abortion advocacy essay

Op-ed: How to save abortion rights

May 10, 2022 – A Supreme Court draft opinion that would overturn the federal right to abortion in the U.S. if finalized is “humanitarian malfeasance,” according to Michelle Williams , dean of Harvard T.H. Chan School of Public Health.

In an op-ed published May 5, 2022 in the Emancipator—a collaboration of Boston University’s Center for Antiracist Research and the Boston Globe—Williams called the draft opinion “egregiously wrong” from a public health perspective, a humanitarian perspective, and an equity perspective. She pointed out that women who can’t get abortions, compared with their peers who are able to terminate pregnancies, are more likely to struggle financially, to have health problems, and to be women of color.

Williams listed four ways to protect a woman’s right to choose. One way is that Congress should codify the right to abortion into federal law. The move may require the U.S. Senate to lift the filibuster, since it has so far been impossible for that chamber to muster the 60 votes needed to protect abortion rights, Williams wrote.

Williams also called on states with progressive legislatures and governors to take steps to protect abortion rights within their borders; recommended that advocacy groups mobilize to support women in the many states where abortion is likely to be banned; and urged voters to elect candidates who support abortion rights.

Read the op-ed in The Emancipator: The right to an abortion can be saved

The negative health implications of restriction abortion access (Harvard Chan School feature)

An Abortion Advocacy Movement for Everybody

Representatives of the Trust, Respect, Access Coalition, holding multicolored signs spelling out ABORTION=HEALTHCARE, gathered in the Texas Capitol Rotunda Thursday afternoon July 27, 2017 to voice their opposition to abortion legislation being considered by the Texas House, Thursday, July 27, 2017 in Austin, Texas.

Abortion is legal in Texas and across the United States, but that doesn’t stop anti-abortion politicians from doing whatever they can to interfere with access to reproductive healthcare. Local governments have added fuel to the fire by passing anti-abortion ordinances that confuse residents about their rights and increase the ever-present stigma around seeking abortion care.

That’s why, for the first time, reproductive rights, health, and justice groups in our state are joining forces to expand essential health care access for all Texans by creating the Texas Abortion Access Network. Join us for TAAN’s launch on Thursday, August 20 at 6 PM CT, to become a founding member of TAAN and hear about how you can get involved.

In the last year alone, 13 cities in Texas have passed so-called “sanctuary cities for the unborn” ordinances. These ordinances attempt to ban abortion in those cities if Roe v. Wade is overturned, and some even attempt to ban contraception. At one point, many of these ordinances even declared abortion providers and other advocacy groups to be “criminal organizations.”

We sued and successfully pushed those cities to remove the most harmful parts of those ordinances — but those laws are just one example of the many ways Texas politicians have attacked reproductive freedom. For years, Texas politicians have piled restriction after restriction on abortion access. From enacting 2013’s House Bill 2, which led to the closure of half of all Texan abortion clinics, to banning abortions during the early COVID-19 pandemic, elected officials in Texas continually work to block essential healthcare.

But together, we are fighting back for the right to determine our own lives and destinies.

The Texas Abortion Access Network (TAAN) is a new collaboration between the ACLU of Texas, AFIYA Center , NARAL Pro-Choice Texas , Progress Texas , Texas Equal Access Fund , Texas Freedom Network , Jane’s Due Process , and Whole Woman’s Health Alliance . We’re building community among Texas residents who are fed up with attacks on their reproductive freedom.

Through TAAN, we are building grassroots power across Texas. We will not only defend against further restrictions but also empower activists to dive into action and put proactive, protective laws on the books in their hometowns. We are building a diverse base of volunteers that represent every corner of the state and equipping them with the tools they need to be leaders in their communities. A key component of TAAN is the Texas Abortion Access Academy, an 8-week online training program led by abortion access experts. The academy will cover a comprehensive array of topics to build each person’s capacity to become an effective abortion rights advocate. We’re including a crash-course on the status of abortion in Texas, how to talk to others about abortion, background on reproductive justice, and how to advocate and organize for abortion access. At the end of the program, cohort members will have gained the skills to lobby their local government, have difficult conversations about abortion, and get others involved in the movement.

Let’s be clear: Attacks on abortion care won’t stop Texans from needing, and seeking, abortion care. They’ll just ensure that the most vulnerable Texans have a much more difficult and costly experience accessing it. We’ve seen it again and again — restrictions to abortion care disproportionately harm Black and Brown people, people struggling to make ends meet, those who are already parenting, folks in rural areas, undocumented immigrants, LGBTQ folks, and young people.

Without access to reproductive health care, our communities can’t thrive. And while abortion remains legal, the fact that the Supreme Court nearly allowed a Louisiana law— one identica l to a Texas law they struck down just four years ago — to take effect shows that we can’t take the judicial system for granted. Our rights won’t be handed to us, we have to take them.

Learn More About the Issues on This Page

Reproductive Freedom
State Abortion Legislation

Florida Supreme Court Allows State to Ban Abortion, But Sends Measure to Protect Abortion Rights to the Voters in November

Ohio Abortion Providers File Lawsuit Challenging 24-Hour Waiting Period and Other Abortion Restrictions

Preterm-Cleveland, et al, v. Dave Yost, et al.

ACLU Brief in Emergency Abortion Care Case Highlights Idaho Politicians' Deeply Flawed Legal Arguments

Find anything you save across the site in your account

How the Right to Legal Abortion Changed the Arc of All Women’s Lives

By Katha Pollitt

Prochoice demonstrators during the March for Women's Lives rally organized by NOW Washington DC April 5 1992.

I’ve never had an abortion. In this, I am like most American women. A frequently quoted statistic from a recent study by the Guttmacher Institute, which reports that one in four women will have an abortion before the age of forty-five, may strike you as high, but it means that a large majority of women never need to end a pregnancy. (Indeed, the abortion rate has been declining for decades, although it’s disputed how much of that decrease is due to better birth control, and wider use of it, and how much to restrictions that have made abortions much harder to get.) Now that the Supreme Court seems likely to overturn Roe v. Wade sometime in the next few years—Alabama has passed a near-total ban on abortion, and Ohio, Georgia, Kentucky, Mississippi, and Missouri have passed “heartbeat” bills that, in effect, ban abortion later than six weeks of pregnancy, and any of these laws, or similar ones, could prove the catalyst—I wonder if women who have never needed to undergo the procedure, and perhaps believe that they never will, realize the many ways that the legal right to abortion has undergirded their lives.

Legal abortion means that the law recognizes a woman as a person. It says that she belongs to herself. Most obviously, it means that a woman has a safe recourse if she becomes pregnant as a result of being raped. (Believe it or not, in some states, the law allows a rapist to sue for custody or visitation rights.) It means that doctors no longer need to deny treatment to pregnant women with certain serious conditions—cancer, heart disease, kidney disease—until after they’ve given birth, by which time their health may have deteriorated irretrievably. And it means that non-Catholic hospitals can treat a woman promptly if she is having a miscarriage. (If she goes to a Catholic hospital, she may have to wait until the embryo or fetus dies. In one hospital, in Ireland, such a delay led to the death of a woman named Savita Halappanavar, who contracted septicemia. Her case spurred a movement to repeal that country’s constitutional amendment banning abortion.)

The legalization of abortion, though, has had broader and more subtle effects than limiting damage in these grave but relatively uncommon scenarios. The revolutionary advances made in the social status of American women during the nineteen-seventies are generally attributed to the availability of oral contraception, which came on the market in 1960. But, according to a 2017 study by the economist Caitlin Knowles Myers, “The Power of Abortion Policy: Re-Examining the Effects of Young Women’s Access to Reproductive Control,” published in the Journal of Political Economy , the effects of the Pill were offset by the fact that more teens and women were having sex, and so birth-control failure affected more people. Complicating the conventional wisdom that oral contraception made sex risk-free for all, the Pill was also not easy for many women to get. Restrictive laws in some states barred it for unmarried women and for women under the age of twenty-one. The Roe decision, in 1973, afforded thousands upon thousands of teen-agers a chance to avoid early marriage and motherhood. Myers writes, “Policies governing access to the pill had little if any effect on the average probabilities of marrying and giving birth at a young age. In contrast, policy environments in which abortion was legal and readily accessible by young women are estimated to have caused a 34 percent reduction in first births, a 19 percent reduction in first marriages, and a 63 percent reduction in ‘shotgun marriages’ prior to age 19.”

Access to legal abortion, whether as a backup to birth control or not, meant that women, like men, could have a sexual life without risking their future. A woman could plan her life without having to consider that it could be derailed by a single sperm. She could dream bigger dreams. Under the old rules, inculcated from girlhood, if a woman got pregnant at a young age, she married her boyfriend; and, expecting early marriage and kids, she wouldn’t have invested too heavily in her education in any case, and she would have chosen work that she could drop in and out of as family demands required.

In 1970, the average age of first-time American mothers was younger than twenty-two. Today, more women postpone marriage until they are ready for it. (Early marriages are notoriously unstable, so, if you’re glad that the divorce rate is down, you can, in part, thank Roe.) Women can also postpone childbearing until they are prepared for it, which takes some serious doing in a country that lacks paid parental leave and affordable childcare, and where discrimination against pregnant women and mothers is still widespread. For all the hand-wringing about lower birth rates, most women— eighty-six per cent of them —still become mothers. They just do it later, and have fewer children.

Most women don’t enter fields that require years of graduate-school education, but all women have benefitted from having larger numbers of women in those fields. It was female lawyers, for example, who brought cases that opened up good blue-collar jobs to women. Without more women obtaining law degrees, would men still be shaping all our legislation? Without the large numbers of women who have entered the medical professions, would psychiatrists still be telling women that they suffered from penis envy and were masochistic by nature? Would women still routinely undergo unnecessary hysterectomies? Without increased numbers of women in academia, and without the new field of women’s studies, would children still be taught, as I was, that, a hundred years ago this month, Woodrow Wilson “gave” women the vote? There has been a revolution in every field, and the women in those fields have led it.

It is frequently pointed out that the states passing abortion restrictions and bans are states where women’s status remains particularly low. Take Alabama. According to one study , by almost every index—pay, workforce participation, percentage of single mothers living in poverty, mortality due to conditions such as heart disease and stroke—the state scores among the worst for women. Children don’t fare much better: according to U.S. News rankings , Alabama is the worst state for education. It also has one of the nation’s highest rates of infant mortality (only half the counties have even one ob-gyn), and it has refused to expand Medicaid, either through the Affordable Care Act or on its own. Only four women sit in Alabama’s thirty-five-member State Senate, and none of them voted for the ban. Maybe that’s why an amendment to the bill proposed by State Senator Linda Coleman-Madison was voted down. It would have provided prenatal care and medical care for a woman and child in cases where the new law prevents the woman from obtaining an abortion. Interestingly, the law allows in-vitro fertilization, a procedure that often results in the discarding of fertilized eggs. As Clyde Chambliss, the bill’s chief sponsor in the state senate, put it, “The egg in the lab doesn’t apply. It’s not in a woman. She’s not pregnant.” In other words, life only begins at conception if there’s a woman’s body to control.

Indifference to women and children isn’t an oversight. This is why calls for better sex education and wider access to birth control are non-starters, even though they have helped lower the rate of unwanted pregnancies, which is the cause of abortion. The point isn’t to prevent unwanted pregnancy. (States with strong anti-abortion laws have some of the highest rates of teen pregnancy in the country; Alabama is among them.) The point is to roll back modernity for women.

So, if women who have never had an abortion, and don’t expect to, think that the new restrictions and bans won’t affect them, they are wrong. The new laws will fall most heavily on poor women, disproportionately on women of color, who have the highest abortion rates and will be hard-pressed to travel to distant clinics.

But without legal, accessible abortion, the assumptions that have shaped all women’s lives in the past few decades—including that they, not a torn condom or a missed pill or a rapist, will decide what happens to their bodies and their futures—will change. Women and their daughters will have a harder time, and there will be plenty of people who will say that they were foolish to think that it could be otherwise.

By signing up, you agree to our User Agreement and Privacy Policy & Cookie Statement . This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

The Messiness of Reproduction and the Dishonesty of Anti-Abortion Propaganda

By Jia Tolentino

A Supreme Court Reporter Defines the Threat to Abortion Rights

By Isaac Chotiner

By Amy Davidson Sorkin

A Tragic Conflict of Competing Goods

Searching for nuance at a pivotal moment in the abortion debate

Police use metal barricades to keep protesters, demonstrators and activists apart in front of the U.S. Supreme Court

Conversations of Note

Abortion has been discussed intensely this past week due to oral arguments in a Supreme Court case that could significantly alter the constitutional right to the procedure in the United States. At issue is a Mississippi law that bans abortions after 15 weeks of pregnancy, contra current precedent. If upheld, the law will likely inspire new abortion restrictions in many red states.

The Legal Fight

We begin with the law’s sponsor, Becky Currie , a Mississippi state legislator and registered nurse. “I pray my bill will save millions of babies,” she wrote in Newsweek , where she explained that she’s helped to deliver many, including a 14-week-old born too early to survive. “I stayed with the mother and baby, watching his heart continue to beat in his tiny chest for about 20 minutes,” she recounted. “Preborn babies can feel pain by 15 weeks,” she argued, noting that many countries protect them at 12 weeks. She wants SCOTUS to take what she characterizes as “a monumental step to limit abortions and protect preborn life by restoring the constitutional protections that long existed in our nation until the disastrous decision in Roe v. Wade .”

The Harvard Law professor Jeannie Suk Gersen framed the law differently. In her telling, it is not an attempt to restore a right to life; it is an attempt to abrogate a constitutional right to privacy and bodily autonomy. “The conservative Justices seemed eager to ‘return’ the question of abortion to the people,” she wrote after listening to oral arguments in the case. “But the point of a fundamental constitutional right is that it shouldn’t be at the people’s mercy, particularly when the composition of the Court itself has been shifted through political means for this purpose.”

What’s more, she argued that the Supreme Court would undermine its own authority by overturning a long-standing precedent in response to a state law that ran afoul of it. As she put the argument: “The spectacle of states brazenly flying in the face of the Court’s constitutional precedents, shortly followed by the Court’s discarding those precedents to make illegal actions legal after all, would effectively communicate that the Supreme Court is not, in fact, supreme.”

The journalist Cynthia Gorney’s reported essay “ Gambling With Abortion ,” originally published in Harper’s , evenhandedly captures an earlier era of debate about so-called partial-birth abortion.

[Caitlin Flanagan: The dishonesty of the abortion debate ]

The Moral Debate

Ross Douthat recently made the straightforward case against abortion . Bill Scher attempted to rebut it , focusing on what he sees as the necessity of abortion rights if women and men are to be equal.

In a winding, sometimes graphic, carefully considered Boston Review essay, “ Why I Provide Abortions ,” Christine Henneberg wrote that she tries to preserve “the woman’s contextualized autonomy.”

I trust that my patients can take the facts I offer and make their own well-informed decisions, even if it is difficult. And it is often very, very difficult. When a woman asks to see a copy of her ultrasound image, I show it to her. When she asks to see the fetus after I’ve removed it (some women do), I will bring it into the room afterward in a small dish. One twenty-five-year-old mother of five asked if she was allowed to take the fetal tissue home to perform a funeral for it. In our clinic, this isn’t permitted; the consent she’d signed specified that all fetal tissue would be disposed of with biomedical waste. So instead she bowed her head toward the dish in my hand, closed her eyes, and whispered, “I love you. And I’m sorry.” The real secret is that abortion is difficult. It is difficult because in a pregnant woman, there are no clear physiologic boundaries, no clean line showing what belongs to whom. Also—and this might sound shocking, coming from someone on this “side” of the debate—it is difficult because mothers love their children, and they often don’t know exactly how to think about, or whether they are allowed to love, an unborn child. Every woman has her reasons for seeking abortion. She may not view her reasons as tragic—probably very few women do. But I am always aware of the tragedy in the shadows, the silent gray area: all the things she will never say outside of that room, the messy truths no one else wants to hear; all the ways we, as women, are squeezed into impossible choices by a society that decontextualizes our autonomy, devalues our work, and disregards our equality.

New York once published vignettes by 26 women describing their abortions. One example:

When I got pregnant with my son, my very controlling boyfriend had convinced me that birth control poisoned my body. We usually slept in the car. I took a pregnancy test peeing over the kind of bucket you mix concrete in outside a dilapidated, vacant house. I decided I couldn’t abort a baby based on a stupid decision I made. They tell you that you love the baby automatically, but it’s not true. Then, in 2008, I was pregnant by my boyfriend Steve. We worked together at Target. He wanted to get married and have the baby. I was barely supporting the son I had, still living with my parents. I didn’t want to be tied to Steve forever. My mom and I went to Planned Parenthood. It was pouring rain. The picketers met us at the car with disgusting pictures. I was quite emotional, but I was so scared that if I showed any emotions, they wouldn’t let me do it. I told them I already had a baby. The doctor acted like it was assembly-line work. I told Steve I miscarried. We dated another year. The secret was devastating. People might be more understanding if I’d had an abortion when I was living in a car in an abusive relationship. This time, I was on birth control, with a full-time job, a boyfriend. People might think I should’ve kept it, but I couldn’t.

Caitlin Flanagan argued in 2019 that the abortion debate is often dishonest because neither side wants to grapple with the most powerful arguments for the position that they hope to defeat.

The argument for abortion, if made honestly, requires many words: It must evoke the recent past, the dire consequences to women of making a very simple medical procedure illegal. The argument against it doesn’t take even a single word. The argument against it is a picture. This is not an argument anyone is going to win. The loudest advocates on both sides are terrible representatives for their cause. When women are urged to “shout your abortion,” and when abortion becomes the subject of stand-up comedy routines, the attitude toward abortion seems ghoulish. Who could possibly be proud that they see no humanity at all in the images that science has made so painfully clear? When anti-abortion advocates speak in the most graphic terms about women “sucking babies out of the womb,” they show themselves without mercy. They are not considering the extremely human, complex, and often heartbreaking reasons behind women’s private decisions. The truth is that the best argument on each side is a damn good one, and until you acknowledge that fact, you aren’t speaking or even thinking honestly about the issue. You certainly aren’t going to convince anybody. Only the truth has the power to move.

Similar conflictedness once led George McKenna to posit that “we can find in Lincoln’s anti-slavery rhetoric a coherent position that could serve as a model for pro-life politicians today.”

Here’s what he advised such a politician to say, in part:

If elected, I will not try to abolish an institution that the Supreme Court has ruled to be constitutionally protected, but I will do everything in my power to arrest its further spread and place it where the public can rest in the belief that it is becoming increasingly rare. I take very seriously the imperative, often expressed by abortion supporters, that abortion should be rare. Therefore, if I am elected, I will seek to end all public subsidies for abortion, for abortion advocacy, and for experiments on aborted children. I will support all reasonable abortion restrictions that pass muster with the Supreme Court, and I will encourage those who provide alternatives to abortion. Above all, I mean to treat it as a wrong. I will use the forum provided by my office to speak out against abortion and related practices, such as euthanasia, that violate or undermine the most fundamental of the rights enshrined in this nation’s founding charter.

As he saw it, the “permit, restrict, discourage” position “is unequivocally pro-life even as it is effectively pro-choice,” because “it does not say ‘I am personally opposed to abortion’; it says abortion is evil. Yet in its own way it is pro-choice … it does not demand an immediate end to abortion … it concludes that all those who oppose abortion can do right now is to contain the cancer … It thus acknowledges the present legal status of ‘choice’ even as it urges Americans to choose life.”

Question of the Week

“A striking thing about the American abortion debate,” Douthat wrote in his column , “is how little abortion itself is actually debated. The sensitivity and intimacy of the issue, the mixed feelings of so many Americans, mean that most politicians and even many pundits really don’t like to talk about it. The mental habits of polarization, the assumption that the other side is always acting with hidden motives or in bad faith, mean that accusations of hypocrisy or simple evil are more commonplace than direct engagement with the pro-choice or pro-life argument.”

The late Christopher Hitchens once wrote, “The only moral losers in this argument are those who say that there is no conflict, and nothing to argue about. The irresoluble conflict of right with right was Hegel’s definition of tragedy, and tragedy is inseparable from human life, and no advance in science or medicine is ever going to enable us to evade that.”

I’m eager to read anything you have to say about abortion that honors the spirit of either of those quotations, whether you’re hopelessly conflicted or a strong proponent of any position.

Email [email protected] .

Provocation of the Week

Barton Gellman, who anticipated Donald Trump’s refusal to accept defeat in the 2020 election in the November 2020 articles “ The Election That Could Break America ” and “ How Trump Could Attempt a Coup ,” has a new article up, “ Trump’s Next Coup Has Already Begun .” It argues, in part:

For more than a year now, with tacit and explicit support from their party’s national leaders, state Republican operatives have been building an apparatus of election theft. Elected officials in Arizona, Texas, Georgia, Pennsylvania, Wisconsin, Michigan, and other states have studied Donald Trump’s crusade to overturn the 2020 election. They have noted the points of failure and have taken concrete steps to avoid failure next time. Some of them have rewritten statutes to seize partisan control of decisions about which ballots to count and which to discard, which results to certify and which to reject. They are driving out or stripping power from election officials who refused to go along with the plot last November, aiming to replace them with exponents of the Big Lie. They are fine-tuning a legal argument that purports to allow state legislators to override the choice of the voters. By way of foundation for all the rest, Trump and his party have convinced a dauntingly large number of Americans that the essential workings of democracy are corrupt, that made-up claims of fraud are true, that only cheating can thwart their victory at the polls, that tyranny has usurped their government, and that violence is a legitimate response.

That’s concerning.

Up for Debate is new. If you have suggestions on future topics or how to improve your reading experience, shoot me an email, and if you’re liking what you see, tell a friend who’d enjoy it, too.

By submitting an email, you’ve agreed to let us use it—in part or in full—in this newsletter and on our website. By default, published feedback includes a writer’s full name, city, and state, unless otherwise requested in your initial note.

Read our research on: Abortion | Podcasts | Election 2024

Regions & Countries

Pro-choice does not mean pro-abortion: an argument for abortion rights featuring the rev. carlton veazey.

Since the Supreme Court’s historic 1973 decision in Roe v. Wade , the issue of a woman’s right to an abortion has fostered one of the most contentious moral and political debates in America. Opponents of abortion rights argue that life begins at conception – making abortion tantamount to homicide. Abortion rights advocates, in contrast, maintain that women have a right to decide what happens to their bodies – sometimes without any restrictions.

To explore the case for abortion rights, the Pew Forum turns to the Rev. Carlton W. Veazey, who for more than a decade has been president of the Religious Coalition for Reproductive Choice. Based in Washington, D.C., the coalition advocates for reproductive choice and religious freedom on behalf of about 40 religious groups and organizations. Prior to joining the coalition, Veazey spent 33 years as a pastor at Zion Baptist Church in Washington, D.C.

