OTI Online
Winter 1998

27 Years, but Who's Counting?
Thoughts on yet another Roe v. Wade
by Merle Hoffman


For the first time, women were in control of patient referrals and clinics, while physicians were brought down from their godlike pedestals to function as employees of women-owned and feminist-run medical centers.


Celebrating Roe in "the worst blizzard of the decade."


I used to celebrate it differently -- very differently.

I remember one January in particular in New York City's Bryant Park. In the midst of the blinding snow and howling winds of what the papers termed "the worst blizzard of the decade," I was part of a band of dedicated pro-choice activists who were passionately celebrating the anniversary of Roe v. Wade -- and just as passionately attacking those who opposed it. Despite, or perhaps because of, the freezing temperatures, my blood was up. I knew the battle was joined, the troops were marshaled, and I was feeling nothing but transcendent.

Years ago on another anniversary, I debated Nellie Gray, the organizer of the annual anti-abortion march on Washington. She was small, sinewy and angry.

She told me that we were a modern version of the Lincoln-Douglass debates. I smiled in recognition until I realized that she was positioning me as Douglass. "We'll stop our attacks when you put down your knives and stop the killing," she told me. "And your vision of women's roles would be to butcher them with illegal abortions or turn them into baby-making slaves," I replied.

Past anniversaries were like that -- collective, powerful, meaningful, engaged.

Now, as the antis plan their January 22 march, complete with mini-caskets for the "murdered unborn," I receive invitations to pro-choice auctions and black tie gala benefits -- cards with hourglasses in the shape of a woman's body reminding me that "the Time is Now" -- glittering messages from the glitterati, thousands of miles away from the streets and the battles.

Some say that one only remembers the last memory of a thing -- as if the real event becomes transfigured, altered as the present shuts out much of the past. Unlike most anniversaries, which are composites of shared memory and ritual, Roe is a Rorschach writ large -- a mass of perceptions codified by law that we share with our enemies.

I have grown up with and outgrown "abortion the issue" as it is played every year in stereotype and soundbite. Is it "a woman's right to choose," or is it killing? The arguments change slightly, if at all. The answer to this philosophical challenge is within the realpolitik of each woman's heart.

Was there really a life before abortion and abortion politics, before holding the hands of women in pain and expectation, and why am I still writing about it so many years later?

"Because of the freezing temperatures, my blood was up."

In the Spring of 1971, when I was 26 years old, abortion had been legal in New York State for almost one year. It would be another two before the Supreme Court would legalize abortion nationally in Roe v. Wade.

In the beginning I was not political. I became political when I counseled my first patient. Like so many others, she came from New Jersey because abortion was still illegal in that state. She was 24 years old-white, married, terrified. I don't remember her name or a word of what passed between us. It was strangely irrelevant. I do remember that her hand stayed in mine the entire time she was with me, throughout her abortion. Hers was the first of thousands of hands I have held -- and her life the first that touched mine in that profound and intimate way.

Simone de Beauvoir has written that the "representation of the world like the world itself is the work of men. They describe it from their own point of view, which they confuse with absolute truth."

When I founded Choices 27 years ago, women's health as a discipline, as a practice and a vision, simply did not exist. Legal abortion brought women's health care out of the closet, radicalized the status of women in society and revolutionized their relationship with the health care establishment.

It was a heady time -- a brave new world where one woman's unique yet collective experience of an unplanned and unwanted pregnancy intersected with a new feminist politic of freedom and responsibility. We inhabited a place where we made women's lives matter; a time when feminism resonated with risk and spoke to struggle rather than privilege. There were so many firsts.

For the first time, women were in control of patient referrals and clinics, while physicians were brought down from their godlike pedestals to function as employees of women-owned and feminist-run medical centers. Because the abortion issue was politicized well before legalization (the National Right to Life Committee was founded in 1969), patients often had to run a gauntlet of abuse from demonstrators just as they do now. Counseling sessions were done by young feminist activists trained in women's health; issues of sexuality, religion, love, psychology, and death augmented technical medical explanations of the procedure. As a result, the traditional medical bifurcation of mind/body was imploded by operationally integrating politics, psychology and clinical treatment.

In those early days I treated many women whose unwanted pregnancies stemmed from their victimization by the medical establishment, what I termed "iatrogenic pregnancies" because they were caused by the medical system's ignorance, misinformation or withholding of accurate information. Pregnancies caused by physician arrogance: "I give all my patients the pill;" "I never refit my women's diaphragms;" "My doctor didn't tell me to use anything else for birth control when I went off the pill."

I realized then that women patients constituted an oppressed class in relationship to their physicians. And understanding that power concedes nothing without demand, I developed a philosophy of Patient Power at Choices, which taught that patients had rights that included informed consent to treatment, second opinions, and access to alternative systems. On the other hand, patients were responsible for engaging honestly and directly with providers and educating themselves about their own bodies.

Those nascent feminist ideals have slowly been incorporated and diffused through much of modern medicine -- from sensitivity training for doctors in medical schools, to the incorporation of interdisciplinary educational and holistic concepts of healing in general medical practice, to the development of women's health care as a separate medical specialty.

