Even abortions in the second trimester, especially after 20 weeks, need to be considered differently from those that happen early in pregnancy. Women who seek abortions in the second trimester generally have special needs and would be helped by more extensive counseling than that available at most abortion clinics. Women who discover their fetuses have anomalies, teens who did not recognize they were pregnant, women who could not make up their minds - these are not routine circumstances. Mandating and funding non-directive counseling on all options is a good thing.
Finally, the abortion-rights movement needs to change the way it thinks about the state. Right now government is mainly treated as the enemy - and it does neglect women's needs. The new ultra-conservative members of Congress are fighting to get rid of the legal right to choose abortion. The public is ambivalent about abortion. It wants it to be legal, but will support almost any restriction that indicates society takes the act of abortion seriously. For the choice movement to regain popular support and to maintain a legal right to abortion, it has to work with the state. Society and the state do have a stake in abortion policy. Reproduction is a private matter with public consequences. Women get to decide, but we all get to weigh in on what the policy should look like.
We need to fight to get government to provide resources that women need, from subsidized birth control to better prenatal care. We also need a real effort to reduce maternal mortality and pregnancy complication rates in this country, which Amnesty International has called "shocking."
If the state wants to weigh in with advice and information on abortion, the least it can do is emulate the European system, which has some regulations but then pays for women's abortions and offers good alternatives such as child care, parental leave and health care. We have been demanding that the state mind its own business. That lets government abdicate all responsibility for funding reproductive health care.
We need more responsible and compassionate state policies. But respect for fetal life also requires that men and women take every step possible not to create fetuses they will have to abort. Too often, the movement sounds as we think women have only rights and the state has only responsibilities.
The moral high ground on abortion is not to be found in asserting an absolute right to choose. Instead, it is to be found in the movement's historic understanding that when abortion is illegal, it is poor women who suffer. The abortion-rights movement needs to focus our work on restoring federal and state funds for abortion for women in the military and on Medicaid, a benefit that Congress cut off as early as 1976. We should also work to sensibly regulate abortion facilities - not to prohibit access, but to ensure safety.
Some of my colleagues in the abortion-rights movement will resist even this modest shift on post-first trimester abortions, fearing that any compromise reflects weakness. Give the opposition an inch and they will take a yard. I believe most in the movement share my concerns and hold more moderate positions on abortion than their rhetoric or silence implies. These shifts I am suggesting are not about compromising or finding common ground with abortion opponents. Compromise assumes that there are two parties prepared to give up something in return for settling an issue. Neither opponents nor advocates of legal abortion are willing to do that. But, for pro-choice advocates, standing our ground will mean losing ground entirely.
For too long, abortion has been treated in black and white. Any discussion that deviates from legal or illegal, women or fetus, faces criticism from the twin absolutes of choice or life. If the choice movement does not change, control of policy on abortion will remain in the hands of those who want it criminalized. If we don't suggest sensible balanced legislation and regulation of abortion, we will be left with far more draconian policies - and, eventually, no choices at all.
fkissling@gmail.com
Frances Kissling is the former president of Catholics for Choice and a visiting scholar at the Center for Bioethics at the University of Pennsylvania.
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