A counterargument explaining the case against abortion rights is made by the Rev. J. Daniel Mindling, professor of moral theology at Mount St. Mary’s Seminary.

Featuring: The Rev. Carlton W. Veazey, President, Religious Coalition for Reproductive Choice

Interviewer: David Masci, Senior Research Fellow, Pew Forum on Religion & Public Life

Question & Answer

Can you explain how your Christian faith informs your views in support of abortion rights?

I grew up in a Christian home. My father was a Baptist minister for many years in Memphis, Tenn. One of the things that he instilled in me – I used to hear it so much – was free will, free will, free will. It was ingrained in me that you have the ability to make choices. You have the ability to decide what you want to do. You are responsible for your decisions, but God has given you that responsibility, that option to make decisions.

I had firsthand experience of seeing black women and poor women being disproportionately impacted by the fact that they had no choices about an unintended pregnancy, even if it would damage their health or cause great hardship in their family. And I remember some of them being maimed in back-alley abortions; some of them died. There was no legal choice before Roe v. Wade .

But in this day and time, we have a clearer understanding that men and women are moral agents and equipped to make decisions about even the most difficult and complex matters. We must ensure a woman can determine when and whether to have children according to her own conscience and religious beliefs and without governmental interference or coercion. We must also ensure that women have the resources to have a healthy, safe pregnancy, if that is their decision, and that women and families have the resources to raise a child with security.

The right to choose has changed and expanded over the years since Roe v. Wade . We now speak of reproductive justice – and that includes comprehensive sex education, family planning and contraception, adequate medical care, a safe environment, the ability to continue a pregnancy and the resources that make that choice possible. That is my moral framework.

You talk about free will, and as a Christian you believe in free will. But you also said that God gave us free will and gave us the opportunity to make right and wrong choices. Why do you believe that abortion can, at least in some instances, be the right choice?

Dan Maguire, a former Jesuit priest and professor of moral theology and ethics at Marquette University, says that to have a child can be a sacred choice, but to not have a child can also be a sacred choice.

And these choices revolve around circumstances and issues – like whether a person is old enough to care for a child or whether a woman already has more children than she can care for. Also, remember that medical circumstances are the reason many women have an abortion – for example, if they are having chemotherapy for cancer or have a life-threatening chronic illness – and most later-term abortions occur because of fetal abnormalities that will result in stillbirth or the death of the child. These are difficult decisions; they’re moral decisions, sometimes requiring a woman to decide if she will risk her life for a pregnancy.

Abortion is a very serious decision and each decision depends on circumstances. That’s why I tell people: I am not pro-abortion, I am pro-choice. And that’s an important distinction.

You’ve talked about the right of a woman to make a choice. Does the fetus have any rights?

First, let me say that the religious, pro-choice position is based on respect for human life, including potential life and existing life.

But I do not believe that life as we know it starts at conception. I am troubled by the implications of a fetus having legal rights because that could pit the fetus against the woman carrying the fetus; for example, if the woman needed a medical procedure, the law could require the fetus to be considered separately and equally.

From a religious perspective, it’s more important to consider the moral issues involved in making a decision about abortion. Also, it’s important to remember that religious traditions have very different ideas about the status of the fetus. Roman Catholic doctrine regards a fertilized egg as a human being. Judaism holds that life begins with the first breath.

What about at the very end of a woman’s pregnancy? Does a fetus acquire rights after the point of viability, when it can survive outside the womb? Or let me ask it another way: Assuming a woman is healthy and her fetus is healthy, should the woman be able to terminate her pregnancy until the end of her pregnancy?

There’s an assumption that a woman would end a viable pregnancy carelessly or without a reason. The facts don’t bear this out. Most abortions are performed in the first 12 weeks of pregnancy. Late abortions are virtually always performed for the most serious medical and health reasons, including saving the woman’s life.

But what if such a case came before you? If you were that woman’s pastor, what would you say?

I would talk to her in a helpful, positive, respectful way and help her discuss what was troubling her. I would suggest alternatives such as adoption.

Let me shift gears a little bit. Many Americans have said they favor a compromise, or reaching a middle-ground policy, on abortion. Do you sympathize with this desire and do you think that both sides should compromise to end this rancorous debate?

I have been to more middle-ground and common-ground meetings than I can remember and I’ve never been to one where we walked out with any decision.

That being said, I think that we all should agree that abortion should be rare. How do we do that? We do that by providing comprehensive sex education in schools and in religious congregations and by ensuring that there is accurate information about contraception and that contraception is available. Unfortunately, the U.S. Congress has not been willing to pass a bill to fund comprehensive sex education, but they are willing to put a lot of money into failed and harmful abstinence-only programs that often rely on scare tactics and inaccurate information.

Former Surgeon General David Satcher has shown that abstinence-only programs do not work and that we should provide young people with the information to protect themselves. Education that stresses abstinence and provides accurate information about contraception will reduce the abortion rate. That is the ground that I stand on. I would say that here is a way we can work together to reduce the need for abortions.

Abortion has become central to what many people call the “culture wars.” Some consider it to be the most contentious moral issue in America today. Why do many Catholics, evangelical Christians and other people of faith disagree with you?

I was raised to respect differing views so the rigid views against abortion are hard for me to understand. I will often tell someone on the other side, “I respect you. I may disagree with your theological perspective, but I respect your views. But I think it’s totally arrogant for you to tell me that I need to believe what you believe.” It’s not that I think we should not try to win each other over. But we have to respect people’s different religious beliefs.

But what about people who believe that life begins at conception and that terminating a pregnancy is murder? For them, it may not just be about respecting or tolerating each other’s viewpoints; they believe this is an issue of life or death. What do you say to people who make that kind of argument?

I would say that they have a right to their beliefs, as do I. I would try to explain that my views are grounded in my religion, as are theirs. I believe that we must ensure that women are treated with dignity and respect and that women are able to follow the dictates of their conscience – and that includes their reproductive decisions. Ultimately, it is the government’s responsibility to ensure that women have the ability to make decisions of conscience and have access to reproductive health services.

Some in the anti-abortion camp contend that the existence of legalized abortion is a sign of the self-centeredness and selfishness of our age. Is there any validity to this view?

Although abortion is a very difficult decision, it can be the most responsible decision a person can make when faced with an unintended pregnancy or a pregnancy that will have serious health consequences.

Depending on the circumstances, it might be selfish to bring a child into the world. You know, a lot of people say, “You must bring this child into the world.” They are 100 percent supportive while the child is in the womb. As soon as the child is born, they abort the child in other ways. They abort a child through lack of health care, lack of education, lack of housing, and through poverty, which can drive a child into drugs or the criminal justice system.

So is it selfish to bring children into the world and not care for them? I think the other side can be very selfish by neglecting the children we have already. For all practical purposes, children whom we are neglecting are being aborted.

This transcript has been edited for clarity, spelling and grammar.

Sign up for our Religion newsletter

Sent weekly on Wednesday

Key facts about the abortion debate in america, public opinion on abortion, three-in-ten or more democrats and republicans don’t agree with their party on abortion, partisanship a bigger factor than geography in views of abortion access locally, do state laws on abortion reflect public opinion, most popular.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

The New Pro-Abortion Generation

As Roe v. Wade faces its greatest challenge yet, young people are taking the reins to protect abortion access.

by Amelia Pollard

August 5, 2021

Rogelio V. Solis/AP Photo

Pro-abortion volunteers with the Pink House Defenders in Jackson, Mississippi

This article appears in the July/August 2021 issue of The American Prospect magazine. Subscribe here.

Every day at the Jackson Women’s Health Organization, Mississippi’s only abortion clinic, resembles trench warfare. Painted like a shade of bubble gum, the center has affectionately earned the nickname the “Pink House.” But its modern windows and copper roof are shielded from the street. Black plastic tarps and panels guard patients’ privacy by keeping the protesters out of eyesight.

Around a dozen anti-abortion protesters often show up with bullhorns and picket signs, while volunteers for the Pinkhouse Defenders, a nonprofit organization, thwart hecklers by blasting music and escorting patients from their cars to the clinic’s waiting room. In the last several months, volunteers have embraced TikTok as their weapon of choice, filming protesters and posting the videos on social media.

Sunna Savani, a second-year medical student at the University of Mississippi and a volunteer with the Pinkhouse Defenders, says Saturdays at the clinic are hectic. “They have street church with over 100 people, a mini-service blocking the roads,” she says, referring to worship services held in front of the abortion clinic. Savani is among the escorts who volunteer their time with the Defenders, 25 percent of whom are under the age of 30.

PHI 240: Ethics of Fetal Development & Abortion (Daniels)

Start here!
Search for More

Bertha Alvarez Manninen

Donald marquis, judith jarvis thomson, mary anne warren, essay: the value of choice and the choice to value: expanding the discussion about fetal life within prochoice advocacy.

Essay: Why Abortion is Immoral

Essay: a defense of abortion, essay: on the moral and legal status of abortion.

<< Previous: Search for More
Next: Help >>
Last Updated: Feb 14, 2024 4:33 PM
URL: https://libguides.pittcc.edu/phi240

Anti-Abortion Movement
Women’s History
Film & TV
Gender Violence
#50YearsofMs

More Than A Magazine, A Movement

Justice & Law

Why Civic Engagement for Abortion Advocacy Matters

The voices of the majority who side with robust reproductive rights must be reflected in legislation..

Last year, Americans lost their federal right to abortion, despite polls that suggest favorable public opinion for abortion access is as high as 85 percent . In a country where legislation is supposed to reflect the demands of its people, this dissonance with public opinion is outrageous.

After all, democracy hinges on effective civic engagement: mechanisms that enable the public to express their concerns, and individual and collective actions designed to address these issues. While polls show the majority of the American public consistently supports abortion rights, 24 states have passed abortion bans so far. Given this landscape and the failure of our country to adopt laws that are widely supported, we must look outside the U.S. for models of strong civic engagement in order to restore abortion rights here at home.

Following the U.S. Supreme Court’s decision to overrule Roe v. Wade and overturn the federal constitutional right to abortion, Republicans moved quickly to pass sweeping abortion bans. Protests broke out across the country—but paled in comparison to other public outcries, such as the 2017 Women’s March. That day, more than 470,000 people in Washington, D.C. , and 5 million people worldwide marched in opposition to the inauguration of Donald Trump—the single largest day of protest in U.S. history.

After four years of no recourse during the Trump administration, people are tired and discouraged. But we still have a voice.

We can use this voice in public and private forums, at events, with our family and friends, and in the voting booth. Public discourse on abortion typically involves a wide-ranging cast of characters: philosophers, scientists, medical providers, religious leaders, people who experienced the procedure and more. The vast array of opinions in these discussions creates a complex, collective social opinion that requires different forms of engagement when it comes to expanding spaces for social participation and collective advocacy. This complexity requires multiple action pathways (legal, political, religious and societal) that citizens can use to achieve positive reproductive health outcomes. We need to take advantage of all of them.

Many of us think of civic engagement on abortion as getting to the polls and voting for candidates who support reproductive rights. Civic engagement is much more than that. It also uses citizens’ voices to spread accurate health information across the general public and to apply pressure on decisionmakers for a specific cause.

For nearly 60 years, PAI has been working to advance universal access to sexual and reproductive health and rights through advocacy, partnerships and funding. Part of this work involves supporting champions that participate and lead civil society organizations to galvanize collective advocacy approaches.

As a result, PAI’s partners have learned to strategically organize the chaos of civic discourse by ensuring access to safe abortions, but also keeping healthy civic spaces alive to protect other social and human rights issues.

In Malawi and Zambia, for example, three of PAI’s partners have been steadfastly implementing multipronged strategies for abortion advocacy through increased civic engagement. The U.S. should be taking notes.

Many of us think of civic engagement on abortion as getting to the polls and voting for candidates who support reproductive rights. Civic engagement is much more than that.

Banja La Mtsogolo (BLM) is effectively creating and broadening civic space for religious leaders, mobilizing interfaith discussions to reduce opposition in the media and building support for lifesaving health services such as abortion in Malawi. In 2022, BLM created a collaborative community radio discussion—the Young Women’s Consortium , Coalition for Prevention of Unsafe Abortion and Religious Network for Choice—to disseminate accurate information about abortion access, alongside stories of women who had experienced medical complications from unsafe abortions. The radio segment reached more than 140,000 listeners and positively influenced Malawian public opinion on abortion by using trusted faith leaders to disseminate accurate information.

In Zambia, the Centre for Reproductive Health and Education (CRHE) has served as a trusted civil society partner for the government since 2006. It has been convening various peer organizations working in reproductive health to define and clarify national abortion policy. Currently leading the Ministry of Health’s Reproductive Health Task Force, CRHE serves as an interface between Zambia’s legislative and judicial branches to interpret the country’s Comprehensive Abortion Care guidelines fairly and accurately. Of note, these guidelines not only currently require three physician approvals, but also a poorly defined hospital requirement, for an abortion to proceed. CRHE is advancing civic engagement in abortion discourse by elevating the collective civil society voices of Zambia’s Safe Abortion Advisory Group members to the Ministries of Health and Justice, ensuring that decision-makers agree on a sustainable solution that is representative of public opinion.

Meanwhile, Copper Rose Zambia (CRZ) is addressing clinical challenges to abortion access by advocating for the inclusion of values clarification and attitudes transformation (VCAT) training in pre- and in-service clinical training, and using its role as a member of the country’s Family Planning and Safe Abortion Advocacy Technical Working Groups. VCAT is the process of identifying the influential values and beliefs that guide individuals’ interests and decisions. This is important because values and beliefs can predict behavior or performance, including among health workers. There is such sufficient evidence of this that the World Health Organization recommends VCAT exercises for medical providers as integral training for addressing stigma so that they can separate their personal beliefs from the needs of clients. This is a critical step toward ensuring providers can adequately fulfill their medical obligation to serve the client’s best interests by performing abortions.

Civic engagement is an invaluable tool to unlock access to safe abortion care. But, globally, protecting civic spaces is an uphill battle. Just like in the U.S., PAI’s partners have shared that critical voices have left the civic space in recent years due to unstable funding and a disproportional wave of U.S.-funded opposition triggered by the Dobbs decision.

“Upholding strong civic spaces is vital for fostering genuine democracy and ensuring reproductive justice,” said Natasha Salifyanji Koama, co-founder of CRZ. “Every silenced voice due to lack of support hinders social progress and undermines gender equality.”

Our greatest protection against these challenges is maintaining strong civic spaces and upholding a strong democracy—so that the voices of the majority who side with robust reproductive rights are loud enough to be reflected in legislation. Just as PAI’s partners are doing everyday around the world, advocates in the U.S. should prioritize maintaining spaces for public opinion and organizing collective action as a key abortion justice strategy if they want to foster the true democracy that America claims to be.

PAI champions policies that put women, youth and at-risk communities in charge of their sexual and reproductive health and rights. We work with policymakers in Washington, D.C., and our network of funded partners across nearly 40 countries to remove roadblocks to access sexual and reproductive health services and support. For nearly 60 years, PAI has helped communities succeed by upholding their basic rights. To learn more, visit www.pai.org and follow PAI on Facebook , Twitter , Instagram and LinkedIn .

The Patriarchs’ War on Women

How Congress Can Help Women and Girls in Conflict Zones

Dobbs, Abortion Rights and the State of U.S. Democracy

U.S. democracy is at a dangerous inflection point—from the demise of abortion rights, to a lack of pay equity and parental leave, to skyrocketing maternal mortality, and attacks on trans health. Left unchecked, these crises will lead to wider gaps in political participation and representation. For 50 years, Ms . has been forging feminist journalism—reporting, rebelling and truth-telling from the front-lines, championing the Equal Rights Amendment, and centering the stories of those most impacted. With all that’s at stake for equality, we are redoubling our commitment for the next 50 years. In turn, we need your help, Support Ms . today with a donation—any amount that is meaningful to you . For as little as $5 each month , you’ll receive the print magazine along with our e-newsletters, action alerts, and invitations to Ms . Studios events and podcasts . We are grateful for your loyalty and ferocity .

About Eve Brecker

You may also like:, project 2025: republicans’ plan to ban abortion pills nationwide, feminists react to the scotus abortion pill case: ‘access to mifepristone is essential’.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

Advanced Search
Journal List
Lippincott Open Access

Abortion as Essential Health Care and the Critical Role Your Practice Can Play in Protecting Abortion Access

Obstetrician–gynecologists have both the skills and the knowledge to incorporate abortion into their clinical practices, and our patients deserve a specialty-wide concerted effort to deliver comprehensive reproductive health care at this critical moment.

Few obstetrician–gynecologists (ob-gyns) provide abortion care, resulting in abortion being separated from other reproductive health care. This segregation of services disrupts the ob-gyn patient–clinician relationship, generates needless costs, delays access to abortion care, and contributes to stigma. General ob-gyns have both the skills and the knowledge to incorporate abortion into their clinical practices. In this way, they can actively contribute to the protection of abortion access now with the loss of federal protection for abortion under Roe v Wade . For those who live where abortion remains legal, now is the time to start providing abortions and enhancing your abortion-referral process. For all, regardless of state legislation, ob-gyns must be leaders in advocacy by facilitating abortion care—across state lines, using telehealth, or with self-managed abortion—and avoiding any contribution to the criminalization of those who seek or obtain essential abortion care. Our patients deserve a specialty-wide concerted effort to deliver comprehensive reproductive health care to the fullest extent.

On June 24, 2022, the Supreme Court overturned nearly 50 years of federal precedent protecting abortion access in its Dobbs v Jackson Women's Health opinion. 1 The American College of Obstetricians and Gynecologists (ACOG) has replied by messaging that, “Abortion is essential health care.” 2 A commanding 95% of obstetrician–gynecologists (ob-gyns) agree with ACOG and support provision of abortion care, reporting that they would provide or facilitate provision of care, even for indications that conflict with their own personal values. 3 , 4 However, abortion provision is not a routine part of most general ob-gyn practices; currently, only 14–24% of ob-gyns perform abortions. 5 , 6 Because few care for many, and are asked to do so primarily in independent clinics, abortion has long been legislatively vulnerable, practically speaking, through TRAP (Targeted Restrictions on Abortion Providers) laws and through more subtle harms created by distancing trainees and attendings from the lived realities of providing stigmatized care. Now, ob-gyns must recognize this vulnerability and consider how their practices could be used to strengthen the U.S. abortion-provision network.

In a field that values longitudinal relationships, it is problematic that our patients have to seek care in abortion-specific settings, unaffiliated with their usual ob-gyn practices. 7 The journey to find abortion care is complex and riddled with deliberate disinformation, discriminatory barriers, labyrinthine legislative hurdles, and the burdensome costs of out-of-pocket care, lodging, lost wages, travel, and childcare. 8 Even when ob-gyns are eager to guide their patients through this circuitous referral path, 53% of these well-intentioned physicians are unable to make effective referrals due to their own lack of knowledge regarding the abortion-referral process. 9 Resulting delays in accessing abortion appointments lead to greater patient cost, more complex logistics such as a multiday abortion procedures and fewer clinician options, and elevated risk of complications at advanced gestational ages. 10 – 12 Ultimately, delays may result in total denial of abortion care, which is associated with medical-, economic-, and safety-related harms. 13 , 14 These harms already accumulate disproportionately among racial and ethnic minority groups, particularly Black people who can become pregnant, a disparity that will be profoundly exacerbated now that Roe has been overturned. 15

Abortion is an essential part of health care, but our collective action as a specialty has not historically lived up to this principle. Now is the time for ob-gyns to actively participate in abortion care and to critically consider the needs of our patients, our personal conscience to act, and the responsibility to wield our professional skills. If we truly believe that abortion is standard health care, we should consider how we can directly contribute to equitable abortion care. We propose that all ob-gyns consider the most that they can do within the confines of their own practice environment from the following recommendations.

FOR THOSE WHO PRACTICE IN STATES WHERE ABORTION REMAINS LEGAL

Provide abortion care.

General ob-gyns have the required skillset both to perform procedural abortion with first-trimester uterine aspiration and the counseling required to guide patients through medication abortion. Consider how you may expand the use of those skills. For either procedural or medication abortion (detailed below), experts have developed clinical resources to refresh your patient-counseling points (Table (Table1 1 ), 16 , 17 and patients can seek counseling and supportive care independently through organizations such as Reprocare, 18 All-Options, 19 and Exhale. 20

Options Counseling Considerations

An external file that holds a picture, illustration, etc.
Object name is ong-140-729-g001.jpg

Provide Medication Abortion

Medication abortion may offer the logistically easiest route toward integrating abortion care into clinical practice. 21 Early pregnancy loss and medication abortion require the same medications and office resources; counseling, evaluation, medications, potential complications, and follow-up are remarkably similar. Important differences that require investment before expansion of care include the development of appropriate consent forms as well as protocols for incorporating unique state mandates for abortion care (eg, counseling scripts, required information modules). Numerous resources, including ACOG and UpToDate, provide guidance on the provision of this care, summarized in Box 1 . 22 , 23 The coronavirus disease 2019 (COVID-19) pandemic prompted the growth of extraclinical pathways for medication abortion, including telehealth, postal mail distribution of mifepristone, and history-based care. 24 , 25 These practices are effective and safe and decrease barriers to care. 26 , 27 Many, but not a majority of, ob-gyns have established mifepristone as part of their practice for medication management of missed abortion given its superior efficacy to the regimen of misoprostol alone (Neill S, Goldberg A, Janiak E. Medication management of early pregnancy loss: the impact of the U.S. Food and Drug Administration risk evaluation and mitigation strategy [A289] [abstract]. Obstet Gynecol 2022;139:83S. doi:10.1097/01.AOG.0000825716.77939.40). 28 With the fall of Roe , the need to provide medication abortion services now should compel remaining ob-gyns to incorporate mifepristone into standard practice. This may involve education of other stakeholders, such as managers and administrators. A primary barrier to clinical use of mifepristone has been limited knowledge of mifepristone indications, safety, and provision logistics, primarily stemming from the Risk Evaluation and Mitigation Strategy (REMS) program (Neill et al. Obstet Gynecol 2022;139:83S; and Kaiser J, Kurtz T, Glasser A, Brintz B, Turok D, Sanders J. Current knowledge and use of mifepristone for miscarriage in Utah and the impact of an educational video on future use [A292] [abstract]. Obstet Gynecol 2022;139:84S. doi:10.1097/01.AOG.0000825728.94972.6d). 29 The American College of Obstetricians and Gynecologists’ position statement on improving access to mifepristone, which includes citations of important additional literature, offers an authoritative source to educate concerned staff. 30 Until the REMS program is dissolved, a change supported by robust safety data, a one-time prescriber agreement form must be filled out, often by just one person on behalf of the entire clinic. 31 , 32 The U.S. Food and Drug Administration has yet to release its certification process for pharmacy dispensation of mifepristone; once details are available, ob-gyns should encourage pharmacist colleagues to satisfy requirements.

