Women, Abortion, and Politics

Republican Ann Stone represents the new breed of pro- choice Republicans. Although she disapproves of government intrusion into women’s health care issues, she is personally anti-abortion.

‘You have to be very careful how you talk about the issue. Many people on our side are vehemently against the government having this control but they are not for abortion. In fact they would favour some restrictions, with third trimester and sex-selection eliminated as an option. By and large they are very much against abortion as a form of birth control.’

A member of the far right wing of the Republican party, Stone and her group, Republicans For Choice, are putting a conservative slant on the US abortion controversy where the movement to restrict women’s rights has been happening on a state by state basis.

In Pennsylvania, a woman who wants an abortion must first notify her husband, then undergo anti-abortion counselling by her doctor and finally wait a mandatory 24-48 hours before the operation. In Louisiana, abortions are illegal even when a woman’s health is endangered. Doctors who give them can get up to 10 years’ hard labour and a fine between Dollars 10,000 and Dollars 100,000.

The most effective pro-life organisations have not been extremists like Operation Rescue who have attacked abortion clinics and staff, but the more mainstream groups such as the National Right To Life Committee. When Stone talks about ‘birth control’ abortion, she is referring to that organisation’s eight steps to influence state legislatures, called ‘model state legislation’, which have framed the issue for the Republican pro-choicers and anti-abortionists alike.

‘Birth control’ abortion is when women using no other contraceptives abort unwanted pregnancies – hardly a practical solution. For women who do use contraceptives, the sub-text is more frightening. Abortion should be made available only in cases of rape, incest and under life-threatening circumstances. Abortion for sex selection is not an issue in this country. Yet as a National Right To Life Committee spokesman once suggested, tactics like this ‘get the public thinking’. Other model legislations, whether husband consent or the banning of state or even federal funding of public information, have formed the basis for the new statutes.

While in Britain abortion remains a matter for a woman and her doctor, in the US it has become one for the courts. Restrictive state laws, passed this year in North Dakota, Mississippi, Utah and Louisiana, have yet to be enforced, since appeals are still pending. However, one or more of the cases will reach the Supreme Court in an attempt to challenge Roe v Wade, the historic 1973 decision that legalised abortion in America.

‘Most people are saying that Roe v Wade will be overturned,’ says Valerie Syme, editor of Abortion Report, a nonpartisan, daily abortion newsletter. ‘The question is when. It could have a tremendous negative impact on the Republican party. There will be a big voter backlash if it is overturned before the 1992 presidential election.’

Recent polls show that 70 per cent of the American public are pro-choice, in the traditional sense of the phrase, meaning they support a wide range of contraceptive alternatives for women. Although the pro-life movement – with some groups advocating a total ban on contraceptives – is considered an extremist minority, it has had an impact. According to the Alan Guttmacher Institute, clinics giving abortions in rural areas dropped by 19 per cent, and in urban centres by six per cent, between 1985 and 1989.

Despite this, the number of women having abortions has been rising. Statistics from the Centres for Disease Control show that, in 1987, 29 out of 1,000 American women had an abortion. There has been an 18 per cent increase among girls younger than 15, an 11 per cent increase among 15-19-year-olds from the ethnic minorities. The highest rate was 62 per 1,000 among women aged 18 and 19.

Considering that minority women are three times more likely than whites to have abortions, this summer’s Supreme Court ruling, which prevents federally-funded family planning clinics from giving abortion counselling, has been seen as political. The ‘gag rule’ prevents doctors at the 4,500 clinics nationwide from referring patients or even mentioning abortion. Servicing four million lower income women, these facilities are the closest the US gets to Brook Advisory and Well Women clinics.

Planned Parenthood, the largest of the clinic groups, with 900 facilities nationwide, has refused to comply with the ruling and, as a result, has lost Dollars 34 million in government aid, a significant part of its operating budget. In June, Planned Parenthood of New York ran a newspaper ad featuring a picture of a gagged woman with the caption, ‘A pregnant woman needs her doctor’s advice. Not the Government’s opinion.’ According to Alex Sanger, its president and chief executive officer, public response to this ad raised Dollars 106,000; their South Bronx clinic alone needs to make up the loss of Dollars 450,000 in federal funds.

More than the restrictive, anti-abortion laws passed by various states, the Supreme Court ruling has effectively taken abortion out of women’s rights and made it a first amendment issue. Sanger explains, ‘We have framed this whole issue as the doctor-patient relationship and one of free speech. That has a much broader constituency in this country than those who want to have safe and legal abortion preserved. Even some of those in the Republican right wing say the gag rule is a mistake.’

In an effort to overturn the Supreme Court ruling, two bills have already been passed by Congress and to stress that it means business, the Senate has added abortion rights wherever possible. Recently the appropriations bill for the Departments of Labour, Health and Human Services included a provision to allow Medicaid, the government-sponsored medical reimbursement insurance for the poor, to pay for abortion in cases of rape and incest. Previously it would pay only when a woman’s life was in danger.

