CHAPTER SEVENTEEN
COLLAPSE

The better part of my early adulthood was spent being an activist against the arms race, raising concerns about the bad health effect of nuclear weapons and their dangers of destruction. Suppose you had come to me in those days and told me the Soviet Union would collapse into its component republics, and the arms race would wind down as tensions decrease because of a popular pro-democracy upsurge in Russia.

I would have told you that I enjoyed the impishness of that idea, but it wouldn't have struck me as realistic. Ideas seemed a little too entrenched to allow for that. But there were underlying weaknesses in the Cold War situation that led to the dynamic which, in hindsight, looks more like it was inevitable.

Part of the demand for abortion is being driven by supply. Some women have no thought of getting an abortion, but are pressured into it by parents, partners, or bosses. Some are talked into it by doctors and abortion counselors. A good large number feel ambivalent about the decision. In all those cases, the proximity of the clinic makes a difference. Pressure is likely to be more intense, and be more likely to have an effect, if that clinic is close by. Those that profit from abortion have to be right there in order to talk women into it. Anyone who feels ambivalent about the decision in the first place might find a three-hour trip daunting enough to avoid it. In short, as the number of doctors and clinics decline, abortions will become more limited to those women who actually are determined to get them.

Occasional local news coverage of malpractice suits, lost medical licenses, and scandalous conditions will also add to an image that will leave people less eager.

As supply becomes harder to come by, some couples will be more careful about getting pregnant. They will either avoid sex or be more careful with contraception. If the availability of abortion means people get a little sloppy about remembering to get the diaphragm during a moment of passion, that three-hour trip may help serve as a reminder. A ten-hour trip all the more so.

This phenomenon has already been noted in those states that had Medicaid funding of abortion one year, but were suddenly cut off by the Hyde amendment the next year. These could be contrasted with those states that kept the Medicaid funding in spite of the Hyde amendment. The number of abortions went down dramatically, and the number of childbirths went down slightly. The abortions that didn't happen weren't replaced by childbirth. They were replaced by more care in getting pregnant.

The greater difficulty of getting to an abortion clinic may well spur a greater availability in necessary services to pregnant women. Many maternity homes that had run for decades actually closed down when abortion was legalized, but the current trend is for many more of those to be established again. Schools are having and will have more childcare and educational services available for teenage parents so they can get their degrees and raise their children properly. Workplaces will be more likely to see employees' child-rearing as something to work around, rather than as an intrusion the woman has no right to inflict on them. More women will insist that they should be able to get into the Board of Directors without having to leave their babies in the trash outside.

The trend of the recent past in insisting that women must cruelly choose between sacrificing their careers and life plans or sacrificing their children will make less and less sense. Women will be in a better position to insist on more rights. Abandoning women to the abortionist is a lot harder to do when the abortionist is not right there.

THE LAW

Legal changes will, to some extent, ratify social changes, rather than causing them. The history of Truman Medical Center in Kansas City, Missouri, can provide a good example of how this works.

In the early 1980s, Missouri prolifers were upset that this public hospital was a major abortion center in the city. Having failed to convince its Board of Directors, they went to the Missouri Assembly in the hope of legislation which would cut off a portion of Truman's funding unless they stopped doing abortions. This became a major press story, and the spokespeople for Truman announced that they absolutely would not stop. The public funds were not used for abortions, but for the medical needs of poor patients. If the funds were cut, then the needs of the poverty-stricken patients would not be met. They declared that the prolifers were unfeeling about the needs of the poor. Prolifers countered that it was the Truman staff's stubbornness about performing abortions that would be the cause of the cut-off, but the press as usual took Truman's side and the prolifers withdrew. Legislation was not going to cause a change in this case.

Change, however, was caused. After a time, a new doctor was appointed to head up the ob-gyn department, and his enthusiasm for abortion was considerably less than his predecessor's. He made it fairly clear to the interns and residents that this really wasn't expected of them. Since the interns knew they made no positive impression performing them, and since very few had much enthusiasm to start with, the numbers went down. Poor women were no longer talked into abortions that they hadn't thought of as they had been before, and the bunching up of abortion appointments was stopped.

Earlier, if a woman called up and said that she wanted an abortion, they would make an appointment for her, and that would be the time when about a dozen women would come in. After the change of circumstances, if a woman wanted an abortion, they would tell her to find a doctor to do it, and it could be done there if they wanted to use the facilities. Under that arrangement far fewer were done.

It was at that point the law passed the Missouri legislature which then wound its way through the courts as the Webster case. In 1989, when the Supreme Court decided that Missouri could in fact disallow abortions to be done at hospitals that have public funding, the spokespeople at Truman said that was fine. The earlier resistance had evaporated. They had done so few abortions the previous year that it was a small matter to simply cut them out completely.

In this case, the law didn't cause the change. The change happened first, and then the law came and made it permanent.

This may well be similar to what will happen all over the country. The law won't be changed by mere persuasion, because there's too much powerful resistance. When the practice changes, the resistance will, too. The purpose of the changing of the law at that point would be to finish the job -- to make the trend official.

