An enormous amount of information and insight is packed into Carol Sanger’s About Abortion: Terminating Pregnancy in Twenty-First Century America. The book is anchored in post-1973 American case law. Yet it repeatedly incorporates examples and ideas from popular culture, prior historical periods, moral philosophy, feminist theory, medicine, literature and the visual arts, and more.
The
panoramic ambition of the book, and its correspondingly multi-disciplinary
method, are established in the first chapter, in a section titled “What
Abortion Is About.” By the end of this section,
the reader has learned something about: Roe
v. Wade; various international treaties on the rights of women; abortion
training protocols in medical schools; the neurological development of a fetus;
the 2012 Republican presidential primary; a 1995 papal encyclical; a 1984
lecture by the New York Governor; a 2001 concurrence by a Mississippi Supreme
Court Justice; the 2003 decision by the FDA to approve the “morning-after-pill”
for over-the-counter sale; the anti-abortion turn within certain Protestant denominations
in the 1970s and 80s; sociological research on pro-life activists and their
views on sex; anthropological research on pregnancy termination decisions
following a diagnosis of fetal disability; prostitution laws in New York; abstinence-only
programs in Texas; President George W. Bush’s Culture of Life; the rise and
rise of parental involvement statutes and personhood amendments; the rise and
fall of federal support for family planning organizations and abortion services
to pregnant soldiers; the intensifying politics of abortion in state judicial
elections; the recent Hobby Lobby litigation
over the Affordable Care Act; and the Supreme Court’s decision last Term in Whole Woman’s Health.
This
section lasts fourteen pages. It is a
testament to Sanger’s skill as a writer and to her synthetic capacities as a
thinker that one comes away from this whirlwind tour feeling not vertigo, but
rather an enhanced sense of clarity about the arc of abortion regulation. While the pace soon slows down, the rest of
the book maintains a relentless inquisitiveness, ever collecting and connecting
data points to help guide the reader through complex socio-legal terrain.
Most
of the chapters could stand on their own as original accounts of one facet or
another of U.S. abortion controversies.
Chapter seven, on “Sending Pregnant Teenagers to Court,” advances an
especially powerful critique of judicial bypass hearings as cruel and
frequently arbitrary degradation ceremonies. But the main throughline of the book is its catalog
of the ways in which Sanger believes this country’s abortion discourse, or “abortion
talk,” has been lacking—and in consequence how abortion policymaking has been
lacking. Not in passion or commitment,
to be sure, but lacking in evidence, lacking in candor, and lacking in
appreciation and respect for the distinctive circumstances and perspectives of
women.
* * *
Secrecy
is a big part of this story. The book’s “central
argument,” Sanger writes in the preface, is that “the secrecy surrounding
women’s personal experience of abortion has massively . . . distorted how the
subject of abortion is discussed and how it is regulated.” These “distortions” take myriad forms. Politically, secrecy means that our debates about
abortion often paint a misleading picture, as by overstating its health risks
or understating its bases of support. Culturally,
secrecy means that abortion often gets coded as something shameful or deviant, which
reinforces the desire for concealment regarding abortion decisions, which in
turn reinforces the sense that there is something ignominious to be hidden
away, and on and on in a self-perpetuating cycle. And substantively, secrecy means that any
number of dubious, paternalistic, or factually erroneous claims about the harms
of abortion are able to circulate with less pushback than we might expect in a
more open conversational climate.
Abortion,
in other words, is in the closet.
Sanger
doesn’t expressly adopt this framing of abortion secrecy, although she draws an
analogy to sexual orientation “closetedness” in chapter two that suggests she
would be amenable to it. Closetedness,
as Sanger observes, refers to “a form of concealment that is both furtive and
debilitating,” set against a “shadow of disapproval.” We know from other contexts that such closets
are costly for inhabitants. They
stigmatize, they suffocate, they alienate, they create vulnerability, they
obscure reality. The abortion closet paradoxically
makes our society both more obsessed with abortion—because like all taboos, it
becomes an object of fascination and fear—and yet less familiar with abortion—because
many of our public debates about it are disconnected from women’s actual
experiences.
One
may wonder whether secrecy deserves such emphasis. Statistics on abortion are regularly compiled
and circulated. Many pro-choice women
have been vocal about their beliefs on abortion, pregnancy, procreation, and
related issues. Their views, however,
are liable to be discounted or discredited by competing discourses that
flourish alongside their own. The
problem here may have less to do with ignorance and “unknowing” than with a
refusal of empathy. It is not clear that
secret-keeping, of whatever sort, has been as central to the development of
abortion regulation as the closet historically has been to gay
subordination.
