The body politic

Abortion and the Politics of Motherhood
by Kristen Luker
University of California Press, 1985

Dubious Conceptions:
The Politics of Teenage Pregnancy
by Kristen Luker
Harvard University Press, 1997

Review by Margaret Foley

The thirty-two years that have passed since the Supreme Courted handed down Roe v. Wade have not been easy for those of us who would like to see that women’s reproductive rights are not infringed upon. In recent years, limitations on access to reproductive information combined with proposed laws that would give the fetus the same rights as a person have polarized debates surrounding women’s health and public policy in ways that have very negative consequences.

Two classic works by sociologist Kristen Luker, Abortion and the Politics of Motherhood (1985) and Dubious Conceptions: The Politics of Teenage Pregnancy (1997) examine the historical roots and complex sociology of the abortion debate and the so-called problem of teenage pregnancy. Her analyses shed light on why these issues are so contentious and why it is so difficult to address them in any meaningful way.

Abortion and the Politics of Motherhood has three main parts: an historical overview of how abortion became a public issue, a discussion of the pro-life and pro-choice movements, and an examination of possible directions the abortion debate could take.

One of the questions Luker attempts to address is “how do people decide whether to regard fetuses as the single-celled creatures they once were or as the babies they will become?” Unfortunately, the historical record provides a vague answer. The idea that abortion is murder has always uneasily coexisted with the idea that those already living have more rights. In the past, laws did not grant the fetus personhood. Laws against abortion were not, and could not be, strictly enforced. In fact, abortions were largely ignored. If someone did want to prosecute an abortion, it was difficult to find the necessary evidence.

Until the middle of the nineteenth century, abortion was a topic for the privacy of the home. The overall lack of medical knowledge, the fact that most medicine was administered and taken in the home, and the fact that pregnancies were not publicly known for several months all combined to create an atmosphere in which there was no public discussion of the issue.

Abortion was brought into the public by what, today, would be considered an unlikely source— physicians. In the nineteenth century, physicians were not a well-defined, or a well-respected, profession. They were part of a continuum of practitioners, ranging from grandmothers to folk healers to anyone who had experience with a particular condition. Non-physicians made a great deal of money selling formulas designed to “unblock” or “release obstructed menses.” If physicians could remove what they considered to be “quacks” from the market, they could eliminate a great deal of their competition.

Physicians formed the “first pro-life movement.” They successfully argued that their special expertise gave them moral knowledge that the general public did not have. Women, they said, did not understand that the embryo was, in fact, a living being. As a result of their lack of knowledge, women became “inadvertent murderesses.” The only way to solve this was to completely outlaw abortion.

However, the physicians’ arguments contained a paradox. They maintained that abortion was murder, but, at the same time, they claimed that only they knew how to decide when an abortion was necessary. They pushed for laws that would allow only them to decide when an abortion should be performed. The physicians succeeded, and by 1900, every state had a law making abortion illegal except to save the life of the mother. The laws did not state what defined a threat to the mother, so doctors has a wide latitude to perform an abortion, if they chose to do so.

What the nineteenth century debate did was move the issue of abortion into a different type of private sphere— the privacy of the doctor’s office. “As a result, abortion as a major social, political, and ethical issue could disappear beneath the cloak of an emerging profession’s claims, there to rest quietly for almost a century.”

However, the environment began to change in the 1950s and 1960s. As medical technology and knowledge improved, many of the standard indicators for abortion, such as tuberculosis, heart disease, and kidney disease were no longer life-threatening. What was left were the “softer” social and psychiatric reasons. As more and more abortions were legally performed in hospitals, doctors became uncomfortable as the medical reasons disappeared. To try to set standards, hospitals instituted abortion boards, which were supposed to determine whether or not an abortion could be justified on medical grounds. However, the boards complicated factors by laying bare the fact that no clear criteria existed for when an abortion could be performed and by taking a class- and/or market-based approach to granting abortions:

Some hospitals turned their boards into quota systems, where only a given number of abortions proportional to the number of live births could be performed. A case could be turned down simply because the month’s quota had already been exceeded. At the same time, these boards also tended to become market systems, in which women with wealth, information and medical advocates were far more likely to be granted abortions than their poorer, less well-informed and less well-connected peers.