Although President Bush has threatened to veto any bill that comes before him, moderate and conservative Republicans have asked him to reconsider and not challenge the house and senate to override his veto.

For Republican political activist Mary Dent Crisp, the President’s position is a travesty. In 1980, she was the national co-chair of the Republican National Committee and witnessed the switch Bush made from his widely acknowledged position as a supporter of family planning to anti-abortion in order to join the Reagan ticket – a move that prompted Crisp to denounce his ‘political expediency’. For her grassroots political organisation, the National Republican Coalition for Choice, abortion cuts across party politics. Unlike Stone’s group, which will not withdraw support from anti-abortion Republican candidates, Crisp believes the abortion issue comes first. ‘If Roe is overturned next summer, it will be blamed on the Republicans and it will not only affect Bush’s re-election. Look at the federal elections, the senate and house, gubernatorial races, state legislative races – all these will also be affected.’

It was this scenario that National Committee Chairman Lee Atwater, author of the notorious Willie Horton ads for the Bush 1988 campaign, wanted to avoid. Before his death, he urged Republicans to reverse their anti-abortion stance and adopt a position less offensive to voters. A poll taken of Republican delegates after the 1988 convention showed that 68 per cent of the same people who elected George Bush described themselves as ‘pro choice’. Despite this, Atwater’s successor, Clayton Yeutter, insists that the policy should not be changed. With an election year looming, the Young Republicans have already voted to take the issue out of the platform altogether.

Another fight the President currently faces is the senate confirmation hearings on Clarence Thomas, Bush’s choice to fill the Supreme Court seat made vacant by the retirement of liberal civil rights jurist Thurgood Marshall. ‘With Marshall’s resignation and Thomas’ nomination coming so close on the heels of the gag rule, far more people believe the use of the abortion issue by the right wing is simply an opening wedge on a broader attack on our individual rights,’ maintains lawyer Patricia Ireland, executive vice president of the National Organisation of Women (NOW).

The last Supreme Court appointment, David Souter, was a clear fifth vote against abortion, insists Ireland. ‘But there is a significant difference in having on the court Clarence Thomas or someone equally opposed to the bill of rights and women’s rights, and the way the court is currently structured. Now they have to play to the middle and what Sandra Day O’Connor (the only woman justice) thinks will be an undue burden on abortion instead of going all the way to the right.’

The attack on abortion has been, in part, a failure of the women’s movement, something that Ireland, who is slated to become NOW’s president in December, slowly acknowledges. ‘(We have) been victims of our own success. So many women have walked through those doors of opportunity who 20 or 25 years ago would have been struggling in the women’s movement, and now they have moved on to more personal career goals. A lot of young women have never known a time when birth control and abortion were not legal.’

As a result, NOW has started an intensive campaign against Thomas. In the past, Supreme Court nominees were not asked their views on abortion, something senators have vowed to change during Thomas’ confirmation hearings this month. Already he has refused to make public his views, but the National Abortion Rights Action League (NARAL) recently leaked a copy of a 1987 speech in which he praised an essay by historian Lewis Lehrman who equated the anti-abortion movement with the abolition of slavery.

The anti-abortion movement officially began after Roe v Wade in 1973 and gained momentum in state legislatures where activists were voted in. Even though groups like NOW and NARAL are on the defensive, they have so far stemmed the tide of regressive legislation. In the year following the 1989 Webster decision, in which the Supreme Court allowed states to enact their own abortion legislation, 350 bills were introduced in state legislatures, of which the majority were either killed in committee or vetoed by state governors. Out of 270 bills introduced in 1991, only a handful have become law. But it takes only one case in the judicial pipeline to go to the Supreme Court. Many predict that restrictive laws in Pennsylvania and in Guam, initially passed by that state and US territory in 1989 and 1990 respectively, will reach the high court first.

What will happen if Roe v Wade is overturned? Ireland has no illusions. ‘Women will continue to get abortions but they will once again be unsafe.’ She sighs. ‘Women will start to die again.’

Special Report on Health at Work

The great success of the Clean Air Act, and the many health benefits it brought, are taken for granted by a generation which has never experienced the death-dealing pea-souper fogs that used to enshroud our major cities.

Today the focus has narrowed from environmental pollution of the atmosphere to the health hazards of the workplace. For the workplace is a microcosm of the environment, says Dr. Geoffrey Brown, secretary of the Society of Occupational Medicine, which commemorates its golden jubilee this year.

The factories and offices, the farmlands and oil rigs and shops, the hospitals and public utilities, the schools and print rooms and lorries and laboratories – where millions spend most of their waking hours – are no less in need of being free from hazard to health than the air we breathe.

