Abortion as Moral Panic 

Visitors to the United States are often astonished at how central the abortion issue is to American political life. A candidate's position on abortion often comes to define his or her candidacy, whether the race is for a local city council seat or for the presidency. This is almost unknown elsewhere in the world. As of this writing in spring 2005, some six months after the 2004 presidential election, the Democratic Party is actively engaged in intensive soul searching about its historic support of abortion rights and is seeking to "reposition" itself on this issue, in the hope of reversing its recent losses. Beyond its impact on elections, the abortion debate (or "war," as it is often called) spills over to many other contemporary conflicts in American life, such as the ?right to die? issue, stem cell research, and contraceptive policies, to name just a few.

How did this happen? In nearly all other Western industrialized societies, abortion has been a largely noncontentious issue, often being fairly easily integrated into those countries? health care systems. What has made the U.S. experience so different? Up until the late nineteenth century in the United States, abortion was actually unregulated and not an object of intense social concern. It was neither forbidden by law nor recognized as legal. We know from historians that a wide range of providers, both medically trained and not, offered abortions and pregnant women attempted the procedure on themselves. This began to change in the mid-1800s, as physicians, under the leadership of the recently formed American Medical Association, began to lead a campaign of criminalization against abortion. This campaign was not primarily motivated by the group?s concern about the morality of abortion. Rather, as a number of scholars have shown, this represented a professionalization drive among "regular" (that is, university-trained) physicians. Midwives, nurses, and lay healers were performing many of the abortions at that time, and the antiabortion campaign was an opportunity to assert physician dominance over this wide range of health care workers. However, after a century of illegal abortion, which resulted in thousands of deaths and injuries, the AMA reversed itself, and physicians, along with feminist health activists, were key players in the fight for legal abortion, which culminated in the Roe v. Wade decision in 1973.

The Roe decision, in turn, led to the emergence of the modern antiabortion movement, a group that continues to wield enormous influence in American politics. Part of the antiabortion movement's strength is that it emerged alongside another conservative development in American politics, the rise of what was then referred to as the "New Right" (today, more commonly referred to as the "religious right"). The New Right represented a "countermovement" that reacted to the progressive social movements of the 1960s and 1970s. The agenda of the New Right went beyond opposition to abortion to include such issues as feminism, gay rights, the protestors of the Vietnam War, sex education, social programs of the welfare state, and so on. But as political scientist Rosalind Petchesky wrote in her now classic book, Abortion and Woman's Choice, abortion was the "battering ram" in this much broader cultural and political offensive. Millions of previously nonpolitical Americans were drawn into conservative politics by the antiabortion movement and were instrumental in electing Ronald Reagan president in 1980. Social and religious conservatives now had emerged as a key constituency of the Republican Party.

From 1980 to the present, abortion has dominated domestic politics in the United States. Indeed, it is useful to see, starting in this period, how well abortion fits with the classic definition of "moral panic," as described by the British sociologist Stanley Cohen. Cohen speaks of a moral panic as "A condition (that)  emerges to become defined as a threat to societal values and interests ... (A)t ... times it has ... serious and long-lasting repercussions and might produce such changes as those in legal or social policy or even in the way society conceives itself." Consistent with this definition, legal abortion came to epitomize for many Americans the enormous discomfort they felt about sexuality and gender roles in the wake of the 1960s and '70s. Abortion, in their view, facilitated promiscuity, especially among teenagers; the displacement of parents as the party in charge of young women?s health care; and a change in the age-old bargain between the genders, when an unplanned pregnancy used to lead to marriage. The coming of the AIDS epidemic in the 1980s to the United States, and the initial official response to the disease as a moral issue, not a medical one, intensified the feeling of many conservatives that American sexuality was truly out of control.

As a result of this immediate backlash, Congress began to restrict abortion services in various ways. One of the first and most significant of these was the Hyde amendment, which forbade the use of public funds to pay for poor women's abortions. Abortion provision itself became increasingly under siege, as a violent wing of the antiabortion movement grew. Picketing, blockades, and sieges became commonplace at the freestanding clinics (where most abortions in the United States take place). In 1993 an antiabortion extremist shot and killed Dr. David Gunn, an abortion doctor, in front of a Florida clinic. Since that time, another six members of the abortion providing community have been murdered, and thousands more have been harassed and, in many cases, terrorized by clinic firebombings and stalkings.

At the present moment, abortion rights supporters in the United States are deeply concerned about the future of legal abortion. President Bush, a strong opponent of abortion, will most certainly have the opportunity to nominate one or more justices to the Supreme Court, and this appointee may be the additional vote needed to overturn Roe v. Wade.

Even if Roe is not overturned, however, abortion services in this country are in crisis. The combination of massive restrictions on abortion care imposed by states, the failure of many medical institutions to live up to their responsibilities of abortion training, and the stigmatization of abortion generally in American culture has led to a shortage in abortion facilities and trained providers. Access is very difficult for many women, especially the young, the poor, and those who live in rural areas. Overall, one out of three American women lives in counties without abortion services.

Beleaguered as the abortion rights movement is, there are some hopeful signs. One is the formation of Medical Students for Choice, an organization that has chapters in medical schools across the country. Just as Roe v. Wade led to the creation of the modern antiabortion movement, the excesses of the latter led directly to the organization of this group of future physicians. These students are committed to providing their patients with a full range of reproductive health services.

Finally, there are signs that the antiabortion movement, and the larger religious right of which it is a part, may have overestimated its support and awakened Americans to the dangers this movement poses, beyond the threatened loss of legal abortion. Many abortion opponents also are opposed to contraception, including Emergency Contraception (EC), which has been shown to prevent thousands of abortions. The Federal Drug Agency (FDA), capitulating to the religious right, has refused to allow EC to be available on "over the counter" status, in spite of a panel of experts testifying that this was safe. Increasingly, there are reports of pharmacists who refuse to fill prescriptions of EC and indeed, of regular oral contraception ("birth control pills"). The religious right has strongly opposed stem cell research (because of its use of embryos), which a majority of Americans support in the belief that this is the next frontier in medicine. Many Americans have been offended by the Bush administration's willingness to please its extremist supporters and put scientific untruths on government websites?such as the discredited link between abortion and breast cancer. Similarly, a majority of the American public was appalled at the heavy-handed government intervention in the recent "right to die" case of a Florida woman, an intervention vigorously promoted by the antiabortion movement.

At this difficult moment, supporters of reproductive freedom can only hope that a new "moral panic" will arise in the United States, as citizens become alarmed about the extent of intrusion of the religious right into Americans? personal lives.

Carole Joffe, PhD, is a professor of sociology at U.C. Davis and a visiting professor in the Center for Reproductive Health Research and Policy at University of California at San Francisco. She is the author of Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v. Wade, and numerous articles on abortion provision.