The 1962 Sherri Finkbine case brought the abortion issue into the public eye. While pregnant with her fifth child, she discovered that her sleeping pills contained defect-causing Thalidomide. Her doctor scheduled an abortion, and he assured her that the hospital board was only a formality. Concerned that other pregnant women might have been exposed to Thalidomide, she allowed a friend to use her experience for a newspaper story. While her name was not mentioned, her abortion was cancelled because of an ensuing public outcry over the idea that women would get an abortion even if their lives were not in danger. Finkbine’s name became public when her husband filed a court order to allow the abortion, and she eventually had to go to Sweden to get it.

American society and politics were changing in ways that would turn the abortion debate from the confines of a medical debate to an all-out public discussion. To try and resolve the public issues around abortion, reformers in California began to push for new abortion laws. In 1967, Ronald Reagan signed California’s new, liberalized abortion law. While the law did not provide abortion on demand, it made abortion legal if done by a qualified doctor in a certified hospital and if done to prevent mental or physical damage to the woman. By 1972, however, data showed that 99% of women who wanted an abortion got one. Abortion on demand was the reality, if not the law.

One of the most fascinating aspects of Abortion and the Politics of Motherhood is the data provided by 212 in-depth interviews Luker conducted with those on both sides of the abortion issue, who describe in detail the personal experiences and beliefs that led them to take sides. Luker argues that attitudes toward abortion are enmeshed in a whole range of values related to attitudes about religion, work, children, and families. Both sides see the legality or illegality of abortion as connected to long-held, but rarely examined, core values. The worldviews created by these core values are so divergent that it is next to impossible for those who are pro-choice and those who are pro-life to have a meaningful exchange about abortion:

Reasonable people who are located in very different parts of the social world find themselves differentially exposed to diverse realities, and this differential exposure leads each of them to come up with different— but often equally reasonable— constructions of the world…When combined with the fact that attitudes toward abortion rest on these deep, rarely examined notions about the world, it is unambiguously clear why the abortion debate is so heated and why the chances for rational discussion, reasoned arguments, and mutual accommodation are so slim.

Although Abortion and the Politics of Motherhood was published twenty years ago, some of Luker’s speculations on the future of abortion rights have proven to be remarkably prescient. The pro-choice movement suffers from what she calls the “paradox of success.” Roe v Wade catalyzed the pro-life movement by giving it a cause to rally around, and today it is a well-funded and influential movement. Although she hoped “that the debate itself will become less important to the American public,” she acknowledged the possibility of what has in fact happened. In America, “the abortion debate [has] not become noted for civility, calm, or reasoned discourse.”

The intersection of attitudes toward class, sexual behavior, and values is not limited to the abortion debate. Another hot-button issue in American politics is what some have termed an “epidemic” of teens having sex and having children.

The image of a fifteen- or sixteen-year-old minority teenager who becomes pregnant just so she can collect welfare has become the poster child for a whole range of perceived social ills— poverty, dropout rates, domestic abuse, sexual promiscuity. The problem with this, as Luker astutely points out in Dubious Conceptions: The Politics of Teenage Pregnancy, is that not only is this image is inaccurate, it obscures the actual causes of teen pregnancy and what could be done to prevent it.

A more accurate portrait of a teen mother is a white, single eighteen- or nineteen-year-old. Many of them have jobs, have found a way to continue their education and care for their children, and are in stable relationships. However, that is not a portrait on which you can pin society’s ills. From a sound-bite perspective, the false picture is more politically compelling, and unfortunately, it results in mean-spirited and ineffective policies. In fact, “Americans have a rather mixed history of doing bad things to young or otherwise vulnerable people ‘for their own good,’ of confusing an unwillingness to make the ‘right’ choice with the incapacity to do so.”

The idea that teen pregnancy is a “social problem” is a relatively recent development. In the United States, the nuclear family has almost always been seen as the only environment in which to raise children. However, it has never been possible to prevent unmarried people from having sex and having children. Historically, American society has dealt with this in a variety of ways from forcing the father to financially support the child to recognizing common-law marriages to providing inheritance rights. Most of these policies were instituted to maintain the well-being of the child, and they seem quite compassionate when compared to today’s world where children often go without needed food, healthcare, and welfare benefits because their parents do not fit some preconceived notion of a “proper” family.