The importance of health at work, established in legislation by the Health and Safety at Work Act, 1974, and by thousands of regulations since, was acknowledged by the Prime Minister earlier this year.

Mrs. Thatcher was visiting the occupational and hygiene laboratories of the Health and Safety Executive, the large but impressively energetic and expert quango which is the Government’s watchdog on health at work. Commenting on their ‘meticulous’ research, she emphasized that for British industry to remain at the top level, it must not only be efficient, it must also be safe.

The need for controls has been recognized since the earliest days of the industrial revolution.

In 1775, Percival Pott pointed to the high incidence of scrotal cancer among chimney sweeps. The Factory Inspectorate began its work more than 150 years ago, in the same year, 1832, as the Great Reform Act. Later legislation effectively established the world’s first national industrial medical service.

Towards the end of the 19th century, an industrial disease notification scheme was begun and in 1898 Thomas Morrison Legge became the first medical inspector of factories.

Illness and death among munition workers in the First World War made the nation aware that both for humanitarian reasons and to preserve human resources, medical services at the workplace were essential. Even during the interwar slump, many businesses set up health facilities.

More recently, bodies such as Nuclear and Agriculture Inspectorates have done much to maintain and improve health standards among workers in those vital industries. Contrary to widespread belief, incidentally, farming is much more hazardous to health, through noise, dust, pesticides, machinery and animals, than atomic power.

For the past 50 years, the now 2,000-strong Society of Occupational Medicine has greatly advanced the cause of health at work, through scientific meetings, education and training, consultations on new measures and in forming a faculty in occupational medicine within the Royal College of Physicians.

It has, says Dr. Tim Carter, its official historian and director of medical services for the Health and Safety Executive, an ‘evangelical’ role. That has not always made it friends.

Its prime work has been to encourage and respond to government initiatives, its members trying to tread the path between state intervention and voluntary action. Unfortunately, doctors in industry have tended, unjustly, to be identified with the employers’ sectional interests, and their integrity has been questioned.

But with both employers and trade unions lukewarm at first about occupational health, many services might well not have come into existence when they did but for the Society’s proselytizing.

As Dr. Carter points out, Britain differs from most European countries in not imposing statutory obligations upon employers to seek occupational health guidance, but relies on voluntary action. The government’s involvement is chiefly regulatory and supervisory.

Nor, of course, does it provide a treatment service.

The National Health Service, which does, is not specifically concerned with health at work. The Robens Committee in 1972 thought occupational health services might wastefully duplicate the NHS.

It was against this background that the House of Lords select committee on science and technology last year, while calling for a major expansion of occupational health services to cover millions in smaller companies, favored voluntary codes of practice for employers to follow rather than compulsion.

The conflict between the advisory and enforcement roles of government agencies is not easy to resolve. Dr. Tim Carter, believes that employers and trade unions sometimes want occupational health advice to bolster some essentially political position rather than to solve a health problem or help remove a hazard.

As a result, the field services of the Employment Advisory Medical Service of the Health and Safety Executive act more as arbitrators than advisers. Scares about the supposed dangers of visual display units, alarmist talk about asbestos in situ, needless fears about occupationally related cancers, distract the service from the real problems.

That is not to say, of course, that asbestos is not dangerous or that some of the 30,000 or so hazardous substances in industry are not, carcinogenic. But the real challenge is different.

Though facilities in many major companies are first-rate-concerns like Esso, Shell, Marks & Spencer, Rank Hovis McDougall and Kodak are among the most notable – such companies form a mere 20 percent minority.

For the majority, however, mostly medium and small companies, to provide such services requires venture capital which they do not have or do not want to provide.

This means that the 60 doctors and 30 nurses of Dr. Carter’s medical advisory service act as troubleshooters and crisis managers with health problems that need never have occurred. Meanwhile, important new problems – and new technology means these constantly arise – are not being adequately researched.

Ensuring health at work has a further difficult dimension. Safety at work is one thing – it is easy enough to identify dangerous equipment or the need to reduce noise (about a million workers have noise-related hearing defects, often severe and distressing). But it may not be so easy to do something about it.

If work causes you to lose an arm, the issue are clear. But what if it causes you to lose your reason? How to pin responsibility for the ‘sick building syndrome’, the vague but disturbing malaise which afflicts so many who work in modern buildings? How even to know for sure when it is or is not manifest?

However, Dr. John Cullen, the former industrialist who now heads the Health and Safety Commission, which advises the Government and develops the policies which the executive puts into practice, points out that the British system is being used as a model by other countries.

The way it involves both sides of industry in forming its policies and executing regulations in detail certainly ensures that measures are workable and realistic. ‘We don’t tell people how to run their show’, Dr. Cullen says. ‘We are not seeking to be over-protective.

‘But a decade ago, health at work was peripheral. Today, it is part and parcel of management. It is considered at the highest level in companies’.