Guide to Facilitating Medication Abortion

History: lmp, options counseling, rule out the following contraindications below:.

Pregnancy longer than 77 d
Suspected ectopic pregnancy (pain, bleeding)
Anemia (typically hemoglobin less than 9.0)
Anticoagulated, bleeding disorder
Long-term oral steroid use
Adrenal insufficiency, porphyria
IUD in place
Allergic to mifepristone

Examination: usually not indicated unless workup for pain, bleeding, or vaginal discharge

Laboratory results.

hCG (if needed for follow-up purposes or PUL workup)
CBC (if a history of anemia or heavy bleeding)
Type and screen (more than 56 d of gestation*; may be extended to 12 weeks)

Ultrasonographic indications

Unclear LMP (can be an informal ultrasonogram in the clinic for gestational dating)
Concern for ectopic pregnancy

Counsel and prescribe medications

Sign state † and institutional consents
Sign mifepristone patient agreement ‡
Provide mifepristone medication guide §
200 mg orally × 1
Patient may swallow pill in clinic or bring the pill home to take when it is convenient
No side effects typically
Dose 24–48 h after mifepristone
200 micrograms × 4 tablets buccally or vaginally; repeat 4 h later buccally if more than 63 d of gestation
Swallow pill remnants after 30 min in buccal mucosa
May premedicate for pain (ibuprofen 600 mg) or nausea before misoprostol
Expected effects within 2–6 h of misoprostol
Cramping, bleeding, passing clots normal
Flu-like symptoms normal
Provide desired contraception as indicated
Bleeding more than 2 pads/h for 2 h
Severe abdominal pain for longer than 24 h
Fever 100.4° F for longer than 4 h
Feeling sick more than 24 h after misoprostol

Follow-up to confirm complete abortion

Phone call for symptom check at 1 wk and negative home UPT at 4 wk, or
hCG level at 5–14 d with greater than 80% decline, or
Ultrasonogram at more than 48 h from misoprostol with no gestational sac

LMP, last menstrual period; IUD, intrauterine device; hCG, human chorionic gonadotropin; PUL, pregnancy of unknown location; CBC, complete blood count; UPT, urine pregnancy test.

*May be extended to 12 weeks.

† State counseling and waiting period laws: https://www.guttmacher.org/state-policy/explore/counseling-and-waiting-periods-abortion .

‡ U.S. Food and Drug Administration–mandated Patient Agreement Form—select and sign correct manufacturers' version: https://genbiopro.com/wp-content/uploads/2019/05/GenBioPro-Patient-Agreement.pdf ; http://www.earlyoptionpill.com/wp-content/uploads/2016/02/Patient-Agreement-Form-March2016-1.pdf .

§Patient Medication Guide—available in Spanish, Arabic, French, Chinese, Hindi, Vietnamese: https://genbiopro.com/wp-content/uploads/2019/05/GenBioPro-Medication-Guide.pdf ; http://www.earlyoptionpill.com/wp-content/uploads/2016/01/DAN_MedGuideEng_FINAL.pdf .

Provide Procedural Abortion

Because the procedural steps are the same for suction aspiration or dilation and curettage no matter the indication, ob-gyns already have the professional skills and expertise to provide procedural abortion in their medical practices. Seek to bolster your training as needed if you do not feel proficient at first-trimester surgical procedures or if you would like to start providing dilation and evacuation at later gestations. Although more than 90% of abortions are performed in the first trimester, induced abortion by suction aspiration through 15 weeks of gestation can be readily integrated into standard ob-gyn care as a single-day procedure with a curette size of 14–16 mm. 34 , 35 Individuals experiencing pregnancy loss or induced abortion benefit from an office or outpatient capacity to deliver manual vacuum aspiration and suction dilation and curettage under local or moderate sedation. 36 – 38 In-clinic procedures may be the most affordable option in these circumstances, and ob-gyns do many other in-clinic procedures that confer the same degree of risk as first-trimester uterine aspiration. The option for a procedure in a main operating room should be made available for individuals who need or desire procedural care under greater anesthesia support. Relationships with labor and delivery unit staff are central to existing care delivery under (at least) exigent circumstances, such as previable or periviable rupture of membranes, advanced cervical dilation, abruption or hemorrhage, and fetal anomalies. In practice settings that create significant barriers to procedural abortion care for most individuals, inroads may begin with institutional policies around the populations for whom there may be exceptions, such as the care of sexual assault survivors, incest survivors, minors, and pregnant people with life-threatening conditions. It is important to generate mutually agreed on, ideally expansively defined, diagnoses that jeopardize maternal health to avoid any delay confirming that care is in line with state and institutional policies at the time of patient presentation. Such conversations may require input from colleagues in subspecialties, namely complex family planning, maternal–fetal medicine, and pediatrics, as well as legal and ethics representatives. Identification of community allies may strengthen referrals and support outside of the institution (eg, child services, intimate partner or sexual violence support advocates) as well. Additionally, financial teams should generate a self-pay package to meet the needs of individuals who travel from states with restrictions on private and public insurance.

Improve Referral Pathways for Patients Who Need Abortion Care Beyond Your Expertise

Conscientious refusal to participate in any aspect of standard reproductive medicine is narrowly defined and always requires timely, nonjudgmental, accurate referral to care. 39 If you will not provide abortion care directly, learn the best way to facilitate care with a colleague who provides the care your patient needs (eg, what anticipatory workup, such as ultrasonograms, can your practice provide while the patient is waiting for an appointment?) Now is the time to solidify your relationships with and support for colleagues who provide complex abortions. Many current family planning clinicians, particularly in places such as Colorado, New Mexico, Illinois, and California that neighbor abortion-hostile states, are experiencing enormous increases in demand for care. Support of these colleagues, if not by providing first-trimester care yourself then by developing a streamlined referral process, will be essential in facilitating necessary patient care.

Become a Spokesperson Committed to Dismantling Abortion Stigma

Talk to your patients, your colleagues inside and outside of obstetrics and gynecology, and your community about accessible abortion care as a requirement for safe, autonomous reproductive health. Become a thoughtful and effective messenger by educating yourself on abortion speaking points supplied through reputable organizations such as ACOG, 40 Physicians for Reproductive Health, 41 and the American Civil Liberties Union. 42 Your complex family planning colleagues may not be available to contribute to this education while they provide direct clinical abortion care .

FOR THOSE WHO PRACTICE IN STATES WHERE ABORTION IS ILLEGAL OR SEVERELY RESTRICTED

Do not contribute to patient criminalization.

Since 2000, at least 21 people have been criminalized for abortions, many of whom were reported by health care professionals. 43 The World Health Organization, the American Medical Association, and ACOG denounce criminalization of abortion. 44 – 46 As of July 2022, no state mandates clinicians to report those who they suspect have undertaken self-managed abortion. 47 In fact, reporting counters current federal and state legal protections of health information. The Department of Health and Human Services affirmed this by releasing guidance on the Privacy Rule as it pertains to reproductive health, clearly stating that intention to seek a legal abortion is not a, “serious and imminent threat to the health or safety of a person or the public,” regardless of local state abortion policy. 48 There is a disgraceful and discriminatory history of collusion between medical professionals and the carceral system in regulating marginalized members of society (eg, biased prenatal substance use testing and reporting, court-ordered and physician-placed contraceptive implants among racial and ethnic minority groups, and forced sterilizations). 49 It is a moral and professional imperative to avoid participation in such discriminatory practices. This includes assuring patients of their right to privacy and limiting history-taking to what is clinically indicated as reports of physician interrogations arise. 50 Despite (poorly substantiated) concerns regarding the health risks of self-managed abortion, the greater risks facing some pregnant people with the fall of Roe are legal persecution and the carceral system; ob-gyns must not contribute to this risk.

Educate Those Inside or Outside of Your Professional Workplace Who May Encounter Patients Who Want or Need an Abortion

For colleagues in health care, such as emergency department clinicians, emphasize the clinician’s role in avoiding any contribution to criminalization as above. Confirm that there is no way and no need to determine a difference between induced abortion and miscarriage. Educate your medical colleagues to perform pregnancy-options counseling and timely abortion referrals when they cannot offer abortion services themselves.

For our medical and nonmedical acquaintances and communities, normalize abortion talk and speak up to correct misinformation and abortion myths. Share the reality that abortion, including self-managed abortion with misoprostol, is safe, especially when framed in direct contrast to the inevitable, dangerous effects of abortion restriction and forced continuation of pregnancy. 51 Review intentional vocabulary in speaking in a medically accurate, nonstigmatizing, and inclusive way about abortion. 40

Identify the Lowest Health-Risk and Legal-Risk Path for Patient Care

The lowest health-risk and legal-risk path for patient care may include self-managed abortion, as outlined by the World Health Organization and the Society of Family Planning. 46 , 52 Familiarize yourself with extraclinical resources and support, such as:

Women Help Women, SASS – Self-Managed Abortion; Safe & Supported: comprehensive resource for medication abortions, available at https://abortionpillinfo.org/
AidAccess: online consultation with physicians and mail service for medication abortion, available at https://aidaccess.org/
Repro Legal Helpline: legal hotline to support those pursuing self-managed abortion, available at https://www.reprolegalhelpline.org/
Miscarriage + Abortion Hotline: support hotline for any questions related to self-managed abortion or miscarriage, staffed by clinicians, available at https://www.mahotline.org/
National Network of Abortion Funds: centralized source to support funding an abortion, including identification of local abortion funds, available at https://abortionfunds.org/

Assist Patients With Safely Accessing Periabortion and Postabortion Care if Needed

Consider providing supportive services, such as ultrasound reports or images, laboratory test results, and anticipatory guidance, for patients who can use that information for abortion by telehealth or by mail. 53 For the many patients who have not already independently connected with care and support, become a knowledgeable clinician who can facilitate warm referrals to online or out-of-state abortion care as well as to abortion funds. Empower your patients with the knowledge that clinicians cannot distinguish between miscarriage and induced abortion. Because the clinical presentation and any necessary clinical care is the same, patients can be reassured that they will receive appropriate treatment if they choose not to share with a health care team information regarding self-managed or induced abortion services they may have received.

Refresh Your Management of Complications of Abortion 54

Medication abortions (self-managed or clinically overseen) are expected to increase in volume, so the absolute number of rare complications, such as infection or clinically relevant bleeding, may as well. Importantly, those who take mifepristone and misoprostol or misoprostol alone to manage first-trimester pregnancy terminations will have extremely low rates of complications, with or without clinician involvement. 55 It remains to be seen how readily these medications will be obtained by pregnant people. If self-administration of the U.S. Food and Drug Administration–approved regimen for medication abortion is not an option in one state, some may be able to seek care in other states. For the majority of individuals seeking abortion with existing financial, logistic, and societal barriers to care, access will likely become (or already had become) impossible. Therefore, alternative measures may be sought, some familiar to those who practiced in the era before Roe . Concerns related to ingestion of substances unfamiliar to clinicians can be reviewed for free and confidentially 24-hours a day through the national toxicology hotline (800-222-1222); callers will be routed to toxicology-trained pharmacists or physicians.

Intensify Abortion Training for Clinical Staff

Regardless of state legislation, all those involved in patient care should continue to receive education in referral and options-counseling training, 56 , 57 use of hospital simulation spaces, 58 and recruitment (and payment) of family planning clinicians for grand rounds, resident training sessions, clinical shadowing, and apprenticeships. These learning opportunities also establish institutional norms around abortion care and allow for those who desire more involvement in abortion care to have their interests recognized.

FOR THOSE WHO PRACTICE ANYWHERE IN THE UNITED STATES

The task of professional and practice transformation may seem great, but it is long overdue. As you personally, and as a practice, work to improve abortion provision, complementary exercises in advocacy include the following.

Know Your State Laws

The Guttmacher Institute provides an excellent overview of state laws, updated monthly. 59 However, legal counsel may provide more nuance and address specific questions (eg, initiating mailing of mifepristone, caring for people from out of state), particularly in what is anticipated to be a rapidly changing landscape.

Leverage Your Professional Position

Physicians and other clinicians have both medical expertise and public trust. 60 By developing relationships around your work and personal communities (eg, with the department chair, hospital committees, state and district professional societies, and community organizations), efforts in destigmatization, buy-in from stakeholders, and pathways for policy change may be easier.

Identify Your Geographically or Professionally Close Complex Family Planning Specialists

Depending on state politics, these individuals may be eager to share with you means of complementing their work, relief of what will be a potentially enormous care burden, and pathways for local advocacy. In other settings, these individuals may have the capacity to support professional development by refreshing your counseling and procedural training or to facilitate practice changes by sharing protocols or relevant troubleshooting efforts.

Support Each Other in a Rapidly Changing Legal Landscape That Puts Good Medical Practice and Legal Practice at Odds

The language of anti-abortion state laws is intentionally threatening and, if upheld, holds new legal precedence within and across state lines. Thus, clinicians and our patients have legitimate concerns regarding the risk of criminalization. The relationship between clinicians in states where abortion is illegal and those in states where it is legal may become one of critical support, trust, and empathy as cross-state transfers potentially increase to care for those with gray-area diagnoses (a term we are using here for individuals who have detectable fetal cardiac activity in the setting of a pregnancy complication that is life-threatening but may not yet be imminently life-threatening). Clinicians will be expected to accept, deny, or transfer care based on what is legally less risky instead of what is best clinical care for the patient, an impossible task for our colleagues in restrictive states that warrants special compassion. For those residing in states with and without legal abortion, ACOG has a toolkit to guide institutional discussions regarding transfer policy, capacity building, and expected legal support for clinicians in an era in which legislation will do irreparable harm to the medical community and those we serve. 61

Center Equity in Abortion Advocacy

In the wake of a number of professional organizations and educational bodies publicly committing to anti-racism and the dismantling of white supremacy over the past 2 years, we must realize that abortion protection is a key part of that work. 62 More than half of abortion need is among people who identify as Black or Latina, a disparity generated by racism, similar to many other aspects of medical care. 63 Further, other intersecting sources of oppression, such as classism, ableism, and the rural–urban divide, have and will continue to generate inequities in reproductive care. Abortion access is a critical tenet in Reproductive Justice, alongside other essential rights of bodily autonomy and having and parenting children in safe and sustainable communities. 64 Uplift the voices and organizations that operate from a Reproductive Justice framework, such as SisterSong, the National Latina Institute for Reproductive Justice, and the Black Women's Health Imperative. 64 – 66 For our White colleagues and masculine-identifying colleagues, commitment to equity may take the form of self-education, community organizing, and advocacy that demands your efforts while creating and preserving space for marginalized members of the abortion advocacy movement to be the vocal, public-facing authorities that this moment demands.

The time for a minority of ob-gyns to provide the nation's abortion care is over. In an era of breathtaking restrictions to access, this division of clinician labor simply cannot be sustained. Our patients deserve continuity of timely, compassionate care from their clinicians. Moreover, most of us are already skilled to perform most abortions. By continuing the status quo within the ob-gyn community—as protections for this clinical care crumble around us—supportive but abstaining ob-gyns contribute to stratified reproduction.

This is a fight for the autonomy, the dignity, the equity, and the lives of our patients and our own loved ones. In our personal lives or through our professional duties, we are all abortion beneficiaries. Obstetrician–gynecologists are qualified to provide this care already; more ob-gyns providing this care not only supports a human right, but also elevates patient experience, trainee education, and parallel services such as pregnancy-loss management. We have contributed to the vulnerability of abortion care, but it is within our power to correct our wrong. Now is the time to act on our principles: abortion is essential health care.

Kathryn Fay receives support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD103096). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The content in this commentary should not be considered legal advice. The opinions herein are our own. Furthermore, the content reflects the best of what we can offer at this critical moment for reproductive health in the United States; we hope the essential principles remain relevant and anticipate that specific resources, needs, and the best paths forward for clinicians and patients will alter as the medical community adapts to this seismic shift. Open Access is made possible by the Division of General Obstetrics and Gynecology Specialists at the Brigham and Women’s Hospital.

Financial Disclosure Deborah Bartz receives royalties from UpToDate related to medication abortion. She also indicated that, although the article describes the U.S. Food and Drug Administration–approved regimen for medication abortion with mifepristone and misoprostol, it also includes text on self-sourcing these prescription medications. The other authors did not report any potential conflicts of interest.

The authors thank Dr. Mindy Sobata for her prior work that contributed to the development of Box 1 .

Each author has confirmed compliance with the journal's requirements for authorship.

Published online ahead-of-print August 10, 2022.

Peer reviews and author correspondence are available at http://links.lww.com/AOG/C846 .

Share full article

Supported by

The Editorial Board

The Persistent Threat to Abortion Rights

An illustration of a woman lifting a huge mifepristone pill on her back.

By The Editorial Board

The editorial board is a group of opinion journalists whose views are informed by expertise, research, debate and certain longstanding values . It is separate from the newsroom.

The Supreme Court this week heard the first major challenge to abortion rights since it struck down Roe v. Wade two years ago — an attempt to severely limit access to mifepristone, the most commonly used abortion pill in the country, by a group of doctors who are morally opposed to the practice.

The justices seem prepared to throw out the lawsuit. During oral arguments, they questioned whether the doctors had suffered the harm necessary to bring the suit in the first place.

But that should come as small comfort to anyone concerned for the future of reproductive freedom in America. Judges at the state and federal levels are ready to further restrict reproductive options and health care access. The presumptive Republican nominee for president, Donald Trump, has indicated support for a 15-week national abortion ban. And while the Supreme Court, in overturning Roe, ostensibly left it to each state to decide abortion policy, several states have gone against the will of their voters on abortion or tried to block ballot measures that would protect abortion rights. Anti-abortion forces may have had a tough week in the Supreme Court, but they remain focused on playing and winning a longer game.

Even potential victories for reproductive freedom may prove short-lived: The mifepristone case, for instance, is far from dead. Another plaintiff could bring the same case and have it considered on the merits, a possibility Justice Samuel Alito raised during oral arguments.

“Is there anybody who could challenge in court the lawfulness of what the F.D.A. did here?” he asked the solicitor general, Elizabeth Prelogar. Such a challenge would be exceptionally weak, given that the F.D.A. provided substantial support for its approval and regulatory guidance on the use of mifepristone, but the right-wing justices on the Roberts court may be willing to hear it again anyway. The justices have already illustrated their hostility to the authority of administrative agencies, and that hostility may persist even in the face of overwhelming scientific evidence.

Then there is the Comstock Act, a 151-year-old federal law that anti-abortion activists are trying to revive to block the mailing of mifepristone and other abortion medication. During the oral arguments this week, Justices Alito and Clarence Thomas repeatedly expressed their openness to the use of the law, which was pushed by an anti-vice crusader decades before women won the right to vote. If anti-abortion activists can get themselves before a sympathetic court and secure a national injunction on this medication being mailed, they may well be able to block access to abortion throughout the country, including in states where it is legal.

However the mifepristone case turns out, the threats to reproductive rights the justices unleashed by overturning Roe go much further.

The anti-abortion movement is pursuing its aims on many legal fronts. One focus of intense activity is so-called fetal-personhood laws , which endow fetuses (and, in some cases, even fertilized eggs) with the same legal rights as living, breathing human beings. Last month, Alabama’s Supreme Court ruled that frozen embryos created through in vitro fertilization were to be protected as “extrauterine children,” relying in part on an 1872 state law. That sent lawmakers in Alabama scrambling to protect a procedure that is highly popular among Republicans and Democrats alike. Three weeks after the court ruling, they passed a law protecting patients and doctors who perform I.V.F. procedures from legal liability.

Fetal-personhood laws can also be used to target access to birth control, embryonic stem cell research and even women who suffer miscarriages.

In eliminating a woman’s constitutional right to choose what happens in her own body, the Supreme Court claimed to be respecting the democratic process by allowing state legislatures to determine whether abortion should be legal and what, if any, limits should be placed on it. Roe v. Wade had been “egregiously wrong” to wrest a fraught public debate from the American public, Justice Alito wrote in the majority opinion for Dobbs v. Jackson Women’s Health in 2022. It was “time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”

Instead of being settled at the state level, less than two years since the Dobbs ruling, the issue of abortion has returned to the court and is likely to continue to do so for the foreseeable future.

The Dobbs ruling has forced a new public debate on abortion and galvanized Americans’ support for it, which has been strong for decades. Since 1975, a majority of Americans have supported legal abortion in some or all cases, according to polling by Gallup , and that support has increased slightly since Dobbs. The percentage of Americans who think abortion should be illegal in all cases has gone down.

Since Roe was overturned in 2022, in every state where reproductive rights have been on the ballot, from Vermont to Kentucky, the abortion rights side has won . This past Tuesday, the same day that the court heard the mifepristone case, voters in Alabama elected to the state legislature a Democrat who ran on a platform of protecting access to abortion and I.V.F. The candidate, Marilyn Lands, lost her race in 2022 by seven points; she won this week by 25 points.

There are limits to the state-by-state approach when it comes to protecting bodily autonomy. Some states don’t allow ballot initiatives of the type that have led to abortion rights victories elsewhere. In Ohio and other states, lawmakers have sought to block or overturn attempts by voters to protect abortion rights, and anti-abortion lawmakers in several states have sought to prosecute anyone who helps a woman travel to another state to get an abortion.

In short, there is no silver bullet for reproductive rights. The judiciary is no haven, not as long as the current Supreme Court majority holds; state and lower federal courts aren’t much better, going by the Alabama I.V.F. ruling and the decisions that pushed the mifepristone case to the Supreme Court. At the same time, voter support for reproductive rights won’t make a difference if they can’t use ballot measures to make that support known.

That is why any successful strategy to protect or restore abortion rights must understand reproductive rights and representative democracy as inextricably linked.

That means understanding the stakes of the elections in November. If Mr. Trump’s party wins solid control of the House and Senate, this could put Americans’ reproductive rights at further risk, especially if Republicans first decide to do away with the filibuster. That would lower the threshold for passing legislation such as a 15-week abortion ban , which Mr. Trump seems likely to support .

Voters will be faced with a stark choice: the choice of whether to protect not just reproductive rights but true equality for women.

Source photograph by Getty Images.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .

The editorial board is a group of opinion journalists whose views are informed by expertise, research, debate and certain longstanding values. It is separate from the newsroom.

August 2022

Rethinking Strategy After Dobbs

David s. cohen, greer donley & rachel rebouché *.

