton told abortion-rights supporters in January as she pressed to find “common ground” with opponents. In February, NARAL placed an ad in the conservative Weekly Standard asking abortion opponents to “Please, help us prevent abortions.” The ad encouraged abortion foes to support a bill introduced by Senate Minority Leader Harry Reid, a Democrat who opposes abortion, that aims to reduce unintended pregnancies by making contraceptives and family-planning services more readily available. The Prevention First Act would require insurance policies that pay for prescription medications to cover birth control, promote emergency contraception (particularly for rape victims), and improve sex education.

The NARAL challenge represents a cunning strategy, if only because it allows pro-choice advocates to define the terms of the debate. “They have avoided wanting to talk about prevention,” said the group's new president, Nancy Keenan. “Instead of us always discussing issues that they want to talk about, let's talk about the issues that we want to talk about.”

Anti-abortion groups are unlikely to engage in the discussion. They haven't so far, and most of them either reject or simply ignore the question of birth control. Even Feminists for Life doesn't take a position on contraception. (Eleanor Smeal, president of the Feminist Majority Foundation, told me that she tried to compromise with abortion opponents while head of NOW in the 1980s. But, she said, “There is no common ground on increasing family planning. They're opposed to family planning.”)

That might not matter now. This isn't a campaign to win over anti-abortion leaders. It's a campaign -- like the other side's “partial-birth” strategy -- to appeal to middle Americans, the vast majority of whom use contraception and support abortion rights to some degree. As Clinton acknowledged in her speech, the search for common ground needs to go hand in hand with a campaign to demonstrate that women who have abortions are not impulsive monsters but people faced with wrenching decisions. “I believe we can all recognize that abortion in many ways represents a sad, even tragic choice to many, many women,” Clinton said. “This decision is a profound and complicated one; a difficult one, often the most difficult that a woman will ever make.”

The choice itself -- the opportunity to decide -- is essential to women's lives. Burk put it like this: “It's not just about whether and when to have children. It's about timing. It's about being able to be free of abusive relationships … the ability to go ahead with a career. ... It's about how your life unfolds. It can mean the difference in being dependent on government largesse or not for great periods of your life. It can mean the difference in the quality of life for your other children.” It can mean, she said, not having a baby at the age of 12. It can mean surviving.

But when politicians and lobbyists argue, it's rarely about 12-year-old girls. More likely, it's about 12-week-old fetuses.

It's time to turn the conversation back -- back to women, back to children, back to people who have been born. Frances Kissling, president of Catholics for a Free Choice, said this might mean acknowledging the growing connection Americans have to fetuses, and the moral complexity behind abortion. Pro-choice leaders need to talk about abortion the way women talk about it at their kitchen tables, Kissling asserted. “My experience with women at abortion clinics is they largely understand the nuances of what's going on,” she said. “They do not come in waving the flag and pounding their shoe on the table demanding an abortion as a political right. They come in ... as rich human beings dealing with a conflict of values. They come in fully aware that the life that is developing within them has value. To me that doesn't give it rights, that doesn't make it a person. Its developing humanity still comes into conflict with women's lives and aspirations.”

It's that sense of the fetus that's convinced some in the pro-choice movement that they should stand back during the upcoming congressional debate on the “fetal pain” bill, which wouldn't restrict abortion, but which would continue to humanize fetuses.

The challenge for pro-choicers is to balance America's growing sympathy for fetuses with an equal -- or greater -- concern for women. They must counter the image of a humanized fetus with that of a human, caring, and sometimes suffering woman -- with a woman who has needs and feelings and morals. The argument won't win over staunch abortion foes. But it should strike a chord with mainstream Americans, the very people the abortion-rights movement needs to reach. The pro-choice movement must speak the language of real people -- and maybe even let real people, like Kimberly, speak.

Jodi Enda, based in Washington, D.C., has covered the White House, presidential politics, and Congress for Knight Ridder Newspapers and was a national correspondent for The Philadelphia Inquirer.