But what's been lost in the years since Roe, if it ever really existed, is any authentic link between the providers who, often at the risk of their lives, serve the women who come for abortions, and the activists and theorists who shape national political pro-choice strategy. "Doing" abortions instead of fighting for the right to have them was always considered the dirty end of the business, but now that elitist negativity has spilled over into prejudicial judgments about having them.

For women to be considered "good" abortion patients they have to be hard cases, i.e. victims. They didn't choose sex; it happened to them -- abortion only in cases of rape and incest. The current intense debate over so-called partial birth abortions is the epitome of this thinking. President Clinton was quoted in The New York Times as saying that while he opposed late-term abortions, he couldn't deny them to that "small group of women in tragic circumstances who need an abortion performed at a late stage of pregnancy to avert death or serious injury." He did at least veto the bill that would have banned them.

This Madonna/whore (hard/soft) labeling of abortion patients has resulted in the continuing disengagement of millions of women from both abortion providers and abortion politics and formed a massive "reluctant constituency." A constituency of 30 million women who have had abortions since legalization but who remain equivocal and removed from the struggle to retain that right for the millions of others who will come after them. Their mantra is the classic "Rape Incest or Me" position.

We are losing the old warhorse abortionists who became committed to the cause when they saw their patients die of botched illegal abortions. No one under forty remembers the days of terror, shame, and extreme personal risk of those desperate pre-Roe searches for an abortion you could survive. Instead, we have the negative and ambivalent attitudes of pro-choice "supporters" wanting to be "good girls," who argue that the abortion "issue" has hijacked the women's movement. Why, they ask, must we spend so much time defending a right that was won in 1973? Why must we argue the same old polemics, strategize the same defensive moves? Wouldn't our energies be better spent setting a broader social agenda that addresses issues of economic equity, racism, welfare?

Why? Because we are in a real war with real casualties.

Because doctors and health care workers are shot dead in their clinics.

Because abortion remains unavailable in 86 percent of American counties, and some patients must still risk their lives to have one.

Because Roe v. Wade, based on the 14th Amendment's right to privacy has been slowly eviscerated by waiting periods, parental consent, the lack of Medicaid funding for abortion in the majority of states, and the attack on "partial birth" abortion.

Because we are still held hostage to the political agendas that disallow even the smallest move forward (RU-486 is still not produced and distributed in this country).

Because of continuing racial and class divisions that block collective action among women.

Because women who have abortions continue to deny the fact that they did.

Because I recently attended a national meeting of providers who reacted to my description of abortion as a fundamental civil right as "not sellable to the American public" - -and because they may be right.

By promulgating a view of abortion as "tragic but necessary," the pro-choice movement has succeeded in remaining in an apologetic and reactive position. Instead of an aggressive visionary strategy we are continually defending things that should require no defense -- women's lives and freedom.

We must reclaim and honor our history. We must remember the women who alone and in pain lost their lives for their right to choose.

We must throw off our personal shrouds of shame and tell the stories of our mothers and grandmothers, and ourselves.

We must close the split between the strategists and national leaders of the pro-choice movement and its foot soldiers, the women who have actually had abortions and the providers who make them possible. Together, we must reposition and redefine legal abortion as an integral core of women's health and as the necessary condition for women's freedom. Nothing stops abortion -- no law, no government, no religious authority. Making abortion illegal only makes it dangerous and deadly.

The movement must speak with a unified voice that articulates a shared vision. Abortion and reproductive freedom are fundamental human rights, not to be abridged by any entity. We must actively strategize, not only for the next skirmish or the next battle, but for the coming 25 years -- to ensure that our daughters and granddaughters do not have to fight the same war.

We must work to regain lost allies (the American Medical Association voted to uphold the ban on "partial birth" abortion). We must move in powerful coalition with other progressive movements -- gays and lesbians, civil rights organizations, environmental activists, labor -- and demand that the leadership of these movements actively support reproductive freedom.

We must expose the fifth column within our own ranks, feminists who are "pro-choice" but handle their personal discomfort with abortion by naming it a "tragedy" and thus making it more difficult for others to choose freely.

We must expand the definition of pro-choice to include those women living with racism and poverty for whom the right to reproductive freedom means the right to bear children with adequate financial and medical support.

We must reach out to the young women who live a feminism of entitlement rather than struggle, and do not understand that freedom requires constant vigilance.

We must be militant when necessary and be ready to sacrifice more then freedom for the cause.

We must creatively develop new legal theories (for one opinion, see "My Body, My Choice, My Consent," page 18 that further secure the constitutional basis of reproductive freedom.

Finally, we must be able to speak the truth to ourselves by answering the question, "Is it a woman's right to choose or is it killing?" by saying yes -- to both -- and taking full responsibility for that profound and powerful truth.

Twenty-seven years and who's counting? I'm counting -- counting the days and years and decades until all women will live in a world where reproductive freedom is a fundamental human right and no one will ever again die for her right to choose.


Merle Hoffman is Publisher/Editor-in Chief of ON THE ISSUES Magazine, and founder of Choices Medical Center and Choices Mental Health Center.


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