Share on Twitter
Share on Facebook
Download the PDF

Introduction

Now that the Supreme Court has overturned Roe v. Wade and Planned Parenthood v. Casey , the movement for abortion rights and access finds itself in uncharted territory. 1 Open this footnote Close this footnote 1 See Dobbs v. Jackson Women’s Health Org., 142 S. Ct. 2228, 2242 (2022) (overruling Roe v. Wade, 410 U.S. 113 (1973), and Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992)). … Open this footnote Close For almost fifty years, abortion rights supporters have been largely on the defensive, trying to prevent backsliding and whittling away of the right to terminate a pre-viable pregnancy. Abortion opponents, on the other hand, have been on the offensive, using creative strategies in all three branches of government across federal, state, and local levels to try to achieve their goal of ending abortion nationwide. It took almost half a century, but with Dobbs v. Jackson Women’s Health Organization , Roe ’s attackers have taken a decisive step toward their goal.

For abortion rights defenders, this new, post- Roe playing field means adapting their strategy and mindset to confront a new environment without a tether to federal constitutional protection. The stakes could not be higher. No one knows the trajectory of this new battle to restore abortion rights, but it will be longer and harder than it needs to be if abortion rights defenders cannot rethink basic strategy assumptions. And the longer the battle, the more dire the effects of forced pregnancy: greater risks to pregnant people’s physical and mental health, deeper economic gender inequity, higher maternal mortality, and higher child poverty, just to name a few exceedingly likely public health consequences. 2 Open this footnote Close this footnote 2 Diana Greene Foster, The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion 99-129, 141-52, 163-86, 199-215, 225-39 (2020) (reporting the results of the Turnaway Study, a comprehensive series of studies that explain the harms incurred by people who carry pregnancies to term after being unable to obtain a wanted abortion). … Open this footnote Close

This Essay, published in the immediate aftermath of Dobbs , offers some initial thoughts about what the changed legal landscape means for abortion rights legal advocacy. Our focus in recent writings has been to identify concrete measures that federal and state actors can take to secure abortion access after Dobbs . 3 Open this footnote Close this footnote 3 See generally David S. Cohen, Greer Donley & Rachel Rebouché, The New Abortion Battleground , 123 Colum. L. Rev. (forthcoming 2023) [hereinafter Cohen, Donley & Rebouché, Battleground ], http://perma.cc/VF3P-7E8B (reviewing several actions that states and the federal government can take in the wake of Dobbs ); Greer Donley, Rachel Rebouché & David S. Cohen, Opinion, Abortion Pills Will Change a Post-Roe World , N.Y. Times (June 23, 2022), http:// perma.cc/H33E-A86J (examining how to protect abortion pill access in a post- Roe America); David S. Cohen, Greer Donley & Rachel Rebouché, Opinion, States Want to Ban Abortions Beyond Their Borders. Here’s What Pro-Choice States Can Do. , N.Y. Times (Mar. 13, 2022), http://perma.cc/TW4B-ZQ6W (exploring what progressive states can do to protect abortion access); David S. Cohen, Greer Donley & Rachel Rebouché, Opinion, Joe Biden Can’t Save Roe v. Wade Alone. But He Can Do This. , N.Y. Times (Dec. 30, 2021), http://perma.cc/G2VK-LARD [hereinafter Cohen, Donley & Rebouché, Joe Biden ] (highlighting what a progressive presidential administration can do to protect abortion access). … Open this footnote Close Here, we explore what we believe to be an immediate overarching concern: What strategies should govern the abortion rights movement going forward? To that end, we identify three themes: (1) trying creative, sometimes novel, approaches to put the antiabortion movement into a defensive posture, (2) expecting and embracing disagreement among abortion rights supporters, and (3) playing the long game. This will require a paradigm shift in movement strategy—one that is in some ways modeled after the now-successful movement to overturn Roe . Such a paradigm shift takes time, will, and responsiveness to change.

An important note before proceeding: The three of us, in our own ways, have collectively served as lawyers, teachers, and scholars of abortion rights for decades. This Essay’s intent is not to critique previous movement strategies. However, to the extent that any of the following can be read as criticism, it is as much a criticism of our past work as it is of anyone else’s.

I. Creative Rather Than Defensive Strategies

Ever since the Supreme Court held that the Constitution protects the right to a pre-viability abortion as a privacy right, that right needed to be defended against an onslaught of antiabortion attacks. Having been given the imperfect foundation of Roe and Casey , the legal arm of the abortion rights movement used that privacy right—grounded in the Fourteenth Amendment’s Due Process Clause—as the main tool in its arsenal. 4 Open this footnote Close this footnote 4 Before Planned Parenthood v. Casey , laws impermissibly restricting abortion were framed as a violation of a fundamental right and subject to strict scrutiny, the standard utilized in Roe v. Wade . See Casey , 505 U.S. at 871 (plurality opinion). After Casey , the standard shifted from strict scrutiny to undue burden. See id. at 877. Regardless, the claim was the same—the laws violated the Fourteenth Amendment’s Due Process Clause. Id. at 874. … Open this footnote Close As much as commentators have criticized Roe ’s and Casey ’s limitations and urged other constitutional bases for the right to terminate a pregnancy, such as the Equal Protection Clause or the Thirteenth Amendment, 5 Open this footnote Close this footnote 5 Before joining the Supreme Court, Ruth Bader Ginsburg urged the Court to recognize abortion as a form of sex discrimination as it concerned women’s ability to participate in public life on equal footing with men, making it a matter of equal protection. Ruth Bader Ginsburg, Sex Equality and the Constitution: The State of the Art , 4 Women’s Rts. L. Rep. 143, 143-44 (1978). Andrew Koppelman argued that the Thirteenth Amendment provides a constitutional abortion right because denying a person the right to an abortion subjects them to “involuntary servitude” in service of the fetus, the precise sort of forced labor that the Amendment prohibits. Andrew Koppelman, Forced Labor: A Thirteenth Amendment Defense of Abortion , 84 Nw. U. L. Rev. 480, 483-84 (1990) ; see also Michele Goodwin, Opinion, No, Justice Alito, Reproductive Justice Is in the Constitution , N.Y. Times ( June 26, 2022), http://perma.cc/E2QX-GH6W (“ This Supreme Court . . . ignores the intent of the 13th and 14th Amendments, . . . which extended . . . to shielding [Black women] from rape and forced reproduction.”). Though these theories have not yet been successful, as we argue below, we think there is increased urgency to try them again. … Open this footnote Close those theories have had limited impact in the federal courts as of yet. 6 Open this footnote Close this footnote 6 Before Dobbs , Supreme Court opinions had increasingly referenced the connection between abortion rights and sex equality, but Justice Alito’s majority opinion rejected this argument in dicta. Dobbs , 142 S. Ct. at 2245-46 (“Neither Roe nor Casey saw fit to invoke this theory [the Fourteenth Amendment’s Equal Protection Clause as a basis for abortion rights], and it is squarely foreclosed by our precedents, which establish that a State’s regulation of abortion is not a sex-based classification and is thus not subject to the ‘heightened scrutiny’ that applies to such classifications. The regulation of a medical procedure that only one sex can undergo does not trigger heightened constitutional scrutiny unless the regulation is a ‘mere pretex[t] designed to effect an invidious discrimination against members of one sex or the other.’” (quoting Geduldig v. Aiello, 417 U.S. 484, 496 n.20 (1974))). … Open this footnote Close Other arguments, such as those based on the First Amendment, have had limited factual application and success. 7 Open this footnote Close this footnote 7 Compare Tex. Med. Providers Performing Abortion Servs. v. Lakey, 667 F.3d 570, 580 (5th Cir. 2012) (finding that a state’s forced ultrasound requirement does not violate the First Amendment), with Stuart v. Camnitz, 774 F.3d 238, 242 (4th Cir. 2014) (finding that a state’s forced ultrasound requirement violates the First Amendment). See also Doe v. Parson, 960 F.3d 1115, 1116 (8th Cir. 2020) (rejecting a Satanic Temple member’s First Amendment challenge to a state abortion law). … Open this footnote Close State court litigation has seen more variety in legal theories, though most state decisions protecting abortion rights still rely on theories very similar to Roe . 8 Open this footnote Close this footnote 8 See Linda J. Wharton, Roe at Thirty-Six and Beyond: Enhancing Protection for Abortion Rights Through State Constitutions , 15 Wm. & Mary J. Women & L. 469, 499 (2009). There have been some state court decisions grounding abortion rights in equality principles, whether through a general equality provision or a state equal rights amendment, but those are not common. See id. at 498-526, 529-30 (reviewing state law approaches to protecting abortion rights). … Open this footnote Close Legislative and administrative strategies have been more varied in the states (rarely at the federal level), but they have, for the most part, been defensive in nature, aimed at removing or preventing new restrictions that make it difficult for someone to obtain an abortion. 9 Open this footnote Close this footnote 9 In this paragraph, as well as throughout this Essay, we speak at a high level of generality when recapping movement history and strategy. There are, of course, outliers with everything we cover and vital sources that, because of space limitations, we do not include here. … Open this footnote Close

As the reproductive justice framework, and its focus on race and class, has become more central to the abortion rights movement, proactive advocacy has become more common. 10 Open this footnote Close this footnote 10 See Zakiya Luna & Kristin Luker, Reproductive Justice , 9 Ann. Rev. L. & Soc. Sci. 327, 343 (2013) (describing the reproductive justice framework); Kimala Price, What Is Reproductive Justice? How Women of Color Activists Are Redefining the Pro-Choice Paradigm , Meridians, 2010, at 42, 46-47 (discussing the international and inclusive origins of the reproductive justice movement); Jael Silliman, Marlene Gerber Fried, Loretta Ross & Elena Gutiérrez, Undivided Rights: Women of Color Organize for Reproductive Justice 1-4, 7-8 (2d ed. 2016).c … Open this footnote Close For instance, some state and local governments have expanded state Medicaid funding for abortion, sent public money to private abortion funds, issued reparations for involuntary sterilization, decriminalized adverse pregnancy outcomes, and extended the rights of pregnant people and parents beyond abortion by bolstering support for workplace accommodations, government health plans, and other welfare benefits. 11 Open this footnote Close this footnote 11 . David S. Cohen & Carole Joffe, Obstacle Course: The Everyday Struggle to Get an Abortion in America 94, 97-98, 232-33 (2020); see, e.g. , Daniel Trotta, California to Compensate People Forcibly Sterilized Under Eugenics , Reuters (July 13, 2021, 6:48 PM PDT), http://perma.cc/8X7E-C9VV ; 2021 Report, Gaining Ground: Proactive Reproductive Health, Rights and Justice Legislation in the States , Nat’l Inst. for Reprod. Health ( Dec . 14, 2021), http://perma.cc/BTP4-U366 ; Press Release, Rob Bonta, Att’y Gen., State of California, California Law Does Not Criminalize Pregnancy Loss (Jan. 6, 2022), http://perma.cc/U2XL-AB7B . … Open this footnote Close But these are relatively new developments that, by necessity, existed alongside defensive legal maneuvers.

After Roe made abortion legal in every state, the antiabortion movement’s strategy was to overturn Roe and end legal abortion. The movement attacked government funding of abortion and won passage of the Hyde Amendment, which bans federal funding for abortions except to preserve the pregnant person’s life or in cases of rape and incest. 12 Open this footnote Close this footnote 12 The Hyde Amendment has been particularly devastating for poor women and women of color who rely on Medicaid for health insurance. Jill E. Adams & Jessica Arons, A Travesty of Justice: Revisiting Harris v. McRae, 21 Wm. & Mary J. Women & L . 5, 50-51 (2014). … Open this footnote Close Once the Supreme Court upheld the Hyde Amendment, 13 Open this footnote Close this footnote 13 See Harris v. McRae, 448 U.S. 297, 326 (1980). … Open this footnote Close the antiabortion movement developed a series of restrictions designed to increase the difficulty of obtaining an abortion: waiting periods, parental consent requirements, and burdensome and shame-inducing informed consent processes. 14 Open this footnote Close this footnote 14 See, e.g. , Planned Parenthood of Cent. Mo. v. Danforth, 428 U.S. 52, 58 (1976) (describing a Missouri abortion statute that required informed consent of pregnant persons, spousal consent, and parental consent for minors); City of Akron v. Akron Ctr. for Reprod. Health, 462 U.S. 416, 422-24 (1983) (describing a city abortion ordinance that required parental notification and consent, the pregnant person’s informed consent, and a 24-hour waiting period between informed consent and the time the abortion is performed), overruled by Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833 (1992); Thornburgh v. Am. Coll. of Obstetricians & Gynecologists, 476 U.S. 747, 759-61 (1985) (describing a Pennsylvania abortion statute that required informed consent and providing the pregnant person with printed information), overruled by Casey , 505 U.S. 833; Hodgson v. Minnesota, 497 U.S. 417, 424 (1990) (describing a Minnesota abortion statute that required a waiting period and parental notice for minors). … Open this footnote Close After the Supreme Court approved these types of restrictions in Casey , 15 Open this footnote Close this footnote 15 Casey , 505 U.S. at 886-87, 899 (plurality opinion). … Open this footnote Close the movement pushed further. It not only expanded previous restrictions (waiting periods, for instance, were vastly increased in many states), 16 Open this footnote Close this footnote 16 Jennifer Ludden, In Several States, Abortion Waiting Periods Grow Longer , NPR (June 2, 2015, 4:33 PM ET), http://perma.cc/N6XA-8XKX . … Open this footnote Close but also targeted particular types of abortion procedures, leading to a federal prohibition of a relatively rare second-trimester abortion procedure; state abortion bans at different gestational ages, frequently below the constitutional minimum; and state requirements for patients to undergo and listen to ultrasounds in the purported pursuit of informed consent. 17 Open this footnote Close this footnote 17 Cohen & Joffe , supra note 11, at 159-62, 177, 199-201, 203-05. … Open this footnote Close

From there, another strategy emerged: targeted regulation of abortion providers (TRAP laws). TRAP laws regulated abortion facilities without any medical justification and more thoroughly than any other type of outpatient medical office. This tactic threatened to shutter almost all abortion clinics in certain states. Though the Supreme Court struck down some of these laws in 2016 and again in 2020, 18 Open this footnote Close this footnote 18 See Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292, 2300 (2016), abrogated by Dobbs v. Jackson Women’s Health Org., 142 S. Ct. 2228 (2022); June Med. Servs. L.L.C. v. Russo, 140 S. Ct. 2103, 2112-13 (2020), abrogated by Dobbs , 142 S. Ct. 2228. … Open this footnote Close the antiabortion movement was undeterred. In the past two years, towns and cities have passed local ordinances declaring themselves “sanctuary cities for the unborn.” 19 Open this footnote Close this footnote 19 See Jessica Glenza, The Tiny American Towns Passing Anti-Abortion Rules , Guardian (Apr. 27, 2021, 2:00 AM EDT), http://perma.cc/6A23-YGX4 . … Open this footnote Close And, most recently, antiabortion activists developed the framework for civil bounty enforcement of abortion laws, paving the way for pre- Dobbs abortion bans that federal courts, including the Supreme Court, have refused to enjoin. 20 Open this footnote Close this footnote 20 See Texas Heartbeat Act, S. 8, 87th Leg., Reg. Sess. § 3 (Tex. 2021) (codified at Tex. Health & Safety Code Ann. § 171.208 (West 2022)) (first civil bounty enforcement law); Whole Woman’s Health v. Jackson, 142 S. Ct. 522, 534-35 (2021) (refusing to enjoin the law). … Open this footnote Close In Texas, Senate Bill 8 (S.B. 8) ended in-state legal abortion after roughly six weeks of pregnancy, ten months before the Court overturned Roe . 21 Open this footnote Close this footnote 21 See Tex. S. 8 § 3 (codified at Health & Safety § 171.204). … Open this footnote Close

The legal theories supporting these restrictions and bans evolved as well. Since before Roe , and continuing after the decision, the antiabortion movement’s main focus had been on protecting fetal life. However, once the Supreme Court reiterated in Casey that this interest was not enough to allow for a ban on abortion, 22 Open this footnote Close this footnote 22 Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 852 (1992), overruled by Dobbs , 142 S. Ct. 2228. … Open this footnote Close the movement pivoted its underlying theoretical position. In addition to protecting fetal life, it began to emphasize arguments that abortion restrictions further the life and wellbeing of the pregnant person and protect the integrity of the medical profession. 23 Open this footnote Close this footnote 23 See generally Reva B. Siegel, Brainerd Currie Lecture, The Right’s Reasons: Constitutional Conflict and the Spread of the Woman-Protective Antiabortion Argument , 57 Duke L.J. 1641 (2008) (describing the rise of the woman-protective antiabortion argument). … Open this footnote Close The Supreme Court supported these theories in 2007, noting that abortion restrictions may protect against maternal regret. 24 Open this footnote Close this footnote 24 Gonzalez v. Carhart, 550 U.S. 124, 159 (2007) (“[S]ome women come to regret their choice to abort [] infant life . . . . The State has an interest in ensuring so grave a choice is well informed.”). … Open this footnote Close Some Justices have gone further, citing the need to protect patients from certain abortion procedures, fetal disability-based abortion, and race-based eugenics. 25 Open this footnote Close this footnote 25 See Jill Wieber Lens & Greer Donley, Second-Trimester Abortion Dangertalk , 62 B.C. L. Rev. 2145, 2160-67 (2021) (discussing disability-based abortion bans and dilation and evacuation bans); Melissa Murray, Abortion, Sterilization, and the Universe of Reproductive Rights , 63 Wm. & Mary L. Rev 1599, 1604-05 (2022) (discussing the eugenics argument against abortion). … Open this footnote Close

With Dobbs eviscerating the federal right to a pre-viability abortion, the strategies of the two movements will be shuffled. The antiabortion movement will continue to push the envelope as it strives for a nationwide abortion ban, 26 Open this footnote Close this footnote 26 Caroline Kitchener, Roe’s Gone. Now Antiabortion Lawmakers Want More. , Wash. Post (June 25, 2022, 7:52 PM EDT), http://perma.cc/4EAD-H2X2 . … Open this footnote Close but it will also be forced into a position of defending Dobbs and every state’s abortion ban when challenged in state courts. Just as Roe created the boundaries that the abortion rights movement had to defend and the framework for the defense—which consumed limited resources and upheld a precedent that many considered flawed—the antiabortion movement will need to defend Dobbs and state bans as part of the new legal framework. In this way, the antiabortion movement will occupy a defensive posture that the abortion rights movement has held since Roe .

And, by contrast, without Roe , the abortion rights movement can both refashion old strategies and imagine entirely new approaches. Arguments sounding in fundamental rights and liberty should not be jettisoned, 27 Open this footnote Close this footnote 27 Just because Dobbs rejected those theories does not mean a future Court might not build a new foundation of abortion rights . See Rachel Rebouché & Linda C. McClain, Opinion, A New Supreme Court Justice’s Dissent on Abortion Could Be Game-Changing , Hill ( Feb. 11, 2022, 9:31 AM ET), http://perma.cc/B25K-L3JX . … Open this footnote Close but they can be supplemented with additional theories. The arguments already discussed above—equality, forced labor, and free speech—need renewed attention from scholars and need to be tested before courts and in the court of public opinion. 28 Open this footnote Close this footnote 28 See, e.g. , Meghan Boone, Reproductive Due Process , 88 Geo. Wash. L. Rev. 511, 558-59 nn.262-67 (2020). … Open this footnote Close Other arguments supporting abortion rights and access need to be developed as well, such as those related to privileges and immunities, the right to travel, religious liberty, federal preemption, the dormant commerce clause, uncompensated takings, procedural due process, federal jurisdiction, health justice, and vagueness, to name a few. 29 Open this footnote Close this footnote 29 See, e.g. , Cohen, Donley & Rebouché, Battleground , supra note 3, at 4-5, 27-29, 39 (discussing many of these arguments). … Open this footnote Close And any legal argument should reflect the evolving nature of abortion services. Abortion rights historically were tethered to the physician-patient relationship, but that is changing as more and more people receive care from healthcare providers who are not doctors and end pregnancies with pills, often without the direct help of any provider. 30 Open this footnote Close this footnote 30 See generally Yvonne Lindgren, When Patients Are Their Own Doctors: Roe v. Wade in an Era of Self-Managed Care , 107 Cornell L. Rev 151 (2021) (framing the right to abortion as one independent of the provider-patient relationship). … Open this footnote Close

The conservative legal movement has moved novel, even outlandish, legal theories from laughable to legitimate by talking and writing about them as part of an unrelenting campaign. 31 Open this footnote Close this footnote 31 See Jack M. Balkin, From Off the Wall to On the Wall: How the Mandate Challenge Went Mainstream , Atlantic (June 4, 2012), http://perma.cc/6ZGC-SU79 . … Open this footnote Close Abortion rights scholars and advocates also can move creative ideas into the mainstream until courts eventually take notice. And victories can come at surprising moments. Surely many in the antiabortion movement thought S.B. 8 was blatantly unconstitutional and a waste of time and resources—yet the Fifth Circuit and Supreme Court allowed it to remain in force. Pressing creative arguments in a variety of jurisdictions will produce unpredictable, possibly surprising results.