THE GREAT SWITCH

The theory of cognitive dissonance plays a great role in all this. In the 1970s and 1980s, the elements were:

(1) The abortion business was expanding. There are more and more clinics, and the numbers were climbing or maintaining themselves at a very high rate, and

(2) We Americans are a noble and virtuous people.

That first one was a fact, and being a fact makes it more resistant to change. It can be unknown, it can be ignored, but it can't be made to be untrue.

The second point, on the other hand, involves our own self-respect. That makes it all the more resistant to change. Many prolifers may have decided that it simply wasn't true, but of course the public in general would be unwilling to.

If both elements resist change, then the tension can best be dealt with by deciding that they don't conflict.

Any attack on the first point will be seen by many as an attack on the truthfulness of the second point. Prolifers have not merely been decrying the morality of abortion. Within their denunciation of abortion is a denunciation of the good will of the American population.

The most daunting obstacle of all for abortion opponents has been that as long as the first point is a fact, then people must either decide that the second point isn't true or that the two points agree with each other. Trying to convince them that the points don't agree with each other leaves them with no other alternative other than to decide the second point isn't true. That point involves the most basic self-respect, and so people are unwilling to do this. Therefore, efforts to persuade them that the two points don't agree runs up against a major brick wall.

There would be the alternative of saying that, because the second element is true, therefore, the first element is not going to last. This point is more easily made when the first element actually starts a process of not lasting.

Under current conditions, (1) Abortion numbers are declining, fewer doctors are willing to do them, and clinics are scarcer, and (2) We Americans are a noble and virtuous people.

In fact, once the first element has changed, it becomes reasonable to suggest that the second element caused the first. At least, the second point, so important to collective self-esteem, is actually strengthened by saying that it caused the change.

In the earlier decades, the dynamics of tension reduction strategies for cognitive dissonance, with the crucial importance of self-respect, were working against the anti-abortion position. But a great switch is under way. Under the new facts, the same dynamic starts working in favor of the anti-abortion position.

Some ruminations taken from a Newsweek article called "Virgin Cool" by Michele Ingrassia (October 17, 1994) illustrate how this is working. "Abortion, never an easy alternative for anyone, is even more daunting when you're young. Back in the '70s -- and even the '80s -- any woman worth her Ms. subscription knew she could pass around the hat in her dorm and collect a few hundred bucks for an abortion. Access was rarely a problem: every big city and most college towns had a clinic or at least an abortion doctor, and if he wasn't Marcus Welby, well, at least he had an office . . . . The climate has chilled; even ardent pro-choicers don't treat 'choice' so lightly."

Take special note of the phrase, "and if he wasn't Marcus Welby, well, at least he had an office." As a sense of collapse proceeds, it will be more and more safe to admit things like that. It will be more psychologically safe to bring scandals to public attention.

In fact, it will be needed to help us account for our behavior.

Other possibilities for accounting for our behavior abound. The new information on the possible link of abortion to breast cancer, especially of a first pregnancy among teenagers with a family history of breast cancer, would be a prime possibility.[1] People will be more open to hearing information on emotional aftermath -- a January 1988 Wirthlin poll showed 78% strongly agree that women who have had abortions experience emotional trauma, such as grief and regret. The injustice of the situations that push women into abortion is regarded with greater concern when abortion itself is not seen as a minor matter.

After detailing how few abortion doctors there were left and mentioning that 60% of them are 65 years old or older, the ABC network news broadcast on January 16, 1998 then went to a story on how technology is showing us the fetus more clearly, and showed examples. Then they had a report on Project Rachel, a post-abortion group counseling effort of the Catholic Church. Both the fetal pictures and the positive coverage of a pro-life program were unusual for network news, but are a reasonable response to the information they had just covered on lower availability. If it seems inevitable, the next thing to do is account for why -- and figure out how to live with the new situation.

When the behavior is a decline in abortions, our explanations for it will naturally be different than when the behavior is an increase. As more and more people realize that our behavior has changed, and seek to find ways to explain it, we will find more and more examples to illustrate this dynamic.

Most of the public for all these years was highly uncomfortable with abortion. Most supporters weren't enthusiastic, but people were willing to put up with the status quo. When the facts of the status quo change, most people find this a great relief.

Most people have really been wishing that the whole problem would just go away. While we all know that it won't go away completely any time soon (any more than rape or child abuse), the hope that it will becomes less widespread appears slowly but surely to be coming true. The middle position, which is uncomfortable with abortion bans but also uncomfortable with abortion itself, is getting its wish.

The accommodation to abortion never really brought relief of the tension felt, but the collapse of the institution does bring relief. People won't want that relief taken from them.

The "Great Switch" will be powerful, because people want it. They want to avoid despair. They want hope. Once it looks possible, once it looks safe to express the desire that it actually happen, then like the people of the former Soviet Union, it will be a dynamic too powerful to resist.

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