Teenagers who have children fall into an ambiguous and unstable category. Although some people may consider 18 to be too young to become a mother, in many states, 18 is the legal age of consent. At 18, a young woman is considered old enough to vote, old enough to have sex, but not old enough to drink. If she is still in high school, she may not be able to have access to sex education. The conflicting messages that young women receive regarding sexual activity combined with the difficulty of accessing health care make it difficult to make informed reproductive choices. After all, which sends a more powerful signal? An abstinence class or reruns of Beverly Hills 90210?

It was largely during the 1970s and the “Reagan revolution” that discussions of teenage mothers began to take on larger political, and more importantly, moral overtones. Part of this was due to changing social norms. As attitudes toward premarital sex relaxed, poor women and teenagers were the two groups with the least amount of access to contraception. When teenagers became pregnant, they were visible, and not very reassuring, signs of how much social mores had changed. Instead of being recognized as part of a new culture in which childbearing was becoming divorced from marriage, “babies having babies” were viewed as taking advantage of the welfare system and sending larger and larger numbers of families into poverty:

However, as Luker demonstrates, teen pregnancy doesn't cause poverty, but poverty is a large contributing factor to teen pregnancy. For example, approximately 80% of all teenage mothers were living at or near the poverty level before they became pregnant. The standard American social narrative is that one goes to college, gets married, and becomes financially responsible before having children. Teenage mothers disrupt a narrative that argues that a woman should only have children when she can afford to. Poor mothers are seen as people who drain society’s resources by making life choices that conflict with social expectations:

The behavior of these young women seemed not only unwise and self-destructive, but unwise and self-destructive in ways that hit particularly close to home. They seemed to be having babies before they were ready, and worse, to be doing so without a legal husband, at a time when Americans were becoming keenly aware that it took two or more workers in a family to maintain a middle-class lifestyle. People who had scrimped and saved until they could marry and set up a household, who lived with all the burdens of the “second shift”…and who were postponing childbearing until they could afford it were particularly unsympathetic: teenagers who had babies seemed to be heedless and irresponsible, and heading for trouble.

Yet, very often, the reasons teenagers become pregnant are not so different from the reasons older women become pregnant. Birth control fails. Some of them believe a child will help them change their lives. Some of them are married and want to start a family. If they do not have middle-class expectations, becoming a parent at an early age does not necessarily undermine a plan one may have for one’s life.

What’s very clear is that if you are poor and pregnant or poor and have a child, there is little help easily available to you. A teenage mother, who is middle-class, has access to private resources, and will not become a “drain” on the state, is not castigated as harshly as someone who is poor. To a certain extent, American society supports single motherhood as long as it is a “lifestyle choice.”

What this class-based attitude creates is a situation in which society turns on its poorest members, undermining support and funding for approaches that could work to reduce teen pregnancy and alleviate poverty. For example, laws that prevent clinics from discussing abortion options, parental consent laws, ending programs such as Aid for Families with Dependent Children, teaching abstinence rather than practical sex education, making it difficult to get birth control and morning-after pills, reducing educational grants, eliminating job-training programs, and cutting off health care do not help people make informed choices regarding their future. In fact, such policies only perpetuate the problems they purport to solve:

Americans seem bent on making the lives of teenage parents and their children even harder that they already are. Society has failed teenage parents all along the line— they are people for whom the schools, the health care system, and the labor market have been painful and unrewarding places. Now, it seems, young parents are being assigned responsibility for society’s failures.

This is not to say that society does not try to help teenagers who have children. Gone are the days when pregnant teenagers could not attend school, be cheerleaders, or join honor societies. But, any program designed to help teen mothers is rarely given universal approval. My local paper, The Oregonian, recently ran an article about a Portland high school that has a daycare center. Someone wrote a letter to the editor saying this was a bad idea— if high school girls knew they could have childcare, it would be an added incentive to get pregnant.

With last week’s release of its proposed budget, it is apparent that the Bush administration is only making the situation worse when it comes to providing people with the information and programs they need to lead stable and productive lives. Proposed cuts in food stamps, health benefits, educational grants, and child care assistance along with increased budgets for ineffective abstinence programs like one in Texas that was shown to increase, rather than decrease, sexual activity among teens create an environment which increasingly puts the health and welfare of women and children at risk. These proposals, along with any future plans to further restrict reproductive rights, will have the harsh consequences of making many people’s futures more limited than they should be.

mmo : February 2005