The same is true for legislative and administrative reform. Abortion rights advocates should continue their recent efforts to persuade legislators and administrative officials to expand access where it continues to exist. We have seen the beginnings of federal, state, and city responses to Dobbs . The Biden Administration has issued an executive order and a variety of guidance documents attempting to mitigate some of the harms of the coming crisis, 32 Open this footnote Close this footnote 32 See Press Release, The White House, Fact Sheet: President Biden to Sign Executive Order Protecting Access to Reproductive Health Care Services (July 8, 2022), http://perma.cc/M62H-STFY ; Press Release, U.S. Dep’t of Health & Hum. Servs., HHS Issues Guidance to the Nation’s Retail Pharmacies Clarifying Their Obligations to Ensure Access to Comprehensive Reproductive Health Care Services (July 13, 2022), http://perma.cc/VUE2-JGSS . … Open this footnote Close although it could surely do more. 33 Open this footnote Close this footnote 33 See generally Cohen, Donley & Rebouché, Joe Biden , supra note 3 (explaining several steps the Biden Administration can take to protect abortion access). … Open this footnote Close State and city responses have been more robust. Oregon and New York will allocate tens of millions of dollars to support abortion patients, including those traveling from out of state because their home state has banned the procedure. 34 Open this footnote Close this footnote 34 Casey Parks, States Pour Millions into Abortion Access , Wash. Post (May 13, 2022, 12:22 PM EDT), http://perma.cc/9YWM-CTYJ . … Open this footnote Close Five states have passed laws that protect, to various extents, abortion providers who care for patients from out of state, pushing the boundaries of what states can do to shield their residents from the policies and laws of other states. 35 Open this footnote Close this footnote 35 See Veronica Stracqualursi, Connecticut Lawmakers Pass Bill to Protect Abortion Seekers and Providers from Out-of-State Lawsuits , CNN (updated Apr. 30, 2022, 2:49 PM ET), http://perma.cc/K96V-FW7K ; Press Release, Kathy Hochul, Governor, New York State, Governor Hochul Signs Nation-Leading Legislative Package to Protect Abortion and Reproductive Rights for All (June 13, 2022), http://perma.cc/W9D8-E3GQ ; Amy Simonson, Delaware Governor Signs Bill Expanding Abortion Access and Provider Protection , CNN (updated June 29, 2022, 9:02 PM ET), http://perma.cc/RS3Q-NBAD ; Press Release, Phil Murphy, Governor, State of New Jersey, Governor Murphy Signs Legislation to Protect Reproductive Health Care Providers and Out-of-State Residents Seeking Reproductive Services in New Jersey (July 1, 2022), http://perma.cc/8Q8A-NU6D ; Press Release, Charlie Baker, Governor, Commonwealth of Massachusetts, Governor Baker Signs Legislation Further Protecting Access to Reproductive Health Care Services (July 29, 2022), http://perma.cc/Y7CL-58HL . … Open this footnote Close In that cohort of states, Massachusetts revamped its telehealth rules to allow its providers to care for abortion patients in other states by telehealth. 36 Open this footnote Close this footnote 36 Act of July 29, 2022, 2022 Mass. Acts ch. 127, §§ 1, 4. … Open this footnote Close And several jurisdictions have passed or are considering creating a new cause of action allowing people to sue anyone who interferes with reproductive rights and access, including by bringing a lawsuit against them. 37 Open this footnote Close this footnote 37 See, e.g. , id. § 4; N.Y. Civ. Rights Law § 70-b (McKinney 2022). … Open this footnote Close Cities within states with abortion bans have deprioritized any enforcement of abortion crimes, regulated deceptive advertising of fake abortion clinics, and passed other regulations to protect their providers. 38 Open this footnote Close this footnote 38 See Nicole Narea, How Blue Cities in Red States Are Resisting Abortion Bans , Vox (June 29, 2022, 5:10 PM EDT), http://perma.cc/KWS6-LQDA ; Morgan Severson, Austin City Council Passes GRACE Act to Decriminalize Abortion Despite Statewide Ban , Daily Texan (July 25, 2022), http://perma.cc/LS5T-JSSP ; Chris Potter, Pittsburgh City Council Passes Bills Affirming Abortion Rights in City Limits , WESA (July 19, 2022, 5:53 PM EDT), http://perma.cc/6MRY-9KLT . … Open this footnote Close

These reforms are the tip of the iceberg now that Dobbs has been decided. New ideas should be aired, considered, and—if there is a plausible argument to support them—tested in some form or other. It is impossible to predict with certainty which strategies will be effective, but there is strategic importance in overwhelming the antiabortion movement with legal arguments it must defend. In short, this current moment calls for creativity and boldness in litigation and advocacy.

II. Expect and Embrace Disagreement

Conflict and disagreement within social and legal movements are common. Over the past half-century, there has been internal disagreement within the abortion rights movement over the movement’s scope and focus, especially pertaining to the minimization and exclusion of racial justice. This tension led to the development of the reproductive justice framework, focusing the movement on racial justice, which for too long did not receive the attention it deserved. 39 Open this footnote Close this footnote 39 See generally Loretta J. Ross & Rickie Solinger , Reproductive Justice: An Introduction (2017) (exploring the evolution of the reproductive justice movement); Asian Comtys. for Reprod. Just. , A New Vision for Advancing Our Movement for Reproductive Health, Reproductive Rights and Reproductive Justice (2005), http://perma.cc/JF68-QFY5 (setting forth the contours of the reproductive justice framework compared to the reproductive rights and reproductive health frameworks). … Open this footnote Close More recently, there has been a push to use gender-inclusive language within the movement, a change that is not without its detractors. 40 Open this footnote Close this footnote 40 See Irin Carmon, You Can Still Say ‘Woman’ but You Shouldn’t Stop There , N.Y. Mag. (Oct. 28, 2021), http://perma.cc/2LVJ-DKPP . … Open this footnote Close

Despite these conceptual critiques, broadly speaking, since Roe , there has been little disagreement about the abortion rights movement’s broader legal strategy. This is in part due to a strong group of national organizations and in part because of the point made in Part I: Roe created a tool to fight against abortion restrictions, and even those critical of Roe agreed it must be a focal point in litigation.

That is not to say there has been consensus over strategy regarding how best to wield Roe as a defense. For instance, part of the package of Texas laws ultimately struck down by the Supreme Court in Whole Woman’s Health v. Hellerstedt 41 Open this footnote Close this footnote 41 136 S. Ct. 2292 (2016), abrogated by Dobbs v. Jackson Women’s Health Org., 142 S. Ct. 2228 (2022). … Open this footnote Close was a ban on abortion at 20 weeks. 42 Open this footnote Close this footnote 42 See Tex. Health & Safety Code Ann. § 171.044 (West 2021) (outlining the 20-week ban provision). … Open this footnote Close Unlike the ambulatory surgical center and admitting privileges requirements that advocates challenged and the Supreme Court found unconstitutional, 43 Open this footnote Close this footnote 43 Hellerstedt , 136 S. Ct. at 2300. … Open this footnote Close the 20-week ban was never challenged because of a fear that the Supreme Court would uphold it, risking a detrimental decision with a nationwide effect. 44 Open this footnote Close this footnote 44 The Authors have had discussions with lawyers and providers in Texas who explained the basis for not challenging the 20-week ban. … Open this footnote Close The decision to let that part of the law take effect was a difficult question upon which reasonable minds have disagreed.

Consider the deep dissension that could have derailed antiabortion legal strategies but ultimately did not. To give just a few examples, there have been many different possible avenues to attack Roe and its progeny. Should state legislation restricting abortion have exceptions for rape, incest, and the health of the pregnant person, or should they be more absolutist, with only an exception for the person’s life? Should state gestational bans start with later abortions so there is a more palatable incremental chipping away, or should they go straight to earlier abortion bans, such as at six weeks or even conception? Should the movement try novel approaches such as civil bounty enforcement, or should it stick to criminal and licensure-based enforcement mechanisms? The antiabortion movement has faced these and many other questions that no doubt caused debate and internal conflict—conflict that will no doubt continue after Dobbs . 45 Open this footnote Close this footnote 45 See generally Mary Ziegler, Dollars for Life: The Anti-Abortion Movement and the Fall of the Republican Establishment (2022) (tracing the evolution of the antiabortion movement in the context of its connection to Republican party politics). For a discussion of recent conflicts within the antiabortion movement, see Rachel Roubein & Brittany Shammas, A Triumphant Antiabortion Movement Begins to Deal With Its Divisions , Wash. Post (July 24, 2022, 8:32 AM EDT), http://perma.cc/7WXA-HUAN . … Open this footnote Close

The abortion rights movement needs to expect similar tumult over strategy as it shifts from a defensive to an offensive posture. Without the analytical framework from Roe and Casey being the starting point for legal claims, the movement will face difficult questions that will lead to inevitable disagreement. Given the reality of limited resources, should money and attention focus on people crossing state lines to obtain abortions in states where it remains legal, or on getting abortion pills in the hands of people in states that ban abortion? Should the movement devote resources to the clinics that are in states where they can no longer provide abortions, supporting them and their employees so they can develop new business models related to full-spectrum early pregnancy care, or should it direct support to clinics in the states where abortion remains legal so that they can handle the influx of abortion patients? Should the movement continue to focus on abortion and contraception, or advance reproductive justice commitments that equally foreground the right to have children and parent those children with dignity? And in light of the resounding victory for abortion rights in the Kansas referendum in August 2022, 46 Open this footnote Close this footnote 46 See Katie Bernard & Lisa Gutierrez, ‘No’ Prevails: Kansas Votes to Protect Abortion Rights in State Constitution , Kan. City Star (updated Aug. 3, 2022, 5:23 PM), http://perma.cc/2WGG-2WL2 . … Open this footnote Close can the movement pour resources into expensive statewide ballot initiatives while also engaging in other forms of organizing?

In addition to resource constraints, there will be disagreements about legal strategy and theory. Five states have passed laws that prohibit state agencies and courts from participating in any out-of-state prosecutions or lawsuits, and several others are considering them. Is this a smart preemptive move on the part of abortion-supportive states, or is this a threat to interstate cooperation, something that is important for many issues such as recognition of diverse family forms and gun regulation? The generic manufacturer of mifepristone brought a now-withdrawn lawsuit in federal court arguing that the FDA’s regulation and approval of medication abortion preempts state laws that further restrict the drug. 47 Open this footnote Close this footnote 47 See Complaint at 1-3, GenBioPro, Inc. v. Dobbs, No. 20-cv-652 (S.D. Miss. Oct. 9, 2020). GenBioPro is expected to file a new lawsuit in a different jurisdiction. … Open this footnote Close Is this a powerful theory that could pave the way for abortion access in the future, or is it a threat to local control over other dangerous drugs in the name of consumer safety and corporate responsibility? Looking at the federal level, should the movement push the Biden Administration to take legally risky steps to improve abortion access via administrative agencies and other executive actions—steps that could result in lengthy court battles over executive power but that, if successful, might mean patients have improved access? Or should it focus on messaging and getting out the vote for pro-choice candidates so that someday Congress can pass a national law protecting abortion rights?

In this new landscape, people who care about the same ultimate goal of restoring abortion access will have principled, intense disagreements about all of these questions and more. Such disagreements will lead to division and tension within the movement. Understanding that this disagreement is inevitable might help make it easier for people to continue to work together despite the tension. And from a slightly more removed view, the movement may be best served by groups with different priorities working on different issues rather than the movement trying to align priorities across all stakeholders. Though resources are finite, and some strategies might have collateral consequences that will make them not worth the costs, there are benefits to taking different approaches in an effort to see which breaks through, even if otherwise allied people disagree.

III. Playing the Long Game

Finally, the abortion rights movement will need to look to the long game with its legal strategy. 48 Open this footnote Close this footnote 48 There have certainly been some strategies, like All* Above All’s efforts to repeal the Hyde Amendment, that have included less immediate goals as focuses. See About , All* Above All , http://perma.cc/SPJ8-FFS6 (archived Aug. 25, 2022). … Open this footnote Close The antiabortion movement has been playing the long game since 1973. When Roe was decided, banning abortion immediately was not a possibility. The movement tried a constitutional amendment, but it never had enough support. Rather than accepting Roe , the movement took different paths to get to where we are today, fifty years later. For one, the movement pressured the Republican party to appoint judges and Justices who would overturn Roe . This strategy is inherently long-term because having enough appointment opportunities takes time. Moreover, several Justices nominated by Republicans ultimately refused to overturn Roe . 49 Open this footnote Close this footnote 49 Justices Stevens, O’Connor, Kennedy, and Souter all voted to uphold Roe in some form. See Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 872-74 (1992) (plurality opinion), overruled by Dobbs v. Jackson Women’s Health Org., 142 S. Ct. 2228 (2022); id. at 912 (Stevens, J., concurring in part and dissenting in part). Only Justice Scalia was a reliable vote against Roe . See, e.g. , Webster v. Reprod. Health Servs. , 492 U.S. 490, 532 (1989) (Scalia, J., concurring in part and concurring in the judgment) (arguing that Roe should be explicitly overruled); Ohio v. Akron Ctr. For Reprod. Health , 497 U.S. 502, 520 (Scalia, J., concurring) (“[T]he Constitution contains no right to abortion.”); Casey , 505 U.S. at 979 (Scalia, J., concurring in the judgment in part and dissenting in part) (“The States may, if they wish, permit abortion on demand, but the Constitution does not require them to do so.”), overruled by Dobbs , 142 S. Ct. 2228; Stenberg v. Carhart , 530 U.S. 914, 955 (2000) (Scalia, J., dissenting) (deriding Casey ’s “undue burden” test and arguing that it should be overruled). … Open this footnote Close In response to these disappointments, the antiabortion movement did not abandon the strategy to pack the Supreme Court; rather, it doubled down and spent the next three decades nominating and appointing judges and Justices whom they were even more certain would vote against Roe . This strategy paid off in Dobbs , as five of the six most recent Republican appointees joined the majority, with the sixth voting to substantially reduce the right.

Meanwhile, another key part of the long-term antiabortion legal strategy played out in state legislatures throughout the country. There, the movement enacted the various approaches to restricting and even banning abortion mentioned in Part I of this Essay. These laws were passed knowing that many would be found unconstitutional. But in some sense, the movement considered it a win whether the law was invalidated or not. If the law was upheld, it would chip away at abortion accessibility on the ground and precedent in the courts. But if it was enjoined, the short-term loss would produce judicial dissents that would be useful in the long term to shore up the argument against Roe . Those dissents, along with a concerted effort by academics and commentators to undermine the rationale of Roe , are the foundation of the Dobbs majority opinion. 50 Open this footnote Close this footnote 50 The majority opinion in Dobbs cites past dissenting opinions forty-nine times. See generally Dobbs , 142 S. Ct. 2228. … Open this footnote Close As Dobbs proves, short-term losses can be valuable in the future for pushing the envelope, changing the conversation, and building momentum toward the movement’s ultimate goal.

Similarly, creative strategies to promote abortion rights and access discussed in the beginning of this Essay will either be successful, even if incrementally, 51 Open this footnote Close this footnote 51 We recognize that risks are different in some cases: For the abortion rights movement, some cases might risk someone being sent to jail, whereas ruling against the antiabortion movement usually just meant striking down legislation and mandating that the state pay attorney’s fees. … Open this footnote Close or create the building blocks for future challenges with powerful dissenting opinions or new narratives. For instance, religious liberty challenges to state abortion bans, regardless of their present success in the courts, could redefine the conversation around abortion’s religious and moral value. Focusing on the Thirteenth Amendment could highlight racial injustice and racial disparities in accessing reproductive healthcare, rebutting the recent antiabortion narrative that abortion bans promote racial equality. 52 Open this footnote Close this footnote 52 See generally Melissa Murray, Race-ing Roe : Reproductive Justice, Racial Justice, and the Battle for Roe v. Wade, 134 Harv. L. Rev. 2025 (2021) (exploring the racialized history of reproductive healthcare in the United States and challenging the current conservative claim that abortion furthers race-based eugenics). … Open this footnote Close Strategies promoting medication abortion could highlight how most abortions mimic the natural experience of miscarriage, upending the antiabortion movement’s narrative on “gruesome” procedures. And new strategies, like using missed period pills—which dispense medication abortion to induce a period without a pregnancy test—have interesting historical analogs that could confound “originalist” judges. 53 Open this footnote Close this footnote 53 See Greer Donley & Jill Wieber Lens, Abortion, Pregnancy Loss, & Subjective Fetal Personhood , 75 Vand. L. Rev. (forthcoming 2022) (manuscript at 36-38), http://perma.cc/WUP7-JVZ8 . … Open this footnote Close Looking to the long game while also keeping an eye on the short term is essential at this moment. A strategy that might have been taken for granted as too risky needs reevaluation and support from a varied set of researchers, litigators, and advocates.

Accepting, even expecting, defeat in the short term has another benefit. As the past decade has demonstrated, unexpected departures from the Supreme Court happen and could quickly change the outlook for abortion rights. If that were to occur, cases need to be in the pipeline. But even in the much more likely scenario that the Court’s composition remains stable for a while, pressing forward with a long-term strategy that accepts the risk of short-term defeat could be effective in changing the narrative and winning hearts and minds.

There is no understating the catastrophe that Dobbs is for the abortion rights and access movement. Its impact will be staggering, probably worse than most people are imagining. But, in the midst of navigating legal complexity and uncertainty, this moment presents an opportunity for a reassessment of strategy and focus. By thinking creatively, pushing past predictable disagreement and division, and thinking of inevitable losses as part of a long-game strategy, the movement can harness some of the antiabortion movement’s most successful approaches for its own purposes. 54 Open this footnote Close this footnote 54 None of what we argue here should be interpreted as approval of antiabortion tactics, especially those relying on violence, harassment, and lies, or as an argument for copying antiabortion strategies without close attention to costs and repurposing messages for reproductive justice ends. … Open this footnote Close

Rethinking strategy like this will be difficult. The abortion rights movement has many different players, from powerful national organizations that have been at the forefront of legal advocacy to nimble local organizations that have been on the cutting edge of providing access on the ground. A model suited for 2022 and beyond will require a big tent that capitalizes on novel yet varied approaches from all of the existing organizations and welcomes newcomers into the fold, even if they disagree and even if there is no guarantee of success.

Rebuilding the right to abortion, whether through a national statute or a renewed constitutional right to abortion, will require rethinking the movement’s strategic orientation. The stakes could not be higher, as every day that passes without nationwide abortion rights leaves countless people in dangerous medical situations and out of control of their lives and bodies. But with new ideas and relentless offensives, we might end up with a right that is less precarious than Roe was.

* Professor of Law, Drexel Kline School of Law; Associate Professor of Law & John E. Murray Faculty Scholar, University of Pittsburgh Law School; Dean and James E. Beasley Professor of Law, Temple University Beasley School of Law. Many thanks to Maya Manian, Yvonne Lindgren, Jill Wieber Lens, Tracy Weitz, and Emily Bazelon for helpful feedback and to Isabelle Aubrun for research assistance.

The featured image is drawn from the United States Supreme Court’s Office of the Curator.

International edition
Australia edition
Europe edition

The fight over US abortion rights in the year without Roe – photo essay

A look back on the year since the US supreme court overturned Roe v Wade with the Dobbs decision, and the advocates who aren’t giving up

While the supreme court’s decision to overturn Roe v Wade sent shockwaves around the country, many activists, physicians and advocacy groups closely engaged in the fight over abortion in the US were not surprised.

Since Roe’s establishment of the federal right to abortion in 1973, anti-abortion advocates and conservative lawmakers have been chipping away at it. Restrictions on abortion increased over the last decade, and by the mid-2010s, seven states had just one abortion clinic left. In Mississippi, where the Dobbs v Jackson Women’s Health Organization case that ultimately ended Roe originated, the state’s one clinic did not provide abortions beyond 16 weeks of pregnancy, meaning many people already had to travel to find care.

For residents in a state with the highest poverty rate in the nation, where there is no guaranteed childcare, and where elected officials have refused to expand Medicaid to cover low-income workers, that often meant obtaining an abortion was unlikely. For those who do move forward with pregnancies, the state doesn’t make that easy either. The states like Mississippi that have now passed the strictest abortion laws are also typically the ones with the lowest minimum wages , the least generous policies that support families, least access to education and to health care. In many southern states, the rates of maternal and infant mortality and morbidity are among the highest in the country. The US has the highest maternal death rate of any wealthy country, and Black women suffer most – they’re three to four times as likely to die from pregnancy-related complications as white women.

Woman in a white coat wearing glasses looks out a window reflecting the outside

The ways the US healthcare system has treated Black people continues to affect their health in profound ways, says Dr Nina Ragunanthan, an OB-GYN who serves the largely low-income Black community in Mississippi’s Delta region.

“You take a group of people that have been so abused for generations,” she says, “the essential stress from that passes down.” Ragunanthan and other doctors say these inherited health challenges combined with ongoing racism mean that abortion bans and their subsequent effects, from medical providers moving away from states with restrictive laws to the potential of criminal penalties, have a disproportionate impact on Black Americans.

In the days after the Dobbs decision, protesters flooded the Pink House, as the Jackson Women’s Health Organization clinic was known. The Pink House Defenders, the group of volunteers who escorted patients to and from the clinic, were used to seeing regular, sometimes heated demonstrations outside, and so tried to keep things as normal as possible for patients, said Derenda Hancock, the group’s founder. “We are just trying to be here for the patients until the last moment.”

Woman in blue PPE stands in front of a brown sectional couch and pink and white wallpaper

Destiny Buchauau had her son at 14 and had her daughter a few months before the Dobbs ruling. She dropped out of school and lives in Rolling Fork, Mississippi, with her children and extended family.

Activist Linda Nicole Stringfellow always has condoms, emergency contraception, and pregnancy tests in her office in Cleveland, Mississippi. Whenever someone arrives, she also provides basic sexual education.

Ebony Jones became pregnant by rape at 17 and miscarried. She later got pregnant again, but the fetus was not developing correctly. Jones had to continue to term because it was illegal to terminate at her stage. When her son was born, she held him as he was dying for 10 hours.

Shantana Stamps, has a four-month-old son at 16. She lives with her mother and aunts in Anguilla, Mississippi. While she knew that contraception existed, she did not know where to find it or who to ask.

Cathy Dolley delivered her daughter prematurely by emergency cesarean section. Years earlier, she had a miscarriage and had to keep the fetus in her uterus for 21 days because of trap laws on abortion.

Dolley has three children and has been pregnant six times. Her first daughter, T’lana La’Faith Davis, died the day she was born in 2018.

Dolley is a certified nurse. Throughout the whole miscarriage and hospital experience she understood completely what are the risks and what was happening to her body.

Many abortion clinics stopped providing care the moment the Dobbs decision came down as they scrambled to interpret what the ruling meant for their state. The Pink House closed its doors for good on 6 July, and as the summer stretched on, more abortion bans took effect. Sixty-six clinics across 15 states stopped offering abortions in the first 100 days after Roe fell, according to the Guttmacher Institute, a research form that supports abortion rights.

Clinics in states where abortion remains legal saw huge increases in patients seeking care, and they tried to expand hours and staffing to meet those needs.

I went home with his birth certificate and an empty box with a black flower on it. – Ebony Jones

Doctors, patients and activists spoke out, drawing attention to the ripple effects that new abortion laws were having not only on those who sought abortions, but also on people experiencing pregnancy complications, miscarriages and on those who used medications that were caught up in the uncertainty around the new legislation. Anti-abortion doctors and advocates, meanwhile, argued that the laws were clear and doctors were at fault for any confusion about when the laws applied.

In August, the new era of abortion restrictions faced its first test at the ballot box when Kansas voters decisively rejected a measure that would have opened the state to future abortion bans. The surprising win for abortion rights supporters served as a symbol of a brewing backlash to the supreme court’s decision, and added fuel to debates within the Republican party about how far it should go with its new ability to restrict abortion.

Woman holding a sign in front of a man speaking

Senator Lindsay Graham proposed a national 15-week abortion ban in September, but other conservative states faltered as they tried to agree on limits for abortion without the constraints of Roe.

The intensity of these fights increased as the country headed toward the midterm elections, where abortion was suddenly at the forefront of nearly every campaign. Members of Congress held hearings on the topic. Advocates flooded into states where more ballot measures addressed abortion, and where voters were now acutely aware of the power that state and local elected officials have over their lives.

Meanwhile, reproductive justice advocates, who had been warning for years that Roe was not enough to guarantee abortion access, ramped up their plans to help people find care. Some clinics that stopped offering abortions remained open in states with bans to provide other reproductive health services, gender-affirming care and follow-up appointments for people who terminated their pregnancies out of state.

