Abortion after “Roe” by Johanna Schoen (review)

In Abortion after “Roe,” Johanna Schoen argues that the 1973 Supreme Court decision Roe v. Wade marked the beginning of a “protracted political, legislative, and legal battle over access to abortion” (11). The issue of access was fundamental, because, as Schoen explains, the decision did not guarantee women’s right to legal abortion. Rather, it overturned existing state regulations and expanded the right to privacy. Unlike previous histories of the abortion rights movement leading up to Roe, histories of the antiabortion activists opposed to Roe, or histories of legal challenges to legal abortion since Roe, Schoen focuses on abortion care, exploring how the battle over abortion affected both women having abortions and providers of abortion.

Schoen’s chapters lead us through the initial years of legal abortion and the creation of the first abortion clinics. She covers the debates over fetal research and the status of the fetus, she details the professional organization of abortion providers as they established medical standards and shared research and strategies for facing antiabortion challenges, and she attends to the heated political, philosophical, and emotional debates about the meaning of fetal bodies, the beginning of life, antiabortion violence, and the question of who has moral agency to make decisions about pregnancy and fetal death. By shifting the historical emphasis away from legal challenges, Schoen makes an important contribution to the historiography on abortion. Her focus on abortion care raises significant questions about how people experienced abortion once it was legal but still deeply contested.

Building on cultural and political histories of the fetus in the contemporary United States, particularly Sarah Dubow’s groundbreaking contribution, Ourselves Unborn,¹ Schoen refines our understanding of how legal abortion was impacted by arguments focused on questions of fetal life and viability. As she notes, two parallel court cases that focused on the meaning of fetal life and viability bookend her history. The first is the 1975 prosecution of Dr. Kenneth Edelin for causing the death of a fetus during an abortion. (The prosecution argued that the fetus had been born alive.) The second is the 2003 United States Supreme Court decision in Gonzales v. Carhart, which upheld the ban on intact dilation and evacuation (D&E) procedures, which antiabortion activists argued required the “partial birth” of a live fetus. Schoen demonstrates that in the intervening three decades between these two cases, abortion providers struggled to affirm “a vision of abortion that powerfully asserts that abortion care is a moral good” and that women who have abortions and the providers who assist them are moral actors (249). Some of the most fascinating material Schoen marshals are the conversations among members of the National Abortion Federation (NAF) about the ethics of abortion, particularly as surgical procedures for abortion in the second trimester became safer, medical technology pushed the point of viability earlier, and the antiabortion movement fought to redefine the meaning of fetal life and viability.

Schoen also demonstrates that abortion providers did not act in unison or always agree about how to respond to antiabortion rhetoric. Debates about how to respond to sharply increased antiabortion violence in the 1980s created a rift in the NAF. Some providers who left the organization argued that more attention needed to be paid to patient attitudes about abortion and how those had changed since Roe as abortion became increasingly stigmatized. Schoen’s book is a noteworthy contribution to emerging historiography on the complex attitudes toward abortion in the contemporary United States, and in it she discusses how providers at clinics tried to address the fact that “noticeably more women were emotionally torn over their abortion decision” (204). One group of providers that split from NAF, the November Gang, developed a new counseling model dubbed “head and heart counseling” to help some patients grapple with their difficult emotional concerns about whether a fetus was a person or abortion was murder (205).

The book concludes with a discussion of the political and legal challenge of antiabortion groups to the abortion procedure of intact D&amp...