That
said, abortion secrecy is very real,
and underexplored, and my sense is that Sanger has opened up significant
conceptual and political opportunities in pointing to the abortion closet. The analogies and disanalogies to the gay
closet warrant sustained attention. Moreover,
if secrecy is at the core of Sanger’s diagnosis of what ails the American
discourse on abortion, the book also identifies a range of supplementary causes. One is the persistence of stark disparities
in the social roles and responsibilities of men versus women, with women
bearing not only most of the practical burden of raising children but also most
of the moral burden of responding to unwanted pregnancies. A number of newer developments that might
seem to enrich the conversation, meanwhile, only end up deepening the closet—from
the proliferation in popular culture of fetal images that foster an association
with personhood; to the proliferation of terminology, such as partial birth
abortion and unborn child, that gives pro-life advocates the “rhetorical advantage”;
to the proliferation of policies, such as mandatory ultrasounds and informed
consent protocols, that dictate what women see and hear in their physicians’
offices.
The
pro-life push to control the conversations that abortion providers have with
their patients, Sanger suggests, betrays an anxiety about frank dialogue. Proponents of Women’s Right to Know laws and
informed consent protocols recognize the importance of the discursive space;
their prescriptions generate a steady stream of abortion talk. Much of this talk, however, is scripted and
unidirectional. It purports to promote
more knowledgeable and responsible choices yet in reality serves to deter and
demean women and to interfere with their decisional processes.
* * *
Among
other contributions, Sanger’s subtle indictment of contemporary abortion discourse
sheds light on a classic subject in legal theory: the distinction between rules
and standards. Whereas rules are thought
to limit case-by-case discretion through crisp ex ante directives, standards
leave much of their content to be worked out by future enforcers and
interpreters. Rules are precise,
standards imprecise. Some legal theorists
have suggested that the very imprecision of standards ought to make them better
at facilitating moral and democratic deliberation. Rather than apply a rule by rote, citizens
faced with a standard are forced to think hard about whether they are acting
appropriately and why.
But
as Sanger shows, standards in abortion law may have just the opposite
effect. In the 1992 case of Planned Parenthood of Southeastern
Pennsylvania v. Casey, the Supreme Court famously replaced Roe v. Wade’s trimester system with the “undue
burden” test to govern when abortion may be restricted. In so doing, the Court shifted the doctrinal
framework from a relatively rigid set of rules to a relatively hazy and
open-textured standard. On the rosy view
of standards as deliberation-forcing, Casey
should have led to richer public argument about the stakes involved in
terminating a pregnancy, in each trimester, and about whether any given
regulatory plan seems reasonable and respectful of women or alternatively
whether it seems excessive and unjustified.
Sanger,
however, suggests that the shift from Roe
to Casey occasioned no such
elevation of our deliberations about abortion, no salutary spur to collective
self-reflection. On the contrary, in her
telling, Casey largely enabled a diminishment of the quality and integrity
of these deliberations, as well as a diminishment of the abortion right. When you combine Casey’s malleable language of undue burden—a phrase that teeters on
the edge of tautology—with all the broader factors that threaten to “distort” abortion
talk and policy, it turns out that you invite endless cycles of opportunism and
obstruction, not sensitive and honest debate.
One
general lesson we might take from Sanger’s account, then, is that the
relationship between legal doctrine and cultural practice in such a politically
charged field may be poorly illuminated by abstract propositions about the comparative
merits of rules, standards, or the like.
Open-minded judges, in particular, might learn from Sanger’s implicit
yet emphatic demonstration of the need for more realistic, empirically
informed, and sociologically grounded approaches to abortion regulation.
* * *
Sanger
begins her book with “the possibility of conversation at a lower decibel by
women concerning their own abortion decisions and experience.” Less heat, more light, is her proposal. Less secrecy and shame, “more openness and
generosity,” as she puts it in the book’s closing line.
Sanger’s
book does not simply offer an eloquent brief in support of this proposal. The book also offers, through the author’s
own exemplary openness and generosity, a model of what such conversations about
abortion might be like. And what we find
is that they can be intensely illuminating.
This post is based on Pozen’s remarks at a recent event
celebrating the publication of About Abortion.