While performing an ultrasound for a patient who was preparing for an abortion, Dr. Cheryl Hamlin saw signs of an ectopic pregnancy, which would make taking abortion pills dangerous for the patient.

Her patient had traveled multiple hours to reach the clinic and needed to return home that night, so Hamlin worked to verify the diagnosis as soon as possible with other specialists.

While some people prefer to take abortion pills on their own, Hamlin believes everyone should have medical support if they desire. Now that many states have outlawed abortion, many people are going without that support.

Kate works at the Hope Clinic for Women in Illinois, where she received an abortion in 2021. After a complicated pregnancy, she was told a future pregnancy would be dangerous but the Catholic hospital where she gave birth refused to tie her tubes.

Kate became pregnant again despite taking birth control. She experienced complications after taking abortion pills and had to have three blood transfusions. The Hope Clinic asked Kate to return to ensure the abortion was safely completed.

Many abortion clinic workers choose these jobs because they have personal experience with the topic or believe strongly in the clinics’ missions.

Grassroots groups known as abortion funds raised money to help people afford abortions and the travel, lodging, childcare and extra costs that come with seeking medical assistance far from home. People like Michelle Colon, founder of Shero in Mississippi, organized volunteers to drive more than 50 women at least 10 hours north to Illinois to obtain abortions. Colon herself drove at least 20 times between the end of June and the fall, sometimes bringing more than one patient in her car and paying for travel costs herself. She is now among the very few individuals left providing such help in Mississippi.

With the country focused on abortion in a way it hadn’t been for years, advocates tried to cut through the stigma around the topic. They held conferences, speakouts and encouraged politicians to talk about the issue on the campaign trail leading up to the November midterm elections.

An anti-abortion sign reading “Unborn Lives Matter” in a direct reference to the “Black Lives Matter” slogan stands in front of a church

Angela Michael, an anti-abortion activist and former nurse performs an ultrasound on Ashley in a recreational vehicle outside the Hope Clinic. Michael convinced Ashley not to have an abortion several years ago.

On 8 November 2022, voters delivered a ringing endorsement of abortion rights in key states, establishing new abortion protections in Michigan, California and Vermont, while rejecting efforts to restrict abortion or criminalize providers in Kentucky and Montana. Elsewhere, voters supported governors and other state level candidates who backed abortion rights in places like Wisconsin, Michigan, Pennsylvania, Kansas and Arizona.

As the post-Roe reality set in, abortion pills, which have been on the World Health Organization’s list of “essential medicines” for years and now account for more than half of US abortions, proved a key flash point.

Abortion rights activists see the pills, a two-drug regimen also known as medication abortion, as a key way to help people get care privately and take some of the load off brick-and-mortar clinics. Telehealth services like Hey Jane, Choix and Abortion on Demand expanded in states where abortion remains legal. The number of abortions provided by virtual-only telehealth providers increased from an average of 4,025 abortions a month (or 5% of all abortions) before Dobbs to 7,461 a month (9% of all abortions) in the first nine months after the decision, according to the Society of Family Planning’s new WeCount report . For people who couldn’t or didn’t want to use official channels, activists expanded underground networks run by groups like Las Libres and Red Necesito Arbortar that are delivering abortion pills to Americans from as far away as Mexico and India.

A car passes by in front of pro-choice protesters

Michelle Colon, founder of Shero, an abortion fund in Mississippi, works with other activists to find ways to continue helping women in the south access abortion.

Plan A mobile clinic provides free basic reproductive healthcare and pre- and postnatal checkups for patients without health insurance. The clinic also refers patients to health centers that provide post-abortion checkups.

Valencia Robinson leads Mississippi in Action, a group that does advocacy and education about sexual and reproductive health issues. Robinson started this work after her own emergency c-section years ago.

April Jackson already had two kids when she got pregnant again. She went to a pregnancy center and was convinced not to have an abortion. Her youngest daughter was born with a heart defect that now needs to be constantly monitored.

April is raising her seven children on her own without any substantial support from any organizations or the state of Mississippi, where she is from and currently lives.

As a teenager, Amanda Furdge had two abortions. She never received sex education growing up in Mississippi. She later got married and had a son but escaped back home after her husband became violent. She soon learned she was pregnant again and was misled by a crisis pregnancy center after she went to them for an abortion.

Several years later she married another man, and though she did not want to have more children, she had another baby. After her second husband also became violent, Furdge got a tubal ligation and left her spouse to raise her children on her own.

Those who oppose abortion see pills as enabling a way around their favored laws. While the vast majority of Americans did not want to see Roe overturned and public opinion has only solidified in favor of abortion rights since last summer, the anti-abortion movement does not care if its positions are not widely popular. This year, Christian legal advocacy group Alliance Defending Freedom filed a lawsuit aiming to force the FDA to take mifepristone, one of the two drugs used for medication abortions, off the market nationwide.

After a Trump-appointed federal judge in Texas agreed with the group, the supreme court eventually blocked the restrictions and maintained access for now. But the case is likely to end up back at the supreme court, where it could still upend abortion access in every state.

She asked me to show her a photo of my oldest son. And then she asked ‘what if I kill him? – Amanda Furdge

The 2023 legislative session brought a number of new state abortion bans and restrictions, though some of these have now been blocked by courts. Democratic-leaning states pushed back by allocating funding and passing new protections for abortion seekers and providers within their borders. In other places, conservative lawmakers sought to limit ballot measures related to abortion. A group of patients in Texas who say they were denied medically necessary abortions despite risks to their lives and their fetuses, sued the state seeking to clarify exceptions to its abortion bans and as physicians in other states highlighted similar situations also arguing for more health-based exceptions, lawmakers often proved skeptical and anti-abortion advocates encouraged them to hold strong.

Women sit and stand by a busy reproductive health booth indoor

Alejandra had an abortion in 2018. She remembers how lonely she felt during her experience. Now Alejandra provides help to other women in Arizona and talks about her story publicly to fight abortion stigma.

Throughout the spring, abortion funds continued to help people access care. But while many groups in places as diverse as Louisiana, Arizona and Colorado doubled and tripled their fundraising from before Dobbs, they are now warning that funding is lagging as the public’s attention wanes. The New York Abortion Access Fund, which has helped patients from 29 states, Washington DC and six countries access abortions in the last year, says it is on pace to run out of money by October if it does not receive more support.

Abortion activist Verónica Cruz Sánchez and members of her group, Las Libres, send abortion pills to women across the US from their office in Guanajuato, Mexico.

Over 3,000 abortion pills were donated to Red Necesito Abortar, an activist group in Mexico so that they can be transported across the border for American women to use.

Misa (pseudonym) is an activist from a feminist collective in Matamoros, Mexico. Since the abortion laws have changed in the US, she has crossed the border multiple times to bring abortion pills to Texas.

In Mississippi, health problems continue and people like Colon, one of the few people helping residents in her state find the resources to travel and obtain abortions, says the situation feels almost like Jenga, the children’s game that involves precariously removing wooden blocks from a tower until they collapse. “They’re just pulling away everything,” she says. “There’s only a couple more blocks left. You’ve got these other blocks just kind of teetering.”

We never thought that we would be the ones who would be able to provide abortion access to women in the US. – Veronica Cruz

It’s not clear what will happen when the last block is gone. More lawsuits and legal attacks are coming, OB-GYNs are leaving states with abortion bans, and training for the next generation of medical residents in states with restrictions remains uncertain.

But for now, abortion rights advocates are not giving up.

Colon says she feels like she is fighting back against the new laws every time she gets someone to an appointment to terminate their pregnancy if that’s what they want. “You may have put up all of these hurdles, but we’re still getting folks there,” she says. “We’re basically crawling over fucking glass, we’re climbing mountains, yet we’re still getting people there.

People stand in a queue at a border crossing outside

Lola, an undocumented immigrant from Mexico who has been living in California for over 20 years, prepares abortion pills provided by a Mexican organization for clandestine distribution around the US.

When Lola had an abortion a few years ago, she was alone. She is now part of a network distributing them to people in the states where abortion has been illegal since more laws started changing in June 2022.

A year without Roe
Photography

Abortions are legal in much of Africa. But few women may be aware, and providers don’t advertise it

Efua, a 25-year-old fashion designer and single mother in Ghana who became pregnant in 2023, poses for a photo in Accra, Ghana, Tuesday, March 19, 2024. Efua sought an abortion at a health clinic but worried the procedure might be illegal. More than 20 countries across Africa have loosened restrictions on abortion in recent years, but experts say that like Efua, many women probably don't realize they are entitled to a legal abortion. Efua spoke to the AP on condition that only her middle name be used, for fear of reprisals from the growing anti-abortion movement in her country. (AP Photo/Misper Apawu)

Show more sharing options
Copy Link URL Copied!

When Efua, a 25-year-old fashion designer and single mother in Ghana, became pregnant last year, she sought an abortion at a health clinic but worried the procedure might be illegal. Health workers assured her abortions were lawful under certain conditions in the West African country , but Efua said she was still nervous.

“I had lots of questions, just to be sure I would be safe,” Efua told the Associated Press, on condition that only her middle name be used, for fear of reprisals from the growing anti-abortion movement in her country.

Finding reliable information was difficult, she said, and she didn’t tell her family about her procedure. “It comes with too many judgments,” she decided.

More than 20 countries across Africa have loosened restrictions on abortion in recent years, but experts say that like Efua, many women probably don’t realize they are entitled to a legal abortion. And despite the expanded legality of the procedure in places like Ghana, Congo, Ethiopia and Mozambique, some doctors and nurses say they’ve become increasingly wary of openly providing abortions. They’re fearful of triggering the ire of opposition groups that have become emboldened since the U.S. Supreme Court’s 2022 decision overturning the nationwide right to abortion.

“We are providing a legal service for women who want an abortion, but we do not advertise it openly,” said Esi Asare Prah, who works at the clinic where Efua had the procedure — legal under Ghana’s law, passed in 1985. “We’ve found that people are OK with our clinic providing abortions, as long as we don’t make it too obvious what we are doing.”

The Maputo Protocol, a human rights treaty in effect since 2005 for all 55 countries of the African Union, says every nation on the continent should grant women the right to a medical abortion in cases of rape, sexual assault, incest, and endangerment for the mental or physical health of the mother or fetus.

Africa is alone globally in having such a treaty, but more than a dozen of its countries have yet to pass laws granting women access to abortions. Even in those that have legalized the procedure, obstacles to access remain. And misinformation is rampant in many countries, with a recent study faulting practices by Google and Meta.

“The right to abortion exists in law, but in practice, the reality may be a little different,” said Evelyne Opondo, of the International Center for Research on Women. She noted that poorer countries in particular, such as Benin and Ethiopia, may permit abortions in some instances but struggle with a lack of resources to make them available to all women. Many women learn of their options only through word of mouth.

Across Africa, MSI Reproductive Choices — which provides contraception and abortion in 37 countries worldwide — reports that staff have been repeatedly targeted by anti-abortion groups. The group cites harassment and intimidation of staff in Ethiopia. And in Nigeria, MSI’s clinic was raided and temporarily closed after false allegations that staffers had illegally accessed confidential documents.

“The opposition to abortion in Africa has always existed, but now they are better organized,” said Mallah Tabot, of the International Planned Parenthood Federation in Kenya. She noted that a significant amount of money backing anti-abortion efforts appears to have come from conservative American groups — and several reports have found millions in such funding from conservative Christian organizations.

The spike from opposition groups is alarming, said Angela Akol, of the reproductive rights advocacy group Ipas.

“We’ve seen them in Kenya and Uganda advocating at the highest levels of government for reductions to abortion access,” she said. “There are patriarchal and almost misogynistic norms across much of Africa. ... The West is tapping into that momentum after the Roe v. Wade reversal to challenge abortion rights here.”

Congo, one of the world’s poorest countries, introduced a law in 2018 permitting abortions in the first 14 weeks of pregnancy in cases of rape, incest, and physical or mental health risks to the woman.

Even so, pamphlets aimed at women who might want an abortion use coded language, said Patrick Djemo, of MSI in Congo.

“We talk about the management of unwanted pregnancies,” he said, noting that they don’t use the word abortion. “It could cause a backlash.”

Accurate language and information can be hard to find online, too. Last week, a study from MSI and the Center for Countering Digital Hate found that Google and Meta — which operates Facebook, Instagram and WhatsApp — restricted access to accurate information about abortion in countries including Ghana, Nigeria and Kenya.

The study said the tech giants banned local abortion providers from advertising services while approving paid ads from anti-abortion groups pushing false claims about decriminalization efforts as part of a global conspiracy to “eliminate” local populations.

Google didn’t respond to a request for comment on the study. Meta said via email that its platforms “prohibit ads that mislead people about services a business provides” and that it would review the report.

Opondo, of the international women’s center, said she’s deeply concerned about the future of abortion-rights movements in Africa, with opponents using the same tactics that helped overturn Roe vs. Wade in the U.S.

Yet, she said, for now it’s “still probably easier for a woman in Benin to get an abortion than in Texas.”

For Efua, information and cost were obstacles. She cobbled together the necessary 1,000 Ghana cedis ($77) for her abortion after asking a friend to help.

She said she wishes women could easily get reliable information, especially given the physical and mental stress she experienced. She said she wouldn’t have been able to handle another baby on her own and believes many other women face similar dilemmas.

“If you’re pregnant and not ready,” she said, “it could really affect you mentally and for the rest of your life.”

Cheng reported from London.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Top headlines by email, weekday mornings

Get top headlines from the Union-Tribune in your inbox weekday mornings, including top news, local, sports, business, entertainment and opinion.

You may occasionally receive promotional content from the San Diego Union-Tribune.

More in this section

Tonya Mitchell becomes emotional during a news conference regarding the double homicide of her parents at the Fort Lauderdale Police Department in Fort Lauderdale, Fla., on Wednesday, April 3, 2024. The couple, Major Melvin, 89, and Claudette Melvin, 87, were slain at their Fort Lauderdale home. (Amy Beth Bennett / South Florida Sun Sentinel)/The Denver Post via AP)

Nation-World

Sisters mystified by slaying of their octogenarian parents inside Florida home

The youngest children of an octogenarian couple who were killed inside their Florida home say they are mystified as to why anyone would harm their parents

FILE - Retire Congress North Dakota Chairman Jared Hendrix, left, and U.S. Term Limits National Field Director Scott Tillman look over petitions they submitted for a North Dakota congressional age limit ballot initiative, Feb. 9, 2024, at the state Capitol in Bismarck, N.D. On Wednesday, April 3, a top legislative panel unanimously approved a $1 million cost estimate for the state to defend the age limit proposed in a constitutional initiative approved for the June 11 ballot. (AP Photo/Jack Dura, File)

Expecting a lawsuit, North Dakota lawmakers estimate $1 million to defend congressional age limit

North Dakota lawmakers expecting a legal challenge to a congressional age limit, if passed through a ballot initiative in the June election

Turkish President and leader of the Justice and Development Party, or AKP, Recep Tayyip Erdogan, right, arrives to vote to a polling station in Istanbul, Turkey, Sunday, March 31, 2024. Turkey is holding local elections on Sunday that will decide who gets to control Istanbul and other key cities. (AP Photo/Khalil Hamra)

Turkey’s top election authority restores newly elected pro-Kurdish mayor’s right to hold office

Turkey’s highest election authority has restored a newly elected pro-Kurdish mayor’s right to hold office

Kansas City Royals owner John Sherman address the crowd during an election watch party after voters rejected the extension of a sales tax to provide funding for a new baseball stadium for the Royals and renovations for the Kansas City Chiefs' football stadium Tuesday, April 2, 2024, in Kansas City, Mo. (AP Photo/Charlie Riedel)

After voters reject tax measure, Chiefs and Royals look toward future, whether in KC or elsewhere

After the decisive failure of a ballot measure that would have provided public funds for a downtown ballpark in Kansas City and renovations to Arrowhead Stadium, the Royals and Chiefs must decide what’s next for the future of their facilities

FILE - Nebraska Gov. Jim Pillen speaks during a news conference, Jan. 12, 2023, at the state Capitol in Lincoln, Neb. On Tuesday, April 2, 2024, Nebraska’s Republican governor called on state lawmakers to move forward with a “winner-take-all” system of awarding Electoral College votes. Nebraska and Maine have stood alone as the only states that can split their electoral votes by congressional district. (Kenneth Ferriera/Lincoln Journal Star via AP, File)

Months ahead of the presidential election, Nebraska’s GOP governor wants a winner-take-all system

Nebraska’s Republican governor is calling on state lawmakers to move forward with a “winner-take-all” system of awarding Electoral College votes

Police say 5-year-old Michigan boy killed when he and 6-year-old find gun at grandparents’ home

Police in Michigan say a 5-year-old boy was killed when he and a 6-year-old boy found a gun at their grandparents’ home

The Moscow Trials and the "Great Terror" of 1937-1938: What the Evidence Shows

Grover Furr July 31 2010

[To be added at the end of Part One of "Stalin and the Struggle for Democratic Reform" ]

Since my two-part essay "Stalin and the Struggle for Democratic Reform" was written in 2004-5, a great deal more evidence has been published concerning the Opposition, the Moscow Trials of 1936, 1937, and 1938, the Military Purges or "Tukhachevsky Affair", and the subsequent "Ezhovshchina", often called "the Great Terror" after the title of the extremely dishonest book by Robert Conquest first published in 1968.

The newly-available evidence confirms the following conclusions:

* The defendants at the Moscow Trials of August 1936, January 1937, and March 1938, were guilty of at least those crimes to which they confessed. A "bloc of Rights and Trotskyites" did indeed exist. It planned to assassinate Stalin, Kaganovich, Molotov, and others in a coup d’�tat , what they called a "palace coup" ( dvortsovyi perevorot ). The bloc did assassinate Kirov.

* Both Rights and Trotskyites were conspiring with the Germans and Japanese, as were the Military conspirators. If the "palace coup" did not work they hoped to come to power by showing loyalty to Germany or Japan in the event of an invasion.

* Trotsky too was directly conspiring with the Germans and Japanese, as were a number of his supporters.

* Nikolai Ezhov, head of the NKVD from 1936 to late 1938, was also conspiring with the Germans.

We now have much more evidence about the role of NKVD chief Nikolai Ezhov than we had in 2005. Ezhov, head of the NKVD (People’s Commissar for Internal Affairs), had his own conspiracy against the Soviet government and Party leadership. Ezhov had also been recruited by German intelligence.

Like the Rights and Trotskyites, Ezhov and his top NKVD men were counting on an invasion by Germany, Japan, or other major capitalist country. They tortured a great many innocent people into confessing to capital crimes so they would be shot. They executed a great many more on falsified grounds or no grounds at all.

Ezhov hoped that this mass murder of innocent people would turn large parts of the Soviet population against the government. That would create the basis for internal rebellions against the Soviet government when Germany or Japan attacked.

Ezhov lied to Stalin, the Party and government leaders about all this. The truly horrific mass executions of 1937-1938 of almost 680,000 people were in large part unjustifiable executions of innocent people carried out deliberately by Ezhov and his top men in order to sow discontent among the Soviet population.

Although Ezhov executed a very large number of innocent people, it is clear from the evidence now available that there were also real conspiracies. The Russian government continues to keep all but a tiny amount of the investigative materials top-secret. We can’t know for sure exactly the dimensions of the real conspiracies without that evidence. Therefore, we don’t know how many of these 680,000 people were actual conspirators and how many were innocent victims.

As I wrote in 2005, Stalin and the Party leadership began to suspect as early as October 1937 that some of the repression was done illegally. From early in 1938, when Pavel Postyshev was sharply criticized, then removed from the Central Committee, then expelled from the Party, tried and executed for mass unjustified repression, these suspicions grew.

When Lavrentii Beria was appointed as Ezhov’s second-in-command Ezhov and his men understood that Stalin and the Party leadership no longer trusted them. They made one last plot to assassinate Stalin at the November 7, 1938 celebration of the 21 st anniversary of the Bolshevik Revolution. But Ezhov’s men were arrested in time.

Ezhov was persuaded to resign. An intensive investigation was begun and a huge number of NKVD abuses were uncovered. A great many cases of those tried or punished under Ezhov were reviewed. Over 100,000 people were released from prison and camps. Many NKVD men were arrested, confessed to torturing innocent people, tried and executed. Many more NKVD men were sentenced to prison or dismissed.

Under Beria the number of executions in 1938 and 1940 dropped to less than 1% of the number under Ezhov in 1937 and 1938, and many of those executed were NKVD men, including Ezhov himself, who were found guilty of massive unjustified repression and executions of innocent people.

Some of the most dramatic evidence published since 2005 are confessions of Ezhov and Mikhail Frinovsky, Ezhov’s second-in-command. I have put some of these on the Internet in both the original Russian and in English translation. We also have a great many more confessions and interrogations, mostly partial, of Ezhov, in which he makes many more confessions. These were published in 2007 in a semi-official account by Aleksei Pavliukov.

Anticommunist Scholars Hide the Truth

All "mainstream" – that is, anticommunist – and Trotskyist researchers falsely claim that there were no conspiracies. According to them, all the Moscow Trial defendants, all the military defendants, and all those tried and sentenced for espionage, conspiracy, sabotage, and other crimes, were innocent victims. Some claim that Stalin had planned to kill all these people because they might constitute a "Fifth Column" if the USSR were attacked. Other anticommunists prefer the explanation that Stalin just tried to terrorize the population into obedience.

This is an ideological, anticommunist stance masquerading as an historical conclusion. It is not based upon the historical evidence and is inconsistent with that evidence. Anticommunist historians ignore the primary source evidence available. They even ignore evidence in collections of documents that they themselves cite in their own works.

Why do the anticommunist "scholars", both in Russia and the West, ignore all this evidence? Why do they continue to promote the false notions that no conspiracies existed and that Stalin, not Ezhov, decided to execute hundreds of thousands of innocent people? The only possible explanation is that they do this for ideological reasons alone. The truth, as established by an examination of the primary source evidence, would make Stalin and the Bolsheviks "look good" to most people.

Collectivization of Agriculture Saved The World from Nazis and Japanese…

We have an example of this ideological bias in the way anticommunist scholars and writers treat the Bolshevik collectivization of agriculture. Anticommunists have long attacked it as immoral and unjustified. Yet collectivization provided the capital for the crash industrialization of the USSR. And only industrialization made a modern Red army possible.

Without a technologically-advanced modern army the Nazis would have conquered the USSR. Then, with the resources and manpower of the USSR and the rest of Europe behind them, the Nazis could have invaded the British Isles. Nazi armies would have been a far more formidable foe against all Allied powers. Meanwhile the Japanese, strengthened by the petroleum of the Soviet Far East, would have been a far more formidable enemy for the USA in the Pacific war.

