Seriously Seeking Common Ground

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A few weeks ago, Senator Bob Casey, who opposes legal abortion, introduced what he described as a common ground bill: The Pregnant Women Support Act. He explained, "I believe there is more common ground in America than we might realize. If only we focus on how we can truly help and support women who wish to carry their pregnancies to term and how we can give them and their babies what they really need to begin healthy and productive lives together."

I have been advocating for a common ground approach for years. Six years ago, on the anniversary of Roe, I published an op-ed on the subject in the New York Times. My co-author was a staunch Right to Life advocate. Even then we found important common ground, particularly on the issue of prevention. That early attempt was controversial on both sides of the issue, though in particular on the right. My co-author was roundly attacked for her trespass which sadly halted our progress. Now, under a new president, perhaps the moment has come; perhaps we can take important steps. I am increasingly optimistic that real partners can be found. There are common ground groups sprouting up across the country. I have spoken with many, and many truly seem sincere. We may well be seeing some cracks in the divide that has kept us apart for so long. Perhaps Senator Casey's bill will provide a platform for more discussion and even action. My view is that it's worth the chance.

First I should say that pro-choice people, and that includes me, get a little defensive over proposals such as his, and the rhetoric that sometimes accompanies them. This legislation proposes to provide support to low-income women who want to bring a pregnancy to term. Pro-choice elected officials have for years proposed providing more support to low-income women and families. But let's put aside pride of authorship. In the new age of conciliation perhaps we can file away past grievances. That's not to say that the Pregnant Woman Support Act is perfect -- it's not. Importantly, it fails to mention family planning. Planning a pregnancy is step one to having a healthy one. And how can any proposal aimed at reducing abortion be taken seriously without including contraception? But it does offer some proposals that both sides can endorse. And there may well be solutions for the problematic areas, assuming there really is good will.

First let's review its attributes:

The Pregnant Women Support Act is inspired by the belief that if women facing unintended pregnancy are provided substantive help they might continue, rather than terminate, a pregnancy. Two-thirds of all women seeking abortion care report it's because they cannot afford to have a child. Perhaps choosing abortion because one can't afford to have a child is not the best choice for her. In a perfect pro-choice world, parenting, abortion and adoption would be equally available options, and, importantly, none would be stigmatized. Neutralizing income as a determining factor for what a woman does in her reproductive life is reproductive justice. Much of the Pregnant Women Support Act is a means to that end. For example it would provide financial, medical, educational assistance, and insurance coverage for those who ordinarily would not qualify for it. A woman can get nurse home visits, counseling, shelter, help with child care, aid to help her stay in school, and a lot of other services that may broaden her choices. That's all good.

Here's where the problem starts for pro-choice people. The bill would:

"Create a new pilot program for "Life Support Centers" to offer comprehensive and supportive services for pregnant women, mothers, and children."

Life Support Centers appears to be a way, among other things, to funnel money into crisis pregnancy centers. These have been a ruse of pro-life activists. They are billed as places a pregnant woman can visit to consider all her options. But they mislead women about the options available to them, offering up inaccurate information intended to scare women about abortion. Misleading women is not something pro-choice organizations or elected officials will be able to support (nor should any self-respecting pro-lifer). Removal of the section should be fought for vigorously.

Or alternatively, find a way to legislate out its heavy-handed agenda. If the ideological and misleading tactics that are the signature of crisis pregnancy centers were prohibited, there could be a limited but legitimate role for these centers to play in the delivery of support services. But an affirmative and explicit disclaimer should be issued right up front. The Pregnant Women Support Act would be a good place to begin to insist that crisis pregnancy centers act in a responsible way. Make "Life Support Centers" stick to medical facts rather than ideology. There ought to be a "no propaganda" agreement right up front in every common ground campaign. Anti-abortion activists have, in several states, succeeded in passing legislation mandating that ideological, medically inaccurate scripts be read to patients who seek abortions services. Mandating that ideology and inaccuracy be inserted into a medical environment, as the anti-abortion movement has done, is ethically troublesome. But what if, instead, the law mandated that medical and scientific accuracy be required of ideological organizations? An amendment to the Pregnant Women Support Act could propose that every "Life Support Center" receiving federal funds be required to provide medically accurate information to all it counsels and also, importantly, disclose that its mission is to convince women not to have an abortion. Providing accurate information should be a common ground goal and anti-abortion organizations should have no problem admitting that convincing women not to choose abortion is their intent. Each center would be required to convey information like this:

"This is not a medical facility. There are no medical personnel on staff. The staff of this facility is unable to diagnose complications of pregnancy or fetal anomalies (birth defects). This facility is staffed by people who are opposed to abortion and contraception. Medical research shows that women who have an abortion are at no greater risk of breast cancer, miscarriage in future pregnancies, mental distress or any other mental or physical disorder than women who have never had an abortion. Ultrasound images may exaggerate the size of the embryo/fetus." Etc.

Sprinkled throughout the Pregnant Women Support Act is the term "counseling." The "no propaganda" rule should apply in every instance a woman receives counseling. (To preemptively address a point that will be made by opponents of abortion: no, medically, scientifically accepted, peer-reviewed evidence does not fall under the category of propaganda.)

Another area of concern is that the bill proposes to promote adoption as an alternative to abortion. There is no doubt that the adoption industry has changed dramatically in the last forty years, in great part because of legal abortion. Among my other roles, I have been consulting with a pro-choice adoption agency, and so I'm familiar with the challenges. Many Americans, including women confronting unwanted pregnancy, are not aware that the adoption choice now offers many avenues, including open adoption. There is a real need to update Americans' understanding of adoption as an option for unwanted pregnancy. But, it should not be in the context of disparaging other choices. As the book, The Girls Who Went Away, and even recent discussions on sites like RH Reality Check, reveal adoption is typically a difficult choice and many women suffer immensely by being pressured into that option. For some women abortion is the wrong choice. For some women adoption is the wrong choice. There is great need for education about adoption, there's no need to present it as an alternative to abortion or parenting. A woman, if given comprehensive and accurate information about all of her choices, is her own best moral agent.

The last sticking point for pro-choice people with the bill is that it seeks to codify the regulation that extends coverage under the State Children's Health Insurance Program (SCHIP) to both low-income pregnant women and unborn children. As long as pregnant women are extended prenatal care coverage through Medicaid, this is a superfluous section and a back-door attempt to create independent rights in law for a fetus. This section would not prevent one abortion or make it any easier for women to bring a pregnancy to term. It defies the "common-ground" spirit the bill was intended to cultivate. Keeping it in the bill could only be interpreted as an attempt to co-opt "common ground" rhetoric for anti-choice purposes.

With these important changes, none of which jeopardize the true intent of the bill, we should be prepared, for the moment, to take Senator Casey at his word when he says he wants a common ground approach. He said of his intent, "I introduce this bill with the deepest conviction that we can find common ground. I believe that we can transform this debate by focusing upon the issues that unite us, not the issues that divide us." If that is true, then with these small but important changes to the bill, I will find myself among those who feel comfortable rallying pro-choice people for the bill. If its sponsors doggedly refuse changes, then this bill may yet be another missed opportunity. And in that case pregnant women won't get the support they deserve.

This post originally appeared on RH Reality Check--Information, commentary and community for Reproductive Health and Justice.