Millions more Slavs and Jews – "Untermenschen" to the Nazis – and millions more Europeans and American soldiers – would have been killed. That this did not occur can be attributed, in large part, to the Soviet collectivization of agriculture. This is an obvious conclusion. There was simply no other way than by collectivizing agriculture that the USSR could have industrialized, and thus stood up to the Nazis and Japanese.

The only alternative was the one promoted by the Right and Trotskyite conspirators: to make peace with the Germans and Japanese, even if that meant granting them huge trade and territorial concessions. That would have greatly strengthened the Axis powers in their war against the U.K. and the USA.

For purely ideological reasons anticommunists cannot admit that collectivization made it possible for the Axis to be defeated.

… And So Did The Defeat of the Conspirators in 1936-1938

Whether they were able to seize political power through a "palace coup", or whether they would have to rely on a German and/or Japanese attack as they only way they might be able to overthrow the Stalin government, the Opposition conspirators were planning some kind of alliance with the Axis.

In fact they would have had no choice, as they realized themselves. A USSR weakened by internal revolt, with or without an invasion from abroad, would have had to make trade, territorial, and ideological concessions to its major potential adversaries simply in order to avoid invasion and inevitable conquest.

At a minimum, a USSR led by some combination of conspirators would have made treaties with Germany and Japan that would have provided the Axis powers with huge natural resources, possibly with manufactured goods as well. The military conspirators were contemplating going much farther than mere trade with the Axis. They were contemplating an outright military alliance with Germany. That would have meant millions more soldiers to fight alongside the German Wehrmacht.

Therefore, in foiling the machinations of the Rights, Trotsky and his supporters, and the Military conspirators, Stalin saved Europe from Naziism – again!

No doubt this is why anticommunist "scholars" insist, in the face of all the evidence, that there were no conspiracies in the USSR and no collaboration with the Germans and Japanese. Once again they refuse to admit these truths on purely ideological grounds because doing so would seem to justify Stalin’s actions.

Bukharin, Not Stalin, To Blame for the Massive Repressions

One interesting aspect of this is that Nikolai Bukharin, leading name among the Rightists and one of its leaders, knew about the "Ezhovshchina" as it was happening, and praised it in a letter to Stalin that he wrote from prison.

It gets even better. Bukharin knew that Ezhov was a member of the Rightist conspiracy, as he himself was. No doubt that is why he welcomed Ezhov's appointment as head of the NKVD -- a view recorded by his widow in her memoirs.

In his first confession, in his now-famous letter to Stalin of December 10, 1937, and at his trial in March 1938 Bukharin claimed he had completely "disarmed" and had told everything he knew. But now we can prove that this was a lie. Bukharin knew that Ezhov was a leading member of the Rightist conspiracy -- but did not inform on him. According to Mikhail Frinovsky, Ezhov's right-hand man, Ezhov probably promised to see that he would not be executed if he did not mention his own, Ezhov's, participation (see Frinovsky's confession of April 11, 1939 ).

If Bukharin had told the truth -- if he had, in fact, informed on Ezhov -- Ezhov's mass murders could have been stopped in their tracks. The lives of hundreds of thousands of innocent people could have been saved.

But Bukharin remained true to his fellow conspirators. He went to execution -- an execution he swore he deserved "ten times over" * -- without revealing Ezhov's participation in the conspiracy.

This point cannot be stressed too much: the blood of the hundreds of thousands of innocent persons slaughtered by Ezhov and his men during 1937-1938, are on Bukharin's hands.

Objectivity and Evidence

I agree with historian Geoffrey Roberts when he says:

In the last 15 years or so an enormous amount of new material on Stalin … has become available from Russian archives. I should make clear that as a historian I have a strong orientation to telling the truth about the past, no matter how uncomfortable or unpalatable the conclusions may be. … I don’t think there is a dilemma: you just tell the truth as you see it. ("Stalin’s Wars", Frontpagemag.com February 12, 2007. At http://hnn.us/roundup/entries/35305.html )

The conclusions I have reached about the "Ezhovshchina" will be unacceptable to ideologically-motivated people. I have not reached these conclusions out of any desire to "apologize" for the policies of Stalin or the Soviet government. I believe these to be the only objective conclusions possible based on the available evidence.

I make no claim that the Soviet leadership was free from error. Stalin’s vision of a socialism leading to communism was obviously faulty in that it did not come to pass. During Stalin’s time, as during the short period of Lenin’s leadership, the Soviets made a great many errors. Error is, of course, inevitable in all human endeavor. And since the Bolsheviks were the first communists to conquer and hold state power, they were in unknown waters. It was inevitable, therefore, that they would make a great many mistakes – and they did.

However, any objective study of the evidence and the historical record shows that there was simply no alternative to forced collectivization and industrialization – except defeat at the hands of some combination of capitalist powers. Likewise, the fact that the Right, Trotskyite, and Military conspiracies really did exist but were snuffed out by the Soviet leadership, which managed to out-maneuver Ezhov and foil his conspiracy as well, proves that once again the USSR – "Stalin" – saved Europe from Naziism and all the Allies from an immense number of additional casualties at the hands of the Axis powers.

* Bukharin's two appeals for clemency, both dated March 13, 1938, were reprinted in Izvestiia September 2, 1992, p. 3. They were rejected, and Bukharin was executed on March 15, 1938. I have put them online in English here.

Additional Bibliography

Ezhov’s interrogations: I have translated all of Ezhov’s interrogations available to me as of July 2010 and put them online here:

http://msuweb.montclair.edu/~furrg/research/ezhovinterrogs.html (Russian original: http://msuweb.montclair.edu/~furrg/research/ezhovpokazaniia.html )

Lubianka. Stalin I NKVD – NKGB – GUKR "SMERSH". 1939 – mart 1946 . Moscow, 2006.

Frinovsky confession of April 11, 1939, pp. 33-50. http://msuweb.montclair.edu/~furrg/research/frinovskyeng.html (Russian original here: http://msuweb.montclair.edu/~furrg/research/frinovskyru.html )
Ezhov confession of April 26, 1939, pp. 52-72. http://msuweb.montclair.edu/~furrg/research/ezhov042639eng.html (Russian original: http://msuweb.montclair.edu/~furrg/research/ezhovru.html )

Petrov, Nikita, Mark Jansen. "Stalinskii pitomets" – Nikolai Ezhov . Moscow: ROSSPEN, 2008, pp. 367-379.

Ezhov confession of August 4, 1939. http://msuweb.montclair.edu/~furrg/research/ezhov080439eng.html (Russian original: http://msuweb.montclair.edu/~furrg/research/ezhov080439ru.html )

Furr, Grover and Vladimir L. Bobrov, "Bukharin's Last Plea: Yet Another Anti-Stalin Falsification." http://msuweb.montclair.edu/~furrg/research/bukhlastplea.html - translation of Russian original published in Aktual’naia Istoriia for February 2009 at http://actualhistory.ru/bukharin_last_plea

Furr, Grover and Vladimir L. Bobrov, "Nikolai Bukharin's First Statement of Confession in the Lubianka" in English translation, Cultural Logic 2007 - http://clogic.eserver.org/2007/Furr_Bobrov.pdf

Furr, Grover and Vladimir L. Bobrov, "Pervye priznatel'nye pokazaniia N.I. Bukharina na Lubianke." Klio No. 1 (2007). http://msuweb.montclair.edu/~furrg/research/furrnbobrov_klio0107.pdf

Furr, Grover and Vladimir L. Bobrov, eds. "Lichnye pokazaniia N. Bukharina." Klio (St. Petersburg), No. 1 (2007). http://msuweb.montclair.edu/~furrg/research/furrnbobrov_klio0107.pdf

Furr, Grover. "Evidence of Leon Trotsky's Collaboration with Germany and Japan." In Cultural Logic for 2009. http://clogic.eserver.org/2009/Furr.pdf

Holmstr�m, Sven-Eric. "New Evidence Concerning the 'Hotel Bristol' Question in the First Moscow Trial of 1936". Cultural Logic 2008. At http://clogic.eserver.org/2008/Holmstrom.pdf

Furr, Grover.Khrushchev Lied: The Evidence That Every "Revelation" of Stalin's (and Beria's) Crimes in Nikita Khrushchev's Infamous "Secret Speech" to the 20th Party Congress of the Communist Party of the Soviet Union on February 25, 1956, is Provably False. Kettering, OH: Erythros Press & Media LLC, 2011. At Amazon.com ; at Erythros Press & Media : at Abebooks.com ; at Abebooks.co.uk (United Kingdom)

Furr (‘Ferr’), Grover Antistalinskaia podlost’ ("Anti-Stalin Villanies"). Moscow: Algoritm, 2007. Home page: http://www.algoritm-kniga.ru/ferr-g.-antistalinskaya-podlost.html Brief summary in this interview: "The Sixty-One Untruths of Nikita Khrushchev" (Interview with Grover Furr). http://msuweb.montclair.edu/~furrg/research/litrossiainterv0608_eng.html (original here: http://www.litrossia.ru/article.php?article=3003 )

Pavliukov, Aleksei. Ezhov. Moscow: Zakharov, 2007.

The Supreme Court Abortion Pill Case Is Based on Imaginary Patients and Shoddy Science

Mifepristone is under attack because it is safe, proven, and popular..

Madison Pauly

Share on Facebook
Share on Twitter

A photoillustration of with the Supreme Court building on the left and mifepristone on the right. The photos have a color pink and green treatment.

Mother Jones illustration; Bryan Olin Dozier/NurPhoto/ZUMA; Soumyabrata Roy/NurPhoto/ZUMA

The last time lawyers from the Alliance Defending Freedom argued before the Supreme Court, their case was entirely hypothetical. The conservative Christian legal advocacy group—the force behind some of the most important anti-abortion and anti-LGBTQ litigation in recent history—was representing a Colorado graphic designer who claimed to be starting a wedding website business, and wanted the right to deny service to same-sex couples. The designer had never before made a wedding website, and the only evidence that a queer couple wanted her to do so, it was later revealed, appeared to be faked . None of that mattered. The court gave her a guarantee that she wouldn’t be punished—creating a new loophole in anti-discrimination laws across the country.

On Tuesday, another ADF lawsuit will be heard at the Supreme Court. And once again, the case rests on a hypothetical: That a member of a small anti-abortion doctors’ coalition might one day have to care for a patient suffering a rare and severe complication from an FDA-approved abortion pill that the American Medical Association considers as safe as Tylenol . Perhaps, the case speculates, that doctor might be forced to administer that patient an emergency abortion, violating their anti-abortion convictions.

This lawsuit—known as FDA v. Alliance for Hippocratic Medicine —aims to limit the availability of mifepristone, the first pill in the two-drug regimen commonly used in medication abortions. ADF, on behalf of the anti-abortion doctors, accuses the FDA of “ betraying women and girls ” when it approved mifepristone 23 years ago by overlooking potentially harmful side effects and by later making it easier to get. The case has the potential to produce the most consequential abortion ruling since 2022, when, in its Dobbs decision, the court ended the constitutional right to an abortion by upholding a Mississippi law that had been written by ADF . Since that decision, 14 states have made it illegal to provide abortion in virtually all cases, and seven more have restricted abortion to earlier in pregnancy. Now, with Tuesday’s case, the Supreme Court could broadly limit access to mifepristone—even in blue states that protect people’s right to end their pregnancy.

The lawsuit first made headlines last spring when a federal judge in Texas, Matthew Kacsmaryk, issued an unprecedented order to take mifepristone off the market entirely, nationwide. Kacsmaryk, a Trump appointee and former lawyer for a religious-right firm , purported to place a “stay” on the FDA’s 23-year-old approval of mifepristone, which has been used by millions of pregnant people in the US over the last two decades. It wasn’t an accident that the controversial judge happened to hear the case. ADF strategically filed in Amarillo, Texas, where Kacsmaryk heard 95 percent of civil cases—and where any appeals are directed to the notoriously right-leaning Fifth Circuit.

Thankfully, Kacsmaryk’s order never took effect, as the Biden administration swiftly appealed the case up to the Supreme Court, which hit pause until the justices got a fuller chance to consider the arguments. Now, that day is finally here, as the ADF prepares to face off in front of the high court with the Justice Department and lawyers for Danco, the manufacturer of brand-name mifepristone.

The stakes of the case have changed somewhat since Kacsmaryk’s order, with the Supreme Court already having decided not to review the portion of a ruling by the conservative Fifth Circuit that, while agreeing with most of the doctors’ arguments, held it was too late for ADF to challenge the FDA’s original approval of mifepristone. What’s still at stake are a series of subsequent FDA rule changes that made the drug easier to access. In 2016, the agency allowed mifepristone to be prescribed up to 10 weeks into pregnancy, rather than seven—almost doubling the number of patients who benefit from it, according to the Kaiser Family Foundation—while cutting the recommended dosage by two-thirds, and allowing certified nurse practitioners and physician assistants to prescribe the pills. It also reduced the number of required clinic visits from three to one, allowing patients to get mifepristone at a single appointment, without follow-ups.

Five years later, in response to the Covid pandemic, the FDA cut the office visit requirement—opening the door for telehealth prescriptions and mailed pills. The decision made it cheaper and simpler than ever to get an abortion in the early stages of pregnancy—especially for people who cannot take time off work, lack transportation, or are experiencing domestic violence . By last September, 16 percent of all abortions were done using telehealth, according to research by Ohio State University, the University of California-San Francisco, and the Society of Family Planning.

In their lawsuit, the anti-abortion doctors contend the FDA put patients in danger by removing these requirements, especially the office visit. The data isn’t on their side: Last month, a study in the journal Nature Medicine looked at 6,000 medication abortions provided by virtual clinics, and found that about 98 percent of them were effective without any additional intervention, and 99.8 percent were “not followed by serious adverse events,” as my colleague Julianne McShane reported .

From the beginning, the anti-abortion doctors’ arguments have been cloaked in such faux concerns about mifepristone’s safety. In their original complaint , the doctors argued that the FDA hadn’t had enough evidence to approve the drug or loosen regulations on it, and they cited flimsy research to suggest mifepristone was harmful. Those claims have been roundly debunked by mainstream medical associations , which explain that mifepristone is backed by decades of data. Even before it came to the United States, the drug was used for years for abortions in Europe ; since its approval here in 2000, around 6 million people in the US have taken it. As the New York Times reports, more than 100 scientific studies have concluded that mifepristone is a safe way to end a pregnancy.

Meanwhile. it turns out that some of the studies cited by the doctors weren’t scientific at all. One, relied on in Kacsmaryk’s decision, was based on anonymous blog posts from a site called “Abortion Changes You.” Last month, a journal retracted three other papers cited by ADF in the case , explaining that an independent review had found “fundamental problems,” “incorrect factual assumptions,” “material errors,” and “misleading presentations.” Sage, the studies’ publisher, reported that nearly all their authors had affiliations with anti-abortion advocacy groups yet had not disclosed any conflicts of interest.

Of course, the real reason mifepristone is a target isn’t a result of science, but rather simple math: Medication abortions are immensely popular, accounting for nearly two-thirds of all abortions across the country. Thanks to recently enacted “ shield laws ” in a handful of states, including California and Massachusetts, providers there can now prescribe the pills to patients in states with abortion bans.

The Supreme Court might avoid ruling on the challenges to the FDA’s mifepristone regulations if it first decides the Alliance for Hippocratic Medicine doctors don’t even have legal standing to bring the case—and court observers say it’s not at all clear that they do . It all comes down to that original hypothetical. As Alison Clapman at the Brennan Center for Justice explains , because the doctors don’t prescribe mifepristone themselves, they’ve had to settle for arguing that they face “imminent” injury from the FDA decisions that increase mifepristone access. The argument that they deserve this day in court is that sometime in the future, an emergency physician who is a member of their group will likely be forced to treat a patient with mifepristone complications, and will feel psychological harm from doing so.

Danco, in its its petition to the Supreme Court, pointed that the doctors’ claim rests on a “series of contingencies: that a woman will obtain mifepristone from another provider; that she will suffer an extremely rare serious adverse event; and that, rather than returning to her provider or another provider that was previously identified, she will seek care from one of respondents’ members.”

It was not clear that this hypothetical patient would need an emergency abortion, Danco argued—or the doctors would be forced to provide it rather than refer her to a colleague, as federal conscience laws allow them to do. “To describe those theories [of standing] is to refute them,” the company wrote. “This Court has repeatedly rejected theories of standing that rest on a ‘speculative chain of possibilities.’ especially where, as here, those possibilities depend on ‘unfettered choices made by independent actors.'”

Tossing the case out on a lack of standing would be an easy way for the judges to keep the status quo. But remember, this is the court that overturned Roe v. Wade , and it could be eager to use Tuesday’s case to seize a similar opportunity . It remains to be seen whether judicial norms around standing—much less the weight of the scientific record—will stop the court’s conservative majority from taking another swipe at abortion access.

A New Study on Medication Abortion Refutes the Arguments Conservatives Are Taking to the Supreme Court

Julianne McShane

Health Care Without Mifepristone? “The Experience for Patients Is Going to Be Awful.”

Abby Vesoulis

Will One Controversial Texas Judge Outlaw the Most Popular Form of Abortion for the Whole Country?

A large white silo sits on top of metal tubing.

This Kind of Fracking Can Help Solve Our Climate Problems

Oliver Milman

We Recommend

With Famine “Imminent,” Israeli Military Kills Seven Aid Workers Delivering Food to Gazans

“They Don’t Want to Teach Black History”

Frances Madeson

Trump’s Truth Social Lost $58 Million Last Year!

A small black monkey lounging in a tree with green leaves

The Biden Administration Just Rescued Parts of the Endangered Species Act

Kiley Price

Abortion rights advocates protested in Florida last year as the legislature debated a six-week ban—which will now take effect next month.

Florida Supreme Court Approves a Six-Week Ban—And Lets an Abortion Rights Ballot Measure Move Forward

She Has Investigated Allegations of Sexual Violence in War Around the World. Here’s What She Wants You to Know.

The Invisible Work of America’s Domestic Workers

Chloe Aftel

A stylized photograph of a parking lot with electric vehicle charging stations. The stations are elevated making them inaccessible. The EV stations are colored black and white and the background has a green color treatment.

Disabled Drivers Can’t Use Many Electric Car Chargers. It Doesn’t Have to Be This Way.

Julia Métraux

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

By signing up, you agree to our privacy policy and terms of use , and to receive messages from Mother Jones and our partners.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Support our journalism

Help Mother Jones ' reporters dig deep with a tax-deductible donation.

Independent. In print. In your mailbox.

Inexpensive, too! Subscribe today and get a full year of Mother Jones for just $14.95.

Mother Jones Magazine Cover : January + February 2024

Bold. Brave. Beautiful.

Award-winning photojournalism. Stunning video. Fearless conversations.

Looking for news you can trust?

We noticed you have an ad blocker on..

Can you pitch in a few bucks to help fund Mother Jones' investigative journalism? We're a nonprofit (so it's tax-deductible), and reader support makes up about two-thirds of our budget.

We noticed you have an ad blocker on. Can you pitch in a few bucks to help fund Mother Jones' investigative journalism?

Don't let an algorithm decide what news you see.

Boris Groys

Professor of philosophy at the european graduate school / egs..

Boris Groys (b.1947) is a philosopher, essayist, art critic, media theorist and an internationally renowned expert on Soviet-era art and literature, specifically, the Russian avant-garde. He is a Global Distinguished Professor of Russian and Slavic Studies at New York University, a Senior Research Fellow at the Staatliche Hochschule für Gestaltung Karlsruhe, and a professor of philosophy at The European Graduate School / EGS. His work engages radically different traditions from French poststructuralism to modern Russian philosophy, yet is firmly situated at the juncture of aesthetics and politics. Theoretically, Boris Groys’s work is influenced by a number of modern and post-modern philosophers and theoreticians, including Jacques Derrida, Jean Baudrillard, Gilles Deleuze and Walter Benjamin.

Born in the former German Democratic Republic, Groys grew up in the USSR. He studied philosophy, mathematics, and logic at Leningrad State University (now Saint Petersburg State University). While a student, he immersed himself in the unofficial cultural scenes taking place in Leningrad and Moscow, and coined the term “Moscow conceptualism.” The term first appeared in the essay “Moscow Romantic Conceptualism,” published in 1979, in the art magazine A-YA . During this time in the Soviet Union, Groys published widely in a number of samizdat magazines, including 37 and Chasy . Between 1976 and 1981, Boris Groys held the position of Research Fellow in the Department of Structural and Applied Linguistics at Moscow State University. At the end of this fellowship, he left the Soviet Union and moved to the Federal Republic of Germany.

In 1992, Groys earned his doctorate in philosophy from the Universität Münster, where he also served as an assistant professor in philosophy from 1998-1994. During this time, Groys was also a visiting professor in the Department of Slavic Languages and Literature at the University of Pennsylvania, followed by another appointment at the University of Southern California, also in the Department of Slavic Languages and Literature. From 1994 to 2009, Groys was Professor of Art History, Philosophy, and Media Theory at the Staatliche Hochschule für Gestaltung Karlsruhe, where he remains a senior research fellow. In 2001, he was the Director of the Academy of Fine Arts Vienna, and from 2003 to 2004, he spearheaded the research program Post-Communist Condition , at the Federal Cultural Foundation of Germany. He assumed the position of Global Distinguished Professor in the Faculty of Arts and Science at New York University in 2005 and in 2009 he became a full Professor of Russian and Slavic Studies at NYU. Groys is also a senior Fellow at the International Center for Cultural Studies and Media Theory at the Bauhaus Universität (Weimar); a member of the Association Internationale des Critiques d’Art (AICA); and has been a senior scholar at the Courtauld Institute of Art (London); and a fellow at the International Research Center for Cultural Studies (IFK, Vienna), Harvard University Art Museum, and the University of Pittsburg.

In the Anglo-American world, Boris Groys is best known as the author of The Total Art of Stalinism (1992), and for introducing the western world to Russian postmodernist writers and artists. His contributions stretch across the field of philosophy, politics, history, and art theory and criticism. Within aesthetics, his major works include Vanishing Point Moscow (1994) and The Art of Installation (1996). His philosophical works include A Philosopher’s Diary (1989) , The Invention of Russia (1995), and Introduction to Antiphilosophy (2012). More recently, he has also published Under Suspicion: A Phenomenology of the Media (2000) , Ilya Kabakov: The Man Who Flew into Space from his Apartment (2006) , and The Communist Postscript (2010). In addition to these works, other significant works in art, history, and philosophy include: History Becomes Form: Moscow Conceptualism (2010), Going Public (2010), Art Power (2008), The Total Enlightenment: Conceptual Art in Moscow 1960-1990 (2008), Dream Factory Communism: The Visual Culture of the Stalin Period (2004), Apotropikon (1991), and Thinking in Loop: Three Videos on Iconoclasm, Ritual and Immortality (DVD, 2008), which is a trilogy of video-text syntheses, wherein Groys reads the composed text superimposed onto a collage of footage fragments taken from movies and film documentations.

As a prominent contemporary art theorist and critic, Boris Groys has also curated a number of notable exhibitions, including: Fluchtpunkt Moskau at Ludwig Forum (1994, Aachen, Germany), Dream Factory Communism at the Schirn Gallery (2003-2004, Frankfurt, Germany), Privatizations at the KW Institute of Contemporary Art (2004, Berlin, Germany), Total Enlightenment: Conceptual Art in Moscow 1960–1990 at the Kunsthalle Schirn (2008-2009 Frankfurt, Germany; Fundación Juan March, Madrid, Spain), Medium Religion with Peter Weibel at the Center for Art and Media Karlsruhe (2009, Karlsruhe, Germany), Andrei Monastyrski for the Russian Pavilion at the 54th Venice Biennale (2011, Venice, Italy), After History: Alexandre Kojève as a Photographer , at BAK Utrecht (2012, Netherlands).

While Boris Groys teaches, lectures, and writes on philosophy, politics, and history, it has been his work in aesthetics, and his co-mingling of ideas through aesthetics, that has brought him the most recognition and where he has made his most significant contributions. Groys proposes and underscores the involvement of the Russian avant-garde in the Bolshevik movement as well as in the early stages of the Bolshevik State. Following this premise, Groys’s work explores the implications of this relationship. One of his fundamental theses is that these artists––like their political counterparts––tried to outpace the developments of modernity, and so, they, like the Bolsheviks themselves, attempted to skip the steps supposed to be necessary and constitutive of historical progress.

While it is widely acknowledged in modern Russian art history that an opposition developed among artists during the revolutionary period between those constituting an avant-garde and those complicit with the state sanctioned art of the Soviet Union, Boris Groys contends that this was the result of a split and not a continuation of a pre-Revolutionary division. More specifically, Groys posits a more refined understanding of the period such that these artists cannot be simply and uniformly grouped as having been in partnership with the state Party and then, slowly, over the period split off into an opposing position. Indeed, he contends that much of the avant-garde remained on the ideological side of the state Party well past its early stages. Moreover, these artistic developments entered the political field and thereby became its extension. Under the leadership of the state, Soviet realism helped fulfil the avant-garde’s dream of demiurgic power. It is in this respect that Groys then posits the relationship between romanticism and twentieth century Russian avant-garde art. The partnership between Soviet realism and the state Party’s ideology resulted in (authorized) artworks as understood as the realization of socialism, thereby abolishing the supposed boundaries between life, art, and politics. According to Groys, the Lenin Mausoleum stands as the embodiment of this achievement of synchrony. Complicating and pushing this position further, Groys finds this phenomenon not at all exclusive to the Soviet Union, but in fact points to its uncanny parallel in the readymades of Marcel Duchamp.

Much of Groys’s work has centered on exploring the consequences of this suture resulting in a particular framework in which to think post-Stalinist art. With the fall of Stalinism, and its “iron laws of history,” Russian artists, both of the post-Stalin period of the Soviet Union and the post-Cold War period, have had to confront the difficult task of overcoming a notion of utopia without falling out of history, or rather, how to dissolve the notion of teleology without falling into the abyss of the end of history. Within this framework, Groys investigates not only the historical, political, and aesthetic relations in the Soviet Union and Russia, but as well specific artistic and literary works such as those by Ilya Kabakov, Komar and Melamid, and Prigov.

Without pronouncement, Boris Groys’s work, in all its varied forms, appears to follow a sustained thesis: art is a symptom of society. While the majority of his work is within aesthetics, his thesis is not exclusive to aesthetics. Rather, Groys tends to think politics, and philosophy, with and through the medium of art. This idea is underscored in a conversation between John-Paul Stonard and Boris Groys while he was Visiting Professorial Fellow at the Courtauld Institute of Art Research Forum, which was transcribed and published in the Institute’s journal, immediations (Vol.1, No. 4, 2007). In response to Stonard’s question as to whether “philosophers have a naturally closer relationship with artists than do art historians?” Groys responded, “We can look at artists in two ways. First, as if we were biologists, trying to construct a neo-Darwinian story of ‘art species’; how artists developed, how they succeeded, failed, survived. In these terms art history is formulated a little like botany or biology. The second way of considering art history is as part of the history of ideas. We have the history of philosophy, the history of science, the history of cultural history, just as we can have the history of art. So the question is whether we define art history more like botany, or more like the history of philosophy – and I tend more to the latter, because, as I have suggested, the driving force of art is philosophical.”

––Srdjan Cvjeticanin

Kommunisticheskiy Postskriptum , Groys, Boris. Kommunisticheskiy Postskriptum. Ad Marginem, 2014. ISBN: 5911031817

Google: Words beyond Grammar/Google: Worte jenseits der Grammatik , Groys, Boris. Google: Words beyond Grammar/Google: Worte jenseits der Grammatik. Hatje Cantz, 2011. ISBN: 3775728953

Unter Verdacht: Eine Phänomenologie der Medien , Groys, Boris. Unter Verdacht: Eine Phänomenologie der Medien. Carl Hanser Verlag, 2010. ISBN: 3446236023

Under Suspicion: A Phenomenology of Media , Groys, Boris. Under Suspicion: A Phenomenology of Media. Translated by Carsten Strathausen. Columbia University Press, 2012. ISBN: 0231146183

Going Public , Groys, Boris. Going Public. Sternberg Press, 2010. ISBN: 1934105309

History Becomes Form: Moscow Conceptualism , Groys, Boris. History Becomes Form: Moscow Conceptualism. MIT Press, 2010. ISBN: 0262014238

Einführung in die Anti-philosophie , Groys, Boris. Einführung in die Anti-philosophie. Carl Hanser, 2009. ISBN: 3446234047

An Introduction to Antiphilosophy , Groys, Boris. An Introduction to Antiphilosophy. Translated by David Fernbach. Verso, 2012. ISBN: 0231146183

Art Power , Groys, Boris. Art Power. MIT Press, 2008. ISBN: 0262518686

Drei Videos über das Ikonoklastische: Rituelle und Unsterbliche/Thinking in Loop: Three Videos on Iconoclasm, Ritual and Immortality. , Groys, Boris. Drei Videos über das Ikonoklastische: Rituelle und Unsterbliche/Thinking in Loop: Three Videos on Iconoclasm, Ritual and Immortality. ZKM/Hatje Cantz, 2008. ISBN: 3775723374

Die Kunst des Denkens , Groys, Boris. Die Kunst des Denkens. Philo Fine Arts, 2008. ISBN: 3865726399

Ilya Kabakov. The Man Who Flew into Space from His Apartment , Groys, Boris. Ilya Kabakov. The Man Who Flew into Space from His Apartment. Afterall/MIT Press, 2006. ISBN: 1846380049

Das Kommunistische Postskriptum , Groys, Boris. Das Kommunistische Postskriptum. Suhrkamp, 2006. ISBN: 351812403X

The Communist Postscript , Groys, Boris. The Communist Postscript. Verso, 2010. ISBN: 1844674304

Le Post-scriptum Communiste , Groys, Boris. Le Post-scriptum Communiste. Translated by Olivier Mannoni. Libella/Maren Sell, 2008. ISBN: 2355800057

Postscriptum Comunista , Groys, Boris. Postscriptum Comunista. Translated by Gianluca Bonaiuti. Metemi Melusine, 2008. ISBN: 8883536738

Die Muse im Pelz , Groys, Boris. Die Muse im Pelz. Literaturverlag Droschl, 2004. ISBN: 3854206720

Topologie der Kunst , Groys, Boris. Topologie der Kunst. Carl Hanser, 2003. ISBN: 3446203680

Kommentarii k Iskusstvu , Groys, Boris. Kommentarii k iskusstvu. KhZh, 2003. ISBN: 5901116089

Politik der Unsterblichkeit: Vier Gespräche mit Thomas Knöfel , Groys, Boris. Politik der Unsterblichkeit: Vier Gespräche mit Thomas Knöfel. Carl Hanser, 2002. ISBN: 3446201394

Politique de l’Immortalité , Groys, Boris. Politique de l’Immortalité. Quatre entretiens avec Thomas Knoefel. Translator Olivieri Mannon. Maren Sell Editeurs, 2005. ISBN: 2350040232

Dialogi , Groys, Boris, and Ilya Kabakov. Dialogi. Ad marginem, 1999. ISBN: 593321003X

Logik der Sammlung , Groys, Boris. Logik der Sammlung. Carl Hanser, 1997. ISBN: 3446189327

Kunst-Kommentare , Groys, Boris. Kunst-Kommentare. Passagen, 1997. ISBN: 3851652916

Die Kunst der Installation , Groys, Boris, and Ilja Kabakov. Die Kunst der Installation. Carl Hanser, 1996. ISBN: 3446185275

Die Erfindung Russlands , Groys, Boris. Die Erfindung Russlands. Carl Hanser, 1995. ISBN: 3446180516

Über das Neue , Groys, Boris. Über das Neue. Versuch einer Kulturökonomie. Carl Hanser, 1992. ISBN: 3446165428

On the New , Groys, Boris. On the New. Translated by G. M. Goshgarian. Verso, 2014. ISBN: 1781682925

Sobre lo Nuevo , Groys, Boris. Sobre lo Nuevo. Pre-textos, 2005. ISBN: 848191648X

Du Nouveau , Groys, Boris. Du Nouveau: Essai d’économie culturelle. Jacqueline Chambon, 1995. ISBN: 2877111156

Zeitgenössische Kunst aus Moskau: Von der Neo-Avantgarde zum Post-Stalinismus ,Groys, Boris. Zeitgenössische Kunst aus Moskau: Von der Neo-Avantgarde zum Post-Stalinismus. Klinkhardt u. B., 1991. ISBN: 3781403033

Die Kunst des Fliehens , Groys, Boris, and Ilya Kabakov. Die Kunst des Fliehens. Carl Hanser, 1991. ISBN: 3446160779

Dnevnik filosofa , Groys, Boris. Dnevnik Filosofa. Beseda/Sintaksis, 1989.

全体芸術様式スターリン/ Zentai Geijutsu Yōshiki Sutārin , Groys, Boris. 全体芸術様式スターリン/ Zentai Geijutsu Yōshiki Sutārin. Translated by Ikuo Kameyama and Yoshiaki Koga. 現代思潮新社, 2000. ISBN: 4329004119

Gesamtkunstwerk Stalin , Groys, Boris. Gesamtkunstwerk Stalin. Translated by Desiderio Navarro. Pre-textos, 2008. ISBN: 848191925X

Lo Stalinismo Ovvero l’Opera d’Arte Totale , Groys, Boris. Lo Stalinismo Ovvero l’Opera d’Arte Totale. Translated by Emanuela Guercetti. Garzanti, 1992. ISBN: 8811598346

The Total Art of Stalinism: Russian Avant-Garde, Aesthetic Dictatorship, and Beyond. , Groys, Boris. The Total Art of Stalinism: Russian Avant-Garde, Aesthetic Dictatorship, and Beyond. Translated by Charles Rougle. Verso, (1992) 2011. ISBN: 1844677079

Staline: Oeuvre d’Art totale , Groys, Boris. Staline: Oeuvre d’Aart totale. Jacqueline Chambon, 1990. ISBN: 2877110370

Gesamtkunstwerk Stalin , Groys, Boris. Gesamtkunstwerk Stalin. Die Gespaltene Kultur in der Sowjetunion. Translated by Gabriele Leupold. Carl Hanser, (1988) 2008. ISBN: 3446187863

Edited Works

Moscow Symposium: Conceptualism Revisited

Groys, Boris, ed. Moscow Symposium: Conceptualism Revisited . Sternberg Press, 2012. ISBN: 3943365115

Empty Zones: Andrei Monastyrski and Collective Action

Groys, Boris, Claire Bishop, and Andrei Monastyrski, eds. Empty Zones: Andrei Monastyrski and Collective Action . Black Dog, 2011. ISBN: 1907317341

Die totale Aufklärung: Moskauer Konzeptkunst 1960-1990/The Total Enlightenment: Conceptual Art in Moscow 1960-1990

Groys, Boris, Max Hollein, and Manuel Fontan del Junco, eds. Die totale Aufklärung: Moskauer Konzeptkunst 1960-1990/The Total Enlightenment: Conceptual Art in Moscow 1960-1990 . Exhibition catalogue. Hatje Cantz, 2008. ISBN: 377572124 X

Die Neue Menschheit

Groys, Boris, and Michael Hagemeister, eds. Die Neue Menschheit . Suhrkamp, 2005. ISBN: 351829363 X

Am Nullpunkt

Groys, Boris, and Aage Hansen-Löve, eds. Am Nullpunkt . Suhrkamp, 2005. ISBN: 3518293648

Zurück aus der Zukunft. Osteuropäische Kulturen im Zeitalter des Postkommunismus

Groys, Boris, and Anne von der Heiden, eds. Zurück aus der Zukunft. Osteuropäische Kulturen im Zeitalter des Postkommunismus . Suhrkamp, 2005. ISBN: 3518124528

Privatisierungen/Privatisations

Groys, Boris, ed. Privatisierungen/Privatisations . Revolver, 2004. ISBN: 3865882285

Dream Factory Communism: The Visual Culture of the Stalin Era

Groys, Boris, and Max Hollein, eds. Dream Factory Communism: The Visual Culture of the Stalin Era . Hatje Cantz, 2003. ISBN: 377571328 X

Kierkegaard

Groys, Boris, ed. Kierkegaard . Schriften. Diederichs, 1996. ISBN: 3424012874

Fluchtpunkt Moskau

Groys, Boris, ed. Fluchtpunkt Moskau. Cantz, 1994. ISBN: 3893226125

Utopia i Obmen

Groys, Boris, ed. Utopia i Obmen . Izd-vo Znak, 1993. ISBN: 5877070010

Today’s Legacy of Classical Modernism

Thinking Media and the Man-Machine Relation

Alexandre Kojève

Advancing social justice, promoting decent work

Ilo is a specialized agency of the united nations, schoolchildren discuss future of work: an essay contest in baku.

On 14 June 2019, the Ministry of Labour and Social Protection of Azerbaijan held in its premises an awarding ceremony of the essay contest on the topics of the ILO Centenary and the Future of Work. Schoolchildren from Baku took part in the contest.

IMAGES

Group launches site to help women self-induce abortions at home, citing
Why the Left Is Losing on Abortion
Trump pushes anti-abortion agenda to build culture that 'cherishes innocent life'
Opinion
Abortion pills are safe and could ease growing access crisis for women
Abortion Futures? Unpacking Access and Reproductive Justice in Illinois

COMMENTS

US: Abortion Access is a Human Right
Human Rights Watch released a new question-and-answer document that articulates the human rights imperative, guided by international law, to ensure access to abortion, which is critical to ...
Where the Pro-Choice Movement Went Wrong
How abortion-rights groups failed to stop the erosion of Roe v. Wade. ... Guest Essay. Where the Pro-Choice Movement Went Wrong ... Planned Parenthood's advocacy and political arms spent $45 ...
Why Exceptions for the Life of the Mother Have Disappeared
Support for the so-called life-of-the-mother exception seemed unshakable. From the May 2022 issue: The abortion underground. Not anymore. Anti-abortion-rights groups, like Pro-Life Wisconsin, have ...
Op-ed: How to save abortion rights
May 10, 2022 - A Supreme Court draft opinion that would overturn the federal right to abortion in the U.S. if finalized is "humanitarian malfeasance," according to Michelle Williams, dean of Harvard T.H. Chan School of Public Health.. In an op-ed published May 5, 2022 in the Emancipator—a collaboration of Boston University's Center for Antiracist Research and the Boston Globe ...
An Abortion Advocacy Movement for Everybody
An Abortion Advocacy Movement for Everybody. The ACLU of Texas and partner organizations are creating a one-of-a-kind advocacy hub for reproductive freedom advocates in Texas — all we need is you. Abortion is legal in Texas and across the United States, but that doesn't stop anti-abortion politicians from doing whatever they can to ...
'The Pro-Life Generation': Young Women Fight Against Abortion Rights
July 3, 2022. DALLAS — The rollback of abortion rights has been received by many American women with a sense of shock and fear, and warnings about an ominous decline in women's status as full ...
How Abortion Changed the Arc of Women's Lives
A frequently quoted statistic from a recent study by the Guttmacher Institute, which reports that one in four women will have an abortion before the age of forty-five, may strike you as high, but ...
The Only Reasonable Way to Debate Abortion
There's a Better Way to Debate Abortion. Caution and epistemic humility can guide our approach. If Justice Samuel Alito's draft majority opinion in Dobbs v. Jackson Women's Health ...
Finding Nuance in the Abortion Debate
In a winding, sometimes graphic, carefully considered Boston Review essay, ... Therefore, if I am elected, I will seek to end all public subsidies for abortion, for abortion advocacy, and for ...
The Value of Choice and the Choice to Value: Expanding the Discussion
In this essay, I provide evidence that a new generation of prochoice advocates wishes to move away from defending abortion rights via the view that fetal life has little or no value (for example, as Mary Anne Warren does in her "On the Moral and Legal Status of Abortion") and toward a more complex view of abortion rights.
Pro-Choice Does Not Mean Pro-Abortion: An Argument for Abortion Rights
Since the Supreme Court's historic 1973 decision in Roe v. Wade, the issue of a woman's right to an abortion has fostered one of the most contentious moral and political debates in America.Opponents of abortion rights argue that life begins at conception - making abortion tantamount to homicide.
The New Pro-Abortion Generation
The larger movement of pro-abortion advocacy in many ways mirrors the drive at Eagan High School. The new wave of activism is pushing for greater inclusivity in the movement by bringing the LGBTQ community and people of color to the fore. Solange Azor, 25, has volunteered and worked for abortion access funds and nonprofits since seeking out her ...
Essays
Essay: The Value of Choice and the Choice to Value: Expanding the Discussion about Fetal Life within Prochoice Advocacy. Revisitng the Argument From Fetal Potential. One of the most famous, and most derided, arguments against the morality of abortion is the argument from potential, which maintains that the fetus' potential to become a person ...
Why Civic Engagement for Abortion Advocacy Matters
Many of us think of civic engagement on abortion as getting to the polls and voting for candidates who support reproductive rights. Civic engagement is much more than that. It also uses citizens' voices to spread accurate health information across the general public and to apply pressure on decisionmakers for a specific cause.
A research on abortion: ethics, legislation and socio-medical outcomes
The analysis of abortion by means of medical and social documents. Abortion means a pregnancy interruption "before the fetus is viable" [] or "before the fetus is able to live independently in the extrauterine environment, usually before the 20 th week of pregnancy" [].]. "Clinical miscarriage is both a common and distressing complication of early pregnancy with many etiological ...
Abortion Care in the United States
Abortion services are a vital component of reproductive health care. Since the Supreme Court's 2022 ruling in Dobbs v.Jackson Women's Health Organization, access to abortion services has been increasingly restricted in the United States. Jung and colleagues review current practice and evidence on medication abortion, procedural abortion, and associated reproductive health care, as well as ...
Abortion as Essential Health Care and the Critical Role Your Practice
On June 24, 2022, the Supreme Court overturned nearly 50 years of federal precedent protecting abortion access in its Dobbs v Jackson Women's Health opinion. 1 The American College of Obstetricians and Gynecologists (ACOG) has replied by messaging that, "Abortion is essential health care." 2 A commanding 95% of obstetrician-gynecologists (ob-gyns) agree with ACOG and support provision of ...
Opinion
The Persistent Threat to Abortion Rights. The editorial board is a group of opinion journalists whose views are informed by expertise, research, debate and certain longstanding values. It is ...
Rethinking Strategy After Dobbs
Introduction. Now that the Supreme Court has overturned Roe v.Wade and Planned Parenthood v.Casey, the movement for abortion rights and access finds itself in uncharted territory. 1 Open this footnote Close this footnote 1 See Dobbs v. Jackson Women's Health Org., 142 S. Ct. 2228, 2242 (2022) (overruling Roe v. Wade, 410 U.S. 113 (1973), and Planned Parenthood of Se. Pa. v. Casey, 505 U.S ...
The fight over US abortion rights in the year without Roe
A look back on the year since the US supreme court overturned Roe v Wade with the Dobbs decision, and the advocates who aren't giving up. Photo essay by Kasia Strek, as told to Abigail Abrams ...
Abortions are legal in much of Africa. But few women may be aware, and
ACCRA, Ghana — When Efua, a 25-year-old fashion designer and single mother in Ghana, became pregnant last year, she sought an abortion at a health clinic but worried the procedure might be ...
Biden Campaign Memo Claims Florida Is "Winnable" Though ...
The memo suggests "investing [campaign spending] in Florida as a pathway to victory," adding that it's a state "where President Biden has a compelling story of results to tell.". Beyond abortion, the memo also believes that Biden can win on other issues in the state, including by opposing (and tying to Trump) laws that have resulted ...
The Moscow Trials and the "Great Terror" of 1937-1938: What the
The Moscow Trials and the "Great Terror" of 1937-1938: What the Evidence Shows. Grover Furr July 31 2010 [To be added at the end of Part One of "Stalin and the Struggle for Democratic Reform"]. Since my two-part essay "Stalin and the Struggle for Democratic Reform" was written in 2004-5, a great deal more evidence has been published concerning the Opposition, the Moscow Trials of 1936, 1937 ...
The Supreme Court abortion pill case is based on imaginary patients and
The conservative Christian legal advocacy group—the force behind some of the most important anti-abortion and anti-LGBTQ litigation in recent history—was representing a Colorado graphic ...
thebmj.com Read reader responses to this essay at bit.ly/1e6qiss E
Ж Read reader responses to this essay at bit.ly/1e6qiss Simon Chapman is professor of public health at the University of Sydney. He was inaugural deputy editor, then editor of Tobacco Control for 17 years and is now emeritus editor. In 2003 he was awarded the American Cancer Society's Luther Terry Medal for outstanding individual leadership in
Boris Groys
Boris Groys (b.1947) is a philosopher, essayist, art critic, media theorist and an internationally renowned expert on Soviet-era art and literature, specifically, the Russian avant-garde. He is a Global Distinguished Professor of Russian and Slavic Studies at New York University, a Senior Research Fellow at the Staatliche Hochschule für ...
Schoolchildren Discuss Future of Work: An Essay Contest in Baku
On 14 June 2019, the Ministry of Labour and Social Protection of Azerbaijan held in its premises an awarding ceremony of the essay contest on the topics of the ILO Centenary and the Future of Work. Schoolchildren from Baku took part in the contest.